BACKGROUND & AIMS: :This paper examines the association between social networks and contraceptive use. Using data from a survey of women belonging to voluntary associations in Yaoundé, Cameroon, we find that the behavior and characteristics of the members of a respondent's personal networks are associated with her contraceptive use, over and above a set of her own individual characteristics that are usually found to be important. Respondents who report that their network partners approve of contraception, use it, and encourage the respondent to use are more likely to use contraception themselves; the association with encouragement is particularly strong. Moreover, there is a strong association between the specific methods of contraception used by a respondent and those used by her network partners, suggesting that members of personal networks exchange and evaluate specific methods. Because most of the respondent's network partners were interviewed, we are able to compare the respondent's perceptions of contraceptive use by her network partners with the network partner's actual use. We find that it is perceptions of use that matter, even if those perception are incorrect.

背景与目标： : 本文研究了社交网络与避孕药具使用之间的关联。使用来自喀麦隆雅温得自愿协会的妇女的调查数据，我们发现受访者个人网络成员的行为和特征与她的避孕药具使用有关，超出了她自己的一系列个人特征，通常被发现很重要。报告自己的网络伴侣赞成避孕，使用避孕并鼓励受访者使用避孕的受访者更有可能自己使用避孕措施; 与鼓励的联系特别强烈。此外，受访者使用的特定避孕方法与她的网络合作伙伴使用的避孕方法之间存在很强的联系，这表明个人网络成员交换和评估特定方法。由于大多数受访者的网络合作伙伴都接受了采访，因此我们能够将受访者对其网络合作伙伴使用避孕药具的看法与网络合作伙伴的实际使用情况进行比较。我们发现，重要的是对使用的感知，即使这些感知是不正确的。

BACKGROUND & AIMS: BACKGROUND:The study was conducted to compare the antifertility effectiveness and side effects of the copper/low-density polyethylene nanocomposite IUD (experimental group) and the copper T220C IUD (control group). STUDY DESIGN:One hundred females were randomly divided into two groups (experimental group and control group, n = 50 in each group). Clinical observation and comparative study were performed on the two groups for 12 months. RESULTS:Follow-up rate was 100% at the 12th month. In the experimental group and control group, the cumulative continuation rates were both 92.0 per 100 women at the 12th month and there was no difference between them (p > .05). The pregnancy rate, removal rate and expulsion rate were low with the difference being not statistically significant (p>.05). The most common side effects were excessive menstrual bleeding, spotting and pain. The rates of side effects were lower in the experimental group than in control group, especially during the initial 3 months after insertion with the differences being statistically significant (p < .05). CONCLUSION:The new design of the copper/low-density polyethylene nanocomposite IUD showed low pregnancy rate, high contraceptive efficacy and satisfactory acceptability. The study suggested that the TCu220C IUD also had high contraceptive efficacy, but had relatively more side effects.

背景与目标：

BACKGROUND & AIMS: :Currently developed progesterone receptor modulators (PRMs) are steroid-derived compounds with mild or potent antiprogestin activity. PRMs may exert a contraceptive activity by different mechanisms such as blockade of ovulation and endometrial desynchronization. Their potential clinical applications are manifold and are very promising in major public health areas, including emergency contraception, long term oestrogen-free contraception (administered alone, or in association with a progestin-only pill to improve bleeding patterns), endometriosis and myoma treatment. The mechanisms of their anti-ovulatory effects and of the endometrial modifications elicited during long term PRM treatment are still not fully elucidated. In future clinical applications, PRMs will be administered orally, via intrauterine systems or vaginal rings.

背景与目标： : 目前开发的孕激素受体调节剂 (prm) 是具有温和或有效抗孕激素活性的类固醇衍生化合物。PRMs可能通过不同的机制 (例如排卵阻断和子宫内膜失步) 发挥避孕活性。它们的潜在临床应用是多方面的，并且在主要公共卫生领域非常有前途，包括紧急避孕，长期无雌激素避孕 (单独使用或与仅孕激素药联合使用以改善出血模式)，子宫内膜异位症和肌瘤治疗。在长期PRM治疗期间，其抗排卵作用和子宫内膜修饰的机制仍未完全阐明。在未来的临床应用中，PRMs将通过宫内系统或阴道环口服。

BACKGROUND & AIMS: PURPOSE:Pregnancy rates among adolescents have declined in the U.S. and Britain but remain high compared with other high-income countries. This comparison describes trends in pregnancy rates, recent sexual activity, and contraceptive use among women aged 16-19 years in the U.S. and Britain to consider the contribution of these two behavioral factors to the decline in pregnancy rates in the two countries and the differences between them. METHODS:We use data from two rounds of the U.S. National Survey of Family Growth, conducted 2002-2003 and 2011-2015, and the British National Survey of Sexual Attitudes and Lifestyles, conducted 2000-2001 and 2010-2012, to describe population-level differences between countries and over time in sexual activity and contraceptive use. We calculate pregnancy rates using national births and abortions data. RESULTS:Pregnancy rates declined in both countries; this began earlier in the U.S. and was steeper. There was no change in sexual activity in Britain, but in the U.S., the proportion reporting recent sex declined. In both countries, there was a shift toward more effective contraception. A higher proportion in Britain than the U.S. reported ever having had sex (65% vs. 49%) and sex in the last year (64% vs. 45%), 6 months (59% vs. 39%), and 4 weeks (48% vs. 29%). A higher proportion in Britain reported using more effective contraception (68% vs. 52%). CONCLUSIONS:In both countries, improvements in contraceptive use have contributed substantially to declines in pregnancy rates; however, the steeper decline in the U.S. likely also reflects declines in recent sex occurring only in that country.

背景与目标：

BACKGROUND & AIMS: :Euphorbiaceae plants are important as suppliers of biodiesel. In the current study, the codon usage patterns and sources of variance in chloroplast genome sequences of six different Euphorbiaceae plant species have been systematically analyzed. Our results revealed that the chloroplast genomes of six Euphorbiaceae plant species were biased towards A/T bases and A/T-ending codons, followed by detection of 17 identical high-frequency codons including GCT, TGT, GAT, GAA, TTT, GGA, CAT, AAA, TTA, AAT, CCT, CAA, AGA, TCT, ACT, TAT and TAA. It was found that mutation pressure was a minor factor affecting the variation of codon usage, however, natural selection played a significant role. Comparative analysis of codon usage frequencies of six Euphorbiaceae plant species with four model organisms reflected that Arabidopsis thaliana, Populus trichocarpa, and Saccharomyces cerevisiae should be considered as suitable exogenous expression receptor systems for chloroplast genes of six Euphorbiaceae plant species. Furthermore, it is optimal to choose Saccharomyces cerevisiae as the exogenous expression receptor. The outcome of the present study might provide important reference information for further understanding the codon usage patterns of chloroplast genomes in other plant species.

背景与目标： : 大戟科植物作为生物柴油的供应商很重要。在当前的研究中，已经对六种不同大戟科植物物种的叶绿体基因组序列的密码子使用模式和变异来源进行了系统分析。我们的结果表明，六个大戟科植物的叶绿体基因组偏向A/T碱基和A/T结尾密码子，随后检测到17个相同的高频密码子，包括GCT，TGT，GAT，GAA，TTT，GGA，CAT，AAA，TTA，AAT，CCT，CAA、AGA、TCT、ACT、TAT和TAA。发现突变压力是影响密码子使用变化的次要因素，但是自然选择起着重要作用。6种大戟科植物与4种模式生物密码子使用频率的比较分析表明，拟南芥，毛白杨和酿酒酵母应被视为六种大戟科植物叶绿体基因的合适外源表达受体系统。此外，选择酿酒酵母作为外源表达受体是最佳的。本研究的结果可能为进一步了解其他植物物种中叶绿体基因组的密码子使用模式提供重要的参考信息。

BACKGROUND & AIMS: :We examined the effect of menstrual cycle (MC) phase on acid-base regulation and ventilatory control at rest in monophasic oral contraceptive (OC) users. Twelve healthy women (25+/-1 years; mean+/-S.E.) were tested during the inactive (IP; 5.1+/-0.2 days) and active (AP; 21.1+/-0.7 days) pill phase of the MC. Central and peripheral chemoreflex responsiveness was examined using a modified CO(2) rebreathing procedure. Minute ventilation (V E), breathing pattern and metabolic rate were measured during 10 min of quiet, resting breathing. Blood for the determination of arterial P(CO2) (Pa(CO2)) and hydrogen ion concentration ([H(+)]); plasma concentrations of the strong ion difference ([SID]) and total weak acid ([A(tot)]); serum concentrations of progesterone ([P(4)]) and 17beta-estradiol ([E(2)]) were also obtained. Although [E(2)] (p<0.05) and [A(tot)] (p=0.05) were increased in the IP versus AP, MC phase had no significant effect on resting V E, breathing pattern, metabolic rate, [H(+)], Pa(CO2), [SID], [P(4)] and central or peripheral chemoreflex characteristics. Overall, OC had no significant physiological effect on acid-base regulation or ventilatory control at rest in healthy women. This may reflect suppression of endogenous fluctuations in circulating [P(4)] typically observed across the MC in healthy, eumenorrheic non-OC users.

背景与目标： : 我们检查了单相口服避孕药 (OC) 使用者的月经周期 (MC) 阶段对静息时酸碱调节和通气控制的影响。在MC的非活性 (IP; 5.1 +/-0.2天) 和活性 (AP; 21.1 +/-0.7天) 药丸期测试了12名健康女性 (25 +/-1岁; 平均 +/-S.E.)。使用改良的CO(2) 再呼吸程序检查了中枢和外周化学反射的反应性。在安静的静息呼吸10分钟内，测量分钟通气 (V E)，呼吸方式和代谢率。血液测定动脉P(CO2) (Pa(CO2)) 和氢离子浓度 ([H(+)]); 血浆浓度的强离子差 ([SID]) 和总弱酸 ([A(tot)]); 还获得了孕酮 ([P(4)]) 和17β-雌二醇 ([E(2)]) 的血清浓度。尽管与AP相比，IP中 [E(2)] (p<0.05) 和 [A(tot)] (p = 0.05) 增加，但MC期对静息V E，呼吸方式，代谢率，[H(+)]，pa (CO2)，[SID]，[P(4)] 和中央或外围化学反射特性。总体而言，OC对健康女性休息时的酸碱调节或通气控制没有显着的生理作用。这可能反映了在健康的，正常的非OC用户中，通常在MC中观察到的循环 [P(4)] 内源性波动的抑制。

BACKGROUND & AIMS: :T cells specific for a single viral epitope, but using different T cell receptors, should have flexibility in their epitope recognition to protect the infected host against the emergence of viral escape mutants. Therefore, polyclonality of the hepatitis B virus (HBV)-specific cytotoxic T lymphocyte response has been hypothesized to be a major determinant in the control of infection. We analyzed the Vbeta chain composition of the core 18-27-specific CD8 cells in acute and persistently HBV-infected patients using HLA-A2 tetrameric complexes and a panel of Vbeta antibodies. Different T cell receptors were utilized by core 18-27-specific CD8 cells both in patients with acute and chronic infection. The functional ability of these epitope-specific T cells to respond to potential viral mutations was then tested. The polyclonal HBV-specific CD8 response present in patients with acute hepatitis displayed a limited efficiency to recognize mutations introduced within the epitope. The ability of core 18-27-specific CD8 to tolerate epitope mutations was found only during persistent HBV infection. The data suggest that although a clonally heterogeneous CD8 response can be largely inhibited by the occurrence of single epitope mutations in primary HBV infection, preferential selection of T cells able to counteract the emergence of viral mutations can occur during persistent infection.

背景与目标： : 对单个病毒表位特异的T细胞，但使用不同的T细胞受体，应在其表位识别方面具有灵活性，以保护受感染的宿主免受病毒逃逸突变体的出现。因此，乙型肝炎病毒 (HBV) 特异性细胞毒性T淋巴细胞反应的多克隆性被认为是控制感染的主要决定因素。我们使用HLA-A2四聚体复合物和一组Vbeta抗体分析了急性和持续HBV感染患者中核心18-27特异性CD8细胞的Vbeta链组成。在急性和慢性感染患者中，核心18-27特异性CD8细胞都利用了不同的T细胞受体。然后测试了这些表位特异性T细胞对潜在病毒突变的响应能力。急性肝炎患者中存在的多克隆HBV特异性CD8反应显示出识别表位内引入的突变的有限效率。仅在持续性HBV感染期间发现核心18-27特异性CD8耐受表位突变的能力。数据表明，虽然克隆异质性CD8反应可以在很大程度上抑制原发性HBV感染中发生单表位突变，但能够抵消病毒突变出现的T细胞的优先选择可以在持续感染期间发生。

BACKGROUND & AIMS: CONTEXT:Oral contraceptive (OC) use is weakly associated with breast cancer risk in the general population, but the association among women with a familial predisposition to breast cancer is less clear. OBJECTIVE:To determine whether the association between OC use and risk of breast cancer is influenced by family history of the disease. DESIGN AND SETTING:Historical cohort study of 426 families of breast cancer probands diagnosed between 1944 and 1952 at the Tumor Clinic of the University of Minnesota Hospital. Follow-up data on families were collected by telephone interview between 1991 and 1996. PARTICIPANTS:A total of 394 sisters and daughters of the probands, 3002 granddaughters and nieces, and 2754 women who married into the families. MAIN OUTCOME MEASURE:Relative risk (RR) of breast cancer associated with history of OC use by relationship to proband. RESULTS:After accounting for age and birth cohort, ever having used OCs was associated with significantly increased risk of breast cancer among sisters and daughters of the probands (RR, 3.3; 95% confidence interval [CI], 1.6-6.7), but not among granddaughters and nieces of the probands (RR, 1.2; 95% CI, 0.8-2.0) or among marry-ins (RR, 1.2; 95% CI, 0.8-1.9). Results were essentially unchanged after adjustment for parity, age at first birth, age at menarche, age at menopause, oophorectomy, smoking, and education. The elevated risk among women with a first-degree family history of breast cancer was most evident for OC use during or prior to 1975, when formulations were likely to contain higher dosages of estrogen and progestins (RR, 3.3; 95% CI, 1.5-7.2). A small number of breast cancer cases (n = 2) limited the statistical power to detect risk among women with a first-degree relative with breast cancer and OC use after 1975. CONCLUSIONS:These results suggest that women who have ever used earlier formulations of OCs and who also have a first-degree relative with breast cancer may be at particularly high risk for breast cancer. Further studies of women with a strong family history who have used more recent lower-dosage formulations of OCs are needed to determine how women with a familial predisposition to breast cancer should be advised regarding OC use today. JAMA. 2000;284:1791-1798.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:This analysis provides the final results on cancer incidence in relation to oral contraceptive (OC) use from the Oxford-Family Planning Association (Oxford-FPA) contraceptive study, which closed at the end of 2010. An additional 6 years of observation have been added since our last report and there has been an increase in the numbers of cancers of over 50% at seven of the sites considered. STUDY DESIGN:The Oxford-FPA study includes 17032 women aged 25-39 years recruited from 1968 to 1974 at contraceptive clinics in England and Scotland. These women were using OCs, a diaphragm or an intrauterine device. Information about cancer incidence among them has been collected from recruitment until closure of the study. RESULTS:OC use was not related to nonreproductive cancer. Breast cancer findings (1087 cases) were entirely negative; the rate ratio (RR) comparing ever users of OCs with never users was 1.0 [95% confidence interval (CI): 0.9-1.1]. Only two cases of cervical cancer have been added since our last report (total: 61 cases); the RR comparing ever use with never use is now 3.4 (95% CI: 1.6-8.9). The risk of this disease increases sharply with duration of OC use and declines steadily with interval since last OC use. OC use protects against both uterine body cancer (124 cases) and ovarian cancer (143 cases). The RRs comparing ever use with never use were 0.5 (95% CI: 0.3-0.7) and 0.5 (95% CI: 0.4-0.7), respectively. Protection against both these cancers increased with duration of OC use and waned with interval since last use, but an effect was still present 28 or more years after discontinuation. CONCLUSIONS:In our study, OC use had no effect on nonreproductive cancers or on breast cancer. The risk of cervical cancer was increased and that of uterine body cancer and ovarian cancer was decreased by OC use. All these effects increased with duration of use and declined with interval since last use. The beneficial effects of OC use on cancer outweighed the adverse effects. These findings should reassure older women who used OCs in the past.

背景与目标：

BACKGROUND & AIMS: PURPOSE:Oral contraceptive use decreases the risk of ovarian cancer, but no previous studies have assessed the impact of cumulative intake of estrogen and progestin on ovarian cancer risk. METHODS:We used data from a population-based case–control study conducted in Denmark in 1995–1999 among women aged 35–79 years; 554 women with epithelial ovarian cancer and 1,564 age-matched controls were included in the analyses. Data were analyzed in multiple logistic regression models. RESULTS:The use of combined oral contraceptives only and the mixed use of combined and progestin-only pills decreased the risk of ovarian cancer, while no association was found with exclusive use of progestin-only pills. No major differences in risk were found for users of combined oral contraceptives with high- and low-potency estrogen and progestin. There was no effect of cumulative progestin intake, but decreased risks of ovarian cancer with increasing cumulative intake of estrogen (OR = 0.82; 95 % CI 0.67–0.99, per 100 mg estrogen) and increasing duration of oral contraceptive use (OR = 0.95; 95 % CI 0.92–0.98, per year of use) were found. No effect of cumulative estrogen intake was found, however, after adjustment for duration of oral contraceptive use. CONCLUSIONS:The protective effect of oral contraceptives against ovarian cancer may be sufficiently explained by duration of anovulation. This suggests that if the estrogen and progestin doses are sufficient to cause anovulation, a higher intake of estrogen or progestin confers no extra protection against ovarian cancer.

背景与目标：

BACKGROUND & AIMS: :Malawi has one of the highest Contraceptive Prevalence Rate (CPR) in Sub-Saharan Africa. However, fertility remains high and fertility decline is slow. This paper uses data from the 2000 and 2004 Demographic and Health Surveys to examine correlates of contraceptive use among currently married women in Malawi. Bivariate and multivariate logistic regression analyses were used to establish the relationships between socioeconomic variables and current use of contraception. The results show that the major determinants of contraceptive use are age, respondents' and partners' approval of family planning, family planning discussion with partner, number of living children, work status, education and visit to a health centre. As a policy measure, information, education and communication programmes on family planning should be intensified, particularly in rural areas and targeting men.

背景与目标： : 马拉维是撒哈拉以南非洲地区避孕患病率最高的国家之一。然而，生育率仍然很高，生育率下降缓慢。本文使用来自2000和2004人口和健康调查的数据来检查马拉维目前已婚妇女中避孕药具使用的相关性。使用双变量和多变量logistic回归分析来建立社会经济变量与当前避孕方法之间的关系。结果表明，使用避孕药具的主要决定因素是年龄，受访者和伴侣对计划生育的认可，与伴侣的计划生育讨论，活着的孩子数量，工作状况，教育程度以及去卫生中心的访问。作为一项政策措施，应加强关于计划生育的信息、教育和宣传方案，特别是在农村地区，并针对男子。

BACKGROUND & AIMS: :The international population policy agenda has traditionally been dominated by demographically driven population control policies. However, in the population policy development that preceded the International Conference on Population and Development in 1994, people's reproductive needs and rights received more emphasis. The aim of this study was to analyze how the new emphasis in population policies has been interpreted at the country level. In analyzing population policy rhetoric and its practical interpretations in India in 1994, the authors found that the rhetoric was broadening to encompass women's empowerment and reproductive health and that the use of direct method-specific monetary incentives and disincentives for accepting family planning methods was disapproved. However, population policy options were still considered mainly in terms of their ability to reduce fertility. Furthermore, the increased emphasis on the general market agenda was more important than that on reproductive needs and rights in molding population policies, as was evident in the greater stress on cost-recovery systems and nongovernmental actors. The findings suggest that the broader agenda for population policies and reproductive rights has been interpreted so that it can serve the aims of population-growth control and be implemented in the context of more market-oriented social policies and trade liberalization.

背景与目标： : 国际人口政策议程历来由人口主导的人口控制政策主导。然而，在国际人口与发展会议1994年之前的人口政策制定中，人们的生殖需求和权利得到了更多的重视。这项研究的目的是分析如何在国家一级解释人口政策的新重点。在分析印度1994年的人口政策言论及其实际解释时，作者发现，这些言论正在扩大到包括妇女赋权和生殖健康，并且不赞成使用针对具体方法的直接货币激励措施和禁止措施来接受计划生育方法。然而，人口政策选择仍然主要是根据其降低生育率的能力来考虑的。此外，在制定人口政策方面，对总体市场议程的重视比对生殖需求和权利的重视更为重要，这在对成本回收系统和非政府行为者的更大压力中显而易见。调查结果表明，对人口政策和生殖权利的更广泛议程进行了解释，以便能够为控制人口增长的目标服务，并在更加面向市场的社会政策和贸易自由化的背景下实施。

BACKGROUND & AIMS: Oxygen consumption, CO2 excretion, and nitrogenous waste excretion (75% ammonia-N and 25% urea-N) were measured daily in 4-g rainbow trout over a 15-day starvation period. Oxygen consumption and CO2 excretion declined while N excretion increased transiently in the mid-part of the starvation period but was unchanged from control levels at the end. Component losses (as percentage of total fuel used) of protein, lipid, and carbohydrate were 66.5, 31.1, and 2.4% respectively, as measured from changes in body weight and body composition, the latter relative to a control group at day 0. Instantaneous fuel use, as calculated from the respiratory quotients and nitrogen quotients, indicated that relative protein use rose during starvation, but contributed at most 24% of the aerobic fuel (as carbon). Lipid metabolism fell from about 68 to 37%, and was largely replaced by carbohydrate metabolism which rose from 20 to 37%. We conclude that the two approaches measure different processes, and that the instantaneous method is preferred for physiological studies. The compositional method is influenced by greater error, and measures the fuels depleted, not necessarily burned, because of possible interconversion and excretion of fuels.

背景与目标： 在15天的饥饿期内，每天测量4克虹鳟鱼中的耗氧量，CO2排泄和含氮废物排泄 (75% 氨氮和25% 尿素氮)。在饥饿期的中期，耗氧量和CO2排泄量下降，而N排泄量短暂增加，但与末控制水平持平。蛋白质、脂质和碳水化合物的组分损失 (占总燃料的百分比) 分别是66.5、31.1和2.4%，这是根据体重和身体组成的变化测量的，后者相对于第0天的对照组。根据呼吸商和氮商计算得出的瞬时燃料使用量表明，饥饿期间相对蛋白质使用量增加，但最多贡献了需氧燃料 (如碳) 的24%。脂质代谢从大约68下降到37%，并被从20上升到37% 的碳水化合物代谢所取代。我们得出的结论是，这两种方法可以测量不同的过程，并且瞬时方法是生理学研究的首选方法。组成方法受到更大误差的影响，并且由于燃料的可能相互转化和排泄而测量消耗的燃料 (不一定燃烧)。

BACKGROUND & AIMS: The purpose of this randomized, double-blind, clinical trial was to determine whether intraoperative, intramuscular (IM) injections of meperidine or ketorolac would improve postoperative pain relief in patients undergoing elective laparoscopic cholecystectomy. A total of 125 patients were entered into five study groups1) (N = 23) control placebo; 2) (N = 31) meperidine 100 mg IM intraoperative preprocedure; 3) (N = 20) meperidine 100 mg IM intraoperative postprocedure; 4) (N = 25) ketorolac tromethamine 60 mg IM intraoperative preprocedure; 5) (N = 26) ketorolac tromethamine 60 mg IM postprocedure. All groups were analyzed by comparing the amount of pain medication received in the recovery room, the time until first oral pain medication was requested, the overall amount of pain medication used in the first 24 hours, the percent requiring IM medication, and the pain score ratings from each group. There was decreased pain medication usage in the recovery room in all groups compared to control (P < 0.05). Group 4 had a longer painfree interval than meperidine groups or control. Both Groups 4 and 5 had decreased postoperative narcotic usage. Finally, the analogue pain scores showed that both ketorolac groups had significantly less postoperative pain compared to control, whereas the meperidine groups showed no improvement in postoperative pain relief. Intraoperative ketorolac given preprocedure or postprocedure significantly improved postoperative pain management and facilitated the transition to oral pain medication.

背景与目标： 这项随机，双盲，临床试验的目的是确定术中，肌肉 (IM) 注射哌替啶或酮咯酸是否可以改善接受选择性腹腔镜胆囊切除术的患者的术后疼痛缓解。共有125例患者进入五个研究组1 (N = 23) 对照安慰剂; 2) (N = 31) 哌替啶100 mg IM术中术前; 3) (N = 20) 哌替啶100 mg IM术中术后; 4) (N = 25) 酮洛酸氨丁三醇60 mg IM术中术前; 5) (N = 26) 酮洛酸氨丁三醇60 mg IM术后。通过比较恢复室中接受的止痛药量，要求首次口服止痛药的时间，最初24小时内使用的止痛药总量，需要IM药物的百分比以及每组的疼痛评分来分析所有组。与对照组相比，所有组在恢复室的止痛药使用量均减少 (P <0.05)。第4组的无痛间隔时间比哌替啶组或对照组更长。第4组和第5组术后麻醉药物使用量均减少。最后，模拟疼痛评分显示，与对照组相比，酮咯酸组的术后疼痛明显减少，而哌替啶组的术后疼痛缓解没有改善。术中给予酮咯酸术前或术后可显着改善术后疼痛管理，并促进了口服止痛药的过渡。

BACKGROUND & AIMS: :The occurrence of upper gastrointestinal disease and the relevance of nonsteroidal antiinflammatory drug (NSAID) usage were documented in 511 consecutive patients (321 women, 190 men) over 70 yr old, referred for upper gastrointestinal endoscopy in a district general hospital. The findings were benign esophageal disease (43%), normal (15%), gastric ulcer (11.5%), and duodenal ulcer (11%). Gastric ulcers were more common in women taking NSAIDs (25%) than in NSAID abstainers (7%) p less than 0.001 and male NSAID users (8%) p less than 0.001. Esophagitis and esophageal stricture were not influenced by NSAID usage, but gastric erosions were more common (10% vs. 3%) p less than 0.01. Of 142 patients receiving NSAIDs, 41% presented with hemorrhage, compared with 20.5% of NSAID abstainers (p less than 0.001). Hemorrhage was as common in aspirin takers (15 of 33, 45%) as in standard-dose NANSAID takers (43 of 109, 39%), even though 86% were taking 300 mg of aspirin per day or less. In elderly patients, esophageal disease is common. NSAID use, even low-dose aspirin, is associated with an increased risk of hemorrhage. In females, NSAID usage is associated with gastric ulcer.

背景与目标： : 在地区综合医院接受上消化道内窥镜检查的连续511例患者 (321例女性，190例男性) 中记录了上消化道疾病的发生和非甾体抗炎药 (NSAID) 使用的相关性。结果为良性食管疾病 (43%)，正常 (15%)，胃溃疡 (11.5%) 和十二指肠溃疡 (11%)。服用NSAID (25%) 的女性比NSAID戒除者 (7%) p小于0.001和男性NSAID使用者 (8%) p小于0.001的女性更常见胃溃疡。食管炎和食管狭窄不受NSAID使用的影响，但胃糜烂更常见 (10% 比3%) p小于0.01。在接受NSAID的142例患者中，41% 例出现出血，而NSAID戒除者的20.5% 例 (p小于0.001)。即使86% 每天服用300毫克或更少的阿司匹林，出血在阿司匹林接受者 (33人中的15人，45%) 与标准剂量NANSAID接受者 (109人中的43人，39% 人) 中一样常见。在老年患者中，食道疾病很常见。使用NSAID，即使是低剂量的阿司匹林，也会增加出血的风险。在女性中，使用NSAID与胃溃疡有关。