超声引导下局部注射MTX治疗有心搏异位妊娠的疗效分析

[目的]研究超声引导下局部注射MTX治疗有心搏异位妊娠的疗效。[方法]25例有胎心搏动的异位妊娠为研究组,以43例无胎心搏动的异位妊娠为对照组,研究组采用阴道超声引导下局部注射MTX同时结合全身用药,对照组仅全身治疗肌肉注射MTX。[结果]研究组与对照组治疗成功率无显著性差异。而研究组治疗前血HCG明显高于对照组。[结论]对有胎心搏动的异位妊娠,超声引导下局部注射MTX结合全身用药疗效较好。     

大鼠胚胎小脑的发育学研究

用Ｎｉｓｌ染色法对大鼠胚胎１４、１６、１８及２０ｄ小脑进行形态学观察。结果表明：胚胎１６ｄ以前小脑由室管膜层、外套层及边缘层构成。胚胎１８ｄ开始出现典型的皮层结构。外颗粒层由较密集的深染细胞组成，数目随着胎龄的增加而增多。蒲氏层由较大淡染细胞组成，数目随着胎龄的增加而逐渐减少。颗粒层内细胞成份较复杂，细胞密度随胎龄增加呈下降趋势。     

骨巨细胞瘤中的多核巨细胞体外骨吸收研究

目的：比较破骨细胞与骨巨细胞瘤中多核巨细胞的特点，明确后者的性质和来源。方法：用倒置相差显微镜观察体外培养的多核巨细胞的一般形态及降钙素对它的影响；用骨片与多核巨细胞共同培养法观察多核巨细胞的体外骨吸收功能，用扫描电镜观察骨吸收陷窝，Ｇｏｍｏｒｉ染色观察多核巨细胞的酸性磷酸酶活性。结果：倒置相差显微镜下可见多核巨细胞胞核较多（２０个以上），胞浆周边不规则，有伪足样突起；胞浆内可见较多大小不等的空泡；降钙素（１００μｇ·Ｌ－１）可抑制多核巨细胞的伪足样运动；多核巨细胞与灭活的骨片共同培养时可见骨吸收陷窝形成，扫描电镜下可见吸收陷窝底面有原纤维；Ｇｏｍｏｒｉ染色时可见多核巨细胞的酸性磷酸酶呈阳性。结论：证实了多核巨细胞具有破骨细胞的形态特征与骨吸收功能，可能来源于骨髓的破骨细胞前体细胞     

胎儿纤连蛋白与早产和绒毛膜羊膜炎的关系

目的　探讨胎儿纤连蛋白 (FFN)与早产和绒毛膜羊炎膜之间的关系 ,为诊断早产和绒毛膜羊膜炎及判定预后提供新方法。方法　采用ELIAS(酶联免疫吸附法 )对 4 2例先兆早产孕妇 (实验组 )和同孕龄健康孕妇 4 8例 (对照组 )进行宫颈阴道分泌物FFN检测。结果　实验组FFN阳性率 4 5 .2 % (19/42 ) ,对照组FFN阳性率 4 .8% (2 /48) ,两组之间有显著性差异 ;实验组中FFN阳性者发生早产及绒毛膜羊膜炎者分别为 68.4 % (13/19)、73.6% (14/19) ,与FFN阴性者比较有显著性差异。结论　FFN对诊断早产和绒毛膜羊膜炎有重要参考价值 ,可为围产期保健提供重要监测手段     

产前超声对胎儿肠管扩张的诊断价值

目的：探讨产前超声诊断胎儿肠管扩张的诊断价值.方法：对120例产前超声检查发现胎儿肠管扩张病例进行回顾性分析.结果：（1）在120例肠管扩张的胎儿中,46.7％出生后排便正常,53.3％发生不良妊娠结局.（2）胎儿肠管扩张发生部位越高,预后越差.（3）十二指肠扩张通常伴有羊水增多,而小肠扩张与结肠扩张多不伴有羊水增多.结论：胎儿肠管扩张可导致不良围产期结果,且妊娠结局与肠管扩张发生的部位有关.     

人胎心房和窦房结心房利钠因子的免疫组织化学研究

用免疫组织化学方法对１８例人胎心（１２～４０周胎）进行了心房利钠因子（ＡＮＤ）分布的研究。结果表明，心房利钠因子免疫反应颗粒存在于大部分心房肌细胞内，少部分心房肌细胞无染色颗粒。ＡＮＦ在心房肌细胞中的染色为颗粒状，分布在核周胞浆中，偶尔可见散在胞浆外周。在心房近心内膜侧的心肌细胞可见染色反应增强。免疫反应在左右心房和房中隔无明显不同。左右心耳有很强的免疫反应且右耳强于左耳。窦房结ＡＮＦ免疫反应亦为阳性，但染色较同时期心房肌弱，较心室肌强。窦房结的头、体、尾无免疫染色强度变化。在１２～２０周胎心室肌中有弱的ＡＮＦ免疫反应。从１２～２０周不同胎龄胎心的染色对比看，ＡＮＦ在人胎心有其发展变化规律，随着胎儿增大出现心室免疫染色减弱而心房免疫染色增强的趋势。对心脏作为内分泌器官可能在调节心脏本身的活动和其他生理活动中的意义进行了讨论。     

多普勒超声评价胎儿房性心律失常常压氧治疗的疗效

目的 应用多普勒超声评价常压氧疗法对胎儿房性心律失常的疗效。方法 对多普勒超声确诊193例未合并先天性心脏病的房性心律失常胎儿[其中各类型房性早搏(PAC)165例、室上性心动过速(SVT)28例]行常压氧治疗;对照组63例为单纯房性早搏未行常压氧治疗者。结果 (1)PAC常压氧疗法治疗第二疗程平均转归率97．8％,SVT为85．7%;经治疗后辨膜返流减轻或消失、心包积液减轻或吸收及外周血流频谱明显改善(P＜0．05);(2)对照组PAC63例中12例停止饮用兴奋性饮品早搏消失,11例随孕周发展加重,1例发生短阵房性心动过速。结论 常压氧疗法可明显提高胎儿血氧分压,增加胎儿氧的供应和利用,有效治疗胎儿房性心律失常。     

Molecular Characterization of Hereditary Persistence of Fetal Hemoglobin in the Karen People of Thailand

Hereditary persistence of fetal hemoglobin (HPFH) is the condition whereby a continuously active γ‐globin gene expression leads to elevated fetal hemoglobin (Hb F) levels in adult life [Stamatoyannopoulos G, Grosveld F. Hemoglobin switching. In: Stamatoyannopoulos G, Majerus PW, Perlmutter RM, Varmus H, eds. The Molecular Basis of Blood Diseases. Philadelphia: W.B. Saunders, 2001:135–182; Wood WG. Hereditary persistence of fetal hemoglobin and δβ thalassemia. In: Steinberg MH, Forget BG, Higgs DR, Nagel RL, eds. Disorders of Hemoglobin: Genetics, Pathophysiology, and Clinical Management. Cambridge: Cambridge University Press, 2001:356–388; and Weatherall DJ, Clegg JB. Hereditary persistence of fetal hemoglobin. In: Weatherall DJ, Clegg JB, eds. The Thalassaemia Syndromes. Oxford: Blackwell Scientific Publishers, 1981:450–507]. The condition is caused either by mutation of the β‐ and γ‐globin genes, or the γ‐gene controlled region on other chromosomes. Several families with this condition have been reported from Vietnam, Cambodia and China, and the Southeast Asian mutation (or HPFH‐6), a 27 kb deletion, was demonstrated. Here we report on a mother and her daughter of the Karen ethnic group with high levels of Hb F, living in the Suan Pueng District on the border of Thailand and Myanmar. Genotyping showed a heterozygosity for the 27 kb deletion of the β‐globin gene. Their conditions have been confirmed by gap polymerase chain reaction (PCR) with three oligonucleotide primers recently developed by Xu et al. [Xu X‐M, Li Z‐Q, Liu Z‐Y, Zhong X‐L, Zhao Y‐Z, Mo Q‐H. Molecular characterization and PCR detection of a deletional HPFH: application to rapid prenatal diagnosis for compound heterozygotes of this defect with β‐thalassemia in a Chinese family. Am J Hematol 2000; 65:183–188.], and a DNA sequencing method. Thus far there has been no official report of the HPFH‐6 anomaly from Thailand. The compound heterozygosity of β‐thalassemia (thal) and hereditary persistence of Hb F causes the phenotype of thalassemia intermedia; in contrast, homozygotes for this anomaly show only mild microcytic anemia. Hence, genetic counseling for hereditary persistence of Hb F carriers is needed for family planning.     

Change of Pulsatility Index of the Fetal Middle Cerebral Artery after Auditory Stimulation in No Risk Pregnancies and in Pregnancies with Gestational Hypertension

Purpose: An aim was to determine the degree and the mode of variation of PI of middle cerebral artery in no risk pregnancies and in pregnancies with gestational hypertension, after the constant sound stimuli. Method: Study included 343 patients divided in two groups. Group 1: low risk pregnancies and group 2: gestational hypertension. Ultrasound prenatal auditory screening was performed after the 27th week of gestation. Results: The percentage of fetuses with increase of cerebral blood flow was slightly higher in the pregnancies with hypertension. Conclusion: An average change of PI of median cerebral artery was higher in this group.