米非司酮致子宫内膜简单型增生二例临床分析

近年来，随着米非司酮应用的日趋广泛，其并发症亦不断增加，尤其是一些少见的以及一些始料未及的并发症，更应引起注意。我院2004年门诊诊治的二例病例，1例为子宫肌瘤剜除术后，1例为子宫腺肌症，在连续口服米非司酮4～6个月后，出现不规则的阴道多量流血，后经诊断性刮宫，二例病理检查均提示为子宫内膜简单型增生。现报道如下：     

Associations between polymorphisms in the vitamin D receptor and breast cancer risk.

Biological and epidemiologic data suggest that vitamin D levels may influence breast cancer development. The vitamin D receptor (VDR) is a crucial mediator for the cellular effects of vitamin D and additionally interacts with other cell-signaling pathways that influence cancer development. Because functional data exist on FOK1 and previous studies have suggested a relation between BSM1 and breast cancer risk, we evaluated the associations of the FOK1 and BSM1 VDR polymorphisms and breast cancer risk. In a case-control study nested within the Nurses' Health Study, we genotyped 1,234 incident cases (diagnosed between return of a blood sample in 1989-1990 and June 1, 2000) and 1,676 controls for FOK1, and 1,180 cases and 1,547 controls for BSM1. We observed a significantly increased risk of breast cancer among carriers of the ff genotype of FOK1 (multivariate odds ratio, 1.34; 95% confidence intervals, 1.06-1.69) compared with those with FF. We did not observe an association between polymorphisms in BSM1 and breast cancer risk (multivariate odds ratio, 0.93; 95% confidence intervals, 0.72-1.20) for BB versus bb). The FOK1 association did not vary significantly by menopausal status, estrogen, and progesterone receptor status of the tumors, or plasma levels of 25 hydroxyvitamin D or 1,25 dihydroxyvitamin D. Our results suggest that the VDR may be a mediator of breast cancer risk and could represent a target for cancer prevention efforts.     

我国“审方药师”的现状分析与建议

目的:培养合格的审方药师,确保患者合理用药。方法:分析我国审方药师的现状,提出培养合格审方药师的具体建议。结果:目前,我国审方药师队伍普遍存在学历、职称偏低,专业知识、医学知识不足,成员匮乏等现象。结论:必须充分认识审方药师的重要性,提高审方药师的准入条件,制订审方药师的业务标准,明确审方药师的责任,加大审方药师的培养力度及增加审方药师的数量,方可确保患者合理用药。     

磷酸氟达拉滨的HPLC测定

目的:建立用HPLC测定磷酸氟达拉滨的方法.方法:采用YMG ODS-AQ色谱柱,梯度洗脱法,A泵用0.68%的KH2PO4的水溶液(用磷酸调pH至3.0),B泵为50%(V/V)乙腈水溶液,流速为1.0 ml·min-1,检测波长为263 nm.结果:磷酸氟达拉滨在10～80μg·ml-1范围内线性关系良好(r=0.999 8),平均回收率为99.6%,RSD=0.5%(n=5).结论:该方法准确、可靠,灵敏度高,重复性好.     

Hepatic metastases from breast carcinoma: comparison of noncontrast, arterial-dominant, and portal-dominant phase spiral CT

PURPOSE: The purpose of this work was to determine the relative value of noncontrast (NC), arterial-dominant (AD), and portal-dominant (PD) phase images in spiral CT of the liver for breast cancer metastases. METHOD: Forty-four spiral CT scans in 18 patients with hepatic metastases from breast cancer were retrospectively reviewed by three radiologists. Subjective evaluations of overall lesion conspicuity and margination were graded on a 5 point scale for NC, AD, and PD phase images, and the three phases were also ranked for demonstration of overall tumor volume. Those scans with hypervascular lesions were separately analyzed, resulting in three groups (all, hypervascular, hypovascular). RESULTS: For lesion conspicuity and margination for the entire study group, AD phase images showed the lowest grades (1.97 and 1.83), whereas the PD phase showed the highest grade (3.34 and 3.14; p < 0.0001) followed by NC (2.36 and 2.42; p < 0.0001). For the hypervascular subgroup, the AD phase also showed the lowest grades (2.39 and 2.24). In no case did the AD phase show more lesions than the combination of NC and PD phases. For depiction of overall tumor volume, the AD phase had the lowest ranking (2.51) compared with the NC and PD phases (1.71 and 1.78; p < 0.001). For the hypervascular subgroup, the AD phase had the lowest ranking (2.33) compared with the NC and PD phases (1.39 and 2.27; p < 0.0001). CONCLUSION: The AD phase is not required for lesion detection in spiral CT for hepatic metastases from breast carcinoma. The NC phase depicts the maximal tumor volume.     

Pyometra as a lower abdominal doughnut sign on a Ga-67 scan

A 77-year-old woman was referred for Ga-67 scan to evaluate intermittent fever and chills that had lasted more than 20 days. The Ga-67 whole-body scan revealed a doughnut-shaped Ga-67 accumulation in the lower abdominal region. Combined Ga-67 and Tc-99m MDP bone scan confirmed that this activity was in the uterus, because the shape of the urinary bladder on bone scan was different from that of the Ga-67-avid lesion. Pyometra was proved during operation, and pus culture was performed.     

磺胺噻唑鱼肝油乳剂的制备及质量控制

目的:介绍磺胺噻唑鱼肝油乳剂制备方法及质量控制.方法:采用三波长分光光度法.结果:经过系列波长筛选,最后确定该制剂的测定组合波长为297,290,263 nm.结论:磺胺噻唑鱼肝油乳剂稳定、制备简便,质量控制方法准确.     

血清中异丙酚的HPLC测定

建立了检测血清中异丙酚的反相高效液相色谱-荧光法.血清样品经含内标百里酚的丙酮溶液直接沉淀后,采用KR100-5 C18柱,甲醇-0.1%三氟醋酸溶液(80:20)为流动相,荧光激发波长为276nm,发射波长为307nm.异丙酚在0.05～12.8μg/ml范围内与峰面积比线性关系良好.检测限为150pg,异丙酚和百里酚的提取回收率均大于90%,批内、批间精密度为1.11%～6.88%.     

氟罗沙星治疗细菌性感染的药物经济学研究

目的:评价氟罗沙星和氧氟沙星治疗细菌性感染的经济性.方法:治疗组患者35例,使用氟罗沙星0.3 g,静脉滴注,1次/d共10.5 d;对照组患者32例,使用氧氟沙星0.3 g,静脉滴注,2次/d,共10.5 d.运用药物经济学的成本-效果分析方法进行评价.结果:2种方案的成本-效果比(C/E)分别为22.87,20.43,效果(以有效率表示)分别为91%,84%(P＞0.05).结论:氧氟沙星经济性最佳,氟罗沙星市场价格太贵,建议厂商重新考虑市场的药品定价策略.     

祁门红茶抗氧化有效成分的研究

祁门红茶有较强的抗芥花子油氧化的活性.从祁门红茶乙酸乙酯部位,使用硅胶柱层析,结合Sephadex LH-20柱层析方法,分离得到了四个抗氧化有效成分,分别为茶黄素(Theaflavin,TF1)、茶黄素A(Theaflavin-3-galate,TF2A)、茶黄素B(Theaflavin-3'-gallate,TF2B)和茶黄素双没食子酸酯(Theaflavin digallate,TF3).