目的 探讨降低神志清醒老年住院患者外周静脉留置针夜间自主拔管的方法.方法 将老年神志清醒住院患者筛选出易自主拔管的高危人群100例,按随机数字表法随机分为实验组和对照组各50例.两组均使用静脉留置针,穿刺成功后对照组在穿刺部位外套弹力网,实验组在穿刺部位包裹肉色丝袜,睡前对侧上肢穿相同丝袜.比较两组穿刺部位舒适度及其夜间无意识拔管情况.结果 对照组患者留置针部位有压痕,局部有痒感,实验组患者留置针部位感觉舒适透气；实验组患者舒适度优于对照组,差异有统计学意义(x2=53.175,P＜0.05)；实验组夜间拔管例数4例占8％,未拔管例数46例占92％；对照组拔管例数12例占24％,未拔管例数38例占76％,两组比较差异有统计学意义(x2=4.762,P＜0.05).结论 留置外周静脉留置针老年患者睡前穿刺针部位使用丝袜进行保护,可减少患者的自主拔管,值得临床推广。

Objective Explore Through biofeedback therapy with electrical stimulation on pelvic floor exercise of the pelvic floor rehabilitation therapy to improve pelvic floor function.Methods Our hospital from March 2011 to May 2012,deliveries in 42 days after delivery at the for review of maternal pelvic floor b-general line understand the Organization of the pelvic floor,select 151 cases prejudicial to the victim for pelvic floor muscle strength determination,POP-Q and SUI survey,pelvic floor rehabilitation therapy effect evaluation of rehabilitation after treatment.Results Treatment of pelvic floor muscle strength after the earlier increased significantly, reduced incidence of SUI,POP a noticeable improvement,differences are statistically significant. Conclusion Delivery on the pelvic floor usually caused varying degrees of damage, postpartum pelvic floor muscle rehabilitation training, can improve pelvic floor muscle tension, reduce the incidence of stress urinary incontinence and improving pelvic organ prolapse.

Objective To develop a method of using epigenetic marker to evaluate the cell-free DNA of fetus in maternal plasma.Methods Forty-eight pregnant women and ten healthy non-pregnant women were selected as observation group and control group respectively.The peripheral blood samples of 10 mL were drew from objects of the two groups.The assay used marker of T-box 3(TBX3),and methylation-sensitive restriction enzymes to eliminate the maternal(unmethylated) fraction of the DNA sample.The undigested fetal DNA fraction was then amplified in the presence of a synthetic oligonucleotide to permit competitive polymerase chain reaction.The free fetal DNA were quantified by MALDI-TOF-MS analysis.Results A mean of(148.0±63.5)×103 copies·L-1 of fetal DNA and a mean fetal propotion of 12% in plasma samples was obtained from observation group.A mean of(6.0±4.5)×103 copies·L-1 of methylated DNA in plasma samples was obtained from control group.The difference of the two groups in copy number of methylated DNA in plasma samples is significant(P0.05).The analytical sensitivity and specificity of the method for the assay was 99% and 100%,respectively.Conclusion Methylation-based reaction can detect and quantify the amount of fetal DNA in a sample isolated from maternal plasma.This technology may help explore the clinic application of noninvasive prenatal diagnosis.

目的探讨不同分娩方式对产后早期盆底功能的影响。方法选择2010年10至11月在我院产科门诊就诊的产后6～8周的初产妇105例,根据分娩方式分为阴道顺产组(74例)和选择性剖宫产组(31例),由专人负责行盆底功能检查,进行POP-Q评分。有漏尿史者需行尿垫实验。比较2组产后早期盆腔器官脱垂(POP)、压力性尿失禁(SUI)的发生率。结果阴道顺产组中,POP2发生率77.03%(57/74),较选择性剖宫产组38.71%(12/31)高,2组差异有统计学意义(P<0.05);阴道顺产组中,产后SUI发生率31.08%(23/74),较选择性剖宫产组3.23%(1/31)高,2组差异有统计学意义(P<0.05)。结论产后早期POP和SUI的发生与分娩方式有关,选择性剖宫产可降低产后早期盆腔脏器脱垂和压力性尿失禁的发生。

Objective To investigate the sexual problems during early postpartum period and the awareness of postpartum sexual health. Methods A questionnaire survey was carried out in 109 women who received routine postpartum check-up in our outpatient department between October and November 2010 to identify postpartum sexual problems and the awareness of postpartum sexual health. Results The first postpartum check-up was received 6 to 12 weeks after the delivery. Of 109 participants,6 (5.5%), 17(15.6%) and 46 (42.2%) resumed sexual activity within 6,6 to 8,and 12 weeks after the delivery,respectively. Postpartum sexual problems included dyspareunia (35/46,76. 09% ), vaginal dryness (29/46,63.04% ), hypoactive sexual desire (25/46,54. 35% ) and lack of orgasm ( 11/46,23.91% ). 10. 87% (5/46)took contraceptive measures,21.10% (23/109) understood the appropriate time to resume sexual activity, 12. 84% (14/109) was aware of the possible postpartum sexual problems, 13.76% (15/109) knew how to avoid pregnant,6.42% (7/109) would visit a doctor in case of the sexual disorders,and 9. 17%(10/109) hoped that their husband know about sexual health. Conclusion Postpartum sexual problems may be common and maternal awareness of postpartum sexual health could be low.

目的探讨HPV感染途径与工作环境及机体免疫状态的关系.方法利用hc-ⅡHPV DNA检测技术检测宫颈刮取物.结果121名高危型HPV感染构成比中,护士所占比例最高.结论医务人员是HPV病毒感染高风险人群,间接传染途径不可忽视.加强医务人员的机体免疫状态和加强工作环境的保护,是预防HPV感染的手段.