暂时性腹部卵巢固定术在预防重度盆腔子宫内膜异位症手术患者术后粘连中的应用

本研究以大学附属医院提供的材料为依据进行回顾性研究,旨在评估重度子宫内膜异位症手术中暂时性应用卵巢固定术对术后粘连再形成及术后受孕的意义。20例行重度子宫内膜异位症手术的女性患者,在其手术过程中的最后一步时,行暂时性卵巢固定术,即将其单侧或双侧卵巢固定于腹内侧前壁,卵巢固定的中位时间为4d。手术效果评价指标为粘连再形成情况和受孕情况。本方法既未导致特殊并发症的出现也未使受试者的住院时间延长;对8例(占40%)受试者进行二次腹腔镜检查显示,受试者卵巢粘连的发生率、范围和严重程度均有所下降;2/3受试者的悬吊卵巢在二次…     

随机尿样中尿蛋白/肌酐比率预测妊娠晚期新发轻度高血压伴蛋白尿

目的:本研究旨在评价随机尿蛋白/肌酐比预测妊娠晚期新发轻度高血压孕妇伴有意义蛋白尿(≥300m g/24h)的准确性。方法:对185例诊断为妊娠晚期新发轻度高血压患者的病例资料进行回顾性分析。在留取24h尿样测定尿蛋白含量之前,先留取一份随机尿样。以24h尿样中蛋白含量≥300m g作为判断有意义蛋白尿发生的金标准,来评估随机尿样中尿蛋白/肌酐比预测有意义蛋白尿发生的诊断价值。结果:39例(21%)为有意义蛋白尿,其24h尿蛋白含量与随机尿样中尿蛋白/肌酐比显著相关(r=0.56,P<0.01)。尿蛋白/肌酐比>0.19作为有意义蛋白尿的预测指标,其敏感度和特…     

普伐他汀对慢性肾病患者心血管事件的影响

背景:HMG-CoA还原酶抑制剂(他汀类药物)对中度慢性肾病(CKD)患者心血管方面的有利作用报道较少。本试验的目的在于确定普伐他汀是否可以降低并发中度CKD的冠状动脉疾病患者或冠状动脉疾病高危人群的心血管事件的发生率。方法和结果:分析来自PPP(普伐他汀汇集项目),一个综合了3项普伐他汀(40mg/d)与安慰剂比较的随机试验的数据库。19700受试者中,4491例(22.8%)患中度CKD。中度CKD指所估计的肾小球滤过率为30～59.99ml/(min·1.73m2)。主要结局变量是到发生心肌梗死、冠状动脉疾病死亡或经皮/外科冠状动脉血运重建术的时间。与肾功能…     

A Double-Blind Comparison of Sinusoidal Wave and Brief-Pulse Electroconvulsive Therapy in Endogenous Depression

In a double-blind prospective study, 29 endogenously depressed patients (RDC) were randomized into sinusoidal wave (SW) and brief-pulse (BP) electroconvulsive therapy (ECT) groups. Bilateral modified treatments were administered on alternate days, three per week, and the treatment variables of current dosage and seizure duration were monitored for each treatment. Significantly more patients responded to SW than to BP ECT, but a comparable number of treatments was required to produce this response in the two groups. There was no difference in clinical or treatment variables between the SW and the BP groups, nor between ECT responders and nonresponders, with the exception that the SW-treated patients received larger doses of current per treatment than did the BP patients. For endogenous depression treated with ECT, we conclude that cumulative seizure duration may not be a parameter of significance, that overall rate of recovery in ECT responders is independent of stimulus waveform, and that some depressives may respond to SW but not to BP ECT. We suggest that the antidepressant effect of the ECT seizure may be characterized by a therapeutic window in current requirements; alternatively, a putative response threshold (again in terms of current requirement) may exist, which is higher in some patients than in others.     

Mania as a Side Effect of Electroconvulsive Therapy

Thirty-two endogenous depressed patients (RDC) were treated with electroconvulsive therapy. Four patients (12.5%) developed a transient manic reaction; in two cases, this reaction occurred in mid-depression. Mania is not a generally recognized side effect of ECT; we detail the clinical characteristics, but fail to define clinical predictors of vulnerability.     

Corneal tissue mass in normal and keratoconic eyes. In vivo estimation based on area of horizontal optical sections

Based on measurements of the corneal diameter, radius of curvature variation, and thickness profile a method for calculation of the horizontal meridian's sectional tissue mass area (M) is described. Pooled values of 52 normal eyes demonstrate M to be 8.57 mm2 +/- SD. Comparing one eye of 27 keratoconic patients with one eye of 28 normals established no significant difference in M. This result is in accordance with a hypothesis in which the keratoconic corneal thinning is a result of an increased sliding of collagen fibers rather than a result of increased collagen degradation.     

The changing family in the Federal Republic of Germany

Changes in family structure in the Federal Republic of Germany are analyzed. Family characteristics are first reviewed, followed by an outline of family policy and legislation. Data are from official and other published sources and concern selected years from 1900 to 1985, with an emphasis on the period since 1950.