Uterine myomas and factors associated with hysterectomy in premenopausal women

OBJECTIVE: Our purpose was to describe clinical characteristics in premenopausal women with uterine myomas and to identify factors associated with hysterectomy.STUDY DESIGN: Data were collected by chart abstraction in 421 premenopausal women with myomas and analyzed by univariate and multivariable regression.RESULTS: Over a median follow-up period of 29 months, 86% of women had symptoms associated with myomas and 40% had an increase in uterine size of >2 gestational weeks. By multivariable regression, bleeding symptoms at presentation and previous surgical history of cholecystectomy and adhesiolysis were significantly associated with greater odds of hysterectomy. There was a significant interaction between age and uterine size, so that as age increased, uterine size had a greater impact on the likelihood of hysterectomy.CONCLUSIONS: In this cohort of premenopausal women myomas were associated with symptoms in almost all women over the follow-up period. Hysterectomy was performed in 22% of women overall. (Am J Obstet Gynecol 1997;176:1213-9.)     

微量肝素对重度窒息并发SIRS新生儿的干预作用

目的探讨微小剂量肝素降低新生儿重度窒息并发全身炎症反应综合征(SIRS)的作用和机制,并观察其副作用。方法对我科2001年1月～2005年10月间94例重度窒息新生儿(不含新生早产儿窒息病例)作回顾性分析。治疗组48例,常规综合治疗基础上加用低分子肝素钠5U/(kg·次),皮下注射,每12h1次,连用3d。对照组46例,采用综合治疗。就组间1周内SIRS的发生率作对照分析。结果治疗组1周内SIRS发生率和对照组间存在比较显著差异(P<0.05〉,而新生儿颅内出血、上消化道出血、和皮下出血的发生情况比较无显著差异性(P均>0.05)。结论早期应用微小剂量肝素可有效降低重度窒息新生儿SIRS的发生率而不致增加继发器官出血的机会。     

Efficacy and safety of nafamostat mesilate anticoagulation in blood purification treatment of critically ill patients: a systematic review and meta-analysis

BackgroundNafamostat mesilate (NM), a broad-spectrum and potent serine protease inhibitor, can be used as an anticoagulant during extracorporeal circulation, as well as a promising drug effective against coronavirus disease 2019 (COVID-19). We conducted a systematic meta-analysis to evaluate the safety and efficacy of NM administration in critically ill patients who underwent blood purification therapy (BPT).MethodsThe Cochrane Library, Web of Science and PubMed were comprehensively searched from inception to August 20, 2021, for potential studies.ResultsFour randomized controlled trials (RCTs) and seven observational studies with 2723 patients met the inclusion criteria. The meta-analysis demonstrated that conventional therapy (CT) significantly increased hospital mortality compared with NM administration (RR = 1.25, p = 0.0007). In subgroup analyses, the in-hospital mortality of the NM group was significantly lower than that of the anticoagulant-free (NA) group (RR = 1.31, p = 0.002). The CT interventions markedly elevated the risk ratio of bleeding complications by 45% (RR = 1.45, p = 0.010) compared with NM interventions. In another subgroup analysis, NM used exhibited a significantly lower risk of bleeding complications than those of the low-molecular-weight heparin (LMWH) used (RR = 4.58, p = 0.020). The filter lifespan was decreased significantly (MD = −10.59, p < 0.0001) in the NA groups compared with the NM groups. Due to the poor quality of the included RCTs, these results should be interpreted with caution.ConclusionGiven the better survival outcomes, lower risk of bleeding, NM anticoagulation seems to be a safe and efficient approach for BPT patients and could yield a favorable filter lifespan. More multi-center RCTs with large samples are required for further validation of this study.     

人牙龈成纤维细胞原代培养方法的比较研究

目的：建立和评价人牙龈成纤维细胞原代培养方法,并观察其生物学特性。方法：分别用组织块法、2种改良酶消组织块法培养人牙龈成纤维细胞（HGF）,用形态学、免疫荧光鉴定细胞来源。通过活细胞观察,MTT比色实验研究细胞体外生物特性。比较3种培养方法培养HGF的效果。结果：细胞抗波形丝蛋白染色阳性,抗角蛋白染色阴性,符合人牙龈成纤维细胞的形态学特征和生物学特性。组织块法、改良酶消组织块法（翻瓶法）、改良酶消组织块法（盖玻片法）的细胞培养成功率分别为26.7%、54%、60%。组织块法和2种改良酶消组织块法间的成功率差异有显著性（P〈0.01）,2种改良酶消组织块法间的成功率差异无显著性（P〉0.05）。结论：本实验建立的细胞系为人牙龈成纤维细胞。2种改良酶消化组织块法可显著提高人牙龈成纤维细胞原代培养成功率。     

奥曲肽治疗对食管胃底静脉曲张出血的肝静脉压力梯度及血流速度的影响观察

目的:观察奥曲肽治疗肝硬化门静脉高压食管胃底静脉曲张出血肝静脉压力梯度(HVPG)等的变化,探讨奥曲肽止血机制.方法:采用随机对照的方法,病例分为低剂量奥曲肽治疗组(A组,n=18);高剂量奥曲肽治疗组(B组,n=18)和对照组(C组,n =18).治疗肝硬化食管胃底静脉曲张出血,在基础治疗(禁食、输液、输血、对症处理)的基础上,全部病例予以奥美拉唑注射液40 mg,每12h1次静脉滴注抑酸.治疗组A、B组分别以奥曲肽注射液25、50 μg/h的速度微泵静脉维持治疗.观察治疗前后HVPG,门静脉内径,血流速度及呕血、黑便等的改变情况.结果:治疗前与治疗后24、72 h,两治疗组HVPG比较对照组显著降低,有统计学差异(P =0.00,P=0.00).而治疗组A、B治疗后24 h HVPG有统计学差异(P=0.00),治疗后72 h HVPG无统计学差异(P=0.14).治疗组比较对照组门静脉内径减小有统计学差异(P＜0.05);治疗组A、B与对照组在治疗24、72 h呕血,黑便量相比较明显减少,有统计学差异(P＜0.05).结论:奥曲肽能显著降低HVPG,减少门静脉内径,较高浓度奥曲肽在24 h内疗效更快,奥曲肽联合奥美拉唑比较单独奥美拉唑止血疗效更显著.     

止崩汤加针灸治疗围绝经期功能失调性子宫大出血320例

目的:观察止崩汤加针灸治疗围绝经期功能失调性子宫出血(功血)大出血的疗效及探讨止血机理。方法:将320例围绝经期功血大出血患者口服止崩汤加针灸观察止血疗效、治疗前后临床症状改善情况、子宫内膜厚度、APTT、PT、血色素(HB)、血清雌二醇(E2)、孕酮(P)的含量。结果:(1)止崩汤加针灸治疗功血大出血止血疗效总有效率为91.3%.(2)治疗后APTT时间明显延长(P≤0.05),PT时间明显缩短(P≤0.05)。(3)子宫内膜的厚度变薄,治疗后与治疗前比较有显著性差异(P0.05);(4)治疗后E2含量明显下降(P0.01),P含量则明显上升(0.01),与治疗前比较有极显著性差异(P0.01)。(5)治疗后血色素明显提高。结论:止崩汤加针灸治疗围绝经期功血大出血具有良好的止血作用,起到药物性刮宫的作用,止血迅速快捷便利,无手术刮宫的疼痛及创伤,可调节卵巢激素。     

绝经后出血妇女性激素水平变化的研究

目的：探讨绝经后出血与性激素的关系。方法：对63例绝经后出的病人进行垂体卵巢性激素水平测定。结果：39例绝经后出血的病人伴有雌二醇（E2）升高,促卵泡素（FSH）,促黄体素（LH）下降,占61．9％,结论：提示绝经后出血与雌激素明显增高有关。     

药物保守治疗异位妊娠70例分析

目的探讨药物保守治疗异位妊娠的临床疗效。方法对2010年5月～2012年2月笔者所在医院就诊的70例异位妊娠患者采用米非司酮配伍中药治疗。结果 70例患者采用米非司酮配伍中药治疗后,62例痊愈,治愈率88.57%,5例不良反应,3例不成功,经手术治疗后痊愈。结论米非司酮配伍中药治疗异位妊娠临床疗效好,治愈率高,副作用小,值得推广。     

消痔灵注射液治疗内痔出血疗效观察

目的 评价消痔灵注射液治疗内痔出血的临床疗效.方法 80例内痔出血患者经口服泻药或者灌肠,排便后自腔缘3、6、9点注入麻醉药,观察应用消痔灵注射液治疗80例内痔出血患者的疗效进行回顾性分析.结果 80例内痔出血患者中76例次日出血停止,4例便后偶有滴血症状,经局部换药、使用痔疮栓及局部熏洗等保守治疗后出血消失,随访6～24个月无复发.结论 消痔灵注射液治疗内痔出血是一种简单、有效、可靠的方法.

Abstract：

Objective To assess the clinical effect and safety of Xiaozhiling injection on bleeding caused by hemorrhoids.Methods A retrospective analysis was performed on 80 hemorrhoid patients treated with Xiaozhiling injection.Results Among 80 patients.76 bleeding stopped after the injection.Four bleeding had interrupted outbreak and was cured after symptomatic treatment.Conclusion Xiaozhiling is an effective medicine for treatment of hemorrhoids bleeding.     

Gingival recessions caused by Herpes Simplex Virus in a patient with COVID‐19 infection

Herpes Simplex Virus type 1 (HSV‐1) is a very common infection often localized in the mucocutaneous junction of the lip. Rarely, it could be detected also in periodontal tissues, associated with an elevated risk of periodontal disease progression and gingival recessions. Recently, HSV‐1 and numerous co‐infections have been reported in literature associated with the Coronavirus and subsequent COVID‐19 disease. This report illustrates a case of HSV‐1 in a patient with Covid‐19 infection, showing the presence of ulcers and vesicles on the gingival margin of maxillary teeth associated with soreness and pain. The histology highlighted the presence of intraepithelial cell ballooning, confirming the diagnosis of HSV‐1 infection.