归芍地黄汤合生脉散治疗围绝经期综合征73例临床观察

目的：观察归芍地黄汤合生脉散对围绝经期综合征的临床疗效。方法：73例围绝经期综合征患者中〈40岁12例,40~44岁14例,45~49岁22例,≥50岁17例。各年龄组均口服归芍地黄汤合生脉散加减进行治疗,分别与治疗前后及治疗12周后比较各年龄组库帕曼评分和激素水平的变化。结果：各年龄组经治疗后与本组治疗前比较库帕曼评分均有明显下降,差异有统计学意义（P〈0.01）。〈40岁的年龄组,促卵泡生成素（FSH）、雌二醇（E2）、促黄体生成（LH）均有改善,差异有统计学意义（P≤0.05）,40～44岁的年龄组,促卵泡生成素（FSH）有改善,差异有统计学意义（P〈0.05）,而雌二醇（E2）、促黄体生成（LH）均无改善（P〉0.05）。≥45岁的两个年龄组,促卵泡生成素（FSH）、雌二醇（E2）,促黄体生成（LH）均无改善（P〉0.05）。结论：归芍地黄汤合生脉散加减可以改善围绝经期综合征患者各年龄组的临床症状,有助于各年龄段的围绝经期妇女平稳度过围绝经期。     

西藏高原三种红景天离体枝条对昆明温度的响应研究

对采集自我国西藏自治区3个地区,分别属于3个不同种的红景天离体枝条在昆明的室温条件下进行新梢生长、根的发生及开花的观测,在昆明室温(室内散射光照;温度17~26℃)条件下,离体枝条均能够长出新梢,并很快开花,水培第7天新梢长度平均达到2.7 cm,2.3 cm和5.5 cm。水培5天后就喜玛红景天和齿叶红景天能观察到开花的新梢,至水培第7天有根生长的仅为长鞭红景天,其余两种红景天至第10天也未观察到生根现象。这些特性对于了解红景天的生物学特性,尤其是从营养生长到生殖生长的快速转化,以及为今后红景天的资源保护、人工繁殖、遗传生理、人工栽培研究有重要意义。     

Hand-assisted laparoscopic management of liver tumors

Background Laparoscopy has clearly advanced the treatment of many diseases related to the liver and biliary tree. The addition of hand assistance can further facilitate minimally invasive liver surgery by providing tactile feedback, atraumatic and versatile retraction, finger-fracture parenchyma dissection, and more precise placement of probes and staplers. Methods Over a 7-year period, 28 patients with liver tumors underwent 31 hand-assisted laparoscopic operations at a tertiary care center. The candidates for hand-assisted laparoscopic resection were patients with lesions involving two hepatic segments or fewer located at the inferior edge of the liver (segments 5 and 6), or confined to the left lateral segment (segments 2 and 3). Ablation was reserved for patients with poor functional status or limited hepatic reserve, and hand-assistance was added for laparoscopic ablation of centrally located tumors (segments 7, 8, and 4a). Results The selection criteria were met by 52 patients, 6 of whom had benign lesions. The remaining 46 patients had malignant disease, and 15 of these patients (33%) were found to have extrahepatic disease: 11 at initial laparoscopy and 4 at hand-assisted abdominal exploration. Manual exploration also detected additional intrahepatic treatable lesions in two cases. A total of 19 patients (68%) had metastatic disease, and 3 (11%) had primary liver cancer. The most extensive resections were five left lateral segmentectomies. All margins were negative. The mean operative time was 2.75 h, and the mean blood loss was 230 ml. Two diaphragmatic injuries occurred during ablation of segment 8 lesions. Three cases were converted to open surgery because of adhesions. The mean hospital stay was 3.7 days. A group of 15 patients who had metastatic colorectal cancer treated with resection and/or ablation had a mean follow-up period of 24 months (range, 2–61 months) and a mean survival time of 36 months. Conclusions For selected patients, the hand-assisted technique can be applied safely and effectively to laparoscopic liver surgery and may identify the presence of previously undetectable intrahepatic or extrahepatic disease. Poster presentation at the 2006 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Scientific Session, April 26–29, 2006, Dallas, TX     

External validation of prognostic models for ongoing pregnancy after in- vitro fertilization

This study aimed to validate prognostic models for predicting ongoing pregnancy after the first and second in-vitro fertilization cycles. Models were developed using data from the University Hospital, Nijmegen, 1991-1994 and tested using more recent data from the same centre and data from two other centres. Although the variables included in the models seemed plausible, the predictions of the models were unsatisfactory. The models did not discriminate between women who had achieved pregnancy and women who did not achieve pregnancy; neither could they indicate which women had a (very) low probability of ongoing pregnancy. Taking into account the success rate of a specific clinic or the success rate during a specific period did not show any advantage. The predictions were even inaccurate in the same hospital during another period. It is obvious that these prognostic models should not be used. This study shows the importance of validating prognostic models before their implementation in clinical practice.