Successful Pregnancies in Women with Diffuse Uterine Leiomyomatosis after Hysteroscopic Management Using the Hysteroscopy Endo Operative System

Study ObjectiveTo evaluate the feasibility, effectiveness, and reproductive outcome of hysteroscopic management using the Hysteroscopy Endo Operative system (HEOS) in patients with diffuse uterine leiomyomatosis (DUL).DesignRetrospective study (Canadian Task Force classification III).SettingBeijing Tiantan Hospital, Capital Medical University, Beijing, China.PatientsEight women of reproductive age suffering from menorrhagia and anemia or infertility diagnosed with DUL by ultrasonography and hysteroscopy.InterventionsHysteroscopic surgery using cold graspers combined with electric loop by the HEOS was performed to excise submucous myomas (including types 0, I, and II), leaving other intramural myomas in place. The fenestration method is used in electrical hysteroscopic myomectomy. Postoperative endometrial repair and synechiae, menstrual improvement, conception, and pregnancy were recorded.Measurements and Main ResultsTwo patients underwent a single hysteroscopic myomectomy, whereas 6 patients underwent 2 to 3 myomectomies. No complications were observed. The mean follow-up period was 39.13 ± 17.01 months (range, 21–67). The endometrium recovered 2 to 3 months after the initial surgery, and 100% improvement in menstruation was observed. Two patients had mild synechia after the first hysteroscopic surgery. Seven patients conceived spontaneously (postoperative pregnancy rate, 87.5%), 6 of whom had a full-term pregnancy. One patient suffered a miscarriage in the second trimester (live birth rate, 75%).ConclusionHysteroscopic surgery using cold graspers combined with electric loop by the HEOS is a feasible and effective for treatment of DUL because it preserves the uterus and yields favorable reproductive outcomes. The cold surgery and fenestration method minimizes electrical and thermal damage to the endometrium surrounding the myoma, consequently reducing surgical risks.     

基于ICP-MS法的桂枝茯苓胶囊中无机元素分析

目的采用电感耦合等离子体质谱(ICP-MS)法建立桂枝茯苓胶囊(GFC)中29种无机元素(Li、Be、B、Na、Mg、Al、Ca、Ti、V、Cr、Mn、Fe、Co、Ni、Cu、Zn、Ga、As、Se、Sr、Mo、Cd、Sn、Sb、Ba、Hg、Tl、Pb、Bi)的测定方法。方法 GFC样品以浓硝酸为消解试剂经微波消解后,以Ge、In元素为内标,以灌木枝叶标准物质作为质控标准物质,采用ICP-MS法测定其中29种无机元素含量。结果待检测的29种无机元素在各的自线性范围内线性关系良好,r≥0.999 4;各元素的检出限在0.012~4.105μg/L,定量限在0.045~14.500μg/L,平均加样回收率在79.88%~105.76%,RSD≤4.55%。测定的12批样品中Ca、Na、Mg含量较高,均超过300μg/g;Fe、Mn、Sr含量也相对较高,而有害元素Be、As、Cd、Sb、Hg、Tl、Bi含量相对较低,均在0.030μg/g以下。结论该方法操作简便,分析速度快,灵敏度高,适用于GFC中无机元素的测定。     

海南黎族、汉族高血压ACE基因多态性相关性研究

目的 研究海南黎族、汉族高血压ACE基因多态性的相关性.方法 采用聚合酶链反应(PCR)检测,对海南黎族111例高血压患者、146例黎族正常人、海南汉族106例高血压患者、97例汉族正常人的ACE基因插入/缺失(I/D)多态性检测,观察DD、DI、II基因型频率及等位基因频率,并对所有普通PCR定为DD型的样本进行插入特异性PCR检测,以减少误分型率.并调查经典危险因素.结果 海南黎族高血压组DD、DI、II基因频率分别为10.8%、37.8%、51.4%;D及I等位基因频率分别为29.7%、70.3%.正常对照组DD、DI、II基因型频率分别为13.0%、43.8%、43.2%;D及I等位基因频率分别为34.9%、65.1%.两组之间DD、DI、II基因型频率及D、I等位基因频率均无显著性差异.汉族高血压DD、DI、II基因频率为16.0%、28.3%、55.7%;D及I等位基因频率分别为30.2%、69.8%.汉族正常人DD、DI、II基因频率15.5%、44.3%、40.2%,D及I等位基因频率分别为37.6%、62.4%.两组之间DD、DI、II基因型频率及D、I等位基因频率有显著性差异(P＜0.05).黎族、汉族高血压组与正常对照组比较,体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)有显著性差异(P＜0.05);黎族高血压组收缩压,舒张压与正常对照组有显著性差异(P＜0.05);汉族高血压组收缩压、舒张压与正常对照组有显著性差异(P＜0.05).结论 在海南黎族高血压和黎族正常人的D等位基因频率均比I等位基因频率低;ACE基因I/D多态性与黎族高血压无显著关联;海南汉族高血压和汉族正常人D等位基因频率均比I等位基因频率低;ACE基因I/D多态性与汉族高血压的发病有相关性,是汉族高血压的主要致病基因,早期应用血管紧张素转化酶抑制剂的治疗干预.     

Testing competing path models linking the biochemical variables in red blood cells from Li+-treated bipolar patients

Objectives: Red blood cells (RBCs) from Li⁺‐treated bipolar patients have shown abnormalities in intracellular Li⁺ concentration ([Li⁺]_i), Na⁺/Li⁺ exchange rates, and membrane phospholipid levels. Based on Li⁺‐loaded RBC studies, we hypothesized that Li⁺‐treated bipolar patients also have varied intracellular free Mg²⁺ concentrations ([Mg²⁺]_f) as compared with normotensive patients. We addressed how these experimentally determined values are intercorrelated. Assuming that Li⁺ treatment alters these biochemical parameters, we provide hypothetical pathways based upon structural equation modeling statistics. Methods: In RBCs from 30 Li⁺‐treated bipolar patients, we determined [Li⁺]_i, serum [Li⁺] ([Li⁺]_e), Na⁺/Li⁺ exchange parameters, membrane phospholipid levels, [Mg²⁺]_f, and Li⁺ membrane binding affinities. Comprehensive statistical analyses assessed correlations among the biochemical data. We used path analysis statistics to propose potential pathways in which the data were correlated. Results: We found significant correlations within the three Na⁺/Li⁺ exchange parameters and percentage composition of the membrane phospholipids. Additional correlations existed between [Mg²⁺]_f and V_std, K_m, or phospholipid composition, between [Li⁺]_i and percentage of phosphatidylcholine, and between percentage of phosphatidylserine and K_m. Based on these findings, we hypothesized and statistically determined the most probable pathway through which these parameters were intercorrelated. Conclusions: Significant correlations existed between the biochemical parameters that describe the cell membrane abnormality and the Li⁺/Mg²⁺ competition hypotheses. Using path analysis statistics, we identified a biochemical pathway by which Li⁺ may assert its cellular effects. This study serves as an illustrative example how path analysis is a valuable tool in determining the direction of a certain biochemical pathway.     

黄甘草皂甙的结构

本文报道自黄甘草(Glycyrrhiza eurycarpa P.C.Li)根茎中获得两个皂甙化合物K-3和K-4。根据理化性质和光谱数据鉴定K-4为3-β-羟基-11-氧化-齐墩果-12-烯-30-羧酸-3-O-β-D-吡喃葡萄糖醛酸基(1→4)-β-D-吡喃葡萄糖醛酸甙,为一新的天然产物,命名为黄甘草皂甙(glyeurysaponin)。K-3为已知皂甙乌拉尔甘草皂甙乙(uralsaponin B)。二者均为首次从该种植物中获得。本文报道化合物K-4的结构鉴定。     

从《镜花缘》看李汝珍的医药养生观

《镜花缘》是古代记载中医药内容最多的小说之一。书中的医药内容丰富而真实,反映出作者李汝珍对中医药及养生问题有独到认识和见解。具体表现在他注重记述杂证实证和祛邪,少言虚证和滋补;对验方秘方情有独钟,重治“症”而轻辨“证”;倾向于使用廉价简便的方药,极力反对以价格论方药优劣。不过他也指责“走方医”缺乏医学素养,甚至轻视其人格。保健养生方面,李汝珍特别强调劳作活动的作用,认为忧思最折寿,主张以保健药代茶。     

补中益气汤加味治疗长期低热证

运用李东垣补中益气汤加味治疗长期低热（内伤发热）症32例,经6天治疗热退症减,疗效较佳。提示“甘温除大热”法同样适用治疗低热症。