米非司酮米索前列醇终止12～16周妊娠

目的 探讨持续米非司酮配伍米索前列醇用于孕12～16周引产临床效果.方法 回顾性分析应用持续米非司酮配伍米索前列醇对92例孕12～16周引产的效果和副作用,并与常规米非司酮配伍米索前列醇引产效果进行对比.结果 引产成功率98.9%,显著高于常规米非司酮配伍米索前列醇引产92.5%,产程较常规米非司酮配伍米索前列醇引产缩短,出血量和胎盘滞留率显著降低.结论 持续米非司酮配伍米索前列醇用于中期妊娠引产是一种更有效、痛苦小、并发症少的方法.     

米非司酮配伍米索前列醇用于终止12～22周妊娠临床观察

目的探讨米非司酮片配伍米索前列醇片用于中期妊娠引产的临床效果,进一步提高药物终止妊娠的有效率。方法选择孕12～22周的孕妇116例,口服米非司酮片配伍米索前列醇片终止妊娠。结果 116例孕妇中109例药物终止妊娠成功,其中5例孕13～20周行大月份钳刮,2例阴道上药无明显宫缩后第2天改为水囊引产,同时给予缩宫素静滴。结论米非司酮片配伍米索前列醇片用于中期妊娠引产效果好、安全、有效、实用,值得推广。     

妊娠中期引产228例临床效果分析

目的:探讨米非司酮配伍米索前列醇用于妊娠中期引产的临床效果.方法:对2008年1月～2010年12月来我院就诊妊娠12～24周要求引产者228例,按不同引产方式进行分组,药物组(140例)及利凡诺组(88例),对两组引产效果进行分析.药物组根据米索前列醇不同给药方式分为口服组及直肠给药组,比较引产时间及用药剂量.结果:药物组与利凡诺组胎盘胎膜残留、引产时间及出血量比较差异有显著性(P＜0.05);妊娠12～16周,口服组与直肠给药组引产时间比较差异有显著性(P＜0.05);妊娠16～24周,口服组与直肠给药组米索前列醇用量比较差异有显著性(P＜0.05).结论:米非司酮配伍米索前列醇用于中期引产具有成功率高、完全流产率高、引产时间短及阴道流血量少等优点,根据孕周不同,选择合适米索前列醇的给药方式可提高引产效率,减轻患者痛苦.     

104例藏族妇女中孕药物流产病例的疗效观察

目的了解米非司酮配伍米索前列醇对终止中期妊娠的疗效观察。方法米非司酮配伍米索前列醇口服,米非司酮50mg,po,q12h连服3天,第四天晨起口服米索前列醇0．6mg,服药前后均禁食2小时。结果口服米非司酮配伍米索前列醇的中期引产成功率约93．26％,失败率约6．73％。结论米非司酮配伍米索前列醇对终止中期妊娠成功率高,清宫率低,值得临床推广应用。     

米非司酮配伍米索前列醇终止不同孕期中期妊娠临床分析

目的探讨米非司酮配伍米索前列醇终止不同孕周中期妊娠(12～16周、17～28周)的疗效及安全性。方法回顾性分析在邹平县计划生育妇幼保健服务中心符合条件药物终止妊娠的妇女173例,根据孕龄分成两组。结果两组的引产成功率分别为97.6%和96.6%,孕周小引产时间短,不全流产率高,孕周大引产时间长,不全流产率低。结论米非司酮配伍阴道放置米索前列醇用于中期妊娠引产,具有临床效果显着、方法简单安全、损伤少等优点。     

米非司酮合并米索前列醇中期妊娠引产的效果观察

自 1996年 12月～ 1999年 12月我院对 16 0例中期妊娠采用米非司酮合并米索前列醇引产 ,通过与利凡诺引产效果相比较证实 ,米非司酮合并米索前列醇引产效果良好 ,是一种安全有效并可替代利凡诺的中期妊娠引产方法。1　资料与方法1 1　观察对象　自 1996年 12月～ 1999年 12月在我院住院自愿要求终止妊娠的 2 96例健康妇女 ,妊娠 13～ 2 7周 ,随机分为观察组和对照组 ,观察组 16 0例 ,无应用前列腺素禁忌证 ,采用米非司酮合并米索前列醇引产 ,对照组 136例采用利凡诺羊膜腔内注入引产。两组引产的年龄、孕产次、孕周均无明显差异 ,具有可比性…     

米非司酮配伍米索前列醇终止妊娠的临床效果

目的观察比较米非司酮配伍米索前列醇与利凡诺用于中期孕引产的效果与安全性.方法将我所174例12～20周孕要求终止妊娠的妇女随机分为A、B两组,A组给予口服米非司酮150mg后配伍米索前列醇口服及阴道给药;B组给予利凡诺羊膜腔内注射行中期孕引产.结果两组引产成功率分别为94.25%和59.77%,A组成功率明显高于B组.两组引产过程中用药至宫缩发动时间分别为(1.14±3.5)h和(29.33±13.24)h,A组宫缩发动时间明显早于B组.两组引产产程分别为(6.72±4.91)h和(28.60±16.52)h,A组产程明显短于B组.A组无并发症发生,且副反应较少.讨论米非司酮配伍米索前列醇是终止12～20周妊娠的有效及安全的引产方法,该方法优于利凡诺羊膜腔内引产.     

米非司酮终止中期妊娠临床效果分析

目的：米非司酮配伍米索前列醇终止中期妊娠（妊娠12～20周）相对依沙吖啶羊膜腔内注射终止中期妊娠（妊娠12～20周）的临床效果分析。方法：本站2005年1月～2009年10月收治的中期妊娠（妊娠12～20周）引产者216例,总结分析采用米非司酮配伍米索前列醇药物引产对比依沙吖啶羊膜腔内注射引产的临床效果。结果：终止中期妊娠（妊娠12～20周）采用米非司酮配伍米索前列醇药物引产在促宫颈成熟及宫缩痛的强度和时间上更明显优于应用依沙吖啶注射引产（P〈0.01）,引产成功率及胎盘胎膜残留也优于依沙吖啶注射引产（P〈0.05）,产后出血差异无统计学意义（P〉0.05）。结论：米非司酮配伍米索前列醇不但可应用于终止早期妊娠,而且终止中期妊娠（12～20周）效果优于依沙吖啶注射引产,值得临床应用和提倡。     

大剂量米非司酮联合米索前列醇用于中期妊娠引产的临床效果观察

目的：观察大剂量米非司酮联合米索前列醇中期妊娠引产的临床效果。方法选取该院2012年6月－2014年6月收治的孕16～24周要求终止妊娠的患者200例,将所有患者随机分为观察组和对照组各100例。对照组给予常规剂量米非司酮联合米索前列醇终止妊娠。观察组给予大剂量米非司酮联合米索前列醇终止妊娠。观察2组流产情况,阴道出血时间及月经恢复时间。结果观察组的流产成功率为94％高于对照组的82％,阴道流血时间及月经恢复时间均短于对照组,差异均有统计学意义（P＜0．05）。结论大剂量米非司酮联合米索前列醇口服能安全有效地终止16～24周妊娠,效果较好,可减少阴道出血量,且服药方法简便,具有临床推广价值。     

米非司酮配伍米索前列醇用于中早期妊娠引产100例临床观察

目的探讨米非司酮配伍米索前列醇用于7～20周妊娠的引产效果。方法 2009年1月至2010年1月在我院住院引产孕妇中随机抽取100例,其中妊娠7～10周50例设为A组,口服米非司酮150mg,3d后口服米索前列醇0.6～1mg,妊娠10～20周50例设为B组,口服米非司酮300mg,3d后口服米索前列醇0.6～1.2mg。结果 A组引产成功48例,2例失败行吸宫术,成功率为96%,B组100%引产成功。结论米非司酮配伍米索前列醇用于终止7～20周妊娠是一种安全、有效、经济、快捷的引产方法。值得推荐。     

妊娠20周前甲状腺功能变化分析

目的：探讨妊娠20周前甲状腺功能参考范围及甲状腺功能异常患病率。方法选取行产检的健康单胎初产妇1706例及同期健康检查的非妊娠女性为研究对象,测定其甲状腺功能,分析甲状腺功能变化特点。结果促甲状腺激素（ TSH）中位数值最低、最高分别为孕8周、孕19^＋6周,分别为0．90 mU／L、2．74 mU／L;游离甲状腺素（ FT4）中位数值最低、最高分别为孕9周、孕19^＋6周,分别为11．34 pmol／L、8．75 pmol／L;TSH随妊娠时间的延长,逐渐增加,而FT4逐渐降低。与非妊娠女性相比,孕8～12^＋6周孕妇TSH中位数下降28．48％,34例孕妇FSH低于非妊娠期参考范围,占5．54％。 FT4较非妊娠女性中位数增加7．98％,39例孕妇FT4高于非妊娠期参考范围,占6．35％。以第2．5百分数和第97．5百分位为甲状腺功能正常参考范围,非妊娠女性、孕8～12^＋6周、孕13～16^＋6周、孕17～19^＋6周TSH 参考范围分别为0．16～5．90 mU／L、0．03～3．66 mU／L、0．06～3．75 mU／L、0．32～4．32 mU／L, FT4分别为6．70～14．04 pmol／L、7．99～18．67 pmol／L、6．19～16．23 pmol／L、6．43～13．50 pmol／L。在1706例妊娠20周前孕妇中,41例存在甲状腺功能异常,总患病率为2．40％,其中1例甲亢、1例甲减、33例亚临床甲减、6例低T4血症,最常见的为亚临床甲减。甲状腺过氧化物酶自身抗体（TPOAb）阳性率为18．70％。结论 TSH于妊娠8～12^＋6周逐渐下降,后逐渐升高;而FT4于妊娠8～12^＋6周逐渐升高,后逐渐降低;甲状腺功能异常中以亚临床甲减最为常见,建议妊娠早期常规行甲状腺功能检查。     

Routine antenatal ultrasound: a retrospective audit

Of 1021 maternity patients 92.6% had at least one ultrasound scan during pregnancy. Eighty-six point two percent of all patients were scanned before 26 weeks gestation. Ultrasound scanning before 26 weeks gestation resulted in dates being changed by two weeks or more in 14.3%. Ultrasound scanning was an important factor in later pregnancy management in 12% of patients and this figure justifies routine antenatal ultrasound at 16-20 weeks gestation.     

Non-clinical single- and repeated-dose toxicity studies of ET-26 hydrochloride in rats

ET-26 hydrochloride (ET-26HCl), a novel analog of etomidate, induces as effective sedation, with good cardiac and respiratory stability, as etomidate but with mild adrenocortical suppression. The objective of this study was to evaluate the potential adverse effects of ET-26HCl in rats. In a single-dose toxicity study, abnormal urine color (red) was observed in all groups: control (100%), 8 mg/kg (10%), 16 mg/kg (50%), and 20 mg/kg (70%) ET-26HCl, which returned to normal on the day of dosing. There were no mortalities or serious toxicological signs; the maximum tolerable dose of ET-26HCl was 20 mg/kg. In the repeated-dose toxicity study, deaths occurred in the 12- (13.33% of males) and 16-mg/kg/day (20% of males and 3.33% of females) groups. Abnormal urine color (red or brown) was detected in the control group (10%) and all treatment groups (30%, 46.67%, and 40% at 8, 12 and 16 mg/kg/day, respectively), at a frequency of 1.43% in the control group, 4.76% in 8 mg/kg/day, 7.62% in 12 mg/kg/day, and 4.29% in 16 mg/kg/day. Increases in neutrophils and plasma fibrinogen were temporary and recoverable effects. Macroscopic and histopathologic changes were found only at the injection sites: abnormal skin color, scabbing, thrombus, ulceration, and inflammation. During the recovery period, there was evidence of reversibility, including fibroblast proliferation and vessel recanalization. The no-observed-adverse-effect level of ET-26HCl was 8 mg/kg/day. Toxicokinetic variables of ET-26HCl, except the calculated initial concentration in females on Day 1, showed a dose-dependent increase to exposure, with no gender difference and no evidence of accumulation.     

文拉法辛联合拉莫三嗪治疗难治性抑郁症的临床研究

目的:探讨文拉法辛联合拉莫三嗪治疗难治性抑郁症的辅助效果及安全性。方法:将60例难治性抑郁症患者随机分为两组:对照组30例,单用文拉法辛(150～225 mg/d)治疗;治疗组30例,在采用文拉法辛(150～225 mg/d)治疗的同时,联合应用拉莫三嗪(100～300 mg/d)。两组持续治疗观察期均为12周。于入组前、入组后第6周和第12周末分别应用汉密尔顿抑郁量表、Qids-C16抑郁症状学记录量表及副反应量表进行评定。结果:①治疗第6,12周末,两组间HAMD、Qids-C16评分的差异有统计学意义(P<0.05或P<0.01)。②治疗组的总有效率为96.67%,对照组的总有效率为50%,两组间的差异有统计学意义(P<0.01)。③治疗组患者中10例出现不良反应,占33.3%;对照组为9例,占30.0%,两组患者的副反应均较轻微。结论:文拉法辛联合拉莫三嗪治疗难治性抑郁症的疗效优于单用文拉法辛,安全性较好,可用于临床治疗。     

Calcium uptake in brain synaptosomes from rats exposed to daily toluene for up to 80 weeks

Rats were exposed to toluene, 500 p.p.m., for 12 hrs/day for up to 80 weeks. The brains were removed and the synaptosomes were prepared. Potassium-stimulated and unstimulated synaptosomes were incubated with 45Ca2+ for 1/2, 2, 4, 8, and 16 min. Toluene exposure for 4 and 12 weeks caused a significant, approximately 20%, increase in 45Ca2+ uptake into unstimulated synaptosomes. The effect was of moderate quantity and transient, since it was not significant after 30 and 80 weeks of exposure. It seems doubtful whether the demonstrated change in calcium uptake should have any relevance in connection with the "organic solvent neurotoxicity syndrome".     

股骨远端复杂骨折的内固定方式选择

目的比较股骨远端复杂骨折2种不同内固定方式的疗效和适应证。方法 2006年1月至2009年3月,分别采用2种内固定方法治疗成年股骨远端复杂骨折46例,男28例,女18例,年龄26-71岁,平均42.9岁。其中逆行交锁髓内钉固定组20例,加压锁定钢板内固定组26例。X线片按AO/ASIF分型,均属复杂类型骨折（A3、C2、C3型）。结果入选病例均获随访16-36个月,平均24个月。切口I期愈合,复位满意,无术后感染、内固定物断裂、骨不连、深静脉血栓、肢体短缩、膝内翻畸形等并发症。骨折愈合时间为15-20周,A组平均18.18周,B组平均18.38周,两组间比较差异无统计学意义（P〉0.05）。膝关节功能按Merchan评分标准评估,A组：优11例,良6例,可2例,差1例,优良率达85.0%。B组：优15例,良8例,可2例,差1例,优良率达88.5%。两组间比较差异有统计学意义（P〈0.05）。结论对于股骨远端的复杂类型骨折,逆行交锁髓内钉和加压锁定钢板均能达到良好的疗效。但观测的结果显示,加压锁定钢板系统能最大限度地减少软组织损伤,对膝关节功能的恢复要优于逆行交锁髓内钉系统。     

Varenicline and Nicotine Patch Therapies in Young Adults Motivated to Quit Smoking: A Randomized,Placebo‐controlled,Prospective Study

This study compares the nicotine patch to placebo in young adult light smokers, and the nicotine patch to varenicline in heavy smokers. Volunteer daily smokers were recruited into a randomized, placebo‐controlled study via community media, colleges and the army (aged 18–26 years). Those subjects with light tobacco dependence were randomized to (i) placebo patch (n = 86) and (ii) nicotine patch 10 mg/16 hr for 8 weeks (n = 94), and those with stronger dependence to (iii) nicotine patch 15 mg/16 hr for 8 weeks (n = 51) and (iv) varenicline for 12 weeks (n = 60). The primary outcome variable was self‐reported smoking abstinence at week 12. Secondary outcome variables were self‐reported smoking abstinence at weeks 4 and 26, and self‐reported abstinence verified by saliva cotinine level at week 12. The prevalence of self‐reported smoking abstinence did not differ statistically significantly in light smokers during the follow‐up (week 4: 19.8% for placebo patch and 26.6% for nicotine patch 10 mg/16 hr; week 12: 17.4% versus 23.4%; week 26: 15.1% versus 20.2%), but the groups of heavy smokers differed significantly for 12 weeks (week 4: 19.6% for nicotine patch 15 mg/16 hr and 73.3% for varenicline, p < 0.001; week 12: 15.7% versus 36.7%, p = 0.018). This statistically significant difference did not endure for the entire follow‐up (week 26: 9.8% versus 18.3%, p = 0.280). However, saliva cotinine verified abstinence at week 12 did not support self‐reported abstinence. Varenicline may be more effective than the nicotine patch as a smoking cessation pharmacotherapy among young adult heavy smokers in the short‐term.     

孕16～28周胎儿脐血β-地中海贫血基因及其血红蛋白电泳、红细胞参数变异分析

目的：探讨红细胞参数和毛细管血红蛋白电泳及β-地中海贫血基因检测在产前诊断β-地中海贫血中的互补作用。方法：210例孕16～28周胎儿脐血标本根据β-地中海贫血基因型测定结果分为4组,对4组血常规结果中的平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）及血红蛋白A（HbA％）、等多参数进行统计分析。结果：对照组MCV、MCH、MCHC与其他各组结果对比差异无统计学意义（P〉0．05）;但HbA（％）在其他组间的结果均低于对照组,差异有统计学意义（P〈0．05）。结论：孕16～28周胎儿脐血MCV、MCH及MCHC检测对β-地中海贫血的产前诊断价值不大,而脐血毛细管血红蛋白电泳及β-地中海贫血基因联合检测则有很好的互补作用。     

75g-2h糖耐量试验和100g-3h糖耐量试验诊断妊娠期糖尿病的可比性探讨

目的：探讨100g-3h糖耐量试验和75g-2h糖耐量试验对妊娠期糖尿病（GDM）诊断的可比性。方法：对1061例体重正常、无糖尿病及内分泌疾病孕妇作为研究对象。用75g糖耐量试验在怀孕的早期（16～20周）和晚期（26～30周）2个时期进行GDM筛查试验。在1周内用100g糖耐量试验对剩余的可能诊断GDM的妇女进行复查。结果：16～20周时在227例妇女用100g糖耐量试验诊断为GDM的有41例,用75g糖耐量试验诊断为GDM的有15g（一致的11g）。κ指数为0.21。在26～30周这个阶段在976例妇女中有484例做了这2个试验。用100g试验在484例中有60例被诊断为GDM,而用75g试验在484例中有26例被诊断为GDM（13例一致）。κ指数为0.18。结论：在孕妇可能患GDM的早期和晚期2个阶段中,用75g糖耐量试验和100g糖耐量试验进行诊断,很难得到一致的结果。     

Comparison of the effectiveness of the HMG-CoA-reductase inhibitors pravastatin versus colestyramine in hypercholesteremia

Comparison of the Efficacy of Pravastatin and Colestyramine in Hypercholesterolemic Patients. We have treated 55 patients with heterozygous familial hypercholesterolemia, familial combined and polygenic hyperlipoproteinemia in a controlled, randomized study to compare the efficacy of pravastatin (CAS 81093-37-0) and colestyramine (CAS 11041-12-6). After an initial therapy of 8 weeks with 20 mg pravastatin doubling of dose led to an additional decrease of the atherogenic lipid fractions (total cholesterol, TC) 21% versus 25%, LDL-C 26% versus 31%, Apo B 12% versus 17%). After 24 weeks of therapy TC decreased by 28%, LDL-C by 33% and Apo B by 14%. Colestyramine reduced cholesterol in 22 FH patients by mean 18%, LDL-C by mean 28% and Apo B by mean 12%. Both drugs did not differ significantly in their lipid-lowering potential. 16 g colestyramine and 20 mg pravastatin did not change the antiatherogenic lipids and apoproteins (HDL-C, Apo AI and AII), however, with 40 mg pravastatin HDL-C increased significantly by 8.4 to 16.5%. The triglycerides remained constant under colestyramine therapy. Pravastatin lowered serum triglycerides after 16 weeks significantly by 11-16%. Pravastatin had no significant effect on liver and kidney function or muscular metabolism. Under therapy with colestyramine well-known complaints like constipation or flatulence were rarely seen.