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NXP-2 positive dermatomyositis with marked dysphagia following an insect bite. NXP-2 阳性皮肌炎,被昆虫叮咬后出现明显的吞咽困难。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-10 eCollection Date: 2024-01-01 DOI: 10.1016/j.clinsp.2024.100420
Larissa M Bombardi, Carla Alexandra Scorza, Josef Finsterer, Fulvio Alexandre Scorza
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引用次数: 0
Transient, self-limiting, antibody-negative myositis with venetoclax. 使用 Venetoclax 后出现一过性、自限性、抗体阴性肌炎。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-10 eCollection Date: 2024-01-01 DOI: 10.1016/j.clinsp.2024.100444
Carla A Scorza, Josef Finsterer, Fulvio A Scorza
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引用次数: 0
Melatonin improves fertilization rate in assisted reproduction: Systematic review and meta-analysis. 褪黑素可提高辅助生殖中的受精率:系统回顾和荟萃分析。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-05 eCollection Date: 2024-01-01 DOI: 10.1016/j.clinsp.2024.100397
Eduardo Carvalho de Arruda Veiga, Marise Samama, Fabio Ikeda, Giovanna Santos Cavalcanti, Amanda Sartor, Suelen Fernanda Parames, Edmund C Baracat, Joji Ueno, Jose Maria Soares Junior

Background: Melatonin is a hormone produced by the pineal gland and it has antioxidant properties.

Aim: This study aimed to evaluate the effects of melatonin on assisted reproductive technologies through a systematic review and a meta-analysis.

Materials and methods: Search strategies were used in PubMed and in other databases covering the last 15 years. After screening for eligibility, 17 articles were selected for the systematic review. For the meta-analysis statistics, two groups were formed, the treatment group (with melatonin) and the control group (without melatonin) for various assisted reproduction outcomes.

Results: The main results were that no statistical differences were found concerning the clinical pregnancy outcome (p = 0.64), but there was a statistical difference with respect to Mature Oocytes (MII) (p = 0.001), antral follicle count (p = 0.0002), and the fertilization rate (p ≤ 0.0001).

Conclusions: Melatonin had beneficial effects such as the improvement in the fertilization rate, although the authors did not obtain significance in the clinical pregnancy rate.

背景:褪黑素是松果体分泌的一种激素,具有抗氧化作用:目的:本研究旨在通过系统综述和荟萃分析评估褪黑素对辅助生殖技术的影响:在 PubMed 和其他数据库中使用了搜索策略,搜索范围涵盖过去 15 年。经过资格筛选,共有 17 篇文章入选系统综述。在进行荟萃分析统计时,针对各种辅助生殖结果分成两组,即治疗组(使用褪黑素)和对照组(不使用褪黑素):主要结果是临床妊娠结果无统计学差异(P = 0.64),但成熟卵母细胞(MII)(P = 0.001)、前卵泡数(P = 0.0002)和受精率(P ≤ 0.0001)有统计学差异:褪黑素具有改善受精率等有益作用,尽管作者在临床妊娠率方面未获得显著结果。
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引用次数: 0
Expression and clinical significance of miR-141-5p as a biomarker in the serum of patients with early spontaneous abortion 早期自然流产患者血清中作为生物标志物的 miR-141-5p 的表达及其临床意义。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100327
XiaoQun Che , Xiao Wang , LiLian Wang , LiHua Xu , Lin Zou , TianZhong Ma , Bi Chen

Aim

miR-141-5p expression in patients with Early Spontaneous Abortion (ESA) and its correlation with hormone levels during pregnancy were investigated.

Methods

A total of 70 pregnant women with ESA were selected as the research group, and 70 normal pregnant women who chose abortion for non-medical reasons were selected as the Con group. Serum β-HCG, Progesterone (P), and Estrogen (E2) were detected by enzyme-linked immunosorbent assay. Differentially expressed miRNAs were screened by miRNA microarray analysis. miR-141-5p expression was detected by RT-qPCR, and its correlation with serum β-HCG, P, and E2 levels was analyzed. The diagnostic value of miR-141-5p for ESA was evaluated by the ROC curve.

Results

Serum β-HCG, P, and E2 were decreased and serum miR-141-5p was increased in patients with ESA. Pearson correlation analysis showed that serum β-HCG, P, and E2 levels were negatively correlated with miR-141-5p expression levels. ROC curve showed that miR-141-5p had a diagnostic value for ESA.

Conclusions

miR-141-5p is related to hormone levels during pregnancy and is expected to become a new candidate diagnostic marker for ESA.

目的:研究早期自然流产(ESA)患者体内miR-141-5p的表达及其与孕期激素水平的相关性:方法:选取70例ESA孕妇为研究组,70例非医学原因选择流产的正常孕妇为对照组。采用酶联免疫吸附法检测血清β-HCG、孕酮(P)和雌激素(E2)。通过 RT-qPCR 检测了 miR-141-5p 的表达,并分析了其与血清 β-HCG、P 和 E2 水平的相关性。用ROC曲线评估了miR-141-5p对ESA的诊断价值:结果:ESA患者的血清β-HCG、P和E2水平降低,血清miR-141-5p水平升高。皮尔逊相关分析显示,血清β-HCG、P和E2水平与miR-141-5p表达水平呈负相关。结论:miR-141-5p与妊娠期激素水平有关,有望成为ESA新的候选诊断标志物。
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引用次数: 0
Effects of Apatinib combined with Temozolomide on levels of sPD-1 and sPD-L1 in patients with drug-resistant recurrent glioblastoma 阿帕替尼联合替莫唑胺对耐药复发性胶质母细胞瘤患者sPD-1和sPD-L1水平的影响
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100376
Ren Zhao Kuang , Jun Wang , Yuan Chuan Wang , Xiao Ping Tang

Objective

This study aimed to explore the effects of Apatinib combined with Temozolomide (TMZ) on the levels of Soluble PD-1 (sPD-1) and Soluble Programmed Death-1 Ligand (sPD-L1) in patients with drug-resistant recurrent Glioblastoma (GB).

Study design

A total of 69 patients with recurrent GB from September 2020 to March 2022 were recruited and assigned to the control group (n = 34) and observation group (n = 35) according to different treatment options after tumor recurrence. The control group was treated with TMZ, and the observation group was treated with Apatinib combined with TMZ. Levels of sPD-1 and spd-l1, clinical efficacy, survival time and adverse reactions were observed and compared between the two groups.

Results

General data including gender, age, body mass index, and combined diseases indicated no statistical significance between groups (p > 0.05). Before the intervention, sPD-1 and sPD-L1 levels were not significantly different in the two groups (p > 0.05). After interventions, levels of PD-1 and sPD-L1 levels decreased significantly (p < 0.05). The objective remission rate and clinical benefit rate of the observation group were higher and overall survival and progression-free survival were longer than those of the control group (p < 0.05). No significant difference was observed in major adverse reactions among patients (p > 0.05).

Conclusions

Apatinib combined with TMZ is safe and effective in the treatment of recurrent GB. The combined application of the two can reduce the levels of sPD-1 and sPD-L1, which has important clinical application value.

本研究旨在探讨阿帕替尼联合替莫唑胺(TMZ)对耐药复发性胶质母细胞瘤(GB)患者可溶性PD-1(sPD-1)和可溶性程序性死亡-1配体(sPD-L1)水平的影响。研究设计从2020年9月至2022年3月共招募69例复发性GB患者,根据肿瘤复发后的不同治疗方案将其分为对照组(34例)和观察组(35例)。对照组接受TMZ治疗,观察组接受阿帕替尼联合TMZ治疗。结果性别、年龄、体重指数、合并疾病等一般资料显示组间差异无统计学意义(P >0.05)。干预前,两组的 sPD-1 和 sPD-L1 水平无明显差异(p > 0.05)。干预后,PD-1和sPD-L1水平明显下降(p < 0.05)。与对照组相比,观察组的客观缓解率和临床获益率更高,总生存期和无进展生存期更长(p <0.05)。结论阿帕替尼联合TMZ治疗复发性GB安全有效。两者联合应用可降低sPD-1和sPD-L1的水平,具有重要的临床应用价值。
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引用次数: 0
Tanshinone IIA alleviates IL-1β-induced chondrocyte apoptosis and inflammation by regulating FBXO11 expression 丹参酮 IIA 通过调节 FBXO11 的表达减轻 IL-1β 诱导的软骨细胞凋亡和炎症反应
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100365
Jin Xu, XiaoCheng Zhi, YunHui Zhang, Ren Ding

Objective

This study explored the pharmacological mechanism of Tanshinone IIA (TAN IIA) in the treatment of Osteoarthritis (OA), which provided a certain reference for further research and clinical application of Tan IIA in OA.

Methods

CHON-001 cells were stimulated with 10 μg/mL IL-1β for 48 h and treated with 10 μM TAN IIA for 48 h. Cellular viability and apoptosis were evaluated by CCK-8 assay and flow cytometry, and Cleaved caspase-3 was measured by Immunoblot assay and RT-qPCR. TNF-α, IL-6, and iNOS in CHON-001 cells were determined by RT-qPCR and ELISA. To further verify the effect of TAN IIA on OA, a rat model of OA in vivo was established by right anterior cruciate ligament transection. TAN IIA was administered at 50 mg/kg or 150 mg/kg for 7 weeks. The degree of cartilage destruction in OA rats was observed by TUNEL and HE staining. Cleaved caspase-3 and FBXO11 were measured by immunohistochemical staining, RT-qPCR, and Immunoblot. TNF-α, IL-6, and iNOS in chondrocytes of OA rats were detected by ELISA.

Results

IL-1β stimulated CHON-001 cell apoptosis and inflammation, and TAN IIA had anti-apoptosis and anti-inflammatory effects on IL-1β-regulated CHON-001 cells. TAN IIA down-regulated FBXO11 and inhibited PI3K/AKT and NF-κB pathways, thereby alleviating apoptotic and inflammatory reactions in CHON-001 cells under IL-1β treatment. Moreover, TAN IIA treatment improved chondrocyte apoptosis and inflammations in OA rats.

Conclusion

TAN IIA inhibits PI3K/Akt and NF-κB pathways by down-regulating FBXO11 expression, alleviates chondrocyte apoptosis and inflammation, and delays the progression of OA.

目的 探索丹参酮 IIA(TAN IIA)治疗骨关节炎(OA)的药理机制,为丹参酮 IIA 在 OA 中的进一步研究和临床应用提供一定的参考。方法CHON-001细胞经10 μg/mL IL-1β刺激48 h后,用10 μM TAN IIA处理48 h,用CCK-8检测法和流式细胞术评价细胞活力和凋亡,用免疫印迹法和RT-qPCR检测裂解的caspase-3。RT-qPCR和ELISA测定了CHON-001细胞中的TNF-α、IL-6和iNOS。为了进一步验证 TAN IIA 对 OA 的影响,我们通过右前十字韧带横断建立了大鼠体内 OA 模型。以 50 毫克/千克或 150 毫克/千克的剂量连续给药 7 周。通过 TUNEL 和 HE 染色观察 OA 大鼠软骨的破坏程度。通过免疫组化染色、RT-qPCR和免疫印迹法检测裂解的caspase-3和FBXO11。结果IL-1β刺激CHON-001细胞凋亡和炎症反应,而TAN IIA对IL-1β调控的CHON-001细胞有抗凋亡和抗炎作用。TAN IIA能下调FBXO11,抑制PI3K/AKT和NF-κB通路,从而缓解IL-1β调控下CHON-001细胞的凋亡和炎症反应。结论 TAN IIA 通过下调 FBXO11 的表达抑制 PI3K/Akt 和 NF-κB 通路,缓解软骨细胞凋亡和炎症反应,延缓 OA 的进展。
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引用次数: 0
Effectiveness of the Cunningham technique for shoulder dislocation reduction and its role in providing analgesia and muscle relaxation as an adjunctive method 坎宁安技术用于肩关节脱位复位术的效果及其作为辅助方法在镇痛和肌肉放松方面的作用。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100447

Background

Shoulder dislocation, particularly anterior dislocation, is a common orthopedic injury often presenting in emergency care settings, characterized by significant pain and muscle spasms. Prompt reduction is essential to alleviate symptoms and restore function. The Cunningham technique employs gentle pulling and massage motions targeted at the muscles and has emerged as a promising method for reducing anterior shoulder dislocations. However, its reported success rates vary widely across studies, and questions remain regarding its efficacy, particularly in cases of failure. This study aims to evaluate the effectiveness of the Cunningham technique for reducing anterior shoulder dislocations and its potential role in providing analgesia and muscle relaxation as an adjunctive method.

Methods

A retrospective study was conducted on patients presenting with acute anterior shoulder dislocation at a single center. Reduction using the Cunningham technique was performed initially, followed by the external rotation technique if unsuccessful. Procedural sedation and analgesia were administered if the reduction was still not achieved, and shoulder dislocation reduction was performed again through the external rotation method. The patients’ VAS scores were recorded and evaluated the Cunningham technique's effectiveness in reduction and whether it increases the effectiveness of other techniques applied for reduction by lowering the VAS score, even in cases where it is not effective.

Results

A total of 61 patients were included in the study. The reduction was performed using the Cunningham technique in 34.4% (21/61) patients, the external rotation technique in 47.5% (29/61) patients, and the external rotation technique with PSA in 18% (11/61) patients. Significant differences were observed in the duration of hospital stay among the three techniques, with ER with PSA resulting in the longest stay. VAS scores showed significant improvements from initial presentation to post-reduction in all three groups. A significant decrease in pre-reduction VAS scores was observed during the transition from the Cunningham technique to other techniques.

Conclusion

The Cunningham technique showed effectiveness in reducing anterior shoulder dislocations, providing analgesia, and muscle relaxation. It demonstrated favorable outcomes as an initial reduction technique, with the external rotation technique used as a subsequent option. Further studies comparing the success rates and complications of the Cunningham technique with other reduction methods are warranted to establish its role in clinical practice.

背景:肩关节脱位,尤其是前脱位,是一种常见的骨科损伤,常出现在急诊护理环境中,其特点是明显疼痛和肌肉痉挛。为减轻症状并恢复功能,及时进行肩关节复位至关重要。坎宁安技术采用针对肌肉的轻柔牵拉和按摩动作,已成为减少肩关节前脱位的有效方法。然而,不同研究报告的成功率差异很大,人们对其疗效,尤其是失败病例的疗效仍存有疑问。本研究旨在评估坎宁安技术在减少肩关节前脱位方面的有效性,及其作为一种辅助方法在提供镇痛和肌肉放松方面的潜在作用:方法: 在一个中心对急性肩关节前脱位患者进行了一项回顾性研究。首先使用坎宁安技术进行复位,如果不成功,再使用外旋技术。如果仍未成功复位,则进行手术镇静和镇痛,然后再次通过外旋法进行肩关节脱位复位。记录患者的VAS评分,并评估坎宁安技术的复位效果,以及是否能通过降低VAS评分来提高其他复位技术的效果,即使在效果不佳的情况下:研究共纳入 61 名患者。34.4%(21/61)的患者采用了坎宁安技术,47.5%(29/61)的患者采用了外旋技术,18%(11/61)的患者采用了带有 PSA 的外旋技术。三种技术的住院时间存在显著差异,外旋加 PSA 的住院时间最长。所有三组患者的 VAS 评分均显示,从初次就诊到缩窄术后均有明显改善。在从坎宁安技术向其他技术过渡的过程中,观察到缩肛前的VAS评分明显下降:结论:坎宁安手法在减少肩关节前脱位、镇痛和肌肉放松方面效果显著。坎宁安手法作为一种初步的肩关节脱位还原技术,在随后的外旋手法治疗中显示出良好的效果。为了确定坎宁安手法在临床实践中的作用,有必要对坎宁安手法与其他手法的成功率和并发症进行进一步研究。
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引用次数: 0
Physician leadership in private acquisitions: Styles for all situations 私人收购中的医生领导力:适合各种情况的风格。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100443
{"title":"Physician leadership in private acquisitions: Styles for all situations","authors":"","doi":"10.1016/j.clinsp.2024.100443","DOIUrl":"10.1016/j.clinsp.2024.100443","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001200/pdfft?md5=923b0a72dd5ac59d9906870931f0b61b&pid=1-s2.0-S1807593224001200-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of serum 25-hydroxyvitamin D with cardiovascular and all-cause mortality in patients with chronic kidney disease: NHANES 2007‒2018 results 慢性肾病患者血清 25- 羟维生素 D 与心血管疾病和全因死亡率的关系:2007-2018 年国家健康调查(NHANES)结果。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100437
Luohua Li , Jinhan Zhao

Background

Vitamin D insufficiency is a prevalent issue in patients suffering from CKD. The purpose of this study was to determine whether serum 25(OH)D levels are associated with all-cause and cardiovascular mortality in patients with CKD.

Methods

To examine the associations between 25(OH)D levels and cardiovascular mortality, this retrospective cohort study used the National Health and Nutrition Examination Survey (NHANES) and the National Death Index (NDI) 2007‒2018 database. A total of 2,668 eligible subjects were included in this study, with follow-up conducted until December 31, 2019. The associations were assessed using Cox proportional hazards regression, restricted cubic splines, Kaplan-Meier survival curves, and competing risks survival analysis. Furthermore, subgroup and sensitivity analyses were performed.

Results

During a median follow-up of 72 months in a weighted population of 11,715,452 eligible participants, there were 665 deaths from any cause, including 196 cardiovascular-related deaths. After adjusting for covariates, lower levels of 25(OH)D were significantly associated with increased risks for both all-cause mortality (HR= 0.85, 95 % CI 0.77∼0.94) and cardiovascular mortality (SHR= 0.80, 95 % CI 0.67∼0.94). Consistent results were also observed when analyzing 25(OH)D as a categorical variable (quartile). Compared to group Q1, both group Q3 (HR = 0.71, 95 % CI 0.54‒0.93) and group Q4 (HR = 0.72, 95 % CI 0.55‒0.94) exhibited a significantly reduced mortality risk. Weighted restricted cubic splines revealed an inverse J-shaped linear association between levels of 25(OH) D and all-cause mortality ((PNonliner > 0.05). Subgroup analysis and sensitivity analysis yielded similar findings.

Conclusions

All-cause mortality and cardiovascular disease-related mortality were significantly increased by lower 25(OH)D levels, both as continuous and categorical variables. 25(OH)D has an inverse J-shaped linear association with all-cause and cardiovascular mortality.

背景:维生素 D 不足是慢性肾脏病患者普遍存在的问题。本研究旨在确定血清 25(OH)D 水平是否与慢性肾脏病患者的全因死亡率和心血管死亡率相关:为了研究 25(OH)D 水平与心血管死亡率之间的关系,这项回顾性队列研究使用了美国国家健康与营养调查(NHANES)和美国国家死亡指数(NDI)2007-2018 年数据库。本研究共纳入了2668名符合条件的受试者,随访至2019年12月31日。研究采用 Cox 比例危险回归、限制性三次样条、Kaplan-Meier 生存曲线和竞争风险生存分析对相关性进行了评估。此外,还进行了亚组和敏感性分析:在由 11,715,452 名合格参与者组成的加权人群中,在 72 个月的中位随访期间,共有 665 人死于任何原因,其中包括 196 例心血管相关死亡。调整协变量后,25(OH)D 水平较低与全因死亡(HR= 0.85,95 % CI 0.77∼0.94)和心血管死亡(SHR= 0.80,95 % CI 0.67∼0.94)风险增加显著相关。将 25(OH)D 作为分类变量(四分位数)进行分析时,也观察到了一致的结果。与 Q1 组相比,Q3 组(HR = 0.71,95 % CI 0.54-0.93)和 Q4 组(HR = 0.72,95 % CI 0.55-0.94)的死亡风险显著降低。加权限制性三次样条显示,25(OH)D水平与全因死亡率之间存在反J型线性关系(PNonliner > 0.05)。分组分析和敏感性分析也得出了类似的结果:结论:无论是连续变量还是分类变量,全因死亡率和心血管疾病相关死亡率都会因 25(OH)D 水平较低而显著升高。25(OH)D与全因死亡率和心血管死亡率呈反向J形线性关系。
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引用次数: 0
Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor 不同麻醉方法对无痛分娩初产妇分娩过程及产后血清雌激素和孕酮水平的影响。
IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-01-01 DOI: 10.1016/j.clinsp.2024.100442
JunYan Liu , ChongLai Shi , Dan Wang , XiaoDong Cui , LiLi Geng , JingJing Cui , DongMei Sun , Zhuo Yin

Objective

To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor.

Methods

60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal & Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods.

Results

At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal & Continuous epidural anesthesia group were signally lower than those in the Spinal & Continuous epidural anesthesia group (p < 0.05). Spinal & Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p < 0.05). SAS and SDS scores of the Spinal & Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p < 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal & Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p < 0.05). The total incidence of postoperative complications in the Spinal & Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p < 0.05).

Conclusion

Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.

目的方法:选取60例接受无痛分娩的初产妇作为研究对象,将其分为脊柱及连续硬膜外麻醉组(30例)或连续硬膜外麻醉组(30例),采用相应的麻醉方法进行麻醉。作者比较了不同时期的血清雌激素和孕激素、炎症指数表达、疼痛程度和新生儿健康状况:结果:在T2和T3,椎管内连续硬膜外麻醉组的血清P、LH、FSH和E2水平明显低于椎管内连续硬膜外麻醉组(P < 0.05)。与连续硬膜外麻醉组相比,脊髓和连续硬膜外麻醉组的感觉阻滞和运动阻滞发生更快,持续时间更长(P < 0.05)。脊髓连续硬膜外麻醉组的 SAS 和 SDS 评分明显低于连续硬膜外麻醉组(P < 0.05)。在T2和T3,脊柱连续硬膜外麻醉组孕妇的VAS评分和血清TNF-α、IL-6水平明显低于连续硬膜外麻醉组(P<0.05)。脊柱和连续硬膜外麻醉组的术后并发症总发生率明显低于连续硬膜外麻醉组(P < 0.05):结论:椎管内麻醉联合连续硬膜外麻醉对初产妇的无痛分娩有较好的麻醉效果,能有效改善产程及血清雌激素和孕激素的表达。
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引用次数: 0
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