48例妊娠合并甲亢临床分析

目的探讨甲亢对妊娠妇女和新生儿的影响。方法通过对孕期、产前测定甲亢孕妇外周血甲状腺[素三碘甲状腺原氨酸(T3)]和甲状腺素T4,促甲状腺素(TSH)水平的变化,了解甲亢的并发症,对新生儿脐血查T3、T4、TSH了解新生儿甲状腺功能。结果甲亢未治疗组甲状腺激素T3、T4、TSH水平明显高于治疗组(P<0.01)。未经治疗的甲亢并发症多,与治疗组相比,有显著性差异(P<0.01)。结论孕前及孕期对甲亢的合理治疗可以减少妊娠并发症和新生儿甲亢。     

前置胎盘对妊娠结局的影响

目的探讨前置胎盘类型与妊娠结局的关系。方法将45例前置胎盘分为轻度组(16例)及重度组(29例);对其临床表现及妊娠结局作回顾性分析。结果重度组产妇剖宫产率、诊断时孕周、分娩孕周、新生儿体重与轻度组比较差异有统计学意义(P<0.05或P<0.01),产前出血率、产后出血量、新生儿产后5min Apgar评分<7分者比较均无差异(P>0.05)。结论前置胎盘患者妊娠结局有很大的差异,没有典型的临床特征可循;重度前置胎盘对母儿危害更大,应适时分娩,以剖宫产为宜。     

晚发性羊水过少285例临床分析

目的探讨羊水过少发生的相关因素及其对母婴的影响,寻找正确的临床处理方法。方法回顾性分析2005年1月至2006年12月分娩的4252例产妇的临床资料,将羊水过少组及羊水正常组各285例在妊娠并发症、分娩方式、新生儿结局等方面进行对比分析,并对羊水过少发生孕周、羊水量与新生儿结局的关系进行分析。结果羊水过少高发于孕40周后,羊水量与新生儿预后呈正相关;过期妊娠、胎儿生长受限、妊高症、脐带缠绕与羊水过少密切相关,观察组与对照组比较有显著性差异(P<0.01,P<0.05);羊水过少组中胎儿窘迫、羊水Ⅲ度污染、新生儿窒息、新生儿高胆红素血症比对照组显著增高(P<0.01,P<0.05)。结论羊水过少妊娠结局较差,应加强围生期保健,及时诊断,及时终止妊娠,对于羊水≤5cm的孕妇,在除外胎儿畸形后剖宫产结束分娩,对于羊水指数5~8cm的,严密监护下可引产、阴道试产,适当放宽剖宫产指征。     

70例重度子痫前期及子痫妊娠结局分析

目的探讨重度子痫前期及子痫的母婴结局,寻求最佳处理方案,降低孕产妇和围产儿的并发症。方法回顾分析我院2000年1月至2007年12月70例重度子痫前期及子痫病例的临床资料,对母婴的妊娠结局与同期无妊娠期高血压疾病者作对照,并分析围产儿结局与分娩孕周的关系。结果重度子痫前期及子痫发生率为2.53%,其剖宫产、胎儿宫内生长受限(FGR)、新生儿窒息、围产儿死亡率等均高于对照组,而规律产检率低于对照组,P<0.01,差异有统计学意义。孕34周后终止妊娠的新生儿窒息率和围产儿死亡率明显低于孕34周前终止妊娠者。结论重度子痫前期及子痫严重危害母婴健康,系统管理对预防、降低重度子痫前期及子痫的发生起着重要的作用;对于孕周已达34周以上的重度子痫前期患者,经促胎肺成熟治疗后即可终止妊娠,剖宫产是重度子痫前期终止妊娠的重要措施。     

前置胎盘32病例分析

目的探讨前置胎盘的类型、阴道出血状况与妊娠结局的关系。方法将32例前置胎盘分为轻度组(16例)及重度组(16例),对其临床表现及妊娠结局做回顾性分析。结果重度组初次出血及诊断时孕周均明显小于轻度组(P<0.05)。结论前置胎盘患者妊娠结局有很大的差异,其类型及产前出血状况难以预测其结局。     

弥漫性甲状腺肿伴甲亢合并肝功能损害临床研究

目的探讨甲状腺功能亢进症与其引起的肝功能的变化关系及临床意义。方法测定28例弥漫性甲状腺功能亢进症患者肝功能,并与38例健康成人甲亢患者肝功能变化的情况对比进行分析。结果甲亢组肝功能指标发生异常变化,其中总蛋白(TP)、白蛋白(ALB)明显低于对照组(P<0.01)。丙氨酸转氨酶(ALT)、碱性磷酸酶(AKP)明显高于对照组(P<0.01)。总胆红素(TB)高于对照组(P<0.05)。结论肝功能测定对于甲状腺功能亢进症患者的病情评估、指导治疗及判断预后具有一定意义。     

重度子痫前期合并腹水26例临床分析

目的探讨重度子痫前期并发腹水孕妇终止妊娠的时机和方式及围生儿的结局。方法通过把26例重度子痫前期并发腹水患者与108例未发生腹水患者进行回顾性对照,分析。结果 26例重度子痫前期并发腹水患者宫产率为100%,明显高于对照组54.6%的比例(P<0.01);病死率为7.7%,与无腹水组的4.6%比较差无统计学意义(P>0.05)。结论重度子痫前期并发腹水经积极治疗,孕周>34周新生儿存活率高,适时终止妊娠是其有效方法,终止妊娠的方式首选剖宫产。     

中西医结合治疗甲状腺机能亢进症

目的观察中西医结合治疗甲状腺机能亢进症的疗效。方法将我院120例甲亢患者随机分为治疗组及对照组。结果治疗组的总有效率为95.0%,显著高于对照组的78.3%(P<0.05),治疗后2组患者血清T3、T4、FT3、FT4均显著低于治疗前(P<0.05),治疗组降幅较大,但与对照组比较,差异无统计学意义(P<0.05)。治疗组出现白细胞减少、药疹等不良反应4例,对照组出现不良反应10例,差异有统计学意义(P<0.05)。结论中西医结合取长补短治疗甲亢疗效安全、可靠,具有良好的调节机体整体功能的协同作用,相辅相成,缩短疗程,疗效满意,确为治疗甲状腺机能亢进症的有效方法之一,但远期疗效有待于进一步研究。     

妊娠合并血小板减少的临床观察

目的探讨妊娠合并血小板减少患者的围生期处理及分娩方式的影响。方法将2006年1月至2009年7月在我院分娩的妊娠合并血小板减少的53例患者按分娩前血小板计数分为观察组13例(PLT≤50×109/L)和对照组40例(PLT>50×109/L)。结果2组的剖宫产率差异相比具有统计学意义(P<0.05)。结论妊娠期严重血小板减少症的对症治疗及分娩方式的选择可以减少孕妇及胎儿的出血风险。     

90例前置胎盘期待疗法的临床观察

目的探讨期待疗法对治疗前置胎盘的可行性,避免孕妇避免诱发宫缩,提高新生儿的成活率。方法对分娩的前置胎盘[经B超检查和(或)剖宫产术中证实]患者90例,将其中62例中入院时前置胎盘阴道大出血、自发子宫收缩强烈、孕足月及孕妇及家属要求而行刮宫产终止妊娠共30例作为对照组;其余60例作为观察组(均知情同意)进行期待疗法,选择合适时机终止妊娠。比较2组患者在分娩孕周、产前产后出血量、产褥感染、围生儿体质量、Apgar评分、病死率、呼吸窘迫综合征等方面上的差异,并进行统计学处理。结果观察组与对照组产前出血比较无差异(P>0.05);但观察组比对照组产后出血少、孕周延长、产褥感染少、新生儿体质最增加、Apgar评分改善、RDS下降(P<0.05)。结论在严密监测下通过期待疗法治疗前置胎盘能在确保母婴安全的前提下延长孕周,增加新生儿体重,降低围生儿病死率,其方法具有可行性。     

Longitudinal Assessment of Erythrocyte Fatty Acid Composition Throughout Pregnancy and Post Partum

Transfer of fatty acids from mother to fetus during pregnancy is a requirement for optimal fetal growth. We report a longitudinal study of full maternal erythrocyte fatty acid profile assessed at each trimester of pregnancy [mean 12.5 (range 8–14), 26.1 (24–28) and 35.5 (33–38) weeks’ gestation] and in the post partum period [18.1 (12–26) weeks]. The study recruited healthy women (n = 47) from routine antenatal clinics at the Princess Royal Maternity Unit, Glasgow, Scotland. There were increases in 16:1n7 (22%, p = 0.0005), 24:1n9 (13%, p = 0.0032), 22:5n6 (25%, p = 0.0003), 18:3n3 (41%, p = 0.0007) and 22:6n3 (20%, p = 0.0005) concentrations during pregnancy. The greatest increases took place between gestations at sampling of 12.5 and 26.1 weeks. The change in 16:1n7 concentration between gestations at sampling of 12.5 and 35.3 weeks was negatively associated with maternal booking body mass index (r = −0.40, p = 0.006). The change in 22:6n3 concentration was correlated with the change in 24:1n9 (r = 0.70, p < 0.001). In samples taken four months post partum, 14:0 concentration was lower (29%, p = 0.0002) and 24:0 concentration (15%, p = 0.0009) and n6/n3 ratio (11%, p = 0.0019) were higher than at a gestation at sampling of 12.5 weeks. In conclusion, several fatty acids are specifically mobilised during pregnancy. The correlation between maternal 22:6n3 and 24:1n9 suggests that mobilisation of these fatty acids may be coordinated. The inverse relationship between 16:1n7 and maternal central obesity warrants further investigation.     

Plasma Ceramides and Triglycerides Are Elevated during Pregnancy in Association with Markers of Insulin Resistance in Hutterite Women

Changes in maternal insulin sensitivity and circulating lipids typically occur during the metabolic transitions of pregnancy and lactation. Although ceramides can cause insulin resistance in mammals, their potential roles during pregnancy and lactation are unknown. We hypothesized that changes in lipids like ceramide and triglycerides could occur across different reproductive states and relate to insulin resistance. Our objectives were to comprehensively characterize lipids in the plasma of pregnant, lactating, and nonpregnant and nonlactating (NPNL) women, and to evaluate the relationship between ceramides and the triglyceride index, a proxy of insulin resistance. Middle-aged Hutterite women from the South Dakota Rural Bone Health Study were classified by reproductive status as nonpregnant and nonlactating (NPNL; 19 observations), pregnant (14 observations), or lactating (31 observations). Several plasma lipids were elevated in pregnancy such as ceramides, triglycerides, and total- and high-density lipoprotein cholesterol. The triglyceride index was highest during pregnancy and was positively associated with long- and very long-chain ceramides. Lipidomics revealed lipid signatures specific to reproductive state, including triglycerides, phosphatidylcholines, sphingomyelins, and cholesteryl esters, which were also related to the triglyceride index. Our data support the possibility that ceramides contribute to the development of insulin resistance during pregnancy, and reveal distinct lipid signatures associated with pregnancy and lactation.     

Genetic Risk Scores for Maternal Lipid Levels and Their Association with Preterm Birth

Maternal lipid profiles are associated with risk for preterm birth (PTB), although the lipid component and effect size are inconsistent between studies. It is also unclear whether these associations are the result of excessive changes in lipid metabolism during pregnancy or genetic variability in genes controlling basal lipid metabolism. This study investigates the association between genetic risk scores (GRS) for four lipid components (high-density lipoprotein [HDL-C], low-density lipoprotein [LDL-C], triacylglycerols [TAG], and total cholesterol [TC]) with risk for PTB. Subjects included 954 pregnant women from California for whom second trimester serum samples were available, of which 479 gave birth preterm and 475 gave birth at term. We genotyped 96 single-nucleotide polymorphisms, which were selected from genome-wide association studies of lipid levels in adult populations. Lipid-specific GRS were constructed for HDL-C, LDL-C, TAG, and TC. The associations between GRS and PTB were analyzed using logistic regression. A higher HDL-C GRS was associated with increased risk for PTB overall and spontaneous PTB. Higher TAG and TC GRS were associated with decreased risk for PTB overall and spontaneous PTB. This study identifies counter-intuitive associations between lipid GRS and spontaneous PTB. Further replication studies are needed to confirm these findings, but they suggest that our current scientific understanding of the relationship between lipid metabolism, PTB, and genetics is incomplete.     

Sex‐specific Alterations in Serology and the Expression of Liver FATP4 Protein in Offspring Exposed to High‐Fat Diet during Pregnancy and/or Lactation

Changes in dietary composition will have a significant impact on the nutritional status of the mother and the offspring. To examine the relevant hormone level changes during lactation and the expression of fatty acid transporters in the placenta and liver under the condition of a high‐fat (HF) diet, we established HF animal models and conducted a cross‐fostering program to mimic the shift in diet. On gestation day (GD)18, the weight of placenta in the HF group was significantly higher than that in the control group (p < 0.05). HF‐fed male pups had a significantly lower serum insulin level, but the same phenomenon was not found in females. On the contrary, serum triacylglycerol (TAG) level presented a tendency to decrease only in female offspring. Oil red O staining showed lipid accumulation in the HF diet offspring livers. The mRNA levels of FATP4 in the placenta in the HF diet group were significantly upregulated compared to the control diet group (p < 0.05). High‐fat diet (HFD) consumption also altered the liver mRNA levels of FATP4, SREBP‐1, and SCD‐1 in the male offspring, while the changes in protein levels of FATP4 were not observed in either sex. In conclusion, maternal HF diet has a profound impact on offspring growth, metabolism, and the risk of metabolic disorders, which would depend on the exposure period of pregnancy and lactation.     

A Docosahexaenoic Acid-Functional Food During Pregnancy Benefits Infant Visual Acuity at Four but not Six Months of Age

Within the visual system, docosahexaenoic acid (DHA, 22:6n−3) is an important structural component for retinal photoreceptors and cortical gray matter. There is a marked decrease in neural DHA accumulation in the face of DHA deficiency. DHA is accumulated at an accelerated rate during pregnancy, especially in the third trimester. However, pregnant women in the US and Canada have dietary DHA intakes that are significantly below the optimal level. The main objective of this study was to determine whether a DHA-functional food during pregnancy would benefit infant visual acuity at four and six months of age measured behaviorally using the acuity card procedure (ACP). In a randomized, longitudinal, double-blinded, and placebo-controlled trial, 30 pregnant women received either the DHA-functional food (n = 16) or the placebo (n = 14). There were significant main effects for visual acuity at four months of age (P = 0.018). The mean acuity scores were 3.8 ± 1.1 cycles/degree in the DHA group versus 3.2 ± 0.7 cycles/degree in the placebo group. At six months there were no group differences. Based on our results, we conclude that DHA supplemented during pregnancy plays a role in the maturation of the visual system.     

Maternal Consumption of trans-Fatty Acids During the First Half of Gestation are Metabolically Available to Suckled Newborn Rats

Dietary trans-fatty acids (t-FA) during pregnancy have adverse effects on growth and development. To determine the effect of dietary t-FA during just the first half of pregnancy, rats were given a diet containing 8 % hydrogenated peanut oil and 2 % olive oil (PO) and compared to rats given a diet containing 10 % olive oil (OO). After 12 days all rats were fed standard diet and were studied at days 12 or 20 of pregnancy or days 1 or 6 postpartum. At day 12 of pregnancy there were small differences in the plasma and lumbar adipose tissue fatty acid profiles and elaidic acid [18:1(n-9)t] was present in the PO group. From day 12 to 20 of pregnancy, plasma non-esterified fatty acids, glycerol, triacylglycerols (TAG) and most individual fatty acids increased more in PO than in OO. At day 20 of pregnancy in the PO group most plasma elaidic acid appeared as plasma TAG and was also present in the mammary gland, to decline in both sites at day 1 postpartum. Elaidic acid concentration was low in the plasma of 20-day fetuses, increased in 1-day newborns declining at day 6. Thus t-FA, eaten during early pregnancy, accumulated in maternal adipose tissue and were released during late pregnancy to be taken up by the mammary gland becoming available to the newborns during suckling.     

Reproductive endocrine influences upon olfactory perception

An overview of relationships between psychophysical measures of olfactory function and reproductive neuroendocrine processes is presented. Human studies are emphasized, and the influences of gender, menstrual cycle phase, pregnancy, and injected gonadal hormones upon olfactory perception are discussed in detail.Supported by National Institute of Neurological and Communicative Disorders and Stroke grant NS 16365.     

乙烯酮(双乙烯酮)下游产品废水的治理技术

乙烯酮(双乙烯酮)是十分重要的化工中间体,其下游产品较多。江苏某化工厂开发生产乙烯酮(双乙烯酮)下游产品三十多个,年生产规模三万多吨,是国内以乙烯酮(双乙烯酮)为中间体生产精细化学品的综合骨干企业。针对乙烯酮(双乙烯酮)下游产品废水特点,该厂结合企业实际,开展了产品优化,结构调整,清洁生产,资源循环利用,节水降耗等工作,从源头削减了污染物的生产。同时投资二千多万元新建预处理装置三套,6000m3/d废水生化处理装置一套,使全厂乙烯酮(双乙烯酮)下游产品的废水得到了有效的治理。     

几种乙炔加压设备性能的比较

阐述并比较了几种加压设备在乙炔加压清净过程中的性能和特点。