卵巢低反应患者大剂量超排卵的助孕结局

在辅助生殖助孕中通常采用控制性卵巢刺激(controlled ovarian hyperstimulation, COS),以获得适当数量的卵子用于体外受精,既希望获得理想的辅助生殖助孕成功率,又能降低卵巢过度刺激并发症.COS中约有9%~24%[1,2]的卵巢低反应发生率.卵巢低反应者获得有效卵子数少、可移植胚胎数少或无胚胎移植、取消治疗周期率高,累计成功率更低等,导致较差的治疗结局,是辅助生殖助孕中面临的棘手问题.针对卵巢低反应者,大多数辅助生殖中心仍会采用增加促性腺激素(Gn)的起始和(或)总用量以期获得提高助孕结局的目的.而大剂量Gn是否为改善低反应患者助孕结局的有效策略却仍存在争议.     

Care of the child in a body cast

Caring for a child in a body cast is a stressful situation for most families and many families state they do not receive adequate information on how to care for their child. This paper presents a comprehensive guide on caring for a child in a body cast. It examines the physical care issues, transportation and cast care. An instrument for assessing the family’s ability to cope with caring for a child in a body cast is described, and further resources for parents and nurses are presented.     

成都市中老年健身女性体成分指标与骨密度和骨代谢指标的相关性研究

目的探讨体重、体重指数(BMI)等体成分指标对中老年健身运动女性骨密度的影响及体成分指标与骨代谢指标、骨密度指标的关系。方法94例成都市城区健身运动女性根据BMI不同分为三组:低体重组(BMI≤20kg/m2)、正常体重组(20kg/m225kg/m2),采用Osteospace超声骨密度仪测定跟骨的BUA、SOS、STI骨密度指标;全自动生化分析仪测定血清AKP含量;应用放射免疫法测定血清hCT、BGP、IL-6、E2、TNF含量。应用方差分析和偏相关方法进行统计学处理。结果不同BMI组的体重、体重指数、瘦体重和体脂百分比差异显著,低体重组T-score与正常体重组、超重组比较有极显著差异;低体重组SOS、STI骨密度指标显著低于正常体重组;BUA、SOS、STI骨密度指标与体重、体重指数、瘦体重和体脂百分比呈正相关,与hCT、IL-6、TNF、BGP、AKP呈正相关,与E2呈负相关。低体重组骨量减少、骨质疏松发生率最高。结论体重、体重指数等体成分指标是影响中老年健身运动女性BMD的重要因素,保持体重有利于防止骨丢失和预防骨质疏松发生。     

先天性心脏病导管介入治疗对小儿生长发育和内分泌功能的影响

目的　了解先天性心脏病 (CHD)导管介入治疗对患儿生长发育和内分泌功能的影响。方法　测定 4 2例CHD患儿导管介入治疗前后的身高、体重和三碘甲状腺原氨酸 (T3)、甲状腺素 (T4 )、促甲状腺素 (TSH)、生长激素(HGH)。结果　治疗前后身高、体重的增长速度明显改善 ,而T3、T4、TSH、HGH无明显改变。结论　导管介入治疗能明显改善先心病患儿生长发育而不会影响患儿的内分泌功能     

体部表面线圈磁共振成像对肛瘘的术前诊断价值

目的:探讨体部表面线圈MRI对肛瘘的术前诊断价值。材料和方法:回顾性分析42例肛瘘患者,均于术前进行非增强MRI检查,将MRI结果与手术结果对照。结果:MRI诊断结果与手术结果一致,其中23例为括约肌间型,5例经括约肌型,5例括约肌上型,9例括约肌外型,所有病例中有12例可见肛周脓肿形成。结论:MRI作为一种安全、准确的肛瘘检查方法,对于肛瘘的术前诊断具有非常重要的价值。     

个体患者适形调强放疗计划模体内剂量实测验证技术的建立

目的建立个体患者适形调强放疗（IMRT）计划的模体内剂量实测验证技术。方法选择1例鼻咽癌患者，设计IMRT计划。将患者计划转移到模体上设计杂交计划。执行杂交计划时，用针点电离室测量感兴趣点的剂量，并与该点的计算剂量比较。用胶片剂量测量系统测量杂交计划中感兴趣平面的剂量，胶片与计划剂量矩阵登记后，依次进行计划，胶片分析、计划，胶片剖面分析和计划／胶片等剂量线分析。采用复合判断标准评价验证结果。结果针点电离室测量得到杂交计划单次照射的总剂量为121．5cGy，比计算值低约4％。计划，胶片分析得到高剂量、高梯度区域的距离差别均在4mm以内；计划／胶片剖面分析显示，计划与胶片在通过靶区的剖面具有较好的一致性；计划，胶片等剂量线分析显示，计划与胶片对应值的等剂量线重合良好。按照复合判断标准，该计划验证通过。结论初步建立了个体患者IMRT计划的模体内剂量实测验证技术，建立并优化了剂量登记技术、剂量归一方法和评价方法。     

浙江医科大学附二院门诊处方中精神药物使用调查

本文对浙江医科大学附属二院１９９３年７月间３１３７８张合格处方进行统计分析，并用限定日剂量（ＤＤＤ）和药物使用指数（ＤＵＩ）为指标，分析镇静催眠药物使用情况。结果表明苯二氮　类药方２０６７张，占总处方量的６．５９％，巴比妥类药方４９张，占０．１６％，麻醉药方１１１张；占０．３５％。苯二氮　类药方中．女性处方量１２０２张，男性处方量８６５张，男、女组间比较有显著性差异。苯二氮　类药方多分布在神经内科，常用的药有舒乐安定和阿普唑仑。九种常用的苯二氮　类药和麻醉性镇痛药的ＤＵＩ均小于１。提示药物滥用现象少见，该院对这类药物的管理比较严格。麻醉性镇痛药中二氢埃托啡处方占６７．５７％。     

Prevalence of vibration-induced white finger and assessment of vibration exposure among travertine workers in Italy

Summary Among 76 stonedrillers and stonecutters/chippers working in the Rapolano travertine quarries (Tuscany, Italy), 27 subjects (35.5%) were affected with vibration-induced white finger (VWF). The median latent period for VWF was ten years (range 0.1–26 years). A VWF prevalence of 8% was found among 60 comparable controls (P < 0.0001). Vibration measurements showed that the frequency-weighted accelerations for two rock-drills and two small chipping hammers ranged from 19.7 to 36.4 m/s². Weighted accelerations between 2.4 and 4.1 m/s². were measured on the handles of a vertical grinder and a hand cutter. Vibration data, daily exposure time and total duration of exposure period were used to calculate two indicators of vibration dose such as the four-hour, energy-equivalent, frequency-weighted acceleration (m/s²) and the vibration exposure level (dB). A significant association between the vibration exposure level and the severity of VWF stages was observed among the travertine operators. The dose-effect relationship proposed by ISO 5349 was not suitable for the data of the present study because it overestimates the risk due to hand-transmitted vibration in the travertine workers. Finally, the results of a cold test indicated that the rewarming time of fingertips to room temperature was more prolonged in the operators with VAT than in those without VWF and in the controls.     

The effectiveness of intermittent isotretinoin treatment in mild or moderate acne

BACKGROUND: Isotretinoin is the only drug that affects almost all factors in acne pathogenesis. Recently, its use for the treatment of chronic mild or moderate acne unresponsive to long-term antibiotic therapy, and with a tendency to cause scarring and leading to negative psychological effects, has became popular. The aim of the study was to investigate the effectiveness of intermittent isotretinoin treatment in mild or moderate acne. METHODS: Sixty patients with mild or moderate acne localized to the face were enrolled in the study. The treatment regimen consisted of isotretinoin, 0.5-0.75 mg/kg per day, applied for 1 week every 4 weeks for a total period of 6 months, according to the degree of acne and number of inflammatory lesions. RESULTS: Forty-one (68.3%) of the 60 patients completed the 6-month therapy. At the end of the treatment complete improvement was observed in 34 patients (82.9%) out of 41. All adverse effects were mild and discontinuation of the treatment was not necessary. CONCLUSION: Intermittent isotretinoin treatment was found to be a safe and effective choice for patients with mild or moderate acne.     

Pharmacokinetics of Controlled Release and Immediate Release Morphine Sulphate Tablets after a Single Dose and Multiple Doses in Chinese Volunteers

健康志愿者１０名，随机交叉口服硫酸吗啡控释片（ＣＲＭＳ）３０ｍｇ（３０ｍｇ×１）和硫酸吗啡普通片（ＩＲＭＳ）２０ｍｇ（１０ｍｇ×２），分别于服药前后各时点取静脉血，用ＧＣＭＳ测定血浆中吗啡含量。以药代软件程序处理，分别求得ＣＲＭＳ和ＩＲＭＳ的Ｃｍａｘ为１９．３８±３．８０和２１．２７±６．２１ｎｇ／ｍｌ；ｔｍａｘ为２．３６±０．３７ｈ和０．５５±０．１６ｈ；ｔ１／２β为３．５３±０．８７ｈ和３．０３±０．７４ｈ，曲线下面积ＡＵＣ为１４５．１５±１７．６５和９３．０８±１６．６５ｎｇ·ｈ／ｍｌ。癌症病人多次口服硫酸吗啡至稳态，ＣＲＭＳ和ＩＲＭＳ的峰浓度分别为２７．４３±０．３３ｎｇ／ｍｌ，２２．６８±０．１６ｎｇ／ｍｌ；谷浓度分别为１９．４５±１．４４ｎｇ／ｍｌ；１８．１４±０．４９ｎｇ／ｍｌ。