胆红素对神经突触膜Na^＋,K^＋—ATP酶影响的实验研究

为了研究胆红素的神经毒性作用，对５９只出生２天的ＳＤ大白鼠分别予以腹腔注射不同剂量胆红素制造高胆红素血症动物模型，不连续密度梯度法分离提取脑神经元突触膜，测定Ｎａ＋，Ｋ＋－ＡＴＰ酶活力。结果：随着血清胆红素浓度的逐渐增加，脑组织中胆红素沉积量也逐渐增加，神经元突触膜Ｎａ＋，Ｋ＋－ＡＴＰ酶活力逐渐降低，Ｎａ＋，Ｋ＋－ＡＴＰ酶活力与脑组织中沉积的胆红素量呈负相关（ｒ＝－０．３４，Ｐ＜０．０１）。提示：胆红素对Ｎａ＋，Ｋ＋－ＡＴＰ酶具有抑制作用。     

妊高征患者合体滋养细胞质膜部分生化指标的变化

目的：研究妊高征（ＰＩＨＳ）患者胎盘合体滋养细胞质膜（ＳＴＣＰＭ）中生化指标的变化及原因。方法：ＰＩＨＳ２４例，其中轻度８例、中度７例、重度９例，以正常孕妇１８例作对照，用Ｗｈｉｔｓｅｔ等法制备ＳＴＣＰＭ，以孔雀石绿无机磷法（ＭＧＩｏＰＡ）测定ＡＴＰａｓｅ的活性，用ＤＰＨ荧光探针测定膜的微粘度来推断膜的流动性，用硫代巴比妥酸荧光微量测定法测丙二醛酸（ＭＤＡ）以代表脂质过氧化物（ＬＰＯ）。结果：ＰＩＨＳ组Ｎａ＋、Ｋ＋－ＡＴＰａｓｅ、Ｃａ２＋、Ｍｇ２＋－ＡＴＰａｓｅ活性均显著低于对照组（Ｐ＜０．０５），且随病情加重而降低，膜的流动性亦显著降低（Ｐ＜０．０５），ＭＤＡ则显著增高，且随病情加重而增高；ＭＤＡ与两种ＡＴＰ酸呈负相关关系（Ｐ＜０．０５）。结论：ＰＩＨＳ的ＳＴＣＰＭ生化指标发生变化，其变化的原因之一是脂质过氧化作用增强     

Recent Advances in Adsorptive Nanocomposite Membranes for Heavy Metals Ion Removal from Contaminated Water: A Comprehensive Review

Water contamination is one of the most urgent concerns confronting the world today. Heavy metal poisoning of aquatic systems has piqued the interest of various researchers due to the high toxicity and carcinogenic consequences it has on living organisms. Due to their exceptional attributes such as strong reactivity, huge surface area, and outstanding mechanical properties, nanomaterials are being produced and employed in water treatment. In this review, recent advances in the use of nanomaterials in nanoadsorptive membrane systems for wastewater treatment and heavy metal removal are extensively discussed. These materials include carbon-based nanostructures, metal nanoparticles, metal oxide nanoparticles, nanocomposites, and layered double hydroxide-based compounds. Furthermore, the relevant properties of the nanostructures and the implications on their performance for water treatment and contamination removal are highlighted. The hydrophilicity, pore size, skin thickness, porosity, and surface roughness of these nanostructures can help the water permeability of the nanoadsorptive membrane. Other properties such as surface charge modification and mechanical strength can improve the metal adsorption effectiveness of nanoadsorptive membranes during wastewater treatment. Various nanocomposite membrane fabrication techniques are also reviewed. This study is important because it gives important information on the roles of nanomaterials and nanostructures in heavy metal removal and wastewater treatment.     

Management of premature rupture of membranes before 25 weeks

OBJECTIVES: The aim of our study was to define the benefits and risks related to expectant management in the midtrimester rupture of membranes and to assess the prognostic factors in order to give objective informations to parents facing these obstetrical situations. STUDY DESIGN: We conducted a retrospective study. The study population included 49 patients with premature rupture of membranes at 16-23 weeks' gestation during the period January 1998-June 2003. The main criterion for judgement was neonate survival. Statistical analysis included chi2-test for the qualitative variables and Student's test for the quantitative variables. The threshold for significance was 5%. RESULTS: Twenty couples out of 49 chose medical termination of pregnancy. Among the 29 other pregnancies, the mean latency period was 2.1 weeks. The mean gestational age at delivery was 23.2 weeks. Nineteen patients were delivered after 22 weeks. The main prognostic factors were the initial amniotic fluid index (2.9 cm versus 0.8 cm) (p=0.042) and gestational age at delivery (26.7 weeks versus 22.6 weeks) (p<0.001). About 2% of the pregnancies were complicated by maternal infection. Eighty-three percent of the survivors had neonatal respiratory distress syndrome. 41.2% of them presented sepsis. We observed no cases of severe intraventricular haemorrhage. The number of infants born after 24 weeks of gestation and still alive at 1 week was 12, representing 24% of pregnancies and 63% of the infants born after 24 weeks. CONCLUSION: Expectant management can be widely suggested to patients. However, termination of pregnancy is acceptable, in cases with a poor prognosis including anamnios and premature rupture of membranes before 21 weeks.     

妊娠高血压综合征及过期妊娠时胎膜超微结构的观察

报告正常足月产、妊娠高血压综合征及过期妊娠时胎膜在光镜和电镜下的结构及变化特点。观察发现,妊娠高血压综合征时胎膜为缺氧所致的可复性病变,而过期妊娠之胎膜则为不可复性自身老化。胎膜广泛纤维化表明在妊娠高血压综合征和过期妊娠时易发生早破膜。此外,尚讨论了胎膜屏障存在的可能机制及明、暗细胞这一现象。     

活化素A在未足月胎膜早破合并羊膜腔感染中的表达及临床意义

目的：探讨活化素A在未足月胎膜早破合并羊膜腔感染中的表达水平及其临床意义。方法将我院妇产科2014年4月至2015年3月收治的30例未足月胎膜早破合并羊膜腔感染(IAI)患者作为观察组,另选同期30例未足月胎膜早破患者为对照组,在征得两组患者知情同意下对其活化素A表达水平进行测定及比较,以分析活化素A在未足月胎膜早破合并羊膜腔感染诊断中的应用价值。结果观察组患者的血清活化素A表达水平和羊水中活化素A表达水平分别为(245.35±12.85) pg/mL、(396.21±5.33) pg/mL,均明显高于对照组的(132.44±11.46) pg/mL、(277.65±5.21) pg/mL,组间比较差异均有统计学意义(P<0.05);观察组中轻度未足月胎膜早破合并羊膜腔感染者血清、羊水中活化素A表达水平分别为(120.85±11.84) pg/mL、(360.72±5.50) pg/mL,均低于中、重度未足月胎膜早破合并羊膜腔感染者的(370.44±12.92) pg/mL、(500.24±5.75) pg/mL,差异均有统计学意义(P<0.05)。结论活化素A表达水平与未足月胎膜早破合并羊膜腔感染息息相关,膜腔感染程度越高,则其表达水平越高,可作为临床判定是否发生羊膜腔感染以及感染程度的重要参照指标。     

Reverse Swiss Roll technique for diabetic vitreous membranes

Background:Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing.Purpose:To demonstrate a safe reverse swiss roll technique to dissect diabetic vitreous membranes.Synposis:Approaches and techniques for membrane dissection are segmentation, delamination and en-bloc dissection using various types of instruments and illumination. With vitreous cutte, picks and scissors, surgical steps are traditionallu performed by using classic lift and shave technique. After identifying the plane, tissue is lifted and then cut, which puts the retina at risk of break because of traction and active suction. Such a threat can be reduced by placing the cutter above the membrane thereby having the membrane itseld acting as a protective cushion to the retina. Port here, unlike lift and shave technique, doesn’t face the edge of membrane but is exactly 180 degree opposite and membrane curls into port because of suction. Also, hemostasis is maintained by continuous aspiration and cutting as the instrument is moved side to side, retracting from the edge.Highlights:Reverse swiss roll technique is safer compared to lift and shave because of the safety cushion of the membrane between the port and the retina. There is inherently less chances of retinal break because the active suction from the port is directed away from the retina. The technique also minimises traction and localised pull on the atrophic macula.Video link: https://youtu.be/WNnSsP69ZLw     

初产妇足月妊娠胎膜早破胎头高浮对分娩方式的影响及处理方法

目的 探讨初产妇足月妊娠胎膜早破胎头高浮对分娩方式的影响及处理方法.方法 选取2011年1月～2013年1月在我院住院分娩与治疗的214例初产足月妊娠胎膜早破胎头高浮且无其他任何相关性疾病的患者作为研究组,再选取同期214例初产足月妊娠胎膜早破胎头入盆且无其他任何相关性疾病的患者作为对照组,记录两组患者的分娩方式、潜伏期及活跃期,对产后新生儿进行Apgar评分和体质检测,对数据进行分析.结果 两组患者在潜伏期低于8小时、8～16小时之间及活跃期低于4小时的人数比较,差异均有统计学意义（均P＜0.05）;两组患者阴道正常顺产和剖宫助产的人数对比,差异均具有统计学意义（均P＜0.05）;两组胎儿宫内窘迫例数、新生儿Apgar评分＜7分例数以及新生儿平均体重比较,差异均具有统计学意义（均P＜0.05）.结论 胎膜早破后胎头高浮极易引起难产且严重危害围产儿体质,产科医护人员需要重视胎膜早破胎头高浮孕妇的临床观察,加强孕妇的孕期保健,产前严密观察孕妇头盆关系,严格试产.     

胎膜早破孕妇宫颈支原体和衣原体感染情况及支原体药敏分析

目的 了解湖州市妇幼保健院因胎膜早破住院分娩的孕妇宫颈支原体和衣原体感染情况及支原体药敏分析。方法 选择湖州市妇幼保健院胎膜早破孕产妇208例为观察组,无胎膜早破分娩孕产妇100例为对照组,对观察组及对照组孕产妇的宫颈分泌物进行支原体培养+药敏检测。结果 观察组支原体、衣原体总感染率为47.12%（98/208）,支原体感染率44.71%（93/208）,沙眼衣原体感染率为5.28%（11/208）,与对照组比较,观察组的UU、MH、CT总感染率及UU、MH感染率、CT感染率均较对照组升高（P<0.05）,且两组孕妇支原体感染中均无单一人型支原体MH感染,人型支原体MH感染均以与UU混合感染形式存在。沙眼衣原体感染中亦多半以与UU混合感染形式存在。支原体阳性标本药敏试验显示,解脲支原体UU、MH及UU联合MH对强力霉素、美满霉素、交沙霉素的敏感度较高,可达100%。结论 胎膜早破孕妇宫颈支原体检出率高提示孕妇胎膜早破与宫颈支原体感染密切相关,衣原体检出率虽然不高,但与对照组相比却明显升高,提示孕妇胎膜早破与沙眼衣原体感染也有一定的相关性,故建议在计划妊娠前、妊娠早、中晚期应进行筛查,做到早发现早治疗,性伴侣同时治疗,减少PROM的发生,提高生育质量。支原体药敏试验提示支原体对多种药物耐药,但对强力霉素、美满霉素、交沙霉素敏感度较高。