产后出血与产妇心理和对新生儿性别切盼影响因素的临床分析

产妇死亡的三大原因是出血、感染、高血压疾病。出血所造成的死亡占第一位。尤其是产后大出血，因产后大出血使得体质虚弱又继发有产后感染是造成产妇死亡最主要的原因。尤以广大的农村多见。在产后出血四大原因中，以宫缩乏力为主要原因，导致宫缩乏力的因素较多，诸如产程过长、子宫过度膨胀，     

产后大出血的护理

产后出血是妇产科常见并发症，也是引起孕妇死亡的重要原因之一。如果预防措施不完善，将会造成产后大出血，发病率占分娩总数3％-5％。一般发生在胎儿娩出24小时内阴道流血超过500ml，可诊断产后出血。患者表现为贫血、休克，甚至导致产褥感染，免疫力下降等。产后出血量超过1000-2000ml为产后大出血，往往出血快，来势凶猛，危及产妇生命。因此对产后出血预防相当重要，     

产后大出血30例临床分析

产后大出血是极常见的分娩并发症，也是导致产妇死亡的首要原因，包括产后大出血及晚期产后大出血，本文资料不包括晚期产后大出血。我院2004年-2005年共分娩2008例，发生产后大出血30例，占分娩总数的1．07％，出血的原因依次为：子宫收缩不良、软产道损伤、胎盘胎膜残留，凝血功能障碍仅1例。     

中央性前置胎盘剖宫产大出血子宫次全切除术16例临床分析

前置胎盘是妊娠晚期产前、出血的主要原因，产前、产后出血一直是产科最严重的并发症．是孕产妇死亡的主要原因之一。近年来，前置胎盘率日益升高．前置胎盘剖宫产术中大出血成为产科的重要问题，如果处理不当会导致产妇死亡。现将我院2002年1月～2007年1月中央性前置胎盘剖宫产术中大出血，16例行次全子宫切除术报告如下。     

产后出血5O例临床防治体会

产后出血是产科严重的并发症．是孕产妇死亡的重要原因之一，在临床上孕产妇死亡半数以上是产科出血所致．因此，产后出血是严重危害产妇身心健康的疾病，应引起重视。本院近5年以来收治的产妇出血患者50例，防治体会如下。     

剖宫产术中大出血的原因分析及护理体会

目的：探讨剖宫产术中大出血的原因及护理配合。方法选取我院2010年1月—2014年8月收治的剖宫产术中大出血患者24例，分析出血原因，并给予精心的护理措施。结果24例术中大出血患者，痊愈19例，顽固性出血保守无效后子宫切除5例。结论术中出血及时采取有效的止血方法及护理措施，给予产妇心理干预，能有效减少出血量，增进康复。     

新生儿性别和产妇精神因素对产后出血的影响

产后出血是产科最严重的并发症，是产妇死亡的主要原因之一，尤以农村多见，预防产后出血降低产妇死亡率是产科领域研究的重要课题。随着计划生育工作的深入，受传统意识重男轻女的影响，产妇精神因素影响子宫收缩导致产后出血有所增加，我院自1996年1月至1997年12月顺产接生2050人，产后官缩乏力大出血47人，其中28人是对新生儿性别不满意者，占59．5％，现报告如下。     

剖宫产术中大出血62例临床分析

产后出血是产科严重的并发症，是产妇死亡的主要原因。由于近年来剖宫产率上升，剖宫产并发产后出血，尤其是术中大出血明显增多，且病情危急，必须及时分析原因，迅速采取有效的止血措施以减少休克的发生。我院2002年1月～2005年1月，3年分娩总数3447例，其中剖宫产1230例，术中及产后24h内出血量≥500ml，199占16．2％，其中术中失血量≥800ml者62例，占剖宫产产后出血31．2％。通过对62例病例的回顾性分析，进一步探讨临床对剖宫产产后大出血的防治。     

产后出血的临床分析（附34例报告）

产后出血是产科最常见的并发症之一，据资料统计占产科并发症的90％以上‘’‘，为产妇死亡原因之首，而产科其他并发症都有可能导致不同程度的产后出血。因而，对我科近3年来34例产后大出血病例进行分析，探索其原因及预防措施。豆；临床资料与诊断标准三．至临床资料自1994年元月至1996年12月3年间我科经阴道分娩产妇728例中，产后大出血者34例，占阴道分娩总数的4．7％，其中产后2h内出血者32例，占出血总数94．1％。1．2诊断标准（1）胎儿娩出后以器械盘置于产妇臀下，收集出血＞4O0ml者。（2）根据血压变化，Zh内收缩压下降＞4kPa、…     

产后大出血伴休克介入治疗

<正>产后大出血是妇产科常见病,胎儿娩出24h内阴道出血超过500mL称产后出血,分娩24h后产褥期发生的子宫大出血称晚期产后大出血,产后出血是产妇死亡的重要原因,在我     

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.