Labor induction post-term with 25 micrograms vs. 50 micrograms of intravaginal misoprostol.

OBJECTIVES: To compare the effectiveness of 25 microg vs. 50 microg of intravaginal misoprostol for cervical ripening and labor induction beyond 41 weeks' gestation. METHODS: The study population consisted of 120 women not in active labor with a gestational age >41 weeks, singleton pregnancy with vertex presentation, reactive fetal heart rate tracing, amniotic fluid index >/=5, and Bishop score <5. Women were randomized to receive either 25 microg (n=60) or 50 microg (n=60) of intravaginal misoprostol. The dose was repeated every 4 h (maximum number of doses limited to six) until the patient exhibited three contractions in 10 min. The main outcome measure was the induction-vaginal delivery interval. RESULTS: There was no significant difference between the two groups with regard to the induction-vaginal delivery interval (685+/-201 min in the 25 microg group vs. 627+/-177 min in the 50 microg group, P=0.09). The proportion of women delivering vaginally with one dose of vaginal misoprostol was significantly greater in the 50 microg group (0/49 vs. 41/47, P<0.001). There were no differences in the rates of cesarean and operative vaginal delivery rates, or in the incidences of tachysystole and hyperstimulation syndrome in the two treatment groups. Neonatal outcomes were also similar. CONCLUSIONS: Intravaginal administration of 25 microg of misoprostol appears to be as effective as 50 microg for cervical ripening and labor induction beyond 41 weeks' gestation.     

Pethidine versus tramadol for pain relief during labor.

OBJECTIVE: To evaluate and compare the analgesic efficacy and adverse effects of tramadol and pethidine in labor. METHOD: Fifty-nine full term parturients were randomly assigned to one of two groups in active labor. Group 1 received 100 mg pethidine; group 2, 100 mg tramadol, intramuscularly. Analgesic efficacy, maternal side effects, changes in the blood pressure, heart rate, and duration of labor were assessed. RESULT: At 30 and 60 min after drug administration, pain relief was greater in the pethidine group than in tramadol group. The incidence of nausea and fatigue was higher in the tramadol group. Following drug administration the decrease in systolic and diastolic blood pressure and the increase in heart rate were statistically significant in both groups. No significant difference was found between the groups when compared for duration of labor and Apgar scores. None of the neonates developed respiratory depression. CONCLUSION: Pethidine seems to be a better alternative than tramadol in obstetric analgesia because of its superiority in analgesic efficacy and low incidence of maternal side effects.     

高选择性环氧化酶—2抑制剂的进展与评价

目的 :介绍高选择性环氧化酶 - 2抑制剂———昔布类药物进展 ,并评价其临床疗效 ,以供临床参考。方法 :查阅国内、外近期相关文献进行分析、评价。结果与结论 :昔布类高选择性环氧化酶 - 2抑制剂进展十分迅速 ,对环氧化酶 - 2的选择性高 ,在治疗骨关节炎和类风湿性关节炎、关节痛、术后疼痛和肿瘤上展现了良好的治疗前景     

薯蓣皂素生产工艺的研究进展

介绍薯蓣皂素生产工艺的现状及存在的问题,对生产工艺的研究进展进行总结,并对生产工艺的发展前景提出了观点,认为低污染或无污染的薯蓣皂素生产工艺将成为其发展方向.     

从药用石斛研究进展看生药学的发展趋势

石斛的生药学研究经历了传统植物器官水平到组织水平、细胞水平和分子水平的发展过程。这一过程显示：社会需求是生药学发展的内在动力，新技术新方法的运用有力地促进了生药学的发展。生药学将在微观和宏观方面深入发展，为中药现代化做贡献。     

子宫内膜癌治疗现状与进展

早期子宫内膜癌的治疗以手术为主,晚期癌则采取手术、放疗、化疗的综合疗法.早期病例的手术方式并不一致,晚期癌手术与放疗如何合理配合仍有争论,化疗的应用也存在不同意见.     

放射免疫导向手术的研究进展

介绍放射免疫导向手术的基本原理及发展情况，探讨其在胃癌、大肠癌中的应用价值。放射免疫导向手术能有效地检出亚临床病灶，提高胃癌、大肠癌的治愈率。     

米非司酮用于足月妊娠引产时脐动脉血流的测定

目的：评价米非司酮用于足月妊娠引产时对胎盘血液供应的影响。方法：将９７例妊娠３８～４２周具有引产指征的孕妇随机分为两组：治疗组（４９例）给予口服米非司酮，每次５０ｍｇ１２小时１次连续２天后，阴道置米索前列醇２５μｇ，１２小时１次；对照组（４８例）予静脉推注蒂洛安２００ｍｇ，每日１次连续３天后，静脉点滴催产素引产。两组孕妇均在用药前及用药后３６～４８小时行脐动脉血流速度测定，以收缩期血流速度峰值（Ｓ）与舒张末期血流速度峰值（Ｄ）的比值（Ｓ／Ｄ）为测定参数，观察用药前及用药后３６～４８小时的脐血流Ｓ／Ｄ值的改变。结果：两组用药前及用药后３６～４８小时的脐血流Ｓ／Ｄ值比较，差异无显著性（Ｐ＞０．０５）。结论：米非司酮５０ｍｇ１２小时１次连续２天口服用于足月妊娠引产不仅效果良好，且对胎盘血流动力学无显著影响。     

Transcutaneous electrical nerve stimulation (TENS) for adjuvant pain-relief during labor and delivery

Objective: We examined the efficacy of transcutaneous electrical nerve stimulation (TENS) in general and the new Freemom TENS device (LifeCare, Israel) in particular, for pain relief during labor and delivery. Methods: The study group consisted of 104 women. Forty-six nulliparas (44.2%) and 58 multiparas (55.8%), all of whom used the TENS device for pain relief during labor. All participants completed a questionnaire on the degree of pain relief afforded them by TENS during the delivery and related questions. The objective evaluation was based on the documented labor and delivery parameters including medical interventions during delivery. Results: The majority of subjects (72% of the nulliparas and 69% of the multiparas) considered TENS effective for the relief of pain during labor. Most of them (67% of the nulliparas and 60% of the multiparas) responded positively to the use of TENS in future deliveries. Sixty-five percent of the multiparas considered TENS at least as effective as the other pain relief methods they had used before. TENS significantly reduced the duration of the first stage of labor P<0.001 for nulliparas, P<0.005 for multiparas and it significantly decreased the amount of analgesics administered to individual patients. No significant difference was found in fetal heart rate tracings, Apgar scores and cord blood pH between the study group and an equal number of matched controls who used other forms of pain management. Conclusions: TENS is an effective non-pharmacological, non-invasive adjuvant pain relief modality for use in labor and delivery. TENS application reduced the duration of the first stage of labor and the amount of analgesic drug administered. There were no adverse effects on mothers or newborns.     

急性缺血性卒中的神经保护药物研究进展

缺血性脑损伤的病理生理机制包括兴奋性氨基酸的释放、梗死灶周围去极化、炎症反应及神经元凋亡等。几乎对缺血级联反应的所有环节都已进行过神经保护药物的开发和试验。许多神经保护药物在脑缺血动物模型研究中证明有效,但临床试验效果却难以令人满意。本文就目前各类神经保护药治疗脑缺血的临床前期和临床试验的结果与进展作简要的回顾和展望。