米非司酮合并前列腺素终止早孕进一步研究

报道３２９例停经≤４９天的健康早孕妇女使用米非司酮１５０ｍｇ分次口服，第３天口服米索前列醇０．６ｍｇ终止妊娠，并对治疗后６小时内排出妊囊的３００例对象，随机分为６例（每组５０例）。追加用药３天：（１）安慰剂，（２）米非司酮；（３）米索前列醇；（４）欧丙嗪；（５）吲哚美辛；（６）宫缩素，观察追加用药对蜕膜，绒行剥脱排出的流产后子宫出血时间及出血量的影响。结果，完全流产率，不全流产率和失败率分别为９６     

米非司酮配伍米索前列醇加中药终止10～14周妊娠的疗效观察

目的总结米非司酮加中药配伍米索前列醇和单纯米非司酮配伍米索前列醇终止70～100d内妊娠各75例临床疗效。方法150例随机分为实验组和对照组,两组全部采用序贯分次口服米非司酮,总量200mg,并同时于第3天上午9时服米索前列醇0．6g,追加0．2g实验组于服药第2天加服中药。结果实验组完全流产率96％,对照组阴道流血量和阴道流血天数明显少于对照组。结论米非司酮配伍米索前列醇加中药终止70～100d内妊娠效果较好,免受大钳刮急引产之苦。     

米非司酮合并米索前列醇终止10～16周妊娠的疗效

目的：观察口服米非司酮合并米索前列醇终止１０～１６ｗｋ妊娠的临床疗效。方法：１７５例妊娠１０～１６ｗｋ妇女用２种不同剂量米非司酮（组Ⅰ２５ｍｇｂｉｄ×３ｄ，总量１５０ｍｇ；组Ⅱ２００ｍｇ单次用药），合并米索前列醇（最大剂量不超过１．６ｍｇ）口服。结果：２组流产成功率分别为８９％和８４％，Ｐ＞０．０５。组Ⅰ胎儿排出时间（７ｈ）明显短于组Ⅱ（９ｈ），Ｐ＜０．０１。组Ⅰ米索前列醇用量（０．７ｍｇ）明显少于组Ⅱ（１．０ｍｇ），Ｐ＜０．０１。结论：口服米非司酮合并米索前列醇终止１０～１６ｗｋ妊娠是安全有效的；给药方法以米非司酮小剂量多次给药法更可取。     

米非司酮合并米索前列醇终止10—16周妊娠的疗效

目的：观察口服米非司酮合并米索前列醇终止１０￣１６ｗｋ妊娠的临床疗效。方法：１７５例妊娠１０￣１６ｗｋ妇女用２种不同剂量米非司酮（组Ｉ２５ｍｇ ｂｉｄ×３ｄ，总量１５０ｍｇ；组Ⅱ２００ｍｇ单次用药），合并米索前列醇（最大剂量不超过１．６ｍｇ）口服。结果：２组流产成功率分别为８９％和８４％，Ｐ〉０．０５。组Ｉ胎儿排出时间（７ｈ）明显短于组Ⅱ（９ｈ），Ｐ〈０．０１。组Ｉ米索前列醇用量（０．７ｍｇ）明显     

丙酸睾丸酮防治药物流产后出血的疗效观察

观察丙酸睾丸酮辅助米非司酮配伍米索前列醇药物流产，减少流产后出血的疗效。将１６０例早孕妇女随机分为治疗组与对照组，两组患者均口服米非司酮１５０ｍｇ，米索前列醇０．６ｍｇ，治疗组同时肌肉注射丙酸睾丸酮１５０ｍｇ。     

中期妊娠药物引产不同给药途径的效果观察

目的：探索米非司酮配伍米索前列醇（米索）终止１６周～２４周妊娠的最佳给药途径。方法：将２４０例孕１６周～２４周要求终止妊娠的妇女随机分为２组，观察组１３０例．米非司酮５０ｍｇ每天二次，连服３ｄ（总量３００ ｍｇ），第４天晨阴道内放置米索２００μｇ，２ ｈ～３ｈ１次．２４ ｈ内最多６次；对照组１１０例，米非司酮用法同观察组，第４天晨口服米索４００μｇ，以后隔２ｈ～３ ｈ服药１次，２４ ｈ内可服４次．两组若２４ｈ内宫口未扩张第２天均可重复用药。结果：两组４８ｈ内的引产成功率分别为９９．２３％和９８．１８％．差异无显著性（Ｐ＜０．０５），２４ｈ小时内流产成功者米索的用量．阴道给药者比口服给药者明显减少（Ｐ＜０．０１）．胃肠道副反应发生率也明显降低（Ｐ＜０．０５）。结论：米索２００μｇ阴道小量序贯给药是中期引产较好的给药方法。     

米非司酮终止早孕用药剂量的探讨

本文作者对８１４例药物流产进行分析比较。Ⅰ组分服米非司酮总量１００ｍｇ，配伍屯服米索前列醇６００μｇ；Ⅱ组分服米非司酮，总剂量１５０ｍｇ，配伍顿服米索前列醇６００μｇ，结果显示，Ⅰ组米非司酮药量虽为Ⅱ组的２／３，但两组的完全流产率相似，无在９３％以上。     

米非司酮伍用终止妊娠151例

目的 观察米非司酚分别配伍米索前列醇（米索）或卡前列甲醇栓（卡孕栓）终止１５１例１０～１６周妊娠,探讨终止此阶段妊娠的理想方法,方法：Ａ组的８７例,米非司酮５０ｍｇ,ｐｏ,ｂｉｄ,总量≤２００ｍｇ,第３天口服米索６００μｇ,ｑ３ｈ,最多１８００μｇＢ组６４例,米非司酮服法同Ａ组,第３天阴道后穹窿放置卡孕栓１ｍｇ,ｑ３ｈ,最多３ｍｇ,结果：Ａ组成功率９０．８０％,Ｂ组成功率９０．６３％,差异不显著（     

米非司酮配伍卡前列甲酯89例与米非司酮配伍米索前列醇110例终止早期妊娠的比较

目的：比较米非司酮配伍卡前列甲酯与米非司酮配伍米索前列醇终止早期妊娠的疗效。方法：妊娠≤４９ｄ孕妇１９９例，年龄２６±５ａ，随机分Ａ组８９例，Ｂ组１１０例。２组均用米非司酮２５ｍｇ，ｂｉｄ，３ｄ，于ｄ４，Ａ组阴道后穹窿置卡前列甲酯栓１ｍｇ。Ｂ组米索前列醇ｐｏ，６００μｇ。结果：Ａ和Ｂ组完全流产率各为８３％和９３．６％，经Ｘ２检验，Ｐ＜０．０５；胎囊排出时间，Ａ组４±５ｈ，Ｂ组３±６ｈ，２组无显著差异。结论：米非司酮配伍米索前列醇的抗早孕效果优于配伍卡前列甲酯。     

米非司酮配伍米索前列醇终止妊娠676例临床探索

目的以往米非司酮配伍米索前列醇终止妊娠一般只限于妊娠50d内,探索米非司酮配伍米索前列醇对妊娠120d以内的妊娠终止的可行性。方法将676例患者分为A组：594例妊娠80d以内,口服米非司酮配伍米索前列醇进行药流观察;B组82例妊娠在81～120d,口服米非司酮配伍米索前列醇、外加米索前列醇阴道后穹窿部给药进行药流观察。结果A组完全流产率为94．9％,完全流产率与妊娠天数无关（P〉0．05）;B组完全流产率为82．9％,妊娠天数越小完全流产率越高,效果显著（P〈0．01）。结论口服米非司酮配伍米索前列醇方案对妊娠80d内终止妊娠效果好,可以推广应用;对妊娠81—120d口服米非司酮配伍米索前列醇加上阴道后穹窿适当给予米索前列醇进行流产安全、方便、有效、副反应小,有实用价值,只是对其在用药量上,观察时间上需要进一步深人探讨研究,以寻找出更加完善的方案。     

颅脑损伤患者并发肺部感染的护理体会

目的：为了使并发肺部感染的病人更多、更好、更早的痊愈。方法：通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果：痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。     

卡马西平联用尼美舒利相关粒细胞缺乏症

1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠（2.25 g静脉滴注,1次/d）、卡马西平（0.2 g口服,2次/d）、尼美舒利（100 mg口服,2次/d）、二羟丙茶碱（0.5 g静脉滴注,1次/d）、甲钴胺（0.5 mg口服,3次/d）、地塞米松（5 mg,静脉滴注1次）、盐酸哌替啶（25 mg,肌内注射1次）和盐酸布桂嗪（100 mg,肌内注射3次）等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠（8 g静脉滴注,1次/d）。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

甘草酸单铵结合氦-氖激光治疗银屑病62例

目的用甘草酸单铵结合低能量氦-氖激光,观察治疗银屑病患者。方法62例寻常型银屑病患者,分为两组,A组用低能量氦-氖激光血管内照射,同时用甘草酸单铵静脉滴注,共36例;B组仅用甘草酸单铵,共26例。通过30d治疗。结果总有效率82.2%,其中A组有效率88.9%,B组73.1%(经Ridit检验,U＝2.76,P＜0.01),两组差异有极显著性意义。结论甘草酸单铵结合氦-氖激光治疗银屑病,比单用甘草酸单铵效果好。     

类风湿关节炎合并肺间质纤维化的临床特征研究

目的 对类风湿关节炎合并肺间质纤维化患者的临床特征进行分析,为今后的临床诊治工作提供可靠的参考依据.方法 选取2010年1月-2013年3月我院收治的类风湿性关节炎患者102例,按照是否合并肺间质纤维化分成合并组和单纯组,而后对这两组的临床观察指标进行对比分析.结果 合并组患者的男性所占比例、吸烟者比例、患者年龄、发病年龄、抗环瓜氨酸抗体、类风湿因子、C反应蛋白水平以及骨破坏发生率均较单纯组高.结论 类风湿关节炎患者合并肺间质纤维化可能与诸多临床指标均存在较大的相关性,临床应给予关注,采取有效措施进行预防和治疗.