疤痕子宫妊娠妇女经产道分娩的可行性、安全性和相关危险因素分析

目的:探讨疤痕子宫妊娠妇女经产道分娩的可行性、安全性和相关危险因素。方法:选择疤痕子宫妊娠妇女120例,根据分娩方式的不同分为剖宫产组(80例)与自然分娩组(40例),观察再次剖宫产的原因与两组的预后情况。结果:再次剖宫产的指征主要为疤痕子宫(患者拒绝试产)、产程异常、胎儿窘迫、前置胎盘等。自然分娩组的产时出血量明显少于剖宫产组(P0.05),产后出血与产后感染发生率也均明显低于剖宫产组(P0.05)。两组的5分钟Apgar评分对比差异无统计学意义,但自然分娩组新生儿黄疸与新生儿湿肺发生情况明显低于剖宫产组(P0.05)。自然分娩组的分娩满意度为97.50%,剖宫产组为83.75%,自然分娩组明显高于剖宫产组(P0.05)。结论:疤痕子宫妊娠妇女经产道分娩可行性好,能减少对于产妇与新生儿的影响,安全性佳,但也要根据产妇的实际情况进行具体选择。     

臀位分娩方式的选择对新生儿的影响

目的探讨单胎臀位分娩方式与新生儿窒息发生率、新生儿体重、新生儿死亡情况及产次之间的关系。方法将251例单胎臀位妊娠产妇按分娩方式分为阴道分娩组及剖宫产组,对其临床资料进行回顾性分析。结果新生儿体重剖宫产组显著高于阴道分娩组（P〈0．01）．新生儿窒息率剖宫产组显著低于阴道分娩组（P〈0．05）。新生儿死亡率剖宫产组显著低于阴道分娩组（P〈0．05）。结论正确选择单胎臀位妊娠分娩方式,将有助于降低新生儿窒息率、新生儿死亡率。     

改良VBAC评分法联合护理干预在剖宫产后阴道试产中的临床价值

为了分析改良剖宫产术后阴道分娩(vaginal birth after cesarean section, VBAC)评分法联合护理干预在剖宫产术后阴道试产孕妇中的临床价值,本研究选取在医院就诊的240例剖宫产术后阴道试产孕妇,随机分为两组,每组120例。对照组给予VBAC评分法联合护理干预,实验组为改良VBAC评分法联合护理干预。统计分析两组孕妇试产时情况(产程时间,产时出血量和产后住院时间)、孕妇术后并发症(产褥感染,产后出血和尿潴留)、新生儿并发症(早产,肺炎和新生儿窒息)和分娩成功率。研究结果显示,相对于未改良VBAC评分组,改良VBAC评分法联合护理干预可明显改善剖宫产后阴道试产时的孕妇临床指数,降低孕妇术后并发症和新生儿并发症的发生率,以及升高分娩成功率(p0.05)。改良VBAC评分法联合护理干预在剖宫产后阴道试产孕妇中具有重要的临床效果和价值,值得临床推广和运用。     

改变产妇体位加用地西泮和山莨菪碱在产程中的效果观察

目的 观察改变产妇体位加用地西泮和山莨菪碱在枕后位及枕横位分娩的效果.方法 对532例临产后分娩早期发现枕后位、枕横位,无头盆不称足月妊娠健康产妇,随机分为改变产妇体位加用地西泮和山莨菪碱组（A组）、常规体位组（B组）,观察两组的产程、分娩方式、出生时胎儿体重、产后出血及新生儿窒息情况.结果 A组的产程短,手术产率低,产后出血及新生儿窒息无增加;对照组的产程长,手术产率高.结论 临产后尽早发现枕后位、枕横位,及时改变产妇体位,加用安定和山莨菪碱可预防持续性枕后位、枕横位的发生,减少难产,提高阴道分娩质量.     

导乐陪伴式分娩的临床效果观察

目的:探讨导乐陪伴分娩对产程、剖宫产率及围产期并发症的影响,提高分娩质量.方法:960例初产妇随机分为观察组和对照组,观察组采用导乐陪伴式分娩,对照组产妇采用传统护理方法分娩,观察两组产程时长、分娩方式、产后24h出血量和新生儿窒息等情况.结果:观察组产程时长显著低于对照组,相比较均有显著性差异(P<0.05);观察组阴道分娩率为85.6%,显著高于对照组(55.2%),相比较有显著性差异(P<0.05);观察组产后24h出血量和新生儿窒息显著低于对照组,相比较有显著性差异(P<0.05).结论:导乐式陪伴分娩能有效地缩短产程、降低剖宫产率、减少产后出血和新生儿窒息的发生,值得临床推广应用.     

剖宫产术后阴道分娩156例临床分析

目的分析剖宫产后再次妊娠经阴道分娩的影响因素,降低二次剖宫产率,提高产科质量。方法回顾性分析我科2013年1月~2016年12月收治的156例剖宫产术后再次妊娠经阴道分娩产妇的临床资料。结果剖宫产术后再次妊娠分娩的890例中,经阴道分娩的156例,占剖宫产术后分娩的17.53%,其中150例自然分娩,6例因胎儿宫内窘迫行产钳助产。结论严格掌握剖宫产术后经阴道试产的指征,并在产程中严密观察下,剖宫产产妇再次妊娠可选择阴道分娩方式。     

不同分娩方式对产妇产后心理和生理的影响

目的:探讨不同分娩方式对产妇产后心理和生理的影响.方法:随机选择2011年1月～2011年12月在苏大附一院分娩的初产妇400例,其中剖宫产、阴道自然分娩各200例,对两组产妇产后42天心理状况、恶露持续时间、泌乳情况进行调查.结果:两种分娩方式对产妇产后42天发生焦虑和抑郁心理的影响无明显差别(P＞0.05);阴道自然分娩组产后恶露持续时间短于剖宫产组,差异有显著意义(P＜0.01).有抑郁、焦虑情绪的产妇泌乳始动时间显著长于正常产妇,24h泌乳量显著少于正常产妇(P＜0.01).结论:剖宫产对产妇身体生理创伤大过阴道自然分娩,应严格控制剖宫产的适应症,鼓励阴道自然分娩.     

妊娠期糖尿病产妇妊娠晚期阴道微生态改变与围产结局的相关性分析

目的探讨妊娠期糖尿病(GDM)产妇妊娠晚期阴道微生态的改变与围产结局的关系。方法选择2017年1月至2019年6月期间在我院门诊进行产检并于我院产科分娩的150例GDM孕妇组成GDM组,并选择同期于我院产检及分娩的150例健康孕妇作为对照组(NC组),孕检时所有研究对象进行阴道分泌物标本采集,并行白带常规检查。检查内容包括阴道分泌物的清洁度、pH值等,采用革兰染色法检测唾液酸苷酶(NA)、过氧化氢(H_2O_2)及白细胞酯酶(LE)水平,根据分泌物培养结果判定阴道菌群密集度及多样性,并对围产结局进行随访。比较GDM组与NC组阴道微生态情况及围产结局。结果 GDM组孕妇妊娠晚期阴道微生态异常的发生率高于NC组(χ~2=14.064,P0.05)。GDM微生态异常组早产、胎膜早破、绒毛膜羊膜炎、产后出血、新生儿窒息、新生儿感染、新生儿黄疸发生率明显高于GDM微生态正常组(P0.05),产褥感染及剖宫产、低出生体重率差异无统计学意义(P0.05)。NC微生态异常组早产、绒毛膜羊膜炎、产后出血、新生儿感染发生率均明显高于NC微生态正常组(P0.05),胎膜早破、产褥感染及剖宫产、新生儿窒息、新生儿黄疸、低出生体重发生率差异无统计学意义(P0.05)。结论 GDM孕妇妊娠晚期阴道微生态异常发生率高,显著增加不良围产结局的发生率,影响孕产妇及新生儿的健康,临床上应动态监测、合理干预以减少围产期不良结局的发生。     

会阴适度保护接生法在低危初产妇阴道分娩的应用研究

目的探讨会阴适度保护接生法在低危初产妇阴道分娩中的应用效果。方法选择我院妇产科2013年1月~2014年12月收治的低危初产妇1176例,按数字随机分组法分为对照组和观察组。对照组采用传统保护会阴法进行分娩,观察组采用会阴适度保护接生法进行分娩,观察比较两组产妇第二产程时间、产后出血、会阴侧切、会阴完整、会阴Ⅰ°裂伤、会阴Ⅱ°裂伤、新生儿产伤、新生儿窒息情况。结果观察组产妇第二产程时间、产后出血、会阴侧切、会阴完整、会阴Ⅰ°裂伤与对照组比较,差异有统计学意义(P0.05);观察组产妇Ⅱ°裂伤、新生儿轻度窒息情况与对照组比较,差异无统计学意义(P0.05);两组产妇均无会阴Ⅲ°裂伤、新生儿产伤、新生儿重度窒息情况。结论低危初产妇采取会阴适度保护接生法阴道分娩可减少对母婴损害,值得临床推广。     

重度妊娠期肝内胆汁淤积症对母婴结局影响的临床分析

目的：分析重度妊娠期肝内胆汁淤积症（intrahepatic cholestasis of pregnancy,ICP）对母婴结局的影响,以提高对ICP的认识与治疗水平。方法：选择ICP产妇58例,根据ICP分度标准分为轻度组（n=26例）和重度组（n=32例）,比较两组产妇的母婴结局。结果：与轻度组相比,重度组产妇剖宫产率、产后出血与平均产后出血量显著升高或增加,阴道分娩率显著降低,组间比较差异均具有统计学意义（P〈0.05）;重度组新生儿早产、胎儿窘迫、羊水污染和新生儿窒息的发生率均显著上升,新生儿平均出生体重显著降低,组间比较差异均具有统计学意义（P〈0.05）。结论：ICP对产妇及新生儿均有不良影响,对ICP严重程度进行划分,有利于临床处理。对于重度ICP产妇,应尽早采取剖宫产分娩的方式终止妊娠。     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Entwicklungsgeschichte und Ultrastruktur von Pollenkitt und Exine bei nahe verwandten entomophilen und anemophilen Angiospermensippen derAlismataceae,Liliaceae, Juncaceae,Cyperaceae, Poaceae undAraceae

Some closely related members of the monocotyledonous familiesAlismataceae, Liliaceae, Juncaceae, Cyperaceae, Poaceae andAraceae with variable modes of pollination (insect- and wind-pollination) were studied in relation to the ultrastructure of pollenkitt and exine (amount, consistency and distribution of pollenkitt on the surface of pollen grains). The character syndromes of pollen cementing in entomophilous, anemophilous and intermediate (ambophilous or amphiphilous) monocotyledons are the same in principal as in dicotyledons. Comparing present with former results one can summarize: 1) The pollenkitt is always produced in the same manner by the anther tapetum in all angiosperm sub-classes. 2) The variable stickiness of entomophilous and anemophilous pollen always depends on the particular distribution and consistency of the pollenkitt, but not its amount on the pollen surface. 3) The mostly dry and powdery pollen of anemophilous plants always contains a variable amount of inactive pollenkitt in its exine cavities. 4) A step-by step change of the pollen cementing syndrome can be observed from entomophily towards anemophily. 5) From the omnipresence of pollenkitt in all wind-pollinated angiosperms studied one can conclude that the ancestors of anemophilous angiosperms probably have been zoophilous (i.e. entomophilous) throughout.

     

Identification and Characterization of the First Equine Parainfluenza Virus 5

正Dear Editor,Parainfluenza virus 5 (PIV5), known as canine parainfluenza virus in the veterinary field, is a negative-sense,nonsegmented, single-stranded RNA virus belonging to the Paramyxoviridae family (Chen 2018). The virus was first reported in primary monkey kidney cells in 1954 (Hsiung1972), then it has been frequently discovered in various