足月胎儿对声音刺激反应的探讨

通过观察声音刺激引起胎儿产生的胎动和胎心率反应,初步探讨声音刺激能否引起胎儿的感觉和相应的反射机制。选择正常足月孕妇94例,分别接受95、100、105、110、115分贝的声音刺激,观察胎儿的胎动和胎心率反应。95分贝声音能引起胎心率轻度下降且不引起胎动,而声强在100分贝以上的声音刺激能引起胎心率加速并伴有胎动,提示95分贝声音可以引起胎儿的定向反射,和胎儿的选择性的注意有关;而100~115分贝的声音能引起胎儿的防卫反应。婴儿与生俱来的无条件反射在胎儿期就已存在。     

Ultrasounds produced by rats accompany decreases in intraspecific fighting

Male intruder rats were placed individually into the cage of an established resident on 2 occasions separated by a 7–8 day interval. Residents readily attacked intruders and both animals lost weight during the first encounter. In contrast, no serious fighting occurred on the second encounter, and both intruders and residents maintained their body weight during the 24-hr test. Observation of the intruder's behavior during the first 30 min of each encounter indicated that defensive-submissive postures represent a response to an attack that only temporarily inhibits aggression whereas the emission of 22 kHz calls by the intruder is associated with a relatively permanent decrease in the resident animal's aggressive response.     

Atypical cerebral lateralisation in adults with compensated developmental dyslexia demonstrated using functional transcranial Doppler ultrasound

Functional transcranial Doppler ultrasound (fTCD) is a relatively new and non-invasive technique that assesses cerebral lateralisation through measurements of blood flow velocity in the middle cerebral arteries. In this study fTCD was used to compare functional asymmetry during a word generation task between a group of 30 dyslexic adults and a group of 30 non-dyslexic individuals. In light of previous evidence of atypical laterality in dyslexia, a reduced leftward asymmetry was predicted and confirmed. We know from previous research that most people with atypical language lateralisation have normal language and literacy skills: nevertheless, our results confirm that language laterality is reduced in those with dyslexia. Theoretical explanations for this apparent conundrum are discussed.     

经阴道超声检查的医学伦理学思考

经阴道超声（transvaginal ultrasound,TVS）检查是妇产科的一项重要检查技术,应坚持将患者的利益放在首位。在检查前应首先充分告知患者检查的必要性、安全性,让患者理解,并征得其同意,检查时应注意保护患者的隐私,检查后不泄露患者的秘密,全心全意为患者服务,真正做到以患者为中心,共建和谐医院、和谐社会。     

B超配合在乳腺良性肿块麦默通手术中的作用

探讨B超配合在麦默通微创行乳腺良性肿块切除术中的作用。对569例乳腺肿块进行麦默通微创切除术,分别于术前进行B超定位,术中进行B超引导,术后B超探查及随访,分析B超配合对手术的彻底性、安全性和准确性等所起的作用与意义。结果569例患者的乳腺病灶均被准确切除,B超熟练程度决定手术的准确性、彻底性及手术时间。术中B超配合20次以上者,其一次定位成功并一次完全切除率达87.4%,与初次(B超配合20次以下)配合者相比,两者有显著性差异(P=0.000);手术时间亦比初次B超配合者要短,两者有显著性差异(P=0.000)。熟练的B超配合,有利于麦默通微创旋切技术准确、有效、快速而安全的切除乳腺良性肿瘤。     

PREGNANT WOMEN'S RECOLLECTIONS OF EARLY MATERNAL BONDING: ASSOCIATIONS WITH MATERNAL–FETAL ATTACHMENT AND BIRTH CHOICES

Recollections of own maternal care measured by parental bonding were found to be important in the pregnant woman's construction of herself as a mother. Although these recollections were studied with regard to various variables, there is a dearth of studies associated with pregnancy and childbirth. In this cross‐sectional study, 341 pregnant women were recruited. Measures included a Sociodemographics–Obstetric History Questionnaire; the Childbirth Choices Questionnaire (H. Preis, M. Gozlan, U. Dan, & Y. Benyamini, 2018); the Parental Bonding Instrument (G. Parker, H. Tupling, & L.B. Brown, 1979); a question regarding the planned presence of the woman's mother at delivery; and the Maternal‐Fetal Attachment Scale (M.S. Cranley, 1981). Parental recollections of Care were associated with fewer natural birth choices (hence, a more “medicalized” delivery), lower maternal–fetal attachment, and a wish for the mother's mother to be present at the birth. Parental recollections of Encouragement of Behavioral Freedom in childhood were associated with more natural choices regarding childbirth. In addition, women with higher scores on the parental bonding Denial of Autonomy factor reported stronger maternal–fetal attachment. Thus, early recollections of experiences with caregivers as manifested in parental bonding may be a possible influence on the transition to motherhood, and working through possible difficulties associated with these recollections may improve adjustment to motherhood.     

Cry analysis detects subclinical effects of prenatal alcohol exposure in newborn infants

The threshold, latency, and peak fundamental frequency (basic pitch) of crying were sensitive to the subclinical effects of prenatal alcohol exposure through the first month of postnatal life. Whereas infants with prenatal alcohol exposure showed a lower cry pitch and higher cry threshold at 2 days of age, higher pitched cries, typical of nervous system insult, were evident at 14 and 28 days. A longer latency was also evident at 14 days.     

Folded Futurity: Epigenetic Plasticity,Temporality, and New Thresholds of Fetal Life

The life sciences are generating a transformative view of the biological body not as fixed and innate but as permeable to its environment and, therefore, plastic: development is open and malleable. Emblematic of these new sciences is environmental epigenetics, which investigates environmental factors that come into the body to shape expression of genes across the life course; prominent are environmental exposures during fetal development, which epigeneticists propose influence not only birth outcomes but also lifelong health. How does this new emphasis on permeability and plasticity during fetal development change how the fetus and fetal vulnerability are understood in the current scientific literature? Perspectives on genomic and reproductive temporality help conceptualize environmental epigenetics as a dynamic relationship between plasticity and determinism. This epigenetic temporality links past, present, and future in way that gives the fetus a keystone role as the vulnerable space-time of environmental epigenetics. Epigenetic temporality produces a new, folded futurity that brings multiple, future generations into the present, influenced by current environmental conditions. In doing this, epigenetics shifts thresholds of fetal vulnerability and intervention to incorporate other entities, including reproductive cells (gametes and primordial germ cells) and very young children. Epigenetic temporality folds in on itself, producing new versions of vulnerable, plastic life that require protection now, in the enduring present, even as the future toward which epigenetics is oriented constantly recedes.     

Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief

Background: Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA’s negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study’s objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG.

Design: An online, retrospective survey was conducted with 161 women.

Methods: Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses.

Results: Moderate levels of PTG were observed for “relating to others,” “personal strengths” and “appreciation of life.” “Positive reframing” was a significant predictor of PTG. Despite using mainly “adaptive” coping strategies, women’s grief levels were high.

Conclusions: “Adaptive” coping strategies such as, “positive reframing” are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women’s experience, may be beneficial.