摘要：我站于1995年11月30日～1997年3月,按浙江省医学科学院计划生育研究所提供的药物、设计及随访计划,接纳100例育龄妇女进行醋酸甲羟孕酮避孕针使用效果及副作用的前瞻性观察。

摘要：背景在英国,基层医疗中非工作时间的电话分诊大多由护士负责,而在丹麦则由全科医生负责。目的描述从全科医生的电话分诊到面对面接触,并评估其相关性及其相关因素。设计与环境2010年6月—2011年5月,丹麦基层医疗中非工作时间的一项前瞻性观察研究。方法 从电子病例管理系统中收集患者的信息,并由全科医生完成与联络相关的电子问卷。进行面对面接触的全科医生评估了电话分诊到面对面接触的相关性。进行二项回归分析,计算相对危险度（RR）和95%CI。结果 59.2%的电话呼入以电话咨询结束。电话分诊到面对面接触的相关因素如下：患者年龄〉40岁（40～64岁：RR=1.13;年龄〉64岁：RR=1.34）、问题持续存在12～24 h（RR=2.60）、潜在的严重问题（RR=5.81）和非严重问题（RR=2.23）。研究发现,电话分诊到面对面接触与12.7%的诊所咨询和11.7%的家访无关。问题持续存在〉24 h（RR=1.25）、在每个工作日晚上联系（RR=1.25）、距离患者拥有全科医疗时间〈2 h（RR=1.80）无关。结论 本文中全科医生认为约12%的面对面咨询与电话分诊无关,这表明全科医生电话分诊是有效的。了解电话分诊的影响因素可以为全科医生提供更好的教育,但仍需对全科医生电话分诊的其他质量方面进行前瞻性研究。

摘要：Objective:To evaluate risk factors for recurrent thrombosis in pediatric patients. Study design:This prospective observational cohort study enrolled 120 patients with acute venous thromboembolism from January 2003 to April 2005. Datacollection included medical and family history,radiologic and laboratory studies,therapy,and follow-up. Results:The overall prevalence of recurrent thrombosis in our cohort was 19/120(15.8%). Patients with recurrence were older,with a median age of 14.8 years (range 2 weeks-23.6 years),compared with 10.1years (range newborn 23.4 years) in patients without recurrence(P = 0.03). Six of the 19 patients with recurrent thrombosis had cystic fibrosis (CF),compared with 0/101without recurrence (P< 0.001). Five of these 6 patients were colonized with Burkholderia cepacia in their sputum. Central venous catheters were associated with most,but not all,of the thromboses in patients with CF. Conclusions:In this study,patients with CF had a high risk of recurrent venous thrombosis,as well as a high prevalence of colonization with B cepacia. The cause of this risk has not been defined. This observation may have important implications for thromboprophylaxis,particularly in the setting of central venous catheters.

摘要：目的:探讨近期曾外出旅游患者中急性卒中的发生率,分析这些患者中的危险因素、卒中类型和卵圆孔未闭(PFO)情况。设计:为期1年的前瞻性观察研究。地点:单中心研究。方法:纳入首次出现大脑缺血的所有患者并补充包括标准化旅游史的一般资料。结果:338例急性卒中患者中有42例(12.4%)有旅游史(PTH)。

摘要：Objective:To determine whether cervical fetal fibronectin is a reliable predictor of first trimester pregnancy outcome in patients with unexplained recurrent miscarriage. Study design:A prospective observational study was carried out on 49 pregnant women with a history of unexplained recurrent miscarriage. In all participants the presence of fetal fibronectin in the cervical secretion was determined with a qualitative rapid immunoassay. The outcome of the first trimester pregnancy was recorded a successful outcome was a pregnancy that progressed beyond 12 weeks of gestation; a miscarriage referred to a pregnancy loss in the first 12 weeks. Results:Of the 49 subjects screened,fetal fibronectin was positive in 17 and negative in 32. Overall,14 pregnancies resulted in fetal loss before the 12th week of gestation. Fetal cervical fibronectin was positive in 6 of the 14 patients who miscarried and in 11 of the 35 in whom outcome was successful. As predictor of first trimester pregnancy outcome the test had a sensitivity and a specificity of 43%and 69%and positive and negative predictive values of 35%,and 75%,respectively. Subgroup analysis by number of previous miscarriages and maternal age gave similar values. Conclusion:This study examines the possible value of cervical fetal fibronectin in predicting first trimester pregnancy outcome. We conclude that the occurrence of positive or negative fetal cervical fibronectin test has only limited predictive value and therefore its use cannot be considered for clinical application.

摘要：Objective: The purpose of this study was to determine the relative effects of pregnancy and mode of delivery on the prevalence of urinary and fecal incontinence. Study design: This was a prospective, observational multicenter study of women presenting to 6 gynecology clinics. Demographic data collected included: height, weight, gravidity, parity, and number of vaginal deliveries. Patients were diagnosed with incontinence by questionnaire. Standard univariate logistic regression analyses’ were performed to determine the contribution of pregnancy, mode of delivery, and BMI on the prevalence of urinary and fecal incontinence. Results: One thousand and four women were enrolled over an 18- month period. Two hundred and thirty-seven and 128 subjects had urinary and fecal incontinence, respectively. Odds ratio (95% CI) calculated for the prevalence of urinary incontinence by pregnancy and mode of delivery were: any term pregnancy vs no term pregnancy was 2.46 (1.53- 3.95), any term pregnancy but no vaginal deliveries (cesarean section only) vs no term pregnancy was 1.95 (0.99- 3.80), any term pregnancy and at least 1 vaginal delivery vs no term pregnancy was 2.53 (1.57- 4.07), and any term pregnancy but no vaginal delivery (cesarean section only) vs any term pregnancy, and at least 1 vaginal delivery was 1.30 (0.77- 3.95). Odds ratio (95% CI) calculated for the prevalence of fecal incontinence by pregnancy and mode of delivery were: any term pregnancy vs no term pregnancy was 2.26 (1.22- 4.19), any term pregnancy but no vaginal deliveries (cesarean section only) vs no term pregnancy was 1.13 (0.43- 2.96), any term pregnancy and at least 1 vaginal delivery vs no term pregnancy was 2.41 (1.30- 4.49), and any term pregnancy but no vaginal deliveries (cesarean section only) vs any term pregnancy, and at least 1 vaginal delivery was 2.15 (0.97- 4.77). BMI and age did not impact these results. Conclusion: Pregnancy increases the risk of urinary and fecal incontinence. Cesarean s

摘要：为了改善贲门癌手术治疗条件,以减少术后复发和播散,提高生存率,我们设计了包括5—氟脲嘧啶(5—Fu),顺氯铵铂(DDP),丝裂霉素(MMC),阿霉素(ADM)在内的两种联合化疗方案,采用贲门癌术前单次联合用药,腹腔动脉灌注化疗,前瞻性观察临床近期疗效与病理组织学改变。现报告如下:

摘要：关键词静脉切开;采血;输血;患儿血液管理;重症监护;儿童;儿科目的50%的重症患儿出现贫血。医源性血液检测可能是导致此问题的原因之一。本研究旨在记录PICU内采血现状,确定与采血增加相关的患儿因素并分析采血量、出PICU时贫血与PICU期间血红蛋白变化之间的关系。设计前瞻性观察性队列研究。场所Sainte-Justine大学医院的PICU。对象4个月研究期内人院的所有患儿。干预措施无。

摘要：目的:描述无ST段抬高的疑似急性冠状动脉综合征男性和女性患者入院前的心肌梗死预测因素。设计:在瑞典斯德哥尔摩和哥德堡进行前瞻性观察研究。结果:433例患者符合研究纳入标准,其中45%是女性。女性(17%)较之男性(26%)更少发生急性心肌梗死(AMI)(P=0.054),尤其是对于初始ST段压低的患者,此类患者中有22%的女性和54%的男性发生了AMI(P=0.001)。