卵巢子宫内膜异位囊肿粘连程度及相关因素分析

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.     

黄牛木中的异戊烯基酮类化合物

目的 研究黄牛木茎60%乙醇提取物的化学成分.方法 运用多种色谱学方法对黄牛木茎60%乙醇提取物的化学成分进行分离,并根据光谱数据鉴定化合物的结构.结果 从该植物中分离得到5个(口山)酮类化合物,分别鉴定为1,7-二羟基-2-(3-甲基丁-2-烯基)-5"-羟基-6"-甲基-6"-(4-甲基戊-3-烯基)-4",5"-二氢吡喃(2",3":3,4)双苯吡酮(Ⅰ)、5,9-二羟基-8-甲氧基-2,2-二甲基-7-(3-甲基丁-2-烯基)-2H,6H-吡喃一[3,2.b]一双苯吡-6-酮(Ⅱ)、黄牛木(口山)酮A(Ⅲ)、4-(3',7'-二甲基辛-2',6'-二烯基)-1,3,5-三羟基-9H-双苯吡-9-酮(Ⅳ)和黄牛木酮A(Ⅴ).结论 化合物Ⅰ为新化合物,命名为越南黄牛木(口山)酮E(cracochinchinone E).化合物Ⅱ和Ⅳ为首次从黄牛木属植物中分离得到.     

西米替丁预防急性脑血管病并发应激性溃疡出血疗效观察

急性脑血管病 (ＡＣＶＤ)并发应激性溃疡出血临床上相当常见 ,病死率甚高 ,我院 1990年 2月～1999年 9月 ,应用西米替丁预防 10 6例病情较重的ＡＣＶＤ并发应激性溃疡患者 ,取得良好疗效 ,现报告如下 :1　临床资料1 1　病例选择　选择经头部ＣＴ检查确诊 ,病变面积大和 /或靠近中线 ,全脑症状重 ,有较大可能发生应激性溃疡者 (就诊时已有消化道出血者未列入 ) ,按入院先后随机分为观察组和对照组 ,每组 10 6例。两组病人年龄、性别、发病时间及病情相似。1 2　方法　观察组除按原发病作相应处理外 ,入院后即给予西米替丁 0 4ｇ加生理盐水稀…     

狭基线纹香茶菜的化学成分

目的对唇形科香茶菜属植物狭基线纹香茶菜(Isodon lophanthoides(Buch.Ham.ex D.Don)Haravar.gerandianus(Benth.)Hara)即中药溪黄草的化学成分进行研究。方法体积分数为95%乙醇提取物的水混悬液经环己烷、乙酸乙酯、正丁醇分步萃取,再对乙酸乙酯层运用硅胶、D101大孔树脂S、ephadex LH 20、ODS等柱层析手段并配合HPLC进行分离、纯化;通过化学方法及波谱分析鉴定其结构。结果分离得到并鉴定了6个化合物:既6去羟基迷迭香酸甲酯(methyl 6 dehy-droxyl rosmarinate,1)、迷迭香酸甲酯(methyl rosmarinate,2)、咖啡酸(caffeic acid,3)、6,7二羟基香豆素(6,7 dihydroxycoumarin,4)、槲皮素(quercetin,5)、蓟黄素(cirsimaritin,6)。结论化合物1为新天然产物,化合物4为首次从该属中分离得到,化合物3、6为首次从该植物中分离得到。     

卵巢子宫内膜异位囊肿粘连程度及相关因素分析

Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence.     

华容县部分健康人群乙型肝炎感染情况分析

目的了解华容县健康人群乙型肝炎(乙肝)感染率及免疫水平,探讨健康人群乙肝预防的对策与措施.方法对2 290名前来华容县疾病预防控制中心预防门诊要求接种乙肝疫苗的健康人群,采用酶联免疫吸附法(ELISA)测定HBsAg、抗-HBs、HBeAg、抗-HBe、抗-HBc,按年龄、性别分组进行5项标志物(HBVM)的分析比较.结果HB-sAg总阳性率为12.93%,男、女分别为16.53%、10.00%,差异有显著性(P＜0.01);抗-HBs总阳性率为49.61%,其中男性为46.93%,女性为51.72%,各年龄组间抗-HBsAg阳性率差异有显著性(P＜0.01);HBVM全阴率为31.44%,男性为31.49%,女性为31.41%,差异无显著性(P＞0.05).结论人群中乙肝感染率高,免疫水平低,易感者多,建议制定成人乙肝疫苗扩大免疫计划,及时对易感人群接种乙肝疫苗,减少乙肝发病率.     

火棘果实提取物对拘束应激负荷引起小鼠肝损伤的保护作用

目的研究火棘果实提取物对拘束应激负荷下活性氧引起小鼠肝损伤的保护作用。方法采用拘束负荷方法造成小鼠应激性肝损伤模型。赖氏法测定小鼠血浆中丙氨酸氨基转移酶(ALT)活性,TBARS法测定血浆及肝组织匀浆中的丙二醛(MDA)水平,ORAC法测定血浆抗氧化能力指数,HPLC法测定血浆及肝组织匀浆中维生素C(VC)水平,以及ORAC方法测定火棘果实提取物和芦丁、金丝桃苷的体外抗氧化活性。结果与拘束模型组相比,火棘果实提取物可以有效降低应激负荷小鼠血浆ALT活力和血浆、肝组织匀浆中MDA水平,并显著提高血浆和肝组织匀浆的抗氧化能力指数和VC水平。火棘果实提取物及其活性成分芦丁和金丝桃苷体外显示出较强的抗氧化能力。结论火棘果实提取物对拘束应激负荷下活性氧引起的小鼠肝损伤具有一定的保护作用,其作用机制可能来自于清除自由基和抑制脂质过氧化过程。     

85例下肢顺行静脉溶栓治疗分析

下肢静脉顺行性造影是诊断下肢静脉疾病的一种重要方法，由于造影剂顺血流方向充盈，故能观察到静脉的全貌，适用于不同类型的静脉疾病诊断，同时也是检验治疗效果的黄金标准。临床上，我们将此方法用于早期下肢深静脉血栓形成(deep vein thrombosis，DVT)的溶栓治疗，研究顺行静脉溶栓(ascending intravenous thrombolysis)临床疗效，现报道如下。     

两种细胞制作的人肝癌裸鼠模型转移性状的比较

目的 比较两种人肝癌细胞株(HCCLM3和SMMC-7721细胞)构建的人肝癌裸鼠模型的转移潜能.方法 实验分为两组:应用HCCLM3细胞构建的人肝癌裸鼠模型组为A组,SMMC-7721细胞构建的模型组为B组.比较A组和B组的原发灶的肿瘤大小和病理检查结果.比较各组的肝内转移率、转移数目,累及的肝叶数以及转移肿瘤体积的大小.所有数据由SPSS16.0软件分析,计量资料采用t检验,率的比较采用Fisher确切概率法,计数资料采用秩和检验.结果 A组的肝内转移率为100%(8/8)、肝内原发肿瘤体积为(6954±1945)mm~3,B组的肝内转移率为62.5%(5/8)、肝内原发肿瘤体积为(6034±2035)mm~3,两组肝内转移率和原发灶肿瘤体积大小比较,差异无统计学意义.肝内转移的数目、累及肝叶数、转移肿瘤的体积大小A组分别为4.5个(中位数)、3个和975 mm~3(中位数),B组分别为1个(中位数)、1个和274 mm~3(中位数),两组比较,Z值分别为-2.818、-2.289和-1.975,P值均<0.05,差异均有统计学意义.两组在肺转移率(P=0.001)和累及其他脏器个数(P=0.041)的比较,差异均具有统计学意义.结论 HCCLM3细胞制作的人肝癌裸鼠转移模型具有高转移潜能,可应用于人肝癌的生物性状的研究.     

栀子属植物化学成分的研究进展

栀子属植物广泛分布于东半球的热带和亚热带地区,已被研究报道的该属植物有20余种。该属植物化学成分多样,包括单萜、三萜、黄酮、藏红花素、有机酸及挥发油等成分。系统的总结了栀子属植物的化学成分研究进展,为该属植物的进一步研究开发提供参考。