替硝唑泡腾片联合雌激素软膏治疗老年阴道炎疗效观察

目的：：探讨替硝唑泡腾片联合雌激素软膏治疗老年阴道炎的临床疗效。方法：80例老年阴道炎患者随机均分为观察组和对照组,对照组仅给予替硝唑泡腾片治疗,观察组在对照组的基础上采用雌激素软膏治疗,比较两组患者的临床疗效、相关症状的变化、不良反应和复发率。结果：治疗后,观察组的总有效率、阴道健康评分、阴道脱落成熟指数明显高于对照组,阴道炎症评分、复发率明显低于对照组,组间比较差异具有统计学意义（P＜0.05）;两组不良反应发生率比较,差异无统计学意义(P＞0.05)。结论：替硝唑泡腾片联合雌激素软膏能够提高老年阴道炎的治疗效果,改善阴道健康状况,降低复发率。     

低剂量结合雌激素软膏治疗绝经妇女泌尿系反复感染的临床观察

目的 探讨低剂量结合雌激素软膏治疗绝经妇女反复泌尿系感染的疗效和安全性.方法 选择绝经后反复泌尿系感染患者56例,其中36例为治疗组,20例为绝经后对照组;另选18例育龄期妇女作为尿道细胞的成熟值育龄对照组.治疗组为症状发作时口服抗生素并同时使用结合雌激素软膏行阴道治疗,绝经后对照组仅用抗生素对症治疗.观察用药后泌尿系感染症状发作次数的变化、了解治疗前后医疗费用的情况,并对三组分别进行尿道细胞涂片检查,计算尿道细胞的成熟值;治疗组观察用药前后子宫内膜厚度和血雌二醇(E2)水平及其他不良反应.结果 56例患者、18例育龄期妇女全部接受随访,观察6个月后与绝经后对照组比较,治疗组泌尿系感染发作次数、医疗费用明显下降[(1.71±1.24)次,(89.74±24.70)元vs(3.54±1.43)次,(294.86±309.73)元],组间比较有显著性差异(P＜0.001).治疗组用药后尿道细胞成熟值由(7.8±2.3)分上升至(36.3±17.5)分,有显著性差异(P＜0.001),与绝经后对照组的(7.2±2.2)分比较亦有显著性差异,但仍低于育龄对照组的尿道细胞成熟值[(94.8±4.7)分],组间比较有显著性差异(P＜0.01);治疗组用药前后血E 2、子宫内膜厚度无改变(P＞0.05).结论 阴道使用低剂量结合雌激素软膏治疗绝经后反复泌尿系感染有明显疗效,且不良反应轻微,可节省医疗费用,是一种较好的治疗方法.     

Prevention and treatment of recurrent urinary system infection with estrogen cream in postmenopausal women

Objective To evaluate the effect and feasibility of using estrogen cream for the prevention and treatment of recurrent urinary tract infection (UTI) in postmenopausal women.Methods Forty-five postmenopausal women with a history of recurrent UTI were divided into two groups (group premarin and group antibiotic). Participants were assigned to apply intravaginal premarin cream (group premarin, n=30) or oral antibiotic (group antibiotic, n=15) for 3 months respectively. Urine routine test, midstream urine and vaginal cultures, vaginal health score (VHS), vaginal cell maturation value (MV), endometrial thickness and blood estrogen level were obtained before and after the study.Results The incidence of UTI in the group premarin was significantly reduced as compared with that in the group antibiotic (2/27 vs 12/15, P<0.001). In the group premarin Lactobacilli reappeared (from 0 to 59.3%) and MV (from 9.2±6.8 to 74.6±14.1) and VHS (from 5.2±0.4 to 13.4±2.5) were improved after 3 months. There was no significant change in the group antibiotic.Conclusion It seems that intravaginal use of estrogen cream would effectively prevent and reduce the UTI in postmenopausal women.     

克林霉素磷酸酯阴道凝胶与磺胺乳膏治疗细菌性阴道炎疗效比较

目的：比较克林霉素磷酸酯阴道凝胶与磺胺乳膏治疗细菌性阴道炎的疗效。方法：使用随机双盲试验,纳入无妊娠、无哺乳、16岁以上有细菌性阴道炎的患者,使用7 d克林霉素磷酸酯阴道凝胶与磺胺乳膏,治疗完成后5-10d及25-39d随访。结果：在25-39d随访时,80名接受克林霉素磷酸酯阴道凝胶患者中的70名,78名接受磺胺乳膏患者中的38名治愈或缓解（ P＜0．05）。大部分的差异出现在有病史组。副作用发生率在两组间无差异。结论：克林霉素磷酸酯阴道凝胶治疗细菌性阴道炎的疗效优于磺胺乳膏。     

The use of corticosteroids in dermatological practice.

OBJECTIVE: To discuss the various uses of corticosteroids in patients with skin diseases. DATA SOURCES: All relevant literature published since 1950 was reviewed and 33 studies were selected. CONCLUSIONS: Systemic and topical corticosteroid preparations are used commonly in patients with skin diseases. Oral administration of steroids is particularly useful in acute hypersensitivity diseases, connective tissue diseases, immunological blistering diseases, and the commoner dermatoses when they are very severe and widespread. Topical steroid preparations are mainly used in the different forms of dermatitis, but are also useful in psoriasis and a number of other skin diseases. If potent topical steroid preparations are used for too long, or in excessive quantities, side effects will be encountered as a direct effect on the skin, for example atrophy, and as a result of systemic absorption, for example, hypothalamic-pituitary-adrenal suppression and Cushing's syndrome.     

Oral versus Vaginal Absorption in Oestradiol in Postmenopausal Women. Effects of Different Particles Sizes

Crystalline oestradiol-17β is poorly absorbed from the gastrointestinal tract. Three different fractions and a standard fraction containing oestradiol-17β of a known particle size and surface area, were administered orally, to postmenopausal women, to test if changes in particle size will influence the absorption. The bioavailability of each fraction was determined by measurements of peripheral plasma oestrogens. Two different dosages of the standard fraction were given vaginally to compare the bioavailability after oral and vaginal administration. The gastrointestinal absorption was dependent of the particle size of oestradiol. The smaller particle the more rapid and effective absorption as reflected by increasing area under the plasma concentration curve of oestrone and oestradiol. The smallest particle, however, resulted in a pronounced initial oestradiol peak. The coarser particles were more slowly absorbed with more even plasma oestrogen elevation for a sustained period of time. The vaginal absorption of oestradiol was more effective than the gastrointestinal. When the same amount of an equal preparation according to particle size, was given vaginally the maximal plasma concentration was almost 40 times higher than when given orally.     

倍美力软膏治疗老年性阴道炎和尿道炎临床观察

目的 :了解倍美力软膏阴道用药对老年性阴道炎和尿道炎的疗效。方法 :5 4例患者将每日 1g含 0 .6 2 5mg的倍美力软膏放入阴道深部 ,一周后改用隔日放置一次 ,直至 2 8d。结果 :5 4例患者用药后 ,阴道炎、尿道炎症状显著改善。血清FSH水平显著下降 ,E2 水平上升至卵泡早期水平 (P <0 .0 5 ) ,用药后体重、子宫内膜厚度较用药前无显著变化 (P >0 .0 5 )。结论 :倍美力软膏能有效改善阴道及尿道的健康状态 ,无内膜过度刺激。     

治疗外阴阴道假丝酵母病55例疗效观察

目的观察在外涂咪康唑(达克宁)霜及阴道填塞咪康唑(达克宁)栓的基础上,加用三九牌复方醋酸地塞米松乳膏外涂,配以HY-290型红外光治疗仪患处照射治疗外阴阴道假丝酵母病的临床疗效。方法回顾性分析我院门诊110例外阴阴道假丝酵母病确诊患者,平均分为A、B两组,B组单纯使用外涂咪康唑(达克宁)霜及阴道填塞咪康唑(达克宁)栓;A组在外涂咪康唑(达克宁)霜及阴道填塞咪康唑(达克宁)栓的基础上,加用三九牌复方醋酸地塞米松乳膏,配以HY-290型红外光治疗仪患处照射治疗,观察A、B两组疗效。结果 A组治疗有效率96.37%,B组治疗有效率70.90%。两组治疗效果差异有统计学意义(P<0.005);两组患者在第3 d症状改善效果比较,差异有统计学意义(P<0.005)。结论在外涂咪康唑(达克宁)霜及阴道填塞咪康唑(达克宁)栓的基础上,加用三九牌复方醋酸地塞米松乳膏外涂,配以HY-290型红外光治疗仪患处照射治疗,通过复方醋酸地塞米松乳膏的抗炎抗过敏作用,樟脑和薄荷的清凉、止痛、防腐,及HY-290型红外光治疗仪可改变局部微循环,促进组织的新陈代谢,加快病理产物的吸收消散,促进组织的再生和修复,达到治疗疾病的目的,终而求得缩短患者不适的时间,明显改善外阴瘙痒、灼痛症状。     

Predicting the predisposition to osteoporosis. Gonadotropin-releasing hormone antagonist for acute estrogen deficiency test

A reliable predictive test to identify perimenopausal women who are vulnerable to the adverse effects of severe estrogen deficiency may be useful in deciding for whom and when to begin estrogen replacement therapy. Primate models were employed to determine whether short-term treatment with gonadotropin-releasing hormone antagonist allows prospective identification of individuals at greatest risk for a negative calcium balance during overt estrogen deficiency; whether high-dose clomiphene citrate is sufficiently estrogenic to abate urinary calcium loss and to sustain vaginal and perineal tissues after ovariectomy; and whether clomiphene citrate will provide these beneficial estrogenic effects without inducing endometrial proliferation and menstruation after progestin withdrawal. The data indicate the capability of short-term gonadotropin-releasing hormone-antagonist test to identify individuals likely to lose calcium rapidly after ovariectomy. This result has potential usefulness in the prediction of susceptibility to osteoporosis after medical castration or spontaneous menopause. At high doses, clomiphene citrate therapy was nearly as effective as high-dose conjugated equine estrogens for conservation of urinary calcium, yet clomiphene citrate did not cause endometrial proliferation or withdrawal bleeding after progesterone therapy.     

丹皮酚泡囊乳膏的制备及其体外透皮吸收考察

目的 以泡囊为载体制备丹皮酚乳膏,优化丹皮酚乳膏的制备工艺及制备处方,并考察体外透皮吸收情况。方法 用乙醇注入法制备丹皮酚泡囊;用乳化法制备丹皮酚乳膏;应用控制变量法优化制备工艺;采用正交设计优化制备处方;并采用TP-6型透皮扩散实验仪,以大鼠腹部离体皮肤作为渗透屏障,通过高效液相色谱法测定药物的累计渗透量来考察丹皮酚乳膏体外透皮吸收情况。结果 基于丹皮酚泡囊制得的乳膏在12 h和24 h的累积渗透量分别是丹皮酚原料药的1.1倍和1.2倍,在24 h时皮内药物滞留量是丹皮酚原料药乳膏的1.26倍。结论 基于丹皮酚泡囊制得的乳膏在有效期内各时间段的体外透皮吸收高于原料药乳膏,且丹皮酚泡囊乳膏的皮内滞留量明显高于丹皮酚原料药乳膏。     

环孢素A脂质体乳胶剂透皮作用的实验研究

目的：观察环孢素A脂质体乳胶剂经小鼠皮肤给药的渗透作用及对豚鼠银屑病模型的影响。方法：采用HPLC测定小鼠皮肤中环孢素A的含量，光镜下观察其疗效。结果：经小鼠皮肤给药，皮肤中环孢素A可达到有效药物浓度；环孢素A脂质体乳胶剂对豚鼠银屑病模型有效。结论：以脂质体为载体，以乳胶剂为剂型，局部外用环孢素A对银屑病有一定效果。     

复方苦蛇乳膏皮肤刺激性和过敏性实验研究

目的:对复方苦蛇乳膏进行皮肤刺激试验和过敏试验,为科学评价其安全性提供依据。方法:采用家兔皮肤刺激试验,分完整皮肤组和破损皮肤组,连续给药5 d后观察;采用豚鼠皮肤过敏试验,于0、7、14 d左侧脱毛皮肤致敏,第28 d右侧脱毛皮肤激发,观察是否引起皮肤过敏或全身性过敏反应。结果:复方苦蛇乳膏对家兔完整皮肤无刺激性,对破损皮肤有轻度刺激性;豚鼠皮肤过敏试验未出现皮肤明显红斑、水肿等皮肤过敏反应及其它全身性过敏反应。结论:复方苦蛇乳膏是安全性较好的外用制剂。     

银屑病患者外用糖皮质激素制剂致不良反应68例临床分析

目的 为了减少银屑病患者外用糖皮质激素制剂致各种不良反应,探讨其发生机制及治疗方法.方法 分别讨论68例银屑病患者各类皮质激素使用后发生不良反应的情况,治疗时采用随机的方法将68例患者分为两组,治疗组停用糖皮质激素制剂,外用萌尔夫软膏,1次/d,连续使用6周;对照组采用逐渐减少使用糠酸莫米松频率,直至停用的方法,其余治...     

雌激素联合乳酸菌阴道胶囊治疗老年性阴道炎疗效观察

目的探讨雌激素联合乳酸菌阴道胶囊对老年性阴道炎患者的临床疗效及安全性。方法 2014年6月至2016年11月在我院接受诊治的老年性阴道炎患者105例,随机数字表法分为单纯乳酸菌阴道胶囊治疗的A组和雌激素联合乳酸菌阴道胶囊治疗的B组,A组52例,B组53例。比较两组临床有效性及安全性。结果在临床症状和p H值改善方面,行雌激素联合乳酸菌阴道胶囊治疗的B组均明显优于A组,P<0.05,差异有统计学意义。结论对于老年性阴道炎患者,雌激素联合乳酸菌胶囊阴道内局部用药能有效改善患者临床症状,不良反应小,值得推广。     

Hypophysectomy for metastatic cancer

Hypophysectomy was studied for its possible effects on cancer by alt eration of the endorcines at the New York Hospital-Cornell Medical Center beginning in 1953. The major effort has been the treatment of 850 cases of metastic breast cancer. In 80 patients with other types of metastatic cancer benefit was found only in 50 cases of prostatic cancer. Prolactin is mediated directly from the anterior pituitary to breast tissue where it aids and abets the growth of breast cancer; its secretion is largely dependent on the estrogen produced in ovaries and adrenals. In humans estrogen given after total hypophysectomy is found to be ineffective in altering metastases. Growth hormone is also produced in the anteriod lobe of the pituitary but its production is not dependent on an estrogen feed-back mechanism. If the primary cancer is dependent on the presence of prolactin, failures with hypophysectomy are explained the tumor having gained autonomy and being no longer so dependent. Contraindications to hypophysectomy include extensive pulmonary, liver, or brain metastases and any systemic disease that would preclude major surgery. Following a remission after oophorectomy, another remission with hypophysectomy may often be obtained. Neither the pathological type of a breast cancer nor the location of metastases alter the results. However the longer the interval between mastectomy and reactivation of the tumor, the more favorable the outlook. Maintenance substitution therapy following removal of the pituitary employs daily hydrocortisone, 17.5 mg orally, or equivalent steroid preparations. The mortality rate is 2% in the first 30 days after operation. In 88 patients evaluated 2 years after operation those who had received a remisssion lasting over 6 months survived nearly 5 times longer than those unbenefitted by the operation. The intracranial procedure is preferred. In cases of failure or when a remission terminates, male hormone therapy, chemotherapy, or radiation may have limited value.     

Nanotechnology: an effective tool for enhancing bioavailability and bioactivity of phytomedicine

To achieve the desired therapeutic objective, the drug product must deliver the active drug at an optimal rate and amount. By proper biopharmaceutic design, the rate and extent of drug absorption (also called as bioavailability) or the systemic delivery of drugs to the body can be varied from rapid and complete absorption to slow and sustained absorption depending upon the desired therapeutic objective. Phytomedicine have served as the foundation for a larger fraction of the current pharmacopeia. But the delivery of phytomedicine is always problematic due to poor aqueous solubility, poor permeation, low systemic availability, instability and extensive first pass metabolism. Current review will discuss in detail about how nanotechnology can enhance the bioavilability and bioactivity of the phytomedicine.     

孕激素对大鼠阴道上皮细胞的影响

目的:研究孕激素对大鼠阴道上皮厚度、细胞层数以及雌激素受体、孕激素受体表达的影响。方法:本研究选用性成熟期雌性SD大鼠40只,体重285～329 g,随机分为4组,对照组(D组)、实验组1(S1组)、实验组2(S2组)、实验组3(S3组),每组10只,全部行双侧卵巢切除术。D组给予灭菌植物油肌内注射,S1组、S2组、S3组分别给予黄体酮1 mg/(kg.d)、5 mg/(kg.d)、25 mg/(kg.d)肌内注射。4周后采用放射免疫法测血清雌激素、孕激素水平,取大鼠阴道上段同一部位组织制成病理切片,测量阴道上皮厚度、细胞层数,采用免疫组织化学方法进行雌激素受体(ER)、孕激素受体(PR)的染色,计数阴道上皮细胞内细胞核ER、PR阳性的细胞所占比例。结果:大鼠血清中孕酮浓度S3组>S2组>S1组>D组,组间比较差异有统计学意义(P<0.01),上皮厚度及细胞层数S2组、S3组多于D组,组间比较差异有统计学意义(P<0.01),随着孕激素的剂量增大S1组、S2组、S3组阴道上皮的ER-、PR的阳性表达评分不断降低,ER-的阳性表达率D组显著高于S2组、S3组,组间比较差异有统计学意义(P<0.01),D组中PR的阳性表达显著高于S3组,两组比较差异有统计学意义(P<0.01)。结论:孕激素可促进卵巢切除大鼠阴道上皮厚度及细胞层数增加,并可抑制阴道上皮中雌激素、孕激素受体的表达。     

苦参凝胶治疗阴道假丝酵母病的药效学研究

目的：在动物模型上进行苦参凝胶治疗阴道假丝酵母病的药效学研究。方法建立阴道假丝酵母病BALB/c小鼠模型,分成模型组、空白凝胶组、苦参凝胶组和酮康唑乳膏组,每天阴道内给药1次,连续7 d,于治疗前和给药后第4、7天取阴道分泌物涂片染色观察。阴道冲洗液在体外培养白色假丝酶母。第7次给药后处死动物,取阴道组织进行病理检查。结果与模型组和空白凝胶组比较,苦参凝胶和酮康唑乳膏两组均可使阴道白色假丝酵母菌落数显著减少。苦参凝胶可增加阴道有益菌-乳杆菌数量,而酮康唑不增加。阴道冲洗液体外培养和计数结果表明,苦参凝胶和酮康唑乳膏可抑制白色假丝酵母生长（P＜0.01）。苦参凝胶还能抑制阴道黏膜水肿及炎性增生。结论苦参凝胶通过抑制白色假丝酵母生长、促进乳杆菌增殖、抑制阴道黏膜炎性增生等机制治疗白色假丝酵母阴道炎。     

Postmenopausal vaginal bleeding during estrogen therapy

Opinions on whether dilatation and curettage is justified in the case of vaginal bleeding in postmenopausal women taking estrogens are presented. Postmenopausal bleeding induced by estrogens usually stops after cessation of treatment, while bleeding due to endometrial cancer usually recurs or continues after cessation of estrogen therapy. Since endometrial cancer may become "silent" after initial bleeding, dilatation and curettage is indicated in all cases of postmenopausal vaginal bleeding, irregardless of estrogen therapy.     

避孕乳膏的制备及透皮吸收研究

为了避免口服避孕对胃肠道刺激性,本文设计制备了避孕乳膏,试图使药物经皮吸收进入体内发挥其避孕作用。通过物理稳定性试验筛选了避孕乳膏基质。用同位素示踪技术和体外流通扩散室研究了炔雌醇和十八甲基炔诺酮的化学结构类似物~3H-雌二醇和~3H-孕酮从避孕乳膏中释药透皮百分率及小鼠体内透皮吸收过程。体外试验结果表明:不同乳膏处方内标记药物的释药透皮百分率不同,水包油型基质释药透皮速度较有规律。处方3,7在8h内分别可释药52%和41.6%。体内试验结果表明:避孕乳膏中药物透皮吸收速度比口服快,透皮吸收峰时为1h,口服吸收峰时为2h。由于小鼠给药时涂布面积较小,透皮吸收程度较差。避孕乳膏对动物皮肤无刺激性。