单次服用10mg米非司酮用于紧急避孕的临床疗效

目的验证10mg米非司酮用于紧急避孕的效果及可接受性.方法征集无保护性交或避孕措施失败120小时内就诊并符合条件的健康妇女,单次口服10mg米非司酮,服药后随访并观察药物不良反应及下次月经情况.避孕有效率按Dixon法计算.结果避孕成功144例,3例妊娠,避孕有效率为71.92%.未孕者月经周期无明显改变且未出现明显不良反应.结论进一步证实10mg米非司酮作为紧急避孕药安全、有效、简便.     

小剂量米非司酮配合阴道冲洗用于紧急避孕

米非司酮作为紧急避孕用药已弓1起一些国家的高度重视,国外报道米非司酮600mg用于紧急避孕的有效率100%,但副反应较大.国内报道米非司酮25mg用于紧急避孕有效率74%～84%.现探讨小剂量米非司酮配合阴道冲洗用于紧急避孕的效果.     

米非司酮、毓婷用于紧急避孕中的临床比较

目的比较米非司酮、毓婷两种紧急避孕方法的有效性。方法对286例要求紧急避孕的健康妇女,月经周期规律,性生活后72 h内来本院接受服药,并能在下次月经前使用屏障法避孕者286例随机分组,1组空腹1次顿服米非司酮片25 mg;2组服用毓婷1片,12 h后再服1片进行避孕效果比较;两种疗效评定如下,成功:服药后月经来潮者为避孕有效;失败:尿HCG阳性,B超检查为宫内妊娠,与停经时间相符。结果米非司酮避孕有效率92.7%;毓婷避孕有效率56.6%,米非司酮组避孕有效率高于毓婷组(P<0.05);两组月经改变基本相同(P>0.05),副反应发生情况毓婷组明显高于米非司酮组,两组差异有统计学意义(P<0.01)。结论米非司酮用于紧急避孕效果优于毓婷,且副反应小,可替代毓婷用于紧急避孕。     

低剂量米非司酮用于紧急避孕136例临床观察

目的 观察低剂量米非司酮用于紧急避孕的临床疗效.方法 从2002年3月～2006年3月,应用米非司酮10 mg用于136例要求紧急避孕的育龄健康女性.136例对象均在无防护性性交后72 h内,1次性口服米非司酮2片(10 mg),服药前后禁食2 h.结果 136例受试者,实际妊娠2例,与相应预期妊娠数11.99例相比,有显著差异(P＜0.05).根据Dixon方法公式计算避孕有效83.3%,收到较好的效果.仅有少数受试者服药后当日出现轻微恶心、头晕、乏力、腹泻等不良反应,反应程度均较轻微,无需处理,各种不良反应发生率均在10%以下.所有受试者月经期出血及流血时间均与平时月经无明显改变.结论 低剂量米非司酮用于紧急避孕对大多数女性是安全有效的.     

口服米非司酮在紧急避孕中的效果观察

目的:通过观察不同剂量米非司酮用于紧急避孕的临床效果、不良反应,评价其疗效及可接受性。方法:将我站180例要求紧急避孕的妇女随机分为观察组与对照组,观察组妇女单次口服10 mg米非司酮,对照组妇女单次口服12.5 mg米非司酮。观察服药后避孕效果、副作用及对月经的影响。结果:观察组避孕有效率为90.5%,对照组为81.7%,组间有显著性差异(P<0.05);对月经周期影响,组间无显著性差异(P>0.05)。结论:米非司酮10 mg用于紧急避孕,不良反应小,效果满意,使用简单,经济实惠,值得广泛推广应用。     

使用Tcu220IUD与米非司酮用于紧急避孕的临床观察

目的评价Tcu220IUD和米非司酮用于紧急避孕的安全性、有效性和可接受性。方法以100例无保护性生活后120小时内放置Tcu220IUD者为IUD组,术前行尿妊娠试验排除妊娠;另100例无保护性生活72小时内口服小剂量米非司酮25mg,服药前行尿妊娠试验排除妊娠。结果 IUD组避孕有效率为100%,米非司酮组为98%,IUD15%有点滴出血,但无感染及大出血的发生。米非司酮组有20%的轻微恶心、呕吐等反应;其中有25%妇女有月经延迟现象,无需特殊处理。结论放置含铜IUD用于紧急避孕安全、有效,最好在无保护性生活后5日内放置,且可以长期避孕;对于未产妇和有生殖器炎症,不宜放置IUD者可口服小剂量米非司酮用于紧急避孕。     

低剂量米非司酮并用双炔失碳酯用于紧急避孕116例分析

紧急避孕是指那些在无防护性性生活后或者避孕失败后几小时或几日内,妇女为防止非意愿性妊娠的发生而采取的避孕方法.紧急避孕药物研究已被引入当前国内外计划生育研究中的一个重要课题,标准的雌孕激素给药的避孕失败率较高,并伴有较重的副反应,WHO时行米非司酮单育随机,多中心试验结果表明,600!mg、50!mg、10!mg三种不同剂量的米非司酮用于紧急避孕可以防止85%～90%的妊娠,国内也有关于25!mg或者50!mg的米非司酮用于紧急避孕的报道,但单独给米非司酮,易致诱导性出血及月经的改变,我院应用10!mg米非司酮加5!mg双炔失碳酯用于紧急避孕即提高了米非司酮的紧急避孕率,又减少了对月经的改变及诱导性出血的发生,现报道如下.     

米非司酮用于紧急避孕30例临床观察

目的:探讨米非司酮用于紧急避孕的临床疗效。方法:收集30例采用米非司酮用于紧急避孕患者的临床资料进行回顾性分析。结果:29例月经来潮,1例妊娠,距排卵期10d,属方法失败,超声检查证实这一点,失败率为3.33%,避孕有效率为96.67%。口服米非司酮不良反应主要有恶心5例(16.67%)、呕吐10例(33.33%)、乏力1例(3.33%)、头晕2例(6.67%)、乳胀2例(6.67%)、腹泻1例(3.33%)、头痛1例(3.33%),反应程度均较轻,无需特殊处理。服药后月经延迟较多,30例中有20例月经延迟,占66.67%;缩短5例,占16.67%;周期不变5例,占16.67%。结论:米非司酮紧急避孕既简便不良反应又小,能有效防止意外妊娠,降低人工流产发生率,从而减轻了对育龄妇女的较大危害,值得临床推广。     

米非司酮、左炔诺孕酮用于紧急避孕的临床效果对比性观察

目的 探讨米非司酮、左炔诺孕酮用于紧急避孕的临床效果.方法 在本次月经周期内只有一次性未保护的同房或避孕失败,同房时间距服药时间不超过72小时且月经规律的育龄妇女分为口服米非司酮、左炔诺孕酮两组来对比性观察.结果 两组对象分别从年龄、孕产情况、避孕有效率、服药后出现头晕、轻微头痛、乳房胀痛、胃肠道反应者及月经情况进行综合分析米非司酮组避孕有效率高于左炔诺孕酮组,副反应发生情况左炔诺孕酮组明显高于米非司酮组.结论 米非司酮作为抗孕酮药物能够通过阻断孕酮受体产生避孕效果,用于延迟或抑制排卵,影响子宫内膜正常发育,干扰受孕卵着床而达到避免妊娠的作用,故米非司酮用于紧急避孕优于左炔诺孕酮.     

小剂量米非司酮用于紧急避孕100例临床观察

目的观察小剂量米非司酮用于紧急避孕的有效性、副反应及可接受性。方法通过对100例健康妇女1次无保护性交后72h内口服米非司酮10mg后的观察随访,了解避孕效果、副反应及月经的变化。结果100例发生1例妊娠,失败率为1%,避孕有效率为90.60%,副反应发生率低,对月经影响小。结论小剂量米非司酮是目前安全、有效的紧急避孕药,值得广泛推广。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.