成年女性系统性红斑狼疮血清中抗黄体抗体与月经异常 的相关性研究

目的:探讨成年女性系统性红斑狼疮(SLE)血清中抗黄体抗体与月经异常的相关性。方法:收集SLE患者及正常对照者的临床资料,详细记录入选研究对象的月经及生育情况,同时记录抗核抗体(ANA)等自身抗体的测定结果。采用酶联免疫吸附试验(ELISA)法检测患者血清中抗黄体抗体。结果:在入选的69例成年女性SLE患者中,26(38%)例患者抗黄体抗体阳性。而在40例健康对照者中,仅2(5%)例出现抗黄体抗体阳性。在入选的69例SLE患者中,29(42%)例患者的月经正常,40(58%)例患者出现月经异常。在40例健康对照者中,31(78%)例患者的月经正常,仅9(21%)例患者出现月经异常。有月经异常的SLE患者中抗黄体抗体的阳性率显著高于无月经异常的SLE患者(66%vs 18%,P<0.01),而在健康对照者中则未见有显著性差异。结论:SLE患者中抗黄体抗体的阳性率为38%,并可能与SLE的月经异常相关。     

耻骨联合面形态学特征与年龄关系的再研究

本文用14岁以后(男180人,女140人)的耻骨,对男女耻骨联合面形态特征差异,影响判断年龄的因素,判断男女年龄的各自指标进行了研究。结果表明:男女耻骨形态特征有差异,应分别使用各自指标。经统计方法比较检验,提出了男女各自指标。某些疾病、下肢外伤、严重营养不良、生育等,可产生耻骨形态变异,影响判断年龄。并对59例盲测结果与Snow(1983)法作了讨论。     

青龙肠溶胶丸治疗脑血管病132例疗效观察

我们从1991年7月开始用青龙肠溶胶丸治疗脑血管病132例,取得较好疗效,兹作一报导。资料与方法本组132例中男性86例,女性46例,男与女之比为1.87:1,年龄40岁以下5例,41～50岁26例,51～60岁40例,61～70岁48例,71岁以上者13例.一、诊断标准:按照全国第二届脑血管病专题会议制定的脑血管病分类的诊断标准,并均作 CT检查确诊:脑血栓115例,脑出血15例,脑栓塞2例.二、病程分期,目前尚无统一标准,暂订如下:1、急性期:自发病日期1个月以内者.2、恢复期:病后1个月至1年以内者.     

介入栓塞在产后出血治疗中的应用

目的:探讨介入栓塞治疗对产后出血的治疗效果和应用价值。方法:回顾性分析在哈尔滨医科大学附属第一医院住院分娩发生产后出血并应用介入技术治疗的16例患者的临床资料。结果:16例患者中有15例一次栓塞成功,均未出现严重并发症及异常阴道流血,未哺乳者术后6-8周恢复正常月经,哺乳者于结束哺乳后4-8周恢复正常月经;1例于栓塞后16小时再次出现大量阴道流血,而改行子宫次全切除术。结论:介入栓塞治疗直观性强、创伤微小、并发症少、止血较快,并保留生育功能,有条件的医院可作为首选治疗方法。     

三种膀胱穿刺造瘘术在44例患者的比较

目的:探讨临床常用耻骨上膀胱穿刺造瘘的方法的优劣及需要注意的问题。方法:采用三件套穿刺套件行耻骨上膀胱穿刺造瘘16例,一次性穿刺套件19例,经皮肾穿刺套件9例,分析各组在手术时间,成本费用及并发症的差异。结果:44例病例均顺利完成手术操作,出现并发症15例次,严重并发症1例,出现并发症病例经适当处治后均治愈或好转。其中3件套组的手术平均用时(10±2.3)min、稍高于一次性组(6±1.4)min、但前者的费用明显低于后者(P<0.05);而经皮肾组的手术平均用时最长,但并发症明显低于其他两组(P<0.05)。结论:采用三件套穿刺套件手术时间短,成本低并发症少,经皮肾穿刺套件最为安全,膀胱穿刺造瘘术在充分术前准备,规范操作,严密术后随访是一种安全有效的治疗手段。     

衣原体感染不孕不育患者血清中自身抗体的检测

目的:探讨衣原体感染与血清中抗精子抗体(AsAb)、抗心磷脂抗体(ACA)、抗子宫内膜抗体(EMAb)之间的关系.方法:用ELISA法检测120例衣原体感染不育男性(男性衣原体感染组)和55例正常生育男性(男性正常时照组)的血清中AsAb、ACA;检测142例衣原体感染不孕女性(女性衣原体感染组)和60例正常生育女性(女性正常对照组)的血清中AsAb、ACA、EMAb.结果:男、女衣原体感染组AsAb、ACA检出率高于相应对照组,具有显著性差异(P值均＜0.05);女性衣原体感染组EMAb检出率高于女性对照组,具有显著性差异(P＜0.05).结论:生殖道衣原体感染和与不孕不育有着密切的相关性,且AsAb、ACA、EmAb的产生与衣原体感染有关.     

88例女性小细胞肺癌临床特征分析

目的了解女性小细胞肺癌的临床特征分布。方法收集2006年1月至2012年11月大连医科大学附属二院收治的341例小细胞肺癌女性患者88例的临床资料,分析患者在年龄、分期、就诊症状、体重下降、吸烟、家族史、肿瘤位置、治疗方式、疗效反应等方面的特征。结果 2006-2012年该院女性小细胞肺癌住院患者数呈上升趋势;女性患者平均患病年龄为（57.8±11.2）岁,小于同期男性患者（60.4±10.3）岁;女性〈65岁患者比例高于男性患者（73.9%vs 67.5%）,两者比较差异有统计学意义（P=0.018）;女性患者吸烟只有13.6%,远远低于男性患者吸烟比例（85.5%）,两者比较差异有统计学意义（P=0.000）;女性家族史、体重下降、就诊症状、肿瘤位置、分期、疗效以及治疗方式的选择均与男性无差别。在广泛期小细胞肺癌中观察到女性最常见的远处转移是肝转移（40.0%）,男性肝转移只占22.2%,两者比较差异有统计学意义（P=0.036）。结论女性小细胞肺癌数一直呈上升趋势;女性小细胞肺癌就诊的平均年龄小于男性患者;在中青年小细胞肺癌中女性常见;女性吸烟患者较少;相对于男性患者,女性更常见于肝转移。     

细菌性阴道病发生的危险因素分析

目的了解平素的生活及卫生习惯对生育年龄女性细菌性阴道病发生的影响,寻找引起该年龄段女性细菌性阴道病发生的危险因素。方法选取2014年7月至2014年9月北京大学第一医院妇产科门诊就诊需要进行阴道微生态检查的生育年龄非妊娠期既往无阴道炎病史的细菌性阴道病270例患者及同期进行阴道微生态检查正常的660例患者进行问卷调查,调查结果进行细菌性阴道病发生的危险因素分析。结果性生活次数的增加、阴道冲洗、经期不清洗外阴、男性性生活前不清洗外阴、不使用避孕套避孕是细菌性阴道病发生的危险因素,两组之间相比差异有统计学意义,P0.05。结论平素不良的生活及卫生习惯与生育年龄女性细菌性阴道病的发生有关,对平素的生活及卫生习惯的健康教育有可能会降低该病的发病率。     

Noonan综合征一例报告

Noonan 综合征由U11rich于1930年首次 报告川，此后国外陆续出现了一些报告。在国 内由冉金彦等于1980年报告了一例女性患 者[21，但至今尚未见男性患者的报告。故现将 我们遇到的一例男性患者报告如下。     

应用软X线推断国人耻骨年龄

对男性１１８副、女性１０８副、１０－６０岁国人耻骨样本应用软Ｘ线进行拍照。根据其内部结构随年龄增长而发生的形态变化规律,采用多变量统计分析法,研制出数量化赋分值标准,用该标准取得的观测数据,使用数量化理论Ｉ和逐步回归数学模型,借助电子计算机技术进行统计分析,建立了推断耻骨年龄男女各自两个方程。经１３例实际案件中应用,其结果达到了设计要求,方程有一定应用价值。     

Cessation of childbearing in the absence of contraception in Sri Lanka

In data from the Sri Lanka Fertility Survey, 1975, the cessation of childbearing is examined among women who have never used contraception. The sample consisted of 6810 currently or previously married women, 57% of whom reported that they had never used contraception. Cessation of childbearing is studied according to age and marriage duration. The variables analyzed are age at last birth, proportions infertile during the last 5 or 7 years, and the infertile open interval. The duration of breastfeeding is taken into account where necessary, and the contraceptive users and nonusers are compared where appropriate. Non-users tend to cease childbearing early, and therefore are infertile for longer periods during their marriages. It is probably age of the 1st child that influences decisions on future fertility. Among women aged 45-49 who married before age 20 and continued in their 1st marriage, mean age at last live birth in non-users, was 34.5 years, about 2 years earlier than in those who had used contraception. Non-users who married at any age below 30 years cease childbearing well below age 40. The proportion not currently pregnant and infertile over the past 5 years increases with marriage duration among the fertile non-users in each age group. When age at last birth and the duration of breastfeeding in the open interval are taken into account and the reference period is increased to 7 years, the period of infertility increases with marriage duration among nonpregnant non-users below age 45. The proportion of women who were currently not pregnant and had remained infertile over the past 7 years is higher among the older non-users whose 1st child was born more than 10 years ago.     

Analysis of dorsal pitting in the os publis in an extensive sample of modern American females

Pubic bones from 486 modern American females between the ages of 13 and 99 were studied in an attempt to explore the relationship between the degree of dorsal pitting and the following variables: (1) number of full term pregnancies, (2) inteval since last pregnancy, (3) age of decedent.A statistical association was found between the number of full term pregnancies and the degree of dorsal pitting. However, the correlation is not strong; 17 females reported as being nulliparous have "medium to large" dorsal changes whereas 22 females having from one to five full term pregnancies have an absence of dorsal changes. Females who had their last child 15 or more years prior to death are more apt to have "medium to large" dorsal changes than are females who have more recently given birth. This effect appears to be independent of the number of full term pregnancies, but is probably related to age. When the data are analyzed by multiple regression analaysis, it is found that age and number of pregnancies are most important in predicting the degree of pitting and the effect of the interval on pitting is not significant. Age is found to be an important variable independent of the number of full term pregnancies. In nulliparas, an absence of dorsal pitting is far more frequently found in females younger than 30 than in those over 30.     

The impact of reproduction on gambian women: Does controlling for phenotypic quality reveal costs of reproduction?

Life history theory predicts that where resources are limited, investment in reproduction will cause a decline in body condition and ultimately may lower survival rates. We investigate the relationship between reproduction and mortality in women in rural Gambia. We use a number of different measures of reproductive investment: the timing of reproduction, intensity of reproduction, and cumulative reproductive investment (parity). Though giving birth is clearly a risk factor for increased mortality, we find limited evidence that the timing, intensity, or cumulative effects of reproduction have a survival cost. Instead, there is some evidence that women who have invested heavily in reproduction have higher survival than women with lower reproductive investment: both high parity and late age at last reproduction are associated with high survival. The only evidence for any cost of reproduction is that women who have given birth to twins (considered a marker of heavy investment in reproduction) have higher mortality rates than other women, after the age of 50 years. A potential confounding factor may be differences in health between women: particularly healthy women may be able to invest substantially in both reproduction and their own survival, leading to the positive correlations between survival and both parity and age at last birth we observe. To control for differences in health between women, we reanalyze the relationship between reproduction and mortality but include variables correlating with health in our models (height, BMI, and hemoglobin). Even when controlling for health, the positive correlation between investment in reproduction and survival remains unchanged.     

Maternal age at last birth in Egypt

To assess the effects of women's education, residence, and marital experience on their age at the birth of their last child, a proportional hazards regression model was applied to 1980 Egyptian Fertility Survey (EFS) data. The detailed data include the date of birth of each child for every women interviewed, and the woman's date of birth and age at interview. Age at last birth was examined by regression analysis on birth history and socioeconomic information. 4 hypotheses were tested: women who are well educated have a greater probability of ending childbearing earlier than women with less education; women in rural areas have a higher probability of having their last child at older ages than urban women; marital disruption without remarriage lowers the probability of older maternal age at last birth; and marital disruption with remarriage increases the probability that a woman stops reproducing at an older age. The overall chi-square indicates a significant regression. All coefficients were significant, except the coefficient for women with intact 1st marriages. Women with more education had a greater probability of ending childbearing earlier than women with less education. Rural women tended to have their last children at ages significantly older than overall age at last birth. Current residence in urban areas had the opposite effect. The coefficient for those with intact 1st marriages was insignificant, meaning that the mean age at last birth for this group of women was not much different from the overall mean. Remarried women tended to end childbearing at ages significantly older than the overall average age at last birth, suggesting that these women tended to have children by their new husbands. Those with dissolved 1st marriages who had not remarried had a higher probability of ending childbearing earlier than did older women. Marriage age and final parity had highly significant negative coefficients; as marriage age and number of children born increased, so did the "survival" time or the age at last birth. Results from the hazards model indicate that the effects were as anticipated. The median age at last birth for the total sample of women aged 45-49 was 45-49 years. The median age at last birth was about 2 years older for rural compared to urban women. Illiterate women had the oldest median age at last birth of the education groups. There was little differences between median ages at last birth for women with intact 1st marriages and those whose 1st unions were dissolved and who had remarried. The median age at last birth increased with final parity.     

Outcome of infants of very low birth weight: a geographically based study.

The outcome of 143 live-born infants of very low birth weight (defined as less than 1500 g) who were born in 1980-81 to women resident in Newfoundland and Labrador is described. Sixty-one infants (43%) died during the first year of life. Of the 82 surviving infants 79 were followed for 18 months to 3 years. Eight (10%) were found to have evidence of severe neurodevelopmental abnormality, and nine (11%) were found to have various minor problems, including seizures, developmental delay and behavioural disorders. There was an inverse association between birth weight and mortality. Neonatal pneumothorax, seizures and clinical evidence of intraventricular hemorrhage were more commonly seen among infants who died; these factors also seemed to be predictive of an adverse long-term outcome. Continuous monitoring of the rates of death and disability among infants of very low birth weight born within a defined region should provide the basis for rational planning and delivery of neonatal intensive care.     

Parental age difference and offspring count in humans

Preferences for certain age characteristics of partners are reported across cultures: men prefer mates who are younger and women prefer mates older than themselves. To examine whether these age preferences entail fitness effects for men and women, we investigated the association among age differences between partners and offspring count. On the basis of a sample of approximately 10,000 post-reproductive Swedish men and women who did not change their partner between the birth of their first and last child, we find maximum offspring count in men if their partner is approximately 6 years younger, and in women if their partner is approximately 4 years older. We further find that after separation, on average, both men and women shift to a partner younger than the first, albeit in women the new partner is still older than the female herself. We conclude that the age preference for the partner yields fitness benefits for both men and women and may thus be an evolutionarily acquired trait.     

Contraception after childbirth in Thailand

Data from the Third Contraceptive Prevalence Study conducted in 1984 in Thailand were analyzed to learn the extent of contraceptive practice after childbirth. Focusing on those women who had a birth within a given period prior to the survey, for some purposes the analysis was limited to those women whose most recent birth occurred within 1 year of interview, while for others it was extended to women whose most recent birth occurred within the last 2-4 years. The number of women in 4 years following childbirth in the Contraceptive Prevalence Survey 3 sample were 3442 in the unweighted ever married group and 3342 in the unweighted currently married group; the figures were 3447 for the weighted ever married group and 3342 for the weighted currently married group. Thai couples adopted contraception in very substantial proportions and very soon following the birth of a child. Based on women interviewed within 1 year of most recent birth, over half started some contraception by the end of the 6th month and almost 4/5 by the end of the 1st year. The timing of female sterilization was quite different from initiation of all other methods. Female sterilization in Thailand occurred primarily during the immediate postpartum period, while women are still in the hospital after delivery. Relatively few women sterilized in the 2 years following the 1st postpartum month. Of women in their first 2 years following childbirth, 17% were sterilized by the end of the 1st postpartum month and only an additional 3% by the end of the 2nd year. Initiation of temporary methods was not linked to the immediate postpartum period but occurred throughout the 1st year following birth. Contraceptive use during the 1st year following childbirth was more likely among menstruating women than among women who were still amenorrheic. Methods other than female sterilization predominated among women who already experienced the return of menses, suggesting that the return of menses was an important stimulus to their adoption. The data suggest that the proportion of Thai women exposed to risk of unwanted pregnancies for any extended period of time following childbirth is quite modest.     

Short term increase in risk of breast cancer after full term pregnancy.

To determine whether there is a short term increase in the risk of breast cancer after a full term birth data from two hospital based, case-control studies in Italy were pooled. Analysis was restricted to women aged under 50 with two or more children (573 women with cancer and 570 controls). A relative risk for breast cancer of 2.66 was seen in women who had given birth during the three years preceding the interview compared with women whose last birth had occurred 10 or more years before, after adjustment for age, age at first birth, and parity. The relative risk slowly decreased for women who had last given birth three to 10 years before. Multivariate analyses confirmed the protective effect of an early age at first birth and the age dependent effect of parity on the risk of breast cancer--that is, a direct relation below age 40 and an inverse one in older women. These data provide epidemiological evidence that a full term birth is followed by a transient increase in the risk of breast cancer, which for some time contrasts with and overcomes the long term protection of pregnancy at an early age. They therefore confirm predictions from animal studies and theoretical models that pregnancy prevents the early stages of breast carcinogenesis but promotes the late stages of the process.     

Can Dreams During Pregnancy Predict Postpartum Depression?

Postpartum depression (henceforth PPD) is an emotional disturbance which occurs in as much as 20% of the childbearing population. This study attempted to ascertain whether dreams, offering unconscious expression of internal emotional processes, could help to identify early signs of PPD. It was hypothesized that differences would be found in the emotional dream work of pregnant women who either later developed or did not develop PPD. 166 women participated in the two stages of the study. During stage I, the women were interviewed in the last trimester of their first pregnancies. The interview included a demographic questionnaire and an account of a dream. During stage II, the women were interviewed 6–10 weeks after giving birth. The second interview included only the EPDS scale for affirming or denying the occurrence of PPD. The findings of the study confirm the hypothesis that dreams of pregnant women can differentiate among women who are or are not at-risk for PPD. It was found that more unpleasant dreams and dreams expressing apprehension were found among women who did not later develop PPD, than among women who did develop PPD.     

Does Absence Matter?

This paper examines the effects of three different types of father absence on the timing of life history events among women in rural Bangladesh. Age at marriage and age at first birth are compared across women who experienced different father presence/absence conditions as children. Survival analyses show that daughters of fathers who divorced their mothers or deserted their families have consistently younger ages at marriage and first birth than other women. In contrast, daughters whose fathers were labor migrants have consistently older ages at marriage and first birth. Daughters whose fathers died when they were children show older ages at marriage and first birth than women with divorced/deserted fathers and women with fathers present. These effects may be mediated by high socioeconomic status and high levels of parental investment among the children of labor migrants, and a combination of low investment, high psychosocial stress, and low alloparental investment among women with divorced/deserted fathers. Our findings are most consistent with the Child Development Theory model of female life history strategies, though the Paternal Investment and Psychosocial Acceleration models also help explain differences between women in low paternal investment situations (e.g., father divorced/abandoned vs. father dead). Father absence in and of itself seems to have little effect on the life history strategies of Bangladeshi women once key reasons for or correlates of absence are controlled, and none of the models is a good predictor of why women with deceased fathers have delayed life histories compared with women whose fathers are present.