坤泰胶囊联合来曲唑治疗多囊卵巢综合征不孕症的效果

〔摘 要〕 目的：探讨多囊卵巢综合征不孕症患者采用坤泰胶囊联合来曲唑治疗的临床效果。 方法：对重庆市万州区妇 幼保健院 2019 年 1 月至 2020 年 6 月期间收治的 60 例多囊卵巢综合征不孕症患者进行分组,以随机数字表法分成对照组与 观察组,各 30 例,观察组患者采用坤泰胶囊联合来曲唑治疗,对照组患者采用来曲唑治疗,比较两组患者治疗前后性激素 水平、卵巢卵泡质量、子宫内膜厚度、排卵率、妊娠率。 结果：治疗后,观察组患者的睾酮、雌二醇、促卵泡激素、促黄 体生成素水平均低于对照组,差异具有统计学意义（P ＜ 0.05）。观察组患者的直径＞ 18 mm 成熟卵泡数多于对照组,子 宫内膜厚度大于对照组,差异具有统计学意义（P ＜ 0.05）。治疗 50 d 后,观察组患者排卵率、妊娠率均高于对照组患者, 差异具有统计学意义（P ＜ 0.05）。 结论：对多囊卵巢综合征不孕症患者采用坤泰胶囊联合来曲唑治疗的效果显著,可以 有效改善患者性激素水平及其卵巢卵泡质量,增加子宫内膜厚度,提高妊娠率。     

丙酸睾丸酮联合hCG诱导OHSS倾向PCOS大鼠模型的建模与评价

目的:制备卵巢过度刺激综合征(OHSS)倾向多囊卵巢综合征(PCOS)大鼠模型,并对造模方法进行评价.方法:将SD雌性幼鼠60只分为实验组(48只)和空白对照组(12只).实验组大鼠予颈背部皮下注射丙酸睾丸酮+中性茶油进行PCOS造模,空白对照组注射中性茶油,连续20 d.造模成功的41只大鼠随机分为PCOS对照组10只、高剂量人绒毛膜促性腺激素(hCG)模型组(简称高hCG组)11只、中剂量hCG模型组(简称中hCG组)10只、低剂量hCG模型组(简称低hCG组)10只.高、中、低hCG组分别给予颈背部皮下注射高、中、低剂量hCG+0.9％氯化钠注射液干预,空白对照组和PCOS对照组注射0.9％氯化钠注射液,连续9 d.比较各组大鼠体质量、卵巢病理形态学改变、卵巢指数、卵巢最大横截面积、腹水评分、腹腔伊文思蓝(EB)含量、血清雌二醇(E2)水平.结果:模型组大鼠卵巢体积增大,卵巢指数降低,最大横截面积增大,卵巢出现多发性滤泡囊肿和黄体囊肿;E2水平升高;腹腔毛细血管通透性增加.与空白对照组相比,高hCG组各项指标差异均有统计学意义(P＜0.05);中hCG组除腹水评分外,其余各项指标差异均有统计学意义(P＜0.05);低hCG组除腹水评分、卵巢指数外,其余各项指标差异均有统计学意义(P＜0.05).与PCOS对照组相比,高、中hCG组大鼠卵巢指数、卵巢最大横截面积、腹腔EB含量、血清E2水平差异均有统计学意义(P＜0.05);低hCG组卵巢指数、卵巢最大横截面积、血清E2水平差异均有统计学意义(P＜0.05).结论:丙酸睾丸酮联合中剂量hCG可以诱导OHSS倾向PCOS大鼠模型,该模型的卵巢病理形态学改变、腹腔毛细血管通透性增加、血清E2水平明显升高,但未出现明显腹水,接近人类OHSS倾向PCOS患者的改变.     

芦黄颗粒对实验性动脉粥样硬化家兔C反应蛋白和白细胞介素-6水平的影响

目的:观察中药复方芦黄颗粒对实验性家兔动脉粥样硬化(AS)炎性细胞因子水平的影响,探讨该方防治AS的机制.方法:40只新西兰白兔随机分为5组:假手术组、模型组、血脂康对照组、芦黄颗粒高剂量组、芦黄颗粒低剂量组.采用高脂饲料喂饲及动脉内膜球囊损伤法建立兔AS模型,制模成功后给予相应的药物8周,分别测定各组C反应蛋白(CRP)和白细胞介素-6(IL-6)的浓度.结果:与假手术组比较,模型组CRP和IL-6均明显升高(P<0.01和P<0.05),芦黄颗粒高剂量组血清CRP和IL-6水平均明显低于模型组(P<0.05和P<0.01),与血脂康对照组比较差异无显著性.芦黄颗粒低剂量组CRP水平与模型组比较差异无显著性.结论:芦黄颗粒可能通过抗炎机制,发挥抑制AS的作用.     

对一种强化碱性戊二醛消毒剂的毒理学评价

为了解四环牌强化碱性戊二醛的安全性,进行了急性经口毒性、蓄积毒性、皮肤变态反应、小鼠骨髓嗜多染红细胞微核和精子畸形试验。结果,该剂对小鼠经口LD50为6329mg/kg（体重）,蓄积系数K>5;豚鼠皮肤变态反应试验未出现过敏反应;试验用戊二醛剂量诱导PCE微核细胞率与阴性对照组差异无统计学意义（P>0.05）,对小鼠精子畸形发生率无影响。因此,在本实验条件下,强化碱性戊二醛为实际无毒、弱蓄积毒性。极轻致敏性物质,没有致突变作用。     

阴囊湿疹样癌的围手术期护理

我院2002年1月-2005年12月采用自体大隐静脉移植显微外科修复治疗19例闭合性胭动脉损伤患者，术后通过早期细致的观察与护理，及时采取有效的措施，取得了满意效果，现报道如下。     

基于“魂魄飞扬”的多梦症病机探讨

多梦症是指睡眠不实,睡眠中梦境纷纭不休,醒后神疲乏力、头昏的一种病症。根据多梦症的临床表现,结合古代医籍,笔者提出"魂魄飞扬"是多梦症的发病机制,认为因脏腑虚损或邪气侵扰而出现魂不定、魄不平,发病为"多梦症",据此提出"定魂平魄"的治疗法则,临证治疗时根据患者病因病症灵活用药,可平肝定魂、益肺平魄,使得魂定于肝,魄平于肺。     

1例心脏原发嗜铬细胞瘤根治术的手术配合

原发心脏肿瘤的发病率很低，其部位、大小及活动度决定了临床表现。体外循环心脏停搏下手术切除是治疗心脏肿瘤最有效的方法。而嗜铬细胞瘤的病例异位于胸腔的病例不到1％，大多见于后纵隔，心脏原发嗜铬细胞瘤更少见。我院2007年3月收治1例，并于2007年4月行体外循环下嗜铬细胞瘤切除，取得了良好的效果。现将手术配合体会总结如下。     

Role of mitochondrial calcium uniporter in regulating mitochondrial fission in the cerebral cortexes of living rats

The mitochondrial calcium uniporter (MCU) transports Ca²⁺ from the cytoplasm to the mitochondrial matrix and thus maintains Ca²⁺ homeostasis. Previous studies have reported that inhibition of MCU by ruthenium red (RR) protects the brain from ischemia/reperfusion (I/R) injury and that mitochondrial fission plays an important role in I/R injury. However, it is still not known whether MCU affects mitochondrial fission. In the present study, treatment with RR was found to decrease the concentration of free calcium in the mitochondria, calcineurin enzyme activity and dynamin-related protein 1 expression, and treatment with spermine was found to have the opposite effect in organisms subjected to occlusion of the middle cerebral artery lasting 2 h followed by 24 h reperfusion. These results indicate that MCU may be related to mitochondrial fission via modulating mitochondrial Ca²⁺ uptake and this relationship between MCU and mitochondrial fission may protect the brain from I/R injury.     

Clinical Outcomes in Patients with Non-Diagnostic Thyroid Fine Needle Aspiration Cytology: Usefulness of the Thyroid Core Needle Biopsy

Background

Patients with non-diagnostic thyroid fine needle aspiration cytology (FNAC) results undergo repeat FNAC or core needle biopsy (CNB) for definite diagnosis or surgical resection, or are followed up by clinical and ultrasound surveillance. We aimed at evaluating the risk of malignancy in patients with non-diagnostic FNACs and their clinical outcomes according to the follow-up modality.

Methods

We retrospectively reviewed 1,496 (8.8 %) cases with a non-diagnostic result on a first aspiration among 17,045 thyroid FNACs performed between October 2008 and August 2012. Of the non-diagnostic FNACs, 389 patients underwent a second FNAC; 125, CNB; and 89, thyroidectomy by clinical indication. The remaining patients were clinically followed up.

Results

The rate of a second non-diagnostic result was significantly higher on repeat FNAC than on CNB (33.2 vs. 2.4 %; p < 0.001). There was no significant difference in the malignancy risk among patients initially non-diagnostic, twice non-diagnostic, and thrice or more non-diagnostic, nor did this differ from the rate following CNB. No further malignancy was found in cases with ≥2 non-diagnostic CNBs. The malignancy risk was 51 % in those who underwent thyroidectomy. The sensitivity for detecting malignancy was 65 and 70 % for repeat FNACs and first CNBs, respectively, with no false positives seen in either test.

Conclusions

Approximately one-third of repeat FNACs after an initial non-diagnostic aspirate are non-diagnostic on repeat examination, and the malignancy risk may not reduce following repetitively non-diagnostic FNACs. However, a single CNB may be enough to exclude malignancy risk for patients with a non-diagnostic aspirate.