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Background: Induction of labour at term is a common obstetric intervention. Prostaglandin E2 has been the agent of choice for pre-induction of cervical ripening for several decades. In recent time, prostaglandin E1 analogue (misoprostol) is a preferred new agent for pre-induction cervical ripening and labour induction owing to inexpensive, stable in room temperature, administrable through several routes. The ideal dose, route, and frequency of administration of misoprostol are still under investigation.Methods: A double blind parallel group placebo control randomized clinical trial was done in the department of obstetrics and gynecology of Agartala Govt. Medical College among 130 pregnant women those required induction of labour. In this clinical trial, the women were allocated by lottery to receive oral misoprostol (25 μg) and vaginal placebo (same dosage) or vaginal misoprostol (25 μg) and oral placebo (same dosage. Both active and placebo drug (25 mcg) were repeated at 4 hours. interval till the parturient reached active labour (not exceeding 5 doses). Both primary (induction delivery interval) and secondary outcomes (failed induction, vaginal/caesarean delivery rate, maternal and foetal complications) were statistically analyzed.Results: The mean induction delivery interval (primary outcome) differences were insignificant among both groups (oral versus vaginal). Success rate of induction (56.9% versus 75.4%), mean dosage (misoprostol 90.5 mcg versus 96 mcg) requirement, maternal and foetal complications was indifferent among two groups. The rate of vaginal delivery (within 24 hours of induction) was significantly higher when misoprostol was used through vaginal route. Caesarean section rate trends to be higher when misoprostol was administered orally.Conclusions: Low dose of misoprostol (25 mcg) offer an additional statistically significant clinical advantage in successful vaginal delivery when used vaginally.
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Objective:To investigate the effect of different angles of atomizer on the delivery rates and total delivery quantities of Tanreqing inhalation solution， so as to provide reference for the clinical use of this preparation. Method:Taking baicalin， ursodeoxycholic acid， caffeic acid as indexes， PARI Boy SX compression atomization inhaler （equipped with red core atomizing cup） and BRS2000 respiratory simulator were used， the effects of different angles of the atomizer （upper 15 degree， lower 15 degree， upper 30 degree， lower 30 degree， partial 15 degree， partial 30 degree， vertical） on the delivery rates and total delivery quantities of Tanreqing inhalation solution were investigated. The respiratory patterns of adults， children， infants and young children were selected to determine the delivery rates and total delivery quantities of three components in Tanreqing inhalation solution. Result:In the same atomization time， the delivery rates and the total delivery quantities of caffeic acid and ursodeoxycholic acid in Tanreqing inhalation solution were not significantly affected by the atomizer from different angles， but significantly affected baicalin. At the vertical angle， the delivery rate and total delivery quantity of baicalin were higher than the other angles. Under different respiratory modes， there were significant differences in the delivery rates and total delivery quantities of these three components in the inhalation solution. Compared with other respiratory modes， the delivery rates and total delivery quantities of baicalin， ursodeoxycholic acid and caffeic acid were the highest in the adult respiratory mode， with delivery rates of （555.5±16.61）， （226.3±6.54）， （26.1±0.32） μg·min-1 and total delivery quantities of （4 001.1±82.97）， （1 754.9±63.73）， （167.6±1.42） μg， respectively. Conclusion:The use angle of atomizer has a certain effect on the delivery rate and total delivery quantity of Tanreqing inhalation solution， so it is suggested that the vertical angle should be kept as far as possible in clinical use. Under the four respiratory patterns， the delivery rate and total delivery quantity of Tanreqing inhalation solution are different， suggesting that the atomization dose or atomization time should be adjusted according to the respiratory characteristics of the patients to ensure the safety and effectiveness of clinical medication.
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Objective To calculate the standardized cesarean delivery rate by considering the individual characteristics of puerprae, and to evaluate the medical quality of obstetrics in the hospital. Methods Medical records of 69 406 puerprae from January to December in 2016 were collected from 33 tertiary general hospitals in Shanxi province. A logistic regression model was used to construct a maternal risk adjustment model of cesarean delivery, with the area under the ROC curve (AUC) used to evaluate the goodness of fit of the model. Results Of the 69 406 puerprae, 30 881 used caesarean delivery, accounting to 44. 37% . The cesarean section rate difference was statistically significant among those of different age, nationality, conditions upon admission, whether to participate in a clinical pathway, fetus number, birth weight and maternal gestational age, as well as the severity of complications (P< 0. 001). According to the logistic model, those of older age, history of cesarean delivery, twins or triplet births, neonatal overweight, malposition, placenta previa, and those with various pregnancy complications tend to use maternal cesarean section surgery, with a goodness-of-fit of 0. 82. With risk adjusted, the ranking of actual cesarean section rate and standardized cesarean section rate varies among the hospitals. Conclusions With the factor of puerprae factor adjusted, the standardized cesarean delivery rate can eliminate risk factors of the puerprae, it is feasible to scientifically evaluate the cesarean delivery rate of the hospital′s obstetric department.
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Objective:To explore the influence of new labor standards on the indications in the birth process and the prognosis of mothers and infants.Methods:186 cases treated in our hospital from January,2015 to January,2016 were divided into the observation group (85 cases) and the control group (101 cases),the observation group received new labor standards,the control group adopt Friedman labor standards.The clinical indications,pregnant complications,pregnant outcome,neonatal-perinatal outcome were compared between two groups.Results:The cesarean delivery rate,number of using oxytocin,forceps delivery rate of observation group were significantly lower than those of the control group(P＜0.05);the duration time of both first and second stage of labor were obviously longer than those of the control group (P＜0.05);the duration time of active phase,bleeding volume in birth process in both groups showed no statistical difference (P＞0.05);there was no adverse maternal and infant events in both groups;the incidence rate of pregnancy complications,fetal distress in uterus,asphyxia neonatorum and neonatal body weight were of no statistical difference (P＞0.05).Conclusion:The new labor standards prolong the duration time of birth and give women fully trial opportunities,could effectively reduce the rate of cesarean section,reduce the over intervention production.
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OBJECTIVE: To evaluate the feasibility and image quality (IQ) of prospectively high-pitch coronary CT angiography (CCTA) with low contrast medium injection rate at 70 kVp. MATERIALS AND METHODS: One hundred and four patients with suspected coronary artery disease (body mass index < 26 kg/m², sinus rhythm and heart rate < 70 beats/min) were prospectively enrolled and randomly divided into two groups. In group A and group B, 28 mL and 40 mL of 370 mgI/mL iodinated contrast media was administrated at a flow rate of 3.5 and 5 mL/s, respectively. CT values, noise, signal-to-noise ratio, contrast-to-noise ratio (CNR) of the proximal segments of coronary arteries and subjective IQ were evaluated. RESULTS: The CT values and noise in group A were significantly lower than those in group B (434–485 Hounsfield units [HU] vs. 772–851 HU, all p < 0.001; 17.8–22.3 vs. 23.3–26.4, all p < 0.005). The CNRs of the right coronary artery and left main artery showed no statistical difference between the two groups (42.1 ± 13.8 vs. 36.8 ± 16.0, p = 0.074; 38.7 ± 10.6 vs. 38.1 ± 17.0, p = 0.819). No statistical difference was observed between the two groups in IQ scores (3.04 ± 0.75 vs. 3.0 ± 0.79, p = 0.526) and diagnostic ratio (96.1% [50/52] vs. 94.2% [49/52], p = 0.647). CONCLUSION: Prospective high-pitch CCTA at 70 kVp with 28 mL of contrast media and injection rate of 3.5 mL/s could provide diagnostic IQ for normal-weight patients with heart rate of < 70 beats/min.
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Humans , Angiography , Arteries , Contrast Media , Coronary Artery Disease , Coronary Vessels , Heart Rate , Noise , Prospective Studies , Signal-To-Noise RatioABSTRACT
OBJECTIVE: To evaluate the feasibility and image quality (IQ) of prospectively high-pitch coronary CT angiography (CCTA) with low contrast medium injection rate at 70 kVp. MATERIALS AND METHODS: One hundred and four patients with suspected coronary artery disease (body mass index < 26 kg/m², sinus rhythm and heart rate < 70 beats/min) were prospectively enrolled and randomly divided into two groups. In group A and group B, 28 mL and 40 mL of 370 mgI/mL iodinated contrast media was administrated at a flow rate of 3.5 and 5 mL/s, respectively. CT values, noise, signal-to-noise ratio, contrast-to-noise ratio (CNR) of the proximal segments of coronary arteries and subjective IQ were evaluated. RESULTS: The CT values and noise in group A were significantly lower than those in group B (434–485 Hounsfield units [HU] vs. 772–851 HU, all p < 0.001; 17.8–22.3 vs. 23.3–26.4, all p < 0.005). The CNRs of the right coronary artery and left main artery showed no statistical difference between the two groups (42.1 ± 13.8 vs. 36.8 ± 16.0, p = 0.074; 38.7 ± 10.6 vs. 38.1 ± 17.0, p = 0.819). No statistical difference was observed between the two groups in IQ scores (3.04 ± 0.75 vs. 3.0 ± 0.79, p = 0.526) and diagnostic ratio (96.1% [50/52] vs. 94.2% [49/52], p = 0.647). CONCLUSION: Prospective high-pitch CCTA at 70 kVp with 28 mL of contrast media and injection rate of 3.5 mL/s could provide diagnostic IQ for normal-weight patients with heart rate of < 70 beats/min.
Subject(s)
Humans , Angiography , Arteries , Contrast Media , Coronary Artery Disease , Coronary Vessels , Heart Rate , Noise , Prospective Studies , Signal-To-Noise RatioABSTRACT
Objective By testing the particle removal efficiency of LG Electronics Company's two types of plasma air cleaners,to explore more scientific and reasonable methods for evaluating the purifying effectiveness of indoor air cleaners so as to obtain scientific and contrastable experimental data and calculating results. Methods This evaluating method referred to Standard Examination Method of Portable Household Electric Cord-Connected Room Air Cleaners of America (ANSI/AHAM AC-1-2000) and used one of indexes regu lated in standard Clean Air Delivery Rate (CADR) as the main evaluating index of the effectiveness of indoor air cleaners,meantime several kinds of domestic and international current evaluating indexes were adopted to synthetically evaluate decontaminating function of the air cleaners. Results The index of CADR could accurately and objectively manifest the true decontaminating function of indoor air cleaner. But if using the index of purifying efficiency to reflect the purifying effectiveness of air cleaners,pollutant's natural decay rate and initial concentration should be considered and at the same time other experimental conditions should be given out. Conclusion The establishments of accurate testing methods and accurate expressions of testing results were the sufficient and essential conditions for accurate evaluation on testing objectives.