目的 评价个案管理模式对妊娠期糖尿病( GDM)孕妇管理的应用效果.方法 选取诊断为GDM并符合纳入标准的114例孕妇为干预组,采用GDM个案管理模式进行有关管理;对照组为同期前1 年诊断为GDM、符合纳入条件的122例孕妇,由妇产科门诊医生及护士直接进行常规健康宣教,给予饮食指导和运动建议.比较两组孕妇血糖、妊娠结局等指标的差异.结果 GDM个案管理模式干预组能降低胰岛素使用率(P＝0.019)、减少因血糖控制欠佳再入院率(P＜0.001),对妊娠结局的影响方面差异无统计学意义(P＞0.05).结论 GDM个案管理模式能有效控制GDM孕妇的血糖,降低胰岛素使用,减少因血糖控制欠佳再入院的次数.

目的:探讨低频脉冲电刺激联合音乐疗法在分娩产妇中的应用效果.方法:将114例自然分娩产妇随机分为观察组与对照组各57例,对照组采用常规助产护理方法,观察组在常规助产护理基础上应用低频脉冲电刺激联合音乐疗法.采用疼痛数字评分法(NRS)对产妇疼痛程度进行评估,比较两组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分,产妇第一、第二产程时间.结果:观察组产妇第2、3、4次NRS评分低于对照组(P＜0.01);胎儿娩出后观察组产妇SAS、SDS评分均低于对照组(P＜0.01);观察组患者第一产程、第二产程时间均短于对照组(P＜0.05).结论:低频脉冲电刺激联合音乐疗法能够降低产妇第一产程、第二产程痛苦程度与焦虑、抑郁水平,缩短产程耗时.

目的 探讨经莫非氏滴管静脉滴注新麦角新碱预防产后出血短时间内对产妇血压的影响. 方法 收集在暨南大学附属第一医院妇产科定期产检、合并产后出血高危因素且在我院顺产的孕妇33例,在胎儿娩出后、胎盘娩出前通过莫非氏滴管静脉滴注新麦角新碱预防产后出血,分别测量用药前、用药后5 min、10 min、15 min、20 min的血压及脉搏,并记录胎盘娩出时间及有无其他不良反应.数据采用SPSS13.0进行统计学分析. 结果 与用药前相比,用药后5 min、10 min、15 min、20 min的收缩压、舒张压均有明显升高,具有统计学意义(P＜0.05),收缩压、舒张压升高的最大值分别出现在用药后10 min和15 min,分别为(7.95±10.58) mmHg、(6.55±10.86) mmHg;用药前后脉搏无明显改变(P＞0.05);胎盘娩出时间为(6.22±1.31) min,产妇均未出现其他不良反应. 结论 静脉滴注新麦角新碱预防产后出血短时间内可导致血压升高,但血压升高幅度较小,无临床意义,且无胎盘嵌顿及其他不良反应等发生,由此证明静脉使用新麦角新碱的安全性.

Purpose: Integrin v3 (ITG v3) participates in the process of implantation between the embryo and the endometrium. This study investigated the effects of prostaglandin E-2 (PGE(2)) on endometrial receptivity and implantation efficiency of the embryo, and their possible mechanisms.Methods: Quantitative real-time reverse transcription PCR (qRT-PCR) and western blotting were used to detect the changes in mRNA and protein levels of ITG v3 in RL95-2 cells after administering PGE(2). BeWo trophoblast cells and RL95-2 endometrial epithelial cells were used to establish an in vitro model, which was used to observe the adhesion rate and spreading efficiency between BeWo spheroids and RL95-2 cell monolayers after pretreatment with different concentrations of PGE(2).Results: PGE(2) at 200nM increased the mRNA and protein levels of ITG v significantly (p<0.05); 100nM PGE(2) increased the mRNA and protein levels of ITG 3 significantly (p<0.05). PGE(2) at 200nM increased significantly the adhesion and spreading efficiency of BeWo spheres to RL95-2 cell monolayers.Conclusions: An appropriate concentration of PGE(2) might increase the expression of ITG v3, which would, promote embryo adhesion and spreading efficiency. This study provides further evidence that increased expression of ITG v3 might promote implantation by improving endometrial receptivity.

MicroRNAs, a group of posttranscriptional regulators of numerous genes, are active participators during the development and progression of ovarian cancer (OC). This study confirmed for the first time that miR-216a was gradually increased in normal, benign, borderline, and OC tissues and that its expression was significantly upregulated in all OC cell lines. Analysis of its clinical association demonstrated that elevated expression of miR-216a was associated with lymph node metastasis and advanced FIGO stage and was correlated with the poor survival of OC patients. Functional experiments showed that miR-216a overexpression potentiated the migration and invasion of CAOV3 cells while miR-216a inhibition reduced the migration and invasion of SKOV-3 cells. Both gain and lose of function assay showed that miR-216a promoted epithelial-mesenchymal transition (EMT) of OC cells. Mechanistically, phosphatase and tensin homolog (PTEN) was confirmed as a direct downstream target of miR-216a in OC cells. Alerting miR-216a expression in OC cells modulated the activity of PTEN/AKT pathway in OC cells. Furthermore, this study confirmed that miR-216a exerted its promoting effects on the metastatic behaviors and EMT of OC cells by inhibiting PTEN/AKT pathway. Taken together, this study demonstrates that miR-216a exerts a promoting role in the metastasis of OC and can serve as a promising biomarker and an attractive therapeutic target of OC.

OBJECTIVE:To study the effect of Taoren Quyu Decoction (TQD) on endometrial cells in patients with endometriosis (EMs) and EMs in rats. METHODS:A total of 60 female Wistar rats were randomly divided into 4 groups, namely, normal group, model group, positive group and TQD group, each group having 15 rats. Except the normal group, EMs model was established in the other three groups by transplanting the rat autologous endometrium. After 4 weeks of intragastric administration, blood, eutopic and ectopic endometrial tissues of rats in each group were collected to detect the serum levels of estrogen (E2), cancer antigen 125 (CA125), endometrial antibody (EMAb), and expressions of microvessel density (MVD), vascular endothelial growth factor (VEGF) and angiopoietin (Ang-2). The volume of endometriosis cyst was determined simultaneously. For the in vitro culture of human endometrial cells, 4 groups, namely, normal group, model group, positive group and TQD group were used. The positive group and TQD group were treated with danazol and TQD respectively. Then 24 h after the treatment, the expressions of survivin and tumor suppressor gene (p53) of each group were detected. RESULTS:The volumes of the endometriosis cysts in the positive group and the TQD group were significantly reduced compared with the model group (P < 0.05). The serum levels of E2, CA125 and EMAb, and the expressions of MVD, VEGF and Ang-2 in the model group were significantly increased compared with the normal group (P < 0.05); while they were all significantly reduced in the positive group and TQD group (P < 0.05). Compared with the normal group, the expression of survivin in the model group was significantly up-regulated (P < 0.05), and expression of p53 was significantly reduced (P < 0.05); compared with the model group, the expressions of survivin in the positive and TQD groups were significantly decreased (P < 0.05), and expression of p53 was significantly up-regulated (P < 0.05). The difference between positive group and TQD group was not statistically significant (P > 0.05). CONCLUSIONS:TQD has a significant anti-EMs effect, and its mechanism of action may be related to anti-angiogenesis and promoting apoptosis of ectopic endometrial cell.

ObjectiveTo analyze lactagogue effect by Buxueshengru particles in clinical application. MethodsA total of 100 puerpera with postpartum hypogalactia or agalorrhea were randomly divided into observation group and control group, with 50 cases in each group. The control group received paspertin for treatment, and the observation group received Buxueshengru particles for treatment. Curative effects were compared between the two groups.ResultsBoth groups had improved lactation yield, lactation filling quantity, serum prolactin (PRL) after treatment, and the difference had statistical significance (P<0.05). After treatment, the observation group had lactation yield as (712.25±160.42) ml, lactation filling quantity as (36.01±19.12) ml and PRL as (2008.46±34.24) mIU/L, which were all better than (258.73±101.29) ml, (238.00±51.40) ml and (1233.20±22.30) mIU/L in the control group, and the difference had statistical significance (P<0.05). The observation group had obviously higher total effective rate as 98% than 80% in the control group, and the observation group had lower incidence of adverse reactions as 6% than 28% in the control group, and their difference had statistical significance (P<0.05).ConclusionClinical application of Buxueshengru particles for lactagogue can effectively improve hypogalactia with excellent effect, and it is worth promoting and applying.

<正>患者,女,62岁,因绝经后阴道流血半年余,左下腹痛10 d于2010年5月18日入院。半年前无诱因持续性阴道流血,量少,色偏红,无伴腹痛,未在意。10 d前无明显诱因左下腹持续性疼痛,可忍受,休息后无缓解,无发热、腹胀、恶心呕吐。2年前阑尾炎手术史。绝经12年,绝经前月经一向规律。孕3产3。体格检查无异常。专科检查:子宫体稍大,活动可,无压痛。左侧附件区可扪及一包块,直径约6 cm,表面光滑,质韧,活动差,无明显压痛反跳痛,与子宫分界不清。入院后B超检查:子宫增大,内膜厚19 mm,欠光整,内部结构较