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1.
地塞米松预防新生儿呼吸窘迫综合征的应用时机 总被引:1,自引:0,他引:1
目的 :研究地塞米松预防新生儿呼吸窘迫综合征的应用时机。方法 :对 80例产前应用地塞米松的早产儿资料进行回顾性分析。结果 :不同用药时间可明显影响新生儿呼吸窘迫综合征发生率。结论 :产前 12 h以上 ,7d以内应用地塞米松明显减少新生儿呼吸窘迫综合征的发生 相似文献
2.
目的 分析术前地塞米松肌肉注射对择期剖宫产足月新生儿呼吸窘迫综合征的临床意义.方法 回顾性分析解放军第一八一医院产科电子病例系统记录的孕37~38+6周剖宫产病历资料400例;随机挑选术前使用地塞米松6mg肌肉内注射,每12小时1次,共4次的患者200例为研究组,使用0.9%生理盐水10mL注射的200例为对照组.采用单因素方差分析母亲一般情况,采用趋势检验方法 比较两组患者剖宫产出生的新生儿呼吸窘迫综合征的发生等情况.结果 研究组与对照组新生儿Apgar 1分钟评分比较差异有统计学意义(χ2=2.84,P<0.05),而5分钟评分差异无统计学意义(P>0.05).两组的呼吸窘迫综合征发生率和转入重症病房新生儿发生率比较差异均有统计学意义(χ2值分别为13.83、3.55,均P<0.05).结论 对孕37~38+6周择期剖宫产患者施行地塞米松注射可有效降低新生儿呼吸窘迫综合征的发生率. 相似文献
3.
目的 探讨地塞米松对大鼠光气吸入性急性肺损伤(ALI)基质金属蛋白酶-9(MMP-9)表达的影响.方法 将SD大鼠随机分为3组:正常对照组(吸入与光气染毒组同等流量的空气)、光气染毒组(吸入8.33 mg/L的光气)、地塞米松预处理组(尾静脉注入2.5 mg/kg地塞米松1 h后,吸入8.33 mg/L的光气).染毒2 h后,收集支气管肺泡灌洗液(BALF)测定中性粒细胞细胞数、蛋白含量和肺湿/干重比(W/D).用放射免疫法测定各组血清和BALF中MMP-9水平.进行肺组织的病理学检查,用免疫组化法和实时定量聚合酶链反应(PCR)测定MMP-9表达的变化.结果 与染毒组比较,预处理组大鼠肺W/D、BALF中中性粒细胞数和蛋白含量明显降低,差异有统计学意义(P<0.01).与染毒组[血清:(9.439±0.100)μg/L、BALF:(20.640±0.446)μg/L]比较,预处理组MMP-9含量[血清(4.799±0.043)μg/L、BALF:(15.052±0.029)μg/L]明显降低,差异有统计学意义(P<0.01).与染毒组(2.789±0.282)比较,预处理组MMP-9mRNA的表达量(1.183±0.260)明显降低,差异有统计学意义(P<0.01).染毒组肺泡壁明显充血、增厚,肺泡壁和肺间质内可见较多白细胞浸润以及肺泡结构破坏;预处理组肺泡结构较为清晰,肺泡壁稍增厚,伴少量炎性细胞浸润.正常对照组大鼠肺、支气管组织中MMP-9蛋白表达呈弱阳性,染毒组MMP-9蛋白表达呈强阳性,预处理组肺、支气管组织中MMP-9蛋白表达明显减弱.结论 地塞米松能有效地保护大鼠光气吸入性ALT,可能通过抑制MMP-9表达而达到肺保护作用.Abstract: Objective To investigate the effects of dexamethasone on expression of matrix metalloproteinase-9 (MMP-9) in rats with acute lung injury induced by phosgene. Methods The rats were randomly divided into 3 groups: normal control group that consists of the rats with air exposure, phosgene group that consists of the rats with phosgene exposure and dexamethasone group that consists of the rats with phosgene exposure after 2.5 mg/kg dexamethasone being injected. Wet and dry ratio of the lung (W/D) was calculated, and leukocyte count and total protein content of bronchoalveolar lavage fluid (BALF) were recorded at 2 h after exposure. The concentrations of MMP-9 in the serum and BALF were measured by enzyme-linked immunosorbent assay. The pathologic changes of lung tissues were observed under light microscopy. The immunohistochemistry and the RT-PCR were used to detect the contents of MMP-9 in the lung tissue. Results Compared with phosgene group, the lung W/D, protein content and WBC count in of BALF dexamethasone group was significantly decreased (P<0.01). MMP-9 levels of the serum and BALF in dexamethasone group were (4.799±0.043) μg/L and (15.052±0.029) μg/L, respectively, which were significantly lower than those [(9.439±0.100) and (20.640±0.446) μg/L] in phosgene group (P<0.01). Compared with phosgene group (2.789±0.282), the expression level(1.183±0.260) of lung M MP-9 mRNA in dexamethasone group was significantly lower than that in phosgene group (P<0.01).Histological experimental results showed the marked hyperemia and thickening of alveolar wallsand stroma cells infiltrating and more visible alveolar structure damage of alveolar walls in phosgene group while the alveolar structure and the alveolar walls were clear and slightly thickened with inflammatory cells in dexamethasone group. Immunohistochemical results showed that MMP-9 protein expression levels of lung and brochus tissues in normal control group and dexamethasone group were weakly positive, which in phosgene group were strongly positive. Conclusion Dexamethasone has a beneficial effects on acute lung injury induced by phosgene in rats due to the inhibiting MMP-9. 相似文献
4.
陆新妹 《中国医师进修杂志》2008,(11):57-58
目的观察产前应用氨溴索在早产儿促胎肺成熟中的临床疗效。方法回顾性分析孕28-35周早产或计划早产的孕妇120例,按用药不同分为氨溴索组和地塞米松组,每组各60例。氨溴索组:产前给予孕妇静脉滴注5%葡萄糖1000ml加氨溴索1000mg/d,连用3d。地塞米松组:产前给予孕妇地塞米松5mg每天2次肌肉注射,连用3d。分别观察两组早产儿呼吸窘迫综合征(RDS)的发生率。结果在预防32周以前出生的早产儿发生RDS方面氨溴索组(28~28^+6周、29~29^+6周、30~30^+6周及31~31^+6周RDS发生率分别为37.5%、11.1%、8.3%及0)明显优于地塞米松组(分别为71.4%、44.4%、40.0%及25.0%),两组比较差异均有统计学意义(P〈0.05)。而孕32周及以上的早产儿RDS发生率两组比较差异均无统计学意义(p〉0.05)。结论产前应用氨溴索促胎肺成熟,在预防32周前出生的早产儿发生RDS方面明显优于地塞米松。 相似文献
5.
陆新妹 《中国医师进修杂志》2008,31(33):57-58
目的 观察产前应用氨溴索在早产儿促胎肺成熟中的临床疗效.方法 回顾性分析孕28~35周早产或计划早产的孕妇120例,按用药不同分为氨溴索组和地塞米松组,每组各60例.氨溴索组:产前给予孕妇静脉滴注5%葡萄糖1000 ml加氨溴索1000 mg/d,连用3 d.地塞米松组:产前给予孕妇地塞米松5 mg每天2次肌肉注射,连用3 d.分别观察两组早产儿呼吸窘迫综合征(RDS)的发生率.结果 在预防32周以前出生的早产儿发生RDS方面氨溴索组(28~286周、29~296周、30~306周及31~316周RDS发生率分别为37.5%、11.1%、8.3%及0)明显优于地塞米松组(分别为71.4%、44.4%、40.0%及25.0%),两组比较差异均有统计学意义(P<0.05).而孕32周及以上的早产儿RDS发生率两组比较差异均无统计学意义(P>0.05).结论 产前应用氨溴索促胎肺成熟,在预防32周前出生的早产儿发生RDS方面明显优于地塞米松. 相似文献
6.
Objective To investigate the effects of dexamethasone on expression of matrix metalloproteinase-9 (MMP-9) in rats with acute lung injury induced by phosgene. Methods The rats were randomly divided into 3 groups: normal control group that consists of the rats with air exposure, phosgene group that consists of the rats with phosgene exposure and dexamethasone group that consists of the rats with phosgene exposure after 2.5 mg/kg dexamethasone being injected. Wet and dry ratio of the lung (W/D) was calculated, and leukocyte count and total protein content of bronchoalveolar lavage fluid (BALF) were recorded at 2 h after exposure. The concentrations of MMP-9 in the serum and BALF were measured by enzyme-linked immunosorbent assay. The pathologic changes of lung tissues were observed under light microscopy. The immunohistochemistry and the RT-PCR were used to detect the contents of MMP-9 in the lung tissue. Results Compared with phosgene group, the lung W/D, protein content and WBC count in of BALF dexamethasone group was significantly decreased (P<0.01). MMP-9 levels of the serum and BALF in dexamethasone group were (4.799±0.043) μg/L and (15.052±0.029) μg/L, respectively, which were significantly lower than those [(9.439±0.100) and (20.640±0.446) μg/L] in phosgene group (P<0.01). Compared with phosgene group (2.789±0.282), the expression level(1.183±0.260) of lung M MP-9 mRNA in dexamethasone group was significantly lower than that in phosgene group (P<0.01).Histological experimental results showed the marked hyperemia and thickening of alveolar wallsand stroma cells infiltrating and more visible alveolar structure damage of alveolar walls in phosgene group while the alveolar structure and the alveolar walls were clear and slightly thickened with inflammatory cells in dexamethasone group. Immunohistochemical results showed that MMP-9 protein expression levels of lung and brochus tissues in normal control group and dexamethasone group were weakly positive, which in phosgene group were strongly positive. Conclusion Dexamethasone has a beneficial effects on acute lung injury induced by phosgene in rats due to the inhibiting MMP-9. 相似文献
7.
目的:探讨给予早产孕妇使用激素以预防新生儿呼吸窘迫综合征的预防效果。方法:回顾性分析笔者所在医院收治的98例早产孕妇,所有孕妇孕周均&lt;34周,随机分为两组,对照组未应用激素进行治疗,研究组应用激素的时间均〉24 h,比较两组早产儿发生呼吸窘迫综合征的几率。结果:研究组发生呼吸窘迫综合征几率明显少于对照组,两组比较差异有统计学意义(P〈0.05),且应用时间越长差异越明显。结论:早产孕妇产前应用激素时间越长,早产儿发生呼吸窘迫综合征的几率就越低。 相似文献
8.
目的 探讨术前肌内注射地塞米松对足月妊娠剖宫产产妇免疫指标以及新生儿动脉血气、新生儿呼吸窘迫综合征(NRDS)预防效果的应用价值。方法 选择2020-05-07-2022-05-10兰陵县人民医院收治的95例足月妊娠择期剖宫产产妇作为研究对象,采用随机数字表法分为对照组和观察组。对照组47例于麻醉前输注氢吗啡酮,观察组48例术前肌内注射地塞米松,对比2组产妇免疫功能、新生儿动脉血气指标、新生儿Apgar评分及NRDS发生情况。结果 手术后24 h, 2组患者免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、补体C3和补体C4水平与手术前24 h比较均降低,但观察组IgA水平为(1.92±0.63) g/L,高于对照组的(1.55±0.58) g/L,F=387.717,P<0.001;观察组IgG水平为(10.84±3.89) g/L,高于对照组的(9.17±3.84) g/L,F=87.211,P<0.001;观察组IgM水平为(1.63±0.57) g/L,高于对照组的(1.27±0.52) g/L,F=... 相似文献
9.
目的通过产前地塞米松治疗,探讨不同给药疗程对仔鼠脑星形胶质细胞发育的影响。方法实验孕大鼠随机分为3种情况用药,孕期1剂组于孕17d肌注地塞米松0.8mg/kg/d,孕期4剂组于孕17、18、19、20d各肌注地塞米松0.8mg/kg/d,对照组肌注等量生理盐水。对各组孕鼠所生的仔鼠,分别于生后第1、7、14d称脑重,检测大脑白质与海马胶质纤维酸性蛋白(GFAP)的表达情况,并与对照组作比较。结果孕期激素治疗各组仔鼠全脑重量较对照组下降,尤以4剂组最明显;孕期激素治疗4剂组7日龄、14日龄鼠脑海马、白质GFAP的表达较对照组减少,1剂组与对照组相比无明显差异。结论大鼠孕期重复激素治疗会影响后代脑星形胶质细胞的成熟。 相似文献
10.
目的:观察腺病毒介导荧光素酶基因转导至大鼠颌下腺后地塞米松对基因表达的影响及IgG的变化.方法:将40只Wistar大鼠随机分为5组,经颌下腺导管转导腺病毒荧光素酶基因重组体即AdCMVLuc,3 d、1周、2周、4周、8周后观察肌注地塞米松对基因表达的影响.结果颌下腺转基因表达3 d最高,在注射地塞米松组明显大于未注射地塞米松组;以后逐渐下降,至4周、8周时仍可测到基因表达,但两组无明显差异.结论:肌注地塞米松能有效地减轻腺体的急性炎症反应,增加腺病毒介导涎腺短期基因表达,说明免疫及炎症反应直接影响转导基因的表达. 相似文献
11.
【目的】观察产前应用地塞米松对早产儿脑损伤的影响。【方法】选择2008年1月—2009年12月在本院新生儿科收治的胎龄≤35周的322例早产儿作为观察对象,据产前是否有效应用地塞米松分为地塞米松组和对照组,出生后常规作头颅超声检查。【结果】地塞米松组脑室周围-脑室内出血(periventricular-intraventricular hemorrha-ges,PVH-IVH)、重度PVH-IVH和脑室周围白质软化(periventricular leukomalacia,PVL)的患病率分别为6.1%、0.9%和4.8%,低于对照组的16.5%(χ2=8.627,P=0.03)、5.5%(χ2=6.556,P=0.01)和15.4%(χ2=10.255,P=0.001)。【结论】产前应用地塞米松能降低早产儿(≤35周)PVH-IVH和PVL的患病率,并能减轻PVH-IVH的严重程度,对早产儿脑损伤有预防作用。 相似文献
12.
锰对大鼠子代脑锥体外系发育的影响 总被引:5,自引:2,他引:3
母鼠及子鼠饮用含氯化锰(2g/L或10g/L)的水,研究锰对大鼠子代行为和脑锥体外系发育的影响。结果显示:(1)在“ElevatedPlusArmsMaze”迷宫测试中,染锰组仔鼠从中央区进入第一臂的潜伏期缩短,但进入开放臂的次数与对照组无差异;在Morris水迷宫肌力测试中,各组动物仔鼠到达平台的时间无差异。(2)高剂量染锰组尾状核和伏隔核的面积、胶质细胞纤维酸蛋白免疫反应强度及反应阳性产物的平均相对密度均较对照组显著升高;(3)高剂量组仔鼠黑质、中脑腹侧被盖区和尾状核的酷氨酸氢氧化酶免疫反应强度及其反应阳性产物的平均相对密度均比对照组明显下降。 相似文献
13.
孕哺期染铅致幼鼠中枢系统氧化损伤的研究 总被引:1,自引:0,他引:1
目的 探讨铅致哺乳期幼鼠中枢神经系统氧化损伤作用。方法 通过大鼠孕期及哺乳期不同剂量进行铅染毒.测定出生后21d幼鼠脑的脂质过氧化物(LPO)水平,还原型谷胱甘肽(GSH)含量及超氧化物歧化酶(SOD)、还原型谷胱甘肽过氧化酶(GSH-PX)、过氧化氢酶(CAT)活力。结果 中、高剂量染铅组脑组织LPO水平升高、SOD活力下降;中剂量染铅组CAT活力下降。结论 重金属毒物铅可有通过增强脑组织脂质过氧化过程而致发育期神经系统的损伤。 相似文献
14.
《Alcohol》1994,11(1):7-10
Chronic administration of disulfiram (DS) to rats was found to affect glutathione (GSH) metabolism. Glutathione was measured in the rat brain following DS administration. Reduced glutathione was decreased significantly (1.52 ± 0.3 μmol/g; p < 0.001), with a concomitant increase in oxidised glutathione (GSSG) content (0.12 ± 0.013 μmol/g; p < 0.001) in the brain as a consequence of DS treatment. However, total glutathione (GSH + GSSG) content of the experimental group did not show any appreciable change. Similar changes were observed in the liver following chronic DS treatment. Brain glutathione reductase (GR) activity was found to be significantly depleted (100 ± 0.16 μmol/min/mg protein), but glutathione peroxidase (GP) activity was not affected in rats chronically treated with DS. It is reported that the treatment with DS decreases the GSH content, with a concomitant increase in GSSG level, and perturbs the GSH/GSSG redox status, inducing an oxidative stress on the brain. Glutathione reductase implicated in maintaining GSH/GSSG homeostasis by replenishing GSH is also affected by DS potentiating the oxidative damage of the tissue. This effect of DS on glutathione metabolism in the brain would explain some of its known neurotoxic effects. 相似文献
15.
《Nutritional neuroscience》2013,16(3):118-124
AbstractObjectivesPostnatal brain development is affected by the in utero environment. Modern people usually have a high sodium intake. The aim of this study was to investigate the effect of sodium hyperingestion during pregnancy on the postnatal brain development of rat offspring.MethodsThe sodium-overloaded rats received 1.8% NaCl in their drinking water for 7 days during the last week of gestation. Their body weight, urine, and blood levels of sodium and other parameters were measured. Some rats were sacrificed at pregnancy day 22 and the weight and length of the placenta and foetus were measured. The cerebral cortex and hippocampus were obtained from their offspring at postnatal day 1 and at postnatal weeks 1, 2, 4, and 8. Western blot analyses were conducted with brain tissue lysates.ResultsThe sodium-overloaded animals had decreased weight gain in the last week of gestation as well as decreased food intake, increased water intake, urine volume, urine sodium, and serum sodium. There were no differences in placental weight and length. The foetuses of sodium-overloaded rats showed decreased body weight and size, and this difference was maintained postnatally for 2 weeks. In the cerebral cortex and hippocampus of the offspring, the protein levels of myelin basic protein, calmodulin/calcium-dependent protein kinase II, and brain-derived neurotrophic factor were decreased or aberrantly expressed.DiscussionThe present data suggest that increased sodium intake during pregnancy affects the brain development of the offspring. 相似文献
16.
氟中毒对仔鼠学习记忆及脑胆碱酯酶活性影响 总被引:1,自引:1,他引:0
目的 探讨粮食污染造成的氟中毒对仔鼠学习记忆影响及其作用机制。方法 SD大鼠随机分为对照组、高氟组。高氟组以地氟病区燃煤烘烤的玉米为主要饲料,复制氟中毒动物模型,饲养6个月后,取雌雄合笼后生产的30 d龄仔鼠,采用Morris水迷宫方法检测仔鼠行为学变化,应用生物化学方法测定脑组织胆碱酯酶活性。结果 高氟组仔鼠逃避潜伏期时间为(9.242±5.852)s,与对照组仔鼠(4.948±2.698)s比较,明显延长(P<0.01);高氟组仔鼠第7d穿过平台次数和逗留平台象限时间分别为(3.040±1.968)次,(23.070±5.427)s,与对照组仔鼠比较,均明显降低(P<0.05,P<0.01);高氟组仔鼠脑组织中胆碱酯酶活性明显低于对照组(P<0.01);胆碱酯酶活性与逃避潜伏期呈负相关,与第7 d穿过平台次数和逗留平台象限时间呈正相关。结论 过量氟可引起仔鼠空间学习记忆能力降低,其机制可能与脑组织胆碱酯酶活性下降有关。 相似文献
17.
Pregnant Sprague-Dawley (CD IGS) rats were orally administered doses of bisphenol A (BPA) at 4, 40, and 400 mg/kg, from gestation days 6 to postnatal day 20. Neurotransmitters such as dopamine (DA) and serotonin (5HT) were extracted from the brains of dams and female offspring, and measured using liquid chromatography. BPA at 400 mg/kg was toxic and dosed rats died. At 3 wk after birth, brain levels of 3,4-dihydroxyphenylacetic acid (DOPAC, a DA metabolite), homovanillic acid (HVA, a DA metabolite), 5HT, 5-hydroxyindoleacetic acid (5HIAA, a 5HT metabolite) in female offspring were increased and the HVA/DA ratio was high in some brain areas of BPA-treated groups as compared with controls. At the age of 6 wk, levels of choline (Ch) in BPA-treated groups at 4 and 40 mg/kg were higher than control in all of eight brain areas. No changes were observed in acetylcholine (ACh) contents. In 9-wk-old offspring, changes in monoamines and metabolites were scattered and not great. At 3 wk after delivery, levels of 5HIAA in some brain areas of dams treated with BPA were higher than in control dams. Dose dependent increases in HVA and the HVA/DA ratio of the occipital cortex, and in the HVA/DA ratio of the frontal cortex were observed. The turnover of DA and 5HT was accelerated in 3-wk-old offspring and dams. BPA possesses very weak estrogenic activity. Changes in cerebral neurotransmitters observed in offspring and dams in this study may have been related to the estrogenic activity of BPA. However, further investigation is needed to examine the contribution of hormonal activity to such neurotransmitter changes. 相似文献
18.
【目的】观察地塞米松(dexamethasone,DXM)预处理对缺氧缺血新生鼠脑组织兴奋性氨基酸(excitatory amino acid,EAA)和C-fos蛋白表达的影响,探讨不同剂量DXM对新生鼠缺氧缺血性脑损伤(hypoxia-ischemia braindamage,HIBD)的保护作用。【方法】60只新生鼠随机分为4组,假手术组,HIBD组,小剂量DXM预处理组及大剂量DXM预处理组,每组15只。所有动物均于造模后2h断头处死,应用高效毛细管电泳和免疫组化方法,分别检测假手术组、HIBD组、小剂量DXM预处理组(0.5mg/kg)及大剂量DXM预处理组(10mg/kg)的脑组织兴奋性氨基酸(谷氨酸、天门冬氨酸、甘氨酸)含量及C-fos蛋白表达水平。【结果】HIBD组的各种EAA含量及C-fos蛋白表达均较假手术组明显升高(P<0.01);小剂量DXM预处理组的各种EAA含量及C-fos蛋白表达较HIBD组无明显变化(P>0.05);大剂量DXM预处理组EAA含量较HIBD组明显减少(P<0.01),较小剂量DXM预处理组减少(P<0.05);大剂量DXM预处理组C-fos蛋白表达较HIBD组及小剂量DXM预处理组均明显降低(P<0.01)。【结论】缺氧缺血促进脑组织EAA的释放,诱导C-fos蛋白表达;大剂量DXM预处理可能通过抑制EAA释放,降低C-fos蛋白表达而对HIBD起保护作用。 相似文献
19.
目的 探讨宫内生长受限(intrauterine growth restriction,IUGR)胎鼠脑组织中PirB的表达情况及孕鼠补充牛磺酸对其表达的影响。方法 采用全程低蛋白饮食法建立IUGR胎鼠模型,将18只孕鼠随机分为对照组、IUGR模型组(IUGR组)、IUGR+孕鼠补充牛磺酸组(牛磺酸组),每组6只。每窝随机抽取3只胎鼠断头取脑。应用免疫组化法检测各组胎鼠脑组织每高倍视野PirB阳性细胞数,Western Blot 法检测各组胎鼠脑组织中PirB蛋白表达情况,实时荧光定量PCR(Real-time PCR,RT-PCR)法检测各组胎鼠脑组织中PirB mRNA的表达情况。结果 对照组、IUGR组与牛磺酸组: 1)免疫组化法检测三组中PirB阳性细胞数分别为(18.40±1.52)、(66.17±3.66)、(21.17±2.71)个/高倍视野;2)Western Blot 法检测三组中PirB蛋白半定量分析结果PirB/β-actin分别为0.05、0.31、0.09; 3)RT-PCR法检测三组中PirB-mRNA表达水平的2-ΔΔCT值分别为1(0.87,1.15)、0.08(0.06,0.11)、1.22(0.97,1.55)。对照组、牛磺酸组与IUGR组比较,PirB阳性细胞数均低于IUGR组,PirB mRNA和蛋白的表达均低于IUGR组,牛磺酸组与IUGR组比较差异均有统计学意义(P<0.05)。结论 本研究结果显示孕鼠补充牛磺酸后IUGR胎鼠脑组织PirB的表达减少,提示牛磺酸可能通过减少或抑制PirB的表达而发挥对IUGR胎鼠脑损伤的保护作用。 相似文献
20.
B Blondel M J Saurel-Cubizolles M Kaminski 《Journal of epidemiology and community health》1982,36(3):183-186
A survey of a representative sample of births in France in 1976 showed that the great majority of women receive at least the minimum antenatal care laid down by law: 4% of women missed one of the three statutory visits linked to payment of the antenatal allowance and 6% missed the fourth visit that should take place in the ninth month. A smaller study conducted in two hospitals, one in the Paris region and the other in Nord-Pas-de-Calais, showed that the date of the first visit did not depend on a knowledge of the regulations. In one of the hospitals, where about 95% of women made more than the four statutory visits, the actual number of visits made was independent of a knowledge of the statutory number, In contrast, in the other hospital, where the mean number of visits was nearer to the statutory minimum, about half the women who said that four visits were required made exactly that number of visits and about half of those who gave three as the number made three visits. 相似文献