Dipyridamole-echocardiography test as a clue for assessing the organic 'ceiling' of individual coronary reserve

Twenty-four patients with a history of effort angina, a positiveexercise stress test (EST) and coronary artery disease wereenrolled in the study; 12 patientshada positive dipyridamole-echocardiographytest (DET) and 12 had a negative DET. Each patient performeda total of 4 ESTs in the absence of therapy on two successivedays; for each test the rate-pressure product (RPP), an establishedindex of my ocardial oxygen demand, was measured at the onsetof ischaemia (ST depression >0–15mV) or at the peakof maximal exercise (if a repeated EST was negative). Taking into account the lowest of the 4 RPP values ( x 1/100)in each patient, there was no significant difference betweenDET-negatives and DET-positives (185.2±49.3 vs 157.4±32.4).Conversely, when considering the highest of the 4 RPP valuesin each patient, there was a significant difference betweenDET-negatives and DET-positives (280.3 ± 63.9 vs 183.3± 37.0; p < 0.01). Thus, DET may provide a clinically useful tool for assessingin the individual the organic ’ceiling‘ of coronaryreserve, by eliminating the variability in coronary tone, whichmay affect EST reproducibility and the correct evaluation ofthe impairment of organic coronary reserve.     

Improvement of oxygen metabolic reserve after extracranial-intracranial bypass surgery in patients with severe haemodynamic insufficiency

Summary The effectiveness of extracranial-intracranial arterial bypass (EC-IC bypass) surgery on impaired haemodynamic status was studied in 12 patients with reduced regional cerebral perfusion pressure (rCPP) and elevated regional oxygen extraction fraction (rOEF) in the area distal to the symptomatic arterial lesion. Postoperative positron emission tomography (PET) study demonstrated a statistically significant decrease of rOEF in the operated hemispheres with disappearance of the pre-operative interhemispheric rOEF difference. Regional cerebral blood flow (rCBF) and regional cerebral oxygen metabolism (rCMRO2) were also increased in the operated hemispheres with disappearance of the pre-operative interhemispheric differences. Regional CBF/regional cerebral blood volume (rCBV) ratios of the symptomatic hemispheres were increased after surgery, but were still lower than in the contralateral hemispheres. We conclude that EC-IC bypass surgery improves impaired cerebral oxygen metabolic reserve.     

多囊卵巢综合征患者血清游离脂肪酸浓度测定及相关因素分析

目的:观察多囊卵巢综合征(PCOS)患者血清游离脂肪酸(FFAs)水平变化及相关因素分析.方法:PCOS患者(39例)分为肥胖组(11例)和非肥胖组(28例),对照组为年龄匹配的健康妇女(21例).测定血清FFAs、游离睾酮、雄烯二酮、睾酮、性激素结合球蛋白、TC、TG、HDL-c、LDL-c、空腹血糖(FPG)、餐后2h血糖(PPG)、空腹胰岛素及胰岛素敏感性(M值,两步法高胰岛素-正葡萄糖钳夹技术评价).结果:血清FFAs水平在肥胖PCOS组和非肥胖PCOS组之间无明显差别,但均高于对照组(P＜0.05).对所有研究对象的血清FFAs进行相关分析表明FFAs分别与游离睾酮(r=0.464,P=0.001),睾酮(r=0.368,P=0.01),雄烯二酮(r=0.418,P=0.003)和PPG(r=0.334,P=0.014)呈正相关,与M值(r=-0.392,P=0.003)呈负相关.进一步做回归分析表明,FFAs与游离睾酮显著相关(β=0.219,P＜0.05).结论:与年龄相当的健康妇女比较,PCOS妇女血清FFAs水平显著增高,并且FFAs升高与游离睾酮水平升高有关.     

两种术式治疗多囊卵巢综合征的远期疗效追踪比较

[目的]评价开腹卵巢楔形切除(OWR)和腹腔镜下双侧卵巢电灼开窗术(LOD)两种术式对多囊卵巢综合征(PCOS)的远期疗效.[方法]1981至2001年在我院诊断为PCOS并接受手术治疗的妇女共151例,其中行OWR 61例、LOD 90例,追踪分析两组妇女术后妊娠率、术后妊娠时间的分布及术前后月经模式变化.[结果]两组的临床特征具有可比性,OWR组累积妊娠率84%,LOD组累积妊娠率72%,两组间没有明显差异,绝大部分妊娠发生在术后18个月内;OWR组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是81.3%、81.3%、77.3%、77.6%、78.9%、85.2%,明显高于术前的31.1%(P值＜0.05);LOD组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是80.6%、63.5%、56.7%、58.0%、57.6%、42.9%,明显高于术前的35.6%(P值＜0.05);术后OWR组月经规律妇女占的比例明显高于LOD组(P均＜0.05).[结论]两种术式的术后妊娠率相似.OWR比LOD更好、更长远地改善PCOS妇女的月经异常.     

晚期卵巢癌理想肿瘤细胞减灭术的可行性研究

目的探讨晚期卵巢癌理想肿瘤细胞减灭术的可行性. 方法对22例Ⅲ、Ⅳ期晚期卵巢癌患者行肿瘤细胞减灭术,手术中尽可能多地切除盆腹腔内原发或继发癌灶,清扫盆腔和腹主动脉旁淋巴结,其中16例行理想肿瘤细胞减灭术(残留灶<2 cm). 结果切除前≥2 cm转移癌主要位于大网膜、盆腔和大肠;术后≥2 cm的残留灶主要位于盆腔,其次在胃结肠韧带、肝门和脾门.术后平均随访10(2～14)个月,达到理想手术的16例均无复发,未达理想减灭术的6例患者中复发及存活各1例,死亡3例,失访1例. 结论理想的肿瘤细胞减灭术对晚期及复发卵巢癌是安全可行的.     

Evaluation ofin vitro drug screening leads using experimental models of human ovarian cancer

Summary Five compounds which were identified as potential new anticancer drugs inin vitro screening with the human tumor colony forming assay were selected for further evaluation usingin vitro andin vivo models of human ovarian cancer. Three of five compounds were found to inhibitin vitro colony formation of ovarian cancer cell lines derived from both untreated and combination chemotherapy refractory patients. One compound was also found to prolong survival in a human ovarian carcinoma xenograft model system. This compound, chloroquinoxaline sulfonamide, was selected for development and has shown preliminary indication of activity in phase I clinical testing.     

A short luteal phase in cycles stimulated with clomiphene and human menopausal gonadotropin for in vitro fertilization

Of 70 cycles stimulated with clomiphene and human menopausal gonadotropin (hMG) for an in vitro fertilization-embryo transfer (IVF-ET) program, a short luteal phase of 11 days or less was found in 18. In this group the mean estradiol and progesterone levels were elevated in the early luteal phase. Despite the elevated initial values, progesterone levels fell rapidly at the mid luteal phase as a sign of premature luteolysis. The mean total amount of gonadotropin administered and the mean number of follicles punctured and of oocytes recovered did not show any significant difference between the groups of normal and short luteal phases. The present findings support the theory that hyperestrogenism in the early luteal phase may initiate the premature luteolysis observed in clomiphene-menopausal gonadotropin-stimulated cycles.     

Prospective randomized study of D-Trp6-LHRH versus buserelin in long desensitization protocols for medically assisted conception cycles

In a prospective, controlled, randomized study where two differentagonists were used, we compared three different long desensitizationprotocols for induction of multiple follicular growth in medicallyassisted conception cycles. In protocol A, 30 patients wereinjected with buserelin twice a day for 15 days prior to ovarianstimulation until human chorionic gonadotrophin (HCG) administration.In protocol B, 30 patients were injected with a single doseof long acting Triptorelin (3.75mg) 15 days before the ovarianstimulation onset. In protocol C, 30 patients were injectedwith the long acting Triptorelin 4 weeks before ovarian stimulationfollowed by daily administration of 0.1 mg of the same agonistuntil HCG injection. There was no difference in the ovarianresponse to exogenous gonadotrophin stimulation, except forthe presence of premature luteinization in two patients in groupB. A significantly higher number of mature oocytes was collectedfrom patients with protocol A; however, the fertilization andcleavage rate demonstrated no significant difference among thethree groups of patients. The ongoing pregnancy rate and theimplanation rate per treatment cycle were very similar in thethree study groups. When the convenience, cost and side-effectsfor the patient are being considered, protocol B should be selectedas the first choice when the agonist is utilized for the purposeof inducing pituitary desensitization before and during ovarianstimulation.     

原位杂交法检测卵巢上皮癌中诱导型一氧化氮合酶mRNA

目的 :研究卵巢上皮性癌诱导型一氧化氮合酶 (iNOS)的转录水平。方法 :原位杂交法检测 71例卵巢上皮性癌 ,13例卵巢良性肿瘤及 11例正常卵巢组织中iNOSmRNA表达水平。结果 :卵巢上皮性癌中iNOSmRNA高于正常卵巢组织和卵巢良性肿瘤 ,P<0 .0 5。但卵巢上皮性癌Ⅲ ,Ⅳ期与Ⅰ ,Ⅱ期比较无显著差异 ,P>0 .0 5。分化程度比较 ,中、低分化组明显高于高分化组 ,但中、低分化组织间差异无显著性。结论 :诱导型一氧化氮合酶转录水平的升高 ,是引起诱导型一氧化氮合酶水平升高的主要原因 ,在卵巢上皮性癌发生、发展中发挥一定作用