A retrospective study on estrogen or contraceptives in the treatment of dysfunctional uterine bleeding in adolescent patients

Objective: To investigate the clinical efficacy of estrogen or contraceptives in the treatment of acute bleeding of dysfunctional uterine bleeding (DUB) in adolescent patients and the optimal starting dosage of drugs.Methods: The clinical records of 106 girls who with DUB and moderate or severe anemia from February 1990 to July 2005 were analyzed retrospectively.Results: All 106 patients received hormonal therapy. 56 patients were treated with estradiol benzoate(E2), 30 patients with conjugated equine estrogen(CEE) and 20 patients with combined oral contraceptives (COCs). The rates for rapidly controlling bleeding and for rapidly stopping bleeding in E2 group were higher than those in CEE group ,but similar to those in COCs group. The days for controlling and completely stopping bleeding were not significantly different between the starting dosages (≤8 mg/d and >8 mg/d) of E2 groups, and also there were no statistical difference between the starting dosages (<7.5 mg/d and ≥7.5 mg/d) of CEE groups, but during the treatment the rate of increasing the dosage in <7.5 mg/d group was higher than that of ≥7.5 mg/d group(40% vs. 5%),while there were no statistical difference between the starting dosages (≤3 pills/d and >3 pills/d) of COCs groups. Conclusions: The clinical efficiency of E2 treatment on DUB in adolescent patients is similar to that of COCs. And the efficacies of treatment of DUB with E2, CEE and COCs in the different dosages are similar.     

左侧气胸的心电图特征及原因分析

目的探讨左侧气胸致心电图改变的特征及产生原因。方法回顾性分析50例左侧气胸患者的心电图和X线胸片资料。结果50例(100%)均呈R波逆递增,V1￣V6导联QRS波平均振幅呈V2>V3>V4>V5。左侧胸导联低电压39例(78%),而II、III、aVF导联QRS波振幅全部>0.5mV。顺钟向转位38例(76%),胸导联QRS波振幅随呼吸周期性改变31例(62%),胸导联QRS波振幅最大/最小的比值与气胸肺组织压缩程度呈正相关(p<0.05)。结论胸导联R波逆递增是左侧气胸最重要的特征性心电图改变,气胸的严重程度与胸导联QRS波振幅最大/最小的比值呈正比。     

Urinary dysfunction and autonomic control in amyloid neuropathy

Abstract Uro-neurological assessment was performed in four patients with small-fiber neuropathy due to amyloidosis (2 transthyretin-type/2 immunoglobulin light-chain-type). Voiding difficulties were due to detrusor weakness and impaired bladder sensation. In two patients cholinesterase inhibition treatment caused urge incontinence, indicating detrusor denervation supersensitivity. The underlying mechanisms of urinary dysfunction seem to involve postganglionic cholinergic and afferent somatic nerves.     

枢星联合方案预防顺铂(DDP)致恶心呕吐的观察及护理

目的:研究枢星联合方案(枢星联合地塞米松及胃复安)预防顺铂联合化疗所致恶心呕吐的疗效及护理干预。方法:将93例接受以顺铂为主联合化疗的患者随机分为两组,实验组53例接受70周期化疗并给予护理干预;对照组40例接受57周期常规化疗,观察1~5d,对两组恶心、呕吐控制率进行比较。结果:实验组对急性恶心、呕吐控制率分别为90%及94.3%,均较对照组(77.2%和80.87%)明显提高(P<0.05)。结论:枢星联合方案结合护理干预可较好地预防顺铂所致的急性恶心、呕吐,使患者以更为舒适的状态接受化疗。     

Changes in hippocampal neurons and memory function during the developmental stage of newborn rats with hypoxic-ischemic encephalopathy

BACKGROUND: Under the normal circumstance, there exist some synapses with inactive functions in central nervous system (CNS), but these functions are activated following nerve injury. At the early stage of brain injury, the abnormal functions of brain are varied, and they have very strong plasticity and are corrected easily. OBJECTIVE: To observe the changes of neuronal morphology in hippocampal CA1 region and memory function in newborn rats with hypoxic-ischemic encephalopathy(HIE) from ischemia 6 hours to adult. DESIGN: Completely randomized grouping, controlled experiment. SETTING: Taian Health Center for Women and Children; Taishan Medical College. MATERIALS: Altogether 120 seven-day-old Wistar rats, of clean grade, were provided by the Experimental Animal Center, Shandong University of Traditional Chinese Medicine. Synaptophysin (SYN) polyclonal antibody was provided by Maixin Biological Company, Fuzhou. METHODS: This experiment was carried out in the Laboratory of Morphology, Taishan Medical College between October 2000 and December 2003. ① The newborn rats were randomly divided into 2 groups: model group and control group, 60 rats in each group. Five rats were chosen from each group at postoperative 6 hours, 24 hours, 72 hours, 7 days, 2 weeks and 3 weeks separately for immunohistochemical staining. Fifteen newborn rats were chosen from each group at postoperative 4 weeks and 2 months separately for testing memory ability (After test, 5 rats from each group were sacrificed and used for immunohistochemical staining)② The right common carotid artery of newborn rats of model group was ligated under the anesthetized status. After two hours of incubation, the rats were placed for 2 hours in a container filled with nitrogen oxygen atmosphere containing 0.08 volume fraction of oxygen, thus, HIE models were created; As for the newborn rats in the control group, only blood vessels were isolated, and they were not ligated and hypoxia-treated. ③ Thalamencephal tissue sections of newborn rats of two groups were performed DAB developing and haematoxylin slight staining. Cells with normal nucleous in 250 μm-long granular layer which started from hippocampal CA1 region were counted with image analysis system under high-fold optical microscope (×600), and the thickness of granular layer was measured. The absorbance (A) of positive reactant of SYN in immunohistochemically-stained CA1 region was measured. Learning and memory ability were measured with step through test 3 times successively. ④ t test and paired t test were used for comparing intergroup and intragroup difference of measurement data respectively, and Chi-square for comparing the difference of enumeration data. MAIN OUTCOME MEASURES: Comparison of cytological changes in hippocampal CA1 region and memory ability at different postoperative time points between two groups. RESULTS: Totally 120 newborn rats were involved in the result analysis. ① Cell morphological changes in hippocampal CA1 region: In the control group, with aging, perikaryon, nucleus and nucleolus in cortex of parietal lobe were significantly increased, Nissl body was compacted, the amount of neurons was declined, but the A of SYN positive reactant was relatively increased. In the model group, at postoperative each time point, neurons were seriously shrunk and dark-stained, nucleus was contracted, chromatin was condensed, nucleolus was unclear, even cells disappeared, especially the cells in 6 hours and 24 hours groups. The amount of neurons with normal morphology in hippocampal CA1 region and granular layer thickness in the model group at postoperative each time point were significantly less or smaller than those in the control group at postoperative 6 hours respectively (t =3.002-1.254, P < 0.01). The A value of SYN positive reactant at postoperative 2, 3 and 4 weeks was significantly higher than that at previous time point (t =2.011－2.716,P < 0.05－0.01). ② Test results of learning and memory ability: In the first test, there was no significant difference in the ratio of rats which kept memory ability between two groups (P > 0.05); In the third test, the ratio of rats which kept memory ability in the model group was significantly lower than that in the control group at postoperative 4 weeks and 2 months[53%(8/15)，100%(15/15)；60%(9/15)，93%(14/15)，χ 2=2.863，2.901，P < 0.01]. CONCLUSION: The destroyed hippocampal structure induces the decrease of learning and memory ability of developmental rats. Early interference can increase the quality of neurons and also promote functional development of the nervous system.     

Adherence to continuous positive airway pressure treatment in patients with Alzheimer's disease and obstructive sleep apnea.

OBJECTIVE: This analysis examined whether patients with Alzheimer disease (AD) tolerate continuous positive airway pressure (CPAP). METHOD: Thirty patients with AD were randomized to CPAP or sham CPAP and completed sleep, depression, and quality-of-life questionnaires. Participants could choose to continue treatment after the trial. RESULTS: Patients wore CPAP for 4.8 hours per night. More depressive symptoms were associated with worse adherence (rS=-0.37; N=30, p<0.04). Patients who continued using CPAP had fewer depressive symptoms (t [19]=2.45, p=0.02) and better adherence (t [19]=2.32, p=0.03) during the trial. CONCLUSION: Patients with AD with obstructive sleep apnea can tolerate CPAP. Adherence and long-term use may be more difficult among those patients with more depressive symptoms.     

Aquaporin and Na+ transport of alveolar type II cells in rats with oleic acid-induced acute respiratory distress syndrome]

OBJECTIVE: To evaluate the capacity of active water and sodium transport of alveolar type II (AT II cells in rats with acute respiratory distress syndrome (ARDS). METHODS: AT II cells were isolated and purified from rats with ARDS, and the distribution of aquaporin-1 (AQP-1) on the cells was observed by immunocytochemistry, immunoelectron microscopy and Western blotting. The sodium currents were detected by patch-clamp technique in whole-cell recording mode. RESULTS: Immunocytochemistry showed staining for AQP-1 in rat AT II cells, and immunoelectron microscope demonstrated the presence of AQP-1, which was decreased as shown by Western blotting in comparison with the control group. The whole-cell currents were also decreased, but remained sensitive to terbutalin treatment. CONCLUSIONS: The capacity of active water and sodium transport is damaged, but not totally lost in AT II cells of ARDS rats. Terbutalin can increase the currents even if in pathological conditions. AQP-1 and sodium transport of AT II cells play an important role in pulmonary liquid clearance.     

显微外科技术在尿道下裂修复中的应用

采用显微外科技术行阴囊纵膈皮瓣尿道下裂修复术18例，均获成功。其手术要点为：将阴茎腹侧纤维索条切除，充分伸展阴茎，皮瓣保留足够长度与宽度，克保血运；在显微镜下采用7－0尼龙丝线缝合，形成皮管，不缝皮肤，只缝皮下。硅胶管支架引流，加压包扎阴茎。本文对手术成功的原因进行了初步讨论。     

室旁核注入八肽胆囊收缩素对兔Oddi括约肌肌电的影响

向５６只雄性家兔下丘脑室旁核（ＰＶＮ）内注射微量胆囊收缩素（ＣＣＫ－８），观察对Ｏｄｄｉ括约肌肌电频率的影响。结果：１．向ＰＶＮ注入微量ＣＣＫ－８肌电频率明显增加（Ｐ＜０．０１）；２．向ＰＶＮ先注入ＣＣＫ拮抗剂丙谷胺（ＰＧＭ）后注入ＣＣＫ－８，肌电增加效应被阻断（Ｐ＞０．０５）；３．向ＰＶＮ注入谷氨酸钠（ＭＳＧ）引起肌电频率增加与注入ＣＣＫ－８效应相似（Ｐ＜０．０１）；４．肌电频率增加效应不受心得安影响。用酚妥拉明、阿托品及切断双侧颈迷走神经均可部分抑制其效应。提示下丘脑ＰＶＮ可能是参与控制Ｏｄｄｉ括约肌运动的中枢之一，传出神经可能是交感神经α受体和副交感神经。     

Effect of acupuncture and moxibustion on the high density lipoprotein cholesterol in simple obesity

For the purpose of understanding regulatory effect of acupuncture and moxibustion, we have observed the changes of the obese indices and the lipid indices in 196 sample obesities before and after the acupuncture and moxibustion. The results showed that a good therapeutic effect of acupuncture and moxibustion on obesity was obtained. At the same time, there are the benign regulatory effect of acupuncture and moxibustion on the lipid metabolism and high density lipoprotein cholesterol.