离子选择性电极法测定温泉与中药材中痕量氟

目的:测定两处海南温泉水样与巴戟天、槟榔仁、益智仁等24种海口市售中药材中氟元素含量。方法:采用离子选择电极法测定温泉水与中药材中痕量氟。结果:氟元素含量:温泉水Ⅰ13.06 mg/L,温泉水Ⅱ6.44 mg/L,丹参1.10 mg/kg,鸡骨草7.26 mg/kg,苦楝皮5.56 mg/kg,白鲜皮1.29 mg/kg,石斛1.38 mg/kg,半夏0.10 mg/kg,桑叶9.33 mg/kg,槟榔仁,益智仁,槐花,金不换,当归,白芍,巴戟天,胡椒根,益母草,旱莲草,溪黄草,桑白皮,茯苓皮,牡丹皮,红藤,天南星,枇杷叶等17种中药材均未检出氟。结论:所测两处温泉水样均达到氟医疗价值浓度(F-≥1 mg/L);中药材氟元素含量远小于《农业部2003年茶叶行业标准(NY659-2003)》(F-≤200 mg/kg)。     

The use of a decremental dose regimen in patients treated with a chronic low-dose step-up protocol for WHO Group II anovulation: a prospective randomized multicentre study

BACKGROUND: In women with chronic anovulation, the choice of the FSH starting dose and the modality of subsequent dose adjustments are critical in controlling the risk of overstimulation. The aim of this prospective randomized study was to assess the efficacy and safety of a decremental FSH dose regimen applied once the leading follicle was 10-13 mm in diameter in women treated for WHO Group II anovulation according to a chronic low-dose (CLD; 75 IU FSH for 14 days with 37.5 IU increment) step-up protocol. METHODS: Two hundred and nine subfertile women were treated with recombinant human FSH (r-hFSH) (Gonal-f) for ovulation induction according to a CLD step-up regimen. When the leading follicle reached a diameter of 10-13 mm, 158 participants were randomized by means of a computer-generated list to receive either the same FSH dose required to achieve the threshold for follicular development (CLD regimen) or half of this FSH dose [sequential (SQ) regimen]. HCG was administered only if not more than three follicles >or=16 mm in diameter were present and/or serum estradiol (E(2)) values were <1200 pg/ml. The primary outcome measure was the number of follicles >or=16 mm in size at the time of hCG administration. RESULTS: Clinical characteristics and ovarian parameters at the time of randomization were similar in the two groups. Both CLD and SQ protocols achieved similar follicular growth as regards the total number of follicles and medium-sized or mature follicles (>/=16 mm: 1.5 +/- 0.9 versus 1.4 +/- 0.7, respectively). Furthermore, serum E(2) levels were equivalent in the two groups at the time of hCG administration (441 +/- 360 versus 425 +/- 480 pg/ml for CLD and SQ protocols, respectively). The rate of mono-follicular development was identical as well as the percentage of patients who ovulated and achieved pregnancy. CONCLUSIONS: The results show that the CLD step-up regimen for FSH administration is efficacious and safe for promoting mono-follicular ovulation in women with WHO Group II anovulation. This study confirms that maintaining the same FSH starting dose for 14 days before increasing the dose in step-up regimen is critical to adequately control the risk of over-response. Strict application of CLD regimen should be recommended in women with WHO Group II anovulation.     

宫腔灌注生长激素有助于改善胚胎反复着床失败后冻融胚胎移植的妊娠结局

目的:探讨宫腔内灌注生长激素对与冻融胚胎移植周期反复着床失败(RIF)妊娠结局的影响。方法:选择2013年至2015年胚胎RIF再次行FET患者的病例资料进行回顾性分析,随机分为对照组和实验组,对照组灌注生理盐水,实验组灌注生长激素,分析比较两组患者子宫内膜厚度、分型、血流等情况,观察两组患者着床率、自然流产率、生化妊娠率、临床妊娠率等有无统计学差异。结果:实验组子宫内膜厚度(9.04±1.20mm)高于对照组(8.59±0.97mm),差异有统计学意义(P0.05)。实验组内膜分型较对照组有所改善,差异有统计学意义(P0.05)。实验组HCG扳机日Ⅱ+Ⅲ血流类型(72.5%)较对照组Ⅱ+Ⅲ血流类型(56%)显著增加,差异有统计学意义(P0.05);实验组PI(2.14±0.13)、RI(0.83±0.06)较对照组PI(2.20±0.17)、RI(0.89±0.06)下降,差异有统计学意义(P0.05)。实验组着床率,生化妊娠率,临床妊娠率均高于对照组,差异有统计学意义(P0.05)。而早期流产率、多胎妊娠率未见明显差异。结论:宫腔灌注生长改善子宫内膜容受性,提高着床率以及临床妊娠率,改善反复种植失败患者妊娠结局。     

Acute Gastric Mucosal Lesion in the Aged

Abstract: Over a period of 3 years between August 1985 and July 1988, 110 patients (male/female ratio, 64: 46, age range 22–89 years, mean 48.1 years) were diagnosed endoscopically as having acute gastric mucosal lesion (AGML). These patients were divided into an elderly group (60 years or more, 26 patients) and a younger group (less than 60 years, 84 patients). The chief complaint, the precipitating factors, the location of the lesion, the disease type, the background gastric mucosa and the state of bleeding were compared between the groups. AGMLs in elderly patients were found to have the following characteristic features. The chief complaints included hematemesis and melena, and oral drugs were the precipitating factor in many patients. The lesion often occurred in the body or whole area of the stomach, and was found to be relatively rare in the vestibule. An acute gastric ulcer was the most frequent clinical finding. The background gastric mucosa was rated C-II or more severe in most cases. Overt bleeding was present in many cases, requiring endoscopic hemostasis.     

A huge low-grade fibromyxoid sarcoma of small bowel mesentery simulating hyper immune splenomegaly syndrome: a case report and review of literature

Introduction

Low-grade fibromyxoid sarcoma (LGFMS) is a rare non epithelial tumour. It usually arises from the smooth muscles of the extremities. It is, however, occasionally reported to arise from other regions of the body.

Case report

We report the case of a 32 year old man who complained of a progressive abdominal swelling of 4 months duration. There was associated abdominal discomfort and weight loss. Abdominal examination revealed a non-tender intra abdominal mass filling the abdomen completely. Abdominal ultrasound suggested a massive splenomegaly. Abdomina Computerized Tomography (CT) scan was not done due to financial constraints. At laparotomy, a large, pearl-coloured mass was found within the mesentery of the proximal jejunum, with dilated, tortuous vessels. It was resected along with the overlying 60cm of jejunum. It weighed 7.5kg. Histology and immunohistochemistry confirmed the diagnosis of lowgrade fibromyxoid sarcoma. Post-operative period was uneventful and there were no features of recurrent after 2 year of follow up.

Conclusion

LGFMS may cause a diagnostic dilemma, especially in a third world setting where preoperative diagnosis is hampered by lack of facilities and poverty. A high index of suspicion is needed for preoperative diagnosis, which is necessary for proper planning of the operation.     

CMV infection is associated with transplant renal artery stenosis

Transplant renal artery stenosis (TRAS) is a significant cause of graft dysfunction, with no clearly defined aetiology. Evidence suggests a role for cytomegalovirus (CMV) infection in cardiac transplant vasculopathy and in native coronary artery restenosis after angioplasty. We investigated the relationship between CMV infection after renal transplantation and subsequent development of TRAS. Of 917 patients receiving renal transplants at a single centre from 1978 to 1994, 75 had TRAS diagnosed by angiography. Each was paired with a control transplanted patient with no TRAS, matched for age, sex, year of transplant and number of grafts. Incidence of CMV infection between transplantation and the time of diagnosis of TRAS was assessed in both groups, using clinical and serological criteria to assign patients to three groups: definite CMV infection (CMV-DEF), possible infection (CMV- POSS) and no evidence of infection (CMV-NUL). CMV-DEF was significantly more common in TRAS than in controls (36 vs. 12, respectively, p < 0.001) and CMV-NUL was less common (TRAS 15, controls 33). We have previously reported an increased incidence of acute rejection in patients with TRAS. The subset of patients with no rejection episodes also had significantly more CMV-DEF cases in the TRAS group (54%) than in controls (10%) (p = 0.002). The data are consistent with the hypothesis that CMV infection can contribute to the development of TRAS. The relationship between CMV and TRAS did not arise from an excess of anti-rejection treatment in the TRAS group. CMV-induced large- vessel damage in immunosuppressed patients may occur through local infection and the mitogenic actions of viral gene products within cells of the vessel wall.