妊娠期糖尿病患者血糖控制与妊娠结局的关系

目的探究妊娠期糖尿病(GDM)患者血糖控制与妊娠结局的关系。方法2017年12月—2019年12月间对该院65例GDM患者的病历资料做回顾性分析,并随机选取30名正常妊娠的孕妇作为健康对照组,GDM患者均给予常规治疗,依据血糖控制情况分为达标组及未达标组,血糖达标以美国糖尿病协会制定的血糖控制目标为标准,分别比较3组对象及围产儿并发症发生情况。结果3组对象分娩前FBG、2 hPG、HbAlc水平比较差异有统计学意义(F=36.100、37.634、48.209,P<0.05);达标组羊水过多、胎膜早破、妊娠期高血压、酮症酸中毒发生率分别为(5.45%、7.27%、5.45%、9.09%)均较未达标组的(60.00%、50.00%、60.00%、70.00%)更低,差异有统计学意义(χ²=21.104、12.950、19.059、20.854,P<0.05),与健康对照组比较差异无统计学意义(P>0.05),3组产后感染、产后出血、剖宫产发生率比较差异无统计学意义(P>0.05);达标组巨大儿、新生儿窒息、新生儿低血糖、胎儿窘迫发生率分别为(7.27%、5.45%、3.64%、1.82%)均较未达标组的(60.00%、50.00%、40.00%、40.00%)更低,差异有统计学意义(χ²=18.071、15.557、9.366、12.412,P<0.05),与健康对照组比较差异无统计学意义(P>0.05),3组早产儿发生率比较差异无统计学意义(P>0.05)。结论GDM患者血糖水平控制情况与其妊娠结局及围产儿并发症具有密切关系。     

妊娠晚期胎膜早破对产妇分娩方式及妊娠结局的影响

目的 探讨妊娠晚期胎膜早破对产妇分娩方式及妊娠结局的影响.方法 回顾性分析2018年9月至2019年3月医院收治的87例妊娠晚期产妇的临床资料,将体感不适但无胎膜早破的43例产妇设为对照组,将胎膜早破的44例产妇设为试验组,统计并比较两组胎方位、分娩方式和不良妊娠结局.结果 试验组枕前位发生率低于对照组,枕横位、枕后位...     

A Novel Characterization Method for Graft‐Polymer Structures Chemically Attached on Thermally Stable Polymer Films

Most polymer grafts in grafted polymer films obtained by radiation‐induced solid graft polymerization are not analyzed in detail due to difficulties in isolation of the grafts without structural decomposition. Herein, a novel structural and molecular weight characterization method is reported for polymer grafts that are chemically attached to thermally and chemically stable polymer substrates, based on a swelling‐induced graft detachment in hot water. Polymer grafts prepared by the radiation‐induced polymerization of alkyl acrylate into poly(ethylene‐co‐tetrafluoroethylene) (ETFE) followed by a sulfonation reaction are found to have a ternary copolymer structure whose monomer units contain –COOH or –SO₃H groups, or both.     

Oclusión temporal con balón de las arterias hipogástricas en una paciente con acretismo placentario

Placenta accreta spectrum is an abnormal placentation that results in an increase in maternal morbidity and mortality, which mostly occurs due to severe haemorrhage. We present the case of a patient diagnosed prenatally with placenta accreta spectrum, premature rupture of membranes and bleeding, who was managed by a multidisciplinary team. Temporary bilateral hypogastric balloon occlusion was placed before caesarean hysterectomy, with good results for the mother.     

213例胎膜早破者胎盘病理改变与妊娠结局的关系探讨

目的分析胎膜早破者胎盘病理改变情况,探讨其与妊娠结局之间的关系。方法在我院入住孕妇中选取213例胎膜早破者作为观察组,同时选取无胎膜早破的正常孕妇200例为对照组。采用常规HE染色对两组孕妇胎盘形态学进行观察,分析胎盘病理变化与妊娠结局的关系。结果两组中胎盘病理改变包括胎盘胎膜感染、合体细胞结节增多、间质血管增多、纤维化蛋白沉积、胎盘钙化等。其中观察组中各病理变化的发生所占比例与对照组比较明显升高,差异均具有统计学意义(P<0.05);对照组中新生儿感染、产褥感染、胎儿窘迫等妊娠结局的发生率明显低于观察组,差异具有统计学意义(P<0.05),对照组中新生儿窒息的发生率与观察组比较差异无统计学意义(P>0.05)。结论胎膜早破者胎盘病理改变与妊娠结局有密切关系,通过对胎盘病理改变的监测,对防治不良妊娠结局具有重要的指导意义。     

Optimization of the defibrillation current density in the heart region by a two-layer segmented electrode

Transthoracic defibrillation is a procedure applying high intensity electrical current through the thorax region by electrodes, in order to simultaneously activate most of the myocardial cells, thus enforcing them to reinstate a normal rhythm. A solution is proposed for analysis and synthesis of the current density distribution field J in the heart region. In an attempt to reach uniform excitation of the greatest possible quantity of myocardial cells, a field image is searched for, with the J-vector uniformity distribution as a criterion. The finite element method and the method of approximating functions are used, as well as nonlinear programming. This approach resulted in designing a two-layer defibrillation electrode, with the layer applied to the thorax divided in three different resistivity regions.     

A Review of Experimental Work on Radio-yttrium Comprising 1. The Tissue Distribution, 2. The Mechanism of Deposition in Bone,and 3. The State in the Blood

The author reviews the literature covering the deposition of injected radio-yttrium in soft tissues and bone. It is clear that when injected in a carrier-free form yttrium is a bone-seeking isotope. In the presence of carrier, aggregates of larger particle size are formed, and these show greater affinity for the soft tissues which have the highest proportion of reticulo-endothelial cells. The effect of chelating agents is to render the yttrium more soluble, thus increasing excretion; they reduce the extent of colloid formation and reduce the size of the colloidal particles formed. Contradictory reports as to the site of deposition of yttrium can be explained by the fact that the authors have not appreciated the radiocolloidal properties of yttrium and that insufficient attention has been paid to the form in which it is present in the blood-stream.     

未足月妊娠胎膜早破临床诊治相关因素分析

目的对未足月妊娠胎膜早破临床诊治的有关因素进行分析。方法以96例孕28～36周即出现胎膜早破的患者作为观察对象,根据孕周的不同采用不同的治疗及处理方式,并对治疗结果进行统计和整理。结果孕周小于34周产儿的并发症和死亡率最高,而孕周为36周围生儿的并发症和死亡率则与足月儿相当。结论对于未足月妊娠胎膜早破的治疗应根据孕妇孕周的长短合理选择治疗措施,以便确保母婴安全,减少早产儿并发症的发生。     

Cost-effectiveness of maternal immunization against neonatal invasive Group B Streptococcus in the Netherlands

BackgroundNeonatal invasive Group B Streptococcus (GBS) infection causes considerable disease burden in the Netherlands. Intrapartum antibiotic prophylaxis (IAP) prevents early-onset disease (EOD), but has no effect on late-onset disease (LOD). A potential maternal GBS vaccine could prevent both EOD and LOD by conferring immunity in neonates.ObjectiveExplore under which circumstances maternal vaccination against GBS would be cost-effective as an addition to, or replacement for the current risk factor-based IAP prevention strategy in the Netherlands.MethodsWe assessed the maximum cost-effective price per dose of a trivalent (serotypes Ia, Ib, and III) and hexavalent (additional serotypes II, IV, and V) GBS vaccine in addition to, or as a replacement for IAP. To project the prevented costs and disease burden, a decision tree model was developed to reflect neonatal GBS disease and long-term health outcomes among a cohort based on 169,836 live births in the Netherlands in 2017.ResultsUnder base-case conditions, maternal immunization with a trivalent vaccine would gain 186 QALYs and prevent more than €3.1 million in health care costs when implemented in addition to IAP. Immunization implemented as a replacement for IAP would gain 88 QALYs compared to the current prevention strategy, prevent €1.5 million in health care costs, and avoid potentially ~ 30,000 IAP administrations. The base-case results correspond to a maximum price of €58 per dose (vaccine + administration costs; using a threshold of €20,000/QALY). Expanding the serotype coverage to a hexavalent vaccine would only have a limited additional impact on the cost-effectiveness in the Netherlands.ConclusionsA maternal GBS vaccine could be cost-effective when implemented in addition to the current risk factor-based IAP prevention strategy in the Netherlands. Discontinuation of IAP would save costs and prevent antibiotic use, however, is projected to lead to a lower health gain compared to vaccination in addition to IAP.