蒂洛安与催产素促宫颈成熟临床对比观察

对１０５例孕周≥３７周，宫颈Ｂｉｓｈｏｐ评分≤５分的孕妇行计划分娩。７２例应用蒂洛安促宫颈成熟，３３例应用催产素作为对照。结果：蒂洛安促成熟总有效率达９０％，催产素为６４％。引产成功率蒂洛安组为８１．４８％，催产素组４５．００％，两组有显著性差别。     

米索前列醇用于孕晚期促宫颈成熟的疗效观察

目的：观察孕晚期妇女应用米索前列醇对促进宫颈成熟的临床疗效。方法将256例孕周在37-42周孕晚期而宫颈发育成熟不良的妊娠者随机分为观察组和对照组各128例。观察组给予阴道后穹窿放入米索前列醇，对照组给予缩宫素静脉滴注，观察用药后2组宫颈成熟效果及分娩结局。结果观察组的总有效率为93．0％显著高于对照组的71．1％，差异有统计学意义（P＜0．05）。2组剖宫产率、产后出血量以及新生儿窒息发生率差异均无统计学意义（P＞0．05）。结论米索前列醇促进宫颈成熟效果显著，安全可靠。     

普贝生与催产素用于足月妊娠引产的效果比较

目的观察并比较普贝生和催产素用于足月单胎妊娠孕妇促宫颈成熟及引产的临床效果。方法选择2010年1-10月在本院分娩的80例具有引产指征的足月单胎,超声影像检查正常,无妊娠期合并症的孕妇作为研究对象,单纯随机分为两组,其中,实验组40例,阴道内使用普贝生栓剂,对照组40例使用小剂量催产素,比较两组宫颈Bishop评分及分娩结局。结果普贝生组宫颈成熟有效率为95％,小剂量催产素宫颈成熟有效率为42．5％。普贝生组经阴分娩28例,阴道分娩率70％,催产素组经阴分娩17例,阴道分娩率为42．5％。结论普贝生能显著促进足月单胎妊娠孕妇的宫颈成熟,增加顺产分娩率,其计划分娩效果明显优于催产素组,值得临床推广使用。     

地诺前列酮栓与缩宫素用于足月妊娠引产效果比较

目的观察控释地诺前列酮（PGE）阴道栓促宫颈成熟的有效性及安全性。方法将73例无阴道分娩禁忌的初产妇随机分为观察组40例和对照组33例，观察组采用控释地诺前列酮阴道栓一枚放置于阴道后穹窿．对照组用0．5％缩宫素静滴。比较两组产妇的宫颈Bishop评分、用药到临产时间、新生儿Apgar评分、不良反应。结果观察组产妇用药后总有效率为92．5％，对照组有效率为66．7％．两组比较有显著性差异（P〈0．05）；观察组从用药到临产时间为6．81±2．31，对照组为10．79±3．72，两组比较有显著性差异（P〈0．05）；两组新生儿体重等无显著性差异（P〉0．05）。结论控释地诺前列酮阴道栓是一种安全有效的促宫颈成熟药物，对母儿无不良影响。值得推广。     

妇康宁与缩宫素对促宫颈成熟和引产的临床研究

目的 探讨妇康宁用于足月妊娠促宫颈成熟及引产的效果和分娩结果。方法选择住院分娩的足月妊娠和过期妊娠单胎、头位初产妇200例，随机分为妇康宁组和催产素组，各100例。妇康宁组：将一枚含前列腺素E210mg妇康宁栓剂置八产妇阴道后穹窿；催产素组：常规用催产素静脉点滴引产。结果妇康宁组促宫颈成熟总有效率为94％，催产素组为57％，2组相比较差异有统计学意义（P〈0．001）；妇康宁组产妇用药后临产时间、第一产程时间、分娩时间明显短于催产素组，差异有统计学意义（P〈0．001）；第二产程差异有统计学意义P〈0．05）；2组产后出血量、胎儿窘迫及新生儿窒息发生率、新生儿体重均差异无统计学意义（P〉0．05）；妇康宁组剖宫产率为18％，催产素为63％，差异有统计学意义（P〈0．001）；妇康宁组因社会因素剖宫产率为0．39％，催产素组为0．68％，2组相比较差异有统计学意义（P〈0．05）。结论妇康宁用于足月妊娠促宫颈成熟和引产成功率明显优于催产素，且可显著缩短产程时间和降低剖宫产率，安全方便，可在临床推广应用。     

用硫酸普拉酮钠促进宫颈成熟

宫颈成熟是正常分娩的重要因素之一，如宫颈成熟不全易造成过期产，导致宫颈难产而使手术产率升高．过期产也威胁围产儿健康。同时，在临床上常遇到某些高危孕妇急需终止妊娠，但因宫颈成熟不全，引产不易成功。促宫颈成熟的方法有口服、羊膜外或明道用前列腺素已，静脉输注销它素和插入Foley氏管等．本文介绍用硫酸普拉酮纳促进宫颈成熟的情况．用酸普拉回钠（普拉雄酮，去氧异雄自酮，硫酸去氢表华团，Dehydroepiandrosteronesulfate，Pras一重er。ne，简称：DHAS，商品名M汕s），是。种体内存在相对弱的雄激素，它与宫颈成熟密切相关…     

普贝生与缩宫素用于足月妊娠引产的效果比较

目的：探讨普贝生用于足月妊娠促宫颈成熟及引产的有效性及安全性。方法：采用对照观察的方法,将86例无阴道分娩禁忌的足月单胎妊娠的孕妇随机分为两组,试验组44例,予普贝生栓剂置阴道后穹隆,对照组42例,静脉点滴小剂量缩宫素,于用药后6、12h分别进行宫颈Bishop评分,比较两组的宫颈评分、分娩情况以及对胎儿和新生儿的影响。结果：试验组用药后6、12h宫颈Bishop评分分别为（3．07±1．32）分和（6．59±1．85）分,对照组为（2．51±0．77）分和（3．54±1．43）分,两组差异显著,P〈0.05及P〈0.01;12h促宫颈成熟总有效率88．64％、24h临产率56．82％、阴道分娩率81．82％,均优于对照组（分别为26．19％、9．52％、42．86％,P〈0.005）;而两组患者总产程及产后出血量、新生儿结局差异无显著性,宫缩过度刺激为主要副作用,但取出后好转。结论：普贝生是一种有效、安全的用于促宫颈成熟、引产的药物。     

经宫颈用前列腺素胶冻剂和片剂对引产的疗效观察

笔者用前列腺素（PGE2）胶冻剂和片剂，经宫颈用药．并观察52例初产妇，随机分成胶冻组（孕龄＞41周14例，＞40周并高血压7例，妊高症、宫内生长弛级各1例，不孕症治疗后足月妊娠3例）和片剂组（＞41周12例，＞叙周并高血压6例，妊高症、宫内生长弛级各3例，不孕症治后足月妊娠2例），进行引产效果观察．同时对成熟宫颈和不成熟宫颈的引产，效果均不理想，失效率胶冻组和片剂组分别为27％和州．自然分娩胶冻剂组仅12％，药片剂组州。现分析如下。1．材料与方法体文观察52例初产妇，均无前列腺素应用禁忌症，并有引产指征（见表1）。经宫颈…     

米索前列醇在绝经后妇女宫腔镜手术前软化宫颈的疗效探讨

目的探讨米索前列醇在绝经后妇女宫腔镜手术时软化宫颈的作用。方法选择2010年6月至2012年12月在我院住院行宫腔镜手术的患者56例，均为绝经一年或以上的妇女，将所有患者随机分为两组：研究组30例，在宫腔镜手术前一日22时阴道后穹隆放置米索前列醇400μg（北京紫竹药业有限公司）；对照组26例，手术前不使用任何促宫颈成熟药物。两组均观察手术中宫颈软化情况及扩张宫颈时间。结果研究组宫颈软化有效率达86．33％，明显高于对照组的19．23％，宫颈软化两组比较差异有非常显著性（P〈O．01）；研究组扩张宫颈时间为（3．6±0．5）min，低于对照组的（8．3±1．2）min，扩张宫颈所需时间两组比较差异有显著性（P〈O．05）。结论绝经后妇女宫腔镜手术前一日22时阴道后穹隆放置米索前列醇400gg，能有效软化绝经后妇女宫颈，缩短扩张宫颈所需要的时间，有利于宫腔镜手术的顺利进行，减少子宫和宫颈损伤的发生。     

地诺前列酮栓用于足月妊娠促宫颈成熟及引产疗效观察

目的探讨地诺前列酮栓（普贝生）用于足月妊娠促宫颈成熟及引产的临床疗效及安全性。方法选择80例足月妊娠有引产指征的产妇,以地诺前列酮栓1枚横置于阴道后穹窿,分析用药前及用药后12—24h的宫颈成熟情况、引产成功率、分娩情况、及对母婴的影响。结果地诺前列酮栓促宫颈成熟显效64例,有效10例,有效率达92．5％;引产成功64例,成功率80．0％;剖宫产22例,占27．5％;有9例发生宫缩过频,经及时处理后无不良后果,新生儿结局良好。结论地诺前列酮栓可有效、安全地用于足月妊娠促宫颈成熟及引产。     

唑来磷酸盐对绝经后骨质疏松女性硫酸脱氢表雄酮的影响分析

目的：观察分析唑来磷酸盐对绝经后骨质疏松女性硫酸脱氢表雄酮的影响。方法选取收治的绝经后骨质疏松女性80例,患者随机分为观察组（ n =40）和对照组（ n =40）。对照组患者给予骨化三醇胶丸治疗,观察组患者在此基础上给予唑来磷酸盐治疗。比较2组疗效、硫酸脱氢表雄酮含量、骨痛症状、不良反应情况。结果治疗后,观察组总有效率为92烫．50%高于对照组的72．50%,差异有统计学意义（ P <0．05）。入组时,2组患者硫酸脱氢表雄酮含量比较无统计学意义（ P >0．05）;治疗60 d时,观察组硫酸脱氢表雄酮含量上升幅度较对照组大;治疗90 d时,观察组患者硫酸脱氢表雄酮含量上升幅度明显高于对照组患者,差异有统计学意义（ P <0．05）。治疗后,观察组骨痛症状缓解率为92．50%,明显高于对照组的75．00%,差异有统计学意义（ P <0．05）。观察组不良反应发生率为7．50%明显低于对照组57．50%,差异有统计学意义（ P <0．05）。治疗后,观察组患者骨密度增加比对照组患者明显,差异有统计学意义（ P <0．05）。结论应用唑来磷酸盐治疗绝经后骨质疏松女性疗效显著,能有效增加硫酸脱氢表雄酮含量,减少不良反应发生,安全性高。     

Effects of dehydroepiandrosterone sulfate on serum steroid hormones in pregnant rabbits (author's transl)

After the administration of dehydroepiandrosterone sulfate (DHAS) (0,10,30,70 mg/kg, i.v.) to rabbits during late pregnancy, serum concentration of DHAS, dehydroepiandrosterone (DHA), testosterone (T), estradiol (E2) and progesterone (Prog) were determined by radioimmunoassay. Serum levels of DHAS increased dose-dependently, and were reduced biphasically to normal levels at 24 hr after the administration. Similarly, the levels of DHA, T and E2 increased, and reached the maximum at 30 min after, though the increase of DHA or T was one-thousandth that of DHAS, and that of E2 was about one-hundred-thousandth. On the other hand, Prog concentration in sera decreased to 50 approximately 60% of that before the injection at 30 min after (p less than 0.05). These results suggest that the changes observed in E2 and Prog levels after the injection of DHAS into pregnant rabbits corresponded to the changes of endogeneous E2 and Prog seen in early parturition in women.     

Changes in circulating androgens during short term carbamazepine therapy.

Serum concentrations of testosterone, androstenedione, dehydroepiandrosterone sulphate (DHAS), sex hormone binding globulin (SHBG) and luteinising hormone (LH) were measured before, during and after 21 days treatment with carbamazepine (CBZ)400 mg daily in six healthy male subjects. Induction of hepatic microsomal enzyme activity was confirmed by an increase in antipyrine clearance (P less than 0.02) and a fall in circulating CBZ concentrations from the seventh to the fourteenth CBZ dose (P less than 0.05). Within 7 days of starting CBZ there was a rise in SHBG (P less than 0.05) and a fall in testosterone, free testosterone fraction, DHAS and androstenedione (P less than 0.05). Testosterone, free testosterone fraction and androstenedione levels rose towards baseline by the end of the treatment period while DHAS concentration remained low (P less than 0.05). The rise in SHBG and increased androgen catabolism is most likely to be secondary to induction of hepatic monooxygenase activity by CBZ. These changes may be implicated in the production of sexual dysfunction encountered in some epileptic patients on chronic anticonvulsant therapy.     

宫腔内人工授精治疗子宫内膜异位症的临床研究

目的探讨子宫内膜异位症（EMS）不孕患者应用宫腔内人工授精技术（IUI）的治疗效果。方法将50例子宫内膜异位症（EMS）不孕患者随机分成两组,其中IUI治疗组30例,对照组20例,比较两组治疗后的妊娠率和复发率。结果 IUI组的妊娠率和复发率分别为46.7%和6.3%,而对照组的则分别为15.0%和23.5%,两组比较差异有统计学意义（P〈0.05）。结论腹腔镜术后辅以宫腔内人工授精,可为不孕症患者提供更多的妊娠机会,并不增加复发风险,是治疗子宫内膜异位症不孕的有效方法之一。     

Inhibition of puerperal lactation with 2-mercaptopropionyl-glycine

OBJECTIVES: Thiols (sulfydryl compounds) have a prolactin-lowering effect in animals. The purpose of our study was to evaluate the effects of orally administered N-2-mercaptopropionyl-glycine (tiopronin) on suppression of lactation and plasma prolactin (PRL) levels in a group of women in the puerperium. METHODS: One hundred women aged 17-37 years were studied. We divided our population in four groups (25 patients in each group). In group I, no medication was administered but only conservative measures were taken (restriction of fluid intake, ice-bags applied on the breasts, tight breast binders). Subjects in group II received tiopronin (200 mg/day) for 14 days. In group III, tiopronin (500 mg/day) was administered for 14 days. Subjects in group IV, took bromocriptine (5 mg/day) for 14 days. Assessment of suppression of lactation was performed clinically and laboratory determinations were obtained before and after 1, 2, 3, 4, and 14 days of treatment. Furthermore, in seven healthy women plasma PRL responses to thyrotropin-releasing hormone (TRH) before and after one week of tiopronin therapy (500 mg/day) were studied. RESULTS: Statistically significant higher percentages of success of lactation suppression were obtained with tiopronin (84% and 88%) and bromocriptine (96%) compared to conservative treatment (60%). In the four groups a significant decrease of PRL was observed. However, in women who received tiopronin and bromocriptine, the levels of PRL after 14 days of therapy were lower compared to the conservative treatment group. Moreover, in the tiopronin groups and the bromocriptine group, lactation was stopped earlier. In the first group (conservative measures) the lactation was suppressed after 13.3+/-5.4 days of treatment. In the groups who received tiopronin (200 mg/day and 500 mg/ day) lactation was suppressed after 4.4+/-1.7 and 4.3+/-1.6 days of treatment. In the bromocriptine group the lactation was stopped after 1.2+/-0.4 days. Bromocriptine treatment was associated with more frequent side effects than the tiopronin. CONCLUSION: Administration of tiopronin in low to moderate doses is effective in suppression of puerperal lactation.     

替比夫定对慢性HBV感染孕妇CD4＋CD25＋调节性T细胞的影响

目的 通过替比夫定对慢性HBV（Hepatitis B Virus）感染妊娠妇女外周血细胞CD4＋CD25＋调节性T细胞（CD4＋CD25＋ regulatory T cells）细胞率影响,探讨乙肝病毒宫内感染的可能作用机制.方法 选取慢性HBV感染孕妇100例,分为治疗组和对照组,治疗前及治疗后1月、3月、分娩前流式细胞术检测孕产妇Tregs比率,新生儿出生后检测乙肝五项及HBVDNA定量,酶联免疫吸附法检测乙肝五项,实时荧光定量PCR检测孕妇及新生儿HBVDNA定量,全自动生化分析仪检测孕妇肝功能.结果 对照组孕妇所生49例新生儿中,有5例HBsAg阳性,阳性率为11.2％,治疗组孕妇所生50例新生儿中有0例HBsAg阳性,阳性率为0％,两组相比差异具有统计学意义（x2=5.373,P＜0.05）.治疗组孕妇外周血Tregs比率治疗前、治疗后1月、3月、分娩前Tregs分别为（4.85±1.83）％、（3.26±1.39）％、（2.24±1.47）％、（1.78±0.56）％,对照组妇外周血Tregs比率治疗前、治疗后1月、3月、分娩前外周血Tregs比例分别为：（4.62±2.01）％、（4.59±2.51）％、（3.42±2.90）％、（1.99±1.64）％.妊娠时间与替比夫定抗病毒治疗之间有交互作用（F=3.88,P＜0.05）,治疗组与对照组CD4＋CD25＋调节性T细胞的差异有统计学意义（F=10.56,P＜0.05）.治疗前后不同时间的CD4＋CD25＋调节性T细胞的差异有统计学意义（F=42.39,P＜ 0.001）.结论 替比夫定能降低乙肝母婴垂直传播,降低妊娠妇女Tregs细胞比率.     

不同方法治疗子宫肌瘤的临床比较

目的：探讨米非司酮药物治疗、子宫动脉栓塞术、腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的临床疗效。方法：分别选取子宫肌瘤患者90例,随机分为药物治疗组、子宫动脉栓塞组、腹腔镜组各30例,药物治疗组在月经周期的第1天开始每日空腹顿服米非司酮12.5mg,3个月为1个疗程,治疗复查B超,比较治疗前后子宫体积和肌瘤数量及体积的变化;子宫动脉栓塞组,经股动脉选择性子宫动脉插管栓塞剂治疗,术后随访比较手术前后肌瘤体积的变化;腹腔镜组,手术剔除肌瘤。结果：药物治疗组子宫和肌瘤体积在应用米非司酮治疗后较治疗前明显缩小;子宫动脉栓塞组治疗后瘤体体积较术前明显缩小（成功率〉80%）;腹腔镜组子宫肌瘤剔除率达98%,术中、术后流血少,对机体损伤小。结论：3种治疗子宫肌瘤的方法各有其优缺点,药物保守治疗可用于年轻有生育要求的妇女避免手术,对于多发性子宫肌瘤或瘤体较大者可采用腹腔镜下子宫肌瘤剔除术。     

A pilot clinical trial comparing an acid-buffering formulation (ACIDFORM gel) with metronidazole gel for the treatment of symptomatic bacterial vaginosis

AIM: To compare the effectiveness of an acid-buffering formulation gel (ACIDFORM) with metronidazole gel in the treatment of symptomatic bacterial vaginosis (BV). METHODS: After a confirmed diagnosis of BV according to the criteria established by Nugent and Amsel, 30 nonpregnant women were enrolled in a randomized, double-blind clinical study. The women were randomly assigned to receive either 5 g ACIDFORM gel (n = 13) or 10% metronidazole gel (n = 17) intravaginally once daily for five consecutive days. Participants were evaluated in two follow-up visits (7-12 days and 28-35 days after treatment). Therapeutic success was defined as the presence of less than three of Amsel's criteria. If three or more criteria were present at first or second follow-up visit, the woman was excluded from the study and treated orally with metronidazole. Nugent scores were recorded at each visit but these were not used to define cure. RESULTS: At the first follow-up visit, 15 (88%) of the women in the metronidazole group were cured compared with only three (23%) in the ACIDFORM group (P < 0.001). The remaining 12 women (10 of the ACIDFORM group and two of the metronidazole group) were considered as failure and were treated orally with metronidazole. At the second follow-up visit, two of the ACIDFORM-treated women and six of the metronidazole-treated women presented recurrent BV. Four women in the ACIDFORM group and one in the metronidazole group reported occasional burning and itching during product use. CONCLUSION: ACIDFORM gel was significantly less effective than high-dose metronidazole gel for the treatment of symptomatic BV.     

重组人甲状旁腺素1-34联合钙尔奇D治疗绝经后女性骨质疏松疗效观察

目的 研究重组人甲状旁腺素1-34(recombinant human parathyroid hormone 1-34,rhPTH1-34)联合钙尔奇D治疗绝经后妇女骨质疏松的治疗效果.方法 84例绝经后骨质疏松妇女被随机分为实验组和对照组,每组均有患者42例.实验组采用rhPTH1 34)联合钙尔奇D治疗,对照组仅采用钙尔奇D治疗,疗程均为6个月.观察两组患者治疗前后骨密度变化、血清钙、磷和碱性磷酸酶(Alkaline Phosphatase,ALP)、骨痛症状变化和治疗期间的骨折发生率.结果实验组治疗后的骨密度(T值)较治疗前增加,差异具有统计学意义(P<0.05);并且实验组治疗后的骨密度(T值)较对照组治疗后的骨密度(T值)增加,差异具有统计学意义(P<0.05).实验组和对照组治疗后ALP的浓度均高于治疗前,差异具有统计学意义(P<0.05),并且实验组治疗后ALP的浓度高于对照组治疗后,差异具有统计学意义(P<0.05).实验组的骨痛治疗有效率为66.67%;对照组为50%,实验组的有效率高于对照组,差异具有统计学意义(χ2=4.04,P<0.05).结论 rhPTH1 34联合钙尔奇D能够有效的提高绝经后女性的骨密度,减少骨质疏松的症状.     

拉米夫定阻断乙肝病毒宫内感染分娩后不同停药时间对妊娠妇女的影响

目的探讨拉米夫定阻断乙肝病毒宫内感染分娩后不同停药时间对妊娠妇女的影响,寻求最佳停药时间。方法选择2008年1月—2010年11月本院门诊检查并住院分娩的HBsAg/HBeAg双阳性且HBV DNA≥105拷贝.mL?1,ALT、AST正常的孕妇120例,分为治疗组90例,对照组30例,治疗组在妊娠28周开始口服拉米夫定100 mg.d?1,再随机分为3组:A组30例分娩后停药,B组30例分娩后4周停药,C组30例分娩后6周停药,对照组D组30例不用药。4组均于孕26~28周和分娩前检测ALT,AST,HBV-M,HBV-DNA定量。A,B,C组停药后(D组为产后)1月、3月、6月检测产妇ALT,AST,HBV-M,HBV-DNA。新生儿出生断脐后立即检测静脉血HBV-M,HBV-DNA定量,再注射乙肝免疫球蛋白200 IU和乙肝疫苗10?g,乙肝疫苗0,1,6方案接种。结果治疗组比对照组HBV-DNA定量在分娩前显著降低,差异有统计学意义(P<0.05);4组检测ALT、AST的总体阳性率比较P>0.05,差异无统计学意义。治疗组停药后1月HBV-DNA定量均回复至治疗前水平,HBsAg均>250 IU.mL?1,HBeAg均未转阴。治疗组与对照组新生儿宫内感染率分别为6.74%(6/89)和31%(9/29),P<0.05,差异有统计学意义。结论拉米夫定用于妊娠晚期阻断乙肝病毒宫内感染安全有效,高病毒载量乙肝携带的孕妇分娩后即可停药,停药后需定期检查肝功能及HBV-DNA定量。