目的 总结糖尿病患者胆道疾病围手术期处理体会。方法 对40例合并糖尿病的胆道疾病患者的血糖进行回顾性分析。结果 本组中行急诊手术23例，择期手术17例，治愈38例，死于败血症2例； 其中14例糖尿病患者在术前未被确诊，占35%。血糖控制在5.5～8.9 mmol/L,尿糖为（-）～（+）及尿酮体阴性，是手术的最佳时机。结论 控制血糖和感染是糖尿病患者胆道围手术期处理的关键。
【Abstract】Objective To investigate the anatomic structure and experimental methods of peribiliary vascular plexus(PVP) in rat’s hepatic portal bile duct.Methods To observe the morphological structure of PVP in rat’s hepatic portal bile duct after the hepatic artery was perfused with Chinese ink and transparency management, performed and to make three dimensional reconstruction of PVP’s spacial structure in MoticBuaa3Dvol software.Results The microvascular distribution and plane structure of PVP in rat’s hepatic portal bile duct could be shown clearly through Chinese ink perfusion and transparency management. The three dimensional structure of PVP could be reconstructed effectively by MoticBuaa3Dvol software, its effect was verisimilitude. Conclusion Chinese ink perfusion and vitrification is a simple and easy method in PVP’s morphologic study of rat’s hepatic portal bile duct. MoticBuaa3Dvol software is useful in microvascular study of hepatic portal bile duct.
ObjectiveTo understand the distribution of demographic sociological characteristics and co-morbidities among primiparous and multiparous pregnant women under the China's universal two-child policy, to provide baseline data for clinical high-risk management and medical resources allocation.MethodsWe included pregnant women from 24 hospitals in 16 provinces (municipality, autonomous region) of China and collected their demographic sociological characteristics and obstetrics information by questionnaires between September 19th, and November 20th, 2016. Then, we used descriptive analysis to present the distribution of demographic sociological characteristics and pregnancy co-morbidities among primiparous and multiparous women and compared differences between groups by t test or Chi-square test.ResultsAmong 12 403 investigated pregnant women, 8 268 (66.7%) were primiparous and 4 135 (33.3%) were multiparous, with highest proportion in East (931/2 008, 46.4%) and lowest in Northeast (385/2 179, 17.7%). Multiparous women, comparing to primiparous women, were more likely to be elderly than 35 years (accounting for 30.6% vs. 6.5%), lower educated with high school or below (29.7% vs. 16.9%), occupied in physical labor or unemployed (49.2% vs. 42.5%), non-local residents (12.7% vs. 10.5%), family annual income higher than 120 thousand yuan (41.3% vs. 33.3%), pre-pregnancy body mass index≥24 kg/m2 (13.6% vs. 9.9%), history of artificial abortions (44.9% vs. 24.0%), or pregnancies≥4 times (23.8% vs. 3.1%) and were less likely to receive assisted reproductive technology (2.3% vs. 4.7%). The most common co-morbidities were gynecology disease (5.5%), thyroid disease (5.4% in all women), blood system disease (5.0%), digestive system disease (4.2%) and hepatitis B infection (2.5%). Multiparous women, comparing to primiparous women, had higher proportions with blood system disease (5.7% vs. 4.7%), hepatitis B infection (3.1% vs. 2.2%) and chronic hypertension (0.6% vs. 0.2%), but lower proportions with thyroid diseases, polycystic ovary syndrome, and immune system diseases, whose distribution also showed regional differences.ConclusionThere existed distribution differences regarding demographic sociological characteristics and co-morbidities proportions between primiparous and multiparous women. Therefore, we should improve clinical risk management and medical resources allocation based on pregnant women’s baseline and gestational characteristics.