功能性宫内节育器MCuⅡ与MCu的多中心随机对照临床研究

目的观察MCuⅡ功能性宫内节育器(intrauterine contraceptive device,IUD)的妊娠率、脱落率、因不良反应取出率和不良反应发生率。方法采用多中心随机对照的研究方法,对MCuⅡIUD与MCuIUD作临床效果比较。常规放置IUD,在置器后第1、3、6、12、24个月进行随访,观察临床效果和不良反应。结果共接纳对象1 000例,放置MCuⅡIUD与MCuIUD各500例,置器满24个月带器妊娠率分别为0.63%、1.45%;脱落率分别为0.42%、0.21%;因不良反应取出率分别为3.44%、3.03%;置器后各阶段不良反应(主诉)发生率及两组取出后5～12月间妊娠率的各项组间差异比较均无统计学意义(P>0.05)。MCuⅡIUD取出时探针探测IUD金属摩擦感比MCu IUD清楚(P<0.05),因此取出手术操作容易。结论 MCuⅡIUD与MCu IUD是带器妊娠率低、脱落率低、因不良反应取出率低和不良反应发生率低的IUD。MCuⅡIUD在MCuIUD基础上铜表面积增加至225mm2,符合国家标准;铜表面积增加了而不良反应未增加;取出时操作容易,证实产品改进是成功的,是值得推广的新型IUD。     

放置爱母MCu功能性宫内节育器300例临床观察

目的：为了观察爱母功能性宫内绝育器（Mcu—UD）的安全性、可接受性及临床效果。方法：将放置（Mcu—UD）300例妇女,随访观察36个月,对其避孕效果、副反应、续用率进行观察比较与评价。结果：放置36个月Mcu—UD,带器妊娠率为1%,脱落率为0%,因症取出率为0%,续用率为97.33%。结论：Mcu—UD避孕效果好,脱落率低,因症取出率低,临床副反应少,置、取方便,适应性广泛,值得推广。     

MCu宫内节育器12个月临床试验效果观察

目的:观察新型宫内节育器MCu IUD的临床效果、安全性、可接受性。方法:由国内6个临床中心参加,随机放置MCu IUD与TCu380A IUD各550例,对比观察临床效果。结果:放置满12个月时,MCuI UD组与TCu380A IUD组的带器妊娠率分别为0.37/百妇女、0.19/百妇女;脱落率分别为0.0/百妇女、1.48/百妇女;取出率(包括因症取出)分别为2.01/百妇女、1.84/百妇女,继续使用率分别为97.63/百妇女、96.52/百妇女。经统计学处理,除脱落率差异显著(P<0.05),其他均无显著性差异(P>0.05)。放置满12个月时,MCu IUD组与TCu380A IUD组的月经改变发生率分别为13.4％、21.4％,差异极显著(P<0.01)。结论:MCu IUD置、取方便,安全、有效,是当前效果比较理想的IUD。     

放置MCu功能性宫内节育器380例临床观察

目的:为观察新型MCu功能性宫内节育器的临床效果、安全性和可接受性。方法:选择放置MCu功能性宫内节育器者380例作临床效果观察。结果:放置MCu功能性宫内节育器12个月带器妊娠率为0.56%,脱落率为0.28%,因症取出率为3.31%,续用率为93.66%。结论:MCu功能性IUD避孕效果好,脱落率低,置、取方便,适应性广泛,值得推广。     

MCu功能性宫内节育器宫颈嵌顿一例

1 病例报告 患者29岁,主因停经2个月,疑妊娠,于2011年7月13日来我院就诊.既往体健,G4P1,2008年妊娠足月顺娩一女活婴.平素月经经期5d,周期60 d,量中,置宫内节育器(IUD)1年,月经量多.末次月经2011年5月12日.超声检查报告:子宫前位,形态规则,腔内可见妊娠囊1.0 cm×0.9 cm×0.9 cm,宫颈管内可见强回声光点(IUD?),左附件见囊状液性区3.1 cm×3.1 cm.右附件未显示.提示:①早期妊娠.     

4999例MCuⅡ功能性宫内节育器多中心临床观察

目的探讨MCuⅡ功能性宫内节育器(intrauterine contraceptivedevice,IUD)的临床效果和安全性。方法在我国不同地域选择9省91个中心的健康育龄妇女放置MCuⅡIUD,放置后1、3、6、12月随访。结果放置满12个月,MCuⅡIUD累积带器妊娠率为0.29/百妇女年,累积脱落率为0.28/百妇女年,因出血/疼痛累积终止率2.15/百妇女年,各省间同项停用率差异无统计学意义(P>0.05);放置后不良反应主要为月经异常、不规则阴道出血、腰腹疼痛和白带增多,随放置时间的延长逐渐缓解。结论 MCuⅡIUD避孕效果好,脱落率低,不良反应发生率低,是比较理想的IUD,推广使用中需规范临床操作。     

放置MCu功能性宫内节育器270例临床效果观察

目的观察新型MCu功能性宫内节育器(intrauterine contraceptive device,IUD)的临床效果。方法将自愿放置IUD的育龄妇女分为两组,分别放置MCu IUD270例、MLCu IUD270例,术后第1、3、6、12、24个月随访,分析比较其脱落率、带器妊娠率、因症取出率、续用率、不良反应等。结果 MCu IUD和MLCuIUD24个月累计脱落率分别为0.74%、7.41%;12个月因症取出率分别为1.85%、5.56%;续用率分别为94.44%、84.44%;脱落率、因症取出率、续用率两组比较,差异均有统计学意义(P0.05)。带器妊娠率MCuIUD和MLCu IUD分别为1.85%、1.48%,两组比较,差异无统计学意义(P0.05)。结论 MCu IUD是一种脱落率低、因症取出率低、续用率高、不良反应少,避孕效果显著的IUD,值得推广。     

新型MCuⅡ功能性宫内节育器的临床效果观察

目的 观察新型MCuⅡ功能性宫内节育器(intrauterine contraceptive device,IUD)的临床使用效果。方法 将在梅县计划生育服务站门诊自愿放置IUD的已婚育龄妇女,随机分为2组,每组各300例,分别放置MCuⅡ IUD和TCu220CIUD,并进行24个月随访观察。结果 MCuⅡ IUD组与TCu220CIUD组比较,24个月累计续用率分别为96.00%、82.67%;脱落率分别为1.00%、7.33%;带器妊娠率分别为0.67%、3.67%;因症取出率分别为2.33%、6.33%;两组比较差异均有统计学意义(P<0.05)。结论 MCuⅡ IUD是一种避孕效果好,续用率高的新型IUD,值得临床推广使用。     

MCu宫内节育器用于紧急避孕26例报告

[目的]观察MCu宫内节育器用于紧急避孕的效果、副反应。[方法]给无保护性生活后120h内要求紧急避孕的妇女放置MCu宫内节育器,术后随访到下次月经来潮,然后术后3月、6月、12月各随访1次。随访内容包括避孕失败、副反应。避孕有效率以Dixon预期妊娠概率计算。[结果]26例紧急避孕患者放置MCu IUD后,紧急避孕有效率为100%。[结论]MCu IUD用于紧急避孕有效、安全。     

An Exploratory Study of Inhalers and Injectors Who Used Black Tar Heroin

AIMS: To undertake an exploratory study to examine the characteristics of patients in narcotic treatment programs who started their use of black tar heroin either as inhalers or as injectors and to compare them with those who started as inhalers but shifted to injecting. Other studies in this area have used subjects using other forms of heroin more amenable to inhaling. PARTICIPANTS, DESIGN, AND MEASUREMENT: A purposive sample of 199 patients in 6 methadone programs in Texas were interviewed in 2002-2003 using a structured instrument. FINDINGS: At admission to treatment, those who were heroin inhalers were more likely to be African American, to live with their families, to have income from wages, and to report fewer days of problems on most of the ASI measures. Those who shifted from inhaling to injecting were more likely to be Hispanic and to have had mental health problems that interfered with their lives and to have had less nurturing while growing up. Injectors were older at this treatment admission, had more treatment episodes and more times in jail, and were more likely to have hepatitis C, AIDS, or gonorrhea. There were high levels of physical and mental problems and histories of traumatization as children and adults for almost all the respondents. Males were as likely as females to have been sexually abused as children or as adults. CONCLUSIONS: The high rates of mental and physical problems among all the clients interviewed showed the need for comprehensive services to be delivered within the substance abuse treatment programs. Histories of trauma and sexual abuse should be addressed for both male and female clients.     

1 251例重复人工流产术后落实不同避孕方法的效果评价

目的：评价重复人工流产术后即时落实不同避孕方法的效果。方法：1 251例重复人工流产者接受流产后服务（PAC）,自愿选择并即时落实避孕方法,随访不同避孕方法的使用情况及不良反应等。结果：所有重复流产者接受PAC后均即时落实避孕措施,其中复方口服避孕药（COC）组随访12个月续用率达31.2%;宫内节育系统（IUS）组随访12个月有3例因有生育要求取出,其余均坚持使用,另外有19例、13例和17例分别于随访3、6、12个月自COC组转入;宫内节育器（IUD）组随访12个月有1例异位妊娠,6例因有生育要求取出,其余均坚持使用,另外有23例、31例和19例分别于随访3、6、12个月自COC组转入。随访中发现部分人群有阴道点滴出血、经量减少、经量增多、闭经、节育环下移和腰酸不适等不良反应,给予处理并充分解释后均继续坚持使用。结论：科学有效的PAC能有效避免重复流产,保护女性生殖健康。     

1050例胸部DR片的影像质量分析

目的探讨提高胸部DR片投照质量的方法。方法收集我院放射科于2009年2月～2010年5月拍摄的胸部DR片共抽查了1 050例,对1 050例胸片的投照过程和投照质量进行分析。结果 1 050例胸片均为甲级片和乙级片,其中甲级片1 279张,占80.0%。结论应重视投照工作中的每一个环节,加强投照质量技术控制,加强投照工作人员的业务管理。     

对2例外籍HIV感染者监护案例的分析

通过对2例外籍HIV感染者的发现及采取的措施,结合相关法规,显示艾滋病在监测、控制感染者等方面存在相应的操作误区和漏洞.这些因素可导致上报疫情延误,感染者失控,影响部门间协作,提示口岸一线人员应熟悉掌握相关艾滋病卫生法规是做好外籍人员艾滋病监测和后续管理工作的基础.     

Representing uncertainty: the role of cost-effectiveness acceptability curves.

Decision-making in health care is inevitably undertaken in a context of uncertainty concerning the effectiveness and costs of health care interventions and programmes. One method that has been suggested to represent this uncertainty is the cost-effectiveness acceptability curve. This technique, which directly addresses the decision-making problem, has advantages over confidence interval estimation for incremental cost-effectiveness ratios. However, despite these advantages, cost-effectiveness acceptability curves have yet to be widely adopted within the field of economic evaluation of health care technologies. In this paper we consider the relationship between cost-effectiveness acceptability curves and decision-making in health care, suggest the introduction of a new concept more relevant to decision-making, that of the cost-effectiveness frontier, and clarify the use of these techniques when considering decisions involving multiple interventions. We hope that as a result we can encourage the greater use of these techniques.     

The ‘natural’ body,God and contraceptive use in the southeastern United States

Data collected among African‐American and Caucasian women and men in the southeastern USA indicate that participants' perceptions of nature, God's will and the human body influence reproductive health and decision‐making. Attitudes about the health care system, pharmaceutical companies and government programmes for fertility regulation reinforce these views and may negatively affect willingness to use contraceptive methods consistently and correctly.     

在海拔2320～4393m农村埋植Norplant400例五年临床观察

本研究目的在观察高寒地区Norplant皮下埋植剂的可接受性。自1989年3月～1994年5月在海拔2320～4393m的少数民族农村,对400例接受对象采用芬兰来乐药厂生产的Ⅰ型:(Nor-plant-6)在月经来潮1～7天内埋于上臂内侧皮下,5年续用率为86.25％,终止55例,终止率为13.75％,其中因月经问题终止38例(69.09％);计划妊娠终止9例(16.36％);其他医学问题终止4例(7.27％);个人因素终止4例(7.27％)。月经问题是终止的主要原因。结果表明,Norplant皮下埋植剂可为高寒地区多民族妇女接受。     

The Acceptability of Food Policies

We propose and test a model of food policy acceptability. The model is structured in four levels: government, topic, policy, and individual. In this study, we focus on two levels that are actionable for policy-makers: the topic and policy levels. We assess nine factors using a first online survey with 600 UK nationals and replicate our results in a second survey with 588 participants. Our results suggest that three factors have a positive effect on acceptability at the topic level: awareness of the issue, the legitimacy of state intervention, and social norms. At the policy level, we report a positive effect of the policy’s expected effectiveness, its appropriate targeting of consumers, and the perceived support of the majority. On the other hand, more coercive interventions and those generating inequalities are judged to be less acceptable. Additionally, we report an interaction between awareness and coerciveness on acceptability. Participants who are aware of the issue were more likely to support coercive policies. We also find evidence for a trade-off between coerciveness, effectiveness, and acceptability, as more coercive measures are considered more effective, but less acceptable by participants. Our findings offer policy-makers, nutrition experts, and advocates for healthier and more sustainable diets a new and integrated understanding of the underlying factors that determine food policy acceptability.     

曲靖市一院甲型H1N1流感就诊病例流行态势及疫情分析

目的 了解哨点医院就诊的甲型H1 N1流感病例分布情况及流行态势.方法 应用统计学方法对病例进行统计分析.结果 760例流感样病例标本确诊病例369例,重症病例152例.结论 爆发流行在冬春季节,以麒麟区城区为主,青壮年发病率居首位.     

老年患者急性心肌梗死PCI术的临床护理探讨

目的探讨老年患者急性心肌梗死PCI术的临床护理效果。方法选取我院2014年12月至2015年12月收治的100例老年急性心肌梗死患者,随机分两组各50例。观察组给予综合护理干预,对照组给予常规护理。对比两组患者的满意度和不良反应发生率。结果护理后,观察组的满意度和不良反应发生率均优于对照组,差异具有统计学意义(P<0.05)。结论对老年急性心肌梗死患者采用综合护理干预,效果显著,值得在临床上推广和应用。