米索前列醇用于晚期妊娠引产127例分析

目的 :探讨一种晚期妊娠安全、简便、有效的引产方法。方法 :选择正常单胎头位足月妊娠具有引产指征而无禁忌证的妇女 12 7例 ,随机分为二组 ,米索组用米索前列醇 2 5 μg置于阴道后穹窿 ,催产素组用催产素 2 .5IU加入 5 %葡萄糖 5 0 0ml内静滴。对引产有效率分娩时间和剖宫产率进行了对比观察。结果 :引产有效率 :米索前列醇组明显高于催产素组。 (P <0 .0 5 )分娩时间米索前列醇组和催产素组有显著差异 (P <0 .0 5 )。剖宫产率两组有明显差异 (P <0 .0 5 )。结论 :米索前列醇用于晚期妊娠计划分娩安全、简便、有效。     

米索前列醇用于晚期妊娠引产随机对照研究

为探讨米索前列醇用于晚期妊娠引产的效果及安全性 ,采用随机对照研究的方法对 2 85例足月孕妇 (孕周 38～ 42 )进行观察研究 ,米索前列醇组 140例 ,用 2 5μg米索前列醇 (以下简称米索 )阴道后穹隆上药 ;对照组 145例 ,催产素静脉滴注引产。结果 :米索引产组 (实验组 )引产成功率 97.14% ,明显高于对照组 82 .75 % (P<0 .0 5 ) ;实验组诱导产兆时间及总产程的时间明显短于应用催产素的对照组 ,差异有统计学意义 (P<0 .0 1)。两组的胎儿、新生儿情况、产后出血、产道撕伤、产后感染均无显著性差异。结论 :2 5μg米索阴道用药用于晚期妊娠引产的方法简单、可靠、安全 ,值得推广。     

孕妇要求的不合理剖宫产的影响因素分析

目的 分析孕妇要求剖宫产的原因。方法 通过配对病例对照研究及问卷调查的方法,分析３９３例不合理剖宫产孕妇的“剖宫产指征”,其中孕妇要求作剖宫产者２２６例,根据第一例要求剖宫产孕妇的妊娠及分娩情况选择配对的阴道分娩孕妇,对两组孕妇进行问卷调查,寻找孕妇要求剖宫产原因。结果 孕妇对分免的认识、对分免疼痛的恐惧、分娩的信心以及入院后医生交代病情对孕妇的影响在两组间差异有显著意义（Ｐ〈０．０５）。结论孕妇     

异氟醚分娩镇痛对母体及胎儿母体循环中cGMP水平的影响

目的;探讨镇痛浓度的异氟醚对母体及胎儿－母体循环中环磷酸鸟苷水平的影响。     

分娩镇痛的临床观察

目的 探讨布比卡因硬膜外自控镇痛和罗湃卡因蛛风膜下腔－硬膜外自控镇痛用于分娩的效果及对产程、母婴的影响。方法 ９０例初产妇分为３组,布比卡因硬膜外自控镇痛组（Ａ组,ｎ＝３０）、罗哌卡因蛛网膜下腔－硬膜外自控镇痛组（Ｂ组,ｎ＝３０）和对照组（Ｃ组,ｎ＝３０,未行分娩镇痛）,观察各组镇痛效果、产程时间、分娩方式血清皮质醇及新生儿Ａｐｇａｒ评分情况。结果 Ａ,Ｂ组镇痛效果满意,以Ｂ组为佳两组 产程未血清     

Reconstructing the life course: health during early old age in a follow-up study based on the Boyd Orr cohort

A method is described for investigating life course influences on health in early old age. The lives of some 300 individuals at present aged 65-75 y have been reconstructed from the archived records of a pre-WWII survey, in which they took part as children, and from lifegrid interviews with the same individuals 60 y later. Despite loss to study at several points those interviewed are shown to be representative of the British population socio-demographically, in comparison with the 1931 and 1991 decennial censuses, and physically, in comparison with the Health Survey for England. Bias is conservative because the most disadvantaged were disproportionately affected by loss to follow-up through death and because non-responders to interview were more disadvantaged as children than the interviewees. Representativeness and conservative bias, it is argued, justify the use of these data for investigating life course influences on health in early old age.     

异氟醚分娩镇痛对母体血液动力学的影响

目的：前瞻性研究异氰醚分娩镇痛对母体血液动力学的影响。方法：应用国产无创性血液动力学测试仪,对分娩活跃期异氟醚分娩镇痛和对照组产妇共３０例的血液动力学状况进行检测。结果：;实验前后,各组母体血液动力学参数;心率（ＨＲ）,每搏量（ＳＶ）,每搏指数（ＳＩ）,心输出量（ＣＯ）,心脏指数（ＣＩ）,左室有效泵力（ＶＰＥ）,平均动脉压（ＭＡＰ）和总外周阻力（ＴＰＲ）均无显著差异;两组间无显著差异。     

眶上神经的走行层次及其临床意义

目的探讨眉区和额部不同手术层面眶上神经的保护方法。方法在１５例成人头部标本上,对眶上神经在眉区和额部的行程、走行层次和入肌点的位置进行解剖观测。结果眶上神经出眶上孔后,以５２．８±７．４°角向外上经额肌筋膜附着处入帽状腱膜下隙,达发际附近穿帽状腱膜和额肌至皮下。眶上神经起始部直径１．４±０．３ｍｍ,本干入肌点至眶上孔的直线距离为４０．２±９．１ｍｍ,水平距离和垂直距离分别为３０．５±８．８ｍｍ和３３．８±８．４ｍｍ。结论根据手术层面的不同,额眉区的深层面手术应注意保护眶上神经     

A decade of spontaneous long-term course of psychogenic impairment in a community population sample

Background: Our epidemiological study demonstrates the spontaneous long-term course of predominantly psychosocially influenced (“psychogenic”) disorders (neurotic spectrum disorders, personality disorders, stress reactions and somatoform disorders) in a representative community sample of the normal adult population of Mannheim, an industrial and university town in Germany. The natural spontaneous course of these disorders in a population sample over a long period remains largely unknown. Method: Beginning in 1979 (n _t1 = 600) a random population sample was investigated three times over a mean period of approximately 11 years. The last follow-up study ended in 1994 (n _t3 = 301). The follow-up sample was representative of the t1 sample. Psychodynamically trained and clinically experienced interviewers used a semi-structured interview and standardized clinical and psychometric instruments. Psychogenic impairment was assessed using a standardized expert rating (Impairment Score, IS). Results: The mean sum-score of psychogenic impairment after 11 years exceeded the value at t1. The case rate (point prevalence, ICD diagnosis + clinical cut-off/IS) increased from 21.6% at t1 to 26.2% at t3 in the investigated follow-up sample. Intra-individual correlation of psychogenic impairment between t1 and t3 was high (r = 0.55). We found strong evidence for an unfavorable long-term course of psychogenic impairment and only a weak tendency (23.1%) for spontaneous remission of clinically relevant psychogenic impairment. Within a regression model clinical variables, childhood development conditions and personality traits at t1 predicted psychogenic impairment at t3. Conclusion: All clinical variables conclusively indicate an unfavorable spontaneous long-term course of psychogenic impairment. Together with the well-known high prevalence of psychogenic disorders in the normal population, this underlines the need for early therapeutic and preventive intervention. Accepted: 20 August 1999     

Application of Akaike's information criterion (AIC) in the evaluation of linear pharmacokinetic equations

According to linear pharmacokinetics, the time course of plasma concentration of a drug, C_p,is expressed by a sum of exponential functions, C_p= _i=1 ⁿ a_i .This article describes a statistical technique to estimate the number of exponential terms, n,for the time course of drug by the application of Akaike's information criterion (AIC). Plasma concentrations of ethoxybenzamide, sulfisoxazole, bishydroxycoumarin, and diazepam measured following bolus intravenous injection were used as clinical examples for this method. Selection of models is compared between the AIC method and an Ftest method at significance levels of 5% and 1%.