A retrospective comparison between lamicel and gemeprost for cervical ripening before surgical interruption of first-trimester pregnancy

To study the effect and complication rate of lamicel versus gemeprost as pretreatment to vacuum aspiration for the interruption of early pregnancy, the files of 622 medical records of women having a first-trimester abortion at S?der Hospital were studied retrospectively. Group A consisted of 317 women treated with lamicel in 1995 and Group B of 305 women treated with gemeprost in 1996. Complications were more common in Group A than in Group B (55 vs. 22; p < 0.05). Re-admission took place more often in Group A (25) than in Group B (6) (p < 0.05). The complications were more severe in Group A than in Group B. Using multivariate logistic regression analysis, the only impact factor for having a complication was the use of product for cervical priming. Gemeprost for preoperative treatment was found to render a fairly low rate of complications in this study, while complication rate was higher after treatment with lamicel.     

A study of the efficacy of cervical ripening with nitric oxide donor versus placebo for cervical priming before second-trimester termination of pregnancy

This was a double-blind randomized control study to evaluate the efficacy of cervical priming by nitric oxide donor before second-trimester induced abortion. One-hundred healthy women with a singleton pregnancy between 14 and 20 weeks of gestation were randomized into either 40 mg isosorbide mononitrate or placebo, given intravaginally 12 h before induction. This was followed by intravaginal misoprostol induction. The induction-abortion interval, abortion rate, side effects and the woman's acceptability of the priming agent were recorded. All women completed the study and there was no severe complication recorded. There was no significant difference in the induction-abortion interval and abortion rate between the two groups. Isosorbide mononitrate group reported significantly more side effects of headache. More than 90% of the women in both groups found the priming agent acceptable. The application of intravaginal nitric oxide donors prior to the prostaglandins induction did not significantly improve the second-trimester induced-abortion process.     

Treating incomplete abortion in El Salvador: cost savings with manual vacuum aspiration

When manual vacuum aspiration (MVA) was introduced to treat incomplete abortion at a regional training hospital in El Salvador, this study evaluated the impact of replacing sharp curettage with MVA. Hospital cost, length of hospital stay, complication rates and postabortion contraceptive acceptance were compared in a prospective, nonrandomized, controlled study of 154 women assigned to either traditional sharp curettage services or MVA services plus contraceptive counseling. Assignment depended on availability of trained providers. Compared to sharp curettage, use of MVA and associated changes in protocol led to a significant cost savings of 13% and shorter hospital stay of 28%. Dedicated family-planning counseling resulted in a threefold higher rate of contraceptive acceptance. Although the difference in cost was significant, much higher savings could be realized if minimal postoperative stays were implemented for both procedures. Barriers to early discharge include patient expectations, physician attitudes and training and hospital systems administration.     

负压吸宫术前口服和阴道放置米索前列醇对宫颈扩张作用的随机比较研究

目的:比较在终止早期妊娠负压吸宫手术前口服和阴道放置米索前列醇对宫颈的扩张作用以及副反应。方法:将停经6～10周要求手术终止妊娠的100名妇女随机分为两组,分别口服或阴道放置400μg米索前列醇,用药后3～3.5小时行负压吸宫术。记录观察对象的宫颈扩张程度和用药后副反应以及术中出血量、手术所用时间。结果:两组对象宫颈扩张程度无明显差异(平均直径分别为6.96mm和7.02mm,P>0.05),口眼用药组恶心、呕吐发生率明显高于阴道用药组(P<0.05),阴道用药组腹痛的发生率大于口服用药组(分别为56％和44％),但差异无显著性(P>0.05)。其他副作用及术中出血量、手术所用时间等均无显著差异。结论:在终止早期妊娠的负压吸引术前口服或阴道放置米索前列醇400μg,均能有效扩张宫颈。口服用药方法简单、方便,可接受性好,但对于妊娠反应较明显的妇女,阴道用药更为可取。     

“病人选医生”贵在坚持和完善

从指导病人选择满意的医生;让年轻医生在“病人选医生”的改革中锻炼成长;防止医务人员之间的不良竞争;深化医院人事及分配制度改革,科学考核,完善激励机制等方面介绍了重庆市外科医院的经验及成效。指出:“病人选医生”贵在坚持和完善;“病人选医生”与传统的三级医生负责制相辅相成,是其完善和补充。     

Up-regulation of transporters of the MRP family by drugs and toxins

Expression of a variety of ABC efflux pumps including certain conjugate transporters of the multidrug resistance protein (MRP) subfamily is inducible in primate and rodent tissues, and in a variety of cell lines and primary cells in culture. In human cell lines (HepG2, MCF-7), we studied the inducibility of MRPs 1–5. Similar to the rat mrp2 gene, human mrp2 is inducible by the chemical carcinogen 2-AAF, the chemotherapeutic drug cisplatin and the barbiturate phenobarbital, as demonstrated in Northern and Western Blots. Furthermore, the antibiotic rifampicin was identified as MRP2 inducer in HepG2 cells. MRP1 and 4 mRNAs being expressed in human liver at a very low level could not be detected in HepG2 cells after treatment with various agents. However, MRP3 and 5 mRNAs were detected in addition to MRP2 and their expression was found to be increased by 2-AAF, cisplatin and rifampicin. MRP1 expression was studied in MCF-7 cells where the chemotherapeutic drug vinblastine and tert-butyl hydroquinone but not the MRP2 inducing agents described above acted as inducers.     

Multipoint analysis using affected sib pairs: incorporating linkage evidence from unlinked regions

In this paper, we proposed a multipoint method to assess evidence of linkage to one region by incorporating linkage evidence from another region. This approach uses affected sib pairs in which the number of alleles shared identical by descent (IBD) is the primary statistic. This generalized estimating equation (GEE) approach is robust in that no assumption about the mode of inheritance is required, other than assuming the two regions being considered are unlinked and that there is no more than one susceptibility gene in each region. The method proposed here uses data from all available families to simultaneously test the hypothesis of statistical interaction between regions and to estimate the location of the susceptibility gene in the target region. As an illustration, we have applied this GEE method to an asthma sib pair study (Wjst et al. [1999] Genomics 58:1-8), which earlier reported evidence of linkage to chromosome 6 but showed no evidence for chromosome 20. Our results yield strong evidence to chromosome 20 (P value = 0.0001) after incorporating linkage information from chromosome 6. Furthermore, it estimates with 95% certainty that the map location of the susceptibility gene is flanked by markers D20S186 and D20S101, which are approximately 16.3 cM apart.     

不全流产的声像图研究

目的探讨不全流产宫内残留物声像图表现,分析其形成原因。方法对369例不全流产宫内残留物声像图进行分析。结果不全流产宫内残留物声像图表现为：高回声型、低回声型、混合回声型、无回声型或无异常回声型。结论超声显像在不全流产宫内残留物有较高的应用价值。     

中西医结合治疗缺血性中风126例辨治研究

目的：观察中西医结合治疗缺血性中风的临床疗效。方法：将126例缺血性中风患者随机分为两组，对照组采用溶栓、降纤、抗凝、抗血小板抑制剂、脑保护剂及对症治疗。治疗组在此基础上加以中医辨证分型予以中药治疗。两组进行神经功能缺损评分及临床疗效比较。结果：经治两个疗程，两组患者自身治疗前后对比均较治疗前有改善，对照组P〈0．05，治疗组P〈0．01；组间比较，治疗组的神经功能缺损评分改善情况优于对照组（P〈0．05）。治疗组总有效率97．22％，对照组88．89％。两组比较，差异有显著性意义，P〈0．01。结论：中西医结合治疗缺血性中风疗效优于单纯西医治疗。     

氟比洛芬酯联合丙泊酚与芬太尼联合丙泊酚用于无痛人工流产术的比较

目的：探讨氟比洛芬酯对无痛人工流产术麻醉及其术后镇痛的效果及安全性。方法：100例要求行人工流产者随机均分为2组，观察组先静脉注射氟比洛芬酯50mg，10min后静脉注射丙泊酚2mg／kg；对照组先缓慢静脉注射芬太尼1μg／kg，10min后静脉注射丙泊酚2mg／kg。两组丙泊酚静注速率均为100mg／min。观察并纪录两组用药前、睫毛反射消失时、术中、术毕时的收缩压、心率、呼吸频率及血氧饱和度，手术时间，苏醒时间，丙泊酚总用药量。不良反应，术中麻醉效果，以及术毕清醒后1、5、15、30min视觉模拟评分（VAS）值。结果：受术者睫毛反射消失时，观察组收缩压显著高于对照组（P〈0．05）；睫毛反射消失时及术中呼吸频率及血氧饱和度观察组显著高于对照组（P〈0．05），术中麻醉效果评定为优、良、差的例数及术毕清醒后1、5、15、30min时下腹部疼痛的VAS值，两组比较差异无统计学意义。结论：在人工流产术中应用氟比洛芬酯联合丙泊酚具有良好的术中麻醉及术后镇痛效果，对呼吸及循环抑制较轻，是一种较为安全有效的配伍方法。