Macroporous thin membranes for cell transplant in regenerative medicine

The aim of this paper is to present a method to produce macroporous thin membranes made of poly (ethyl acrylate-co-hydroxyethyl acrylate) copolymer network with varying cross-linking density for cell transplantation and prosthesis fabrication. The manufacture process is based on template techniques and anisotropic pore collapse. Pore collapse was produced by swelling the membrane in acetone and subsequently drying and changing the solvent by water to produce 100 microns thick porous membranes. These very thin membranes are porous enough to hold cells to be transplanted to the organism or to be colonized by ingrowth from neighboring tissues in the organism, and they present sufficient tearing stress to be sutured with surgical thread. The obtained pore morphology was observed by Scanning Electron Microscope, and confocal laser microscopy. Mechanical properties were characterized by stress–strain experiments in tension and tearing strength measurements. Morphology and mechanical properties were related to the different initial thickness of the scaffold and the cross-linking density of the polymer network. Seeding efficiency and proliferation of mesenchymal stem cells inside the pore structure were determined at 2 h, 1, 7, 14 and 21 days from seeding.     

薄层色谱法在当前中药质量标准中的应用探讨

薄层色谱鉴别在历版《中国药典》中的应用经历了从无到有、从少到多的过程；而薄层扫描含量测定在最近几版《中国药典》中的应用比例逐渐降低。随着对中药质量标准体系要求的进一步提高，薄层色谱法的不足之处陆续显现，如仪器普及率低、设备并不简单、结果重复性和稳定性较差、鉴别速度及准确性不及高效液相色谱法、展开剂毒性大等，逐渐不合时宜。在制定中药质量标准时，研究者不应该墨守成规，薄层色谱鉴别也不应该是雷打不动的定性鉴别必备选项。高效液相色谱法具备完全取代薄层色谱法的可行性，薄层色谱法可作为高效液相色谱法的补充。为充分降低检测成本、缩短检测周期、提高鉴别效率，笔者建议中药质量标准体系应该大幅减少薄层色谱鉴别方法的应用，增加高效液相特征图谱鉴定，尽量做到“一个条件，一张图谱”；除非确有必要，《中国药典》等国家质量标准体系应将薄层色谱鉴别作为推荐方法，而非强制标准。     

Pharmacodynamics of combined estrogen–progestin oral contraceptives: 4. Effects on uterine and cervical epithelia

ABSTRACT

Introduction: Steroid hormones are responsible for specific changes in the endometrium during the menstrual cycle, when they are sequentially secreted and, because of this, in the early days sequential combined oral contraceptive regimens were utilized. The same basic concept has been utilized with multi-phasic regimens, in order to produce endometrial pictures mimicking the normal cycle.

Areas covered: The Endometrial effects of progestins and estrogens; combined monophasic high- (50 μg), medium- (30 μg), low- (20 μg), ultralow- (15 μg) estrogen content; sequential regimens; multiphasic combinations; treatment schedules.

Cervical effects of combined high-dose and sequential combinations, including evidence for an increase in malignant lesions.

Expert opinion: Overall, combined oral contraceptives (COCs) inhibit normal proliferative changes and the endometrium becomes thin, narrow, with widely spaced glands and pre-decidual changes in the stroma. During the first few cycles the progestin induces a coexistence of proliferative and secretory features; with time, the picture changes because the progestin induces a down-regulation of estrogen receptors, resulting in tortuous glands similar to those in the secretory phase, but characterized by a quiescent, atrophic glandular epithelium.

In the cervical epithelium, under the influence of high-dose COCs, endocervical glands became hypersecretory and in some instances, distinctive type of atypical polypoid endocervical hyperplasia is found.     

Principles of chemotherapy and radiotherapy

The current management of all gynaecological malignancy requires complex multidisciplinary investigation and discussion, leading to multi-modality treatment. The delivery of systemic therapy or radiotherapy can have different aims depending on the type of cancer, clinical context and patient wishes. This review explores the systemic treatment options and radiotherapy that form part of the standard management of this group of tumours and looks at current research that may help shape the treatment of the future.     

子宫内膜异位症并发不孕患者子宫内膜超微结构观察

目的：探讨子宫内膜异位症（EM）并发不孕患者围着床期子宫内膜的超微结构。方法：选择轻度子宫内膜异位症并不孕患者10例为研究组，已生育妇女7例作为对照组，选择在月经周期第19－22天刮取少量子宫内膜，进行扫描及透射电镜观察。结果：异位症患者围着床期子宫内膜出现超微结构改变，内膜表面腺体开口数少，纤毛再生不全，分泌细胞表面微绒毛极少，子宫内膜着床窗的形态学标记－细胞表面胞饮小泡减少 或缺失；胞质肿胀疏松，有的细胞出现核固醇，结论：异位症患者围着床期在位子宫内膜出现超微结构改变，细胞出现轻度变性，可能是其不孕的原因之一。     

细针抽吸活检术诊断脾结核

脾结核发病较少见，临床症状表现也不典型，常易误诊为其他病变如淋巴瘤、脓肿等，影像表现未见特异征象，极易误诊。现将我院收治的3例脾结核临床特点、影像表现进行介绍。特别是在B超或CT引导下的细针抽吸活检术应用，旨在提高对本病认识、及时正确诊断，避免误诊。     

耳穴埋针配合薄氏腹针治疗失眠症临床疗效观察

目的：评价耳穴埋针配合薄氏腹针治疗失眠症的应用价值。方法：将60例患者依数字随机法分为对照组、治疗组各30例，其中对照组依常规对症处理，合理使用安眠药，治疗组进行耳穴埋针配合薄氏腹针治疗？结果：对照组有效率66．67％，治疗组有效率为93．33％。结论：治疗组的总有效率优于对照组，两组比较有显著性差异（P〈0．05）结论：耳穴埋针配合薄氏腹针治疗失眠症疗效显著，无副作用，患者易于接受。     

第2代(温控)射频消融子宫内膜切除术

目的探讨第2代（温度控制）射频消融子宫内膜切除术的疗效、安全性和可行性。方法2004年9月-2006年2月由上海市4家医院联合开展一项多中心、前瞻性研究,完成功能性子宫出血温控射频消融子宫内膜切除术81例。在超声监护下,射频治疗以温度控制模式输出功率50 W、温度设定85℃,按照两侧宫角、宫底、宫体、下段部位顺序射频消融子宫内膜。每个治疗点治疗时间为4 min。结果81例术后随访4-17个月。术后6个月随访70例,其中闭经48.6%（34/70）,点滴状月经41.4%（29/70）,少量月经10%（7/70）,总有效率为100%（70/70）。术后12个月随访67例,其中闭经56.7%（38/67）,点滴状月经29.9%（20/67例）,少量月经9.0%（6/67）,正常月经量3.0%（2/67）,月经量过多1.5%（1/67）,总有效率98.5%（66/67）。结论温控射频消融子宫内膜切除术不仅使患者的异常子宫出血在保留子宫的情况下得到有效的治疗,同时具有操作方便、治疗时间短、并发症少、术后恢复快等特点。     

刃厚皮片联合微型带真皮下血管网全厚皮片修复截瘫褥疮

目的：应用刃厚皮片联合微型真皮下血管网全厚皮片修复截瘫褥疮。方法：对6例截瘫褥疮，增强全身支持治疗，彻底清除褥疮的炎性肉芽组织及坏死组织后，采用刃厚皮片联合微型真皮下血管网全厚皮片修复．结果：5例Ⅰ期愈合，1例Ⅱ期愈合。结论：本法操作简单，愈合较快，具有一定的耐磨性，为进一步皮瓣修复奠定了基础，是修复难治性截瘫褥疮较理想的方法．