腹腔镜治疗异位妊娠的疗效探讨

目的 探讨腹腔镜手术治疗异位妊娠疗效和优势.方法 以43例实施腹腔镜治疗异位妊娠为观察组,以同期行开腹手术的45例患者为对照组,比较两组手术情况.结果 观察组术中出血量、术后使用镇痛剂、术后并发症、术后肛门排气时间、下床活动时间及住院时间与对照组比较具有明显的优势,差异有统计学意义(P＜0.05).结论 腹腔镜手术治疗异位妊娠创伤小、恢复快、并发症少,比开腹手术有明显的优势,但要注意掌握手术适应证.     

腹腔镜手术治疗异位妊娠的疗效观察

目的观察腹腔镜手术治疗异位妊娠的临床疗效,并与开腹手术进行比较。方法将82例异位妊娠患者随机分为两组,观察组（42例）行腹腔镜手术治疗,对照组（40例）行开腹手术治疗,观察两组术中及术后随访情况。结果观察组患者手术时间、术中出血量、肛门排气时间、术后下床活动时间、留置尿管时间和术后住院时间均明显优于对照组（P〈0.05）;观察组术后不良反应发生率明显低于对照组（P〈0.05）。结论腹腔镜手术治疗异位妊娠具有创伤小、恢复快和并发症少等优点,值得临床推广应用。     

腹腔镜治疗异位妊娠的疗效探讨

目的探讨腹腔镜手术治疗异位妊娠疗效和优势。方法以43例实施腹腔镜治疗异位妊娠为观察组,以同期行开腹手术的45例患者为对照组,比较两组手术情况。结果观察组术中出血量、术后使用镇痛剂、术后并发症、术后肛门排气时间、下床活动时间及住院时间与对照组比较具有明显的优势,差异有统计学意义(P<0.05)。结论腹腔镜手术治疗异位妊娠创伤小、恢复快、并发症少,比开腹手术有明显的优势,但要注意掌握手术适应证。     

腹腔镜手术与开腹手术治疗异位妊娠的临床效果比较

目的观察腹腔镜手术与开腹手术治疗异位妊娠的临床效果。方法将2007年1月至2010年1月我院行手术治疗的异位妊娠患者200例随机分为观察组100例（腹腔镜手术）和对照组100例（开腹手术）,对两组的治疗效果进行比较。结果两组的术中出血、术后肛门排气时间、术后病率及住院时间相比差异有显著性（P〈0.05）。结论腹腔镜手术治疗异位妊娠优势明显,是治疗异位妊娠的积极选择。     

腹腔镜手术与开腹手术治疗异位妊娠的临床疗效对比

目的对腹腔镜手术和开腹手术治疗异位妊娠的临床效果进行比照研究。方法 64例异位妊娠患者,根据治疗方法不同分成观察组和对照组,各32例。观察组给予腹腔镜手术治疗,对照组采用开腹手术治疗。比较两组临床疗效。结果两组盆腔包块均消失,异位妊娠病症均得到治愈。察组手术时间、术中失血量、下床时间、排气时间、住院时间均优于对照组,差异有统计学意义(P<0.05)。此外观察组无术后并发症,对照组有9例出现术后发热,两组并发症发生率比较差异有统计学意义(P<0.05)。结论腹腔镜手术治疗异位妊娠能够有效缩短治疗时间、创伤小、恢复快、出血量小、安全性高,值得临床推广。     

腹腔镜手术与开腹手术治疗异位妊娠的临床疗效比较

目的分析腹腔镜手术与开腹手术治疗异位妊娠的效果。方法66例异位妊娠患者,按照随机双盲法分为观察组与对照组,每组33例。对照组予以开腹手术治疗,观察组予以腹腔镜手术治疗。对比两组患者手术指标、症状(腹痛、停经、阴道出血)缓解时间、并发症发生情况。结果观察组患者的手术时间、术后排气时间、术后下床活动时间、住院时间均明显短于对照组,术中出血量少于对照组,差异具有统计学意义(P<0.05)。观察组患者腹痛、停经、阴道出血缓解时间分别为(7.3±0.6)、(7.6±1.1)、(7.2±1.1)d,均短于对照组的(10.6±1.1)、(11.3±1.4)、(10.3±1.5)d,差异具有统计学意义(P<0.05)。观察组患者术后并发症发生率为6.1%(2/33),显著低于对照组的27.3%(9/33),差异具有统计学意义(χ²=5.345,P=0.021<0.05)。结论相比于开腹手术,腹腔镜手术在异位妊娠治疗中具有更好的效果和安全性,更适宜在临床中推广应用。     

腹腔镜手术与开腹手术治疗异位妊娠的临床分析

目的 对异位妊娠腹腔镜手术与传统开腹手术进行临床比较,探讨两种术式的优缺点。方法 回顾性分析124例异位妊娠手术治疗的临床资料,其中观察者63例行腹腔镜手术,对照组61例行传统开腹手术,进行临床对比分析。结果 两组均未发生明显手术并发症。术后血β-HCG逐渐转阴,病理检查均诊断异位妊娠。观察组患者手术时间、术中出血量、术后留置尿管时间、肛门排气时间、住院天数均明显少于对照组,两组比较差异均有统计学意义(P<0.05);两组切口愈合情况无明显差别。但观察组住院费用明显高于对照组(P<0.05)。1年后随访结果显示:与对照组相比,观察组内的患者发生宫内妊娠的多,同时发生再次异位妊娠的少,两组相比均具有统计学意义(P<0.05)。结论在排除禁忌证的情况下,腹腔镜手术创伤小、术中出血少、术后恢复快、住院时间短且外形美观,值得临床推广,但治疗费用高,存在其相应禁忌证,有较高的设备要求及术者的要求,尚不能完全替代开腹手术。     

腹腔镜下保守性手术治疗异位妊娠疗效评价

目的探讨腹腔镜下保守性手术治疗异位妊娠的疗效。方法 100例适合保守性手术治疗的异位妊娠患者平均随机分为腹腔镜组和开腹组,分别行腹腔镜下和开腹保守治疗,比较2组的手术相关指标、并发症、远期疗效。结果腹腔镜组手术时间、术中出血量、下床时间、住院天数均少于开腹组(P<0.05)。腹腔镜组总并发症发生率5%,开腹组为32%,腹腔镜组术中、术后各种并发症发生率均低于开腹组(P<0.05)。腹腔镜组β-HCG恢复时间与开腹组相比差异无统计学意义(P>0.05),腹腔镜组输卵管再通率、宫内妊娠率均高于开腹组(P<0.05),持续性异位妊娠率低于开腹组(P<0.05)。结论腹腔镜技术治疗异位妊娠效果肯定,与传统开腹手术相比可缩短手术时间,减轻患者痛苦,促进术后康复,提高术后宫内妊娠率,降低持续异位妊娠率。     

31例异位妊娠患者经腹腔镜治疗后的疗效分析

目的探究与分析异位妊娠患者经腹腔镜治疗与开腹手术治疗后的疗效对比。方法选取我院妇产科自2011年8月至2013年8月收治的62例异位妊娠患者,按照患者意愿分为开腹手术组与腹腔镜组,观察并对比其临床效果。结果腹腔镜组患者较开腹手术组相比,可达到较高治愈率的同时,并发症发生率减少,手术时间明显缩短、术中出血量明显较少、平均住院天数明显缩短,P<0.05,具有统计学意义。结论经腹腔镜手术治疗的异位妊娠较传统开腹手术相比,不但取得了更加显著的临床效果,还在一定程度上减少了术中出血量,缩短了住院时间,加快了康复进程,从根本上提高了患者的生存质量。     

腹腔镜与开腹手术治疗异位妊娠的疗效对比

目的 探讨腹腔镜与传统开腹手术治疗异位妊娠的临床效果.方法 选择本院2008年5月～2012年6月收治的136例异位妊娠患者,随机分为实验组和对照组各68例,实验组采用腹腔镜手术治疗,对照组采用开腹手术治疗,比较两组患者手术后的情况.结果 实验组患者的手术时间、术后住院时间、下床活动时间、肛门排气时间、尿管置留时间及术中出血量均明显少于对照组,而对照组并发症的发生率也比实验组高,差异均有统计学意义(P＜0.05).结论 与传统开腹手术比较,腹腔镜手术治疗异位妊娠具有创伤小、术后恢复快、并发症少、伤口美观等优点,是治疗异位妊娠最理想的方法,值得在临床推广应用.     

Interaction of estrone and estradiol with DNA and protein of liver and kidney in rat and hamster in vivo and in vitro

[6,7-³H] Estrone (E) and [6,7-³H]estradiol-17 (E₂) have been synthesized by reduction of 6-dehydroestrone and 6-dehydroestradiol with tritium gas. Tritiated E and E₂ were administered by oral gavage to female rats and to male and female hamsters on a dose level of about 300 g/kg (54 mCi/kg). After 8 h, the liver was excised from the rats; liver and kidneys were taken from the hamsters. DNA was purified either directly from an organ homogenate or via chromatin. The radioactivity in the DNA was expressed in the units of the Covalent Binding Index, CBI = (mol chemical bound per mol DNA-P)/(mmol chemical administered per kg b.w.). Rat liver DNA isolated via chromatin exhibited the very low values of 0.08 and 0.09 for E and E₂, respectively. The respective figures in hamster liver were 0.08 and 0.11 in females and 0.21 and 0.18 in the males. DNA isolated from the kidney revealed a detectable radioactivity only in the female, with values of 0.03 and 0.05 for E and E₂, respectively. The values for male hamster kidney were < 0.01 for both hormones. The minute radioactivity detectable in the DNA samples does not represent covalent binding to DNA, however, as indicated by two sets of control experiments. (A) Analysis by HPLC of the nucleosides prepared by enzyme digest of liver DNA isolated directly or via chromatin did not reveal any consistent peak which could have been attributed to a nucleoside-steroid adduct. (B) All DNA radioactivity could be due to protein contaminations, because the specific activity of chromatin protein was determined to be more than 3,000 times higher than of DNA. The high affinity of the hormone to protein was also demonstrated by in vitro incubations, where it could be shown that the specific activity of DNA and protein was essentially proportional to the concentration of radiolabelled hormone in the organ homogenate, regardless of whether the animal was treated or whether the hormone was added in vitro to the homogenate.Carcinogens acting by covalent DNA binding can be classified according to potency on the basis of the Covalent Binding Index. Values of 10³–10⁴ have been found for potent, 10² for moderate, and 1–10 for weak carcinogens. Since estrone is moderately carcinogenic for the kidney of the male hamster, a CBI of about 100 would be expected. The actually measured limit of detection of 0.01 places covalent DNA binding among the highly unlikely mechanisms of action. Similar considerations can be made for the liver where any true covalent DNA binding must be below a level of 0.01. It is concluded that an observable tumor induction by estrone or estradiol is unlikely to be due to DNA binding.Paper presented at the Satellite Symposium of the European Society of Toxicology, Rome, March 29, 1983     

Penetration and action of edoxudine in vitro and in vivo

The penetration of 5-ethyl-2'-deoxyuridine (edoxudine, Aedurid) from gel base with and without the addition of urea and other adjuvant has been studied in an in vitro model using guinea pig skin. The formulation of 3% edoxudine gel with 5% urea showed the best results. In vivo experiments on hairless mice infected intracutaneously with herpes simplex virus type 1 also showed this formulation's good efficacy as compared to other formulations.     

Mechanisms of antiplatelet and antithrombotic activity of midazolam in in vitro and in vivo studies

Dopamine regulates various physiological functions in the central nervous system and the periphery. Dysfunction of the dopamine system is implicated in a wide variety of disorders and behaviors including schizophrenia, addiction, and attention-deficit hyperactivity disorder. Medications that modulate dopamine signaling have therapeutic efficacy on the treatment of these disorders. However, the causes of these disorders and the role of dopamine are still unclear. Studying the dopamine system in a model organism, such as Caenorhabditis elegans, allows the genetic analysis in a simple and well-described nervous system, which may provide new insight into the molecular mechanisms of dopamine signaling. In this review, we summarize recent findings on pharmacological and biochemical properties of the C. elegans dopamine receptors and their physiological role in the control of behavior.     

Extraction and determination of prednisolone in drugs and excipients in ointments and creams and the uniformity of distribution in prednisolone ointment

For the purpose of measuring the contents of prednisolone in low concentrated ointments and creams an instruction was elaborated that includes several steps of extraction, in the resulting solution of which the assay of the steroid by Blue Tetrazolium reaction will be done. The procedure permits the determination of prednisolone in presence of most of usual ingredients of ointment bases except wool alcohols. Also no influence is given by some remedies combined with prednisolone for topical application except coal tar solution. The results confirm a correct reflection of the steroid contents declared respectively the recovery of the steroid added to various ointment bases. Introducing discussion to content uniformity concerning low concentrated ointments is made, and some deviations are shown.     

Comparative in vivo and in vitro studies of phenytoin protein binding and in vitro lipolysis in plasma of pregnant and nonpregnant rats

This investigation was designed to determine the cause of the changes in drug protein binding that occur in rat plasma, particularly in plasma from pregnant animals, during in vitro drug-protein binding measurements. In vivo estimates of phenytoin binding in plasma were obtained from steady-state CSF-plasma concentration ratios in pregnant and nonpregnant rats. Immediate ultrafiltration of heparin- or EDTA-anticoagulated plasma yielded phenytoin free fraction values that were in good agreement with in vivo estimates for nonpregnant rats but that were about one-third higher than in vivo estimates for pregnant animals. In vitro free fraction values tended to increase during incubation of plasma and/or during equilibrium dialysis. The concentrations of the four major endogenous free fatty acids were similar in plasma of pregnant and nonpregnant rats if determined immediately after blood collection. Six hours of incubation at 37 degrees C caused fatty acid concentrations to increase about fivefold and twofold in heparin-anticoagulated plasma from pregnant and nonpregnant animals, respectively. The corresponding increases in EDTA-anticoagulated plasma were only about twofold and 1.14-fold, respectively. These changes were associated with decreased plasma protein binding of phenytoin. The in vivo differences between pregnant and nonpregnant rats with respect to phenytoin binding in plasma are not due to differences in fatty acid concentrations, but the in vitro differences are due primarily to corresponding differences in free fatty acid concentrations if extensive in vitro lipolysis occurs.     

Mathematical modelling of in situ and in vitro efflux of ciprofloxacin and grepafloxacin

The efflux process due to p-glycoprotein-like mechanisms of ciprofloxacin (CIP) and grepafloxacin (GRX) has been studied "in situ" in rats and "in vitro" in Caco-2 cells. The results were modelled by a curve fitting procedure which allowed the characterization of the passive (Pd) and carrier mediated parameters (Vm and Km) from the raw data without initial velocities estimation. CIP absorption in rat was characterized as a passive diffusion at the assayed concentrations. Although the involvement of an efflux transporter cannot be ruled out, its relevance in the transport of the fluoroquinolone is negligible. In GRX absorption, an efflux process is implicated and it is detected in both absorption models. GRX permeability depends on the intestinal segment, reflecting the previously reported different expression level of the efflux transporters along the gut in rat. A first attempt to correlate the "in vitro" and the "in situ" data has been done. The mathematical model has been constructed using very simplistic assumptions and it will require further refinement but, nevertheless, the results are promising and demonstrate that a good modelling approach helps to identify the system critical parameters and how the system behaviour change when the parameters are modified as it happens when we move from the "in vitro" to the "in situ" level. Predicted versus experimental permeability values show a good correlation, demonstrating that the relevance of the secretion process "in situ" in rat can be predicted from the "in vitro" cell results.     

Comparison of in vitro and in vivo developmental toxicity and pharmacokinetics of phenytoin in the rat

The rat whole embryo culture was compared to an in vivo experiment with regard to embryotoxicity as well as exposure characteristics, using phenytoin as a model compound. Intra-embryonic concentrations and their embryotoxic effects were determined on gestation day 11 after in vitro administration of 50-150 microg/ml or in vivo gavage of 500-1500 mg/kg body-weight on gestation day 10. In addition, exposure kinetics were studied in vivo after a single oral dose on gestation day 10, and developmental defects on gestation day 21 were scored. The embryotoxic effects observed on gestation day 11 were more pronounced after in vitro exposure in comparison to in vivo exposure at similar intra-embryonic concentrations. Exposure of phenytoin on gestation day 10 in vitro via the culture medium resulted in general embryotoxicity on gestation day 11, whereas in vivo effects as determined on gestation day 11 were minimal. Plasma concentrations of phenytoin increased and plateaued around 35 microg/ml during the 48 hr monitoring period. Plasma concentration curves and pharmacokinetic parameters did not show remarkable differences between the dose groups, indicating that absorption is the limiting factor at the dose range used. Although the developmental effects were minimal as observed in vivo on gestation day 11, specific malformations (defects encompassing the urogenital. craniofacial and skeletal systems) were observed on gestation day 21. These findings show that with similar intra-embryonic concentrations of phenytoin the embryotoxicity in rat whole embryo culture was not comparable with the in vivo embryotoxicity as determined on gestation day 11. This discrepancy may at least partly be explained by differences in exposure characteristics.     

Comparison of pulmonary and hepatic glucuronidation and sulphation of ethanol in rat and rabbit in vitro

1. Pulmonary and hepatic UDP-glucuronyltransferase and sulphotransferase activities in subcellular fractions from rats and rabbits were determined, comparing ethanol with known substrates for these enzymes.

2. No ethyl glucuronide formation was detected with either hepatic or pulmonary microsomal incubations.

3. Chromatographic, autoradiographic and scintillation counting analysis indicated that ethanol is sulphated by rat and rabbit pulmonary cytosol, although this activity was approx. 2–6% of that in liver.

4. Rat hepatic and pulmonary sulphotransferase activities with β-naphthol were approx. 13 and 60 times higher than with ethanol, respectively.

5. Rabbit hepatic and pulmonary sulphotransferase activities with both substrates were higher than those in rat.