大理市1986年～2000年孕产妇死亡分析

目的:为进一步降低孕产妇死亡率提供科学依据,总结大理市孕产妇系统管理工作的经验教训.方法:回顾性分析大理市15a孕产妇死亡病例.结果:大理市15a孕产妇死亡率逐年下降,从1986年的127.4/10万降至2000年的49.4/10万.死亡原因前五位依次为产科出血、妊高症、产褥感染、羊水栓塞、妊娠合并心脏病.结论:本市的孕产妇死亡原因主要与医疗保健人员知识技能水平相关、家庭个人知识水平及经济状况相关.     

贵州省实施妇幼卫生项目效果分析

报道５个实施妇幼卫生项目县（市）与６个非项目县（市）妇女卫生状况的调查比较。揭示实施项目工作５年来，贵州省妇幼卫生工作取得很大进展，孕产妇死亡率由实施前２３６．８／１０万降至１４９．１／１０万。其中项目县降至９６．８／１０万，非项目县降至１８１．８／１０万。新法接生率、产前检查率与产后访视率均比项目实施前有明显提高。项目工作的实施促进了项目地区基层网络与妇幼队伍的建设，提高了基层人员妇幼卫生服务的主动性，出现了新婚女性婚姻生育观念的转变。还必须深入持久地推行孕产妇系统管理，尤其是高危孕产妇的分级管理，努力提高住院分娩率，才能大幅度降低孕产妇的死亡率     

Impairment of bone turnover in elderly women with hip fracture

Summary Hip fracture is one of the most severe consequences of osteoporosis affecting aged women. However, abnormalities of bone turnover responsible for bone loss in this condition have not been clearly defined. To further evaluate the bone metabolic status of women sustaining hip fracture, we have prospectively measured serum osteocalcin as a marker of bone formation and urinary excretion of pyridinoline (Pyr) and deoxypyridinoline (D-pyr) cross-links as markers of bone collagen degradation in 174 independently living women (80 ± 8 years) within a few hours after a hip fracture. Comparison was made with 77 age-matched controls (80 ± 5 years) and 17 premenopausal women (39 ± 3 years). In addition 15 of the patients were followed with daily measurements during the first postoperative week. At the time of admission osteocalcin was 20% lower in the fractured women compared to the elderly controls (7.6 ± 3.8 vs. 9.5 ± 4.5 nglml,P = 0.001). Pyr and D-pyr were 36% and 40% higher, respectively (P = 0.0001), than in elderly controls and 85% and 76% higher than in premenopausal controls (P = 0.0001). Serum osteocalcin did not correlate with the cortisol level measured at the same time (r = 0.03, ns), nor with serum albumin and creatinine. Serum osteocalcin remained unchanged within 18 hours after fracture, whereafter it progressively decreased until the third postoperative day. No correlation was noted between the excretion of pyridinoline cross-links and the time elapsed from fracture.These data suggest that the abnormal levels of osteocalcin and pyridinolines are unrelated to traumatically induced acute changes, but reflect abnormalities of bone turnover existing prior to the fracture. Thus, hip-fracture patients have biochemical evidence of decreased bone formation and increased bone resorption when compared to age-matched controls. We suggest that these abnormalities may play a role in the decrease of the bone mass and the consequently increased bone fragility that characterize the osteoporotic hip fracture in the elderly.     

不同孕期阶段孕妇凝血四项及FDP和D-二聚体的变化及临床意义

目的:研究不同孕期阶段(早、中、晚)孕妇凝血四项、血浆纤维蛋白(原)降解产物[plasma fibrin/fibrinogen degradation products, FDP]、D-二聚体的变化及临床意义,为临床诊疗提供理论支持。方法:回顾性分析2021年1月至2021年12月200例孕妇就诊资料中的凝血四项,纤维蛋白原(fibrinogen, FIB)、凝血酶原时间(prothrombin time, PT)、凝血酶时间(thrombin time, TT)、活化部分凝血活酶时间(activated partial thromboplastin time, APTT)。并对FDP与D-二聚体的检测结果进行统计分析,比较孕早期、中期、晚期三个阶段凝血四项、FDP和D-二聚体水平的变化。结果:孕早期、孕中期与孕晚期PT水平比较,差异有统计学意义(P<0.05);孕早期、孕中期与孕晚期三个阶段的TT相比,差异无统计学意义(P>0.05);孕早期的APTT明显长于中期、晚期孕妇,差异有统计学意义(P<0.05);孕早期、中期、晚期孕妇,随着孕周的增加,FIB水平逐渐升高...     

HIV epidemic in Central African Republic: high prevalence rates in both rural and urban areas

A sentinel serosurveillance study was conducted in Central African Republic to estimate the prevalence of HIV seropositivity in the general adult population in each province so that the public health authorities can target HIV prevention programmes to the priority areas. Blood samples were collected from women attending 48 antenatal clinics in urban and rural areas of the Central African Republic. These samples were tested for HIV antibodies in an anonymous and unlinked manner using strategy II recommended by WHO. The data were extrapolated to all women of reproductive age in Central African Republic by use of a parity-based adjustment involving the application of correction factors to the observed prevalence rates. A total of 9,305 pregnant women were recruited from November 2001 to October 2002. HIV seroprevalence was high in all age groups (12% in the less than 20 year age group to 17% in the 25-29 year age group). The median prevalence of HIV in antenatal clinics was similar for rural areas, for Bangui and for other urban areas (16.5, 15.0, and 12.5% respectively). Adjustment for parity and fertility pattern increased the prevalence of HIV in all antenatal clinics except in Bangui. This first national study of HIV prevalence in Central African Republic revealed that the HIV epidemic is continuing to spread in both urban and rural areas. Thus, efforts to reduce transmission should be made in every part of the country.     

Clinicopathologic features and incidence of invasive lobular carcinoma in Japanese women

Intending to clarify the true Incidence of Invasive lobular carcinoma of the breast In Japanese women as well as the frequency of unilateral multlcentriclty, 362 cases of clinically defined monocentrlc breast cancer without pre-operative biopsy (previously fine needle aspiration or needle biopsy were routinely carried out for every case) were examined by whole mammary gland serial sectioning. On the basis of pathology and the World Health Organization classification of breast tumors, each case was assigned to one of two main histologlc types: Invasive lobular carcinoma (ILC) or Invasive ductal carcinoma (IDC). Invasive lobular carcinoma was further separated into classic and variant types by employing previously published criteria. Twenty-one cases of ILC (5.8%) were diagnosed, which Is more than In most previous Japanese studies. Unilateral multicentric breast carcinoma was detected In 9.5% of ILC and 16.1% of IDC (the difference was found not significant). Microscopically, ILC tumors were found to be, on average, larger than IDC. Patients with classic type ILC tended to be younger than those with variant type or IDC. Estrogen receptor expression was found more frequently In variant type ILC than in classic type. These results suggest that the incidence of invasive lobular carcinoma of the breast In Japanese women is low and that unilateral multicentricity Is not significantly higher in ILC than in IDC.     

1049例育龄妇女下生殖道感染情况调查

目的了解育龄妇女下生殖道感染情况,为育龄女性生殖健康提供进一步的数据资料。方法对1049例来自健康体检中心的21~40岁育龄妇女的阴道后穹窿及宫颈分泌物标本进行检测,阴道清洁度、滴虫采用显微镜镜检法,淋球菌、解脲支原体、人型支原体、真菌采用培养法,沙眼衣原体则采用免疫层析法。检测结果进行统计学分析。结果女性生殖道感染的感染率为53.3%,其中混合感染率为9.8%,而清洁度异常率仅为28.4%;前三位病原体感染依次为解脲支原体(35.9%)、衣原体(18.1%)、真菌(6.7%)。结论女性生殖道感染情况严重,具有隐匿性,应加强对无症状感染的育龄妇女的监测。     

Elektronenmikroskopische Befunde an inneren Organen bei Morbus Fabry

Zusammenfassung Es werden elektronenmikroskopische Beobachtungen zur Lokalisation und zur Feinstruktur der Glykolipideinschlüsse in verschiedenen inneren Organen bei Morbus Fabry berichtet. Die intrazellulÄren und extrazellulÄren Einschlüsse bestehen aus vielschichtig lamellÄren Membransystemen in konzentrischer und exzentrischer sowie in stapeiförmiger paralleler Anordnung. Diese lamellÄre Anordnung ist charakteristisch für flüssigkristalline Phasen von Phospholipid-Wasser-Systemen. Erstmalig werden ultrastrukturelle Befunde an den inneren Organen einer erkrankten Frau mitgeteilt. Demzufolge lassen sich bei heterozygoten Frauen gleiche Glykolipidablagerungen wie bei homozygoten MÄnnern nachweisen. Die Beziehung der Glykolipideinschlüsse zu den Lysosomen wird erörtert.

---

Electron microscopic observations in internal organs in morbus fabry

Summary Electron microscopic findings are reported on the localization and fine structure of glycolipid inclusions in different organs (heart, kidney, lymph nodes, arterial blood vessels, pancreas) in Fabry's disease in a female. The intracellular and extracellular inclusions were made up of multilamellar membraneous systems in concentric, excentric, and parallel arrangement. This fine structure is characteristic of liquid-crystalline phases of phospholipid-water systems.The same type of inclusions are found in the internal organs of heterozygotic women as in homozygotic men. The relationship between the glycolipid inclusions and the lysosomes is discussed.

Herrn Prof. Dr. F. Bolck, Direktor des Pathologischen Instituts der Friedrich-Schiller-UniversitÄt Jena, zum 60. Geburtstag gewidmet.     

Short-term estrogen test for cytodiagnosis in postmenopausal women

A short-term estrogen test was used to obtain a correct cytologic diagnosis in 73 patients with an equivocal atrophic cellular pattern. Overestimation in cytodiagnosis was markedly eliminated, and the correct cytologic diagnosis was made in 81% of the cell samples after the estrogen test. The purpose of this study was not only to confirm the usefulness of the short-term estrogen test, but also to observe the cytomorphologic changes before and after the test. Thick cytoplasm, vacuoles in the cytoplasm, and a distinct cell border increased, while the amorphous chromatin pattern was eliminated after the estrogen test. Maturation of atypical cells in cases of dysplasia, carcinoma in situ, and invasive squamous-cell carcinoma was investigated before and after the estrogen test. Although malignant cells were not influenced by estrogen, maturation of dysplastic cells was induced after the test.     

GRO-alpha in Human Serum: Differences Related to Age and Sex

PROBLEM: Human GRO-alpha (GRO-α) is a new member of the chemokine family that is supposed to play an important role in inflammatory and immune reactions. We established a sandwich enzyme-linked immunoassay (ELISA) system with polyclonal antibodies against human GRO-α and investigated the serum level of healthy donors to establish normal ranges for this chemokine in adults. METHODS: GRO-α concentrations were measured cross-sectionally in the sera of 240 healthy adults. The variability of serum GRO-α levels was also measured in normal volunteers, samples from whom were obtained by sequential venipunctures or by a small plastic cannula with a heparin-saline lock, to determine short-term variability. RESULTS: Whereas there was no difference between the concentration of human GRO-α from men (logarithmic mean, 77.6 pg/ml, n = 120) and that from women with normal menstrual cycles (log mean, 71.6 pg/ml, n = 73), the concentration from postmenopausal women (log mean 45.0 pg/ml, n = 31) was lower than that from women with normal menstrual cycles (log mean 71.6 pg/ml, n = 73). However, we could not detect any significant difference between healthy donors' serum levels and those of donors with acute inflammation. Fewer variations were recognized in the case of the sequential venipunctures method than in that of the heparin-saline lock method. CONCLUSION: We found that the GRO-α concentration of postmenopausal women was significantly lower than that of women with normal menstrual cycles. These results suggest the GRO-α serum levels of normal healthy women may have some correlation with sex hormones.