正常足月孕妇骨矿物质含量的测定

用单光子吸收法对足月孕妇尺、桡骨骨矿物质含量（ＢＭＣ）、骨面密度（ＢＭＣ／ＢＷ）进行测定及作血清钙、磷的生化测定。结果显示：足月孕妇的尺、桡骨骨矿物质含量、骨面密度明显低于同年龄组的未孕妇女。主要因为妊娠胎儿的骨胳生长发育，需要孕妇向胎儿输送大量的钙离子，若母亲对钙摄入不足或吸收不良，则造成孕妇的骨矿物质含量降低，骨质疏松；而孕妇血清钙、磷降低不明显。     

Blood pressure reduction in pregnancy by sodium chloride.

Volume expansion in the presence of elevated aldosterone availabilityis a hallmark of normal pregnancy. Intravascular volume depletioncharacterizes severe pregnancy-associated disease conditionssuch as intra-uterine growth retardation, chronic hypertensionor pre-eclampsia [1]. Two hypotheses have been forwarded toexplain volume depletion in pregnancy: the first hypothesischarges inappropriate sensing of vascular ‘overfilling’,resulting in an increased transendothelial loss of fluid tothe extravascular compartment. In contrast, the second hypothesisfocuses on vascular ‘underfilling’ due to inappropriatelylow aldosterone levels. The second hypothesis is based on theassumption that a compensatory increase in the circulating fluidvolume is required in normal pregnancy to support fetal substratedelivery. According to the second concept, maternal blood pressureincreases due to counter-regulatory mechanisms when placentalblood supply is reduced [2]. In support of the ‘underfilling’hypothesis are observations that a     

长沙地区孕妇CMV感染状况及其临床追踪观察

研究了７７例长沙地区孕、产妇的宫颈排毒（ＣＭＶ）情况及母、婴的免疫状态，并对宫颈排毒及ＣＭＶ一ＩｇＭ阳性的母亲所生小孩进行临床追踪。结果显示：孕妇宫颈排毒率为４．５％，抗ＣＭＶ－ＩｇＧ和抗ＣＭＶ－ＩｇＭ阳性率分别为７７％和１３％，５９例脐血ＣＭＶ－ＩｇＭ阴性。宫颈排毒的３例其抗体检测抗ＣＭＶ－ＩｇＧ均阳性，抗ＣＭＶ－ＩｇＭ仅一例阳性。作者认为，对妊娠期活动性ＣＭＶ感染的诊断，仅检测抗ＣＭＶ－ＩｇＧ和抗ＣＭＶ－ＩｇＭ抗体滴度仍不足，尚须结合病毒分离和其它检测手段。     

Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin.

A patient who suffered from polycystic ovarian disease and anovulation, was treated with pure follicle stimulating hormone for induction of ovulation. The treatment was stopped and human chorionic gonadotrophin was not administered because of high serum oestradiol levels and multiple follicular development. Ovulation occurred 11 days after pure follicle stimulating hormone was discontinued, the patient developed third-degree ovarian hyperstimulation syndrome and conceived with a quintuplet pregnancy.     

未破裂期输卵管妊娠介入治疗术的护理配合

目的 :根据 14例未破裂期输卵管妊娠病人在介入治疗过程中的护理配合 ,提出术前、术中、术后的护理配合是介入治疗成功的重要环节。方法 :14例病人中 ,7例采用经阴道输卵管孕囊内药物注射方式 ,7例采用经健侧股动脉穿刺子宫动脉内插管灌注栓塞方式。结果 :全部病例均获得满意的疗效。结论 :随着介入技术的应用和普及 ,对护理工作提出了更高的要求 ,总结经验、完善新技术条件下的护理配合 ,是摆在护理工作者面前的一项新任务     

Perception and social consequences of tuberculosis: A focus group study of tuberculosis patients in Sialkot, Pakistan

Treatment defaulting is one of the major causes of the failure of TB control programs. In Bethania Hospital. Sialkot, defaulting rates are high: 72% for the standard 12 months course and 56% for the 8 months course. Attrition is especially important in the first weeks of treatment: < 70% of the patients start the 10th week of treatment. A focus group discussion study has been carried out to gain a better understanding of the impact of social stigmatization, treatment cost and pregnancy on defaulting. The study population consisted of 3 male and 3 female groups each with 8 hospitalized TB patients. The study shows that TB is perceived as a very dangerous, infectious and incurable disease. This perception has many social consequences: stigmatization and social isolation of TB patients and their families; diminished marriage prospects for young TB patients, and even for their family members; TB in one of the partners may lead to divorce. Due to fear patients often deny the diagnosis and reject the treatment. While both male and female TB patients face many social and economical problems, female patients are more affected. Divorce and broken engagements seem to occur more often in female patients. Females are usually economically dependent on their husbands and family in law, and need their cooperation to avail of treatment. The belief that pregnancy enhances the risk for relapse decreases their marriage prospects. Pregnancy is also a reason for stopping TB treatment as both are considered as incompatible. The findings of this study reveal the urgent need for a health education campaign to convince the general population that tuberculosis is curable. All health care providers should act as destigmatizers.     

口服抗原对巨噬细胞共刺激分子CD80/CD86表达的影响

目的探讨口服抗原对巨噬细胞(M)共刺激分子CD80/CD86表达的影响及其在诱导妊娠免疫耐受中的作用。方法自然流产小鼠(CBA/J×DBA/2)分为免疫组和未免疫组,免疫组分别口服滋养细胞膜抗原(TMA2)和卵清蛋白(OVA),以正常妊娠小鼠(CBA/J×BALB/c)作为对照组。采用双标记流式细胞分析技术,分别检测各组小鼠脾脏及肠系膜淋巴结(MLN)CD80 M和CD86 M的表达。结果MLN内,未免疫组CD80 M表达明显高于对照组(P<0.05),而CD86 M含量明显低于对照组(P<0.001);TMA2免疫组CD80 M含量明显低于未免疫组(P<0.05);OVA免疫组CD86 M含量明显高于未免疫组(P<0.001)。脾脏内,CD80 M表达在各组间比较无显著差异;CD86M表达,未免疫组明显低于对照组(P<0.05),TMA2免疫组显著低于未免疫组(P<0.05),OVA免疫组则显著高于未免疫组(P<0.001)。结论流产的发生与M表面共刺激信号CD80/CD86异常有关;口服适当抗原可改变CD80/CD86 M表达模式,诱导妊娠免疫耐受的形成。     

Mechanobiology and force transduction in scars developed in darker skin types

BACKGROUND: Scarring is a complex process involving many cell types, cytokines and biological pathways including mechanobiology. Some subtle mechanical properties of skin can be assessed by measuring the speed of ultrasound shear wave propagation. The orientation of abnormal skin tension forces can be visualized, particularly in darker skin types, using dermoscopy showing distinct patterns of rete ridges' conformation. AIM: To assess some mechanobiological features of scars in darker skin types. PATIENTS AND METHODS: Large atrophic and hypertrophic surgical scars were examined on the trunk of 35 darker skin subjects. The surrounding skin was used as a comparator. Dermoscopic aspects were recorded. Resonance running time measurements (RRTM) were performed using a shear wave propagation device (Reviscometer). They were performed in four specific directions at given angles with regard to the long axis of the scar. The minimum, maximum and mean RRTM values were recorded at each site. RESULTS: Dermoscopy revealed patterns of melanin deposits in scars distinct from the normal honeycomb network seen in the surrounding skin. Hypertrophic scars showed a patchy pattern of large macular melanoderma dispersed in a lighter background. In these cases, low RRTM values were obtained with little variations according to the orientation of the measurements. By contrast, atrophic scars showed a streaky laddering melanotic pattern under dermoscopy. Higher RRTM values were often obtained, particularly in the transversal direction of the scars. Mechanical anisotropy was greater in the atrophic scars compared with the normal skin. DISCUSSION: Darker skin types represent a model for visualizing the main orientation of the epidermal rete ridges. A correlation was found between the pattern of melanized rete ridges of scars and the main orientation of the intrinsic forces in the skin.     

ALTERATION OF CHOLESTEROL SULFATE IN HUMAN SERA DURING THE COURSE OF PREGNANCY

Objective To determine the concentrations of cholesterol sulfate ( CS) in human sera and pla-cental villi during the course of pregnancy. And to analyze its inhibitory activity on thrombin and further characterize the functional significance of CS. Methods The concentrations of CS were determined by thin-layer chromatog-raphy (TLC) on 60 cases of normal pregnant women and 30 cases of normal placental villi. The effect of CS in human sera on the activity of thrombin was analyzed. Results The concentrations of CS in human sera gradually increased from the first to third trimester of gestation with a correlation coefficient of 0. 69, and a correlation between the concentration of CS and weeks of gestation (P <0. 01). CS was also contained in the placental villi, and its concentrations at the second and third trimester of gestations were 4. 7 and 6. 2-fold of that at the first trimester of gestation. CS inhibited the activity of thrombin. Conclusion Placental CS is one of the sources of CS in the serum , pr