早发型重度子痫前期79例临床分析

目的探讨早发型重度子痫前期的治疗及对母儿的影响。方法回顾性分析本院79例早发型重度子痫前期患者的有关临床资料,按发病孕周将其分成三组即A组（孕周〈28周）12例、B组（28周≤孕周〈32周）35例和C组（32周≤孕周〈34周）32例,分析各组孕期治疗期限、孕妇并发症、胎儿和新生儿结局。结果三组保守治疗时间比较,A组与B组、C组与B组之间差异有统计学意义（P〈0.05）,其中B组延长孕龄最长;三组孕妇并发症发生率随发病孕周延长而下降,但三组间比较无显著性差异（P〉0.05）;胎儿及新生儿死亡率比较,C组明显低于A、B组（P〈0.01）,B组低于A组（P〈0.05）。结论早发型重度子痫前期严重影响母儿健康,保守治疗可行,但要严密监测母儿情况,适时终止妊娠,终止妊娠的方式首选剖宫产。     

重度子痫前期不同发病孕周对围产儿结局的影响

目的探讨重度子痫前期不同发病孕周与围产儿结局的关系。方法对我院112例重度子痫前期患者以孕34周发病时间为界，分为早发型和晚发型两组，即A组孕妇55例，新生儿59例，B组孕妇57例，新生儿62例，对两组孕妇及分娩新生儿的一般临床资料，新生儿疾病的发生情况及围产结局进行分析比较。结果（1）两组孕妇分娩孕周及早产发生率的比较，有显著统计学差异（P〈0．01）。（2）两组新生儿出生时的平均胎龄、平均出生体重、平均身长进行统计学比较，有显著差异（P〈0．01）。A组新生儿中低出生体重儿41例（发生率69．49％），B组17例（发生率27．42％），两组统计学比较有显著差异（P〈0．叭）。A组中小于胎龄儿（SGA）11例（18．64％），适于胎龄儿（AGA）46例（77、97％），大于胎龄儿（LGA）2例（3．39％），B组新生儿中SGA14侈4（22。58％），AGA40例（65．57％），LGA8例（12．90％），两组比较，差异无统计学意义（P〉0．05）。（3）两组新生儿先天畸形，新生儿窒息，呼吸系统疾病，酸中毒及糖代谢混乱的发病率比较，均有统计学差异（P〈0．05）。其他各种疾病的发病率比较，无统计学意义。（4）比较两组孕妇妊娠不良结局的发生率，则早发型组为6例，晚发型组为0，两组比较有统计学差异（P值为0．012）。结论重度子痫前期患者的发病孕周直接影响围产结局，且早发型重度子痫前期孕妇早产儿、低体重儿的发生率明显增加，相关新生儿疾病（如RDS、新生儿窒息等）的发病率也明显增加，但SGA及红细胞增多症等疾病的发生率与发病孕周无关。     

77例早发型重度子痫前期的临床分析

目的探讨早发型重度子痫前期治疗、终止时机与母儿的结局。方法对我院2006年1月~2007年12月收治的早发型重度子痫前期77例患者进行回顾性分析,根据发病的孕周分组:A组(孕周28周),B组(28孕周32),C组(32孕周34)。结果保守治疗时间B组明显长于其他两组(P0.05),而A组与C组之间差异无统计学意义(P0.05);三组孕妇并发症随孕周的延长而下降,但差异无统计学意义(P0.05);B、C两组分娩方式以剖宫产为主,三组间围产儿死亡率及新生儿窒息率均有显著性差异(P0.05),随着孕周的延长而下降;三组间宫内生长受限发病率比较均无显著性差异(P0.05)。结论早发型重度子痫前期的母儿结局与发病孕周密切相关,在期待过程中,应严密观察母婴情况,选择适时终止妊娠时间是至关重要的。     

早发型重度子痫前期的临床分析

目的 探讨早发型重度子痫前期对围生期母婴预后的影响.方法 对2003年2月至2006年2月3年中84例早发型重度子痫前期病例进行分析根据其发病孕周分为3组,即A组（孕周＜28w）,B组（28孕周≤孕周＜32孕w）,C组（32孕周≤孕周＜34孕w）.观察发病情况、病情特点及母婴并发症.结果 早发型重度子痫前期3组患者并发症发生率无统计学意义;3组间新生儿窒息率和围产儿死亡率均随孕周延长而下降,且3组间差异均有统计学意义（P＜0.05）;B组期待治疗时间均明显长于其他两组（P＜0.05）.各组患者的分娩方式均以剖宫产为主.结论 早发型重度子痫前期有较高的母婴病死率,是重度子痫前期的一种特殊类型,在期待治疗过程中,应严密监护母婴情况,适时终止妊娠,终止妊娠方式首选剖宫产.     

子痫前期孕妇血清、胎盘组织MMP-9表达变化及其意义的研究

目的探讨孕妇血清基质金属蛋白酶-9（MMP-9）水平变化及胎盘组织中MMP-9mRNA表达变化在子痫前期发病中的作用。方法选取40例重度子痫前期孕妇,按发病时孕周不同分为早发型组（发病孕周≤34w）和晚发型组（发病孕周〉34w）各20例;另选20例正常晚期妊娠妇女为对照组。采用RT-PCR技术检测3组孕妇胎盘组织中MMP-9mRNA表达水平;采用酶联免疫吸附（ELISA）法检测3组孕妇血清MMP-9水平。结果早发型组及晚发型组孕妇血清中MMP-9水平均高于对照组,两两比较,差异均有统计学意义（P〈O．05）,且早发型组高于晚发型组（P〈0．05）。早发型组及晚发型组孕妇胎盘组织中MMP-9mRNA表达水平均低于对照组,两两比较,差异均有统计学意义（P〈0．05）,且早发型组低于晚发型组（P〈0．05）。结论子痫前期孕妇血清MMP-9水平的上升及在胎盘组织mRNA的表达下降可能通过不同途径参与子痫前期的病理生理过程,可能参与子痫前期的发病。     

431例重度子痫前期的诊治与母儿妊娠结局分析

目的探讨重度子痫前期母婴预后的影响因素。方法对上海交通大学附属市六医院妇产科2005年1月-2010年12月收治的431例重度子痫前期患者的诊治过程进行回顾性分析并进行6月-5年产后随访。根据其发病孕周不同分两组,A组为早发型子痫前期:20周≤发病孕周<34周,B组为重度子痫前期(发病孕周≥34周),分析重度子痫前期的发病、诊治现状及母婴结局。结果重度子痫前期发病率2.27%,A组发病率(2.49%)高于B组(1.51%),P<0.05;重度子痫前期正规产检比率29.7%,A组正规产检率(24.35%)明显低于B组(41.32%),P<0.05;重度子痫前期产后随访率26.3%;重度子痫前期高中以上文化比率25.25%,A组(24.01%)明显低于B组(34.13%),P<0.05;重度子痫前期孕妇严重并发症发病率为48.72%,A组发生率(67.8%)明显高于B组(18.34%),P<0.05;两组有产检母婴并发症发生率低于无产检病人,(A组62.7%VS 69.26%,P>0.05,B组0 VS 31.63%),P<0.05;孕产妇死亡2例,均为早发型无产检患者;重度子痫前期围产儿死亡率20.65%,A组围产儿死亡率32.85%明显高于B组(1.8%),P<0.05;重度子痫前期产后远期并发症(包括持续高血压、尿蛋白、眼底病变、子痫前期再发)发生率14.15%,A组发生率(20.08%)明显高于B组(4.79%),P<0.05。结论无正规产检及系统治疗的重度子痫前期尤其早发型严重影响母婴预后,定期产检、及时诊治有助于改善母儿结局。     

早发型子痫前期的临床特征及其预后意义分析

目的分析早发型子痫前期的临床特点与遗传异质性,探讨其围产儿死亡的高危因素与临床观察指标。方法回顾性分析370例子痫前期患者,并根据其发病孕周分为〈32周：104例;32-34周：50例;以及≥34周的216例,其中多胎妊娠31例。对患者的一般临床资料、临床观察指标进行分析,总结产妇的并发症、围产儿结局。结果（1）在32周之前组病人既往有子痫前期病史的比例、高血压家族史的比例均明显高于其它两组,而且此次妊娠发展成为重度子痫前期的病人数明显高于其它两组,差异有统计学意义（P〈0.001）,3组间早孕期体重指数、妊娠期糖尿病（GDM）检出率无明显差异（P〉0.05）;（2）发病在32-34周与≥34周组比较,发病时的平均动脉压（MAP）无明显差异,3组间24h尿蛋白定量、超声检查宫内生长受限（FGR）的比例、彩色Doppler检查脐动脉血流搏动指数（PI）、收缩期/舒张期血流速度比值（S/D）3组间差异有统计学意义（P〈0.001）;（3）围产儿死亡的危险因素分析显示：子痫前期32周之前发病时间与围产儿死亡存在强相关（P〈0.001）。结论（1）根据母儿结局分析,32周之前发病的早发型子痫前期容易引发重度子痫前期,导致母儿的不良预后。（2）具有子痫前期病史的经产妇易于发生早发型子痫前期,针对高危人群,加强规律产前检查,及早发现FGR、血流异常者,并给予及时的干预,可减少围产儿的死亡率。     

早发型重度子痫前期的临床分析

目的：探讨早发型重度子痫前期对母儿的影响,以降低母婴死亡率。方法回顾性分析我院28例早发型、96例晚发型妊娠期高血压疾病患者胎盘早剥、产后出血、视网膜剥离等并发症发生率的差异及围产儿结局。结果早发型重度子痫前期组的胎盘早剥、产后出血、视网膜剥离等并发症的发生率高于晚发型重度子痫前期组(<0.05);早发型重度子痫前期组的剖宫产率高于晚发型组(<0.05);重度子痫前期组早发型与晚发型的围产儿结局有统计学差异(<0.01)。结论早发型重度子痫前期发病早病情重,对母儿危害大,需适时适式终止妊娠。     

可溶性人类白细胞抗原G与重度子痫前期的相关性研究

目的：在重度子痫前期患者血浆中的含量水平,探讨s HLA-G在早发型及晚发型重度子痫前期患者血浆中表达的差异性。方法：选择南京医科大学附属南京医院2013年07月至2014年04月间收治的6例早发型重度子痫前期患者（早发型组）、18例晚发型重度子痫前期患者（晚发型组）的临床资料,比较早发型组及晚发型组患者的一般临床情况;应用免疫组织化学染色法（enzyme linked immunosorbent assay,ELISA）,检测6例早发型组,18例晚发型组及32例正常足月妊娠者（正常对照组）的血清中s HLA-G的表达,并比较三组s HLA-G含量的差异。结果：1）早发型组与晚发型组的发病孕周,分娩孕周及期待治疗天数差异均有统计学意义（P〈0.05）,而年龄差异无统计学意义（P〉0.05）;2）早发型组与晚发型组的收缩压及舒张压差异均有统计学意义（P〈0.05）;3）早发型组中s HL A-G含量均值为（4.284±1.932）ng/m L,晚发型组中s HL A-G含量均值为（7.036±1.623）ng/m L,正常孕妇组中s HLA-G含量均值为（10.399±3.168）ng/m L。正常对照组s HLA-G含量高于重度子痫前期组（P〈0.01）,且早发型组低于晚发型组（P〈0.05）。     

重度子痫前期的临床分析

目的 探讨重度子痫前期患者早发型与晚发型母儿妊娠结局.方法 对我院170例重度子痫前期患者的临床资料进行回顾性分析.分为早发型孕周≤34周及E组85例,和晚发型孕周>34周即L组85例,主要分析患者的分娩孕周、终止妊娠时的孕周及方式,孕妇并发症发生、围产儿结局.结果 E组终止妊娠孕周早于L组(P<0.05);孕妇并发症E组与L组相比,差异具有极显著统计学意义(P<0.05);围生儿并发症的发生率E组远大于L组,差异具有特异性(P<0.05).结论 早发型重度子痫对于孕妇和围生儿的危害远大于晚发型,对于早发型重度子痫前期患者,要延长孕周时实施严密监护,一旦出现重要脏器功能损害及并发症倾向即应终止妊娠.     

Active and passive forearm flexor tension patterns in the continuous perceptual-motor task paradigm: The significance of motivation

The psychophysiology of skeletal muscle tension patterns during goal-directed behavior was investigated by using the continuous perceptual-motor task paradigm. Subjects were recruited to form serious-minded and playful extreme groups according to their responses to the Telic Dominance Scale (10 subjects in each group). They all performed a continuous perceptual-motor task 5 times at a ‘slow’ speed followed by a final ‘fast’ task. All performance periods lasted for 150 s. Measures of passive (tonic) and active (phasic) forearm flexor EMG activity were derived. It was concluded that serious-mindedness was significant to a tonic build-up of tension in the passive forearm flexor over the course of task performance. In contrast, the playful state was associated with high phasic response amplitudes in the active forearm flexor contingent upon changing the position of the joy-stick. Training moderated the range of state-specific EMG activation. State measures confirmed that the subjects maintained their state dominance during task performance. Error-scores and scores on felt level of arousal did not discriminate between the groups.     

Brainstem control of sensory information: a mechanism for perception

We have proposed a theory in which pathways ascending from the brainstem reticular formation control sensory centers in the dorsal thalamus and neocortex. We assumed that the sensory messages received at a given level are transformed by a stochastic process, called Alopex, in a way which maximizes responses in central feature analyzers. Perception is seen as a process involving a close cyclic interaction between brainstem and sensory relays. We discuss the specific case of visual information flow and the proposed modification of visual images at the level of the dorsal lateral geniculate nucleus (dLGN). Computer simulations of a simple model, representing the dLGN and reafferent control emanating from the reticular formation, show that sensory features are effectively enhanced and--in the absence of sensory input--quasi-sensory features may be generated by feedback of a simple scalar variable that is formed by the non-linear superposition of the responses of any number of feature analyzers. The model proposes a specific mechanism for such processes as visual imagery, hallucinations, and dreaming, and provides a framework for further studies into the nature of cognitive brain functions.     

EEG activity during cognitive processing: influence of attentional factors

The research draws upon two separate areas of inquiry: that of lateralized electrocorical processing of cognitive material; and that of psychophysiological information processing studies related to foci of attentional demands. Eighteen subjects on each of three separate days were presented with tasks considered to be 'right hemispheric' or 'left hemispheric'. These tasks were paired in a 2 X 2 design with an attentional factor requiring attention to the environment or to internal processing. All subjects received all types of tasks. Bilateral EEG measures were taken from the frontal and parietal areas referenced to linked ears. Major frequency bands were determined by a Fast Fourier Transform (FFT) and appropriate ANOVAs performed. The results suggest that task factors (left vs right hemisphere tasks) and attentional demands (internal vs external) are differentially represented in terms of EEG functioning. In general the higher beta frequencies were more sensitive to the hemispheric tasks demands and the middle frequencies (alpha and low beta) more sensitive to the attentional demands especially in the parietal areas.     

Weight gain. A side-effect of tricyclic antidepressants

Body weight and appetite were evaluated in 40 depressed outpatients from a private psychiatric practice who were receiving low-modest doses of tricyclic antidepressants. Amitriptyline (maximum of 150 mg/day), nortriptyline (maximum of 50 mg/day), and imipramine (maximum of 80 mg/day) were given for an average of 6 months of treatment. There was a mean weight increase of 1.3-2.9 lbs/month, which led to an average total weight gain of 3-16 lbs, depending on drug, dose and duration. These weight increases were linear over time and were accompanied by marked increases in the preference for sweets. Ultimately, excessive weight gain was the most common cause of discontinuation of treatment, occurring in one-half of the patients. Significant weight loss occurred upon discontinuation of drug. These findings show that chronic administration of low-modest doses of tricyclic antidepressants frequently cause considerable weight gain and can significantly interfere with the ability to provide long-term maintenance therapy.     

The perception of Necker cube reversal interacts with the Bereitschaftspotential

Subjects observed a reversible figure (Necker cube), and were asked to switch a lever about twice a minute. The direction of the lever switch indicated whether a reversal of the Necker cube was just experienced or not experienced. The Bereitschaftspotential (BP, readiness potential) turned out to be smaller in amplitude but earlier in onset prior to the reversal, especially over fronto-central regions. During another condition a tonic background stimulation (achieved by a radio-play) was introduced. Distraction reduced the BP, mainly when no reversal was reported. The results suggest a dependency of pre-movement potentials from non-motoric, psychological variables.     

EEG correlates of emotional tasks related to attentional demands

This research brings together two separate areas: (1) that of EEG processes associated with positive and negatively valenced emotional material; and (2) that of traditional psychophysiological research related to the “intake” and “rejection” of environmental stimuli. Forty males on each of two days were presented with tasks reflecting both attentional demands and affectual processing. Heart rate and bilateral EEG measures from frontal, parietal and temporal sites were recorded. Using a FFT (fast Fourier transform) electrocortical activity in the 2–7 Hz, 8–15 Hz, and 16–24 Hz was determined and analyzed. The results suggest emotional valence (i.e. positive and negative) and attentional demands (i.e. intake vs rejection) are differentially represented in terms of EEG functioning. An interaction of attentional demand with hemisphere was found for EEG alpha activity in the temporal and parietal areas. For emotional valence there was a significant main effect for EEG beta activity in both the temporal and parietal areas. Differential hemispheric activity was found using a factor analytic technique (PARAFAC) with positively valenced tasks being associated with right temporal beta. Heart rate changes for the attentional dimension were consistent with previous research.     

The need-informational theory of emotions

As an evolvement of Pavlov ideas on higher nervous (psychic) activity 'the need-informational theory of emotions' was suggested by the author in 1964. According to it an emotion is a function of two major factors: (1) power and quality of actual need (or drive, or motivation) and (2) estimation of probability (possibility) of need satisfaction on the basis of phylo- and ontogenetic experience. In the process of experimental testing of 'the need-informational theory of emotions' the role of different cerebral structures (frontal neocortex, hippocampus, amygdala, hypothalamus) in the genesis of emotional states and in the organization of goal-directed behavior was elucidated. The experimental data showed that these 4 brain structures play the major role in estimation of signals coming from environment and in the choice of subject's reactions. The individual characteristics of the interaction between the 4 brain structures must be taken into consideration in discussing neurophysiological backgrounds of different types of the higher nervous activity (temperaments), parameters of extra-introversion and neurotism (emotionality), the formation of main types of neurosis.     

Asymmetry of brain potentials related to sensorimotor tasks

The present study investigates the hemispheric specificity of event-related (ERP) and slow potentials (SP) of the brain during preparation and performance of sensorimotor (haptic) tasks. Tasks were selected which have been assumed to be processed primarily by only one brain hemisphere. ERPs, SPs and spontaneous EEGs were obtained from both hemispheres (C3-C4, P3-P4) and from Fz and Cz in a constant foreperiod (6 s) paradigm. Warning and task stimuli comprised up to four tactile stimuli, applied to index and middle finger of each hand. To maximize lateralized processing, the right-hand task required counting, the left hand task pattern matching. Components of the ERP (N1, P3, SW) and of SPs show task-dependent lateral asymmetry with the larger amplitudes contralateral to the preparing and responding hand. Results confirm hemisphere-specific processing of the tactile tasks but quantification as indicated by ERP amplitudes show considerable activity in both hemispheres. The SP-distribution rather reflects task-specific preparation than general alertness or orienting.     

Cardiovascular and respiratory responses to electrical stimulation of the midbrain in the rat

In descending through the midbrains of rats with stimulation electrodes, we have observed some remarkable reversals of pressor and depressor autonomic effects as the electrode was moved from one locus to another. Autonomic effects of stimulating in the midbrain areas that we studied are of special interest because stimulations in some of these midbrain loci have pain-relieving effects (Hosobuchi et al., 1977, 1979; Mayer et al., 1971; Soper, 1976). Our observations of cardiac arrest are of particular concern because of the use that is being made of midbrain electrical stimulation to relieve pain in human patients.     

An evaluation of two doses of isocarboxazid in depression

Two fixed doses of isocarboxazid were studied over a 4-week period in depressed in-patients. Thirty-five patients completed treatment, 20 of whom received 30 mg isocarboxazid per day, and 15 of whom received 50 mg isocarboxazid per day. No overall difference between the two doses was observed. When patients were subdivided into melancholia/endogenous depression or non-melancholia/non-endogenous depression, the higher dose exerted significantly greater antidepressant effects in the latter groups. Diagnostic type is considered to be an important variable in studies of dose-effect relationships with antidepressant drugs. The side effects of isocarboxazid at the two doses studied did not differ materially, although there was a suggestion of greater anticholinergic effect at 50 mg.