Analysis of 28 cases with oviduct occlusion-related infertility treated with a guide wire under uteroscopy and laparoscopy

目的 探讨联合应用宫腔镜-腹腔镜进行导丝治疗输卵管阻塞性不孕症的疗效.方法 28例不孕症患者,经输卵管造影术证实为输卵管不同程度阻塞,联合应用宫腔镜-腹腔镜进行导丝疏通阻塞的输卵管.结果 治疗后,双侧输卵管通畅24例,治愈率85.7％,有效的患者26例,总有效率92.9％.结论 联合应用宫腔镜-腹腔镜进行导丝治疗输卵管阻塞性不孕可视、微创、安全、有效、治愈率高.     

护理干预法在糖尿病性眼病患者术后疼痛的应用评价

目的探讨护理干预方法对糖尿病性眼病行手术后疼痛的应用价值。方法将147例糖尿病性眼病眼科手术患者随机分为对照组74例及干预组73例,对照组进行常规护理,干预组给予护理干预,比较两组术后疼痛情况、术后第2天血糖情况及平均住院时间。结果干预组和对照组术后第2天空腹血糖分别为（6.96±2.50）mmol/L,（8.91±3.00）mmol/L,平均住院时间分别为（10.0±2.5）d,（15.0±5.2）d。干预组术后疼痛等级、术后第2天空腹血糖及平均住院时间低于对照组（P〈0.05）。结论对糖尿病性眼病患者实施术后的护理干预,可有效地降低镇痛药物的使用,有效控制患者术后血糖。     

The inhibitory effects of m-nisoldipine on the 5-hydroxytryptamine-induced proliferation of pulmonary artery smooth muscle cells via Ca2+ antagonism and antioxidant mechanisms

The excessive proliferation of pulmonary artery smooth muscle cells (PASMCs) plays a critical role in the development of pulmonary arterial hypertension. Recent studies indicate that Ca(2+) and reactive oxygen species are critically involved in the process of smooth muscle cell proliferation stimulated by mitogens, such as 5-hydroxytryptamine (5-HT). Because m-nisoldipine, a Ca(2+) channel blocker of the dihydropyridine class, possesses some calcium antagonistic and antioxidant properties, we investigated the effect of m-nisoldipine on PASMC proliferation. The results indicated that m-nisoldipine inhibited 5-HT-induced PASMC proliferation, evaluated by BrdU incorporation and the MTT assay, and this effect was associated with a decreased expression of proliferating cell nuclear antigen (PCNA). Flow cytometry analysis showed that m-nisoldipine blocked 5-HT-induced cell-cycle progression by arresting the cells in the G(0)/G(1) phase. Next, the production of reactive oxygen species and the levels of [Ca(2+)](i) in PASMCs were measured by laser scanning confocal microscopy; m-nisoldipine pretreatment attenuated the [Ca(2+)](i) elevation and the production of reactive oxygen species induced by 5-HT. In addition, m-nisoldipine significantly decreased the 5-HT-induced activation of extracellular signal-regulated kinase (ERK1/2) and c-Jun N-terminal kinase (JNK) and the subsequent c-fos and c-jun mRNA expression. Meanwhile, results also showed that N-acetylcysteine (a reactive oxygen species scavenger) suppressed the proliferation and the ERK1/2 and JNK activation induced by 5-HT. In summary, this study demonstrated that m-nisoldipine effectively suppressed the 5-HT-induced PASMC proliferation, ERK1/2 and JNK activation and subsequent c-fos and c-jun mRNA expression, all of which might be associated with the Ca(2+) antagonistic and antioxidant properties of m-nisoldipine.     

联合应用宫腔镜-腹腔镜进行导丝治疗输卵管阻塞性不孕症28例分析

目的探讨联合应用宫腔镜-腹腔镜进行导丝治疗输卵管阻塞性不孕症的疗效。方法28例不孕症患者,经输卵管造影术证实为输卵管不同程度阻塞,联合应用宫腔镜-腹腔镜进行导丝疏通阻塞的输卵管。结果治疗后,双侧输卵管通畅24例,治愈率85.7%,有效的患者26例,总有效率92.9%。结论联合应用宫腔镜-腹腔镜进行导丝治疗输卵管阻塞性不孕可视、微创、安全、有效、治愈率高。     

In vivo recovery effect of silibinin treatment on streptozotocin-induced diabetic mice is associated with the modulations of sirt-1 expression and autophagy in pancreatic β-cell

Improper adjustments of autophagy and silent information regulator 1 (Sirt-1) expression were reported to be closely associated with metabolic disorders. In this study, we examined the roles of Sirt-1 and autophagy in streptozotocin-induced diabetes mellitus, assessed the relationship between autophagy and Sirt-1, and investigated the protective mechanism of silibinin. Diabetes was induced in 6-week-old mice by intravenous injection of streptozotocin (150 mg/kg/day, for 2 weeks). In the treatment groups, silibinin (50 mg/kg/day, intramuscular injection, for 8 weeks) or inhibitors (50 mg/kg/day, subcutaneous injection, for 8 weeks) were given. Diabetic control animals received vehicle for the same time. Compared with diabetic controls, silibinin or autophagy inhibitor, 3-methyladenine, treated mice showed decreased levels of glycosylated hemoglobin A1C (P < 0.01), serum triglyceride (P < 0.01), cholesterol (P < 0.01), blood glucose (P < 0.05), autophagy (P < 0.05), and apoptosis ratio (P < 0.05) of pancreatic β-cells. Systemic administration of silibinin reversed streptozotocin-induced downregulation of Sirt-1 expression. Sirt-1 may play a role in regulating the physiological level of autophagy and is associated with loss of pancreatic β-cells and metabolic biochemical disorders. Through promoting Sirt-1 expression and recovering autophagy physiologically, silibinin may reverse hyperglycemia and repair damaged pancreatic β-cells.     

多药耐药基因多态性对利培酮及9-羟基利培酮稳态血药浓度的影响

多药耐药基因(MDR1)是跨膜转运体P-糖蛋白(P-gp)的编码基因。胃肠道和血脑屏障等组织中的P-gp可以将包括药物在内的外源性底物排出细胞,影响P-gp底物药物的吸收和分布。MDR1基因多态性会影响P-gp表达和活性,进而影响底物药物的血药浓度和临床疗效,非典型性抗精神药物利培酮及代谢物9-羟基利培酮都是P-gp底物,MDR1基因多态性与这类药物的血药浓度和临床疗效可能相关。     

RP-HPLC法同时测定甘草酸制剂中18α-、18β-甘草酸的含量

目的:建立RP-HPLC法同时测定甘草酸制剂中18α-、18β-甘草酸的含量。方法:采用Phenyl-Hexyl(4.6 mm×250mm,5μm)色谱柱,流动相为10 mmol·L-1醋酸铵溶液(pH=7.75)-乙腈(83∶17),流速1.0 mL·min-1,柱温38℃,检测波长250 nm。结果:18α-、18β-甘草酸的线性范围均为0.3～80μg·mL-1(r2分别为0.9998和0.9999)。两差向异构体得到良好的分离,各制剂中异构体的组成比各不相同。结论:该方法准确,简便,重复性好,可为控制甘草酸制剂中18α-甘草酸和18β-甘草酸的质量标准提供参考,为对18α-甘草酸和18β-甘草酸的进一步研究奠定了基础。     

某三级甲等医院干预前后住院患者的抗菌药物使用强度分析

目的:了解某三级甲等医院开展抗菌药物临床应用专项整治活动前、后住院患者抗菌药物使用强度(AUD)的变化情况。方法:回顾性调查该院2010年12月-2011年5月(整治前)和2011年6-11月(整治后)住院患者抗菌药物的使用品种、品规,计算其AUD,并进行对比分析。结果:整治后该院抗菌药物品种、品规从整治前的75种、144个分别下降至48种、79个;抗菌药物的AUD由整治前的85.6DDDs/100人/天下降为56.8DDDs/100人/天;静脉用药的AUD由整治前的73.3DDDs/100人/天下降至49.4DDDs/100人/天;排序前10位药品的AUD由整治前的54.0DDDs/100人/天下降至44.5DDDs/100人/天。结论:通过开展抗菌药物临床应用专项整治活动,抗菌药物的AUD、品种、品规降幅较大,但抗菌药物特别是β-内酰胺类复方制剂的AUD仍较高,还须进一步加强干预和控制抗菌药物的使用。     

HSV-1基因转移载体在荷瘤裸鼠体内的生物分布研究

目的 研究HSV-1基因转移栽体在BALB/c荷瘤裸鼠体内的生物分布.方法 BALB/c裸鼠注射人乳腺癌MCF-7细胞制备肿瘤模型,瘤体内注射1×107pfu HSV-1,每2天给药1次,共给药3次.分别于给药后24h、5d和17d采集组织脏器,采用Taqman实时荧光定量PCR法,检测不同组织脏器中HSV-1基因拷贝数.结果 成功制备裸鼠肿瘤模型.在不同时间点,肿瘤中检测到的病毒载体最多,且随着时间延长不断增加;淋巴结、背根神经节和性腺中也有较高水平的病毒载体;其他组织器官中病毒载体量较少.结论 HSV-1能为基因转移提供有效、安全的载体平台,并能用于构建溶瘤基因治疗产品.     

临床药师在癌痛患者镇痛治疗中的作用与体会

目的:评价临床药师在癌痛患者镇痛治疗中的作用。方法:采用前瞻性对照研究方法,将2011年3月～2012年2月在我院肿瘤内科病房住院的符合病例选择标准的224例癌痛患者等间隔分为观察组、对照观察组和对照组各112例;临床药师为观察组患者及其相关人员提供药学服务,记录两组患者随访3个月的药物治疗情况及疼痛评分。结果:开始治疗1个月内患者应用镇痛药物情况,组间差异有统计学意义(P=0.013)。两组患者经7日综合治疗后,重度疼痛基本缓解。患者治疗第7日疼痛程度组间差异无统计学意义(P>0.05),但每组患者疼痛程度与治疗前比较,组内差异均有显著统计学意义(P<0.01)。治疗第15日,两组患者疼痛状况趋于稳定,疼痛程度组间比较差异有显著统计学意义(P<0.01);每组患者疼痛程度与其治疗前比较,组内差异也有显著统计学意义(P<0.01)。第30日、45日、60日、90日,在同一时间点患者疼痛程度组间差异均有统计学意义(P<0.05)。结论:临床药师参与癌痛患者镇痛治疗,可以明显提高患者用药合理性、依从性,有效缓解患者的长期疼痛。