Study on Therapeutic Mechanism of Neiyifang (内异方) in Treating Endometriosis

Objective: To observe the clinical effect of Neiyifang (内异方,NYF) in treating endometri-osis and to explore its therapeutic mechanism through observing its influence on plasma β-endorphin β-EP) in different menstrual stages and levels of prostaglandins (PGs) in menstruation. Methods: NYF was administered to 104 patients with endometriosis one dose daily with 3 successive menstrual cycles as one therapeutic course. Peripheral blood β-EP level in follicular, luteal and menstrual stages, as well as PGF2a, PGE2, thromboxane B2 and 6-keto-PGF1a levels in menstrual stage were detected by RIA, and controlled with those in 15 healthy persons. Results: (1) The total effective rate of NYF was 81. 3% and it showed significant effect in improving patients' clinical symptoms and physical signs; (2) In menstrual stage, the levels of β-EP, 6-keto-PGF1α/ TXB2 were lower(P<0.05) and levels of PGF2a, PGE2, TXB2 and 6-keto-PGF1α, were higher (P<0. 05) in patients than those in control, and the higher the level of     

子宫内膜异位症导致不孕的原因探讨

对４４例子宫内膜异位症患者行腹腔镜检查术，同时行输卵管通液检查以了解输卵管通畅情况，并在腹腔镜下观察排卵情况，测定患者腹腔液及血液中前列腺素浓度。结果表明：异位症患者３８．７％的输卵管部份或全部阻塞；无排卵管为３２．３％；异位症患者腹腔液中ＰＧｓ浓度显著高于同体血管及对照组腹腔液，表明异位症合并不孕与多种因素有关。     

Study on the analgesic effect and mechanism of Zhitong Capsule in adjuvant arthritis rats

Objective: To observe the analgesic effect of Zhitong Capsule (ZTC) and study its mechanism in adjuvant arthritis (AA) rats.Methods: Forty-eight male Sprague-Dawley rats were randomly divided into six groups with 8 rats in each group. On the first day, except to those in the normal group that were treated with normal saline, the same amount of Freund’s complete adjuvant (FCA) was given through intradermal injection into the right hind paw to all the rats in the other groups. From the 17th day of the modeling on, the rats in groups of ZTC were administered daily through gastrogavage with a dose of 1000, 500, 250 mg/kg respectively, while equal volume of normal saline was given to those in the normal group and model group, and an equal volume of aspirin (ASA) solution was given to rats in the ASA group through gastrogavage for 10 days, once per day, and on the 27th day, the analgesic effect of ZTC was measured with heat withdraw method. The activities and contents of Superoxide dismutase (SOD) and lipid peroxides (LPO) in serum were observed by spectrophotometry, and the level of beta-endorphin (β-EP) in hypothalamus were determined by the assay of immunohistochemistry.Results: ZTC showed significant effects on enhancing the pain threshold and at the same time it increased the activities of SOD and reduced the contents of LPO in serum. ZTC could also increase the level of β-EP in hypothalamus.Conclusion: ZTC has analgesic effect and its mechanism is probably related with its effect in inhibiting the level of oxygen free radicals in serum and increasing the level of β-EP of hypothalamus in rats. Supported by the Commission for Science and Technology of Jiangsu Province (No. BS96361)     

珍香胶囊治疗子宫内膜异位症作用机制的初步研究

目的探索中药珍香胶囊治疗大鼠子宫内膜异位症的机制。方法采用自体子宫移植方法建立大鼠子宫内膜异位症模型。4周后，将大鼠随机分组进行药物治疗（珍香胶囊组、内美通组、空白对照组）。治疗4周后，免疫组化方法检测大鼠异位内膜组织的雌激素（ER）α和β受体、血管内皮生长因子（VEGF）、芳香化酶（Aromatase）。ELISA方法检测大鼠血清、腹腔液中白介素（IL）-6、VEGF、肿瘤坏死因子（TNF）α。结果疗效：珍香胶囊能够抑制、破坏异位内膜的增长，其作用与内美通相似。ER—α、ERβ、VEGF、IL-6、Afomatase在对照组及各用药组大鼠的移植组织中均有表达，各组之间无明显差异（P〉0．05）；ELISA检测各组大鼠血清、腹腔液中VEGF、IL-6、TNF—α水平，均未见阳性表达。结论珍香胶囊治疗大鼠子宫内膜异位症可能并不影响异位病灶组织的雌激素受体、血管内皮生长因子、芳香化酶，不影响大鼠血液、腹腔液的各种因子，其确切治疗机制目前尚不清楚。     

孕三烯酮和米非司酮治疗术后子宫内膜异位症的疗效观察

目的：探讨孕三烯酮和米非司酮治疗术后子宫内膜异位症的临床疗效.方法：82例盆腔子宫内膜异位症手术患者,随机分为孕三烯酮组和米非司酮组,每组41例.孕三烯酮组,按2.5 mg/次,2次/周,口服给药.米非司酮组,按12.5 mg/次,1次/d,口服给药,分析两组患者的疗效.结果：米非司酮组缓解率90.3％,与孕三烯酮组缓解率87.8％比较,差异无统计学意义（P＞0.05）;治疗后米非司酮组血清P（12.96±7.33）nmol/L,与孕三烯酮组血清P（11.88±7.29） nmol/L比较,差异有统计学意义（P＜0.05）;服药期间,米非司酮组出现恶心症状患者6例（14.6％）,明显低于孕三烯酮组21例（51.2％）,差异有统计学意义（P＜0.05）.结论：子宫内膜异位症术后应用米非司酮的治疗效果较孕三烯酮好.     

子宫内膜异位症患者腹腔液对正常NK细胞活性的抑制及相关因素分析

目的 :探讨子宫内膜异位症 (EM)患者的腹腔液对自然杀伤 (NK )细胞的作用 ,以及与腹腔液中白细胞介素 6 (IL -6 )、前列腺素 (PG)含量的关系。方法 :以 He L a细胞作为靶细胞 ,采用 L DH释放法测定与 EM患者腹腔液共同孵育后正常人血 NK细胞活性的变化。应用放射免疫法测定腹腔液中 PG和 IL - 6的含量。 结果 :在作用 2 h时 ,非 EM患者和 EM患者腹腔液对正常人外周血 NK细胞活性的抑制率分别为 (37.1± 18.9) %和 (6 5 .2± 2 1.8) % ,两者相差非常显著 (P<0 .0 1) ,抑制率与 EM临床分期呈正相关 (r=0 .6 0 2 3,P<0 .0 5 )。延长腹腔液与淋巴细胞的作用时间 ,则对 NK细胞活性的抑制率也随之升高。 EM - 期的患者腹腔液中 IL - 6含量为 (0 .6 1± 0 .4 7)μg/ L ,明显高于对照组的 (0 .4 3± 0 .39)μg/ L (P<0 .0 1) , - 期组 [(0 .4 9± 0 .36 )μg/ L ]与对照组相似 (P>0 .0 5 )。腹腔液中 IL - 6的含量与其对 NK细胞活性的抑制率之间无明显的相关性 (r=0 .2 38,P>0 .0 5 )。 EM患者腹腔液中 PGE2 和 PGF2α含量均明显升高 ,其中 - 期患者腹腔液对 NK细胞抑制率与PGE2 含量呈正相关 (r=0 .5 13,P<0 .0 5 ) ;与 PGF2α也呈正相关 (r=0 .4 2 5 ,P<0 .0 5 )。结论 :EM患者的腹腔液对 NK细胞活性具有     

阴道超声对复发性卵巢子宫内膜异位囊肿治疗的临床价值

目的 探讨阴道超声对复发性卵巢子宫内膜异位囊肿治疗的临床价值.方法 对35例复发性卵巢子宫内膜异位囊肿的声像图进行回顾性分析,并经阴道超声引导穿刺、无水乙醇注入治疗,观察随访1年.结果 35例患者共42个囊肿,根据声像图特点囊肿分为三类,即单房型(30例),多房型(3例),混合型(2例).超声诊断均为卵巢子宫内膜异位囊肿,与病理结果完全符合,诊断准确率为100%.穿刺均一次成功.30例治愈,5例复发,治愈率为85.7%,总有效率为100%.结论 阴道超声对复发性卵巢子宫内膜异位囊肿诊断准确.同时应用阴道超声对其介入治疗,是一种安全、简单、微创、有效的方法,尤其适合治疗术后复发患者.     

子宫内膜异位症患者腹腔液中自然杀伤细胞活性及前列腺素和白介素-6水平的研究

目的探讨子宫内膜异位症(EM)患者的腹腔液(PF)中白细胞介素-6(IL-6)、前列腺素(PGs)的含量变化与PF对自然杀伤细胞(NK)活性影响的关系。方法选择42例EM患者作为观察组(EM组),13例症状相似的非EM患者作为对照组,采用乳酸脱氢酶(LDH)释放法测定NK细胞活性。放射免疫法测定PF中PGs和IL-6的含量。结果作用2h时,非EM患者和EM患者的PF对NK细胞活性的抑制率分别为34.8%±26.2%和66.1%±30.4%,两者比较有显著性差异(P<0.01)。EM组抑制率与EM临床分期呈正相关(r=0.6207,P<0.01)。EMⅠ~Ⅱ期患者PF的IL-6含量为0.62±0.45μg/L,Ⅲ~Ⅳ期患者为0.48±0.35μg/L,对照组为0.41±0.38μg/L,三者间差异无显著性(P>0.05)。PF中IL-6的含量与其对NK细胞活性的抑制率之间无显著相关(r=0.2231,P>0.05)。EM患者PF中PGE2和PGF2ɑ含量均较对照组明显升高(P均<0.01),其中Ⅰ、Ⅱ期患者PF对NK细胞抑制率与PGE2、PGF2ɑ含量呈正相关(r=0.5098或0.4102,P均<0.01)。结论EM患者的PF对NK细胞活性具有明显的抑制作用,Ⅰ、Ⅱ期患者PF中PGs的增高可能对NK细胞活性有一定的抑制作用。     

内异方对子宫内膜异位症大鼠腹腔微环境的影响

目的:观察内异方对子宫内膜异位症大鼠腹腔微环境的影响,初步探讨其作用机理。方法:观察内异方对子宫内膜异位症实验大鼠腹腔液中巨噬细胞的数量及其吞噬功能的影响,检测给药前后内异症大鼠腹腔液中血管生成关键因子VEGF的含量,了解其变化情况。结果:内异方可降低内异症大鼠腹腔液中巨噬细胞的数量;可降低内异症大鼠腹腔液中VEGF的含量,使内膜异位种植灶的体积缩小。结论:内异方可通过降低腹腔液中巨噬细胞的数量,使腹腔微环境中血管生成的关键细胞因子-VEGF的含量减少,使内膜种植灶的体积缩小,故可从抑制血管生成角度解释内异方治疗子宫内膜异位症的作用机理。     

腹腔镜诊治子宫内膜异位症新进展

子宫内膜异位症是育龄妇女的常见病，且发病率逐年增高。随着腹腔镜微创技术在妇科临床的广泛、深入应用，腹腔镜检查已成为子宫内膜异位症诊断的金标准。在腹腔镜直视下可确定诊断，并利用其放大作用能识别微小病灶，对可疑病变处可进行热-色试验、美兰着色试验或活组织检查，使诊断率明显提高。同时腹腔镜下可进行病灶电凝、内凝、激光烧灼或病灶切除、粘连分离，卵巢内膜异位囊肿剥除，骶韧带切断等各种术式的治疗。缓解、消除疼痛、减少复发和术后粘连，可明显提高合并不孕症患者的妊娠率。与传统的开腹手术比较，具有创伤小、恢复快、术后粘连发生率低、并发症少、住院时间短、治疗效果好等优点，已成为子宫内膜异位症的首选术式。     

子宫内膜异位症保守术后复发相关研究探析

子宫内膜异位症作为一种难治性慢性疾病,腹腔镜下子宫内膜异位囊肿剔除术是目前内异症保守性手术的首选。然而内异症保守术后极易复发,复发特点、复发定义及二级预防的效果目前尚无统一定论,复发因素也尚不明确。笔者整理近20年来内异症术后复发相关研究并对国内外子宫内膜异位症复发研究现状进行分析探讨,以期对内异症复发的研究和治疗提供新思路。     

Clinical effect and action mechanism of Weicao Capsule (威草胶囊) in treating gout

Objective： To study the therapeutic effect of Weicao Capsule （威草胶囊, WCC） on gout. Methods： Two hundred gout patients were assigned to two groups. The treated group was treated with WCC and the control group was treated with Tongfengding Capsule （痛风定胶囊）. Both groups were given the respective treatments orally 3 times a day, 2 capsules each time with 2 weeks as one course and all patients received 2 successive courses of treatment. Changes of blood β2- microglobulin （13 2-M）, hemoglobin （Hb）, 24 h urinary protein （24 h UP）, pH value of urine and blood uric acid （BUA） as well as kidney function were observed. Results： After treatment, level of β 2-M got lowered significantly, Hb and 24 h UP, blood urea nitrogen, serum creatinine and the clearance rate of creatinine, as well as blood lipids all improved obviously in the treated group （all P〈0.01）, while these parameters remained unchanged in the control group （P〉0.05）. The pH value of urine was improved in both groups showing an insignificant difference between them （P〉0.05）. BUA was decreased in both groups with a decrease to a larger extent in the treated group （P〈0.01）. The total effective rate was 87% in the treated group, which was superior to that in the control group （62%, P〈0.05）. Conclusion： WCC has a favorable therapeutic effect on gout and its mechanism of action for improving renal function and reducing urinary protein could be related with the lowering of blood β 2-M, BUA and lipids.     

米非司酮、达那唑治疗复发性子宫内膜异位症的疗效比较

目的比较米非司酮、迭那唑治疗保守性手术后子宫内膜异位症复发的临床疗效及不良反应。方法选择经开腹腔镜确诊的子宫内膜异位症复发患者87例,随机单盲分为两组。米非司酮组46例,服用米非司酮12．5mg。1次／d;达那唑组41例,服用达那唑200mg,2次/d,疗程6个月,定期随访。比较应用来非司酮及达那唑治疗子宫内膜异位症的症状、体征变化及不良反应情况。结果米非司酮组痛经、非经期下腹痛、性交痛、盆腔触痛、后陷凹结节、子宫活动受限的改善率与达那唑组比较,差异均无统计学意义（P〉O．05）。米非司酮组阴道异常出血、体重增加、转氨酶升高及皮肤改变不良反应发生率显著低于达那唑组,差异有统计学意义（P〈O．05）。结论米非司酮治疗复发性子宫内膜异位症与达那唑疗效相当,但不良反应较达那唑明显减少,安全性高。     

中药周期疗法治疗子宫内膜异位症临床思路与应用

子宫内膜异位症是具有活性的子宫内膜组织出现在子宫腔被覆黏膜以外的部位而引起的一组临床症状, 发病率逐年上升, 临床诊治较为棘手。王建玲主任根据多年临床经验, 认为本病病机关键为血瘀痰阻, 治疗当分行经期与非经期不同而有所侧重。临床治疗子宫内膜异位症, 可运用中药周期疗法。同时, 需兼顾患者气滞、寒凝、肾虚致瘀之不同, 审证求因, 用药随证加减。临床配合中药灌肠, 内外合治, 疗效显着。     

Follicular fluid levels of prostaglandin E2 and the effect of prostaglandin E2 on steroidogenesis in granulosa-lutein cells in women with moderate and severe endometriosis undergoing in vitro fertilization and embryo transfer

Background  The mechanisms of endometriosis with infertility have not been fully studied. The present study aimed to assess the follicular fluid (FF) levels of prostaglandin E2 (PGE2), which plays a critical role within the ovary, and to investigate the effect of PGE2 on steroidogenesis in granulosa-lutein cells (GLCs) from women with and without endometriosis.

Methods  Thirty-three women with laparoscopically documented endometriosis and 40 controls undergoing in vitro fertilization (IVF) were studied. We assayed the concentrations of PGE2 in FF, the production of E2 and progesterone in FF and in culture medium, and the expression of steroidogenic acute regulatory protein (StAR) and CYP19A1 in GLCs with the intervention of PGE2.

Results  PGE2 and progesterone concentrations were increased and displayed positive correlation in endometriotic FF. PGE2 induced the expression of StAR and the production of progesterone in GLCs from women with endometriosis, and the expression of StAR and the production of progesterone were increased in GLCs from women with endometriosis. However, there were no significant effects of PGE2 on promoting the production of E2 or the expression of CYP19A1 in GLCs. Moreover, the production of E2 and the expression of CYP19A1 in GLCs from women with endometriosis were significantly decreased compared to the controls.

Conclusions  PGE2 concentrations are increased in endometriotic FF, along with concomitant increases in progesterone and StAR. In contrast, the E2 and CYP19A1 are decreased in GLCs, which may delay the development of the follicles and cause an imbalance in the follicular steroid hormone levels. These changes may have close relationship with endometriosis-associated infertility.

     

Study of therapeutic mechanism of acupuncture in treating bronchial asthma

Ｉｔｈａｓｂｅｅｎｃｏｎｓｉｄｅｒｅｄｂｙｍｏｄｅｒｎｍｅｄｉｃｉｎｅｔｈａｔｂｒｏｎｃｈｉａｌａｓｔｈｍａｉｓａｃｈｒｏｎｉｃａｉｒｗａｙａｌｌｅｒｇｉｃｉｎｆｌａｍｍａｔｉｏｎ（ＡＡＩ）ｗｈｉｃｈｉｓｔｈｅｍａｊｏｒｆａｃｔｏｒｔｈａｔｉｎｄｕｃｅｓｒｅｖｅｒｓｉｂｌｅａｉｒｗａｙｖｅｎｔｉｌａｔｉｎｇｄｉｓｔｕｒｂａｎｃｅａｎｄｂｒｏｎｃｈｉａｌｈｙｐｅｒ ｒｅ ｓｐｏｎｓｉｖｅｎｅｓｓ（ＢＨＲ）ｉｎａｓｔｈｍａｔｉｃｐａｔｉｅｎｔｓ,ａｓｗｅｌｌａｓａｃｏｒｒｅｌａｔｉｏｎｂｅｔｗｅｅｎｔ…     

子宫内膜异位症恶变的研究进展

子宫内膜异位症（内异症）是妇产科常见病,给育龄期妇女的生活和工作造成严重影响。内异症恶变作为内异症的严重并发症,近年来发病呈上升趋势,但是其发病机制及与妇科恶性肿瘤的相关性尚有待探讨。本文就内异症的发病机制,内异症与妇科恶性肿瘤、特别是与卵巢癌的相关性,内异症相关性卵巢癌的起源,内异症相关性卵巢癌的信号通路等相关问题进行归纳总结,以期更好地了解内异症恶变。     

小剂量米非司酮治疗复发性子宫内膜异位症的疗效评价及卵巢功能和血皮质醇水平的变化

目的：探讨小剂量米非司酮治疗保守性手术后子宫内膜异位症复发的临床疗效、对卵巢功能及血皮质醇的影响。方法：选择经开腹或腹腔镜确诊的子宫内膜异位症复发患者126例,双盲随机分为米非司酮组（n=72）和达那唑组（n=54）。两组分别口服米非司酮和达那唑,治疗3个月后观察治疗前后症状、体征、卵巢功能及血皮质醇的变化。结果：两组间治疗后痛经、非经期下腹痛、性交痛、盆腔触痛、后陷凹结节、子宫活动受限、卵巢异位囊肿体积改善率比较差异均无显著性（P>0.05）。米非司酮组及达那唑组治疗后血清雌二醇(E₂)值分别为（74.18±22.32）pmol•L^-1 和（24.96±3.94）pmol•L^-1,两者比较差异有显著性（P<0.01）。米非司酮组及达那唑组停药后恢复月经平均日数分别为（27.0±8.9）d和（40.0±12.4）d,两组比较差异有显著性（P<0.01）。两组治疗前后血清皮质醇值比较差异无显著性（P>0.05）。结论：米非司酮组与达那唑组均能有效改善患者的症状及体征;米非司酮组血清E₂保持在卵泡期水平,达那唑组血清E₂处于绝经后水平,米非司酮组不出现雌激素缺乏症;停药后米非司酮组较达那唑组排卵功能恢复快,月经复潮时间短,有利于早日受孕;米非司酮与达那唑短期治疗对血清皮质醇均无明显影响。     

子宫内膜异位症动物模型建立及应用的研究现状

子宫内膜异位症是常见疾病,是生育年龄妇女盆腔痛和不孕的主要原因之一.目前其发病机制不清,治疗效果不理想,复发率高达50%.在人类研究中由于有创性操作受到限制,因此,需要动物模型作为研究的基础.     

Clinical efficacy and molecular mechanism of nourishing shen and supplementing marrow principle in treating β-thalassemia

Objective: To explore the possibility of using traditional Chinese medicine (TCM) in treating β-thalassemia, its clinical effect and molecular mechanism of the action.Methods: According to the TCM theory of “Shen producing marrow”, the composite recipe, Yisui Shenxueling Granule (YSSXL), consisting of Chinese drugs for nourishing Shen and supplementing marrow (NS & SM) was given orally to 78 patients with β-thalassemia (49 of the severe type and 29 of moderate type), 3 times a day, 10 g each time (for children, the dose would be reduced properly), with 3 months as one therapeutic course, and no blood transfusion used in the course. The clinical therapeutic efficacy and hematologic parameters in patients were observed, and systemic gene analysis was conducted with PAGE, PCR, PCR-SSCP, RT-PCR and DNA sequences analysis and mRNA detection, in order to study the molecular mechanism from the relationships between genetic mutation and clinical efficacy, gene expression and its regulation.Results: YSSXL showed obvious therapeutic effect in treating β-thalassemia. Gene analysis revealed that it did not change the genetic mutation type, but could obviously increase hemoglobin, fetal hemoglobin (HbF), γ/(β+γ) globin ratio, γ-globin mRNA expression and GM-CSF mRNA expression in patients, as well as the GM-CSFmRMA in marrow of mice after60Co radiation.Conclusion: YSSXL has a remarkable therapeutic effect on β-thalassemia, and its possible mechanism is its action in unlocking γ-gene, increasing the γ-globin expression and enhancing HbF synthesis so as to compensate for the gene defect. This study has opened a new path for the treatment of β-thalassemia with TCM. This item was supported by National Funds of Natural Sciences (No. 30171199) and Natural Science Foundation of Guangxi Autonomous Region (No. 014402C)