The 18 0 -20 6 weeks fetal anomaly screening scan your online
胎儿炎症反应综合征研究进展
胎儿炎症反应综合征研究进展唐秦【摘要】胎儿炎症反应综合征(fetal inflammatory response syndrome,FIRS)是胎儿固有免疫系统被激活的一种亚临床状态,是全身炎症反应综合征(systemic inflammation response syndrome,SIRS)在胎儿期的特殊表现.宫内感染及胎儿宫内慢性缺氧是导致FIRS的两个重要原因.感染或缺氧所致的\"失控\"的全身性炎症反应是FIRS发生的主要机制.FIRS与早产、支气管肺发育不良、新生儿早发型败血症、新生儿脑损伤、新生儿坏死性小肠结肠炎等新生儿严重并发症密切相关.FIRS宫内表现通常不典型,极易忽视,如不及时干预,新生儿期可能出现脑瘫、多器官功能衰竭、死亡等严重后果.本文就近年FIRS的临床诊断、发病机制和危害等方面的研究进展进行综述.【期刊名称】《国际妇产科学杂志》【年(卷),期】2019(046)001【总页数】5页(P48-52)【关键词】胎儿炎症反应综合征;全身炎症反应综合征;胎儿疾病;早产;支气管肺发育不良;新生儿早发型败血症;新生儿脑损伤;新生儿坏死性小肠结肠炎;新生儿严重并发症【作者】唐秦【作者单位】400016 重庆医科大学附属第一医院产科【正文语种】中文胎儿炎症反应综合征（fetal inflammatory response syndrome，FIRS）是全身炎症反应综合征（systemic inflammation response syndrome，SIRS）在胎儿期的特殊表现。
宫内感染及胎儿宫内慢性缺氧是导致FIRS的两个重要原因。
当感染或缺氧所致的炎症反应过度时，大量炎症因子释放，超过了局部调节能力，启动“瀑布效应”样炎症级联反应，形成“失控”的全身性炎症反应。
FIRS与多种新生儿严重并发症密切相关，但其宫内表现常不典型，极易被忽视，而新生儿期可能出现严重后果。
心血管系统疾病先天性心脏病英文
Epidemiology of CHD
Etiology
A child born to a parent with CHD has a substantially大体上increased likelihood of having a similar congenital lesion. The risk may be as high as 15 percent. For certain lesions, there appears to be a greater risk of transmission from the mother than from the father.
Noninvasive Diagnostic Studies
Cardiac catheterization and selective angiocardiography
are the most definitive diagnostic techniques currently available for use in congenital heart disease.
The size of the shunt through a septal defect can also be estimated from Doppler ultrasound studies by comparing the velocity of the blood flow through the aorta with velocity through the pulmonary artery.
Epidemiology of CHD
Etiology
The cause of most CHD is unknown. Genetic factors play some role in CHD. About eight percent of cases result mainly
Risk-factors-for-CHD(先天性心脏病危险因素)
• Maternal PKU (7 fold increase in CHD)
Maternal indications
• Autoantibodies (anti-Ro/SSA and anti-La/SSB) associated with Sjogren syndrome (40-95%) and SLE (15-35%) • 1-2% risk of complete heart block • Recurrence risk of 15-20% • Pregnancies conceived with assisted reproductive technology (ART) • Exposure to known teratogens or certain medications
ART
• Fertility related services (artificial insemination, inductors of ovulation) • Removal of a woman’s eggs from her body, “mixing” them with sperm to make an embryo, and then reintroduce them to the woman’s body
• In vitro fertilization/IVF (1978) • Intracytoplasmic sperm injection/ICSI (1992)
• Reprd countries
ART
• First infant born to ART was over 30 years ago (1978) • CDC started collecting data on ART in the US in1996
Percy_Bysshe_Shelly 英文介绍
Percy Bysshe Shelley(4 August 1792 – 8 July 1822) was one of the major English Romantic poets, and is regarded by some as among the finest lyric(抒情诗), as well as epic（史诗）, poets in the English language. A radical （激进）in his poetry as well as in his political and social views, Shelley did not see fame during his lifetime, but recognition for his poetry grew steadily following his death. Shelley was a key member of a close circle of visionary（空想主义的） poets and writers that included Lord Byron（拜伦）; Leigh Hunt; Thomas Love Peacock; and his own second wife, Mary Shelley, the author of Frankenstein.
Harriet Westbrook had been writing Shelley passionate letters threatening to kill herself because of her unhappiness at the school and at home. They were married in Edinburgh（爱丁堡） in 1812 at the age of sixteen. Percy was nineteen. Two years later he left her for Mary Godwin.
产科：High risk pregnancy
Third trimester
1. Fetal growth monitoring uterine height B ultrasound BPD, FL, AC polyhydramnios oligohydramnios (AFI) IUGR Malpresentations, macrosomia, placent degree treat maternal complications
High Risk infant
Gestational week <37 or >42; Birth weight <2500g; Small or large gestation age; Apgar score/1’ 0-3; Infection during delivery Neonate with the high risk gravada Infant after operational delivery
diagnosis
Secord trimester find new high risk factors clinical examination: BP weight urine uterine height fetal heart predicate PIH B ultrasound: screen fetal anomalies BPD, FL, AC screen diabetes mellitus 50g glucose oral, >7.2mmol/L 75gOGTT
High Risk gravida
Pregnancy and coexisting diseases diabetes mellitus, chronic hypertention, cyanotic heart disease, hyperthyroidism, renal disease, viral hepatitis hematologic complications,viral infection.
在妊娠哺乳期用药
etritinate
24
第二十五页，共四十九页。
Unknown 65%
Genetic 25%
Chemicals, drugs
radiation/ hyperthermia
1%
Schardein JL, 2000.
Mechanical 2%
第二十六页，共四十九页。
Maternal conditions
There are two major considerations regarding drug use in pregnant women:
第二页，共四十九页。
第三页，共四十九页。
1. About 40% 2. 6%
antacids.
analgesics, antibacterial,
3
第四页，共四十九页。
I. Effect of pregnancy on drugs
(
)
Absorption
The rate
The extent
Vomiting
. Effect?
Reduced bioavailability
4 第五页，共四十九页。
1 Maternal
& ECF ▲ 50% (3rd trimester)
the drug 6. The effects of drugs used in combination
18 第十九页，共四十九页。
2-Pharmacological effects:
indirect
direct
第二十页，共四十九页。
Interference by drugs in this stage leads to failure of pregnancy (death of fetus) at a very early and probably sub-clinical stage.
胎儿埃布斯坦畸形一例
DOI:10.12280/gjszjk.20200492冷芹，林丽苹，张君，秦瑶【摘要】埃布斯坦畸形（Ebstein anomaly ）是一种罕见的先天性心脏异常，伴有各种相关的心脏内异常，占所有先天性心脏异常的1%。
埃布斯坦畸形的胎儿易并发重度三尖瓣返流，肺动脉瓣狭窄，肺动脉与主动脉比例变小，胸腔、腹腔、心包的积液。
胎儿超声心动图对埃布斯坦畸形胎儿的详细诊断和预后评估起关键作用。
妊娠早期胎儿埃布斯坦畸形的实际检出率高于新生儿期的报道。
然而在妊娠早期和妊娠中期对胎儿心脏的正常描述并不能排除随后出现埃布斯坦畸形的可能性。
报道1例妊娠23周时被诊断出埃布斯坦畸形，有明显的心脏肥大和严重的三尖瓣关闭不全的胎儿情况。
【关键词】Ebstein 畸形；胎儿；妊娠；心脏缺损，先天性；超声检查，产前；病例报告A Case Report of Fetal Ebsten Anomaly LENG Qin,LIN Li-ping,ZHANG Jun,QIN Yao.Maternal and Child Health Hospital of Xiamen University,Xiamen 361000,Fujian Province,China Corresponding author:QIN Yao,E-mail:*****************【Abstract 】Ebstein anomaly is a rare congenital cardiac abnormality with various associated intra -cardiac anomalies,which accounts for 1percent of all congenital cardiac anomalies.Severe tricuspid regurgitation,pulmonary stenosis/hypoplasia,the decreased ratio of pulmonary,aorta diameter and pleural effusion/ascites/pericardial effusion are common in fetuses with Ebstein anomaly.Fetal echocardigraphy plays a key role in the detailed diagnosis and prognosis evaluation.Fetal Ebstein anomaly may be found in early pregnancy.The incidence is higher than what is reported in newborns.However,depiction of a normal fetal heart in early pregnancy and midpregnancy does not exclude the possibility of subsequent development of Ebstein anomaly.This article describes a fetal Ebstein anomaly diagnosed at 23weeks of gestation.There was significant cardiomegaly and severe tricuspid regurgitation in this case.This case report provides us a comprehensive overview of fetal Ebstein ′s anomaly.【Keywords 】Ebstein anomaly ；Fetus ；Pregnancy ；Heart defects ，congenital ；Ultrasonography ，prenatal ；Case reports（ＪＩｎｔＲｅｐｒｏｄＨｅａｌｔｈ蛐ＦａｍＰｌａｎ，2021，40：196-197）·病例报告·作者单位：361000厦门大学附属妇女儿童医院通信作者：秦瑶，E-mail ：*****************埃布斯坦畸形（Ebstein anomaly ）是一种罕见的先天性疾病，在出生婴儿中发病率为20万分之一，在先天性心脏病中的比例不到1%[1]。
the death of the moth
• Death of her father in 1905 • -caused second major breakdown that resulted in institutionalization.
• Virginia and sister Vanessa were subjected to sexual abuse by half brothers George and Gerald.
Bloomsbury
• Formed the intellectual Bloomsbury group • Married Leonard Woolf in 1912
Relationships
• In 1922 Woolf began her relationship with Vita Sackville-West. • After their affair ended, the two women remained friends until Woolf's death.
•• •岁月（The Nhomakorabeaears） (1937年)
幕间（Between the Acts） (1941年) 自己的房间（A Room of One's Own，1929年）
• Woolf is considered one of the greatest innovators in the English language. In her works she experimented with stream-ofconsciousness and the underlying psychological as well as emotional motives of characters. Woolf's reputation declined sharply after World War II, but her eminence was re-established with the surge of Feminist criticism in the 1970s.
The 18th century literature
Important Literary TermEnlightenment （启蒙运动）：The Enlightenment was a progressive intellectual movement throughout Western Europe in the 18th century. It was an expression of struggle of the bourgeoisie against feudalism. The Enlighteners thought the chief means for bettering the society is enlightenment or education for the peopleSentimentalism（感情主义）：It indulges in emotion and sentiment, which are used as a sort of relief for the grief felt towards the world’s wrongs and as a kind of mild protest against the social injustice.●What are the characteristic of English literature in the 18th century?The main literary stream of the 18th century was realism. What the writers described in their works were social realities. The main characters of their works were usually common men. Most of the writers concentrated their attention on daily life. In this century the newspaper was born. And prose literature which include the book, the newspaper and the magazine, became the chief instument of the nation’s progress. The new social and political conditions demanded expressions not simply in books but more especially in pamphlets, magazines and newspapers. Poetry, which had been the glory of English literature in the preceding ages, was inadequate for such a task. So prose had a rapid development in this age. The 18th century was an age of prose. A group of excellent prose writers,such as Addison, Steele, Swift, Fielding, were produced.Novel writing made a big advance in this century. The main characters in the novels were no longer kings and nobles but the common people.In this age satire was much used in writing. Since there was fierce strife between the two political parties in society, nearly every writer of this century was employed and rewarded by Whigs or Tories for satirising their enemies. English literature of this age produced some excellent satirists, such as Pope, Swift and Fielding.●What are Jonathan Swift’s writing features?⑴Jonathan Swift is one of the realist writers. His realism is quite different from Defoe’s. Defoe’s stories are based upon the reality of human life, while all of Swift’s plots come from imagination, which is the important device he uses in his satires. His satire is marked by outward gravity and apparent earnestness. This makes his satire all the more powerful. He not only criticises the evils of the English bourgeoisie but those of other bourgeois countries.⑵Swift expresses democratic ideas in his works. This exerts strong influence on later writers, such as Sheridan, Fielding, Byron and even Bernard Shaw.⑶Swift is one of the greatest masters of English prose. His language is simple, clear and vigorous. He said, “Proper words in proper place, makes the true definition of a style.” There are no ornaments in his writings. In simple, direct and precise prose, Swift is almost unsurpasses in English literature.●How are the poems in Songs of Innocence contrasted with the poems in Songs of Experience? Songs of innocence contains short lyrical poems with little children as the speakers. Through the mouths of the little children, the poet expresses his own love for the beauty of the world. Each poem in the collection is the expression of love and tender feeling and of belief in the goodness of nature. Using the language of small babies, Blake expresses his delight in the sun, the hills, thestreams, the insects and the flowers. The best-known poems in the collection are “The Lamb”, “Holy Thursday”and “Laughing Song”. The whole collection is pervaded with the breath of simplicity and fancy. The sweetest poems are those cradle songs. The melody is simple, artless, and yet exquisite.Songs of Experience is the counterpart of the first collection. It is a much maturer and Blakes’s most important work. The poems in this collection show that the poet’s eyes are open to the evils and vices of the world. He points out that the earth is unhappy and lacks love and gaiety. The miserable living conditions of the poor are reflected. The savation is to come through revolt or revolution. Through symbolic devices, Blake expresses his progressive democratic ideas. The best-known poems in the collection are “The Tyger”, “The Fly”, “London”, and “The Chimney-Sweeper”.What are the features of Robert Burns’ poetry?1) Burns is one of the greatest songwriters in the world. He is the national poet of Scotland. Most of his poems and songs are written in the Scottish dialect. 2) Burns is a plowman. He comes from the people and writes for the people. He is the people’s poet. 3) Burns has a deep knowledge and an excellent mastery of the old Scottish song tradition. He learns a lot from it in his poems. This is the main factor of his great success.Selected ReadingA Red，Red Roseby Robert BurnsO my luve is like a red, red rose,That's newly sprung in June;O my luve is like the melodieThat's sweetly played in tune.As fair thou art, my bonie lass,So deep in luve am I;And I will luve thee still, my dear,Till a' the seas gang dry.Till a' the seas gang dry, my dear,And the rocks melt wi' the sun;And I will luve thee still , my dear,While the sands o' life shall run.And fare thee weel, my only luve,And fare thee weel a while;And I will come again, my luve,Tho'it wre ten thousand mile!Auld Lang SyneShould auld acquaintance be forgot,And never brought to mind?Should auld acquaintance be forgot,And auld lang syne!For auld lang syne, my dear,For auld lang syne.We'll tak a cup o' kindness yet,For auld lang syne.We twa hae run about the braes,And pou'd the gowans fine;But we've wander'd mony a weary fit,Sin' auld lang syne.For auld, &c.We twa hae paidl'd in the burn,Frae morning sun till dine;But seas between us braid hae roar'dSin' auld lang syne.For auld, &c.And there's a hand, my trusty fere!And gie's a hand o' thine!And we'll tak a right gude-willie waught,For auld lang syne.For auld, &c.And surely ye'll be your pint stowp!And surely I'll be mine!And we'll tak a cup o'kindness yet,For auld lang syne.For auld, &c.1.in the following descriptions of the Neoclassical Period, Which is wrong?A.The Neoclassical Period is prior to the Romantic Period.B.Henry Fielding is one of the representatives of the Neoclassical Period.C.The modern English novel came into being in the Neoclasssical Period.D.Neoclassical Period is also known as the Age of Enlightenment.2.By making the truth-seeking pilgrims suffer at the hands of the people of Vanity Fair, JohnBunyan intends to show the prevalent political and religious ______ of his time.A. persecutionB. improvementC. prosperityD. disillusionment3. An honest, kind-hearted young man, who is full of animal spirit, and lacks prudence, is expelled from the paradise and has to go through hard experience to gain knowledge of himself and finally to have been accepted both by a virtuous lady and a rich relative. The above sentence may well sum up the theme of Fielding’s work ______.A. Jonathan Wild the GreatB. Tom JonesC. The Coffee-House PoliticanD. Amelia4. Which of following works was not written by Jonathan Swift?A. A Modest ProposalB. Gulliver’s TravelsC. A Tale of a TubD. The Rivals5. ______ was the greatest dramatist during the Neoclassical Period in England.A. GoldsmithB.SheridanC. SternD. Fielding6. ______is the most successful religious allegory in the English language.A. GenesisB. ExodusC. The Pilgrim’s ProgressD. The Holy War7. ______is one of Swift’s masterpiece. It is a satire on corruption in religion and learning.A. The Way of the WorldB. Love for LoveC. The Beggar’s OperaD. A Tale of a Tub8. Many lines from Alexander Pope’s poem “Essay on Criticism” have become proverbial maxims, such as: “To err is human; to forgive, divine.”“______ learning is a dangerous thing.”A. A littleB. LittleC. NoD. Few9. Which of the following does not belong to pioneering efforts in the creation of the English novel?A. John Lily’s EuphuesB. Sir Philip Sidney’s ArcadiaC. Thomas Lodge’s RosalymdeD. Samuel Richardson’s Pamela10. The novel Gulliver’s Travels was written by ______.A. Tobias SmollettB. Jonathan SwiftC. Laurence SterneD. John Bunyan11. Whose work signaled the beginning of the age of Restoration Drama?A. William WycherleyB. John DrydenC. William CongreveD. John Gay12. Which of the following books was Samuel Johnson’s monumental success?A. The Dictionary of the English LanguageB. Oliver TwistC. The Old Curiosity ShopD. Barnaby Rudge13. Who is best remembered as the recipient of Johnson’s famous letter?A. DickensB. Lord ChesterfieldC. Thomas HardyD. Joseph Addison14. The Enlightenment movement was an expression of the struggle of the bourgeoisie against ______.A. social prejudiceB. feudalismC. superstition of religion15. The main literary current of the 18th century was ______.A. realismB. romanticismC. sentimentalism16. The romantic poets of late 18th century fought against the poetic tradition of ______.A. neo-classicismB. ancient timesC. sentimentalism17. Alexander Pope’s ______ was a manifesto of English neo-classicism because Pope put forward his aesthetic theories in it.A. An Essay on CriticismB. An Essay on ManC. The Dunciad18. The rise and Growth of the ______ is the most prominent achievement of the 18th centuryEnglish literature.A. realistic novelB. neo-classical literatureC. romantic poetry19. Among the pamphlets written by Swift about Ireland, the most famous are The Drapier’s Letters and ______.A. The Battle of the BooksB. A Tale of a TubC. A Modest Proposal20. Henry Fielding’s career as a playwright paved the way for his writing of ______.A. novelsB. poemsC. satiric plays。
马洛及浮士德博士的悲剧
Literary career
• Of the dramas attributed to Marlowe
Dido, Queen of Carthage is believed to have been his f i r s t , and performed by the Children of the Chapel, a company of boy actors, between 1587 and 1593. The play was f i r s t published in 1594; the t i t l e page attributes the play to Marlowe and Thomas Nashe.
Sources Structure
Themes &motifs Quotations
Sources
• Doctor Faustus i s based on an older t a l e ; i t i s believed t o be the f i r s t dramatization of the Faust
Doctor Faustus
• The Tragical History of t h e Life and Death of Doctor F a u s t u s , commonly r e f e r r e d t o simply as Doctor Faustus, i s a play by Christopher Marlowe, based on t h e Faust s t o r y , i n which a man s e l l s h i s soul t o t h e d e v i l f o r powe and knowledge. Doctor Faustus was f i r s t published i n 1604, eleven years a f t e r Marlowe"s death and a t l e a s t twelve years after the f i r s t performance of the play.
The Silence of the Lambs
6
Hitchcock film adopted suspense tactics and psychological analysis of modern horror film, makes the plot of the film, the audience the introduction of a symbolic world of human consciousness.
沉默的羔羊
机械1610班
1
The Silence of the Lambs
is a 1991 American horror-thriller film directed by Jonathan Demme and starring Jodie Foster, Anthony Hopkins, and Scott Glenn. It is adapted by Ted Tally from the 1988 novel of the same name by Thomas Harris.
影片通过探索人物心理疾患，试图探寻当代美国社 会恐怖的根源，这使得影片的主题得以深化，寓示了 好莱坞文以载道的策略。
9
The art of it is very commendable, that spirit of confrontation, the "angels and devils", in sharp contrast to those based on slow rhythm inherent philosophy is impressive, so it can leave a film in the history.
儿科医学英语词汇
儿科医学英语词汇儿科学pediatrics儿童保健child care疾病防治disease prevention营养基础basal nutrition婴儿喂养infants’ feeding营养不良malnutrition小儿肥胖obesity in childhood解剖anatomy生理生化physiology and biochemistry 营养代谢nutrition and metabolism免疫immunity病理pathology疾病的种类variety of disease临床表现clinical situation诊断diagnosis治疗treatment预后prognosis预防prevention胎儿期fetal stage胚卵期ovigerm stage胚胎期embryo stage新生儿期neonatal period脐带omphalus足月儿term infant早产儿premature过期产儿post term infant围产期perinatal stage婴儿期infancy幼儿期toddler period学龄期school age青春期adolescence遗传inheritance性别sex内分泌endocrine孕母情况mother’s condition营养nutrition。
生活环境living environment急性感染acute infection慢性疾病chronic disease消化道疾病disease of digestive tract内分泌疾病endocrine disease先天性疾病congenital disease体格生长physique growth摄入不足insufficiency of intake胎粪排出excretion of meconium水分丢失loss of moist生长高峰summit of growth卧位clinostatasm站立位erect position头顶vertex耻骨联合上缘superior margin of pubic symphysis 耻骨联合上缘superior margin of pubic symphysis 足底sole脐nave头围head circumference胸围chest circumference颅骨cranium颅缝cranial sutures前囟anterior fontanel后囟posterior脊柱rachis ——生理弯曲的形成长骨long bone干骺端metaphysis软骨骨化cartilaginous ossification骨膜下成骨subperiosteum ossification 乳牙deciduous teeth恒牙permanent teeth(乳牙)萌出eruption神经系统nervous system脊髓spinal cord运动发育motor development发音器官organs of voicing听觉sense of hearing大脑语言中枢cerebral language center 语言交流communication护理nursing计划免疫planned immunity心理卫生mental health生活习惯living habit社会适应能力social adaptation亲情 parent-child relationship健康查体physical examination随访follow-up户外活动open field activity身体抚触 stroking massage窒息apnea中毒intoxication外伤trauma预防接种vaccination主动免疫active immunity被动免疫passive immunity预防接种vaccination小儿传染病infectious disease卡介苗 bacillus calmette-guerin vaccine, bcg vaccine脊髓灰质炎疫苗 polimyelitis vaccine麻疹疫苗 measles vaccine百白破三联疫苗 pertussis-diphtheria-tetanus triple vaccine 乙肝疫苗hepatitis b vaccine初种primary vaccination复种revaccination不良反应reaction热量的需要caloric requirement基础代谢basal metabolism排泄 excretion蛋白质protein碳水化合物carbohydrate脂肪fat维生素vitamins水溶性维生素water-soluble vitamin脂溶性维生素fat-soluble vitamin矿物质mineral膳食纤维dietary fiber母乳喂养breast feeding母乳的成分component of mother’s milk免疫物质immune material免疫球蛋白immune gloulin补体complement乳铁蛋白lactoferrin溶菌酶lysozyme双歧因子bifidus factor细胞成分components of cells慢性消耗性疾病chronic consumptions精神障碍mental disorders急性传染病acute infectious diseases断奶weaning人工喂养bottle-feeding稀释dilution加糖add sugar煮沸boiling定时定量time and rationed feeding个体差异individual difference混合喂养mixed feeding大小便defecation代授法breast-bottle-feeding补授法supplemental feeding辅食添加the introduction of solid food营养不良malnutrition代谢异常developmental and metabolic disorder 临床分型clinical typing消瘦型marasmus malnutrition浮肿型edema malnutrition消瘦－浮肿型marasmus—edema malnutrition病因etiological factor摄入不足deficiency of intake辅食添加不及时introduction of solid food饮食结构不合理incorrect components of diet不良饮食习惯bad eating habit消化吸收障碍disorder of digestion and absorption消化道先天畸形congenital anomaly of digestive tract先天性代谢障碍congenital dysbolism消化功能紊乱disorder of digestive function需求增多requirement increases生长发育迅速的时期the period when children grow rapidly 疾病恢复期recovery phase of diseases双胎或多胎twins or multiplets早产premature消耗性疾病consumptions病理生理pathophysiology代谢异常dysbolism体温调节thermoregulation机体各系统功能低下incapacity of body systems消化系统digestive system循环系统circulatory system泌尿系统urinary system神经系统nervous system免疫系统immune system临床表现clinical situation皮下脂肪subcutaneous fat腹abdomen躯干trunk臀breech四肢extremities面颊cheeks皮肤skin干燥dehydration苍白pale；肌肉muscles松弛laxity萎缩atrophy；精神状态mental status萎靡dispirited反应差low response；全身症状general symptoms并发症complication营养性贫血nutritional anemia各种维生素缺乏症various kinds of avitaminosis感染infections低血糖hypoglycemia诊断标准standard of dignosis分型types分度degrees实验室检查laboratory examination鉴别诊断differential diagnosis治疗原则therapeutic principle综合治疗comprehensive treatment治疗方法therapeutic method积极治疗原发病cure the primary disease饮食治疗diet therapy药物治疗drug treatment支持治疗supporting therapy危重症处理treatment in crises度营养不良伴腹泻时的治疗severe malnutrition companied by diarrhea营养不良性水肿的治疗nutritional edema蛋白质缺乏综合症（恶心营养不良综合症）kwashiorkor添加辅食instruction of solid food睡眠充足sufficient sleeping防治先天性疾病和小儿急性传染病prevention and treatment ofcongenital diseases and acute infectious diseases孕期保健与产前诊断health care in pregnancy and prenatal diagnosis新生儿筛查neonatal screening治疗先天性疾病cure congenital diseases按时预防接种vaccination on time定期体格检查regular physical examination营养障碍性疾病dystrophy病因及病理生理etiological factor and pathophysiology单纯性肥胖simple obesity摄入过多excessive intake活动过少lack of movement家族遗传inheritance神经、精神因素nervous and mental factors继发性肥胖secondary obesity膝外翻genu valgum扁平足fallen arch性发育较早early sexual development实验室检查laboratory examinations胆固醇cholesterol甘油三酯triglycerideβ脂蛋白beta lipoprotein胰岛素insulin生长激素growth hormone诊断标准standard of diagnosis轻度mild制度moderate重度severe。
产检流程和时间表及费用
产检流程和时间表及费用英文回答：Prenatal Care Schedule and Costs.First Trimester.6-8 weeks: First prenatal appointment, medical history and physical exam, ultrasound to confirm pregnancy.10-12 weeks: Nuchal translucency scan to screen for chromosomal abnormalities.16-18 weeks: Quad screen to screen for neural tube defects and Down syndrome.Second Trimester.18-20 weeks: Anomaly scan to assess fetal growth and anatomy.24-28 weeks: Glucose tolerance test to screen for gestational diabetes.Third Trimester.28-32 weeks: Group B streptococcus screening to prevent neonatal infection.36-38 weeks: Biophysical profile to assess fetal well-being.37-40 weeks: Weekly appointments to monitor fetal growth and mother's health.Costs.The cost of prenatal care varies depending on the type of insurance coverage, the provider, and the location.Uninsured women: $2,000-$10,000。
新生儿颅内出血英文
➢ Periventricular leukomalacia (PVL)
• Prenatal or neonatal ischemic or reperfusion injury • Necrosis of the periventricular white matter • Damage to the cortico-spinal fibers in the internal capsule
➢ Occasionally seen in near-term and term infants ➢ Rarely present at birth
• 50% occur on the 1st day, 80~90% occur between birth and the 3rd day • 20~40% progress during the 1st week • Delayed hemorrhage may occur after the 1st week in 10~15% of the cases • New-onset IVH is rare after the 1st month of life regardless of the birthweight
normal labor 正常分娩 英文PPT
● Posterior sagittal diameter: 8.5 cm
● from the tip of the sacrum to the centre of the bituberous diameter.
● Transverse diameter + Posterior sagittal diameter>15cm ,the term fetus can dilever through the posterior triangular planes
outlet
THE PASSAGE
pelvic inlet plane
The pelvic inlet is bounded anteriorly by the superior margin of the symphysis pubis, laterally by the iliopectineal lines, and posteriorly by the superior portion of the sacrum.
● anteriorly by the subpubic arch, ● laterally by the ischial tuberosities ● posteriorly by the tip of the sacrum (not
the coccyx). ● The outlet actually consists of 2
THE POWER
abdominal palpation Electronic monitor tracing
complaint
THE POWER
●The uterine contraction have four charicteristics 1)节律性(regularity) 2)对称性(symmetry) 3)极性 (polarity) 4)缩复性(retraction )
医学专题胎儿的循环系统英文版
ocp, vit A, steroids, etc.)
Fetal Cardiology
• Causes > 50% deaths from congenital disease
Fetal Cardiology
• Risk Factors for congenital heart disease:
➢ Family history ➢ Recurrence risk (hypoplastic left heart as
Tetralogy of Fallot
Courtesy of Dr Mark Skalansky
Tetralogy of Fallot
Caliber of aorta > PA
Tetralogy of Fallot video
click image to play video Courtesy of Dr Alfred Albahamed
Left Atrium Left Ventricle Right Ventricle Aorta Mitral Valve (closed) Aortic Valve (open) Interventricular Septum
Left Ventricular Outflow Tract
Right Atrium
LA LA
RA
• Weak association with cardiac abnormalities • Doubles the risk for Trisomy 21 • Can be confused with portions of the chordae
母体血清甲胎蛋白联合超声在产前诊断中的临床应用
母体血清甲胎蛋白联合超声在产前诊断中的临床应用黎冬梅;章锦曼;银益飞;朱宝生;曹永久;朱姝【摘要】目的探讨母体血清甲胎蛋白联合超声检查在产前诊断胎儿神经管畸形及遗传综合征中的价值.方法回顾性分析中孕期(15～20+6周)血清甲胎蛋白AFP≥2.5MoM孕妇胎儿超声检查结果,统计分析胎儿神经管缺陷、遗传综合征及其他异常检查结果.结果 1405例血清甲胎蛋白AFP≥2.5MoM孕妇中,超声检出神经管缺陷37例,其中露脑畸形2例、无脑儿5例、脊柱裂14例、脑膜脑膨出16例.检出遗传综合征12例,其中肢体-体壁综合征5例、VATER联合征3例、Cantrell五联征2例、Meckel-Gruber综合征2例.其他畸形例47例,包括心脏畸形2例、腹壁裂5例、脐膨出6例、死胎13例.胎儿附属物异常中,胎盘厚12例、羊水少12例.结论利用孕妇血清AFP水平测定结合胎儿超声检查是中孕期胎儿神经管缺陷及合并脊柱裂或腹壁裂的遗传综合征等异常产前筛查、产前诊断的首选方法,能为临床遗传咨询及孕期管理提供科学依据.是减少出生缺陷发生的有效手段之一.【期刊名称】《中国产前诊断杂志（电子版）》【年(卷),期】2017(009)002【总页数】5页(P17-21)【关键词】甲胎蛋白;神经管缺陷;遗传综合征;产前诊断【作者】黎冬梅;章锦曼;银益飞;朱宝生;曹永久;朱姝【作者单位】云南省第一人民医院云南省遗传诊断中心,云南昆明 650032;云南省第一人民医院云南省遗传诊断中心,云南昆明 650032;云南省第一人民医院云南省遗传诊断中心,云南昆明 650032;云南省第一人民医院云南省遗传诊断中心,云南昆明 650032;云南省第一人民医院云南省遗传诊断中心,云南昆明 650032;云南省第一人民医院云南省遗传诊断中心,云南昆明 650032【正文语种】中文【中图分类】R714.53神经管缺陷(neural tube defect，NTDs)是一种常见的严重神经系统先天畸形，是临床最常见的出生缺陷之一，约占全部畸形的1/4。
the-Deadlly-doodle-原文译文
the Deadly noodleOf all the ways France has resisted the cultural imperialism of the United States, it has arguably achieved its greatest success in the realm of food. Not only is French cuisine the envy of the world, but culinary tradition has allowed the French to consume their sauce veloute and creme brulee without succumbing to the ills of over consumption that plague the land of burgers, fries and angioplasty. In recent years, however, statistics have begun to reveal that France is vulnerable to America's junk-food influence after all. Although southern, rural France remains steadfastly healthy, its more urban neighbors to the north suffer more from eating-related problems, not least a rise in childhood obesity. "We can't point our finger at any one thing," says Mariette Gerber, a nutritional scientist at the National Institute for Medical Research and Health in Montpellier. "It's a modern way of life, very urban. And it has come from the United States."在法国抵制美国的文化帝国主义的各种方式中，它可以说在食品领域取得了最大的成功。