妊娠合并HIV感染的围生期护理

妊娠合并人类免疫缺陷病毒（HIV）感染已成为全球艾滋病流行中令人关注的问题。妊娠合并HIV感染在给家庭和社会造成严重危害的同时,也在分娩、新生儿护理、职业暴露预防及处置方面,给护理人员提出了新的课题。现对我院7年间收治的妊娠合并HIV感染孕产妇3例资料作回顾性分析,旨在探讨此类孕产妇的围生期护理经验。

Establishment of a model for pregnancy-induced hypertension syndrome resulting from cold-stress in rats

Objective: To establish a model for pregnancy-induced hypertension syndrome in rats. Methods: Adult female Wistar rats were randomized into non-pregnant control (NN), non-pregnant cold-stress control (NC), pregnant control (PN) and pregnant cold-stress (PC) groups. The rats of NN and PN groups were put under 25 ℃ and those of NC and PC groups under (4±2)℃ for 4 h every morning respectively in the whole experimental period. The blood pressure, urine protein, body weight, haematocrit, weight of the placenta and weight and length of the fetus were recorded and the histological changes of the placenta and the kidneys were also studied. Results: The blood pressure and urine protein of the rats of the NC and PC groups after 2 weeks of cold-stress were more significantly increased than the rats of the NN and PN groups. In addition, the weight of the placenta and the weight and length of the fetus were more significantly lower in the former than the latter. Obvious changes of anoxia and ischemia were observed in the tissues of the kidneys and every layer of the placenta. Conclusion: Our findings of hypertension syndrome induced with repeated cold-stress in pregnant rats can be applied to illustrate the pathogenesis of pregnancy-induced hypertension syndrome in human beings.

Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

AIM： To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS： A total of 2 147 persons （1 111 females, age 42.8 ＋ 12.7 years; 1 036 males, age 42.3 ＋ 13.1 years） participating in an investigation on the prevalence of Echinococcus rnultilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index （BMI）. A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS： Gallbladder stones were detected in 171 study participants （8.0%, n = 2 147）. Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy （yes/no） and number of pregnancies did not exert any influence. CONCLUSION： Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations.

Management of Pregnancy with Ankylosing Spondylitis

Objective To discuss the interaction between pregnancy and ankylosing spondylitis, and the management of pregnancy with ankylosing spondylitis. Methods Twelve cases of pregnancy with ankylosing spondylitis in Peking Union Medical College Hospital from September 2004 to July 2011 were analyzed retrospectively, focusing on the arteritis condition, pregnancy complications, and outcomes. Results All the 12 patients had full-term pregnancy. Five cases gave birth naturally, and 7 cases received cesarean section for maternity factors. No adverse pregnancy outcomes were encountered. Waist pain appeared in 2 cases in the second trimester, for both of which medication failed. One of the 2 cases had natural childbirth, while the other maintained pregnancy smoothly to cesarean section. Conclusions Pregnancy monitoring can help obtain favorable pregnancy outcomes. Attention should be paid to postpartum change of the illness.

A rare case of pregnancy complicated by mesenteric mass:What does chylous ascites tell us?

Mesenteric fibromatosis is a rare benign nonmetastatic neoplasm that appears as a sporadic lesion or occurs in patients with familial polyposis, while chylous ascites associated with aggressive mesenteric fibromatosis during pregnancy has never been reported thus far. Here we present the case of a 28-year old pregnant woman, in whom an aggressive mesenteric fibromatosis with chylous ascites was detected, involving the jejunum, superior rnesenteric artery （SMA） and superior rnesenteric vein （SMV） and pancreas. One year after a successful surgical excision, the patient had no signs of recurrence. The authors report the case for its rarity and emphasize on combining clinicopathological, radiological and immunohistochemistry analysis for management of the disease.

Increased apoptosis in third - trimester placental tissue from gestations complicat-ed by PIH

Objective: To investigate a possible role of apoptosis in the pathophysiologic mechanisms of PIH (pregnancy-induced hypertension syndrome).Methods: In this study, placental samples were obtained from 16 uncomplicated third-trimester pregnancies and from 16 cases of PIH.We used light microscopy, electron microscopy to identify apoptosis.Light microscopy was used to quantify their incidence of apoptosis.Electron microscopy was used to confirm the occurrence of apoptosis.Results: Apoptosis has been conclusively demonstrated within human third-trimester placental tissue.Medians and interquartile ranges of normal placenta (n=16) was 0.12% (0.08%-0.19%); Medians and interquartile ranges of PIH group (n=16) was 0.37% (0.15%-0.49%).Compared to normal placentas, the incidence of apoptosis was higher in placentas from gestations complicated by PIH (P<0.05, T'-test).Conclusion: Placental apoptosis increases significantly in PIH, and it may play a role in the pathophysiologic mechanisms of this syndrome.