511例高龄初产妇的临床分析和处理对策

目的 探讨高龄初产妇妊娠合并症和并发症的发生率及其处理对策。方法 对我院1990年1月至2002年12月间收治的511例高龄初产妇（高龄组）与同期511例年轻初产妇（对照组）的临床资料进行回顾性对照分析。结果 高龄组妊娠期合并症、并发症、剖宫产率及分娩期并发症发生率均明显高于对照组（P值均〈0．05）。结论 高龄初产妇妊娠合并症和并发症发生率明显高于年轻初产妇,因此应加强对高龄初产妇的围产期监护,合理掌握剖宫产指征,以期获得良好的分娩结果。     

35岁以上初产妇对妊娠及分娩期的影响

目的；探讨高龄初高对妊娠、分娩及母儿的影响。方法：选301例≥35岁单胎初产妇为观察组和同期20－30岁的单胎初产妇301例作为对照组进行回顾性分析。结果：≥35岁单胎初产妇的比率逐年上升；其妊娠合并症和并发症发生率明显高于对照组＜0．05；剖宫产率明显增高于对照组P＜0．01；第一、第二产程较对照组明显延长（P＜0．05）；低体重儿、胎儿畸形和围产儿死亡率与对照组比较明显增加（P＜0．01）。结论：≥35岁单胎初产妇应加强围产期保健，积极处理和治疗妊娠合并症和并发症，放宽剖宫产指征，安全地经过妊娠与分娩。     

754例高龄初产妇妊娠与分娩的临床分析

目的 探讨高龄初产妇妊娠合并症和并发症的发生率及其处理对策.方法 采用回顾性对照研究,对大连市妇产医院2005年1月1日至2006年12月51日分娩的754例单胎初产妇临床资料进行分析.比较高龄初产组(≥35岁)和非高龄初产妇组(<55岁)妊娠合并症和妊娠并发症的发生率、分娩方式及妊娠结局的差异.结果 高龄初产组妊娠合并高血压疾病、前置胎盘、妊娠合并子宫肌瘤、妊娠期糖尿病,产后出血及剖宫产率明显高于非高龄初产组.差异有显著性(P值均<0.05).结论 高龄初产妇妊娠合并症和并发症发生率明显高于年轻初产妇,应加强对高龄妊娠的围产期保健及对妊娠并发症的预防,合理控制剖宫产率,确保母婴安全与健康.     

高龄初产妇121例临床分析

目的:探讨高龄初产妇妊娠合并症和并发症等高危因素的发生率及其处理对策。方法:对我院2000年1月至2006年12月间收治121例高龄初产妇(高龄组)与同期121例非高龄初产妇(对照组)的临床资料进行回顾性对照分析。结果:高龄初产妇自然流产率21.49%,妊娠高血压综合征发生率19.01%,产后出血发生率7.44%,早产发生率5.78%,子宫肌瘤发生率4.96%,新生儿窒息发生率23.97%,剖宫产率59.50%。高龄组妊娠期合并症、并发症、剖宫产率及分娩期并发症发生率均明显高于对照组(P值均<0.05)。结论:高龄初产妇妊娠合并症和并发症发生率高,围生儿并发症高,增加了妊娠期及分娩期的高危状况。因此,应加强对高龄初产妇的围产期监护,合理掌握剖宫产指征,以期获得良好的分娩结果。     

高龄初产妇121例临床分析

目的:探讨高龄初产妇妊娠合并症和并发症等高危因素的发生率及其处理对策.方法:对我院2000年1月至2006年12月间收治121例高龄初产妇(高龄组)与同期121例非高龄初产妇(对照组)的临床资料进行回顾性对照分析.结果:高龄初产妇自然流产率21.49%,妊娠高血压综合征发生率19.01%,产后出血发生率7.44%,早产发生率5.78%,子宫肌瘤发生率4.96%,新生儿窒息发生率23.97%,剖宫产率59.50%.高龄组妊娠期合并症、并发症、剖宫产率及分娩期并发症发生率均明显高于对照组(P值均<0.05).结论:高龄初产妇妊娠合并症和并发症发生率高,围生儿并发症高,增加了妊娠期及分娩期的高危状况.因此,应加强对高龄初产妇的围产期监护,合理掌握剖宫产指征,以期获得良好的分娩结果.     

高龄初产65例临床分析

目的　探讨高龄初产妇的妊娠与分娩。方法　对我院 1995年 1月至 2 0 0 0年 1月 5年间住院分娩 6 5例高龄初产妇的临床资料进行回顾性分析。并与随机抽样同期住院分娩年轻初产妇 6 5例进行比较。结果　高龄组妊娠期合并症、并发症高于年轻组 (P <0 .0 5 ) ,产程异常发生率及手术产率明显高于年轻组 (P <0 .0 1)。结论　重视高龄初产妇监护 ,合理掌握剖宫产指征。     

141例高龄初产妇的临床观察分析

目的研究高龄初产妇并发症及合并症、分娩方式,为临床治疗提供理论依据。方法选取我院两年分娩的141例高龄初产妇作为研究对象与同期住院的同例数适龄初产妇在并发症及合并症、分娩方式、新生儿情况等方面进行比较。结果高龄组妊娠并发症、剖宫产率、分娩并发症、新生儿窒息、畸形率均明显高于适龄组（P〈0.05）。结论高龄初产妇妊娠并发症及合并症发生率明显高于适龄组产妇,应加强对高龄初产妇的围生期保健,以期获得良好的分娩结果。     

高龄初产妇妊娠结局探讨

目的：分析35岁以上高龄初产对妊娠结局的影响。方法：回顾性分析2000年1月-2004年12月在我院分娩的52例35岁以上高龄单胎初产妇（观察组），并选择同期分娩的104例30岁以下单胎初产妇（对照组）作为对照，比较两组孕妇妊娠期糖尿病、妊娠高血压疾病、早产、低体重儿及剖宫产发生率的差异。结果：高龄组妊娠合并糖尿病、妊娠高血压疾病、早产、低体重儿及剖宫产的发生率均显著高于对照组（P〈0．05），两组新生儿畸形率及围产儿死亡率差异无显著性。结论：高龄孕妇合并症与并发症明显增加，剖宫产率升高，应当避免高龄妊娠。     

高龄初产妇673例临床分析

目的探讨高龄初产妇分娩方式及剖宫产指征。方法对1996年1月至2006年1月在我院分娩的673例高龄初产妇（高龄组）及同期同等数量年轻初产妇（对照组）的临床资料进行回顾性对照分析。结果高龄组妊娠剖宫产率明显高于对照组（P〈0.05）。结论高龄初产妇中,剖宫产率明显高于非高龄初产妇。在无明显剖宫产指征情况下,应阴道试产,一般能经阴道分娩且不增加新生儿窒息发生率。     

高龄初产妇妊娠与分娩状况的临床分析与处理对策

目的:探讨高龄初产妇的妊娠合并症、并发症的发生率及其处理对策。方法:回顾分析110例高龄初产妇(高龄组)的临床资料,并与同期正常生育年龄初产妇(对照组)进行对照。结果:观察组妊娠合并症、并发症的发生率高于对照组,手术产率明显上升。结论:高龄初产妇妊娠合并症、并发症的发生率高于对照组,剖宫产率明显增加;加强高龄初产妇产前监护、做好分娩处理十分重要。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.