Objective To explore the application value of self-made visual teaching aids in gynecological and obstetrical nursing education. Methods A total of 240 nursing students in grade 2009 from Fujian Medical University and Fujian Health College were selected by cluster sampling and divided by simple randomization into 2 groups (the trial group and the control group). Besides the multimedia combined with traditional teaching adopted in both groups, the visual teaching aids for fetal intrauterine condition was also adopted in the trial group rather than the control group. Questionnaire survey and focus group interview were adopted to appraise the satisfactory degree of all nursing students and the teaching effects evaluation of students in the trial group. Results There were no significant differences between the two groups in education background, and intelligibility evaluation of theoretical study on both the fetal intrauterine condition and the complications in pregnancy and delivery periods (Pgt;0.05), while the difference was statistically significant in the satisfactory degree between different teaching methods (Plt;0.05). 85.0% of nursing students in the trial group thought that visual model could help them to better understand the complications in pregnancy and delivery periods, and the intrauterine condition, 99.17% of students thought that the teaching effect of visual model was better than traditional teaching, and 95.83% of students considered that visual model was favorable for course study. Conclusion The application of self-made visual teaching aids for fetal intrauterine condition makes gynecological and obstetrical nursing education more visual, facilitates students to better understand fetal intrauterine situation and part of the mechanism of pregnancy complications, arouses students’ learning interests, and lays a theory and practice foundation for follow-up internship, so as to enhance the quality of nursing teaching.
Objective To define an evidence-based conclusion concerning ultrasound screening for fetal genital system malformations during pregnancy. Methods In order to assess whether or not ultrasound screening for fetal genital system malformations is effective and feasible, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1981 to 2009), ACP Journal Club (1991 to 2008), and BMJ Clinical Evidence (1999 to 2008) for systematic reviews, randomized controlled trials (RCTs), cohort studies, and controlled clinical trials. Results Five cohort studies and three crosssectional studies were retrieved. The results showed ultrasound screening detected fetal sex determination by the contour of the rump and the angle of the genital tubercle to a horizontal line through the lumbosacral skin surface in the first trimester. Scrotal size and penile length increases with gestational age for male fetuses, and by 32 weeks, bilateral testicular descent was observed in most cases. Ultrasonographic scans, fetal genetic studies, and hormonal assays of amniotic fluid can diagnosis certain diseases, fetal sex differentiation disorders, fetal endocrinal disorders, and chromosome abnormality. Conclusion The findings of this study should reassure physicians and parents alike that ultrasound screening is an reliable option for the prenatal diagnosis of fetal genital system malformations, but more randomized controlled trials are needed to further supply relevant evidence.
目的 分析死胎死亡原因及可能的相关因素，为降低死胎发生的措施提供依据。 方法 对2007年1月－2011年12月住院分娩的609例死胎（≥28周） 的病例资料进行回顾性分析,包括对产检次数差异、死胎性别、死胎孕周分布、母亲年龄差别、母亲文化程度等进行统计分析。 结果 ① 死胎的原因依次为：胎儿因素（41.2%），母体因素（24.1%），胎盘因素（21.7%）及不明原因（13.0%）；其中胎儿畸形、重度子痫前期及胎盘早剥为主要原因；② 母亲的文化程度低、未建卡或未正规产检者死胎发生的几率高于正规产检者，差异有统计学意义（P＜0.05）。 结论 加强围产保健，早期筛查胎儿畸形、防治妊娠期并发症及合并症等都有助于降低死胎的发生率。
Fontan operation is still a main procedure for treatment of complex congenital heart disease, such as univentricular heart. Fontan procedure has undergone many revisions since its introduction in 1968. The earlyapplied atriumpulmonary connection has been replaced by total cavopulmonary connection. The midterm and late results of both the intraatrial lateral tunnel and extracardiac total cavopulmonary connections were compared and analyzed in this article. Extracardiac conduit is better. The Fontan circulation failure would appear at last because of nopump function of the right ventricle. Once Fontan circulation failure occurred and could not recover by medicine, heart transplantation is mandatory, but the source of donor heart is lacking. The study of mechanical cavopulmonary assist device, to “biventricularize” the univentricular Fontan circulation, has been developed, which is quite promising. Following the development of diagnostic and treatment techniques for fetal heart disease, the treatment procedure of complex congenital heart disease has been broadened in recent years, such as to prevent the severe aortic stenosis from developing into hypoplastic left heart syndrome with fetal cardiac intervention so as to increase the chance of biventricular repair, and to terminate gestation to decrease its birth rate of complex heart abnormalities, which could not be completely repaired to date.
Abstract: Objective To investigate the influence of cryopreservation on cellular viability of latepregnancy fetal valved allografts in human. Methods The fetal valved allografts with gestational ages ranged from 24 to 40 weeks were sterilely procured within 6 hours after brain death. Each sample was bisected into control group and experiment group. The cellular viability of control group was directly tested and that of experiment group was examined after being storaged in liquid nitrogen for a week through a programmed frozen procedure. The light microscopy, tissue culture and Methylthiazol tetrazolium assay (MTT assay) were used to determine the cellular viability. Results Twelve latepregnancy fetal valved aortic allografts were procured. Light microscopy showed the integrity of the basic structure of the thawed aorta, the normal structure of the collagen and elastic fibers, with part of vascular endothelium lost. There were lots of cells deriving from both groups,but the cellular growing rate of the experiment group was relatively slower. At 490 nm, MTT assay valve of control group was 0.442±0.046, and that of experiment group was 0.424±0.041. The difference between two groups failed to statistically significance(t=1.617, P=0.328). Conclusion There were viable cells in latepregnancy fetal valved allografts after cryopreservation.
Objective To investigate the gene expression of p38mitogen-activated protein kinase (p38MAPK) and its upstream signaling molecule (mkk3 and mkk6) in fetal skin at different developmental stages and postnatal skin and its potential biological significance. Methods The fetal skin biopsies were obtained from human embryo of spontaneous abortion at gestational ages from 13 to 32 weeks and postnatal skin specimens were collected from patients(4-16 years) undergoing plastic surgery. After the morphological characteristics of skins at different developmental stages were detected with pathological methods, the gene expressions of p38MAPK, mkk3 and mkk6 in skins were examined with reverse transcriptionpolymerase chain reaction analysis (RT-PCR). Results The gene expressions of p38MAPK, mkk3 and mkk6 could all be detected in fetal and postnatal skins. In fetal skins, these 3 genes were bly expressed. Along with fetal growth and development, the gene expressions of p38MAPK and its upstream signaling molecules were faded gradually. In postnatal skin, the mRNA contents of these 3 genes were significantly decreased in comparison with those in fetal skin (Plt;0.01). Conclusion p38 MAPK mediated signal pathways might be involved in the skin developmentat embryonic stage and in the determination of cutaneous structure and function, and also in wound healing at postnatal stage. The relative increment of these gene transcription in younger fetal skin might be one of the reasons why cutaneous cells proliferate rapidly and the wounds heal without scar.
OBJECTIVE: To explore the expression of basic fibroblast growth factor(bFGF) during the wound healing of human fetal and adult skin and its significance. METHODS: We established the animal model of fetal scarless healing by transplanting full-thickness skin grafts from human fetus to a subcutaneous location on the athymic mouse recipient, and then making the linear incisions. The expression of bFGF was observed in the normal adult skin, normal fetal skin and during wound healing by immunohistochemical method. The positive staining cells were counted under selected high-power focus randomly. RESULTS: bFGF staining was not observed in the normal fetal skin and the wounded one. However, bly positive staining was shown around the vessels in normal adult skin. Moreover, the positive straining became ber in the wounded skin, especially in dermal fibroblasts and endotheliocytes. The number of positive staining cell was 2.1 +/- 0.1 in normal fetal skin, and 2.2 +/- 0.1, 2.1 +/- 0.3, 2.1 +/- 0.3 and 2.0 +/- 0.1 in the fetal skins after 12 hours, 1 day, 3 days and 7 days of wound respectively. The number of positive staining cell were 23.2 +/- 4.2 in normal adult skin and 40.5 +/- 3.6 in the wound adult skin. There was significant difference between the fetal skin and adult skin (P lt; 0.01). CONCLUSION: The negative expression of bFGF in the fetal skin may be one of the important reasons for fetal scarless healing.
OBJECTIVE To evaluate the clinical results of repair of bone defect by embryonic bone transplantation. METHODS From January 1994 to June 1999, 148 cases of bone defect were repaired by embryonic bone transplantation following alcohol treatment, there were 63 cases with bone cyst, 42 cases with fibrous dysplasia of bone, 26 cases with giant cell tumor of bone, and 17 cases with enchondroma among them. The maximal bone defect was 3.5 cm x 10.0 cm, while the minimal defect was 0.5 cm x 1.0 cm. RESULTS All of those bone defect with benign tumor were bone union used by embryonic bone transplantation after 3 months to 1 year of operation, the average healing course was 6.2 months, followed up 1 to 6 years, averaged 14 months, no tumor recurrence and no obvious local or system response were observed. CONCLUSION Embryonic bone can be used as a good repairing material of postoperative bone defect of benign tumors, the clinical results are satisfactory.
OBJECTIVE: To select a satisfactory surgical approach in vaginoplasty with minimum injury and maximum effectiveness. METHODS: From January 1997 to December 1998, 86 cases of congenital absence of vagina were treated by three types of vaginoplasty, using abdominal skin graft, fetal skin graft and vulvar-inguinal skin flap respectively. The duration of operation and hospitalization, the wound healing of donor site, as well as the moist sensation of the artificial vagina and the sexual life quality were compared among the three types of vaginoplasty. RESULTS: Compared with those by abdominal skin graft and vulvar-inguinal skin flaps, the vaginoplasty by fetal skin graft had the shortest surgical duration (P lt; 0.01); the duration of hospitalization with fetal skin grafting was shorter than that of abdominal skin grafting (P lt; 0.01) but almost the same as that of vulvar-inguinal skin transferring (P gt; 0.05). The fetal skin grafting had minimum injury. Moreover, artificial vagina by fetal skin grafting had the best moist sensation and the most satisfactory sexual life quality (P lt; 0.01). CONCLUSION: In view of the minimum injury and maximum mimic of nature vagina, the vaginoplasty by fetal skin graft is the most ideal approach among the three types of vaginoplasty investigated in this trial.
OBJECTIVE To investigate the clinical results used fetal bone repairing the defect after osteoma resection. METHODS In 8 hours after abortion, the fetal bones of four limbs were cut and kept in the normal saline with gentamycin. Then the graft was storaged under 6 degrees C-8 degrees C and the longest storage time was 48 hours. Since 1990, seven cases of osteoma had been cured with fetal bone graft. Among them, there were 5 males and 2 females, aged from 6 to 38 years, the bone defect volume ranged from 5.5 cm x 3.6 cm x 2.5 cm to 9.0 cm x 4.3 cm x 3.2 cm. During operation, the osteoma was resected radically, then the defected cavity was impacted with prepared fetal bone. RESULTS After operation, the general condition was good, all the incision wound healed primarily. Sixteen weeks after operation, the defected cavity was repaired completely and the medullary cavity reopened. Follow-up for 8 months to 5 years, no recurrence or side-effect were observed. CONCLUSION Because of the more rapid expansion and replacement effect, the ber osteoinduction, and the lower immune response, the fetal bone is practical material for repairing the bone defect in osteoma resection.