2014-2018年某院剖宫产率及剖宫产指征的变化情况分析

目的分析我院2014-2018年剖宫产率及剖宫产指征的变化,探讨降低剖宫产率的策略和措施。方法回顾性分析2014年1月至2018年12月于我院行剖宫产分娩的42385例产妇的临床资料,分析其剖宫产率及主要剖宫产指征。结果2016年的剖宫产率均低于2014年、2015年、2017年、2018年,差异具有统计学意义(P<0.05)。瘢痕子宫在二胎政策开放后所占比例明显增加;羊水过少及相对头盆不称所占比例呈现逐年下降的趋势。2014-2018年,母体因素所占比例均最高,胎儿因素及头盆因素所占比例逐年下降。另外,社会因素在二胎生育政策开放后仍呈上升趋势。结论2016年剖宫产率明显下降,瘢痕子宫在二胎政策开放后所占比例明显增加。临床需提高剖宫产术后再次妊娠阴道试产的比例、提高助产技术水平、发挥营养门诊及助产士门诊的作用、提高产科医生对胎心监护的正确解读以降低剖宫产率。     

Ecological study of gastric cancer in Brazil:Geographic and time trend analysis

AIM:To investigate the geographic distributions and time trends of gastric cancer(GC)incidence and mortality in Brazil.METHODS:An ecological study of the DATASUS registry was conducted by identifying hospitalizations for GC between January 2005 and December 2010.The data included information on the gender,age,and town of residence at the time of hospital admission and death.RESULTS:The GC rates,adjusted according to available hospital beds,decreased from 13.8 per 100000in 2005 to 12.7 per 100000 in 2010.The GC rates decreased more among the younger age groups,in which the male-to-female difference also decreased in comparison to the older age groups.Although the lethality rates tended to increase with age,young patients were proportionally more affected.The spatial GC distribution showed that the rates were higher in the south and southeast.However,while the rates decreased in the central-west and south,they increased in the northern regions.A geographic analysis showed higher rates of GC in more urbanized areas,with a coast-toinland gradient.Geographically,GC lethality overlapped greatly with the hospital admission rates.CONCLUSION:The results of this study support the hypothesis of a critical role for environmental factors in GC pathogenesis.The declining rates in young patients,particularly males,suggest a relatively recent decrease in the exposure to risk factors associated with GC.The spatial distribution of GC indicates an ongoing dynamic change within the Brazilian environment.     

miR-429 expression in bladder cancer and its correlation with tumor behavior and clinical outcome

We previously showed that microRNA-429 (miR-429) played an important role in epithelial–mesenchymal transition (EMT) of urothelial cell carcinoma of the bladder. We herein evaluated the expression of miR-429 in bladder cancer and its potential relevance to clinicopathological characteristics and patient survival. Relative expression levels of miR-429 in surgical bladder cancer tissue specimens obtained from 76 patients with bladder cancer were measured by chromogenic in situ hybridization. miR-429 expression was significantly higher in specimens from alive patients than expired patients in both of 5-year overall survival (OS) (0.59 ± 0.09 vs. 0.27 ± 0.12; p < 0.05) and 5-year recurrence-free survival (RFS) (0.63 ± 0.10 vs. 0.33 ± 0.10; p < 0.05). The univariate Cox proportional hazards analysis revealed that tumor grade, stage, and miR-429 expression were significantly associated with patient survival. In multivariate analysis, tumor stage and miR-429 expression were significantly associated with 5-year OS (hazard ratio [HR] 4.70, p < 0.001) and 5-year-RFS (HR 2.20, p < 0.05). The Kaplan–Meier analysis showed that patients with miR-429 expression had significantly better 5-year OS and 5-year RFS rates than those without miR-429 expression (84.4% vs. 61.4%, p < 0.05 and 71.9% vs. 45.5%, p < 0.05, respectively). miR-429 may be considered as an adjunctive prognostic marker in addition to tumor grade and stage in bladder cancer.     

不同药物对急性中毒性肾衰家兔作用效果的比较

目的观察10%葡萄糖、0.9%氯化钠溶液、肾上腺素对急性中毒性肾衰家兔的作用效果。方法制备家兔急性中毒性肾衰模型,观察急性中毒性肾衰状态下家兔动脉血压、心率、血尿素氮、血清肌酐的变化,以及注射10%葡萄糖、0.9%氯化钠溶液、肾上腺素对肾衰家兔动脉血压、心率、血尿素氮、血清肌酐的影响。对比肾衰前后以及肾衰后各药物注射后家兔的生命体征变化。结果肾衰家兔与正常家兔相比动脉血压下降,心率略下降,血清尿素氮、肌酐明显上升;肾衰家兔注射葡萄糖后动脉血压和心率都基本不变,血清尿素氮、肌酐略上升;注射0.9%氯化钠溶液后血压升高,心率略升高,血清尿素氮、肌酐略下降;注射肾上腺素后动脉血压上升,心率下降,血清尿素氮、肌酐明显下降。结论肾上腺素对急性中毒性肾衰家兔的治疗效果最佳。     

The Cardiovascular Response to Acoustic Stimuli

The purposes of this investigation were to determine whether adults display alterations of cardiac rate under acoustical stimulus conditions and whether such alterations are influenced by signal level. The stimulus consisted of a narrow band of noise centered at 1000 Hz and presented at 20, 40, 60 and 80 dB SPL. The stimulus was found to produce alterations of heart rate significantly different from variation under non-stimulus conditions, indicating that cardiovascular responses occurred. However, the responses themselves were unaffected by differences of sound pressure level.     

Type a Behavior and Cardiovascular Recovery from a Psychosocial Stressor

Abstract

The present study examined heart rate responses of Type A and Type B individuals during and after performance on the Stroop perceptual conflict task. The student version of the Jenkins Activity Survey was administered to thirty-two male Caucasians, who then performed the Stroop task for six minutes under conditions that emphasized time urgency and competition. Results showed that Type A's recovered significantly slower than Type B's after task completion. Type A's, compared to Type B's reported feeling more angry, time pressured, and impatient. The notion that Type A individuals may be at higher risk for coronary heart disease because of maladaptively prolonged cardiovascular arousal was discussed.     

Continuous Measurement of O2 Consumption and CO2 Elimination During a Wakeful Hypometabolic State

Abstract

A previous investigation has demonstrated that the practice of a meditational technique elicits a wakeful, hypometabolic state. Measurement of O₂ consumption and CO₂ elimination was made by sampling techniques; mean values of these parameters were calculated from 6–10 minute samples. The present study extends this investigation, using a recently developed method of continuous measurement of O₂ consumption and CO₂ elimination. Continuous measurement of these parameters permitted the determination of mean values for the entire experimental periods as well as for selected intervals and permitted the examination of the sequence of respiratory changes. The present study reports statistically significant decreases in O₂ consumption of 5 percent and CO₂ elimination of 6 percent for the entire 20 minutes of the meditation period. These are lower than the sample values of 16 percent and 15 percent reported in the previous study. However, when selected intervals of the meditation period are examined, decreases in O₂ consumption and CO₂ elimination are comparable to those previously reported. The results are consistent with the difference between the discontinuous sampling measurement method originally employed and the continuous measurement method of the present investigation.