Does stopping smoking delay onset of angina after infarction?

This study was designed to determine the relation between stopping smoking and angina after infarction in survivors of an acute coronary attack. The study population comprised 408 men aged under 60 who survived a first attack of unstable angina or myocardial infarction by 28 days and were smoking cigarettes at the time of their attack. These patients were followed up for an average of nine years. Three hundred and eighty four were alive at the one year follow up examination, when the presence or absence of angina together with habits of smoking were recorded. The prevalence of angina at one year was 19.5% in the 241 who had stopped smoking cigarettes compared with 32.2% in those who had continued (p less than 0.01). Six years later, however, the prevalence of angina after infarction was the same in the two groups. It is concluded that the onset of angina after infarction can be delayed by stopping smoking cigarettes but that this effect is not maintained in the long term.     

南充市育龄妇女受孕力现状调查

目的:掌握南充市育龄妇女受孕力现状。方法:采用横断面设计,以医院首次进行孕前超声检查的人为对象,回顾性收集受孕等待时间和相关因素;引入离散时间模型计算累计怀孕率和识别影响因素。结果:共调查1 374人,平均计划怀孕年龄为(21.65±2.37)岁,3、6、12月累积怀孕概率依次为64.38%,77.45%和88.18%,不孕率为11.82%。计划怀孕年龄、文化程度和避孕方式与受孕力存在明显关联。结论:不同地区影响受孕力的因素存在分布差异,因此人群受孕力也明显不同。     

The profile of women who seek emergency contraception from the family planning service

OBJECTIVES. To review the profile of emergency contraceptive users, their reasons for using emergency contraception, and whether they use it correctly. DESIGN. Retrospective analysis of medical records. SETTING. Six Birth Control Clinics and three Youth Health Care Centres of the Family Planning Association of Hong Kong. PARTICIPANTS. Women requesting emergency contraception between 2006 and 2008. MAIN OUTCOME MEASURES. Demographics of emergency contraception users, reasons for requesting emergency contraception, number of times the subject had unprotected intercourse before emergency contraception use, type of emergency contraception provided, coitus-treatment intervals, and outcomes. RESULTS. A total of 11 014 courses of emergency contraception were provided, which included 10 845 courses of levonorgestrel-only pills, 168 intrauterine contraceptive devices, and one course of pills plus an intrauterine contraceptive device. The mean age of the users was 30 years. Two thirds (65.6%) were nulliparous and 64.9% had not had a previous abortion. Their major reasons for requesting emergency contraception were: omission of contraceptive at the index intercourse (38.9%), condom accidents (38.0%), and non-use of any regular contraceptives (20.6%). Non-users of contraceptives were more likely to have had a previous abortion. In all, 97.9% of women took emergency contraception within 72 hours of their unprotected intercourse; 98% had had a single act of unprotected intercourse. None of the intrauterine contraceptive device users became pregnant. The failure rate for emergency contraceptive pills was 1.8%. CONCLUSIONS. Women requested emergency contraception because contraceptives were omitted or condom accidents. Health care providers should focus on motivating women with a history of abortion to use contraceptives, and ensure that condom users know how to use them correctly. Most women followed instructions on the use for emergency contraception and their outcomes were satisfactory.     

GnRH-A滴眼法溶黄体抗生育作用的临床应用研究

16例正常健康育龄妇女,自月经中期起,使用国产0.2％GnRH-A滴眼液滴眼,每日一次,每次25μl,连用10天为一个用药周期,共观察20个周期。结果表明,受试者于用药期间E_2、P明显被抑制,黄体期明显缩短。有1例因眼病延迟用药者妊娠,停药后第一个月经周期即恢复正常的性激素水平和黄体期长度,亦未见任何毒副作用,提示该方法具有很好的溶黄体抗生育效果,值得进一步研究。     

郑州市人工流产女青年避孕知识、态度、行为及其影响因素分析

目的:调查郑州市人工流产女青年人工流产的原因和对避孕的知识、态度、行为,并分析其影响因素.方法:采用整群抽样的方法,选取2005年8月至2005年10月在郑州市所辖医院要求人工流产的女青年共1 100人进行横断面调查.结果:被调查者首次性行为始于16.4～25.0岁,中位数22.5岁.65.1%的女青年是第1次做人工流产.未采取避孕措施(67.9%)和避孕失败(32.1%)是导致非意愿妊娠的主要原因.在622名曾经使用过避孕方法的女青年中,最常用的避孕方法依次是安全套、紧急避孕、安全期.单因素分析结果显示:年龄、出生地、文化程度是影响避孕知识得分的主要因素(P＜0.05或0.01).Logistic回归分析结果显示:流产女青年在过去3个月中的避孕行为与男方是否关心避孕问题、流产次数、避孕知识水平有关(P＜0.05或0.01).结论:亟需对未婚青年开展有关避孕知识的教育,提高对意外妊娠风险的认识,促进男性积极参与避孕.     

Malnutrition, fertility and family planning.

Data derived primarily from published reports is used to assess the relationship between malnutrition and reproductive capacity in India. Findings of numerous studies support the conclusion that improvements in nutritional status are associated with increased fertility in the absence of contraception. Nutritional programs should therefore be provided in conjunction with family planning services in order to avoid an increase in population growth. Improvements in the nutritional status of members of a community may help motivate the community toward family planning. A recent Indian study demonstrates that higher caloric intake is associated with smaller family size, and other studies reveal a relationship between malnutrition and pregnancy failure, stillbirth, and infant mortality. The high infant mortality rate in India at the present time may serve to increase family size since couples tend to over produce in order to insure that some of their children will survive. The hypothesis that an inadequate diet is compensated for by an increase in sexual appetite, and hence, in fertility is not substantiated by recent investigations. For example, Indian states with higher protein intake/person have higher birth rates than those states with lower protein intake/person. Tables provide data on 1) birth rates, death rates, infant mortality rates, % of population increase, and sex ratios for each decade from 1921-1970 for India; 2) the relationship between diet and birth rates in several countries; 3) the relationship between various dietary factors and birth, death, and infant mortality rates forIndia; 4) fertility rates observed in several populations where contraception was not practiced; and 5) the relationship between family size and diet in India.     

Blood carboxyhaemoglobin, plasma thiocyanate, and cigarette consumption: implications for epidemiological studies in smokers

Carboxyhaemoglobin and plasma thiocyanate concentrations were found to be significantly correlated with self-reported daily cigarette consumption in 360 smokers (r = 0.416 and 0.412 respectively; p less than 0.001). The extent to which inhalation patterns affected the intake of cigarette smoke constituents was determined from the partial correlation between carboxyhaemoglobin and plasma thiocyanate concentrations after the number of cigarettes smoke per day had been allowed for (r = 0.48). Thus 23% of the variation in carboxyhaemoglobin and thiocyanate concentrations was accounted for by the was a cigarette was smoked and a further 21% by the number smoked a day. Furthermore, the relation between carboxyhaemoglobin or plasma thiocyanate and daily cigarette consumption was not linear but reached an asymptote at consumption rates above 25 cigarettes a day. These results suggest that by itself daily cigarette consumption will not identify those smokers most at risk and will also underestimate and dose-response relationship between smoking and selected diseases.     

Cigarette smoking as a risk factor for stroke. The Framingham Study

The impact of cigarette smoking on stroke incidence was assessed in the Framingham Heart Study cohort of 4255 men and women who were aged 36 to 68 years and free of stroke and transient ischemic attacks. During 26 years of follow-up, 459 strokes occurred. Regardless of smoking status and in each sex, hypertensive subjects had twice the incidence of stroke. Using the Cox proportional hazard regression method, smoking was significantly related to stroke after age and hypertension were taken into account. Even after pertinent cardiovascular disease risk factors were added to the Cox model, cigarette smoking continued to make a significant independent contribution to the risk of stroke generally and brain infarction specifically. The risk of stroke increased as the number of cigarettes smoked increased. The relative risk of stroke in heavy smokers (greater than 40 cigarettes per day) was twice that of light smokers (fewer than ten cigarettes per day). Lapsed smokers developed stroke at the same level as nonsmokers soon after stopping. Stroke risk decreased significantly by two years and was at the level of nonsmokers by five years after cessation of cigarette smoking.     

The effect of female age on the likelihood of a live birth from one in-vitro fertilisation treatment

OBJECTIVE: To determine the chance of at least one live birth from one round of in-vitro fertilisation (IVF) treatment and the effect of the woman's age on that likelihood. DESIGN: Retrospective analysis of outcomes from IVF treatment that did not involve donated gametes, but which included embryos cryopreserved in the retrieval cycle. SETTING AND PATIENTS: All IVF patients (median age, 36 years; range, 22-48 years) who attended a private IVF clinic in Sydney for an egg retrieval between 1 January 1998 and 31 December 1998, and had embryo placements (fresh and cryostored) performed up to 30 June 2001. MAIN OUTCOME MEASURE: Independently audited live births surviving the neonatal period. RESULTS: 565 women had 648 egg retrievals during the period. The age of peak utilisation of IVF was 39 years. For women aged 34 years or less, the chance of a live birth from one round of egg retrieval and IVF treatment was 52.4% (95% CI, 47%-59%). For women aged 35-44 years, there was a linear decline in the live birth rate, and no babies were born from retrievals at age 45 years and over. There was an age-dependent rise in the frequency of miscarriages, from 10.5% (95% CI, 5%-18%) for women under 35 years, to 16.1% (95% CI, 9%-25%) for those 35-39 years, and 42.9% [95% CI, 24%-63%] for those over 40 years (P < 0.001). A third of the first births resulted from embryo transfers performed after a period of cryostorage. CONCLUSION: As fertility with IVF falls from the age of 34 years, and the age of peak IVF utilisation is 39 years, many Australian women are seeking IVF at an age when the likelihood of a live birth is reduced.     

湖北省土家族育龄妇女婚姻生育状况调查

目的 :了解湖北省土家族育龄妇女的婚姻、生育状况。方法 :采用分层整群抽样抽取 5 0 2 2户 ,用统一的调查表入户调查育龄妇女 5 70 2人。结果 :1994年湖北省土家族育龄妇女的在婚 (初婚和再婚 )比为 79.6 6 % ,离婚分居比、未婚比、丧偶比分别为 0 .34%、19.17%和 0 .83%。 2 0岁以下育龄妇女的已婚比为 3.49% (宣恩、咸丰、来凤3县分别为 2 .79%、3 .2 1%和 4.5 5 % ) ,30岁及 30岁以上育龄妇女已婚比为 99.5 8%。土家族育龄妇女不同年代的平均初婚年龄有逐渐增大的趋势 ,其中 1993年 1月～ 1994年 7月育龄妇女平均初婚年龄为 2 2 .2 5岁。 1993年 8月～ 1994年 7月土家族育龄妇女的普通生育率为 8.84% ,标化生育率为 8.12 % ,总和生育率为 2 .2 2 %。来凤县标化生育率 (9.77% )高于宣恩 (7.44 % )和咸丰 (7.2 6 % ) (P <0 .0 5和P <0 .0 1)。 2 0岁以下育龄妇女的生育率为 1.36 % ,其中 ,来凤县达 2 .86 %。活产婴儿中 ,一孩比为 5 3.6 8% ,二孩及多孩比分别为 41.35 %和 4.97% ,来凤县多孩比(11.2 3% )高于宣恩 (1.95 % )和咸丰 (0 .6 2 % ) (P <0 .0 1) ,活产婴儿性别比 (男∶女 )为 12 8.1∶10 0。结论 :湖北省土家族育龄妇女婚姻较稳定 ,平均初婚年龄逐年推迟 ,生育率仍处于较高水平 ,某些地区存     

农村已婚育龄妇女生育健康卫生需求调查

目的 了解云南省少数民族地区已婚育龄妇女的生育健康卫生需求。方法 用定量调查表入户进行调查和小组定性调查。结果 医院分娩率、产前检查率和产后访视率较低,家属接生和旧法接生率较高,已婚育龄妇女的文化程度和经济收入低,节育器的使用率最高达到46．8％,但是未采取任何避孕措施仍达25．5％。结论 提高家庭经济收入,加强已婚育龄妇女的文化知识教育,特别是健康教育和改变健康观念,才能提高已婚育龄妇女的卫生需求和利用及生命质量,宣传教育和培训方法可根据当地实际情况采取丰富多彩的方式,可用农村参与性评估（PRA）的方法进行,应加强已婚育龄妇女家属的共同教育。     

Risk/benefit considerations in antiarrhythmic therapy

The effects of cigarette smoking and alcohol consumption on the length of gestation were examined in a prospective study of 30,596 pregnant women in northern California. Preterm births (less than 37 weeks' gestation) were 20% more common in women smoking at least one pack of cigarettes per day. This effect was strongest for births occurring before 33 weeks, where the excess was 60%. This excess was not accounted for by differences in maternal age, education, ethnicity, time prenatal care began, drinking during pregnancy, or eight other potential confounding factors. The results indicate a probable effect of smoking on the time of parturition, which is additional to its well-known effect on intrauterine growth retardation. The effect of alcohol consumption on preterm births was also examined, but no consistent trends were found.     

1 913例初产妇产程曲线分析

目的通过对1 913例初产妇产程数据进行分析,探讨初产妇第一产程产程曲线特征。方法选取经阴道分娩的1 913例单胎、足月、头先露初产妇,其中自然临产产妇1 523例为自然临产组,应用静滴缩宫素计划分娩产妇390例为缩宫素组。采用回顾性分析方法,收集记录2组产妇的年龄、分娩孕周、体质量、身高、新生儿出生体质量、第一产程宫口扩张程度及持续时间,并计算宫口扩张每进展1 cm所经历的时间等资料。结果自然临产组分娩时孕周为（39.6 ±0.9）周,缩宫素组分娩时孕周为（39.9±1.1）周,2组产妇孕周差异有统计学意义（P < 0.05）。2组分娩时年龄、体质量、身高、体质量指数、新生儿体质量差异均无统计学意义（P>0.05）。2组产妇产程曲线均呈现缓慢上升趋势,在宫口开大5 cm后,2组产程的进展均呈现加速趋势。自然临产组宫口开大3~4、4~5、5~6、7~8 cm所持续的时间均长于缩宫素组（P < 0.05~P < 0.01）,2组宫口开大6~7、8~9、9~10 cm所持续的时间差异均无统计学意义（P>0.05）。2组产妇活跃期起点分布差异无统计学意义（P>0.05）。结论Friedman产程图和新产程标准均不能很好描述国内人群产程特征,应进一步收集国内产妇产程数据,绘制合适的产程图指导产程处理。     

Injectable contraception

When deciding on the choice of a contraceptive, it is necessary to determine whether the method is to be permanent or reversible. If permanent, then the menstrual irregularities, the weight gain, headaches and subjective side effects of depot medroxyprogesterone acetate (DMPA) would suggest that it is not the most appropriate contraceptive for use up to the onset of menopause. Indeed there would be difficulty, given the frequent incidence of amenorrhea, in determining when this had occurred. If the contraception required is to be reversible, then it would be essential to inform the women that, provided she is of proven fertility, her chance of becoming pregnant after the use of DMPA is severely limited for 12 months after her last injection, and that she will have a conception rate of 75% by 15 months and 95% by 24 months. Very few women planning further pregnancies would tolerate that sort of delay in return of fertility, which makes the reliable spacing of their pregnancies impossible. DMPA seems not be the most appropriate agent for permanent contraception, for nulliparous women, for lactating women, or for women planning to space their pregnancies as accurately as possible. Sensitive discussion and accurate information on the advantages, disadvantages and relative reliability of all the available methods of contraception (hormonal, chemical, mechanical, barrier, and natural methods) should enable the woman, in consultation with her sexual partner and her medical practitioner, to choose the method most appropriate to her current and future needs. On the basis of the most recent information about DMPA, it is doubtful that DMPA will ever be the most appropriate choice.     

不同浓度HFMC对大鼠输精管通畅性与生育可复性的影响

Great efforts have been made to develop non-occlusive or non-ever-lasting-occlusive contraception devices in vas deferens during the recent decade at home and abroad. In our previous studies both in vivo and in vitro, polymer HFMC was found to have a spermicidal effect. In this investigation in SD rats, the relationship between the concentration of HFMC injected into the vas deferens and the resumption of fertility was studied by means of continual observations on the existence of sperms in vaginal smears from the caged female and on pup-birth delaying, so as to determine occlusion of the vas lumen and the effect of HFMC on contraception in male. The histopathological changes in the vas deferens and caudal epididymis of the HFMC-injected male rats were also observed. The results indicated: (1) HFMC in concentration over 7.5% could show temporary contraception effect by its slow releasing of H+; (2) HFMC could induce definite contraception effect which lasted longer as the concentration of HFMC given increased; (3) HFMC had no effect on the descendents in number, mortality, sex ratio, body weight and appearance; (4) the bilateral internal reproductive structures were identified normal after resumption of fertility, but 20% HFMC induced vas deferens occlusion and spermatoceles; (5) moderate concentration of HFMC was considered favorable for reversible intra-vas deferens contraception.     

年龄及卵巢刺激对卵子利用率的影响

目的：探讨不同年龄及卵巢刺激对周期活产率、每卵活产率和每活产所需的卵子数的影响。方法： 回顾性分析2012年1月-2014年2月在我院生殖医学中心行卵胞浆内单精子注射（ICSI）的1 637个有移植周期的临床资料,按不同年龄或获成熟卵子个数不同分组,比较各组患者周期活产率、每卵活产率和每活产所需的卵子数,分析临床结局。结果：每个活产所需成熟卵子数以及每个成熟卵子的活产率显示卵子质量在23～37岁间相对稳定,37岁之后每卵活产率开始逐步下降,40岁之后显著下降,实现活产所需的卵子数目增加明显。卵巢反应性不同的3组比较发现,获成熟卵子数目多的组,周期累积活产率高,提示周期累积活产率可能与成熟卵子数量有关;每卵活产率与卵巢反应性呈负相关,成熟卵子数越多,每卵活产率越低（P＜0.01）,每活产所需的卵子数越多（P＜0.01）,提示过度卵巢刺激可能影响卵子质量。结论：估算实现不同年龄女性活产所需的卵母细胞数量对于妊娠结局的预测以及患者咨询的解答具有一定的指导意义,并可以为希望通过卵子冷冻进行生育力保存的妇女及本中心开展卵子冷冻项目提供参考数据。     

Australian patterns of tobacco smoking in 1986

A total of 9440 Australian men and women of over 15 years of age was interviewed at home in 1986 to determine the prevalence and consumption levels of tobacco products. Current smokers were defined as those who smoked any combination of cigarettes, cigars or pipes regularly. The percentage of current smokers among men was 32.9% and among women was 28.5%, and the peak prevalence of smoking was in the age-group 20-24 years for both men (40.5%) and women (40.8%). Among men, 27.7% were past smokers, and among women, 16.5% were past smokers. The proportion of past smokers among those who had ever smoked was higher in men (0.46) than among women (0.37), but in the younger age groups there was no relative excess among men. Male smokers consumed more cigarettes per day than did female smokers and men were exposed to a higher daily average amount of cigarette tar. Sociodemographic variables that were associated with smoking in both men and women included age and educational and occupational level. Asian-born persons had a significantly lower prevalence of smoking than did persons who were born in Australia.     

Teenage smoking in pregnancy and birthweight: a population study, 2001-2004

OBJECTIVE: To determine the association between smoking in pregnant teenagers and baby birthweight. DESIGN, SETTING AND PARTICIPANTS: A retrospective population-based study of women aged < 20 years who gave birth to liveborn singletons in Australia between January 2001 and December 2004. Data were drawn from the National Perinatal Data Collection. MAIN OUTCOME MEASURES: Maternal smoking, birthweight, low birthweight (LBW). RESULTS: The prevalence of LBW in babies born to teenage smokers was 9.9%, compared with 6.0% in babies born to teenage non-smokers (odds ratio [OR], 1.72 [95% CI, 1.57-1.90]). On average, babies born to teenage smokers were 179.8 g lower in birthweight than babies born to teenage non-smokers (95% CI, 165.5 -194.1 g; t = 24.6, P < 0.001). Smoking, Indigenous status, Socio-Economic Indexes for Areas category and parity were independently associated with LBW (all ORs > 1.3; P < 0.001) after adjusting for maternal age group. Teenagers smoking > 10 cigarettes a day had babies with lower birthweight that those who smoked < or = 10 cigarettes a day, demonstrating a dose-response relationship. The babies of teenage smokers who stopped smoking before 20 weeks' gestation had birthweights similar to those of babies born to teenage non-smokers. One in 15 teenage smokers stopped smoking during pregnancy. CONCLUSION: Babies whose mothers smoked during pregnancy were more likely to have LBW than babies whose mothers did not smoke. Mothers who continue to smoke in the second half of pregnancy increase their baby's risk of LBW. There is significant scope to improve the quitting rate, and health professionals need to target smoking cessation at all contacts with pregnant women who continue to smoke.     

Risk factors for uterine fibroids: reduced risk associated with oral contraceptives

Risk factors for pathologically confirmed uterine leiomyomas (fibroids) were investigated using data from the Oxford Family Planning Association study, a long term follow up study of women using various methods of contraception. For each of 535 women who had had a fibroid an individual control was selected who matched the patient on age, date of entry into the cohort, and family planning clinic at recruitment and who was alive (and still being followed up) at the date the patient underwent surgery for fibroids. Case-control analysis showed that reproductive experiences were closely linked to development of fibroids. Risk of fibroids decreased consistently with increasing number of term pregnancies; women with five term pregnancies had only a quarter of the risk of women who had had none. Risk also decreased consistently with increasing duration of oral contraceptive use; the risk of fibroids was reduced by some 31% in women who had used oral contraceptives for 10 years. Risk was strongly related to weight: women who weighed under 55 kg had a particularly low risk, and overall the risk rose roughly 21% for each 10 kg increase. Cigarette smoking was associated with a decreased risk of fibroids; smokers of 20 cigarettes a day had a risk roughly two thirds that of non-smokers. These risk factors have all previously been identified as risk factors for endometrial cancer; this strongly suggests that the underlying risk factor is "unopposed" oestrogen.