促宫颈成熟与足月延期引产应用双球囊及缩宫素的临床效果评价

目的:评析促宫颈成熟与足月延期引产应用双球囊及缩宫素的临床效果。方法:抽选106例足月延期引产产妇为观察对象随机分为各包含53例的缩宫素组(对照组)与双球囊组(实验组),分别进行缩宫素静滴、双球囊导管置入处理,评估比较两组产妇促宫颈成熟效果,并观察产妇的妊娠结局与引产效果。结果:实验组产妇的促宫颈程度效果高达94.3%,相比于对照组的43.4%显著更高(P0.05),宫颈Bishop评分提升优于对照组(P0.05);实验组的剖宫产率、总产程时间与诱发临床时间相比于对照组均明显更少(P0.05),而两组在新生儿体重、新生儿Apgar评分无明显差异(P0.05)。结论:双球囊导管对于足月延期引产产妇而言可有效促宫颈成熟,缩短产程时间,并降低剖宫产率,相较于缩宫素更为安全、有效。     

双球囊导管促宫颈成熟在足月妊娠及引产中的应用

目的 探讨双球囊导管促宫颈成熟在足月妊娠及引产中的应用效果。方法 选取我院2017年3月～2019年2月入院的有完整诊疗信息的足月妊娠孕妇60例,按随机数字表法分为观察组和对照组,各30例,观察组孕妇应用双球囊导管促宫颈成熟和引产,对照组孕妇直接应用缩宫素静滴引产。比较两组干预后孕妇的促宫颈成熟率(宫颈Bishop评分)、分娩方式和分娩结局。结果 两组孕妇干预前宫颈Bishop评分比较无统计学差异,干预后观察组的宫颈Bishop评分显著高于干预前的宫颈Bishop评分,且高于对照组干预后的;观察组孕妇剖宫产率及催产素使用率明显低于对照组;观察组未出现子宫强直收缩,对照组出现2例,两组孕妇产后尿潴留的发生率及产后2h出血量无统计学差异(P 0.05)。结论 应用双球囊导管促宫颈成熟在足月妊娠及引产中能够有效改善宫颈条件,从而缩短产程,提高阴道分娩率,并能够减少新生儿并发症的发生,值得临床推广。     

子宫颈扩张球囊对足月妊娠促宫颈成熟引产的效果评价

目的讨论子宫颈扩张球囊对足月妊娠促宫颈成熟引产的效果。方法84例Bishop评分≤6分的足月妊娠产妇,随机分为观察组和对照组,各42例。对照组采用常规缩宫素进行干预,观察组采用子宫颈扩张球囊进行干预。比较两组干预前后的Bishop评分及引产情况、产妇产程时间、产后出血量、新生儿Apgar评分。结果观察组引产失败0例,对照组引产失败9例(21.43%);观察组引产失败率明显低于对照组,差异有统计学意义(χ²=10.08,P<0.05)。干预前,两组Bishop评分比较差异无统计学意义(P>0.05);干预后,观察组Bishop评分高于对照组,差异有统计学意义(P<0.05)。观察组产程时间(432.05±26.45)min短于对照组的(702.45±32.15)min,产后出血量(215.45±6.37)ml少于对照组的(251.35±8.44)ml,新生儿Apgar评分(8.45±0.45)分高于对照组的(7.48±0.31)分,差异有统计学意义(P<0.05)。结论对足月妊娠宫颈Bishop评分≤6分的产妇通过子宫颈扩张球囊进行干预可以有效促进宫颈成熟,提升引产的质量和新生儿的质量,值得推荐。     

控释地诺前列酮栓与缩宫素用于足月妊娠促宫颈成熟引产36例

目的观察控释地诺前列酮栓与缩宫素用于足月妊娠促宫颈成熟引产的疗效。方法选择70例足月妊娠初产妇,分为观察组和对照组,分别采用控释地诺前列酮栓和小剂量缩宫素引产。观察并比较两组产妇治疗后的促宫颈成熟效果、宫颈Bishop评分、产妇分娩结局和药物不良反应。结果观察组的临床总有效率明显高于对照组(χ2=10.26,P<0.01)。两组产妇治疗12 h后Bishop评分均较治疗前明显上升(P<0.05或P<0.01),且观察组上升的幅度高于对照组(P<0.05)。观察组总产程时间明显短于对照组(t=2.36,P<0.05),剖宫产率明显低于对照组(χ2=4.94,P<0.05)。两组产后出血率和新生儿窒息率比较无明显统计学差异(χ2=0.21和0.46,均P>0.05)。结论控释地诺前列酮栓用于足月妊娠促宫颈成熟引产疗效肯定,能明显增加宫颈Bishop评分,缩短产程,减少剖宫产率,是一种安全有效的促宫颈成熟和引产药物。     

COOK宫颈扩张球囊与缩宫素静脉滴注在足月妊娠引产中的优劣差异

目的分析COOK子宫颈扩张球囊及缩宫素对辅助足月妊娠引产的优劣差异。方法选取2017年3月~2018年3月我院行引产的68例足月妊娠产妇,按随机数字表法分为两组,各34例。缩宫素组采用缩宫素静脉滴注引产,球囊组采用COOK宫颈扩张球囊引产,统计对比两组产妇的引产效果。结果对比两组产妇宫颈成熟情况,球囊组产妇的宫颈成熟率高于缩宫素组(P 0.05);对比两组产妇引产和分娩情况,球囊组产妇的引产成功率高于缩宫素组,剖宫产率较低于缩宫素组,临产时间和产程短于缩宫素组(P 0.05);对比两组产妇不良反应,球囊组产妇的不良反应总发生率低于缩宫素组(P 0.05)。结论针对足月妊娠引产产妇应用COOK宫颈扩张球囊进行引产更加安全有效,可以提高产妇的宫颈成熟率和引产成功率,缩短临产时间和产程,降低剖宫产率,减少不良反应发生。     

间苯三酚联合缩宫素对需引产分娩的初产妇产程进展和分娩结局的影响

目的 探讨间苯三酚联合缩宫素应用对于需引产分娩的初产妇产程进展、产妇及新生儿分娩结局的影响.方法 选取2019年1月至2020年12月在合肥市第三人民医院需引产分娩的足月单胎初产妇60例,采用随机数字表法分为观察组与对照组,每组30例,对照组单用缩宫素治疗,观察组应用缩宫素联合间苯三酚治疗,收集产妇的产程进展、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率、阴道分娩率和新生儿Apgar评分等,并对两组数据进行比较.结果 观察组第一产程、总产程时间分别为(407.9±125.4)min、(450.5±131.0)min,均显著短于对照组的(663.3±218.2)min、(722.1±223.4)min(P<0.05).两组阴道分娩率、产后出血量、宫颈或阴道裂伤发生率、产时羊水Ⅲ度发生率的差异无统计学意义(P>0.05).结论 间苯三酚联合缩宫素静滴,可缩短产程,且不影响母婴安全.     

缩宫素与米索前列醇在足月妊娠引产中的对比应用

目的:探讨缩宫素与米索前列醇在足月妊娠引产中的应用效果.方法:选择2014年3月～2016年3月我院产科住院部有引产指征的孕晚期产妇200例作为观察对象,使用随机数字表分为对照组和观察组各100例,观察组给予小剂量米索前列醇引产,对照组给予缩宫素引产,对比两组引产效果(Bishop评分、产程时间、成功率).结果:用药4h、8h及12h后,观察组Bishop评分明显高于对照组,用药至分娩的总产程、第一产程及第二产程时间均明显短于对照组,两组阴道分娩率及剖宫产率差异显著,具有统计学意义(P<0.05);观察组成功率为91.00％,对照组成功率为85.00％,组间比较无明显差异(P>0.05).结论:在足月妊娠引产中,与缩宫素比较阴道放置小剂量的米索前列醇可促进宫颈成熟、缩短产程、提高经阴道分娩率、减少剖宫产率,可在临床推广.     

宫颈扩张球囊联合缩宫素促宫颈成熟对妊娠结局及抑郁自评量表评分的影响

目的 观察宫颈扩张球囊联合缩宫素促宫颈成熟对妊娠结局及抑郁自评量表(SDS)评分的影响。方法 选取2019年3月—2021年3月广州市番禺区第二人民医院妇产科收治的产妇208例,按照随机数字表法分为试验组和对照组,每组104例。试验组实施宫颈扩张球囊联合缩宫素治疗,对照组实施常规治疗。比较2组Bishop宫颈成熟度评分、宫颈成熟比例、剖宫产率、阴道分娩率、产程时间、妊娠结局及分娩前后SDS评分。结果 试验组产妇Bishop宫颈成熟度评分、宫颈成熟率及阴道分娩率均高于对照组,剖宫产率低于对照组(P<0.05或P<0.01),总产程时间短于对照组(P<0.01),产妇产后出血量少于对照组(P<0.01);2组新生儿体质量和5 min Apgar评分比较差异均无统计学意义(P>0.05);分娩后,2组产妇SDS评分均低于分娩前,且试验组低于对照组(P<0.01)。结论 宫颈扩张球囊联合缩宫素对促进宫颈成熟有一定帮助,可改善妊娠结局,提高阴道分娩率,降低剖宫产率,减少产后出血量,改善新生儿结局,减轻分娩后抑郁程度,可在临床推广。     

欣普贝生用于足月妊娠产妇促宫颈成熟引产效果观察

目的观察欣普贝生用于足月妊娠产妇促宫颈成熟引产的临床效果。方法选取2018年8月-2019年7月云南省第一人民医院产科收治的足月妊娠引产产妇180例,利用随机数字表法分为研究组和对照组,每组90例。对照组予以缩宫素促宫颈成熟引产,研究组予以缩宫素联合普贝生促宫颈成熟引产。比较2组促宫颈成熟效果、分娩情况及不良反应发生情况。结果给药12 h后,2组宫颈Bishop评分均升高,且研究组给药12 h后宫颈Bishop评分高于对照组(P<0.05)。研究组给药至临产间隔时间短于对照组(P<0.05)。研究组自然分娩率高于对照组(P<0.05),产程时间短于对照组(P<0.05),2组新生儿Apgar评分比较差异无统计学意义(P>0.05)。2组孕产妇围生期产后出血、先兆子宫破裂、羊水Ⅱ度污染、胃肠道反应、子宫过度刺激发生率比较差异无统计学意义(P均>0.05)。结论欣普贝生促宫颈成熟效果显著,有利于提高足月妊娠产妇经阴道分娩成功率。     

子宫颈扩张球囊在足月妊娠引产中的效果及护理

目的评价子宫颈扩张球囊在足月妊娠中促进宫颈成熟和引产的有效性和安全性。方法选择足月妊娠,有引产指征的产妇112例,Bishop宫颈6分,随机分为两组,56例为球囊组,56例对照组采用小剂量缩宫素静脉滴注引产的病例进行回顾性观察、护理、分析。结果取出子宫颈扩张球囊与静脉滴注小剂量10h相比,球囊组宫颈成熟率为98%,对照组为75%;阴道分娩率、缩短产程时间明显高于对照组(P0.05),剖宫产率低于对照组(P0.05),在新生儿Agpar评分及产后24h出血中,差异无统计学意义。结论子宫颈扩张球囊在足月妊娠促宫颈成熟并引产效果优于缩宫素,安全有效、简单易行,值得在临床上推广。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Polymorphisms in genes involved in neurotransmission in relation to smoking

Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D₁, D₂, and D₄ receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D₃ and D₅ receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.     

Tramadol concentrations in blood and in cerebrospinal fluid in a neonate

Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.     

Disease control in asthmatic children seen in private practice in Switzerland

ABSTRACT

Background: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice.

Methods: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2.

Results: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2.

Conclusions: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.