多囊卵巢综合征患者达英-35治疗后不同间隔启动促排卵的妊娠结局

目的 探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)高雄激素血症不孕患者应用达英-35(炔雌醇醋酸环丙孕酮)降低雄激素后,不同间隔启动HMG促排卵对妊娠结局以及子宫内膜血管体积百分比的影响.方法 33名高雄激素PCOS不孕患者,在给予达英-35治疗至血睾酮正常后,启动HMG促排卵.根据促排卵前停用达英-35的时间不同分为短间隔组和长间隔组.统计组间HCG日子宫内膜厚度、妊娠率等差异.再选择实验组5名高雄激素PCOS患者,停用达英-35月经来潮第3天开始应用人工周期诱导胚胎种植窗子宫内膜;对照组为5名因男性不孕就诊,月经周期正常的女性患者,尿LH峰值后7~9d取子宫内膜.病理证实为分泌中期子宫内膜后,CD34免疫组织化学染色内膜组织,计数血管内皮细胞体积百分比.结果 入选病例的一般情况、HCG日内膜厚度等组间差异无统计学意义.短间隔组(20.83%)的临床妊娠率较长间隔组(54.2%)显著降低(P<0.05).达英-35后月经来潮当月胚胎种植窗的子宫内膜血管内皮细胞体积百分比中位数(4.82%)较对照组(6.35%)显著降低(P<0.05).结论 PCOS不孕患者停用达英-35后月经来潮当月启动促排卵的临床妊娠率较停用至少一个月经周期的患者显著降低.达英-35治疗后月经来潮当月的胚胎种植窗子宫内膜血管较正常月经周期患者明显稀疏.     

Lonicerin targets EZH2 to alleviate ulcerative colitis by autophagy-mediated NLRP3 inflammasome inactivation

Aberrant activation of NLRP3 inflammasome in colonic macrophages strongly associates with the occurrence and progression of ulcerative colitis. Although targeting NLRP3 inflammasome has been considered to be a potential therapy, the underlying mechanism through which pathway the intestinal inflammation is modulated remains controversial. By focusing on the flavonoid lonicerin, one of the most abundant constituents existed in a long historical anti-inflammatory and anti-infectious herb Lonicera japonica Thunb., here we report its therapeutic effect on intestinal inflammation by binding directly to enhancer of zeste homolog 2 (EZH2) histone methyltransferase. EZH2-mediated modification of H3K27me3 promotes the expression of autophagy-related protein 5, which in turn leads to enhanced autophagy and accelerates autolysosome-mediated NLRP3 degradation. Mutations of EZH2 residues (His129 and Arg685) indicated by the dynamic simulation study have found to greatly diminish the protective effect of lonicerin. More importantly, in vivo studies verify that lonicerin dose-dependently disrupts the NLRP3–ASC–pro-caspase-1 complex assembly and alleviates colitis, which is compromised by administration of EZH2 overexpression plasmid. Thus, these findings together put forth the stage for further considering lonicerin as an anti-inflammatory epigenetic agent and suggesting EZH2/ATG5/NLRP3 axis may serve as a novel strategy to prevent ulcerative colitis as well as other inflammatory diseases.     

孕二烯酮宫内节育器的研制

目的:采用乙烯-醋酸乙烯共聚物(EVA)改性的甲基乙烯基聚硅氧烷(硅橡胶)作为控释材料制备孕二烯酮宫内节育器(Ges-IUD)。方法:以十八烷基键合硅胶为填充剂,甲醇:水(65:35)为流动相,流速为1ml/min,检测波长为240nm,采用高效液相(HPLC)分析法进行体外药物释放试验及测定药物在控释膜中的通透率。结果:本品药物释放符合零级动力学,其释药速度与释药管管壁厚度的倒数成线性关系,表明本品释药过程符合膜控制释药的特性。结论:体积分数20%的EVA改性硅橡胶可制备缓释放Ges的IUD。     

曲安奈德治疗瘢痕增生的方法及疗效观察

<正>瘢痕是由各种创伤所致皮肤组织外观形态和组织病理学改变的统称。其形成是一个受多因素影响的复杂病理过程,它既是人体创伤后,伤口自然愈合过程的一种正常、必然的生理反应,也是创     

中药龟丝补骨片防治大鼠类固醇性骨质疏松的实验研究

目的：采用醋酸泼尼松建立类固醇性骨质疏松大鼠模型,以探讨中药龟丝补骨片对类固醇性骨质疏松模型的预防作用及其机理。方法：取醋酸泼尼松按0．45mg/100g,每周2次灌胃,共90天造模（B组）,同时设立对照组（A组）和龟丝补骨片防治组（C组）。实验结束后采用DXA骨密度仪测量各组大鼠全身骨矿含量和胫骨骨组织显著结构观察,并取血检测部分钙调激素。结果：龟丝补骨片对类固醇激素导致大鼠骨量减低有显著的抵抗作用,其部分作用机理有：抗类固醇激素的继发性甲旁亢作用,抗类固醇激素所致的VD3代谢异常的作用和刺激降钙素分泌的作用。结果：龟丝补骨片对醋酸泼尼松所致的类固醇性骨质疏松具有明显的预防作用。     

甲地孕酮防治肿瘤化疗中白细胞减少的临床研究

目的研究甲地孕酮防治肿瘤化疗中白细胞减少的疗效和对患者生活质量的影响。方法100例肿瘤患者被随机分为研究组（50例）和对照组（50例）,对照组：地榆升白片4片/次,3次/d,全程口服。研究组：地榆升白片4片/次,3次/d,全程口服;甲地孕酮160mg,1次/d,连用10d,自化疗第1天早晨口服,3周为1周期,两周期后评价患者白细胞减少的程度及生活质量。结果研究组和对照组白细胞减少发生率分别为50.0%和72.0%,差异有显著性（P〈0.05）。Ⅲ度以上减少发生率分别为12.0%和26.0%（P〉0.05）。食欲降低发生率分别为58.0%和90.0%（P〈0.01）,Karnofsky未下降比率分别为90.0%和52.0%（P〈0.01）,体重增加比率分别为86.0%和38.0%（P〈0.01）。两组疼痛减轻比率分别为72.0%和56.0%（P〉0.05）。结论在肿瘤化疗中,甲地孕酮能够明显缓解肿瘤化疗中白细胞减少,同时明显提高患者生活质量。     

Management of ocular complications of Vogt-Koyanagi-Harada syndrome

Background Vogt-Koyanagi-Harada syndrome (VKH) is a multisystem disorder, characterized by the T-cell-mediated autoimmune process directed against melanocytic antigens in the ocular, nervous, auditory and integumentary systems. The ocular hallmarks of the disease involve severe bilateral panuveitis associated with exudative retinal detachment. Case report We report a pediatric case of probable VKH Syndrome with isolated ocular findings, in which bilateral vitritis, papillitis and serous retinal detachments involving the macula with intra-retinal edema and choroideal thickening were detected. Intervention Subtenon triamcinolone acetonide injection was performed in addition to systemic corticosteroid and cyclosporine treatments. Evolution Prompt improvement was seen in the ocular manifestations of VKH syndrome, which persisted for at least 4 months. Subtenon corticosteroid injection, together with systemic corticosteroid and cytotoxic treatment, prevented the ocular complications of invasive intraocular treatment modalities, and at the same time reduced the systemic corticosteroid dosage. Conclusion We recommend use of ocular invasive treatment modalities in Vogt-Koyanagi-Harada Syndrome only if the disease progression cannot be controlled. If systemic medications fail to stop the progression of the disease activity, subtenon injections may be considered before intraocular treatment modalities. The authors have full control of all primary data and they will allow International Ophthalmology to review their data upon request.     

曲安奈德对视网膜裂孔光凝愈合的影响

目的观察玻璃体腔注射曲安奈德（TA）对视网膜裂孔光凝愈合的影响。方法8只实验兔双眼制作视网膜裂孔模型,光凝孔周,左眼注入4mgTA作为实验组,右眼注入平衡液作为对照组,光镜和电镜观察双眼裂孔光凝斑,Western blot法测定双眼视网膜裂孔处组织内转化生长因子β2（TGF-β2）的表达。结果光镜下两组损伤均主要累及色素上皮层、视锥视杆层、外核层。电镜下仅在对照组发现感光细胞与色素上皮细胞之间微绒毛交叉及色素上皮细胞与邻近细胞之间桥粒连接。实验组裂孔光凝后局部视网膜组织内TGF-β2的表达量为0.308±0.057,对照组为0.418±0.036,两组比较差异有统计学意义（P〈0.01）。结论玻璃体腔注射TA有阻碍视网膜裂孔光凝后愈合的风险。