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避孕失败与根据末次月经开始日期估算受孕日有关
Contraceptive failure related to estimated cycle day of conception relative to the start of the last bleeding episode
Wiebe ER, Trussell J  2010/8/19 14:02:00 
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Contraception, 2009,
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Background:
The objective of this study was to estimate the menstrual cycle day of conception in women presenting for abortion.

Study Design:
This was a retrospective chart survey in two urban free-standing abortion clinics.

Results:
There were 913 charts reviewed of women presenting for an abortion at less than 63days' gestation as determined by endovaginal ultrasound who were “sure” of the date of their last normal menstrual period. The estimated mean cycle day of conception determined by sonographically estimating length of gestation was 14.6. There were 26 (26.3%) of 99 women using cyclic hormonal contraception who conceived before 10days after the onset of withdrawal bleeding compared to 100 (14.7%) of 679 who conceived before 10days after the onset of their last menstrual period who were using all other forms of contraception, including “none” (p=.005). No other differences in the proportions conceiving early in the cycle were observed with respect to age, ethnicity or obesity.

Conclusion:
These data suggest that there is a sizeable subset of women who ovulate earlier after onset of withdrawal bleeding when using 21/7 hormonal contraceptives than after onset of menses when not using hormonal contraception. It is possible that women using hormonal contraceptives may have a higher risk of pregnancy if they ovulate sooner after the onset of bleeding.
 
Cycle Day of Conception Cyclic Hormonal Contraception All Other Methods of Contraception p Value
1–9 26 (26.3%) 100 (14.7%) 0.005
10–40 73 (73.7%) 579 (85.3%)  
Total 99 (100%) 679 (100%)  

Table 2: Estimated Cycle Day of Conception Relative to the Start of the Last Bleeding Episode Among 778 Women Presenting for Abortion by Use of Cyclic Hormonal Contraceptives vs. Other Methods
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甲状腺功能亢进合并黄疸

 王燕燕 王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
 

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