双球囊导管用于瘢痕子宫足月引产的临床观察

目的 探讨瘢痕子宫使用双球囊导管促宫颈成熟及引产后阴道分娩的安全性和有效性.方法 以2016年1月—2018年7月本院收治有阴道分娩条件和意愿的59例宫颈未成熟的足月瘢痕子宫作为研究组,以同期分娩的67例足月非瘢痕子宫宫颈未成熟的为对照组,两组均使用双球囊导管促宫颈成熟及引产,比较两组的母婴结局.结果 研究组孕产妇的年...     

慢性肺源性心脏病急性加重期98例糖代谢异常分析

目的:探讨慢性肺源性心脏病(肺心病)急性加重期糖代谢异常变化及其原因。方法:选择无糖尿病病史的肺心病急性加重期患者98例进行糖耐量试验(OGTT),并同健康对照组相比较。结果:肺心病患者血糖峰值为(8.46±0.61)mmol/L,显著高于对照组(7.59±0.50)mmol/L(P<0.01);平均高峰时间为(0.60±0.18)小时,而对照组为(0.75±0.24)小时,2组差异有显著性意义(P<0.05)。结论:肺心病患者糖代谢异常,可能与胰岛素分泌不足和胰岛素灭活障碍有关。     

缺氧缺血性脑病79例临床分析

目的总结分析新生儿缺氧缺血性脑病(HIE)发病的相关因素及临床特征。方法对79例临床诊断为HIE新生儿的发病相关因素、CT表现等进行分析。结果羊水污染占56%,胎膜早破占42%,脐带绕颈占39%,妊高征占30%,母贫血占13%,其中存在两种因素占30%。全部病例中CT检查76例有异常表现,阳性率96%,合并蛛网膜下腔出血占61%,合并脑室出血占15%,脑室内出血羊水Ⅲ度污染占58%,重度窒息占67%,分析颅内出血的发病因素,其中有两种异常因素占50%。早产儿有71%存在脑室内出血。结论羊水污染是HIE发生的首要因素,脑室出血与羊水Ⅲ度污染及重度窒息关系密切,早产儿易合并脑室出血。要加强围产期预防,对产科异常因素,临床有症状的新生儿,颅脑CT应作为常规检查手段。     

73例成年支气管哮喘缓解期患者Th1/Th2失衡与健康管理的相关性研究

目的：观察健康管理对成年支气管哮喘缓解期不同证型患者Th1/Th2变化的影响。方法：73例患者分为肺虚型、脾虚型、肾虚型、兼痰浊型及兼瘀血型,随机单盲对照将每型患者分为治疗组和对照组,对照组口服孟鲁司特钠片,治疗组在对照组基础上予以健康管理,检测各组患者治疗前后IFN-γ、IL-4水平并计算IFN-γ/IL-4比值。结果：各证型治疗组IFN-γ、IL-4和IFN-γ/IL-4差值均显著高于对照组（P〈0.05）。结论：哮喘缓解期患者通过系统的健康管理可以改变Th1/Th2失衡,系统健康管理计划对哮喘缓解期起到积极的防治作用。     

洋金花最佳采收期评价

目的:探索中药材洋金花最佳采收期评价新方法的可行性。方法:将洋金花的生长过程进行Logistic生长曲线方程拟合,建立数学模型,运用有序聚类分析的方法将其生长过程划分并将各划分期拟定为采收期,以生物活性成分为指标,结合产量对洋金花最佳采收期进行评价。结果:洋金花的生长过程与Logistic生长曲线方程拟合度良好,有序聚类分析后将洋金花采收期拟定为五个时期,评价后发现与以往采收期试验研究结果有差别。结论:洋金花药材最佳采收期评价新方法可行。     

Postpartum thyroid dysfunction in women with autoimmune thyroiditis

Introduction: Autoimmune thyroiditis (AIT) is a predisposing factor for developing postpartum thyroid dysfunction (PPTD).

Aim: To study the characteristics of PPTD in women with AIT.

Methods: Thirty-eight women with pre-existing AIT were included in the study. Thyroid-stimulating hormone, free triiodthyronine, free thyroxine, thyroid peroxidase antibodies, thyroglobulin antibodies were measured and ultrasound evaluation of the thyroid gland was performed in the first trimester of pregnancy and during the first year following delivery.

Results: Thyroid dysfunction was recognized in 68.4% of the patients – 28.9% presented with hypothyroidism and 39.5 % with thyrotoxicosis. The immunological and morphological parameters did not differ between euthyroid women and those with thyroid dysfunction. At the end of the postpartum period restoration of euthyroid state (being on the treatment before pregnancy) was observed in 15.4% of patients with PPTD, while 84.6% required increase of the levothyroxine dose. The analysis found a significantly lower volume of the thyroid gland, shorter duration of the disease, a lower dose of levothyroxine before and during gestation in patients with impaired thyroid function at the end of the postpartum period.

Conclusion: The risk of PPTD in women with AIT predating pregnancy is higher among women with preserved thyroid functional capacity motivating a thorough assessment of thyroid hormone levels and close follow-up of those women during the postpartum period.     

基于多指标成分定量结合化学计量学评价不同产地和不同采收期桔梗质量

目的 采用多指标成分定量结合化学计量学方法对不同产地和不同采收期的桔梗Platycodon grandiflorum进行质量评价。方法 采用热浸法测定其醇溶性浸出物含量,应用超高效液相-电喷雾检测器（UPLC-CAD）法同时测定桔梗皂苷D、桔梗皂苷D₃、去芹糖桔梗皂苷D、桔梗皂苷E、去芹糖桔梗皂苷E 5个活性成分含量,揭示不同采收期桔梗化学成分含量动态积累规律。运用主成分分析法分别对不同生长年限、不同产地桔梗进行综合评价,单因素方差分析比较不同产地桔梗各指标成分含量。结果 以春季4月、秋季9～10月、三年生为桔梗的最佳采收期。主成分分析、方差分析表明不同产地桔梗中指标含量存在显著性差异,同一产地不同批次间也有区别;根据主成分分析对不同产地桔梗进行综合评分,排名靠前的产地为甘肃陇南及河南省地区,陕西商洛、安徽亳州、内蒙古赤峰产地次之,山东淄博和山西太原产地排名较后。结论 以多指标成分定量结合化学计量学建立的评价方法明确了桔梗最佳采收期,评价了不同产地桔梗的质量,为桔梗药材质量控制研究提供依据。     

Pregnancy management for a woman with extensive vulvar and pelvic malformations caused by Klippel–Trénaunay syndrome

Klippel–Trénaunay syndrome (KTS) is a rare congenital disorder defined by a triad of capillary malformation, venous malformation, and soft tissue or bone hypertrophy most commonly affecting unilateral lower limbs. Due to the rarity of KTS, evidence‐based guidelines for the management of pregnancy in people with KTS are still lacking. A 34‐year‐old woman (gravidity 1; parity 0) presented at 25 weeks of gestation with malformations of the right side of her body. The extent of the KTS affecting the vulva, pelvis, and right leg was remarkable. As the prenatal MRI showed massive vascular malformations of the pelvis and vulva, we performed an elective cesarean section to avoid severe perinatal hemorrhage during a vaginal delivery. Intraoperatively, we observed varices on the parietal peritoneum within the vesico‐uterine pouch and the isthmocervical transition of the uterus, which were not identifiable in the preoperative MRI. Although KTS patients have been discouraged from pregnancy in the past because of a high risk for complications, successful and uncomplicated pregnancies are possible. For this purpose, we believe a multidisciplinary strategy that is crucial.     

多粘菌素B对小白鼠右心室肌动作电位的影响

The effects of polymyxin B (PXB) on action potential of the mice right ventricular myocardial cell were studied by means of intracellular capillary glass electrode. The action potential amplitude (APA) and maximal depolarization rate of phase O (V_max) of action potential were lowered after administering PXB for 5 min. APA was lowered from 104.0±4.2 mV to 100.7±5.1mV, decreasing 3.2% (P<0.01); V_max was lowered from 691.5±114.1 v/s to 515.15±71.5 v/s, decreasing 25.5% (P<0.001). Practically, the resting potential remained unchanged. With the continued administration of PXB, the functional refractory period was significantly prolonged. APA₉₀ was temporarily shortened and then prolonged. The results suggest that PXB inactivate or block the fast sodium channel in myocardial cell membrane, which may relate to the antiarrhythmic effect in animal experiment.