移植部位和外源性激素刺激时间对人胎卵巢组织异种移植后卵泡发育的影响

目的:探讨移植部位和外源性激素刺激时间对胎儿卵巢组织异种移植后卵泡发育的影响.方法:将胎儿卵巢组织移植到裸鼠背部皮下和肾被膜下,移植1个月后开始隔天腹腔注射PMSG 5 IU,分别于移植后10～14 w、18～22 w、26-30 w取材,通过石蜡包埋切片进行组织学评价和免疫组织化学技术(增殖细胞核抗原,PCNA)分析.结果:肾被膜下组移植物回收率显著高于背部皮下组(95.8%～70.8%),但两组组织存活率比较差异无显著性(83.3%～62.5%),各个移植组中每高倍视野下的原始卵泡数与对照组相比都呈显著下降(P＜0.05),术后10 w移植物中已见初级及次级卵泡的发育,18 w有窦卵泡的发育.结论:胎儿卵巢组织异种移植后能存活且外源性促性腺激素下其原始卵泡在4个月左右发育到窦卵泡阶段;背部皮下和肾被膜下均为适合移植物中卵泡发育的部位.     

裸鼠皮下移植卵巢组织的组织学研究

目的探讨人胎儿卵巢组织移植于裸鼠皮下后的卵泡生长发育情况。方法28只裸鼠行去势手术后分为3组：0组为对照组；A组为新鲜胎儿卵巢组织移植组；B组为冻融人胎儿卵巢组织移植组。A、B两组均于移植1个月后开始隔天注射5IU的马血清促性腺激素（PMSG）持续2个月，获取移植物36h前注射HCG。将获取胎儿卵巢组织进行光学显微镜的观察。结果移植后存活P的卵巢组织中有40％哆50％的原始卵泡丢失。A、B两组中均以原始卵泡为主，可见少量初级卵泡和次级卵泡，未见窦卵泡的生长。移植后人胎儿卵巢组织中初级卵泡和次级卵泡的比例较移植前显著增加（P〈0．01）,A、B两组相比，各级卵泡比例无显著性差异（P〉0．05）。结论冻融人胎儿卵巢组织移植于裸鼠的背部皮下青皂存活，其卵泡处于良好的生长发育状态。     

人胎儿卵巢组织异种移植后卵母细胞的发育及成熟能力

目的探讨人胎儿卵巢组织冷冻复苏、体外培养和异种移植后卵母细胞的发育和成熟情况。方法取5例胎龄20周引产的胎儿卵巢,采用丙二醇慢速冷冻保存,复苏后在组织培养条件下进行体外培养,6d后移植到免疫缺陷小鼠的肾被膜下,应用卵泡刺激激素作用23周后取出卵巢组织,机械法取出窦卵泡内的卵母细胞,结合体外成熟培养,观察卵子成熟情况,并通过移植前后组织学和增殖细胞核抗原(PCNA)表达变化观察卵泡发育情况。结果冷冻复苏组织和新鲜卵巢组织中各期卵泡的构成比之间差异无显著性(P>0.05);培养组织与新鲜组织和冻融组织相比,增殖期卵泡的比例显著增加(P<0.05);移植组织与新鲜组织、冻融组织和培养组织相比,增殖期卵泡比例亦显著增加(P<0.05)。各组织中原始卵泡均未见PCNA阳性表达,其表达最早出现于初级卵泡,新鲜组织和冻融组织中偶可见PCNA阳性表达,而培养组织和移植组织中可见明显的PCNA阳性表达。从移植卵巢的窦卵泡中获得未成熟卵子42个,经体外成熟培养有21.43%的卵子可发育到MII期。结论人胎儿卵巢组织能耐受冻融、组织培养和移植过程,其卵泡能够重新生长发育,恢复内分泌功能,且不影响卵母细胞的发育及成熟能力。     

人胎儿卵泡发育及培养时对促性腺激素反应的形态学研究

取人胎儿卵巢19例作体外培养,观察培养前后与加不同比例促性腺激素后的卵巢形态学变化。培养维持最长达6d。随妊娠进展,胎儿卵泡逐渐生长,自16周起胎儿卵巢在体外就有对促性腺激素起反应的潜力。24周以上的胎儿卵巢可见窦前期和窦期卵泡,伴有透明带基膜和泡膜细胞形成。给予适当剂量的促性腺激素(FSH、LH或hMG)体外培养,可维持培养前的良好状态,不加激素组则易见卵泡闭锁。本文19例胎儿卵巢加激素培养未见发育到较大的窦状卵泡。     

外源性促性腺激素治疗低促性腺激素性闭经不孕症患者的临床疗效

目的：探讨外源性促性腺激素治疗低促性腺激素性闭经不孕症患者的临床治疗效果。方法选取150例低促性腺激素性闭经不孕症患者,对患者行外源性促性腺激素治疗方案,观察治疗效果。结果9例卵泡发育成熟,但其数量＞3,同时对绒毛膜促性腺激素注射和妊娠计划进行放弃;35例患者卵泡发育成熟,然而没有成功进行妊娠;还有12例患者促卵泡发育失败;94例妊娠。结论外源性促性腺激素治疗低促性腺激素性闭经不孕症患者疗效显著,但疗效需要结合患者个人情况而定,一个周期未必能显效,不孕不育涉及到夫妻双方共同因素,要注意卵巢过度刺激综合征,患者治疗期间要使用B超密切注意观察卵泡发育程度。     

胎儿卵巢组织玻璃化冻存效果的研究

目的探讨玻璃化冻存法对胎儿卵巢组织形态和功能的保存效果。方法采用改良EG5.5/30玻璃化液冻存胎儿卵巢皮质片,解冻后观察卵巢组织学变化,卵巢皮质片异种异位移植后,观察受体鼠动情周期恢复率、恢复时间、卵泡发育状况。结果实验组与新鲜培养后移植组、添加抗氧化剂培养后移植组相比动情周期恢复率差异无统计学意义(P>0.05),但高于新鲜移植组(P<0.005);动情周期恢复需要的天数接近于新鲜移植组,明显短于两种培养组(P<0.05);在卵泡计数上,实验组每高倍视野的卵泡计数明显高于新鲜移植组(P<0.005),与培养后移植组间的差异无统计学意义(P>0.05)。移植后18周,组织学观察见大量窦卵泡,而培养组仅偶见窦卵泡。结论玻璃化冻存法可有效冻存胎儿卵巢组织,且不影响卵泡继续发育的潜能。     

β-巯基乙醇对培养胎儿卵巢组织异种移植效果的研究

目的探讨β-巯基乙醇(β-ME)对体外培养的卵巢组织的保护作用,寻找提高胎儿卵巢组织异种移植存活率的有效方法。方法取中晚期引产的死亡女胎,分别进行新鲜移植(对照组)或将卵巢组织在不含β-ME(培养对照组,β-ME0)、含100μMβ-ME(培养组,β-ME100)的培养液中新鲜培养3d后移植到裸鼠体内,从动情周期的恢复情况、组织学变化等方面比较各组移植物的活力。结果(1)β-ME0、β-ME100及对照组裸鼠动情周期的恢复率分别是62.5%、87.5%和33.3%,β-ME100组与对照组比较差异有统计学意义(P<0.05)。β-ME0、β-ME100组和对照组移植后动情周期开始天数为(25.20±4.49)d、(23.5±5.79)d和(12.75±1.5)d,两培养组均明显长于对照组(P<0.05);(2)异种移植后的组织学观察可见到存活移植物内有不同发育阶段的卵泡;卵泡计数β-ME100组(16.4±3.7815个/高倍视野)与对照组(4.0±2.8000个/高倍视野)比较差异有统计学意义,P<0.05。结论胎儿卵巢组织异种移植后卵泡可继续发育,经培养可提高移植物的活力,β-ME有利于提高移植物的存活率,促进卵泡的发育。     

冻存复苏人卵巢皮质在裸鼠体内的发育及卵细胞的提取

目的 探求冻存复苏人卵巢皮质在裸鼠体内的发育及卵细胞的提取。方法 取手术切除的5例患者的卵巢皮质，放入1．5mol／L的二甲基亚砜＋10％血清中，应用可控程序冻冰仪逐渐降温，移入液氮中冻存。3个月后，将融解的卵巢皮质移植入90只裸鼠皮下，注射hFSH12周，刺激卵泡生长。注射hCG36h后，用18号针头穿刺提取卵细胞。结果 卵巢直径为3～9mm，穿刺获19个卵细胞，放入TC-199培养基，加20％胎牛血清。25mmol／L丙酮酸，75mIU／mLFSH和LH培养，获15个分裂中期的次级卵母细胞。结论 人卵巢组织冻融后可异体移植生长，且其卵细胞可在体外发育成熟。     

宿主状态对人卵巢组织异种皮下移植的影响

【目的】 探讨异种移植宿主状态对解冻后人类卵巢组织皮下移植效果的影响。【方法】 利用解冻后的人类卵巢组织片进行SCID小鼠皮下移植。按照卵巢组织在宿主不同的性别、去势以及局部创伤情况分为六组,观察移植后人类卵巢组织片中卵泡存活、生长、凋亡以及间质重构等情况。【结果】各组原始卵泡存活率与解冻后未移植组织相比明显下降(P < 0.05)。六组间比较,移植后第一周原始卵泡形态正常率差别有统计学意义(P = 0.046),无菌创伤雄性小鼠组最高(64.6%),完整雌性小鼠组最低(39.7%)。性别、去势情况对移植后一周原始卵泡形态正常率无明显影响,差别无统计学意义(P均 > 0.05)。异种移植10周中,随移植时间推移,生长期的卵泡百分比明显增加(P均 < 0.05);而六组间比较,不同时间点差别都没有统计学意义(P均 > 0.05)。移植后组织中的Ki-67和TUNEL原位杂交表达情况与解冻组织相似,而MMP-9的表达在间质中显得更加广泛。经过10周的SCID小鼠异种移植后,有肉眼可见小窦卵泡形成。 【结论】 人类卵巢组织异种皮下移植后能存活并生长,但有着不一样的间质重构;宿主性别和去势情况对10周移植效果影响不大,局部无菌性创口可改善卵泡存活率。     

肉芽组织内自体移植大鼠卵巢组织卵泡存活的研究

目的:观察卵巢移植后甾体激素分泌和卵泡存活及卵巢组织VEGF和CD31的表达.方法:将未成熟SD雌性大鼠新鲜卵巢组织分别自体移植到下肢根部肌肉内和移植前2～5 d预制的肌层创面肉芽组织内,于移植后17 d回收移植物,做HE染色卵巢卵泡计数及VEGF和CD31免疫组化分析,并用化学发光法测定各组血清中17β-雌二醇(E2)水平.结果:移植卵巢内可见不同阶段的发育卵泡,其中肌层肉芽组织中原始卵泡数明显高于肌肉组,有统计学意义(P＜0.05);肉芽组织组移植物VEGF、CD31表达和E2水平高于肌肉组织组,其中VEGF、E2水平在移植前3d预制的肌层肉芽组织内高于其它各组,有统计学意义(P＜0.05).结论:自体异位移植卵巢组织到具有丰富新生毛细血管的肉芽组织内,可以提高移植卵巢卵泡的存活和激素分泌.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…