崇州市围绝经期妇女生殖健康状况调查

目的：通过对崇州市中老年妇女围绝经期生殖健康情况调查，为开展针对中老年妇女的生殖健康保健提供依据，方法：采用问卷形式对崇州市375名45岁以上妇女的一般情况和生殖健康状况进行调查。结果：祟州市妇女的平均绝经年龄是48.0岁。有54．7％的妇女在绝经前出现月经紊乱，1／3左右的绝经妇女在围绝经期出现潮热盗汗等围绝经症候群，但是，不足一半的妇女因此而就诊。所有妇女中仅58人服用过雌激素，主要因为潮热盗汗，睡眠障碍，泌尿道感染等。大多数妇女的服药时间少于一年。结论：中老年妇女在围绝经期和绝经后有许多绝经相关症状，需要我们为这 些妇女的生殖健康服务。     

围绝经期胸痛病人冠状动脉造影结果分析及护理

心血管疾病尤其是动脉粥样硬化以及冠心病是工业化国家妇女居首位的死亡原因[1] ,但妇女冠心病多发生于绝经后。临床上围绝经期妇女以胸痛就诊者较多 ,本文分析我科 2 0 0 0年 6月至 2 0 0 1年 12月年龄在 45岁～ 5 5岁的冠脉造影病人的临床资料 ,为了解其胸痛病因进而采取针对性的护理措施提供依据。1　一般资料我科自 2 0 0 0年 6月至 2 0 0 1年 12月对 12 7例年龄在 45岁～ 5 5岁的胸痛病人行冠脉造影术 ,其中男 75例为对照组 ,女5 2例为实验组。冠脉造影结果显示 ,血管狭窄程度 >5 0 %定义为阳性 ,结果在男性 75例中阳性者 6 0例 ,阳性…     

葛根治疗59例围绝经期及绝经后综合征

笔者自 1997年 7月至 2 0 0 3年 12月应用葛根治疗 5 9例围绝经期及绝经后常见的综合症状群 ,取得较满意效果 ,现总结报告如下。1　临床资料1.1　一般资料　 5 9例观察病人均为门诊病人 ,其中年龄 4 0～ 4 7岁 33例 ,平均 4 3岁 ;围绝经期症状 3个月至 1年不等 ,以潮热、易汗、精神情绪异常症状为主。年龄 4 8～ 5 5岁 2 6例 ;平均 5 1岁 ,绝经后常见症状以心悸气促、头晕耳鸣、头痛恶心、健忘、肩腰酸痛、手足易冷、智力减退为主。这部分病例心电图检查、X线腰颈椎片检查未见异常。1.2　治疗方法　均给予葛根注射液 4 0 0mg/次 (最大剂量…     

围绝经期综合征的护理现状

<正>围绝经期综合征也称更年期综合征,是妇女在绝经前后由于雌激素水平波动或下降所致的以自主神经系统功能紊乱为主,伴有神经心理症状的一组症候群[1],多发生于45~55岁的妇女。有研究认为,46~50岁发病率最高[2]。一般持续至绝经后2~3年。主要表现为月经紊乱、情绪不稳定、阵发性潮热、头晕、失眠、心悸、抑郁、暂时性血压升高等[3]。因此对围绝经期妇女进行综合治疗和护理干预,使她们顺利地度过心理、生     

围绝经期两种药物激素替代治疗的对比性研究

激素替代治疗能缓解围绝经期症状,提高围绝经期妇女生活质量。作者采用利维爱和尼尔雌醇对围绝经妇女160例进行3个月的激素替代治疗,以探讨不同药物对围绝经妇女血清雌二醇、子宫内膜及症状的影响。1临床资料与方法2002~2004年在本所门诊就诊的围绝经期且有绝经期综合征表现的妇女160例。入选标准:①自愿接受治疗,能定期随访至疗程结束;②近3个月内无服用激素类药物史;③经B超检查子宫内膜厚度<5 mm;④无激素替代治疗禁忌证。采用双盲法将符合纳入标准的160人随机分为试验组[平均年龄(49±6.4)岁]和对照组[平均年龄(50±5.5)岁],2组年龄、…     

上海市南京东路社区妇女围绝经期症状分析

目的：了解黄浦区社区围绝经妇女围绝经期症状的发生情况。方法：采用2个阶段随机抽样方法,选取南京东路社区40~60岁妇女作为调查对象,进行问卷调查。结果：被调查677例妇女中自然绝经者386例,平均绝经年龄为49.36±3.71岁。围绝经期症状发生率70.3%。在13项症状中,出现频率最高前5位症状依次为潮热出汗（53.2%）、骨关节痛（47.6%）、性生活障碍（45.2%）、眩晕（41.5%）、疲乏（41.2%）。围绝经期症状的严重程度随年龄的增长而加重。经多元线性回归分析显示,是否工作、性生活满意度及是否患有慢性病与围绝经期症状有相关性。结论：绝大多数妇女在围绝经期存在围绝经期症状,其发病与雌激素水平降低有关。依托社区,加强健康教育;针对病因进行预防,可降低围绝经期症状的发生率,提高妇女生活质量。     

妇女更年期综合症中西医结合治疗

妇女更年期综合症是较常见的病症。从卵巢功能逐渐消退到完全消失，可经过生育期、绝经前期、绝经、围绝经期、绝经后期、老年期，它是妇女从中年进入老年的一个重要转折阶段，临床所表现出来的一系列病变及症候群统称为更年期综合症。     

苏州市围绝经期妇女围绝经期症状和保健知识需求调查

目的了解围绝经期妇女围绝经期症状发生情况以及对围绝经期症状保健知识的需求。方法2011年在苏州市随机选择2 066例年龄在38~70岁的女性,对其进行面对面问卷调查,所得数据全部录入Excel 13.0表,采用SPSS 19.0软件对数据进行统计分析。结果 2 066例调查对象年龄为（50.22±7.17）岁,围绝经期综合征患者695例,发生率为33.7%。13项症状中发生率最高的为性生活改变（48.6%）。绝经前后女性的BMI、腰围/臀围、收缩压、舒张压存在统计学差异（P均〈0.05）。围绝经期保健知识的普及欠缺。结论大多数围绝经妇女存在围绝经期症状,应该加强围绝经期保健知识的普及。     

绝经后妇女雌激素缺乏与胆固醇酯转运蛋白水平改变的关系

目的　探讨雌激素是否影响血清胆固醇酯转运蛋白 (CETP)水平的调节。方法　采用放射免疫分析法测定了 196例包括绝经前 (5 2例 ,年龄 18～ 40y)、绝经后妇女 (87例 ,年龄 61～ 81y)及围绝经期妇女 (5 7例 ,年龄 41～ 60 y)的血清雌二醇(E2 )、促卵泡生成激素 (FSH) ;自制CETP单抗建立的ELISA法测定CETP水平 ,同时测定血脂类指标。结果　绝经后妇女CETP水平明显低于绝经前和围绝经期妇女 (P <0 0 0 0 1) ,E2 水平较绝经前和围绝经期妇女显著下降 (P <0 0 0 0 1) ,而FSH水平显著升高 (P <0 0 0 0 1) ,各组血脂水平亦有显著性差异。CETP与E2 呈正相关 (r =0 .2 4,P <0 0 0 1) ,与FSH呈负相关(r =- 0 .2 7,P <0 0 0 1) ,与年龄呈负相关 (r=- 0 .3 1,P <0 0 0 0 1)。结论　雌激素水平的下降可影响绝经后妇女血清CETP水平     

围绝经期两种药物激素替代治疗的对比性研究

激素替代治疗能缓解围绝经期症状，提高围绝经期妇女生活质量。作者采用利维爱和尼尔雌醇对围绝经妇女160例进行3个月的激素替代治疗，以探讨不同药物对围绝经妇女血清雌二醇、子宫内膜及症状的影响。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.