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The Relationship between the Implantation of Ovarian Stimulated Embryos and the Expression of Leukemia Inhibitory Factor Protein in Mice Metrium

观察受体鼠妊娠和胚胎着床情况,并检测胚胎移植时小鼠子宫内膜中白血病抑制因子(Lif)表达水平,探讨超排卵对小鼠胚胎着床潜能的影响。方法:建立超排周期胚胎和自然周期胚胎移植小鼠模型,比较妊娠率、胚胎着床率的差异及其与Lif蛋白的表达水平之间的关系。结果:超排卵周期受体组的妊娠率(20.00%)和胚胎着床率(8.33%)显著低于自然周期组的妊娠率(55.00%)和胚胎着床率(35.00%)(P＜0.05)。自然周期胚胎和超排周期胚胎受体组内膜中Lif蛋白的表达水平相似(P＞0.05),妊娠受体组Lif蛋白的表达水平显著高于未孕受体组(P＜0.05),但单胎妊娠和多胎妊娠受体组内膜中Lif蛋白的表达水平相似(P＞0.05)。结论:超排卵可能降低胚胎的着床潜能,Lif蛋白的表达水平与胚胎着床有关,但与着床胚胎的数目无比例关系。

Ultrasonographic Diagnosis for Ovaria Torsion during the Pregnant Period of 11 Cases

摘要:目的: 探讨二维及彩色多普勒超声对妊娠合并卵巢扭转的诊断价值。 方法 :对11例经手术及病理证实的妊娠合并单纯卵巢扭转,进行二维及彩色多普勒和能量多普勒超声图像分析。 结果 :11例患侧卵巢在二维图像中均有不同程度的肿大,超声压痛征均呈阳性反应;其中7例有明显的位置改变,5例有不同程度的盆腔积液;彩色多普勒和能量多普勒显示患侧卵巢内部均无明显血流信号。 结论 :妊娠期卵巢扭转有典型超声图象特征,可为临床提供较可靠的诊断依据。Abstract: Objective: To evaluate the diagnostic value of two dimension ultrasound (2DUS), color Doppler flow imaging (CDFI) and power Doppler imaging (PDI) for ovarian torsion during the pregnant period.〖WTHZ〗Methods : Using the techniques of 2DUS, CDFI and PDI to analyze sonographic features of 11 ovarian torsion cases which were dominated by operation and pathology.〖WTHZ〗Results : The tumescent sick ovaries were detected in all case with ovaries torsion by 2DUS. The patient felt pain when their sick ovaries were pressed. The position of seven sick ovaries was changed. The pelvic effusion was detected in five cases. The blood flow signal was not demonstrated in all sick ovaries by CDFI and DPI.〖WTHZ〗Conclusion : The ultrasonic imaging characteristics are reliable to diagnose ovarian torsion during the pregnant period.

不同健康教育方式对妊娠期糖尿病相关因素的影响

【摘要】目的 探讨不同健康教育方式对妊娠期糖尿病患者治疗效果及母婴合并症的影响。方法 2005年6月-2009年9月将62例妊娠期糖尿病患者随机分为个体健康教育组(A组,31例)及集中健康教育组(B组,31例)。在应用胰岛素治疗的基础上,分别给予相应的健康教育,2个月后进行随访及生化检测,观察两组患者的空腹及餐后2 h血糖、糖化血红蛋白及并发症发生情况。结果 健康教育前,两组患者空腹及餐后2 h血糖、糖化血红蛋白比较均无统计学意义。实施不同健康教育后,A组患者空腹血糖、餐后2 h血糖、糖化血红蛋白明显优于B组(Plt;005);低血糖发生率、母婴合并症发生率均显著降低(Plt;0.05)。结论 个体化健康教育可有效地控制血糖,降低相关并发症的发生,且更有效地帮助妊娠期糖尿病患者达到安全分娩的目的。

子宫峡部剖宫产切口部位妊娠的彩色多普勒超声诊断分析

目的探讨子宫峡部剖宫产切口部位妊娠的彩色多普勒超声声像图特点，为临床诊疗提供有价值的参考依据。 方法选取2011年8月－2013年7月诊断的12 例子宫峡部剖宫产切口部位妊娠的患者作为研究对象，回顾性分析其彩色多普勒超声声像图特点及临床资料。 结果12例患者中5例停经时间短、妊娠囊较小，位置完全位于子宫峡部切口处因声像图典型而确诊；3例因停经时间长、妊娠囊大部分位于宫腔内，少部分位于切口处误诊为宫内孕；2例切口妊娠流产，误诊不全流产；另外2例因院外人工流产术后阴道流血增多就诊，诊断为切口妊娠。 结论彩色多普勒超声对子宫峡部剖宫产切口妊娠的诊断具有准确性、可靠性。

妊娠合并乳腺肉瘤一例

双胎妊娠临床结局分析

【摘要】 目的 探讨双胎妊娠剖宫产指征构成比、临床处理与妊娠结局的关系。 方法 对2000年1月-2009年8月321例双胎妊娠的临床资料进行回顾分析。 结果 ①A组第1胎儿为头位，191例双胎妊娠剖宫产指征首位为社会因素，其次为妊娠并发（合并）症、瘢痕子宫；B组第1胎儿为非头位，65例双胎妊娠剖宫产指征首位为单纯臀位因素（包括肩先露），其次为妊娠并发（合并）症、瘢痕子宫。②平均分娩孕周（36±4）周，剖宫产256例占79.75%， 经阴道分娩65例占20.25%。③剖宫产组新生儿体重≥2 500 g者高于阴道分娩组；两组第1胎儿新生儿窒息率比较无差异，第2胎儿经阴道分娩者新生儿窒息率明显高于剖宫产术者。校正孕周影响后，不同分娩方式间新生儿评分无差异。④lt;33孕周的双胎妊娠以阴道分娩为主，占83.33%；≥33孕周的双胎妊娠剖宫产率明显高于阴道产率。不同分娩方式的产后出血率无差异。 结论 双胎妊娠不是剖宫产的手术指征，孕期须加强监护管理，正确选择双胎妊娠的分娩方式，将有助于降低剖宫产率及新生儿窒息率。

妊娠晚期急腹症手术预防早产的护理

目的:探讨妊娠晚期急腹症手术预防早产的护理措施。方法:回顾分析26例妊娠晚期急腹症孕妇的术前、术后护理情况。结果:26例患者经及时治疗、精心护理,顺利痊愈出院。结论:做好妊娠晚期急腹症孕妇术前心理护理、监测患者生命体征及胎儿一般情况;术后严密监测生命体征变化、做好胎心、胎动的观察与护理疼痛的护理、采取合理的卧位、防止感染、加强饮食的护理和出院指导,这样才能及时发现早产或流产的征兆, 及早处理以保证母婴平安。

ANALYSIS OF FACTORS INFLUENCING PROGNOSIS OF BREAST CANCER ASSOCIATED WITH PREGNANCY AND LACTATION

The authors studied retrospectively clinical data of seventy cases with breast cancer during pregnancy and lactation.They were treated and diagnosed by operation and pathology.Primary factors influencing prognosis were analyzed.It was demonstrated that 5year survival rate of the patients were significantly influenced by clinical stage , month of pregnancy and lactation, time of symptoms, type of operation, type of pathology, histological grade of malignancy, recurrence and metastasis, and estrogen receptor status (Ｐ＜0.05).Age and termination of pregnancy had no beneficial effect on survival (Ｐ＞0.05).The prognosis of pregnant and lactating breast cancer was poorer than ordinary breast cancer.Their 5year survival rate were 55.7% and 74.3%, respectively. After they were matched for stage and for age, no difference in survival was found.Early diagnosis and radical operation combined with radiotherapy, chemotherapy and hormonal therapy have better prognosis.The method can shorten time of treatment and improve survival rate.Termination of pregnancy has not been shown to improve survival and shall not be advised routinely.Future pregnancy may be detrimental and shall be discouraged.

Serial Study of Liver Function Variables of Normal Pregnancy

目的:了解正常妊娠妇女血清中常用肝功能指标测定结果及变化。方法:分别在早孕（孕10～14周）、中孕（孕20～24周）、晚孕（孕30～34周）及产后（产后12周）四个时期序贯性测定120例正常妊娠妇女血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ谷氨酰转移酶（GGT）、乳酸脱氢酶（LDH）、总胆红素（TBIL）、直接胆红素（DBIL）、总蛋白（TP）、白蛋白（ALB）、前白蛋白（PA）的水平并进行比较。结果:ALT、AST在早、中、晚孕及产后各期相对于正常对照均升高（P＜0.01）；TBIL和DBIL在早、中、晚孕均降低（P＜0.01）；TP、ALB随孕期增加逐渐下降,产后回升,到产后12周上升到正常水平（早、中、晚孕P＜0.01,产后P＞0.05）；GGT在孕期中逐渐升高,于晚孕期达最高峰（P＜0.01）,产后稍有下降；LDH在孕早中期无明显变化（P＞0.05）,孕晚期上升,到产后12周仍呈一上升趋势（P＜0.01）；PA在孕早期低于正常对照（P＜0.01）,后随孕期上升,到中孕期后上升到正常（P＞0.05）。结论:本次实验观察到在妊娠期肝功指标ALT、AST、GGT、LDH升高,可能因为孕妇肝脏负荷增加、基础代谢和能量消耗增多、甾体激素水平增高引起。胆红素代谢指标及营养性指标TBIL、DBIL、TP、ALB、PA降低,可能是妊娠期血浆稀释引起。临床诊断妊娠合并肝功能损害时应考虑上述变化。

Systematic Review of Effects for S-Adenosyl-L-Methionin on Improving the Pregnancy Outcomes of Intrahepatic Cholestasis of Pregnancy

Objective　To assess the efficacy and safety of S-adenosyl-l-methionine (SAMe) for outcome improvement of intrahepatic cholestasis of pregnancy. Methods　Randomized controlled trials (RCT) and quasi-randomized controlled trials were identified from MEDLINE (1983 to 2003), The Cochrane Library (Issue 4,2003), EMBASE (1980 to 2003), China Hospital Digital Library (CHDL) and Wanfang data (1994 to 2003). We also handsearched the relative references. Two researchers evaluated the quality of the trials and extracted the data independently. RevMan software 4.2 was used for meta-analysis. Results　Eight studies involving 424 pregnant women were included. The following data were the results of meta-analysis of SAMe for improvements: ① Reducing cesarean-section ratio: no significant difference was seen between SAMe and placebo groups with OR 1.00, 95%CI 0.23 to 4.33 and P= 1.00; significant differences were seen SAMe versus dexamethasone and SAMe versus Dianglining with OR 0.44, 95%CI 0.23 to 0.85 and P=0.01; OR 0.28 95%CI 0.10 to 0.75 and P=0.01 respectively。② Prolonging the period of pregnancy: SAMe had no significant difference compared with placebo groups with WMD=0.70, 95%CI －0.69 to 2.10, P=0.32. SAMe was more effective than dexamethasone, Ganyinling and Qianglining on prolonging the period of pregnancy with WMD=1.10，95%CI 0.46 to 1.74, P=0.000 07; WMD=2.50，95%CI 1.86 to 3.14, P≤0.000 01; WMD=2.20，95%CI 1.61 to 2.79, P≤0.000 01 respectively；③ Increasing the weight of the newborn: meta-analysis showed that SAMe group had not significant difference compared with placebo group on increasing the weight of the newborn with WMD=-26.27，95%CI -338.35 to 285.82, P=0.87. Significant differences were seen between SAMe and dexamethasone, SAMe and Ganyiling, SAMe and Qiangling with WMD=386.86，95%CI 134.41 to 603.31, P=0.002; WMD=410.00,95%CI 321.10 to 498.90, P≤0.000 01 respectively. ④ Fetal distress: There was no significant difference compared with dexamethasone and Kuhuang groups on decreasing the fetal distress with OR=0.47, 95%CI 0.14 to 1.16, P=0.23; OR=0.44, 95%CI 0.10 to 1.97, P=0.29 respectively; ⑤ Decreasing pollution of amniotic fluid: no significant differences were seen in SAMe versus dexamethasone, SAMe versus ursoddeoxycholic and SAMe versus Kuhuang with OR=0.46, 95%CI 0.21 to 1.02, P=0.06; OR=0.68, 95%CI 0.20 to 2.31, P=0.53; OR=0.82 95%CI 0.24 to 2.81,P=0.75 recpectively. ⑥ Newborn stifile: SAMe group had no significant difference compared with dexamethasone and Kuhuang groups on decreasing the Newborn stifile with OR=0.19, 95%CI 0.01 to 4.06, P=0.29; OR=0.31, 95%CI 0.08 to 1.13, P=0.08 respectively. Compared with Qianglining group, SAMe group had better effect on reducing ratio of newborn stifile with OR=0.09, 95%CI 0.02 to 0.42, P=0.002. ⑦ Improving Apgar scores: no significant differences were seen between SAMe and placebo, dexamethasone and ursoddeoxycholic with OR=0.25, 95%CI 0.02 to 3.04, P=0.28; OR=2.09, 95%CI 0.70 to 6.27, P=0.19; OR=1.22, 95%CI 0.35 to 4.19, P=0.75 respectively. Six RCTs mentioned the side effects of S-adenosy-l-methionine, only one RCT reported mild gastrointestinal irritation. Conclusions　SAMe is partly effective on improving the pregnancy outcomes of intrahepatic choletasis of pregnancy, such as reducting cesarean-section ratio, prolonging the period of pregnancy and increasing the weight of the newborn. The specified efficacy and safety of SAMe require rigorously designed, randomized, double-blind and placebo-controlled trials to offer evidence.