哈蟆油石油醚提取物的抗抑郁作用

目的:探索哈蟆油石油醚部位(ROS)的抗抑郁作用及可能的机制.方法:雄性ICR小鼠,分为2批,每批均设空白对照组(生理盐水)和6个治疗组(分别给予阳性药氟西汀10 mg·kg-1和ROS不同剂量10,30,100,300,900 mg· kg-1),连续灌胃给药8d.第1批动物在第7天给药后1h和第8天给药后1h,分别采用小鼠强迫游泳和小鼠悬尾2种“行为绝望”抑郁动物模型进行行为学观察;行为学观察结束后小鼠眼球取血,用放射免疫法检测小鼠血清皮质酮(CORT)水平.第2批动物在第8天给药后采用利血平拮抗模型,观察ROS对由利血平引起小鼠体温下降和运动不能的影响.结果:ROS 100,300,900 mg· kg-1均能不同程度地缩短小鼠强迫游泳和悬尾不动时间(P＜0.05),能拮抗利血平致小鼠体温下降和运动不能(P＜0.05),降低小鼠血清皮质酮水平(P＜0.05).结论:ROS具有抗抑郁作用,其机制可能与单胺类神经递质以及下丘脑-垂体-肾上腺(HPA)轴密切相关.     

罗布麻叶总黄酮抗抑郁作用及其机制研究

目的 探讨罗布麻叶总黄酮的抗抑郁作用及与多巴胺能系统相关的可能机制.方法 采用经典的小鼠强迫游泳和悬尾抑郁模型,观察罗布麻叶总黄酮的抗抑郁作用.同时观察多巴胺D1受体阻滞剂SCH23390、D2受体阻滞剂舒必利对小鼠强迫游泳和悬尾试验中罗布麻叶总黄酮抗抑郁作用的影响,研究罗布麻叶总黄酮抗抑郁的作用机制.结果 罗布麻叶总黄酮具有明确的抗抑郁作用;SCH23390、舒必利与罗布麻叶总黄酮联合ig给药10 d,能明显延长悬尾小鼠累计不动时间(P＜0.05).结论 罗布麻叶总黄酮的抗抑郁作用与多巴胺能系统有关.     

米非司酮联合亮丙瑞林治疗子宫肌瘤的疗效研究

目的 探讨米非司酮联合亮丙瑞林治疗子宫肌瘤的临床疗效。方法 以回顾性研究的方法选取2015年7月-2018年7月漯河市郾城区中医院88例子宫肌瘤患者为研究对象,根据不同的给药方法将受试者进行分组,其中对照组44例患者接受亮丙瑞林治疗,观察组44例患者在对照组的基础上联合米非司酮治疗,两组均连续治疗3个月。比较两组患者的临床疗效、治疗前后各性激素与血清细胞因子水平变化以及子宫与肌瘤体积变化。结果 观察组的治疗总有效率为93.18%,显著高于对照组的77.27%（P<0.05）。治疗后两组患者孕激素（P）、雌二醇（E2）、促卵泡生长激素（FSH）、黄体生成激素（LH）等各性激素水平及基质金属蛋白酶-9（MMP-9）、胰岛素样生长因子（IGF-1）、肿瘤坏死因子-α（TNF-α）、表皮细胞生长因子（EGF）、超敏C反应蛋白（hs-CRP）等细胞因子水平较治疗前均显著降低（P<0.05）,且观察组均显著低于对照组（P<0.05）。治疗后两组患者的子宫及肌瘤体积较治疗前均显著减小（P<0.05）,且观察组显著小于对照组（P<0.05）。结论 米非司酮联合亮丙瑞林可有效降低各性激素及血清细胞因子水平,改善患者的临床症状及体征,疗效确切,在子宫肌瘤治疗中具有较高的应用价值。     

止崩汤加针灸治疗围绝经期功能失调性子宫大出血320例

目的:观察止崩汤加针灸治疗围绝经期功能失调性子宫出血(功血)大出血的疗效及探讨止血机理。方法:将320例围绝经期功血大出血患者口服止崩汤加针灸观察止血疗效、治疗前后临床症状改善情况、子宫内膜厚度、APTT、PT、血色素(HB)、血清雌二醇(E2)、孕酮(P)的含量。结果:(1)止崩汤加针灸治疗功血大出血止血疗效总有效率为91.3%.(2)治疗后APTT时间明显延长(P≤0.05),PT时间明显缩短(P≤0.05)。(3)子宫内膜的厚度变薄,治疗后与治疗前比较有显著性差异(P0.05);(4)治疗后E2含量明显下降(P0.01),P含量则明显上升(0.01),与治疗前比较有极显著性差异(P0.01)。(5)治疗后血色素明显提高。结论:止崩汤加针灸治疗围绝经期功血大出血具有良好的止血作用,起到药物性刮宫的作用,止血迅速快捷便利,无手术刮宫的疼痛及创伤,可调节卵巢激素。     

液基涂片细胞学检查联合高危型HPV检测在宫颈病变诊断中的价值

目的 探讨液基涂片细胞学(TCT)检查联合高危型人乳头瘤病毒(HPV)检测在宫颈病变诊断中的价值.方法 收集500例宫颈脱落细胞标本,采用宫颈细胞学检查、HPV DNA检测或2种方法联合检查后,选择所有的HPV阳性和TCT报告为意义不明确的不典型鳞状细胞(ASC-US)以上者,均通过阴道镜取活检,以组织学诊断为金标准,比较宫颈细胞学检查、HPV DNA检测及以上2种方法联合检查与组织病理学诊断的符合率、灵敏度和特异度.结果 313名TCT报告为ASC-US以上者,与组织病理学诊断的符合率为82.4％.268名检测结果为HPV DNA阳性的女性与组织病理学诊断的符合率为77.2％.2种方法联合检查251名女性,与组织病理学诊断的符合率为92.0％.TCT联合HPV DNA检测与单纯HPV DNA检测比较,差异有统计学意义(P＜0.01).TCT联合HPV DNA检测与单纯TCT比较,差异有统计学意义(P＜0.01).HPV DNA检测诊断宫颈癌的灵敏度为83.8％,特异度为75.9％,TCT检测诊断宫颈癌的灵敏度为93.5％,特异度为75.4％,TCT检查联合HPV DNA检测诊断宫颈癌的灵敏度为96.3％,特异度为87.5％.结论 TCT联合HPV DNA检测在宫颈病变筛查中比单纯TCT或单纯HPV DNA检测更具有实用价值.     

Evidences for the Involvement of Monoaminergic and GABAergic Systems in Antidepressant-like Activity of Tinospora cordifolia in Mice

The present study was taken up to investigate the effect of petroleum ether extract of Tinospora cordifolia (Wild.) Miers, on depression in mice. The extract (50, 100 and 200 mg/kg, p.o.) was administered for 14 successive days to Swiss young albino mice (either sex) and evaluated for antidepressant-like activity using tail suspension test and forced swim test. Petroleum ether extract at all three doses produced significant antidepressant-like effect in tail suspension test as well as in forced swim test and their efficacies were found to be comparable to imipramine (15 mg/kg, p.o.) and sertraline (20 mg/kg, p.o.). The extract at a dose of 50 mg/kg showed most potent effect and did not show any significant change in locomotor functions of mice as compared to control. The antidepressant-like effect of the extract was significantly reversed by pretreatment of animals with prazosin (a α(1)-adrenoceptor antagonist), sulpiride (a selective dopamine D(2)-receptor antagonist), p-CPA (a serotonin synthesis inhibitor) and baclofen (GABA-B agonist), when tested in tail suspension test. Moreover, petroleum ether extract also reduced the mouse whole brain monoamine oxidase (MAO-A and MAO-B) activities as compared to control, resulting in increase in the levels of brain monoamines. Therefore, the extract may have potential therapeutic value for the management of depressive disorders.     

几丁聚糖预防输卵管通液术后再粘连的疗效观察

目的:观察输卵管通液术中加入几丁聚糖提高受孕率的效果。方法:将184例输卵管性不孕患者随机分为2组,治疗组95例常规通液治疗后再注入0.3%几丁聚糖10ml;对照组89例仅用常规通液治疗。结果:术后6mo内,治疗组和对照组的受孕率分别为40.7%和24.4%(P<0.05);通液1次受孕率分别为40.32%和25.42%(P<0.05);通液2次以上受孕率分别为41.67%和21.74%(P<0.05)。结论:几丁聚糖能有效减少输卵管通液术后再粘连的发生,通液术后注入几丁聚糖是提高受孕率的有效方法。     

A prospective cohort study of the value of maternal plasma concentrations of angiogenic and anti-angiogenic factors in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia

Objective.?Changes in the maternal plasma concentrations of angiogenic (placental growth factor (PlGF) and vascular endothelial growth factor (VEGF)) and anti-angiogenic factors (sEng and vascular endothelial growth factor receptor-1 (sVEGFR-1)) precede the clinical presentation of preeclampsia. This study was conducted to examine the role of maternal plasma PlGF, sEng, and sVEGFR-1 concentrations in early pregnancy and midtrimester in the identification of patients destined to develop preeclampsia.

Methods. This longitudinal cohort study included 1622 consecutive singleton pregnant women. Plasma samples were obtained in early pregnancy (6–15 weeks) and midtrimester (20–25 weeks). Maternal plasma PlGF, sEng, and sVEGFR-1 concentrations were determined using sensitive and specific immunoassays. The primary outcome was the development of preeclampsia. Secondary outcomes included term, preterm, and early-onset preeclampsia. Receiving operating characteristic curves, sensitivity, specificity, positive and negative likelihood ratios, and multivariable logistic regression were applied. A p-value of <0.05 was considered significant.

Results.?(1) The prevalence of preeclampsia, term, preterm, (<37 weeks) and early-onset preeclampsia (<34 weeks) was 3.8 (62/1622), 2.5 (40/1622), 1.4 (22/1622) and 0.6% (9/1622), respectively; (2) Higher likelihood ratios were provided by ratios of midtrimester plasma concentrations of PlGF, sEng, and sVEGFR-1 than single analytes; (3) Individual angiogenic and anti-angiogenic factors did not perform well in the identification of preeclampsia as a whole; in particular, they perform poorly in the prediction of term preeclampsia; (4) In contrast, a combination of these analytes such as the PlGF/sEng ratio, its delta and slope had the best predictive performance with a sensitivity of 100%, a specificity of 98–99%, and likelihood ratios for a positive test of 57.6, 55.6 and 89.6, respectively, for predicting early-onset preeclampsia.

Conclusions.?(1) The PlGF/sEng ratio and its delta and slope had an excellent predictive performance for the prediction of early-onset preeclampsia, with very high likelihood ratios for a positive test result and very low likelihood ratios for a negative test result; and (2) Although the positive likelihood ratios are high and the positive predictive values low, the number of patients needed to be closely followed is 4:1 for the PlGF/sEng ratio and 3:1 for the slope of PlGF/sEng.     

子宫动脉栓塞术治疗子宫腺肌病的临床观察

目的探讨子宫动脉栓塞术(uterine artery embolization,UAE)治疗子宫腺肌病的临床疗效。方法选择2003年4月至2006年4月北京仁和医院48例子宫腺肌病患者,以改良的Seldinger s技术完成双子宫动脉超选择插管并栓塞,观察术后1个月、3个月和6个月的疗效。结果 48例患者中,UAE治疗后临床症状全部缓解;患者治疗前活动能力丧失程度、疼痛分级与治疗后比较,差异有统计学意义(P0.01);48例患者术后月经量为术前的(51.2±18.3)%,差异具有统计学意义(P0.01);所有患者贫血改善,术后3个月均恢复正常;术后6个月子宫体积平均缩小46.6%(P0.01),病灶体积平均缩小65.2%(P0.01);卵巢内分泌激素无明显变化(P0.05)。结论 UAE治疗子宫腺肌病近期疗效显著,且微创、安全、副反应少。     

Selective vessel ligation in the pelvis: an invaluable tool in certain surgical procedures

While developing the technique of abdominal radical trachelectomy for conservative cervical cancer management, the vascular supply of the uterus was thoroughly examined. The question of how many vessels the uterus requires to ensure its viability arose. Following an abdominal radical trachelectomy for stage IB cervical carcinoma, blood supply of the body of the uterus is successfully maintained by only the two infundibulopelvic vessels (n= 34). Pregnancy has resulted following this technique (n= 2). Selective ligation of the pelvic vasculature has been utilized in the abdominal radical trachelectomy procedure. The objectives of this study were to investigate the vasculature of the infundibulopelvic and broad ligaments, to assess the contribution of the ovarian and uterine vessels to overall uterine perfusion, and to consider the clinical applications of selective pelvic vessel ligation. Ten fresh dissections of the infundibulopelvic vessels, broad ligaments of benign total abdominal hysterectomy, and bilateral salpingo-oophorectomy specimens were performed. Perfusion index (PI) and oxygen saturation (O(2)Sat) measurements using a modified probe were taken at specified intervals at the uterine cornu during ten routine benign abdominal hysterectomies to assess the contribution of the ovarian and uterine vessels to overall uterine perfusion and the concepts studied were utilized in certain gynecological procedures. The ovarian/infundibulopelvic vessels course medially through the broad ligament toward the uterine cornu and consistently give off a branch to the ovary on its lateral border. In addition, further vessels were noted to run laterally from the uterine cornu along the ovarian ligament to the medial aspect of the ovary. PI and O(2)Sat measurements imply that the uterine and ovarian vessels contribute almost equally to uterine perfusion. Clinical application by selective ligation of the pelvic vasculature has been utilized in certain gynecological procedures often prone to torrential life-threatening uterine hemorrhage. Selective temporary ligation of the uterine and ovarian vessels has proven useful in the surgical management of chemoresistant gestational trophoblastic disease, in the Strassman procedure, fertility-sparing surgery in ruptured cornual ectopic pregnancies, and unrelenting postpartum hemorrhage. Of the six supplying vessels (ovarian, uterine, and vaginal) to the uterus only two (ovarian or uterine or a combination thereof) are required for uterine viability.