4760例孕中期产前筛查和产前诊断产妇随访结果分析

目的：探讨孕中期产前筛查和产前诊断在临床中的应用和意义。方法：应用时间分辨法,以血清AFP、β-HCG作为指标,对4 760例在孕15～20＋6周孕妇进行产前筛查,对筛查为高风险的孕妇进行一对一的遗传咨询和产前诊断,并在产后3月内对其分娩结局进行随访观察。结果：随访中发现有不同程度畸形、流产、死胎等不良妊娠共29例：高风险者6例,低风险者23例。其中羊水染色体异常2例、超声检查检出各种畸形（开放性神经管畸形如脊柱裂、小头畸形、脑膨出等）6例、内脏畸形（如先心病、肾发育不良、胎儿宫内发育异常等）5例。不明原因死胎、晚期流产3例,21-三体新生儿1例（产前筛查唐氏高风险而拒绝羊水穿刺细胞学检查所致）。结论：孕中期产前筛查和产前诊断可降低出生缺陷的发生。     

准妈妈最关心的N个问题

我今年37岁,现在怀孕16周,11月生产。因为高龄初产,医生建议我剖宫产,但我希望能尝试无痛分娩,因为我有重度宫颈糜烂。请问可以吗?当初孕妇年龄≥35岁时,称为高龄孕妇。你这个年龄怀孕,无论对你本身及对胎儿来说,风险都要相对增大,因为随着年龄的增长,子宫颈的坚硬度在增加,故高龄孕妇富颈性难产发生率大大增加。无痛分娩不仅能消除或减轻孕     

孕期问与答

在我国的“母婴保健法”中已经规定,35岁以上的孕妇建议直接进行产前诊断。而唐氏筛查仅适用于35岁以下的孕妇。因此,分娩时年龄已达35岁的孕妇,又做了唐氏筛查高风险,更应该进行产前诊断。目前产前诊断最常用的技术是羊膜腔穿刺技术,即在B超指引下,将针通过准妈妈腹部刺入羊水中,抽取羊水,在实验室中分离出胎儿细胞,对胎儿细胞进行染色体核型分析,以明确诊断胎儿是否为唐氏综合症患儿。羊膜腔穿刺适宜孕周为16～22周。     

米非司酮与依沙吖啶联合用于中孕引产效果观察

目的探讨米非司酮与依沙吖啶联合用于中孕引产效果及其对产程的影响。方法将457例孕16—26周的妇女随机分成两组，观察组227例和对照组230例，观察组经腹壁向羊膜腔内注入依沙吖啶100mg后。空腹分次口服米非司酮最大用药总量为150mg，对照组注药后口服安慰剂，服法同米非司酮。比较两组胎儿胎盘娩出时间、总产程、清宫率、引产成功率及宫颈裂伤发生率、产后出血量。结果观察组自引产开始至胎儿胎盘娩出时间及总产程均较对照组短，宫颈裂伤发生率和清宫率较对照组低，有显著性差异（P〈0．01）。产后出血量少于对照组，但差异无显著性（P〉0．05）。结论两药联合应用减少了引产孕妇的痛苦和住院时间，是一种较好的中期妊娠的引产方法。     

孕中期体重指数管理在改善妊娠结局的效果

目的:探讨孕中期体重指数管理在改善妊娠结局的效果.方法:将中山市东升医院产科门诊建档的孕妇148例作为研究对象,采用单双号数字表法分为观察组与对照组,每组各74例,对照组仅进行常规的产前检查,孕期运动及饮食指导,观察组进行体重指数管理,比较两组孕妇BMI变化及妊娠结局情况.结果:观察组孕产妇孕26周、孕28周、孕30周、孕32周、孕34周、孕36周及孕38周的BMI均显著低于对照组同期水平,p0.05;观察组孕妇产后出血、剖宫产发生率均显著低于对照组,p0.05;观察组新生儿中巨大儿、新生儿缺氧性疾病发生率均显著低于对照组,p0.05.结论:体重指数管理可有效控制妊娠孕妇BMI增长过快,改善母婴结局.     

香椿叶总黄酮对早期糖尿病肾病大鼠血糖值及血清中SOD、MDA水平的影响

目的：观察香椿叶总黄酮对早期DN大鼠血糖值及血清中SOD、MDA水平的影响．方法：腹腔注射STZ60mg．kg^-1以造成糖尿病大鼠．注射1周后测定大鼠血糖,若血糖≥16．7mM者则纳入为糖尿病大鼠,并按血糖值范围随机分为模型组、氨基胍组（0．1g．kg^-1．d^-1）和香椿叶总黄酮低、中、高剂量组（O．1、0．2、0．4g．kg^-1．d^-1）,同期另设一正常组,各组连续灌胃12周．于给药第6、12周测定大鼠血糖值,给药12周末测定大鼠血清SOD、MDA的含量．结果：香椿叶总黄酮能降低早期DN大鼠的血糖值,提高SOD活力,降低MDA水平．结论：香椿叶总黄酮具有降血糖作用,对早期DN引起的氧化应激损伤具有一定保护作用．     

准妈妈之旅 安全孕期大检索[二]

孕中期手册 孕13～16周时 胎儿的生长状况 胎儿身长16厘米,体重约135克;人体功能逐渐健全,内脏、颈部周围的器官基本发育完成;透明的皮肤略带红色,能看到皮肤下面的血管网;眼睛、耳朵形状清晰,面部长有胎毛;眉毛、睫毛正在生长;妊娠14周后,医生用听胎心仪器已能听到胎心音;胎儿在羊水中活动,他能吸吮自己的手指,你可能在本月第一次感觉到胎动。 你的生理变化 小腹稍稍隆起,腹部中央向下出现一条黑线;早孕现象已基本消失。部分敏感孕妇会持续几周;由于体内雌激素的作用,乳房明显     

氟伐他汀对不稳定型心绞痛患者血清白介素-18和肿瘤坏死因子α干预的研究

目的研究氟伐他汀对不稳定型心绞痛患者血清白介素-18（IL-18）和肿瘤坏死因子α（TNFα）的影响。方法选择2006年9月至2007年7月79例不稳定型心绞痛患者,入院后随机分为2组：氟伐他汀干预组42例：常规药物治疗基础上加用氟伐他汀40mg／d;对照组37例：常规药物治疗。分别于药物治疗前、药物治疗后2周采集静脉血,测定血清IL-18和TNFα的浓度。结果药物治疗后,对照组（P〈0．05）及氟伐他汀干预组（P〈0．01）血清IL-18和TNF＆浓度均明显降低;氟伐他汀干预组血清IL-18（P〈0．01）和TNFα（P〈0．01）浓度明显低于同期对照组。结论氟伐他汀可明显降低不稳定型心绞痛患者血清IL-18和TNFα浓度。     

632名产后抑郁症发病率及其认知功能障碍分析

目的：了解张家口市部分孕妇产后抑郁症（PPD）发病状况，探讨产后抑郁妇女的认知功能障碍的情况。方法：应用抑郁自评量表（SDS）、爱丁堡产后抑郁问卷（EPDS），对我院632名产妇进行调查。筛选出产后抑郁妇女70人。在调查后1周内复查，EPDS填表得分前后一致的68人作为产后抑郁妇女组。另选同期正常产后妇女68人为对照组，进行P300电位测定，将两组结果加以比较。结果：调查产妇632名，EPDS总分〉13分的68例，产后抑郁患病率为10．75％，产后抑郁妇女与正常产后妇女组相比，P300电位成分中N2与P3波潜伏期延长和P3波幅降低。其差异有显著性（P〈0．05）。结论：张家口市孕妇PPD发病率不高，产后抑郁症妇女的认知功能有一定的损害。评价产后妇女的抑郁率及认知状况对促进其全面康复有重要意义。     

孕37周后正常胎儿脐带血流频谱与胎儿脐带绕颈血流频谱的对比超声研究

目的：探讨孕37周后胎儿脐血流频谱和脐带绕颈血流频谱的特点。方法：对孕37周后的胎儿脐血流和脐带绕颈脐血流进行动态频谱监测。结果：孕37周后正常胎儿的脐动脉血流速度≤20cm／s。脐静脉血流速度≤10cm／s。脐带绕颈及发生在其它部位缠绕者，脐动脉血流速度＞20cm／s．脐静脉血流速度〉10cm／s。结论：当孕晚期发生胎儿脐带绕颈、特别是大于1周时，脐动脉、脐静脉血流速度加大．与自然飘浮于羊水中的脐血流速度存在一定的差异性。     

LIST FORMATS IMPROVE MEDICATION INSTRUCTIONS FOR OLDER ADULTS

We conducted a survey to compare a group of older adults’ and a group of younger adults’ beliefs regarding their own and each other's memory abilities. We also asked both age groups to identify items they believed older adults remember well. The survey was returned by 185 older (ages 60‐92) and 184 younger (ages 17‐39) participants. Of the 30 items we generated older adults reported that they would remember 23 better than younger adults would and 7 worse than younger adults would, and younger adults reported that they would remember 12 of the items better and 18 of them worse than older adults. Both age groups also generated many items that they believed older adults remember better than younger adults do. Finally, respondents generated items that they believed adults in their own age group had to remember routinely that adults in the other age group did not. The two groups agreed that older adults would spend more time and have more difficulty learning lines for presentation to an audience than would younger adults. Most of the older adults reported that their memories had changed; most of the younger adults reported that their memories had not changed. The belief that although older adults’ memory is worse than young adults’ they still remember some things better than the young is viewed as a realistic assessment, and implications for future research are discussed.     

CLERGY REQUEST LINKAGES: IMPLICATIONS FOR PLANNING MINISTRY WITH OLDER ADULTS

In this study, 159 volunteers aged 50 years and older were grouped into age decades (i.e., those in their 50s, 60s, etc.) and tested on measures of spelling, fluid intelligence, and crystallized intelligence. The younger subjects had significantly higher spelling test scores. Statistically removing the effects of crystallized intelligence and length of education by analyses of covariance had no effect on the difference, but removing the effect of fluid intelligence reduced the difference to nonsignificant levels. This implies that in older people spelling, although intuitively considered to be a crystallized skill, relies heavily on fluid intelligence.     

Assessing positive attitudes toward older and younger adults

Meaningful intergenerational interactions between older and younger adults are rare outside of family relationships. Interventions to increase positive intergenerational interactions are growing, but finding appropriate measures of attitudes toward both younger and older age groups is difficult. Many measures assessing attitudes toward older adults can remind participants of negative stereotypes of aging and are rarely used to assess attitudes toward younger adults. We adapted Pittinsky, Rosenthal, and Montoya’s allophilia measure to assess attitudes toward younger (18–25 years old) and older (over age 65) adults. In the first study, 94 traditional college age and 52 older adults rated older and younger adults. The allophilia measure distinguished between younger and older adults’ attitudes toward each age group. In the second study, we compared the age-related allophilia measures with seven traditional measures of attitudes toward older adults. Forty-seven traditional college age students completed measures. As predicted, correlations between allophilia toward older adults and the traditional semantic differential measures were weak (i.e., r = |0.15|or less), whereas correlations with general attitudes toward older adults were more moderate (r = 0.59 or less). Correlations between allophilia toward younger adults and the traditional measures were primarily non-significant as predicted. The allophilia measure differentiated between the five domains of positive attitudes toward younger and older adults and was not highly correlated with measures of more negative attitudes toward older adults. Results suggest that the allophilia measure can fill a need for a measure of positive attitudes toward older and younger adults.     

Traditional and nontraditional student attitudes toward the mixed age college classroom

As the numbers of nontraditional students on college campuses continue to climb, college educators should become increasingly aware of issues regarding the mixed age college classroom. The research reported in this paper is focused on understanding mixed age classrooms from the student's perspective. Through telephone interviews with over 300 students we explored three major areas: attitudes traditional and nontraditional students hold regarding their mixed age classroom experience; attitudes each group has toward their own age group and the other age group; and perceptions of the differences between older and younger students' relationships with their professors. Data on both younger and older students were collected, analyzed and compared.Jean M. Lynch is an Assistant Professor of Sociology/Anthropology, and Associate Director of the Applied Research Center at Miami University. She received her Masters in Sociology from the University of Rhode Island and her Ph.D. in Sociology from Brown University. Her research interests include the mixed age college classroom and the sociology of law and gender. Cathy Bishop-Clark is an Assistant Professor in the Systems Analysis Department at Miami University. She holds an M.S. in Information Systems, and is currently a doctoral candidate in Educational Foundations at the University of Cincinnati. Her research interests include the mixed age college classroom and cognitive style as relates to computer programming.     

Teaching by Keller Plan‐‐Comment on a Course in Spain

The use of the 'Cognitive Acceleration through Science Education' (CASE) intervention programme was explored in Malawi to see if the critical period for cognitive transition from concrete operations to formal operations at 12-14 years of age actually exists. The older pupils (16-17 years of age) in secondary school classes in Malawi made similar cognitive gains to younger English pupils after being taught CASE for 2 years. This was taken to suggest that the critical period does not exist. However, in Malawi, girls, who are on average a year younger than boys in the same class, and older boys, had lower academic achievement than younger boys. Explanations for this age and gender interaction are explored.     

Intelligence,Belief in the Paranormal,Knowledge of Probability and Aging

Older adults are less likely to be using computers and less knowledgeable about Internet security than are younger users. The two groups do not differ on trust of Internet information. The younger group shows no age or gender differences. Within the older group, computer users are more trusting of Internet information, and along with those with more education, are more knowledgeable about security hazards. The oldest women are less knowledgeable about security hazards. Older adults' greater risk when using computers and the Internet may be primarily due to cohort differences in education and computer use.     

Theory of Mind: Deaf and Hearing Children's Comprehension of Picture Stories and Judgments of Social Situations

We compared 20 prelingually profoundly deaf adolescents (age: 11-16 years) and 20 matched, hearing adolescents on a picture-sequencing task and on a social judgment test. In addition, we also tested 14 younger deaf children (age: 6-10 years) and compared their data with those from 20 hearing peers as well as those from the older deaf participants on the picture-sequencing task. The results from this study did not provide evidence for the hypothesis that deaf adolescents possess significantly poorer knowledge about social reasoning than age-matched hearing peers, but it did present further additional support for Peterson and Siegal's (1995) conversational hypothesis: a proposal that a deprivation in conversations about mental states leads to an impairment in the development of an awareness of mental states in the younger deaf children.     

Adult learners and traditional age freshmen: Comparing the “new” pool with the “old” pool of students

First year adult learners (23 years of age and older) from a residential campus and an urban commuter campus and traditional age (17–20 years of age) freshmen were compared on a variety of demographic variables. Many of the commonly held assumptions about older students visà-vis younger students were substantiated. In general, adult learners at the residential campus comprised a distinct group unlike commuter campus adult learners and traditional age freshmen. Implications and suggestions for additional research are discussed.     

Early literacy interventions: The relative roles of storybook reading, alphabetic activities, and their combination

The study examined the differential contributions on vocabulary and alphabetic skills of three literacy programs: (a) storybook reading program; (b) alphabetic skills program; and (c) a combined program. It was expected that storybook reading would enhance primarily vocabulary while alphabetic skills training would promote primarily alphabetic skills. Program by age interactions were examined in two age groups (3–4 and 4–5 years old) to test whether the storybook reading program may be more productive for the younger children whereas alphabetic skills program more productive for the older children. Twelve low-SES preschools participated in the study, three in each program and three as a comparison group. Results indicated that the children in the three intervention programs progressed significantly more than the comparison group on name writing, letter knowledge and phonological awareness. Further, the alphabetic skills program outperformed the other groups on word writing, letter knowledge and initial letter retrieval, whereas the storybook reading program outperformed only the comparison group. Results on the combined program were mixed – enhancing more initial letter retrieval and book vocabulary than storybook reading program. In general, no differences emerged in the progress of younger versus older children except on receptive vocabulary – the younger surpassing the older in all programs.