血管内皮生长因子、微血管密度在子宫平滑肌瘤中的表达意义

Objective:To investigate vascular endothelial growth factor(VEGF) expression and microvessel density(MVD) on the fibromyoma uteri treated with mifepristone.Methods:VEGF expression and MVD were counted on 60 cases of the fibromyoma uteri by SP method,including 40 cases of mifepristone treated and 20 cases of untreated patients as controlled group.Results:VEGF positive expression rate and MVD in treated group were 37.5% and 9.90 ± 5.95,which were lower than those in controlled group(80% and 16.36 ± 2.07;P < 0.05).Meanwhile,in treated group,those in marked shrink in tumor size sub-group were lower than in not obvious sub-group(12.0% and 7.89 ± 4.36 vs.80% and 11.29 ± 3.10;P < 0.05).Conclusion:VEGF and MVD expression decreases in the fibromyoma uteri after treatment with mifepristone,suggesting that mifepristone could inhibit angiogenesis and blood supply resulting in tumor shrink.     

顶空气相色谱法测定米非司酮中有机残留溶剂含量

目的建立米非司酮中残留有机溶剂的检测方法。方法采用顶空进样毛细管气相色谱法.以为1%的盐酸水为溶解介质,色谱柱为DB-Waxetr PEG2000,载气为氮气,FID检测器,测定米非司酮中残留的丙酮、二氯甲烷、异丙醚、四氢呋喃、环己烷。结果溶媒对残留溶剂测定无干扰,线性关系良好。结论顶空气相色谱法测定米非司酮中残留溶剂分离效果好,方法灵敏、准确。     

米非司酮和去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血分析

目的:比较和分析2种治疗围绝经期功能失调性子宫出血药物的临床效果。方法:采用回顾性分析方法对2003年7月—2006年7月我院80例围绝经期功血病人分别进行米非司酮和去氧孕烯炔雌醇治疗比较。结果:米非司酮组治疗有效率98%,去氧孕烯炔雌醇组治疗有效率100%,2组差异无显著意义(P>0.05);2组治疗后血清雌二醇(E_2)、孕酮(P)均下降,治疗前后差异具有非常显著意义(P<0.01),卵泡刺激素(FSH)、黄体生成素(LH)下降但无显著意义(P>0.05),催乳素(PRL)、睾酮(T)相对稳定;米非司酮组治疗后39例子宫内膜变薄,有1例出现子宫内膜异常增生;氧孕烯炔雌醇组治疗后子宫内膜均变薄,差异有显著意义(P<0.05)。2组不良反应均轻微。结论:米非司酮和去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血的临床效果相当,长期应用米非司酮应注意其安全性。     

米非司酮和抑那通治疗子宫肌瘤的有效性和安全性

目的:比较米非司酮不同剂量组和抑那通在治疗子宫肌瘤上的有效性和安全性。方法:采用随机、阳性药平行对照、临床试验方法,将符合入选标准的78例患者以3:1:1比例随机分为3组。试验1组口服米非司酮10mg/d,试验2组口服米非司酮25mg/d,对照组肌肉注射抑那通每月1次。用药3个月后,比较3组患者的疗效。结果:抑那通组子宫缩小率为83.7%,显著高于米非司酮1、2组(分别为70.83%、76.47%)。用药后3组患者血红蛋白均明显改善。不良事件发生率,抑那通组为36.84%,显著高于米非司酮1、2组(分别为13.58%、18.1%)。结论:米非司酮治疗子宫肌瘤有明显疗效,且不同剂量组(10mg、25mg)之间无显著性差异。抑那通在治疗子宫肌瘤缩小子宫体方面疗效显著优于米非司酮,不良事件发生率显著高于米非司酮。     

Chemotherapy for meningiomas

The most efficacious treatment for meningiomas is surgery. For incompletely resected or recurrent tumors, radiotherapy can be given. However, when the meningioma is unresectable and/or all other previous treatments have failed, immunotherapy or chemotherapy may be considered for malignant tumors and immunotherapy and hormone therapy may be considered for benign ones. Various chemotherapy treatments that have shown some efficacy in individual cases include combinations of Adriamycin and Dacarbazine or Ifosfamide and Mesna. The most effective immunotherapy appears to be administration of interferon-alpha, which is relatively non-toxic and easily tolerated. However, more studies are needed to better define the roles of these agents in the management of a recurrent, unresectable, or malignant meningiomas.     

氨甲喋呤联合米非司酮治疗异位妊娠的Meta分析

目的评价氨甲喋呤联合米非司酮治疗异位妊娠的有效性和安全性。方法按照循证医学的要求全面检索中国知识期刊网(1994.1-2005.5)、中国生物医学光盘数据库(1995.1-2005.5)及Pubmed(1995.1-2005.5),收集氨甲喋呤联合米非司酮与单用氨甲喋呤治疗异位妊娠的随机对照试验。结果检索到符合纳入标准的随机对照试验文章23篇,共1706例病人。Meta分析结果显示,氨甲喋呤联合米非司酮能有效治疗异位妊娠[OR合并=2.84,95%CI(2.18,3.69),P=0.0000]。在森林图中,OR合并的95%CI横线落在无效竖线右侧,可认为氨甲喋呤联合米非司酮治疗异位妊娠有效。结论目前较低质量研究的Meta分析提示,氨甲喋呤联合米非司酮治疗异位妊娠与单用氨甲喋呤比较,疗效的差异有高度显著性;在森林图中,,OR合并的95%CI横线落在无效竖线右侧,可认为氨甲喋呤联合米非司酮治疗异位妊娠有效,安全性可能较高,副作用较小,但还需要严格设计的、大样本的随机双盲对照试验来进一步验证和支持。     

新疆紫草颗粒剂与汤剂对药物流产效果影响的比较性研究

目的:比较新疆紫草颗粒剂与紫草汤剂对米非司酮配伍米索前列醇药物流产效果的影响,及不良反应。方法:将648例妊娠38-45　d、要求终止妊娠的妇女,随机分成3组,各组在米非司酮配伍米索前列醇药物流产时分别加服紫草颗粒剂或安慰剂或紫草汤剂,对3组的流产效果、出血时间、月经恢复时间等及不良反应进行观察。结果:紫草颗粒剂组和汤剂组的完全流产率(97.74%、97.70%)、平均出血时间(12.0±4.1　d、12.7±3.8　d)均无显著性差异(P均>0.05),且均显著优于安慰剂组(91.90%、14.3±4.8　d)(P均<0.05)。3组药物流产后月经恢复时间均无显著性差异。但紫草汤剂服用时有明显异味。结论:　紫草颗粒剂祛除了紫草的异味,服用方便,对其提高药物流产疗效与紫草汤剂相同,有必要进一步探讨。     

米非司酮终止早孕致阴道流血的危险因素Logistic回归分析

目的：探讨米非司酮终止早孕致阴道流血的危险因素。方法：调查396例健康妇女药物流产的出血情况，采用单因素及多因素Logistic回归模型，对影响因素进行分析。结果：单因素非条件Logistic回归分析显示年龄、职业、文化、孕次、孕周、流产次数、孕囊大小、蜕膜、绒毛残留、生殖器官炎症、子宫位置、疤痕子宫11个变量与药流后阴道流血量有天，多因素Logistic逐步回归分析筛选出蜕膜、绒毛残留、多次孕产史、生殖器官炎症、孕囊大小、子宫过度倾屈、疤痕子宫6个变量具有统计学意义．结论：蜕膜或绒毛残留、多次孕产史、生殖器官炎症、孕囊大小、子宫过度倾屈、疤痕子宫是米非司酮终止早孕致阴道流血的危险因素。     

米非司酮配伍桂枝茯苓胶囊对子宫肌瘤患者血清性激素水平的影响

目的观察米非司酮配伍桂枝茯苓胶囊对子宫肌瘤患者血清性激素水平的影响及临床效果。方法将62例确诊为子宫肌瘤的患者进行药物治疗,将其随机分为两组:观察组口服米非司酮10mg,1次/d,共3个月,3个月后加服桂枝茯苓胶囊,3片/次,3次/d,共服3个月;对照组单独口服米非司酮10mg,1次/d,共服3个月。结果两组服用米非司酮期间均闭经,血红蛋白上升,子宫肌瘤平均体积均明显缩小,血清性激素水平明显下降,观察组远期复发率较对照组明显降低,两组间差异有显著性(P<0.05)。结论米非司酮配伍桂枝茯苓胶囊是目前中西医结合保守治疗子宫肌瘤的一种经济实用方法。     

Acceptability of suction curettage and mifepristone abortion in the United States: a prospective comparison study

OBJECTIVE: We sought to compare the acceptability of suction curettage abortion with that of medical abortion with mifepristone and misoprostol in American women. STUDY DESIGN: We performed a prospective, serially enrolled, cohort analysis. The study population consisted of 152 subjects receiving mifepristone and misoprostol and 174 subjects undergoing suction curettage abortion aged > or =18 years with intrauterine pregnancies of up to 63 days' estimated gestation. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit. RESULTS: Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (mean rank, 121 vs 149; P <.01) but were no more likely to recommend the method they had just experienced to a friend (97% vs 93.3%). If a future abortion was required, however, 41.7% of subjects undergoing surgical abortions indicated they would opt for a medical abortion, whereas only 8.6% of subjects receiving medical abortions would choose a surgical abortion (P <.001). Failure of the abortion decreased satisfaction in the medical group and increased the likelihood of choosing a surgical abortion for a subsequent procedure (P <.001). Surgical subjects who experienced more anxiety than expected during the abortion were more likely to choose a medical procedure for a subsequent abortion (P <.01). CONCLUSION: Women receiving mifepristone and misoprostol were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. Failure of a medical abortion and increased anxiety during surgical abortion were associated with preference for the alternative technique in a future procedure.