妊娠晚期羊水偏少及羊水过少分娩结局分析

目的:探讨羊水过少的病因及相关因素,观察羊水偏少或羊水过少对围生儿的影响,不同羊水量与妊娠结局的关系。方法:对羊水偏少69例及羊水过少50例进行回顾性分析。根据B超检测羊水指数(AFI)分成两组,羊水量偏少组(51 mm相似文献   

羊水过少256例临床分析

目的　探讨羊水过少的病因及相关因素 ,寻找正确的处理方法 ,降低围生儿病死率。方法　对羊水过少 2 56例临床资料进行分析。结果　B超对羊水量的估计准确率可达 97% ;羊水过少主要并发症是妊娠高血压综合征、胎儿宫内发育迟缓 (IUGR)、过期妊娠、延期妊娠 ,羊水过少组胎儿畸形率高于对照组 ,脐带缠绕、羊水粪染发生率、胎儿窘迫及新生儿窒息率明显高于对照组 (P <0 .0 1 )。结论　羊水过少确诊后应适时以剖宫产结束分娩。     

82例羊水过少妊娠临床分析

目的 :探讨羊水过少与围生儿预后关系 ,以寻求降低围生儿的病死率的方法。方法 :对 82例羊水过少临床产科情况进行分析。结果 :B超对羊水量的估计准确率可达 95 %。羊水量越少 ,羊水粪染率及胎儿窘迫发生率越高 ,羊水过少组新生儿窒息率明显高于对照组 (P <0 .0 5 )。结论 :羊水过少确诊后适时以剖宫产术终止妊娠为宜。     

妊娠晚期羊水过少对围生儿的影响及相关因素分析

目的 探讨妊娠晚期羊水过少对围生儿的影响及相关因素.方法 对175例妊娠晚期羊水过少孕妇进行分析,并与羊水量正常分娩者进行比较.结果 在孕≥42周者中,羊水过少的发生率为13.5%,在孕40+1～41+6周者为4.28%,在孕37～40 周者为2.86%,在孕＜37周者为2.21%;在妊娠合并症者中为24.79%.羊水过少组剖宫产、胎儿窘迫及羊水Ⅱ～Ⅲ度污染发生率均较对照组高(P＜0.01),且羊水量越少,羊水粪染及胎儿窘迫发生率越高(P＜0.01).羊水过少组新生儿窒息发生率与对照组差异无统计学意义(P＞0.05).结论 羊水过少与延期妊娠及妊娠并发症关系密切,它严重威胁围生儿生命,造成不良妊娠结局.发生羊水过少后,应及时终止妊娠,可分娩者以剖宫产为宜,可改善围生儿预后.     

妊娠晚期羊水过少对围生儿的影响及相关因素分析

目的:探讨妊娠晚期羊水过少对围生儿的影响及相关因素。方法:对121例妊娠晚期羊水过少孕妇进行分析,并与羊水量正常分娩者进行比较。结果:在孕≥ 42周者中,羊水过少的发生率为13.51%,在孕40+1~41+6周者为4.28%,在孕37~40周者为2.86%,在<37周者为2.21%;在妊娠合并症者中为24.79%。羊水过少组剖宫产、胎儿窘迫及羊水Ⅱ~Ⅲ度粪染发生率较均对照组高(P<0.01),且羊水量越少,羊水粪染及胎儿窘迫发生率越高(P<0.01)。羊水过少组新生儿窒息发生率与对照组差异无统计学意义(P>0.05)。结论:羊水过少与延期或过期妊娠及妊娠并发症关系密切,它严重威胁围生儿生命,造成不良妊娠结局。发现羊水过少后,应适时终止妊娠,可分娩者以剖宫产为宜,可改善围生儿预后。     

延期妊娠合并羊水过少母婴结局180例分析

[目的]分析延期妊娠羊水过少对母婴的影响,探讨正确的处理方法,降低围生儿病死率.[方法]回顾性分析2003年1月至2007年12月在我院分娩的延期妊娠合并羊水过少孕妇180例(观测组)及随机抽取同期延期妊娠羊水量正常孕妇180例(对照组)的临床资料,分析两组孕妇妊娠结局及母婴并发症.[结果]延期妊合并羊水过少组胎儿窘迫、羊水污染、新生儿窒息及剖宫产率明显高于对照组,B超测量羊水量可及时发现羊水过少.[结论]延期妊娠合并羊水过少严重威胁胎儿、新生儿的生命,应加强产前检查及早发现羊水过少,应严密监护,积极处理,适当放宽手术指征.     

羊水过少对围生儿影响的临床分析

目的　探讨羊水过少对围生儿的影响。方法　对羊水过少 6 1例临床资料进行分析。结果　羊水过少组羊水粪染、胎儿窘迫、新生儿窒息、新生儿肺炎、胎儿宫内发育迟缓、过期妊娠发生率均明显高于对照组 ,差异显著 (P <0 .0 1)。结论　羊水过少对围生儿的影响较大 ,确诊后适时剖宫产结束妊娠为宜     

羊水过少30例临床分析

目的:探讨羊水过少临床观察。方法:回顾性分析羊水过少者30例与羊水正常者30例,进行对比分析。结果:羊水过少组妊娠并发症发生率为46.67%,正常组为4.43%;羊水少组围生期小儿死亡率为4.43%,正常组为0%。羊水过少组中,AFI<2.0 cm有12例,发生率为33.33%。AFI在2.0～3.0 cm,胎儿窘迫的发生率为30%;3.0～4.0 cm间,胎儿窘迫的发生率为20%;4.0～5.0 cm间,胎儿窘迫的发生率为10%。结论:孕晚期加强孕妇的产前检查,定期对患者进行B超检查,及时发现产妇羊水过少,适时终止妊娠,能明显降低围生儿的死亡率。     

羊水过少临床分析及其对母儿的影响

目的探讨羊水过少与妊娠并发症及其围生儿预后的关系。方法收集我院2007年1月—2013年2月住院的羊水过少孕妇120例,与同期我院分娩的羊水量正常孕妇120例做对照分析,比较2组妊娠并发症围生儿情况。结果羊水过少组胎儿生长受限、妊娠高血压疾病发生率高于对照组,2组比较差异有统计学意义(P<0.01)。羊水过少组胎儿窘迫、羊水粪染、新生儿窒息、吸入性肺炎的发生率及围生儿死亡率分别为32.0%,42.5%,3.33%,2.5%,0.83%;对照组分别为17.5%,20.0%,0.83%,0.0%,0.00%;羊水过少组胎儿窘迫、羊水粪染发生率明显高于对照组,差异有统计学意义(P<0.01)。结论羊水过少与妊娠并发症发生率增加密切相关,选择最佳分娩方式及时终止妊娠可明显改善围生儿预后。     

足月妊娠并发羊水过少62例妊娠结局分析

目的　探讨足月妊娠并发羊水过少对母儿的影响及其处理方法。方法　将足月妊娠并发羊水过少 62例与羊水量正常 10 0例的分娩方式与围生儿结局进行对比分析。结果　羊水过少组的剖宫产率、胎儿窘迫率、围生儿病率均显著高于羊水正常组 (P <0 .0 5或 0 .0 1)。结论　羊水过少是足月妊娠胎儿宫内缺氧的早期表现 ,在排除胎儿畸形后 ,可将羊水绝对过少作为足月妊娠剖宫产指征之一     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.     

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.