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.     

鞘内注射治疗狼疮中枢损害8例临床观察

系统性红斑狼疮 (ＳＬＥ)合并中枢神经系统损害比率高达14%～ 83% [1] ,其死亡率仅次于肾脏病变和继发感染[2 ] 。狼疮脑病 (ＣＮＳ ＳＬＥ)可以表现为癫痫、精神异常、狼疮性头痛、器质性脑病综合征、横断性脊髓炎等[3 ,4 ] 。目前除甲基强的松龙和环磷酰胺冲击治疗外 ,尚无其他确切有效的方法[5] 。本文报道 8例ＣＮＳ ＳＬＥ用甲氨蝶呤 (ＭＴＸ)和地塞米松 (ＤＸＭ)鞘内注射治疗情况 ,以探讨在全身用药的基础上鞘内治疗的作用。1　资料和方法一般资料 :8例患者为 1997～ 1999年 3月在本院住院及门诊的病例 ,符合美国风湿病学会 1982年修…     

脑通胶囊的质量控制

脑通胶囊由丹参、川芎、延胡索、石菖蒲、桂枝、三七等组成 ,用于冠心病、脑梗塞及后遗症。笔者经研究制定如下质量标准 ,对其质量进行严格控制。1　仪器与试药点样仪 (NanomateⅡ ,瑞士CAMAG公司 ) ,计算机 ,定量毛细管 (瑞士CAMAG公司 )。丹参酮IIA对照品 ,川芎对照药材 ,延胡索乙素对照品 ,石菖蒲对照药材 ,桂皮醛对照品 (中国药品生物制品检定所 ) ,硅胶G(青岛海洋化工厂 ) ,双槽层析缸 (上海信谊仪器厂 )。所用试剂均为分析纯。2　方法与结果2 1　丹参的鉴别取本品 8粒内容物 (4g) ,加乙醚 15ml,置具塞三角瓶中 ,振摇 ,放置 1h…     

HPLC法测定心脑舒胶囊中人参皂苷Rg1的含量

目的:建立高效液相色谱法测定心脑舒胶囊中人参皂苷Rg1含量的方法.方法:采用ODS C18色谱柱,乙腈-0.02%磷酸(20.6:79.4)为流动相,流速为1ml/min,柱温:40℃;检测波长203nm.结果:本法可测定心脑舒胶囊中人参皂苷Rg1含量,回收率为97.55%,RSD为1.79%.结论:该方法简便、准确,可作为心脑舒胶囊中人参皂苷Rg1的含量测定方法.     

小儿CD_7抗原阳性急性髓系白血病55例临床研究

目的 　研究小儿CD7抗原阳性急性髓系白血病 (CD7+AML)的临床生物学特征及治疗效果。方法 　对 55例初治小儿AML进行细胞形态学、免疫表型、多药耐药P糖蛋白 (P1 70 )检测 ,临床观察 ,并常规采用HAE方案诱导治疗 ,判定疗效。结果2 3例CD7+小儿AML在FAB分型中以M2 、M5 多见。M3 中无一例CD7抗原表达 ,将CD7+与CD7-两组小儿AML进行对比 ,CD7+AML具有肝脏明显增大 (P <0 0 0 5) ,外周血白细胞数、原始细胞比例及P -糖蛋白表达增高等特点 (P <0 0 0 5,P <0 0 1及P <0 0 5) ,且年龄偏低 ,中位数年龄 7 6岁 (P <0 0 1 ) ,治疗效果差 ,完全缓解率4 3% ,达首次缓解中位时间为 55 5天。结论 　小儿CD7+AML具有独特的临床生物学特征 ,常表达P -糖蛋白 ,临床症状重 ,治疗效果差 ,完全缓解率低 (P <0 0 5) ,达首次缓解时间长 (P <0 0 5)。     

玻璃体切割术治疗复杂性玻璃体视网膜病变

目的：回顾性分析玻璃体切割术治疗复杂性玻璃体视网膜病变的疗效。方法：对58例（61日艮）复杂性玻璃体视网膜病变病人行常规睫状体平坦部三通道玻璃体切割术。并根据病情相应处理视网膜病变，选择眼内激光及眼内填充物。结果：随访3～13mo，术后矫正视力不同程度改善46眼（75％），12眼（20％）不变，3眼（5％）视力减退。结论：玻璃体切割术联合视网膜手术及光凝、眼内气体、硅油填充治疗复杂性玻璃体视网膜病变有效。     

中药单体及复方制剂抗艾滋病的研究进展

艾滋病,即获得性免疫缺陷综合征(Acquired Immunodefiency syndrome,AIDS)是由人类免疫缺陷病毒(HumanImmunodeficiency Virus,HIV)引起的传染性疾病,其感染性强,死亡率高,引起国内外医药工作者的广泛关注.目前,抗HIV药物的研究已经发展到高效抗逆转录病毒疗法,但此种疗法均来自发达国家,治疗药物的价格昂贵,无法在发展中国家普及.因此价格低、疗效佳,副作用少的抗HIV药物急待问世.中医药学博大精深,在治疗HIV方面有着独特优势,正日益受到研究学者的重视,已成为HIV治疗的另一途径.从中医学的发病原理来讲,艾滋病当属瘟疫毒邪乘虚而入,导致机体阴阳失调、五脏不相协调,正气亏虚,因虚生瘀、积结成症,或变生它症.从中医药治病机理来讲,如能做到从整体出发,辨证论治,扶正祛邪,平调阴阳,即可调整病人的全身机体障碍、代谢失调,使HIV感染者的免疫功能得以增强,使病毒增殖受到抑制继而被控制或减少,从而延缓病情发展,减轻HIV携带者的全身症状,消除体征,提高生存质量,使其生存期得以延长.现将中药有效成分抗艾滋病的研究进展做一简要介绍.     

糖尿病肾病相关miR-130b-3p靶点的生物信息学预测

目的：预测miR-130b-3p靶基因,并对靶基因的分子功能、生物学进程和信号通路进行富集分析,为深入研究糖尿病肾病相关miR-130b-3p的靶基因功能提供理论基础。方法：通过NCBI和miRbase数据库检索基因。应用Vector NTI软件进行miR-130b-3p序列分析,应用TargetScan,picTar,RNA22,PITA和miRanda软件预测靶基因,通过DAVID 和KEGG 数据库进行靶基因功能与信号通路富集分析。结果：已知成熟的不同物种miR-130b-3p核酸序列高度保守。靶基因主要富集在核质和细胞溶质,分子功能主要富集在蛋白绑定和转录因子激活。经典的miR-130b-3p靶基因集合明显富集于KEGG数据库中的TGF-β、AMPK和内吞作用等7个信号转导通路。疾病富集分析与糖尿病高度相关。结论：成功预测miR-130b-3p靶基因,部分靶基因参与的功能及信号通路与糖尿病肾病发生发展过程密切相关。     

忍冬叶中木犀草素及木犀草苷含量的动态变化

建立了高效液相色谱法同时测定忍冬叶中的木犀草素(1)和木犀草苷(2),并考察两者含量随采摘时间的动态变化.采用依利特Hypersil ODS C18柱,以乙腈-0.5％冰乙酸为流动相,梯度洗脱,检测波长350 nm.l和2在2.5～80 μg/ml和5.25～168 μg/ml浓度范围内线性良好,平均回收率为100.1％和99.9％,RSD为0.89％和1.06％.测定了不同月份采摘的忍冬叶中的1和2,结果显示1、2含量分别在11月(0.75 mg/g)和6月(6.05 mg/g)达到最高.     

健肝乐颗粒剂质量标准研究

健肝乐颗粒剂是由黄芪、茯苓、蒲公英、柴胡等组成的纯中药复方制剂,具有增强机体免疫力、理气、消炎等作用.为控制本品质量,笔者对方中主药黄芪、柴胡、虎杖、蒲公英作了薄层色谱鉴别,并用薄层扫描法测定了本品中的黄芪甲苷的含量.