探讨无保护会阴接生对会阴裂伤程度及侧切率的影响

目的:探讨无保护会阴接生在产妇分娩中的应用效果。方法:将在某院行分娩的144例产妇分成观察组与对照组,分娩时分别采取无保护会阴接生法与常规接生法,观察对比两组产妇的会阴裂伤程度、侧切率情况及风险事件。结果:观察组产妇会阴完整的比例明显高于对照组,会阴裂伤Ⅱ、Ⅲ级的比例明显低于对照组,两组产妇的会阴裂伤Ⅰ级比例对比差异不明显;观察组产妇的会阴侧切率明显低于对照组产妇的会阴侧切率。结论:无保护会阴接生法能有效减轻产妇的会阴裂伤程度并降低侧切率,为母婴健康提供了有力保障。     

无保护会阴接生法在阴道分娩中的应用效果分析

目的：分析无保护会阴接生法与传统保护会阴接生法对阴道分娩中各项因素的影响,探讨无保护会阴接生技术的应用效果。方法2013年1－10月初产妇238例,其中传统接生法的110例为对照组,无保护会阴接生法的128例为观察组,比较两组在会阴侧切率、会阴裂伤、第二产程时间、阴道出血量、新生儿窒息、产后尿潴留、会阴伤口感染率等方面的差异。结果观察组与对照组比较能够显著降低会阴侧切率,降低产妇的会阴裂伤,且观察组产后尿潴留、会阴伤口感染率显著下降（ P均＜0．05）;两组在阴道出血量、新生儿窒息、第二产程时间比较差异无统计学意义（ P均＞0．05）。结论无保护会阴接生技术有利于降低阴道分娩会阴侧切率及会阴裂伤,更符合自然分娩的理念,是一项值得推广的技术。     

无保护会阴接生与传统保护会阴接生对产妇阴道裂伤程度的影响差异

目的：探讨无保护会阴接生与传统保护会阴接生对产妇阴道裂伤程度的影响的差异。方法选取2012年4月-2015年2月住院进行阴道分娩的产妇252例,随机分为观察组和对照组各126例。观察组产妇采用无保护会阴接生法,对照组采用传统保护会阴接生法。比较2组产妇的会阴裂伤程度及会阴伤口愈合情况。结果观察组产妇会阴裂伤率为80.9％低于对照组的95.2％,差异有统计学意义（P ﹤0.05）。观察组会阴伤口愈合良好率高于对照组,会阴合并水肿率低于对照组,差异均有统计学意义（P ﹤0.05）。结论无保护会阴接生较传统保护会阴接生可减轻产妇会阴裂伤程度,有利于会阴伤口的愈合,值得推广应用。     

无保护接生185例临床分析

目的探讨无保护接生降低初产妇会阴侧切率的方法和效果,降低分娩住院费用。方法回顾性分析2012年10月月本院采用新式无保护接生法接生的初产妇185例产妇的临床资料,并以2012年8月采用传统接生法的初产妇185例产妇作为对照组,比较两组初产妇会阴侧切率、会阴裂伤情况。结果观察组未作会阴侧切,会阴仅有121例一度裂伤,45例二度裂伤,19例会阴均完好无创口,对照组会阴侧切112例（60.54%）,22例一度裂伤,41例二度裂伤,7例会阴无创口。结论新式无保护接生理念的应用可明显降低初产妇会阴侧切率,明显降低对会阴损伤,值得临床进一步研究推广。     

2011-2012年大新县人民医院阴道分娩会阴状况分析

目的 了解住院阴道分娩产妇会阴状况.方法 对2011-2012年大新县人民医院阴道分娩产妇会阴状况进行统计分析.结果 2011-2012年大新县人民医院产妇阴道分娩3692例,会阴侧切1048例,会阴侧切率为28.39%,会阴裂伤1875例,会阴裂伤率为50.79%,会阴侧切后并会阴裂伤24例,发生率为0.65%.结论 合理掌握分娩技巧,可以降低会阴侧切及会阴裂伤率.     

无创接生技术在促进人性化自然分娩中的应用

目的 探讨无创接生技术在促进人性化自然分娩中的应用。方法 将该院接诊的360例单胎头位初产妇用随机数字表法分为观察组和对照组,各180例。观察组采用无创接生技术(即无保护会阴接生法),对照组产妇采用传统接生方法,即保护会阴法。比较两组产妇会阴侧切率、会阴裂伤、母婴不良结局、产后会阴伤口疼痛等指标。结果 观察组产妇会阴侧切率明显低于对照组,会阴完整率和Ⅰ度裂伤率高于对照组,Ⅱ度裂伤率和正切率则明显低于对照组,组间差异有统计学意义。观察组产妇第二产程时间明显少于对照组产妇,组间差异有统计学意义。观察组产妇产后不良结局事件发生率及产程过程中疼痛程度明显低于对照组,组间比较差异有统计学意义;观察组发生新生儿不良事件发生率略低于对照组。观察组产妇产程过程中疼痛状况明显轻于对照组,差异有统计学意义。结论 无创接生技术可降低产妇会阴侧切率,减少助产士对接生过程的干预,促进自然分娩成功率,更加符合人性化自然分娩的理念。     

无保护会阴接生配合会阴体按摩在初产妇分娩中的应用

目的:探讨无保护会阴接生配合会阴体按摩降低初产妇会阴侧切率及会阴严重裂伤率的方法与效果.方法:将1000例初产妇按入院时间分为两组.自愿接受正常分娩不保护会阴的初产妇为观察组(500例),于宫口开全胎头拨露后,进行产道按摩,助产士指导产妇正确用力,在无保护会阴状态下接生;传统法保护会阴接生的初产妇为对照组(500例),采用传统的保护会阴的接生方法进行接产.比较两组的会阴情况(侧切率和裂伤)、第二产程时间及新生儿锁骨骨折发生率.结果:两组产妇在产后出血、新生儿Apgar评分、第二产程时间的差异均无统计学意义(P＞0.05).观察组会阴侧切40例,占8.0％;对照组会阴侧切128例,占25.6％;观察组的会阴侧切率低于对照组,差异有统计学意义(P＜0.05).观察组新生儿锁骨骨折发生率低于对照组(P＜0.05).结论:无保护会阴接生法在降低初产妇会阴侧切率及会阴严重裂伤率上效果显著,可在产科治疗中实施.     

双侧会阴阻滞联合无保护会阴接生用于自然分娩的临床分析

目的：探讨在采用无保护会阴接生实现自然分娩时联合双侧会阴阻滞的临床疗效。方法将252例采用无保护会阴接生方式自然分娩的产妇,随机分为观察组与对照组各126例。所有患者均给予常规护理和细致的产前检查,观察组产妇分娩时采取双侧会阴阻滞联合无保护会阴接生,对照组采用单侧会阴阻滞麻醉联合无保护会阴接生。比较2组第二产程时间、新生儿窒息、会阴完整、会阴裂伤和分娩时疼痛程度分级。结果观察组第二产程时间短于对照组,新生儿窒息率低于对照组,会阴完整率高于对照组,会阴Ⅰ度、Ⅱ度损伤率低于对照组,差异均有统计学意义（P＜0．05）。观察组无痛和轻度疼痛率高于对照组,而中度疼痛和重度疼痛率低于对照组,差异具有统计学意义（P＜0．05）。结论双侧会阴阻滞联合无保护会阴接生,可缩短第二产程、减少新生儿窒息率,提高会阴完整率,减轻会阴裂伤程度和分娩时疼痛程度,具有良好的应用价值。     

无保护会阴接生法降低初产妇会阴侧切率临床分析

目的:探讨无保护会阴接生法降低初产妇会阴侧切率的临床效果。方法:选择152例经阴道足月头位分娩的初产妇随机分为两组:观察组实施无会阴保护等综合方法不做会阴侧切术;对照组行会阴侧切术,观察两组产妇产后恢复情况。结果:无保护接生会阴不行侧切,产后恢复及生活质量优于对照组(P<0.05)。结论:采用不侧切、无会阴保护等综合方法可严格控制会阴侧切率,促进了自然分娩及孕产妇产后恢复,提高产后生活质量,维护产妇身心健康。     

无保护会阴分娩的临床探讨

目的通过观察产妇无保护会阴状态下分娩会阴裂伤情况,降低会阴切开率,减少产科创伤,提高“自然分娩”的成功率。方法将本院2013年8～12月间正常分娩的的产妇100例,分为观察组和对照组各50例,观察组入院后给予讲解“自然分娩”的好处,宫口开全胎头着冠后,助产士指导产妇屏气和哈气,疼痛时屏气,不疼痛时哈气,在无保护会阴状态下分娩,对照组在宫口开全、胎拨露后,传统托肛保护会阴的接生方法进行会阴分娩,观察两组“自然分娩”会阴裂伤情况。结果产妇会阴裂伤例数及程度比较差异无统计学意义（P〉0．05）。结论无保护会阴接生方法简单、实用,对产妇及新生儿均无不良影响,降低了产妇会阴侧切率,值得在临床推广。     

Nicotinamide and methionine reduce the liver toxic effect of methotrexate.

Methotrexate is widely used as a therapeutic agent in different diseases. This therapy is connected with various side effects, including liver toxicity. We have developed a mouse model to demonstrate the toxic effects of methotrexate: mice were given 50 mg/kg acetaminophen, which itself has no effect on the liver. If, additionally, methotrexate is applied, there is an increase in the death rate, as well as in glutamate-oxaloacetate transaminase (GOT) and glutamate-pyruvate transaminase (GPT) activities. If methotrexate is administered in conjunction with either nicotinamide or methionine, the rise in the death rate and in GOT and GPT activities associated with methotrexate application is markedly reduced. On the basis of these results, it can be concluded that methotrexate therapy should be combined with either nicotinamide or methionine, respectively.     

Enkephalin and other peptides reduce passiveness

Enkephalin and other brain peptides previously have been shown to be active in the dopa potentiation test which may be considered an animal model of mental depression. A recently described model of passive immobility during swimming, also sensitive to tricyclic antidepressants, was therefore used to study a large number of naturally occurring peptides and some of their analogues. It was found that several enkephalins with no opiate activity after peripheral injection reduced the immobility and thus increased the activity of swimming rats. α-MSH, but not its 4–10 core or a 4–9 analogue, also caused significantly more swimming than did the diluent control. As we have previously found in several animal and clinical studies, a smaller dose of MIF-I was more effective than larger doses. The results confirm our concept of the CNS actions of brain peptides and support the suggestion that some of them, like the enkephalins, might be useful after peripheral administration in mental depression or other CNS disorders.     

更新知识，规范诊疗——应对骨质疏松症的高患病率

2001年，美国国立卫生研究院（NIH）提出的骨质疏松症定义是：以骨强度下降、骨折风险增加为特征的骨骼系统疾病。NIH的骨质疏松定义强调了骨强度的重要性，在一般情况下，骨强度由骨矿密度和骨质量两个主要参数反映。但是，     

Naloxone and rimonabant reduce the reinforcing properties of exercise in rats

Naloxone and rimonabant block neurotransmitter action of some drugs of abuse (such as ethanol, opiates, and nicotine), and thereby reduce drug seeking and self-administration by suppressing the drugs' reinforcing properties. The present study represents an attempt to elucidate whether these drugs may also reduce rewarding properties of other events, in this case, activity-based reinforcement. In Experiment 1, 10 obese and 10 lean Zucker rats pressed a locked door under a progressive ratio schedule of reinforcement that, when unlocked, provided access to a running wheel for 2-min intervals. After baseline breakpoints were established, doses of naloxone (0.3-10 mg/kg) were administered prior to experimental sessions. Obese rats exhibited lower baseline breakpoints for wheel activity, lower response rates, and fewer revolutions compared to lean rats. Naloxone decreased revolutions and response rates for lean and obese rats, but did not reduce breakpoints. In Experiment 2, five Long-Evans rats pressed a door to unlock a wheel for 20 s of wheel activity. Doses of rimonabant (1-10 mg/kg) were administered before some experimental sessions. The highest dose of rimonabant suppressed breakpoints and response rates, but did not affect revolutions. These data suggest that both drugs reduce the reinforcing properties of wheel running, but do so in different manners: naloxone may suppress wheel-based activity (consummatory behavior), but not seeking (appetitive behavior), and rimonabant does the converse. The data also support the role of endocannabinoids in the reinforcing properties of exercise, an implication that is important in terms of CB1 antagonists as a type of pharmacotherapy.     

Preventing problems in Ecstasy users: reduce use to reduce harm

Increasing use of 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") has been accompanied by concern about acute and possible long-term toxicity. This article discusses acute serious toxicity, chronic toxicity, and common problems associated with Ecstasy use, as well as the implications of these areas for prevention programs targeted at current Ecstasy users. The low incidence of serious adverse events in users creates difficulties for attempts to develop harm reduction recommendations. Many hypothesized risk factors for serious adverse events cannot be confirmed or denied and may not be associated with dramatic elevations in risk. Research on chronic toxicity in users provides strong evidence of neurophysiological changes and suggestive evidence of possible neurocognitive changes. Because these worrisome changes are clinically subtle, users may not be influenced by concerns of neurotoxicity. In contrast, common Ecstasy-related complaints are relatively well documented and have identified risk factors, including factors relating to extent of Ecstasy use (such as "binges"). Common complaints include modest acute and subacute adverse effects,some lasting several days, and problems in life. The apparent willingness of users to modify drug use and other behaviors to decrease these common problems could be used by harm reduction or other prevention programs to encourage users to decrease the extent of Ecstasy use.     

Ketotifen and its analogues reduce aversive responding in the rodent

The abilities of ketotifen and other 4-piperidylidene derivatives (HF200-184, HE36-953, SDZ209-321 and SDZ206-703) to inhibit aversive responding were compared in the mouse light/dark test box and in the rat social interaction test. Ketotifen and HF200-184 reduced aversive responding of the mouse to the brightly illuminated area of the test box and facilitated rat social interaction; HF200-184 was approximately 100 times more potent than ketotifen. The chronic administration and withdrawal from treatment with diazepam, ethanol, nicotine and cocaine in the mouse was associated with increased behavioural suppression which was prevented by the administration of ketotifen and HF200-184 during the period of withdrawal. HE36-953 also prevented the behavioural consequences of withdrawal from diazepam and cocaine. The relative potencies of ketotifen and its analogues to inhibit aversive responding did not correlate with their affinities for the 5-HT3 recognition site. It is concluded that compounds within the 4-piperidylidene series can reduce behavioural suppression in rodent models of anxiety and attenuate the behavioural consequences of withdrawing from treatment with drugs of abuse.