米非司酮及米索前列醇在计划分娩中的应用

目的：探讨米非司酮及米索前列醇在足月妊娠计划分娩中的作用，方法：对９０例妊３８～４２周正常孕妇行计划分娩，按宫颈Ｂｉｓｈｏｐ评分分为二组，第一组宫颈评分≤５分共４０例，首先口服米非司酮２日，总量２００ｍｇ，促宫颈成熟，第３日口服米索前列醇；第二组宫颈评分≥６分共５０例，直接口服米索前列醇。结果：总引产成功率达９１１％，宫颈评分≤５分组经口服米非司酮后宫颈评分提高≥２分者为５０％；宫颈评分≥６分组总产程缩短主要表现在潜伏期缩短Ｐ＜００５，且用米索前列醇１００μｇ分娩率为７０％。结论：应用米非司酮及米索前列醇可提高日间分娩率，减少过期妊娠，对母婴安全，有推广和应用价值     

米索前列醇用于计划分娩的临床观察

米索前列醇用于计划分娩的临床观察附属医院妇产科王会民曾德会苏晓霞关键词米索前列醇；计划分娩；疗效晚期妊娠引产是临床工作中常见的问题，妊娠足月分娩者占妊娠总数的７６％～９０％，过期妊娠的发生率为５％～１２％。过期妊娠是影响围产儿发育和生存的病理妊娠，其...     

口服米索前列醇在计划分娩中的应用

分类号Ｒ７１４４３＋３近几年来国内外许多学者对米索前列醇用于足月妊娠引产进行了许多研究，均认为其效果肯定，但一般以阴道上药为多。本文就口服米索前列醇用于计划分娩进行了研究，为探索米索前列醇用药的时间、剂量、白天分娩率及副反应，设计了本组进行前瞻性研...     

阴道内放置米索前列醇足月妊娠引产效果分析

本文采用阴道内放置米索前列醇进行足月妊娠引产，其目的在于研究米索前列醇的引产效果及使用安全性。对１１０例符合引产指征的足月妊娠妇女，随机分为二组；二组妇女在年龄、孕周、孕产次及宫颈Ｂｉｓｈｏｐ评分等方面条件相似，分别采用阻道内放置米索前列醇引产（研究组）和静脉点滴催产素引产为（对照组）。结果：用药后宫颈Ｂｉｓｈｏｐ评分研究组由原５．９８分提高至９．４８分，对照组由原６．１６分提高至８．５５分，两组宫颈Ｂｉｓｈｏｐ评分平均变化相比有极显著差异（Ｐ＜０．００１），用药至分娩时间研究组为９．０小时较对照组为１４．４小时明显缩短（Ｐ＜０．００１），自然分娩率研究组为７９％，对照组为４６％（Ｐ＜０．０５），而产后出血，新生儿Ａｐｇａｒ评分及用药副作用等两组相比均无显著差异（Ｐ＞０．０５），提示：阴道内放置米索前列醇是一种安全有效的引产方法。     

米非司酮及米索前列醇在计划分娩中的应用

目的：探讨米非司酮及米索前列醇在足月妊娠计划分娩中的作用。方法：对９０例妊３８～４２周正常孕妇行计划分娩，按宫颈Ｂｉｓｈｏｐ评分分为二组，第一组宫颈评分≤５分共４０例，首先口服米非司酮２日，总量２００ｍｇ，促宫颈成熟，第３日口服米索前列醇；第二组宫颈评分≥６分共５０例，直接口服米索前列醇，结果：总引产成功率达９１．１％，宫颈评分≤５分组经口服米非司酮后宫颈评分提高≥２分者为５０％，宫颈评分≥６分组     

米索前列醇诱导分娩的研究

米索前列醇诱导分娩的研究杜凤泽徐凤芳赵爱书＊（沂南县人民医院２７６３００，＊沂南县妇幼保健院）关键词米索前列醇；催产素；计划分娩为探讨新的催引产方法，我院自１９９５年３月～１９９６年１０月，用米索前列醇行计划分娩研究。共行足月妊娠引产２６８例，与同期...     

米索前列醇预防产后出血90例临床观察

目的探讨米索列醇用于预防产后出血的可行性。方法将足月阴道分娩产妇１８０例，随机分为观察组及对照组各９０例。观察组胎儿娩出后立即于阴道后穹窿放置米索列醇６００μｇ；对照组胎儿娩出后产妇立即肌住催产素２０ｕ。结果观察组第三产程平均为７２ｍｉｎ对照组平均为１０２ｍｉｎ，观察组较对照组缩短３０ｍｉｎ。观察组产后２ｈ内平均出血量为１４０４ｍｌ对照组产后２ｈ平均出血量为２１０５ｍｌ，经统计学处理有显著性差异（Ｐ＜００１）。结论米索前列醇可有效地缩短第三产程，减少产后出血     

米索前列醇用于晚期妊娠引产127例分析

目的：探讨一种晚期妊娠安全、简便、有效的引产方法。方法：选择正常单胎头位足月妊娠具有引产指征而无禁忌证的妇女１２７例,随机分为二组,米索组用米索前列醇２５μｇ置于阴道后穹窿,催产素组用催产互２．５ＩＵ加入５％葡萄糖５００ｍｌ内静滴。对引产有效率分娩时间和剖宫产率进行了对比观察。结果：引产有效率：米索前列醇组明显高于催产素组。（Ｐ〈０．０５）分娩时间米索前列醇组和催产素组有显著差异（Ｐ〈０．０５）。剖宫产率两组有明显差异（Ｐ〈０．０５）。结论：米索前列醇用于晚期妊娠计划分娩安全、简便、有效。     

米非司酮配伍米索前列醇终止10-16周妊娠临床观察

近年来我们用米非司酮配伍米索前列醇终止１０－１６周妊娠，疗效满意，现报告如下。１ 对象与方法１．１ 对象１９９８年１月至２０００年１１月在我院要求流产的妊娠１０－１６周的孕妇２００例，年龄１８－３０岁，均为自愿要求药物终止妊娠，无用药禁忌症，且近３个月内来未用过甾体类激素等药物，无药物过敏史。１．２ 用药方案 米非司酮１００ｍｇ，每天１次，连服２次，总量２００ｍｇ，第３天开始放置米索前列醇０．６ｍｇ于阴道后穹隆，每１２小时重复１次，最多３次。２ 结果２．１ 药流效果 １５９例（７９. ５％）用米索前列醇…     

米索前列醇在足月妊娠引产中的应用

足月妊娠单胎头位初产妇１８６例,阴道后穹窿放置米索前列醇１／４片（每片２００μｇ）,每４小时１次,１天３次,无效者第２天再放。米索前列醇分娩引产７８例,同等条件孕妇催产素引产１０８例。结果：经阴道分娩成功率米索组为９３．５％,催产素组为８９．６％,差异无显著性（Ｐ＞０．０５）。米索组平均分娩时间７．８ｈ,催产素组１３ｈ,差异有显著性（Ｐ＜０．０５）。结论：米索前列醇后穹窿放置,于足月妊娠引产疗效显著、安全、方便,易被孕妇接受。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.