妊娠及其相关因素与初孕妇压力性尿失禁的关系

目的  探讨妊娠相关因素与初孕妇压力性尿失禁（SUI）的关系,不同孕周尿道膀胱连接部移动度（UVJ-M）的变化以及SUI患者与无SUI者UVJ-M的变化。方法  采用国际尿失禁咨询委员会尿失禁问卷表简表（ICI-Q-SF）对182例初孕妇,其中孕期SUI者78例与无SUI者104例,于孕6～10、24～28和36～40周及产后6～8周进行问卷调查,并行会阴部超声,分析妊娠相关因素与初孕妇SUI的关系以及UVJ M的变化。结果  ① 孕6～10、24～28、36～40周、产后6～8周SUI发病率分别为3.85%、13.19%、25.82%、2.20%。孕6～10与孕24～28周、孕24～28与孕36～40周、孕36～40与孕6～10周、孕24～28与产后6～8周、孕36～40与产后6～8周SUI发病率两两比较差异有统计学意义(P＜0.05);② 孕6～10、 24～28、 36～40周、产后6～8周UVJ-M分别为（3.26±1.62）、（4.67±1.47）、（6.65±1.12）、（2.64±0.97）mm。孕6～10与孕24～28周、孕24～28与孕36～40周及孕36～40与孕6～10周、孕24～28与产后6～8周、孕36～40与产后6～8周UVJ-M两两比较差异有统计学意义(P＜0.05);③ 同一妊娠阶段SUI患者与无SUI者UVJ-M比较差异均有统计学意义（P＜0.05）。结论  SUI发病率随妊娠周数的增加而上升,且UVJ-M逐渐增大;同一妊娠阶段SUI者与无SUI者UVJ-M比较有明显增大。     

松芪胶囊对小鼠应激能力和抗氧化酶的实验研究

目的研究松芪胶囊对小鼠应激能力和血中超氧化物歧化酶（SOD）、丙二醛（MDA）水平的影响,进而探讨松芪胶囊的抗衰老作用机制。方法取小鼠随机分为松芪胶囊大、小剂量组和对照组,然后行小鼠游泳耐疲劳、耐寒冷、常压耐缺氧实验,测定并比较松芪胶囊组与对照组血清MDA含量和SOD的活性。结果松芪胶囊可以提高小鼠在低温环境下的耐寒冷能力,降低死亡率;延长小鼠力竭游泳时间,提高抗疲劳能力;延长小鼠常压耐缺氧时间,提高抗耐缺氧能力;同时使血清SOD活力明显升高、MDA含量明显降低,与对照组相比,差异有统计学意义（P〈0.01）。结论松芪胶囊具有良好的体内抗氧化作用,可以延缓衰老。     

舒芬太尼对腹腔镜下胆囊切除应激反应的抑制作用

目的观察舒芬太尼全凭静脉麻醉对腹腔镜下胆囊切除术心血管应激反应的抑制作用。方法择期行腹腔镜下胆囊切除术患者40例,ASAI-Ⅱ级,随机分为舒芬太尼组和芬太尼组。舒芬太尼组0.6μg/kg诱导,持续静脉输注舒芬太尼0.01μg/（kg.min）维持;芬太尼组3μg/kg诱导,持续静脉输注芬太尼0.05μg/（kg.min）;记录麻醉诱导前（T1）、气管插管后2min（T2）、气腹完全充气后10分钟（T3）、胆囊切除时（T4）及术毕拔管后2min（T5）的心率（HR）、平均动脉压（MAP）。结果与T1时比,舒芬太尼组T2、T4时MAP均明显低于T1时（P〈0.05）,HR无明显变化（P〉0.05）;与T1时比,芬太尼组T3、T4、T5时MAP明显高于T1时（P〈0.05）,HR也明显增快（P〈0.05）。除T1外,舒芬太尼组各时点MAP均明显低于芬太尼组（P〈0.05）;T5时点舒芬太尼组心率明显慢于芬太尼组（P〈0.05）。结论腹腔镜下胆囊手术病人,5舒芬太尼较芬太尼更有效抑制麻醉手术的伤害刺激的应激反应,异丙酚用量亦较少。     

女性盆底功能障碍疾病诊断及康复治疗效果研究

目的探讨女性盆底功能障碍疾病的诊断、有效的康复治疗方法及其治疗效果.方法采用问诊、临床检查、低频电诊断、女性性功能障碍量化评分表等方法综合诊断,应用凯格尔盆底康复锻炼、生物反馈治疗、电刺激治疗、阴道康复器治疗等方法对产后有盆底功能障碍疾病的妇女进行综合治疗,评价治疗效果.结果综合治疗总有效率100%,其中治愈率61%,好转率39%.压力性尿失禁患者治愈率57.4%;盆腔器官脱垂患者治愈率59.7%;性功能障碍患者治愈率61.0%.结论凯格尔盆底康复锻炼、生物反馈治疗、电刺激治疗、阴道康复器治疗等综合治疗方法,是女性盆底功能障碍疾病治疗的有效方法.     

急性脑卒中患者应激性高血糖的临床意义

目的研究急性脑卒中患者起病48h内血糖水平与脑卒中严重程度、卒中类型和预后的关系。方法测定300例无糖尿病史的急性脑卒中患者起病48h内的血糖水平。结果本组300例中,脑出血108例中发现应激性高血糖45例,占41.7%;脑梗死192例中出现应激性高血糖39例,占20.3%,脑出血应激性高血糖出现率显著高于脑梗死(P<0.01)。300例中,正常血糖组216例,死亡5例,占2.3%;高血糖组84例,死亡19例,占22.6%。高血糖组病死率显著高于正常血糖组(P<0.01)。216例血糖正常组中,重症8例,占3.7%;血糖升高组84例中,重症32例,占38.1%,两者相比具有显著性(P<0.01)。结论急性脑卒中无糖尿病史发生应激性血糖升高患者的血糖水平,可作为判断其症状、观察病情变化、判断预后的参考指标。     

盆底肌功能训练预防和治疗产后尿失禁的临床观察

目的探讨产后进行盆底肌肉锻炼(PFMT)对产后压力性尿失禁的影响。方法将192例住院自然分娩初产妇,随机分为观察组和对照组。对照组实施常规产后健康教育指导,观察组由专业助产士实施8周以上一对一的健康教育及盆底肌功能训练指导。分别于产后3、6及12个月随访,通过两组排尿状况、盆底肌张力及尿垫试验进行评估,评价PFMT对产后压力性尿失禁的影响。结果观察组产后3、6、12个月排尿状况评分、盆底肌张力强度评分与对照组比较,差异显著有统计学意义(P<0.001),产后6、12个月尿垫试验阳性率与对照组比较,差异有计学意义(P<0.05,P<0.01)。结论产后行PFMT可以有效防治产后压力性尿失禁的发生和发展。     

中西医结合治疗大面积脑梗死后应激性溃疡75例疗效观察

目的观察中西医结合治疗大面积脑梗死后应激性溃疡的临床疗效。方法将75例患者随机分为治疗组和对照组,治疗组38例和对照组37例,对照组采用西医综合治疗(即保护胃黏膜、抗感染、降颅压、保护脑细胞、稳定血压、维持水电解质平衡等措施),治疗组在对照组治疗的基础上加用中药汤剂(自制和胃汤:大黄、制半夏、厚朴、苏梗各10g,田七片15g,浙贝15g,黄连15g,旱莲草30g,白术10g,白芨10g),每日一剂分早、晚两次鼻饲。两组均连续治疗3d后观察临床疗效。结果治疗组的总有效率68.42%,对照组为56.76%,两组疗效有显著性差异(P<0.05)。结论在西医综合治疗基础上,加用自拟和胃汤治疗大面积脑梗死后应激性溃疡,能缩短疗程,促进溃疡修复,有较好疗效。     

LC, LC-MS/TOF and MS(n) studies for the identification and characterization of degradation products of nelfinavir mesylate

The objective of the present investigation was to separate, identify and characterize the major degradation products (DPs) of nelfinavir mesylate generated under hydrolytic, oxidative, photolytic and thermal stress conditions as advised in International Conference on Harmonization (ICH) guideline Q1A(R2). The drug was found to degrade under acidic, basic, oxidative and photolytic stress, while it was stable in neutral and thermal stress conditions. A total of three degradation products were formed, which were separated on a C-18 column employing a gradient HPLC method. A complete mass fragmentation pathway of the drug was first established with the help of multi-stage (MS(n)) and MS/TOF accurate mass studies. Then stressed samples were subjected to LC-MS/TOF studies, which provided their fragmentation pattern and accurate masses. The mass spectral data were employed to characterize the DPs and assign structures to them. The total information was also used to establish the degradation pathway of the drug. The degradation products were identified as 3-hydroxy-N-((2R,3R)-3-hydroxy-1-(phenylthio)butan-2-yl)-2-methylbenzamide and (3S,4aS,8aS)-N-tert-butyl-2-((2R,3R)-2-hydroxy-3-(3-hydroxy-2-methylbenzamido)-4-(phenylsulfinyl)butyl)decahydroisoquinoline-3-carboxamide.     

Genes differentially expressed in CB1 knockout mice: Involvement in the depressive-like phenotype

Recent hypotheses to explain the neurobiology of depression underline the role played by stress in mood disorders. The endocannabinoid system is one of the major physiological substrates involved in emotional responses and stress. Thus, mice lacking CB₁ receptor exhibit a depressive-like phenotype and an increased vulnerability to deleterious effects of stress. In order to identify possible molecular pathways contributing to this phenotype, we have examined the gene expression profile of mutants at basal conditions and after the exposure to repeated stress. Several genes coding for neurotransmitter receptors, neurotrophic factors, neuropeptides and hormones receptors were differentially expressed in CB₁ knockout mice.     

Effect of relaxation on the level of nursing internshipstudents＇ stress

Objective： To explore how relaxation reduce the effect of stress in Iranian nursing students. Methods： A total of 40 nursing students were randomly selected and divided into two groups of test and control each with 20 students. An exam questionnaire consisting of the stress test of Spilberger and control of physiological determinants （blood pressure, pulse respiration, temperature） was performed to two groups. The practice of relaxation continued for two weeks and three times a day. Data were collected and analysed using t-test and Chi-square. Results： Two groups did not show any difference in relation to the average of physiological determinants before and after investigation. However, pulse was significantly different between the two groups. The average scores of stress before and after relaxation were significantly differed between the two groups investigation so that the level of stress was reduced in the test group （t= 2.5, df =39, P= 0.02）. Conclusion： To alleviate stressors associated with clinical practice and create a healthy work environment for practice it is recommended that nursing students have some relaxation before entering practical environments.