Bakri球囊填塞与补丁缝合联合术治疗中央性前置胎盘产后出血的分析

目的:探讨选择Bakri球囊填塞+补丁缝合联合术对中央型前置胎盘产后出血患者加以治疗后获得的临床效果。方法:选择我院2014年01月-2016年01月收治的中央型前置胎盘产后出血患者112例作为实验研究对象。根据不同的临床治疗方法实施分组对比研究。对观察组56例产后出血患者临床治疗方法选择Bakri球囊填塞+补丁缝合联合术;对对照组56例产后出血患者临床治疗方法选择Bakri球囊填塞。对比两组患者的手术时间、止血时间以及临床出血量。结果:观察两组中央型前置胎盘患者完成治疗后,在手术时间、止血时间以及临床出血量方面,观察组优于对照组产后出血患者明显(P0.05)。结论:针对中央型前置胎盘产后出血患者,治疗方法采用Bakri球囊填塞+补丁缝合联合术加以治疗,对于术中出血可以显著控制,不会导致产后出血患者出现疾病并发症的现象。     

子宫下段注射益母草针注射液联合Bakri球囊在前置胎盘剖宫产术中应用

目的:探讨在实施前置胎盘剖宫产手术过程中,应用子宫下段注射益母草针注射液+Bakri球囊的临床效果。方法:选择我院2014年01月-2016年01月收治的前置胎盘剖宫产术患者100例作为此次实验研究对象。根据临床采用不同干预方法展开分组。对60例观察组前置胎盘患者选择子宫下段注射益母草针注射液+Bakri球囊进行治疗;对40例对照组前置胎盘患者临床选择Bakri球囊的方法进行治疗;对比两组患者的出血量。结果:在术后24小时出血量以及手术时间几方面,观察组明显优于对照组前置胎盘患者(P0.05)。结论:探讨针对前置胎盘患者在实施剖宫产手术过程中,临床有效应用子宫下段注射益母草针注射液+Bakri球囊的方法进行治疗,可以显著缓解术后出血症状,获得的治疗安全性较高。     

麦角新碱联合米索前列醇治疗前置胎盘的临床疗效及对血清ROS、SOD、GSH-px水平的影响

目的:分析麦角新碱联合米索前列醇治疗前置胎盘的临床疗效及对血清活性氧(ROS)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-px)水平的影响。方法:选择2016年5月-2017年5月我院收治的前置胎盘患者100例纳入本次研究,根据随机分组法分为观察组(n=52)和对照组(n=48)。对照组使用米索前列醇治疗,观察组采用麦角新碱联合米索前列醇进行治疗。比较两组患者的临床疗效、治疗前后血清ROS、SOD、GSH-px水平的变化、术中、术后出血量、止血时间及不良反应的发生情况。结果:治疗后,两组患者的总有效率分别为96.15%、81.25%,观察组显著高于对照组(P0.05);两组患者血清ROS、SOD、GSH-px水平均较治疗前显著改善,且观察组患者血清ROS低于对照组,血清SOD、GSH-px水平显著高于对照组(P0.05);观察组患者术中、术后出血量及止血时间均显著低于对照组(P0.05);两组患者不良反应总发生率分别为7.69%、22.92%,观察组显著低于对照组(P0.05)。结论:麦角新碱联合米索前列醇治疗前置胎盘的疗效和安全性均显著优于单用米索前列醇治疗,可能与其有效改善血清ROS、SOD、GSH-px水平有关。     

脐血管前置产前超声表现及临床效果分析

目的:研究脐血管前置产前超声表现及临床效果。方法:回顾性分析2017年1月至2018年12月期间本院收治的34例脐血管前置孕妇临床资料,均进行产前超声检查,将结果与产后病理结果进行比较,分析超声表现。结果:同产后病理检查结果相比较,34例孕妇的产前超声诊断准确率、误诊率分别为97.06%、2.94%,数据对比差异无统计学意义(P>0.05),产前超声检查显示的胎盘及脐带入口情况主要为帆状胎盘、脐带胎盘边缘附着、边缘性前置胎盘、低置性前置胎盘、副胎盘等。结论:产前超声检查具有较高的脐血管前置诊断准确率,可为临床分娩结局的改善提供指导,适合推广应用在临床中。     

对比分析超声引导下与X线引导下腹主动脉球囊阻断在凶险性前置胎盘术中的应用价值

摘要 目的：评价分析B超和X线下引导下腹主动脉预置球囊阻断术在凶险性前置胎盘剖宫产术中的应用价值。方法：收集2016年8月至2022年6月我院收治的83例凶险性前置胎盘患者病历,其中在B超引导下腹主动脉预置球囊行剖宫产术者40例（治疗组A）,X线引导下腹主动脉预置球囊行43例（治疗组B）。比较分析两组患者子宫切除率和死亡率等;比较两组新生儿出生后1 min、5 min的Apgar评分;比较两组患者术后并发症发生率。结果：治疗组A手术时间短于治疗组B,治疗组A术中出血量小于治疗组B（P＜0.05）;两组患者术中胎盘粘连率、胎盘植入率及子宫切除率无明显差异（P＞0.05）;两组新生儿出生后均未出现新生儿窒息现象,治疗组A新生儿出生后1 min、5 min Apgar评分以及早产儿率与治疗组B比较均无统计学差异（P＞0.05）;两组患者术后总并发症发生率无差异（P＞0.05）。结论：将B超下腹主动脉预置球囊阻断术应用于凶险性前置胎盘患者剖宫产,可有效减少术中和术后出血量,对新生儿出生后Apgar评分无影响,不增加术后并发症的发生。     

"U"字缝合止血法对前置胎盘剖宫产患者术中出血量的影响

目的:探讨"U"字缝合止血法对前置胎盘剖宫产患者术中出血量的影响。方法:将2015年9月至2017年9月在西北妇女院儿童医院行前置胎盘剖宫产术的产妇96例作为研究对象,将其随机分组为两组,每组各48例患者。两组均给予常规止血处理,对照组采用"8"字缝合止血法,观察组为"U"字缝合止血法,比较两组手术指标及止血效果。结果:观察组手术时间、止血时间、术中出血量均显著少(短)于对照组(P0.05),凝血酶时间(TT)、血浆凝血酶还原时间(PT)、D-二聚体(D-D)、血小板(PLT)以及活化部分凝血活化酶时间(APTT)水平均明显低于对照组(P0.05),血红蛋白(HGB)、纤维蛋白原(FIB)水平均显著高于对照组(P0.05);止血有效率[97.92%(47/48)]显著高于对照组[85.42%(41/48)](P0.05),患者下床活动时间、住院治疗时间均显著短于对照组(P0.05)。结论:在前置胎盘剖宫产术中,实施"U"字缝合止血法可快速止血,且操作简单,确保降低出血量,降低对患者的损害,保证产妇健康和安全。     

凶险型前置胎盘对孕产妇的危害性研究

目的:探讨凶险型前置胎盘对孕产妇的危害性。方法:选择我院2009年3月至2012年3月收治的凶险性前置胎盘40例,对其临床资料进行回顾性分析。结果:植入型前置胎盘(植入组)占凶险型前置胎盘的55%(22例),非植入型前置胎盘(非植入组)占45%(18例)。植入组产前出血18例,占81.8%,非植入组产前出血8例,占44.4%,差异有统计学意义。植入组完全性前置胎盘17例,占77.3%;部分性4例,占18.2%;边缘性1例,占4.5%。非植入组分别为5例,占27.8%;1例,占5.6%;12例,占66.7%。两组之间比较差异具有统计学意义(P<0.05)。两组术前Hb值无明显差异(P>0.05),术后非植入组Hb水平高于植入组,手术时间、术中出血量、产后出血均显著少于植入组,差异均有统计学意义(P<0.05)。非植入组术中输血、切除子宫、应用宫腔纱条的百分率均显著低于植入组(P<0.05)。两组术中刮宫、徒手剥胎盘的百分率比较均无明显差异(P>0.05)。结论:对于凶险型前置胎盘孕产妇,产前应做好预防保健,术中加强观察,术中术后放置腹腔引流管,最大限度的降低对孕产妇的危害,确保母婴安全。     

腹主动脉球囊预置术治疗凶险型前置胎盘疗效评价

目的:探讨腹主动脉球囊预置术治疗凶险型前置胎盘的疗效及安全性。方法:收取2014年3月至2016年3月我院收治的凶险型前置胎盘患者71例临床资料进行回顾性分析,观察组患者35例,行剖宫产前进行腹主动脉球囊预置术;对照组患者36例,直接进行剖宫产。对两组患者手术情况、术后情况以及新生儿情况进行观察比较。结果:两组患者手术时间及胎盘植入情况无显著差异,观察组术中出血量及输血量明显低于对照组,医疗费用明显高于对照组,产后出血及并发症发生率明显低于对照组,差异均有统计学意义(P0.05)。两组患者子宫切除率无显著差异(P0.05)。两组新生儿体质量及窒息情况无显著差异(P0.05)。结论:剖宫产前行腹主动脉球囊预置术可有效控制术中出血,是治疗凶险型前置胎盘安全有效的方法。     

经腹彩色超声多普勒在前置胎盘并发胎盘植入诊断中的价值

目的探讨经腹彩色超声多普勒在前置胎盘并发胎盘植入诊断中的价值。方法对2010年1月-2014年12月在我院住院的232例前置胎盘产妇进行产前腹部彩超检查,预测胎盘植入发生与否,并通过分娩和病理结果对胎盘植入进行评估。结果本组232例产妇中,经腹壁彩超诊断为胎盘植入有23例,其中包括表现为胎盘后间隙不可见6例,经临床和病理均证实符合胎盘植入,表现为胎盘和周围血流异常丰富17例,其中有13例符合胎盘植入,4例为假阳性;其他209例产妇中,发生6例胎盘植入,此6例均在彩超下表现为后壁性中央性前置胎盘,胎盘面积稍增大但无其他彩超下异常表现。除胎盘面积较大外,未发现其他胎盘植入的彩超声像特点;本次彩超诊断胎盘植入的灵敏度为76%(19/25),特异度为98.07%(203/207)。结论经腹壁的彩超声多普勒在预测前置胎盘并发胎盘植入上有较好的诊断价值。     

腹主动脉球囊置入术治疗凶险性前置胎盘疗效和对血清AFP、CK表达以及手术结局的影响

摘要 目的：探讨与分析腹主动脉球囊置入术治疗凶险性前置胎盘疗效和对血清AFP、CK表达以及手术结局的影响。方法：将2019年1月到2021年12月在本院住院剖宫产的凶险性前置胎盘产妇153例作为研究对象,对照组48例为剖宫产术,研究组105例为剖宫产术前行腹主动脉球囊置入术。检测两组血清甲胎蛋白（AFP）、肌酸激酶（CK）表达水平,记录手术结局。结果：所有产妇都顺利完成治疗与分娩,无死亡产妇与新生儿。研究组的产后出血量较对照组低（P<0.05）,而产前出血量在两组对比无差异（P>0.05）。两组新生儿体重对比无差异（P>0.05）,研究组的1 min Apgar评分、5 min Apgar评分较对照组高,而呼吸窘迫综合征发生率较对照组低（P<0.05）。两组手术后3 d的血清AFP与CK含量明显低于术前,研究组也显著低于对照组（P<0.05）。研究组出院时的满意度为94.29 %,明显高于对照组的79.17 %（P<0.05）。结论：腹主动脉球囊置入术治疗凶险性前置胎盘能促进降低血清AFP与CK含量,能促进产妇与新生儿恢复健康,提高产妇的满意度。     

Peak power, ground reaction forces, and velocity during the squat exercise performed at different loads

This study examined the changes in peak power, ground reaction force and velocity with different loads during the performance of the parallel squat movement. Twelve experienced male lifters (26.83 +/- 4.67 years of age) performed the standard parallel squat, using loads equal to 20, 30, 40, 50, 60, 70, 80, and 90% of 1 repetition maximum (1RM). Each subject performed all parallel squats with as much explosiveness as possible using his own technique. Peak power (PP), peak ground reaction force (PGRF), peak barbell velocity (PV), force at the time of PP (FPP), and velocity at the time of PP (VPP) were determined from force, velocity, and power curves calculated using barbell velocity and ground reaction force data. No significant differences were detected among loads for PP; however, the greatest PP values were associated with loads of 40 and 50% of 1RM. Higher loads produced greater PGRF and FPP values than lower loads (p < 0.05) in all cases except between loads equal to 60-50, 50-40, and 40-30% of 1RM for PGRF, and between loads equal to 70-60 and 60-50% of 1RM for FPP. Higher loads produced lower PV and VPP values than lower loads (p < 0.05) in all cases except between the 20-30, 70-80, and 80-90% of 1RM conditions. These results may be helpful in determining loads when prescribing need-specific training protocols targeting different areas of the load-velocity continuum.     

兰州地区孕妇和新生儿血清中风疹病毒特异性IgM抗体测定研究

本文采用ＥＬＩＳＡ抗ｕ抗体捕捉法检测了兰州地区７１２例孕妇和６２４例新生比血清中风疹病毒特异性ＩｇＭ抗体（ＲＶ－ＩｇＭ）。实验结果为：７１２例孕妇中,ＲＶ－ＩｇＭ阳性者有８例,阳性率为１．１２％：６２４例新生儿脐带血清标本中,ＲＶ－ＩｇＭ阳性者６例,阳性率为０．９６％。结果表明,兰州地区孕妇中有一定的风疹病毒原发感染病例,新生儿也存在一定的风疹病毒先天性感染问题。     

Sweat lactate in exercising children and adolescents of varying physical maturity.

This study attempts to explain some of the individual variability in sweating pattern by comparing prepubescents and pubescents. Sweating rate and muscular anaerobic capacity are higher in adults than in children; thus we hypothesized that sweat gland anaerobic metabolism, as reflected by lactate excretion, might be higher with advanced physical maturity (PM). Lactate concentration in sweat ([LAC]sw) was measured at various stages of PM in boys who exercised in the heat. The subjects were divided into three groups on the basis of Tanner staging: prepubertal (PP, n = 16), midpubertal (MP, n = 15), and late pubertal (LP, n = 5). Subjects cycled at 50% of maximal O2 uptake for three 20-min bouts, with 10-min rest periods, in 42 degrees C and 18% relative humidity. Sweat samples were harvested, and population density of activated sweat glands was determined after each exercise bout. [LAC]sw during bout 1 was higher in PP than in LP [PP = 22.2 +/- 2.2, MP = 19.5 +/- 1.4, LP = 14.3 +/- 1.3 (SE) mmol/l]. In all groups, [LAC]sw decreased during subsequent bouts, and there were no intergroup differences in [LAC]sw during bout 3 (PP = 11.2 +/- 0.4, MP = 10.6 +/- 0.5, LP = 9.7 +/- 0.2 mmol/l). [LAC]sw was inversely related to sweating rate. Lactate excretion rate per gland was greater with the increase in PM (PP = 61.0 +/- 8.2, MP = 79.1 +/- 11.3, LP = 99.9 +/- 11.0 pmol/min; P = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)     

Pregnancy termination with the PGE2-analogue SHB 286

A group of 94 volunteers were treated with PGE₂-analogue SHB 286 at the 12±1 week of pregnancy. Of the 94 gravidas, 78 received a single extraovular dose of 50–200μg (Mean±S.E. 76±7μg) while 16 a short intravenous infusion of 1000–200μg SHB 286. Despite the single treatment and low dose, the success rate was 69% and the instillation-abortion time only 15±1 hours. At 24 hours after treatment even those gravidas who failed to abort (31%) had sufficient cervical dilatation for curettage and thus could be spared from rapid surgical dilatation.Peripheral plasma progesterone and estradiol-17β decreased significantly at 4 hours after treatment in those gravidas who subsequently aborted. After an initial contracture response of the uterus to SHB 286, the cyclic intrauterine pressure evolved gradually. In 4 hours it reached significantly higher levels in those gravidas who subsequently aborted than in those who did not.     

外周血Th1/Th2比值、IL-23/Th17轴与中重度斑块状银屑病患者颈动脉粥样硬化和临床疗效的关系

摘要 目的：探讨外周血辅助T细胞（Th）1/Th2比值、白介素（IL）-23/Th17轴与中重度斑块状银屑病（PP）患者颈动脉粥样硬化和临床疗效的关系。方法：选取2021年1月～2022年1月徐州医科大学附属医院收治的97例中重度PP患者为中重度PP组,根据颈动脉内中膜厚度（CIMT）分为增厚组39例和正常组58例,根据甲氨蝶呤（MTX）治疗是否应答有效分为无应答组和应答组,另选取同期50例体检健康志愿者为对照组。采用流式细胞术检测外周血Th1、Th2百分比和Th1/Th2比值,酶联免疫吸附法检测外周血IL-23、IL-17A水平。采用Pearson相关性分析中重度PP患者外周血Th1、Th2、Th1/Th2比值和IL-23/Th17轴相关因子与CIMT的相关性,多因素Logistic回归分析中重度PP患者MTX治疗无应答的影响因素。结果：与对照组比较,中重度PP组外周血Th1、Th1/Th2比值、IL-23和IL-17A水平升高,Th2比例降低（P均＜0.001）。97例中重度PP患者颈动脉粥样硬化发生率为40.21%（39/97）。与正常组比较,增厚组外周血Th1、Th1/Th2比值、IL-23和IL-17A水平升高,Th2比例降低（P均＜0.001）。Pearson相关性分析显示,中重度PP患者外周血Th1、Th1/Th2比值、IL-23、IL-17A与CIMT呈正相关,Th2与CIMT呈负相关（r=0.695、0.706、0.688、0.650、-0.639,P均＜0.001）。97例中重度PP患者MTX治疗无应答率为21.65%（21/97）。多因素Logistic回归分析显示,重度PP和Th1、Th1/Th2比值、IL-23、IL-17A升高为中重度PP患者MTX治疗无应答的独立危险因素,Th2升高为独立保护因素（P均＜0.05）。结论：中重度PP患者外周血Th1/Th2比值和IL-23/Th17轴相关因子升高,与颈动脉粥样硬化和MTX治疗无应答有关,可能成为中重度PP患者颈动脉粥样硬化和临床疗效评估指标。     

Modified norcantharidins; synthesis, protein phosphatases 1 and 2A inhibition, and anticancer activity

Fourteen modified norcantharidin analogues have been synthesised and screened for their ability to inhibit the serine/threonine protein phosphatases 1 and 2A. The most potent compounds found were 10 (PP1 IC(50)=13+/-5 microM; PP2A IC(50)=7+/-3 microM) and 16 (PP1 IC(50)=18+/-8 microM; PP2A IC(50)=3.2+/-0.4 microM). Overall, only analogues possessing at least one acidic residue at the former anhydride warhead displayed any PP1 or PP2A inhibitory action. The ability of these analogues to inhibit PP1 and PP2A correlates well with their observed anti-cancer activity against a panel of five cancer cell lines: A2780 (human ovarian carcinoma), G401 (human kidney carcinoma), HT29 (human colorectal carcinoma), H460 (human lung carcinoma) and L1210 (murine leukemia).     

Gardiovascular responses to prostaglandin f2α in spontaneously hypertensive rats

To test the hypothesis that abnormal prostaglandin reactivity may be a characteristic of essential hypertension, cardiovascular responses to prostaglandin F_2α (PGF_2α) were measured in young spontaneously hypertensive (SHR) and Wistar normotensive rats (NR). PGF_2α(1 sec injection; 50 l/100 g.; .05, .5, 5, 50 g salt/kg) was injected retrograde into the femoral artery. Maximum changes were measured with respect to: 1) four different diameter categories of cremaster muscle arterioles, 2) mean arterial pressure (MAP), 3) pulse pressure (PP) and 4) heart rate. PGF_2α at 5 and 50 g/kg significantly increased NR and SHR blood pressure. SHR MAP increased significantly more than NR MAP with the 50 g dose (P <. 001). PGF_2α increased NR PP at the 50 g/kg dose and increased SHR PP at the .5, 5 and 50 g/kg dose. SHR PP response was significantly greater than that of the NR with the .5, 5 and 50 g/kg dose (P < .05, .01, .001 respectively). The mean SHR arteriolar constriction was greater than that of NR with the 50 g dose. The only change in heart rate was a 3% decrease from control in both NR and SHR during the pressor response to 50 g/kg. These results show an increased cardiovascular reactivity to PGF_2α in SHR and may further suggest prostaglandin involvement in hypertensive disease.     

Pregnancy termination with the PGE2-analogue SHB 286.

A group of 94 volunteers were treated with PGE2-analogue SHB 286 at the 12+1 week of pregnancy. Of the 94 gravidas, 78 received a single extravular dose of 50-200 microgram (Mean +/- S.E. 76 +/- 7 microgram) while 16 a short intravenous infusion of 1000-2000 microgram SHB 286. Despite the single treatment and low dose, the success rate was 69% and the instillation abortion time only 15 +/- 1 hours. At 24 hours after treatment even those gravidas who failed to abort (31%) had sufficient cervical dilatation for curettage and thus could be spared from rapid surgical dilatation. Peripheral plasma progesterone and estradiol-17 beta decreased significantly at 4 hours after treatment in those gravidas who subsequently aborted. After an initial contracture response of the uterus to SHB 286, the cyclic intraterine pressure evolved gradually. In 4 hours it reached significantly higher levels in those gravidas who subsequently aborted than in those who did not.     

Evolution of the Metazoan Protein Phosphatase 2C Superfamily

Members of the protein phosphatase 2C (PP2C) superfamily are Mg²⁺/Mn²⁺-dependent serine/threonine phosphatases, which are essential for regulation of cell cycle and stress signaling pathways in cells. In this study, a comprehensive genomic analysis of all available metazoan PP2C sequences was conducted. The phylogeny of PP2C was reconstructed, revealing the existence of 15 vertebrate families which arose following a series of gene duplication events. Relative dating of these duplications showed that they occurred in two active periods: before the divergence of bilaterians and before vertebrate diversification. PP2C families which duplicated during the first period take part in different signaling pathways, whereas PP2C families which diverged in the second period display tissue expression differences yet participate in similar signaling pathways. These differences were found to involve variation of expression in tissues which show higher complexity in vertebrates, such as skeletal muscle and the nervous system. Further analysis was performed with the aim of identifying the functional domains of PP2C. The conservation pattern across the entire PP2C superfamily revealed an extensive domain of more than 50 amino acids which is highly conserved throughout all PP2C members. Several insertion or deletion events were found which may have led to the specialization of each PP2C family. Electronic Supplementary Material Electronic Supplementary material is available for this article at and accessible for authorised users. [Reviewing Editor: Dr. Hector Musto]     

Relationship between intravenous ethanol, alcohol-induced inhibition of pancreatic secretion and plasma concentration of immunoreactive pancreatic polypeptide, vasoactive intestinal peptide, and somatostatin in man

We have studied in seven men, consuming less than 50 g alcohol daily, the effect of intravenous (i.v.) ethanol on (a) hormonally (secretin + CCK PZ) submaximally stimulated pancreatic secretion and (b) blood levels of pancreatic polypeptide (PP), vasoactive intestinal peptide (VIP) and somatostatin. After intravenous ethanol (600 mg/kg), pancreatic secretion decreased in all subjects and plasma levels of PP and VIP increased significantly. Moreover, there was a significant correlation between the mean inhibition of chymotrypsin output and the mean increase in PP plasma levels during the first 45 min following ethanol infusion. Therefore i.v. infusion of alcohol elicits release of PP and VIP and PP release could explain in part at least the alcohol-induced pancreatic inhibition observed in non-alcoholic men.