米非司酮配伍米索前列醇终止早孕I临床观察

米非司酮为人工合成的受体水平抗激素,具有终止早孕、抗着床、诱导月经及促进宫体成熟等作用,与孕酮竞争受体而达到拮抗孕酮的作用,米非司酮明显增强妊娠子宫对前列腺素的敏感性,故小剂量米非司酮配伍米索前列醇、终止早期妊娠的效果较好。木垒县妇幼保健院自2006年2月一2008年2月对217例哈萨克妇女早孕者终止妊娠,效果满意,现报告如下。     

米索前列醇直肠给药预防剖宫产术后出血

剖宫产术后出血在临床上较常见。2003年6～12月，我们对153例行剖宫产术分娩者，采用米索前列醇直肠给药预防剖宫产术后出血，疗效满意。现报告如下。     

超小水囊联合米索前列醇直肠给药用于足月妊娠引产临床观察

305例足月妊娠需引产的孕妇随机分为A、B、C三组。A组（99例）：超小水囊联合米索前列醇（米索）直肠给药引产;B组（96例）：米索直肠给药引产;C组（110例）：静滴催产索引产。A组促宫颈成熟效果好,临产发动时间短于其他两组（P均〈0．01）;与C组比较,A组剖宫产率低、总产程短。认为超小水囊联合米索直肠给药用于足月妊娠引产效果较好,对母儿无不良影响。     

米非司酮联合米索前列醇终止早期妊娠80例体会

2006年2月～2007年9月,我们采用米非司酮联合米索前列醇(下称米索)口服终止早期妊娠(孕5～8周)80例,并观察了其流产效果.现报告如下.     

利凡诺尔配伍米索前列醇终止妊娠的临床效果观察

目的探讨利凡诺尔配伍米索前列醇终止妊娠的临床效果。方法选择90名孕20～28周自愿要求终止妊娠的健康妇女,随机分为实验组和对照组各45名,实验组实施羊膜腔内注射利凡诺尔,同时联合应用米索前列醇置于阴道后穹窿终止妊娠,对照组单纯实施羊膜腔内注射利凡诺尔终止妊娠,观察两组终止妊娠的临床效果。结果实验组24 h内引产成功率为100.0%,胎盘胎膜自娩率为82.2%,平均住院时间为(3.5±1.3)d,子宫平均出血量为(30.2±10.5)ml,阴道流血时间为(6.3±3.7)d;对照组24 h内引产成功率为0.0%,24～48 h引产成功率为80.0%,胎盘胎膜自娩率为51.1%,平均住院时间为(5.5±2.0)d,子宫平均出血量为(80.4±30.8)ml,阴道流血时间为(11.5±6.9)d。两组各项指标比较差异有统计学意义(P0.05或P0.01)。结论羊膜腔内注射利凡诺尔同时联合应用米索前列醇置于阴道后穹窿终止早中期妊娠具有明显的效果,与单纯实施羊膜腔内注射利凡诺尔相比具有显著优势,值得在临床实践中推广应用。     

米非司酮合并米索前列醇用于中期妊娠82例效果观察

1998年 9月～ 2 0 0 0年 12月 ,我站应用米非司酮合并米索前列醇中止早期妊娠 (停经 49天内 ) 82例 ,取得满意效果。现报告如下。一般资料 :本组 82例均为自愿要求中止妊娠的健康妇女 ,年龄 2 1～ 37岁 ,平均 2 8岁 ;未产妇 5 3例 ,经产妇 2 9例 ,妊娠 10～ 2 2周 ,其中 2例为人工流产漏吸 ,2例为稽留流产。用药方法 :入院后常规查体 ,做必要的辅助检查如血、尿常规、肝肾功能等 ,B超检查确定宫内妊娠周数 ,无禁忌症。首日上午 9:0 0米非司酮口服 5 0 mg,下午 9:0 0口服 2 5 m g,连服两天 (总量 15 0 mg) ,第 3天上午 8:0 0口服米索前列醇0…     

米非司酮配伍米索前列醇用于稽留流产196例临床分析

1998年 2月～ 2 0 0 0年 12月 ,我们收治稽留流产患者196例 ,采用米非司酮配伍米索前列醇治疗 ,效果满意现报告如下。临床资料 :196例稽留流产患者的年龄 2 3～ 35岁 ,初孕妇 142例 ,经孕妇 5 4例。停经 7～ 18周 ,其中有少量阴道流血者 16 8例 ,无特殊症状者 2 8例 ;有 36例患者因阴道流血来站前行黄体酮或中药保胎治疗。妇科检查子宫小于停经周数 ,质地不软 ,宫口未开 ,多数患者阴道有血迹。B超检查无胎芽及原始心管搏动 ,妊娠囊变形 ,或有胎芽甚至胚胎结构 ,但无胎心反射。方法 :196例稽留流产患者确诊后 ,询问病史无使用米非司酮和米索…     

米非司酮配伍米索前列醇终止9～20周妊娠1975例

米非司酮配伍米索前列醇用于终止早孕取得了良好的效果，我们从1995年开始改进服药方法，增加米索前列醇片用量用于终止9～20周妊娠，取得了满意效果。现对近7年来的在我院行早孕晚期妊娠药物流产及中期妊娠引产的孕妇1975例进行回顾性分析，总结报道如下。     

复方米非司酮和米非司酮终止早期妊娠的临床效果比较

目的比较复方米非司酮和米非司酮终止早期妊娠的效果。方法将2013-01~2013-12到该院自愿要求终止妊娠的停经≤49 d的早期妊娠妇女120例,根据接诊的先后顺序分为两组。观察组60例,服复方米非司酮1片(每片含米非司酮30 mg,双炔失碳酯5 mg),连服2 d,第3天口服米索前列醇0.6 mg。对照组60例,服米非司酮25 mg,早晚各1次,第3天服米非司酮50 mg后,口服米索前列醇0.6 mg。观察两组引产结果。结果观察组完全流产56例,不全流产3例,失败1例。对照组完全流产48例,不全流产8例,失败4例。观察组引产效果优于对照组(P0.05),观察组孕囊排出时间、流产后阴道出血时间较对照组短,差异均具有统计学意义(P0.01)。结论复方米非酮司联合米索前列醇引产效果优于米非司酮联合米索前列醇。     

米索前列醇预防产后出血效果观察

20 0 0年 3月至 2 0 0 1年 5月 ,我们对 10 0例足月妊娠者于胎头着冠后一次性肛内装置米索前列醇 4 0 0μg预防产后出血 ,经临床观察 ,效果显著。现报告如下。临床资料　选择同期单胎头位足月妊娠阴道分娩的初产妇 2 0 0例 ,无前列腺素应用禁忌 ,无内外科合并症和产科并发症。随机分为米索组和对照组 ,各为 10 0例。两组的年龄、体重、孕次、分娩孕周、第一产程和第二产程时间、会阴缝合时间和新生儿体重方面均无明显差异 (P>0 .0 5 ) ,具有可比性。给药方法　米索组在胎头着冠后一次性经肛门放置米索前列醇 4 0 0 ug(2片 ) ,对照组放置维…     

米非司酮和米索前列醇用于HBV携带者和慢性丙型肝炎患者早孕药物流产安全性评价*

目的调查米非司酮配伍米索前列醇行药物流产在肝病患者中应用的安全性。方法270例HBV感染者、12例慢性丙型肝炎患者和181例非肝炎病毒感染者早期妊娠,给予米非司酮和米索前列醇口服行药物流产。常规检测血生化指标和血清病毒指标。结果HBV和HCV感染者排出胎囊大小为2.36±0.89 cm,对照组排出胎囊大小为2.37±0.79 cm;在270例HBV感染者中,流产成功率为90.5%,12例丙型肝炎患者流产成功率为90.7%,对照组流产成功率为90.6%,各组差异不具有统计学意义（P>0.05）;无论是HBV感染者、慢性丙型肝炎患者,还是非肝炎病毒感染者,在流产后肝功能无显著性变化,无肝损伤病例发生。结论HBV和HCV感染者行米非司酮联合米索前列醇药物流产是安全有效的。     

Effect of daytime oral melatonin administration on neurobehavioral performance in humans

ABSTRACT: The pineal hormone melatonin has been proposed as a potential treatment for insomnia and circadian rhythm disorders, as experienced by shiftworkers and transmeridian travellers. If melatonin is to be used in a clinical setting, it is important that the neurobehavioral performance effects associated with its administration be identified. As with other drugs that increase sleepiness, e.g., sedatives and antihistamines, inappropriate effects on neurobehavioral performance could result in a corresponding increase in side effects and potential risk to users. The aim of this study was to investigate the effects of 5 mg oral melatonin, administered at 12.30 hr to 16 young (22.4±1.8 years), healthy subjects (ten males and six females), on the following neurobehavioral performance tasks: two-choice visual reaction and response time, unpredictable tracking, extended two-choice visual reaction and response time, and simple auditory response and reaction time, in a randomised, double-blind crossover protocol. Following melatonin administration, significant decrements in performance on the tracking task and on response and reaction time scores for the visual choice and extended two-choice visual tasks were observed. The profile of these performance decrements across the experimental sessions were found to closely map the profile of salivary melatonin levels. The findings of the present study highlight the significant neurobehavioral performance effects associated with the daytime administration of melatonin.     

Comparison of deep and shallow endotracheal administration of dionosil in dogs and effect of manual hyperventilation

The endotracheal route has been used as a second route of choice for administration of emergency drugs for several years; however, the optimal technique for administration of drugs by this route has not been clearly defined. One important aspect of technique involves the question of how distribution to the distal-most endobronchial tree is influenced by initial depth of endotracheally administered drug instillation and use of forced manual hyperventilation. This study demonstrates that depth of instillation of drugs administered by the endotracheal route may not be an important factor in the delivery of medications to absorptive sites in the lung. It appears, however, that forced manual hyperventilation is essential to assure bilateral and optimal distal delivery of endotracheally administered medications.     

米索前列醇对切除卵巢大鼠骨质疏松的影响

目的研究米索前列醇[前列腺E1(PGE1)类似物]对切除卵巢雌性大鼠骨质疏松的影响及作用机制. 方法应用切除卵巢大鼠的骨质疏松模型,随机分为治疗前组、对照组、低剂量组、高剂量组、假手术组(每组10只),给予不同剂量的米索前列醇后,以双能X线吸收法测定骨密度(BMD)、血清骨钙素(BGP)及尿羟脯氨酸与肌酐比值(HOP/Cr),并进行组间比较. 结果米索前列醇治疗组的BMD[(0.26±0.03)g/cm2和(0.28±0.02)g/cm2]明显高于对照组[(0.23±0.02)g/cm2,P＜0.05];高剂量治疗组的BMD接近假手术组[(0.30±0.01)g/cm2](P＞0.05);治疗组的血清BGP[(3.85±0.56)μg/L和(4.36±0.62)μg/L]明显高于对照组[(3.02±0.42)μg/L,P＜0.05];尿HOP/Cr治疗组[(31.27±6.44)mg/g和(28.52±6.56)mg/g]与对照组[(29.76±5.82)mg/g]差异无显著性(P＞0.05). 结论米索前列醇对骨质疏松模型鼠有增加骨量的作用,且主要影响骨形成环节.     

Subcutaneous administration of methotrexate at high doses makes a better performance in the treatment of rheumatoid arthritis compared with oral administration of methotrexate: A systematic review and meta-analysis

ObjectivesThis study was conducted to determine whether subcutaneous (SC) methotrexate (MTX) makes better performance on bioavailability, clinical efficiency, side effects occurrence, and treatment failure in the treatment of RA compared with oral MTX.MethodsThe databases PubMed, Web of Science, Embase, and Cochrane Library were systematically searched. Seven studies involving 1335 patients were eligible for data extraction and meta-analysis. The outcomes of meta-analysis were presented as mean difference (MD) or odd ration (OR) with 95% confidence interval (95% CI).ResultsMeta-analysis showed that SC MTX can significantly increase the AUC_0−t (area under plasma concentration curve from administration to last observed concentration at time t) (MD = 506.84; 95% CI: 80.80–932.89), shorten the time to reach maximum observed concentration (T_max) (MD = −0.13; 95% CI: −0.25 to −0.01) and the apparent terminal elimination half-life (t^1/2) (MD = −0.39; 95% CI: −0.70 to −0.08), reduce the occurrence of nausea (OR = 0.53; 95% CI: 0.28–0.97) and diarrhea (OR = 0.43; 95% CI: 0.20–0.95), improve the American College of Rheumatology criteria for 20% improvement (ACR20) (OR = 1.68; 95% CI: 1.09–2.61) and ACR70 (OR = 1.52; 95% CI: 1.02–2.26), and relieve the pain (MD = −0.65; 95% CI: −0.93 to −0.37) compared with oral MTX. However, the differences in maximum plasma concentration (C_max), the occurrence of headache, vomiting and dyspepsia, ACR50, treatment failure were not significant between the two groups.ConclusionSC route of MTX at high doses made better performance on improving the bioavailability and clinical efficacy, reducing the GI disorders, but it cannot decrease the treatment failure when compared with oral administration of MTX.     

Effect of the acute sublingual administration of ketanserin in hypertensive patients

The purpose of this study has been to compare the acute antihypertensive effect of a dose of 20 mg of ketanserin in 18 patients after sublingual administration and in 19 after oral administration. In three patients ketanserin and ketanserin-ol plasma levels were measured after both sublingual and oral administration. The results showed a more rapid, considerable antihypertensive effect after sublingual administration. In addition, the high plasma levels of ketanserin-ol, the metabolite produced by hepatic reduction of ketanserin, reached after sublingual administration, rather than transmucosal absorption, indicate that the clinical effect observed is due to more rapid dissolution of the tablet formulation and liberation of the active drug.     

The effect of captopril on peripheral hemodynamics in patients with esential hypertension: Comparison between oral and sublingual administration

Summary A comparative study of the effects of oral and sublingual captopril on the hemodynamics of the peripheral musculocutaneous vasculature was carried out on ten patients with essential hypertension. Both routes of administration of captopril lead to lower blood pressure and decreased regional resistance, and to an increased arterial blood flow at rest. The first measurable effect and the peak effect on blood pressure and peripheral hemodynamics appear slightly earlier with sublingual administration. The data provided in this study support the usefulness of the sublingual route in clinical situations in which oral administration of captopril is not feasible.     

尿道灌注配合中药内服治疗非淋菌性尿道炎

目的　观察尿道灌注同时配合中药内服治疗非淋菌性尿道炎 (NGU)的临床疗效。方法　将 310例患者随机分为灌注治疗组 112例 ,西药与中药内服组 10 4例 ,西药内服组 94例。灌注治疗组是从尿道灌注欣匹特 (阿奇霉素 ) ,同时服用龙胆泻肝汤 ;西药与中药内服对照组则是同时口服阿奇霉素和龙胆泻肝汤 ;西药内服组只口服阿奇霉素。结果　尿道灌注配合中药内服治疗NGU有较好疗效 ,其治愈率及症状、体征消失 ,好转率均明显高于两个对照组 (P <0 0 5 )。灌注治疗组及西药、中药内服组总有效率明显高于单纯西药内服组 (P <0 0 5 )。灌注治疗组尿道拭子、细菌培养消失好转率明显高于西药内服组 (P <0 0 5 )。灌注治疗组与西药、中药内服组总有效率、尿道拭子、细菌培消失好转率差异无显著的统计学意义 (P >0 0 5 )。结论　尿道灌注配合中药内服为治疗的有效方法之一。