十元的戒指 蛋炒饭的爱情

那是一段快乐的日子，两个人口袋里只有一百元。 很突然地去了他的城市，两手空空，我说，我们就这样在一起吧。他抱着我。紧紧的。 他的一个朋友因为打官司借了他的积蓄。所以，他的钱所剩无几。     

写给我的研究生的几句话

不知道应该怎么称呼你们,论年龄,我是你们的父辈,我的儿子和女儿年纪都比你们大,称你们为孩子颇感亲切;论成熟,你们有些人已经结婚或者即将结婚,也是成年人了;论社会责任,有些人已经升级为父亲或母亲,肩负起育儿成才的重担;论地位,你们已跻身硕士、博士甚至博士后,最低的也是硕士头衔,位列高级知识分子;论前途,你们已经是医生或者即将成为医生……真有点为难,我想我还是称你们为研究生吧,这是我们共同拥有过的经历,无论是硕士还是博士。     

早产的预测及预防措施的评价

早产是产科十分常见的并发症之一。目前早产发生率各国报道不一．大约为5％11％．20世纪后期美国组织进行了许多大样本多中心早产预防的研究，但美国早产发生率仍一直居高不下．目前为12．7％。加拿大、澳大利亚早产发生率分别为7．6％，8．2％，中国早产发生率为6％-7％。当然各国早产诊断标准的不一致（如美国标准是妊娠24-37周分娩为早产）也影响各国早产发生率的统计。     

命运的玩笑捉弄诚挚的爱恋

男人始终爱恋着女人，这一点，女人是深有感触的。 恋爱的时候，男人追求女人是那种蕴而不发的感觉，他不显山，不露水，也不示声音；他的言辞、举动，与他对周围的女人一样，无甚二致。     

奋斗的历程 光辉的未来

2019年10月,我们欢欣鼓舞地庆祝中华人民共和国成立70周年,现今我们又满怀豪情地迎接2020年的到来。我们应该对70年来,妇产科学和妇女保健事业跟随祖国前进的脚步,所经历的壮阔发展,进行一次巡礼,这正是我们坚定自信的理念。一、致敬祖国,致敬改革开放,致敬妇产科前辈新中国成立后,祖国各方面飞跃发展,妇女保健事业和妇产科学专业长足进步。改革开放迎来了科学的春天,也迎来了妇产科学发展的春天。     

永远的三毛 不及的故梦

正书名:你是我不及的梦作者:三毛内容推介:作为撒哈拉沙漠的文艺女青年的唯一代表,三毛的传奇经历几乎成为一代又一代少女的浪漫梦想,她远离故土奔赴沙漠,与荷西跨越生死、绵绵不绝的爱情,都已成为那个时代的最好注脚,也是激励当下年轻人最纯净的青春文学。     

永远的三毛不及的故梦

对大多数人来说,“三毛”已成为一种象征。提起这个名字会想到什么？一杯黄沙,一捧清泉,一次轰烈的爱,一场恣意的旅行……人们谈三毛,往往不是谈她的文字,而是她用文字塑造出的那个敢爱敢恨、甘愿为爱走天涯的形象。以至于谈得太多,过犹不及成了附会,人们心中的“永远的三毛”,到底是个曾经存在过的名叫“陈平”的女人,还是世人编织出的美丽幻象？此书压轴的《你是我不及的梦》是最让我感动的一篇,尽管它用词质朴,所讲的故事也平淡,只是三毛在西北旅行的一段小插曲：她骑骆驼,跟牵骆驼的农家姑娘玉莲三言两语攀谈起来,于是跟着她到家里坐一坐。农家小院落被三毛的手笔描绘得爽利干净;农家人的感情亦然,泼泼辣辣,直来直去,爽脆舒心。三毛在离去时欣羡又怅然地写道,玉莲,你就是那我所得不到的梦。     

羞答答的玫瑰静悄悄的开——旖旎的夫妻密码

我和我老公属于比较“色”的一对儿，他比较喜欢喝酒，尤其是红酒，有时他力请我也喝几口，我不干，他便说：“为了酒后乱‘性’，饮了这杯酒吧，宝贝!”我当然听出他话中有话，心怀“不轨”．便半推半就地喝几口……     

你的天经地义毁了我的一生

正我曾经接触过一位单身女士,当时年近四十,一直没结婚。她是因为严重的抑郁症来找我的。在我们的交谈中,她谈到了自己的童年成长经历。她父母都是小学教师,对她有很好的早期启蒙教育,在各方面要求也很严。她在很小的时候就会背很多经典诗文,聪明伶俐,而且认字很早,上小学就读了不少课外书,学习成绩一直很好。但她父母在她童年时期犯了一个不可     

当你的火焰碰到他的冰川

正作为一对恩爱夫妻,或许你一直对自己那"温吞水"的性爱耿耿于怀,对他的习以为常不甚乐意,忽而有一日你心血来潮,想用自己学到的"助性花招"来"勾引"他,试图用自己的风情点燃他那熊熊性火,不料你的火焰却碰到了他的冰川,你会如何?会反省自己过犹不及还是迁怒于他?     

可控释地诺前列酮栓与米索前列醇及Foley尿管用于足月妊娠促宫颈成熟及引产的效果及安全性比较

Objective?To explore the effects and safety of controlled-release dinoprostone suppositories, misoprostol and Foley catheters for full-term pregnancy in promoting cervical ripening and induce labor. Methods?86 full-term pregnant primiparas with cervical Bishop score<6 and indications for labor induction were prospectively selected and admitted between May 2020 and August 2021. They were divided into 3 groups according to the internal sampling method, 29 cases as group A were treated with controlled-release dinoprostone suppositories, 27 cases as group B were treated with misoprostol, and 30 cases as group C were treated with Foley catheters. The treatment effects and safety of the three groups were compared. Results?The time from induction to labor and the time from labor induction to delivery in group A and C were shorter than those in group B (P＜0.05), and the success rate of induction was higher than that in group B (P＜0.05). The cervical Bishop scores after administration of 4 h, 12 h and 24 h were all higher than group B (P＜0.05). Conclusion?Compared with misoprostol, the controlled-release dinoprostone suppository and Foley catheter are more suitable for full-term pregnancy induction, which can promote cervical ripening and increase the success rate of labor induction.     

Extra-amniotic Foley catheter and prostaglandin E(2) gel for cervical ripening at term gestation.

OBJECTIVE: This study evaluated the efficacy of intravaginal prostaglandin E(2) gel in comparison with that of a Foley catheter for cervical ripening and induction of labor. STUDY DESIGN: Consecutive patients with unfavorable cervix requiring preinduction cervical ripening and induction of labor at term gestation were asked to participate in the study. One hundred and two patients were assigned to treatment with intravaginal prostaglandin E(2) gel (group 1) and 122 patients underwent the placement of an intracervical Foley catheter (group 2). After a maximum of three applications of intravaginal prostaglandin E(2) gel (18h) or after 18h from Foley catheter insertion oxytocin was administered to patients not in active labor. Labor profiles and pregnancy and neonatal outcome were compared between groups. RESULTS: The groups were comparable in term of demographic characteristics, indications for induction of labor, Bishop score at admission. The induction to labor time and the induction to delivery time were similar between groups. The cesarean sections rate was higher in group 1 than in group 2 (26.5 versus 14.7%, P<0.05). This remained significant when the analysis was restricted to nulliparous patients (32.3 versus 14.2%). The incidence of urinary tract infections, chorioamnionitis, and febrile morbidity was similar between groups. CONCLUSION: For preinduction cervical ripening, the Foley catheter is a valid alternative to the application of intravaginal prostaglandin E(2) gel and it is associated with a lower cesarean rate in nulliparous women.     

Preinduction cervical ripening. A randomized trial of intravaginal misoprostol alone vs. a combination of transcervical Foley balloon and intravaginal misoprostol.

OBJECTIVE: To determine if the addition of a mechanical ripening agent (transcervical Foley balloon) to a pharmacologic agent (intravaginal misoprostol) improves the efficiency of preinduction cervical ripening. STUDY DESIGN: Singleton patients with an indication for delivery, unfavorable cervix (Bishop score < or = 5) and no contraindication to labor were randomly assigned to two groups: misoprostol alone (25 micrograms intravaginally every 3 hours for no more than 12 hr) or combination therapy (25-French transcervical Foley balloon inflated to 50 mL of sterile water with identical intravaginal misoprostol dosing). All patients received a history and physical examination (including Bishop score), preripening ultrasound, electronic fetal heart rate and contraction monitoring (to rule out spontaneous labor and document fetal well-being). Multiple variables of perinatal outcome were analyzed, including the main outcome variables of ripening-to-delivery time and cesarean section rate. RESULTS: During August 1998 to August 1999, 81 patients were randomized, 40 to misoprostol alone and 41 to combination therapy. There were no differences between the groups with respect to maternal demographics, preripening Bishop score, maternal complications, intrapartum intervention or neonatal outcome. The misoprostol group spent longer periods of time in active labor, and there was a trend for the combination group to require oxytocin for longer intervals. These findings did not significantly affect the total ripening-to-delivery time or cesarean section rate which were similar for both groups. CONCLUSION: The addition of mechanical ripening with a transcervical Foley balloon to intravaginal misoprostol did not improve the efficiency of preinduction cervical ripening. Mechanical and pharmacologic cervical ripening agents appear to act independently rather than synergistically.     

Cervical ripening and induction of labor with misoprostol,dinoprostone gel,and a Foley catheter: a randomized trial of 3 techniques

OBJECTIVE: The purpose of this study was to compare the efficacy of 3 different techniques of cervical ripening and induction. STUDY DESIGN: Patients who required cervical ripening and induction were randomized to one of 3 groups: (1) supracervical Foley catheter and intravaginal dinoprostone gel, (2) supracervical Foley catheter and 100 microg oral doses of misoprostol, or (3) serial 100-microg oral doses of misoprostol. Intravenous oxytocin was administered when a protraction disorder of labor was identified. RESULTS: There were 339 women randomized. There was no significant difference in the time from first intervention to delivery in the 3 groups (P =.546). In each group, a similar percentage of women required oxytocin (P =.103). The rates of cesarean delivery were equivalent among the groups (P =.722). Rates of tachysystole were high but statistically equivalent among the 3 groups. There were no significant differences in Apgar scores or umbilical artery pH. CONCLUSION: Oral 100 microg serial doses of misoprostol, with or without the use of a supracervical Foley catheter, were equivalent to the use of a supracervical Foley catheter and serial 4-mg doses of dinoprostone gel for cervical ripening and the induction of labor.     

30 mL和60 mL容量宫颈扩张球囊对足月妊娠促宫颈成熟效果比较

目的：探讨两种不同容量的宫颈扩张球囊用于足月妊娠促宫颈成熟的临床疗效观察,为提高引产成功率,降低产后不良影响提供临床依据。方法：随机抽取2017年6月-2017年12月同济大学附属第一妇婴保健院收治的具有引产指征且宫颈评分＜6分的足月单胎孕妇400例作为观察对象,根据不同的球囊注水容量随机分为2组,Foley单球囊注水30 mL促宫颈成熟组（F30组）200例,Foley单球囊注水60 mL促宫颈成熟组（F60组）200例,比较2组患者的促宫颈成熟效果、引产效果以及孕产妇和新生儿转归情况。结果：2组患者治疗前Bishop评分比较,差异无统计学意义（χ2=1.280,P=0.201）,治疗后2组患者Bishop评分均上升,治疗后Bishop评分比较,差异有统计学意义（χ2=-4.137,P=0.000）。2组初产妇的引产-分娩时间比较差异有统计学意义（t=4.204,P=0.000）。多因素分析显示球囊容量是初产妇24 h内成功阴道分娩的影响因素（OR=1.990,95%CI：1.444～2.742,P=0.000）。研究中20例瘢痕子宫孕妇用宫颈扩张球囊促宫颈成熟,其中18例顺利阴道分娩,无相关并发症。2组孕产妇和新生儿结局比较,差异均无统计学意义（均P＞0.05）。结论：对足月宫颈条件不成熟的孕妇（包括剖宫产术后再次妊娠者）采用宫颈扩张球囊引产,安全有效,Foley 60 mL球囊在促宫颈成熟方面效果更好,且适当缩短引产-分娩时间。     

Foley尿管水囊促宫颈成熟用于足月妊娠引产的前瞻性随机对照研究

目的 比较Foley尿管水囊与普贝生栓促宫颈成熟用于足月妊娠引产的安全性和有效性. 方法 采用前瞻性随机对照研究方法,选择2009年6月至12月在本院待产的孕足月、单胎头位、有引产指征、阴道清洁度≤Ⅱ度、胎膜完整、官颈Bishop评分＜6分的初产妇,签署随机对照研究知情同意书后,随机分为2组,最终纳入分析的共126例,分别予Foley尿管水囊(64例)和普贝生栓(62例)促官颈成熟,Foley尿管水囊组与普贝生栓组孕妇的孕周、引产前宫颈评分、引产指征差异无统计学意义.采用t、x2检验或Fisher精确概率法比较2组孕妇的引产成功率、分娩方式、产程时间及母儿结局. 结果 Foley尿管水囊组与普贝生栓组宫颈评分改善、引产成功率、阴道分娩率、总产程、产后出血量差异均无统计学意义(P＞0.05).Foley尿管水囊组较普贝生栓组引产24 h内阴道分娩率低[28.1％(18/64)与56.5％(35/62),t=10.37,P＜0.05],宫缩过频过强发生率也较低[0.0％(0/64)与17.7％(11/62),P＜0.05],但缩宫素使用率高[87.5％(56/64)与21.0％(13/62),x2 =56.27,P＜0.05].2组新生儿Apgar评分、羊水胎粪污染发生率、新生儿体重差异均无统计学意义(P＞0.05).2组孕妇无一例发生产褥感染. 结论 严格掌握Foley尿管水囊促宫颈成熟的指征及执行无菌操作规程,可以取得与普贝生栓相似的促官颈成熟效果及引产母婴结局,未发生过频过强官缩,具有安全性高及成本低廉等优点.     

Hyaluronidase versus Foley catheter for cervical ripening in high-risk term and post term pregnancies.

OBJECTIVE: To evaluate the effectiveness and safety of Foley catheter and hyaluronidase for cervical ripening. METHOD: Randomized controlled trial where 140 pregnant women, with gestational age > or = 37 weeks, indication for labor induction and an unripe cervix, were enrolled, allocated in two groups according to the method of cervical ripening before labor induction. Statistical analysis used Student's t-test, Mann-Whitney, Chi-square test, survival analysis, risk ratios and number needed to treat. RESULTS: Time of induction, dose of oxytocin and mode of delivery had better results in the Foley catheter group. Comfort with the method was higher in the hyaluronidase group. CONCLUSIONS: Both methods were effective and safe for cervical ripening. The Foley catheter group experienced a shorter period of induction, required a lower dose of oxytocin and had higher vaginal delivery rates, while the women who used hyaluronidase declared greater comfort with the method.     

地诺前列酮、米索前列醇及缩宫素用于促宫颈成熟及引产的对比研究

目的:对比地诺前列酮(普贝生)、米索前列醇及缩宫素促宫颈成熟及引产的效果。方法:随机将200例单活胎、具备引产指征的初产妇分为3组:(1)实验组100例,阴道后穹窿放置普贝生;(2)对照1组50例,阴道后穹窿放置米索前列醇;(3)对照2组50例,静脉输注缩宫素。结果:用药24h后,普贝生组宫颈成熟度明显优于缩宫素组,平均临产时间、破膜时间以及分娩时间均明显短于缩宫素组。24h内分娩率:普贝生组为57.0%,明显高于缩宫素组的4.0%(P<0.01);引产成功率:普贝生组为75.0%,明显高于缩宫素组的20.0%(P<0.01)。普贝生组促宫颈成熟及引产效果与米索前列醇组相近,米索前列醇组出现高张宫缩1例(2%),胎盘早剥1例(2%),普贝生组无上述情况。结论:普贝生是一种安全、有效、方便的促宫颈成熟和引产药物,对母儿无明显不良影响。     

Preinduction cervical ripening techniques compared

OBJECTIVE: To assess the clinical efficacy of pharmacologic, mechanical and combination techniques of cervical ripening. STUDY DESIGN: From March 1997 to August 1998, all cervical-ripening patients at Lehigh Valley Hospital were randomly assigned to three groups: intravaginal misoprostol, intracervical Foley catheter, or combination prostaglandin E2 (PGE2) gel and Foley catheter. Inclusion criteria included Bishop score < or = 5 and no contraindication to labor. The remaining delivery process was actively managed according to established guidelines. Multiple variables in perinatal outcome were analyzed, with the cesarean section rate and time from ripening to delivery as the main outcome variables. RESULTS: Of the 205 patients, 65 were randomized to the misoprostol group, 71 to the Foley group and 69 to the catheter-and-gel group. There were no differences between groups in delivery indications, maternal demographics, ultrasound findings, labor interventions, intrapartum times, mode of delivery, postpartum complications or neonatal outcomes. The misoprostol group demonstrated a higher rate of uterine tachysystole and required oxytocin less when compared to the two catheter groups. CONCLUSION: The higher rate of uterine tachysystole with misoprostol did not increase the cesarean section rate. The higher rate of oxytocin required by the two catheter groups did not increase the delivery time intervals. There appears to be no benefit to adding intracervical or intravaginal PGE2 gel to the intracervical Foley balloon. The misoprostol and catheter ripening techniques have similar safety and efficacy.     

Cervical ripening with transcervical foley catheter and the risk of uterine rupture

OBJECTIVE: To estimate whether the rate of uterine rupture in patients with a previous cesarean delivery is related to labor induction and/or cervical ripening using transcervical Foley catheter. METHODS: Charts of all patients who had a trial of labor after a previous cesarean delivery in our institution between 1988 and 2002 were reviewed. The rates of successful vaginal birth after cesarean delivery and uterine rupture in patients with spontaneous labor (control group) were compared with those of patients who underwent a labor induction by means of amniotomy with or without oxytocin and patients who underwent a labor induction/cervical ripening using a transcervical Foley catheter. Logistic regression analysis was performed to adjust for confounding variables. RESULTS: Of 2479 patients, 1807 had a spontaneous labor, 417 had labor induced by amniotomy with or without oxytocin, and 255 had labor induced by using transcervical Foley catheter. The rate of successful vaginal birth after cesarean delivery was significantly different among the groups (78.0% versus 77.9% versus 55.7%, P <.001), but not the rate of uterine rupture (1.1% versus 1.2% versus 1.6%, P =.81). After adjusting for confounding variables, the odds ratio (OR) for successful vaginal birth after cesarean delivery was 0.68 (95% confidence interval [CI] 0.41, 1.15), and the OR for uterine rupture was 0.47 (95% CI 0.06, 3.59) in patients who underwent an induction of labor using a transcervical Foley catheter when compared with patients with spontaneous labor. CONCLUSION: Labor induction using a transcervical Foley catheter was not associated with an increased risk of uterine rupture.