200例皮下埋植避孕方法的可接受性因素分析

对本院 1994年 7月至 1995年 7月 ,采用左炔诺孕酮硅胶棒 I型皮下埋植避孕剂 (皮埋剂 )避孕的 2 2 6例受试者进行了分析 ,试图通过有关影响因素的探讨 ,提高人群对该避孕剂的可接受性和续用率。一、资料与方法1.受试者 :本院门诊知情选择左炔诺孕酮硅胶棒 I型皮埋剂避孕 2 2 6例 ,年龄 2 0～ 40岁、体重 45～ 70 kg、体检无埋植禁忌 ,以表格式的接受记录 ,项目完整。2 .埋植剂 :左诀诺孕酮硅胶棒 I型 (丹东鸭绿江制药厂生产 )为 6根型 ,含左旋 -18甲(L NG) 2 16mg,第一年释放率占总量约 10 % ,以后逐年下降 ,有效期为 5年。3 .方法 :术前…     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

正皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

<正>皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

<正>皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

<正>皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

<正>皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

<正>皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

正皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

正皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

“千日关爱”皮下埋植避孕方法患者教育活动征文通知

正皮下埋植剂经由一次植入给药后,通过药物缓慢释放,使药物在体内维持在相对恒定的最低有效水平,从而达到避孕效果;既可维持长效,避免了用药初期过高的血药峰值引起的不良反应,又可避免通过肝脏代谢的首过效应。皮下埋植避孕方法具有高效、长效、安全、简便和可逆的优点。目前国内临床使用的皮下埋植避孕产品有:左炔诺孕酮硅胶棒I型(6根),左炔诺孕酮硅胶棒Ⅱ型(2根)以及依托孕烯植入剂(1根)。     

国产皮下埋植避孕剂对细胞免疫功能的影响

为了解皮下埋植避孕剂对细胞免疫功能的影响 ,对 159例应用国产左旋 18甲基炔诺酮皮下埋植避孕剂妇女血清中细胞因子白细胞介素 (IL ) - 2、IL- 6、α肿瘤坏死因子(TNFα)、γ干扰素 (IFNγ)的水平 ;外周血单核细胞 (PBMC)体外培养自发分泌和在植物血凝素 (PHA)刺激下分泌细胞因子水平 ;T细胞总数及亚群 ,CD4 /CD8比值进行测定。方法 :细胞因子的测定采用酶联免疫吸附测定法 ,T细胞数量及亚群的测定采用改良的碱性磷酸酶抗磷酸酶桥联酶标染色 (APAAP)法。结果 :药物应用 <1.5年者 ,IL- 2和 TNFα水平有所升高 ,以用药时间 0 .5～年的水平最高 ,明显高于正常对照组 (P<0 .0 1) ;IL- 6的水平在早期有所降低 ,但无统计学意义 ;IFNγ未见明显变化。PBMC自发分泌 IL- 2和TNFα水平在用药时间为 0 .5～年最高 ,IL - 6的分泌水平最低 ,以上变化在 >1.5～ 4 .5年者基本恢复正常 ,并保持稳定 ,>4 .5～ 6 .5年者无明显波动。血清 IL- 2、IL- 6和 TNFα的水平变化与 PBMC自发分泌水平相关 ;PBMC在体外经 PHA刺激后 ,分泌 4种细胞因子的水平与对照组无显著性差别。 CD3+、CD4 +、CD8+T细胞数及 CD4 /CD8比值未见明显变化。结论 :左旋 18甲基炔诺酮皮下埋植避孕剂在药物的应用早期对机体的细胞免疫功能有所影响 ,但未     

Combination of subcutaneous levonorgestrel implants and transdermal dihydrotestosterone gel for male hormonal contraception

The primary aim of the present study was to determine the therapeutic dose of subcutaneous levonorgestrel (LNG) to induce azoospermia or severe oligozoospermia (<3 x 10(6)/mL) in normal men requiring contraception. Transdermal 5 alpha-dihydrotestosterone (DHT) was combined to the treatments to maintain peripheral androgen level. Forty-three 21-45-year-old healthy men were enrolled in this phase II randomised and comparative clinical performance study. The subjects were allocated to five groups to receive: (1) transdermal DHT (Andractim(R), Besins Iscovesco, Paris, France) and one subdermal LNG implant (Jadelle, Leiras, Turku, Finland); (2) transdermal DHT and two subdermal LNG implants; (3) transdermal DHT and four subdermal LNG implants; (4) transdermal DHT and oral LNG (Microluton, Schering, Germany); or (5) transdermal DHT only. A total of 27 men completed the suppression phase. None of them reached azoospermia. One subject with oral LNG and transdermal DHT reached <3 million/mL at 5 months of suppression, but not repeatedly. Together 2/27 (7%) subjects, one with oral LNG and DHT and the other with four subdermal LNG implants and DHT reached <5 million/mL temporarily. Altogether 9/27 (33%) subjects reached <20 million/mL. Serum testosterone concentrations (S-T) decreased significantly during the first 3 months of treatment with one, two and four LNG implants and DHT and during the next 3 months S-T remained significantly lower with two or four implants. Serum oestradiol concentrations (S-E(2)) decreased significantly during the first 3 months only with four implants, but at 6 months S-E(2) was lower also in the group with two implants. Serum luteinizing hormone (LH) decreased significantly only with two LNG implants and DHT gel at 5 and 6 months. Serum FSH did not decrease in any of the groups. None of the subjects filled the criteria to continue to the efficacy phase. A total of 16 men discontinued for various reasons. Of the 27 men completing the suppression phase, all have recovered to sperm levels >20 million/mL. There were no changes in blood count, lipid profile, liver function tests, prostate-specific antigen (PSA), sex hormone binding globulin (SHBG), prolactin or cortisol. The mixed antiglobulin reaction (MAR)-IgG, MAR-IgA or tray agglutination test (TAT) did not change during any of the treatments. The present study shows that the LNG implants themselves are well-tolerated by men and safe, and might be suitable for replacing part of the testosterone used as injections to reduce the androgen dose during male hormonal contraception. The DHT gel was considered as quite or very uncomfortable by 66% of the men because of feeling cold during the time it was on the skin, but noncompliance in using the gel was not reported by the men.     

国产皮下埋植剂可接受性的对比研究

自１９９４年４～６月共接收对象１８４６人。课题统一设计，统一表格，经过筛选对象随机植入国产Ｉ或Ｉ型皮下埋植剂，术后按期回访。术后６、１２、２４个月时随访率分别为９７．３５％、９９．１２％及９６．１５％；两型的２年末净累积妊娠率分别为０及０．３６８／每百妇女；同期继续使用率分别为９０．６６及８９．５３／每百妇女。两型药物的有效率及继续使用率均无显著性差异（Ｐ＞０．０５）。术后６、１２、２４个月副反应发生率，Ｉ型为６２．３％、３２．８５％、２３．９３％；Ｉ型为６３．６９％、３２．１１％、２２．７１％（Ｐ＞０．０５）。其中以月经异常最常见（占４０％以上），其他依次为类早孕反应、情绪改变等。月经异常经Ｌｏｇｉｓｔｉｃ多元回归分析，年龄越小、孕次越少、文化程度越高，月经异常发生率越高。术后体重、血压、乳房及盆腔等项检查均未发现明显异常。认为国产（Ｉ型、Ｉ型）皮下埋植剂具有长效、高效及可接受性好等优点，可推广使用     

两种国产皮下埋植剂与Norplant多中心临床对比研究——三年随访

为了进一步对比两种国产皮下埋植避孕剂和Ｎｏｒｐｌａｎｔ在避孕效果、副反应和可接受性方面有无差异。方法：采用前瞻性、随机分配、定期随访的研究方法,全国有１０个临床中心分别承担国产Ⅰ、Ｉ型皮下埋植剂和Ｎｏｒｐｌａｎｔ各１００例,结果：自１９９３年开始共接收国产Ⅰ型１００１例,Ｉ型１０００例,Ｎｏｒｐｌａｎｔ９９８例。２４个月随访率为９９．２％,３６个月随访率为９９．１％。３年内仅国产Ⅰ型发生１例妊娠,Ⅰ型的净累积妊娠率为０．１每百妇女,因各种原因终止的净累积终止率国产Ⅰ、Ｉ型和Ｎｏｒｐｌａｎｔ分别为１５．１、１４．１和１２．９每百妇女,其中因月经问题而终止者占７５．１％。３６个月的续用率分别为８４．９％、８５．９％和８７．１％,３组间无差异。随访时的副反应主诉分别为２２．６％、１９．０％和１９．７％,３组之间也无差异。结论：３年的临床观察表明：两种国产皮下埋植避孕剂和Ｎｏｒｐｌａｎｔ一样,是一种高效、长效的避孕方法,在全国不同地区和群体中具有较高的可接受性,可供广大育龄妇女选用。     

保留纤维包膜的乳房假体置换术

目的 探讨胸大胸后间隙乳房假体置入术后纤维包膜挛缩所致远期并发症的手术治疗原则及方法。方法 乳晕切口行假体转换术,在充分保留原纤维包膜的原则下,针对手感较硬,乳房变形等并发症行相应的手术处理。结果 ２４例术后均取得满意效果。结论 转换假体结合对症处理可有效纠治隆乳术后纤维包膜挛缩所致并发症,充分保留原纤维膜可获得较好远期效果。     

固体硅胶隆鼻术假体植入层次的应用研究进展

通过近五年有关隆鼻术硅胶假体植入层次的文献回顾，归纳出以下两点：１．假体植入鼻背皮下的方法术后并发症较多，不宜采用；２假体植入层次以较深为宜，但究系于鼻骨膜下还是鼻背筋膜下，目前尚有争议，有待进一步研究探讨。     

Prevention of biofilm-induced capsular contracture with antibiotic-impregnated mesh in a porcine model

Background: A growing body of evidence implicates subclinical (biofilm) infection around breast implants as an important cause of capsular contracture (CC). Objectives: The authors use an in vivo porcine model to investigate the potential of antibiotic-impregnated mesh as a prophylactic measure against biofilm formation and CC. Methods: A total of 28 implants (14 untreated controls, 14 treated with antibiotic mesh) were inserted into 5 adult female pigs. All implants and pockets were inoculated with a human clinical strain of Staphylococcus epidermidis. The implants were left in situ for 16 weeks and then analyzed for contracture using both Baker grading and applanation tonometry. The presence of biofilm infection was assessed by subsequent microbiological analysis of implants and capsules. Results: One untreated implant had extruded and was excluded from analysis. The tissue surrounding the 13 untreated control implants had Baker Grade III/IV CC, whereas no CC was identified around the 14 antibiotic mesh-treated implants. This difference was highly significant (P < .001). Tonometry findings were consistent with the Baker assessments. Although bacterial biofilm was detected on all implants and capsules, the biofilms on the antibiotic-treated implants and surrounding capsules were generally single-layered or isolated in contrast to the multilayer biofilms found on untreated implants and capsules. Conclusions: Based on the findings from this study of a porcine model, the use of antibiotic-impregnated mesh reduces bacterial access to breast implants at the time of surgical insertion and may subsequently protect against subclinical infection and CC.     

Evaluation of the tolerability of Hydrogel breast implants: a pilot study

BACKGROUND: During the 90s the widely publicised controversy regarding the use of silicone gel breast implants stimulated research into alternative alloplastic filling materials. In this context, a new type of breast implant, containing Carboxymethylcellulose at 3.7% in the form of Hydrogel, was introduced into the European market. METHODS: A preliminary pilot study was carried out to evaluate the tolerability and reliability of breast implants pre-filled with Hydrogel. A group of 12 consecutive patients was recruited for this purpose and underwent plastic surgery for breast augmentation or reconstruction (20 implants) at the Department of Plastic and Reconstructive Surgery at the University of Genoa between December 1996 and October 1997. All patients were then followed up for a minimum of 3.5 years. The mean age of patients was 50 years and ranged from 28 to 67 years old. After surgery the patients were examined at 4 weeks (evaluation of any immediate complications), 3 months, 6 months and 1 year (evaluation of any delayed complications). RESULTS: No immediate complications were reported in any patient. After 3.5 years of follow-up, the degree of capsular contraction according to Baker in these patients varies between 1 and 2. In general, the implants were very soft to touch even some time after surgery, above all in patients undergoing breast augmentation. Four implants (20%) were removed from 3 patients for reasons unconnected to the implants themselves (because of neoplasm in one case and due to inadequate volume in the other two patients). No case of rupture has been reported. CONCLUSIONS: This pilot study appears to confirm the validity of implants prefilled with Hydrogel in reconstructive or cosmetic breast surgery. A larger population and longer periods of minimum follow-up are obviously required to confirm these results over the long term.     

性激素缓释硅胶囊对去势狗的激素替代作用

观察性激素缓释硅胶囊对去势狗的激素替代作用，为男科疾病的动物实验研究创造条件。将自制的性激素缓释硅胶囊埋置于狗的皮下，用ＲＩＡ方法检测血清中性激素的含量。按照１个Ｔ囊／２ｋｇ体重，同时１个Ｅ囊皮下埋置性激素缓释硅胶囊能使实验狗体内雌二醇的含量升高１４０％，雌、雄激素的比率升高，近似于老年狗的比率，并且在短期内维持稳定水平，结果表明用此性激素缓释硅胶囊皮下埋置能很好地控制实验狗体内性激素的水平。     

左旋18甲基炔诺酮皮下埋植避孕剂对机体细胞免疫功能的影响

探讨左旋 1 8甲基炔诺酮皮下埋植避孕剂 (皮埋剂 )对机体细胞免疫功能的影响。对应用皮埋剂妇女 1 59例 (观察组 )及 3 1名对照组妇女 ,采用改良的碱性磷酸酶抗碱性磷酸酶桥联酶标染色技术 (APAAP) ,测定 T细胞总数及亚群 ;红细胞 C3 b受体花环试验 ,测定红细胞膜补体受体 (RBC-CR)活性 ;红细胞免疫复合物花环试验 ,测定红细胞膜粘附免疫复合物 (IC)能力的大小 ;直向肿瘤红细胞花环试验 ,测定红细胞免疫粘附肿瘤细胞的能力。结果显示 ,不同埋植时间妇女 CD3、CD4、CD8及 CD4 /CD8细胞比值 ,观察组与对照组相比 ,差异无显著性意义 (P>0 .0 5) ;埋植时间为 0 .5～年的妇女 ,两组相比 ,RBC-CR花环率差异具有显著性意义 (P<0 .0 5) ;IC花环率差异具有非常显著性意义 (P<0 .0 1 ) ;其它埋植时间妇女红细胞的各项免疫指标与对照组接近 (P>0 .0 5)。认为 ,该皮埋剂不影响 T细胞总数及亚群的功能 ;红细胞免疫功能在早期可呈一过性增强 ,在中后期恢复正常并保持稳定。其原因可能是由于药物的直接作用和阴道出血引起的局部感染刺激所致 ,因此 ,该埋植剂长期应用是安全的。