Study on Relevance of Endothelin to Abnormal Uterine Bleeding Associated with Long-Term Subdermal Implants Use

Objective To investigate the relationship between estradiol, progesterone and endothelin (ET) and abnormal uterine bleeding after using sub-dermal contraceptive implant Materials & methods A prospective self-control clinical trial was conducted in 29 women in the self-control group. Blood samples were obtained on four occasions across the different phases of menstrual cycle before and after using implant. A blood sample was taken for a single determination in another 59 women in the already-use implant group. Plasma of estradiol, progesterone and endothelin were determined by using radioimmunoassays (RIA) in both groups.Results The level of estradiol and progesterone had no significant differences in women before and after using implant in self-control group. The level of estradiol,progesterone had no differences between women with normal and abnormal menstrual cycle in both groups. The levels of plasma endothelin (ET) in women with abnormal bleeding pattern were higher than women with normal bleeding pattern, but difference was not significant. Women with abnormal bleeding pattern had significantly higher ET level than that in women with normal bleeding pattern before using implants,especially in early-proliferative phase and mid-proliferative phase. the level of plasma endothelin was significantly higher in women with disturbed bleeding pattern than that in normal women in the already-use group.Conclusion High serum concentrations of ET are likely to be correlated with abnormal uterine bleeding in long-term subdermal contraceptive implants users.     

脑损害昏迷患者上消化道出血的预防

目的 探讨脑损害昏迷患者上消化道出血的发病因素和预防措施。方法 对274例脑损害昏迷患者,分析其并发上消化道出血的内环境因素和预防效果。结果 并发上消化道出血49例,占17.9%,而在ICU条件下早期鼻饲西沙必利、奥美拉唑及氢氧化铝凝胶预防组消化道出血的发生率为40%(2/50);伤后休克低血压、低氧血症、低钠血症、氮质血症、酸中毒、高血糖、高脂质过氧化水平均可增加上消化道出血的发生率。结论 ICU条件下维护内环境平衡、早期鼻饲、胃肠动力及抑酸药物应用,可显著关注脑损害昏迷患者上消化道出血的发生。     

新生儿应激性溃疡出血38例临床分析

目的 :探讨新生儿应激性溃疡出血病儿的防治措施。方法 :综合治疗原发病 ,纠正缺氧、酸中毒、抗感染等 ,静滴止血敏、甲氰咪胍止血 ,效果欠佳者加用云南白药鼻饲。结果 :治疗 3 8例 ,治愈率 86.84% ,病死率 10 .5 4% ,死因为多脏器功能衰竭和DIC。结论 :止血敏、甲氰咪胍合用止血效果好 ,加用云南白药可用于防治应激性溃疡出血。     

产后出血量的影响因素分析

目的 阐明影响产后出血量的相关因素,提高围产期的保健质量。方法 对２４１例孕妇在孕期产后进行问卷式调查,分娩时测量产后出血量。用相关、方差等统计方法分析。结果 影响产后出血量的因素涉及生理病理、心理、社会环境等诸多方面。其中生理病理因素为：①剖宫产术,②胎位异常,③腹围过大,④会阴裂伤,⑤胎盘晚出不全;心理因素为：珍贵胎儿,孕期、产时、产后情绪波动;社会环境因素为：孕期使用吸尘器、电话,上班路途径     

绝经后阴道出血242例临床及病理分析

目的 探讨绝经后阴道出血的病因。方法 分析２４２例绝经后阴道出血并行诊断性乔宫的临床和病理资料。结果 绝经后阴道出血的主要病理诊断分另是功能性子宫内膜（６０．７３％）、炎症（２８．９２％）和恶性肿瘤（１０．３５％）。结论 内分泌紊乱性疾病是绝经后出血的常见病因,年老妇女恶性肿瘤发生率高。     

北京市通州区产妇泌乳启动延迟发生情况及相关影响因素研究

目的 探讨北京市通州地区产妇泌乳启动延迟发生情况及相关影响因素,为提高母乳喂养率提供科学依据。方法 以2019年3月至2021年2月在北京市通州区妇幼保健院分娩的产妇为研究对象,由经过统一培训并考核合格的护理人员随访其泌乳情况并通过问卷收集孕妇相关资料。采用描述性分析方法对产妇泌乳延迟发生情况进行分析,并采用单、多因素分析方法对泌乳延迟发生影响因素进行分析。结果 共纳入2 109名产妇进行研究,产妇年龄20~48岁,以35~48岁居多,占54.10%。泌乳启动正常者1 387人,占65.8%,泌乳启动中位时间为50.65(19.33,70.14)h。泌乳启动延迟者722例,占34.2%。二分类Logistic回归分析结果显示,年龄≥35岁(OR=1.278)、孕期增重过多(OR=1.992)、初产妇(OR=1.243)、妊娠期糖尿病(OR=1.459)、妊娠期高血压疾病(OR=3.314)、剖宫产(OR=1.584)是产妇泌乳启动延迟发生的危险因素。结论 北京市通州区产妇泌乳启动延迟发生率较高,高龄、孕期增重过多、初产妇、妊娠期糖尿病、妊娠期高血压疾病、剖宫产均是产妇泌乳启动延迟发生的危险因素,医护人员应当对于上述类型产妇予以重视,及时关注治疗,以期改善产妇泌乳启动延迟情况。     

Anti-thrombotic effects and bleeding risk of AJvW-2, a monoclonal antibody against human von Willebrand factor

1. A murine anti-human vWF monoclonal antibody, AJvW-2, was developed that inhibited the interaction between platelet glycoprotein Ib (GPIb) and von Willebrand factor (vWF) during the ristocetin- (IC₅₀=0.7±0.1 μg ml⁻¹) and botrocetin- (IC₅₀=1.8±0.3 μg ml⁻¹) induced aggregation of human platelets.
2. AJvW-2 inhibited the high shear stress (10.8 N m⁻²) induced aggregation of human platelets dose-dependently with an IC₅₀=2.4±0.3 μg ml⁻¹, but had no effect on low shear stress induced platelet aggregation (1.2 N m⁻²) up to 100 μg ml⁻¹.
3. AJvW-2 also inhibited the high shear stress (5.0 N m⁻²) induced adhesion of human platelets to collagen I with the same efficacy (IC₅₀=2.4±0.3 μg ml⁻¹), but had no effect at low shear conditions (1.5 N m⁻²).
4. AJvW-2 inhibited the botrocetin-induced aggregation of platelets from guinea-pig, rat, rabbit, dog and pig at the same concentration range as human platelets; it likewise also inhibited the high shear stress induced aggregation and adhesion to collagen I of guinea-pig platelets.
5. AJvW-2 prevented arterial thrombus formation in guinea-pigs at a dose of 100 μg kg⁻¹ without prolonging the template bleeding time, whereas the GPIIb/IIIa antagonist lamifiban mediated inhibition of thrombosis at 1000 μg kg⁻¹ was accompanied by a significant prolongation of the bleeding time.
6. These results suggest that AJvW-2 is a potent inhibitor of the GPIb-vWF interaction and a potential novel antithrombotic agent with lower bleeding risk than GPIIb/IIIa antagonists.

     

Effects of benzodiazepine receptor ligands on the performance of an operant delayed matching to position task in rats: opposite effects of FG 7142 and lorazepam

The effects of a series of benzodiazepine (BZ) receptor ligands, ranging from a full agonist through to partial inverse agonists, were examined on short term working memory in the rat. The behavioural paradigm used was a discrete trial, operant delayed matching to position task, as originally described by Dunnett (1985), with delays of 0, 5, 15 and 30 s. The benzodiazepine receptor (BZR) full agonist lorazepam (0.25, 0.375 and 0.5 mg/kg) dose and delay dependently impaired matching accuracy. Lorazepam also increased the latency to respond and decreased the number of nose pokes made into the food tray during the delays. In contrast, the BZR partial agonist ZK 95 962 (1, 3, 10 mg/kg) did not affect matching accuracy, but did increase the speed of responding. The BZR antagonist ZK 93 426 (1.25, 5, 25 mg/kg) had no effects in this paradigm. The BZR weak partial inverse agonists Ro 15-4513 (0.1, 1 and 10 mg/kg) and ZK 90 886 (1, 3 and 10 mg/kg) did not affect accuracy of performance. However, both of these drugs increased the latency to respond and decreased nose poke responses. These motoric effects were particularly strong following 10 mg/kg Ro 15-4513. This shows that the effects of drugs on the accuracy of responding and on the speed of responding can be dissociated. The BZR partial inverse agonist FG 7142 had effects on matching accuracy that were dependent upon dose. The lowest dose of FG 7142 (1 mg/kg) significantly improved accuracy, whereas the highest dose (10 mg/kg) impaired accuracy. This impairment induced by FG 7142 (10 mg/kg) was accompanied by an increase in the latency to respond and a decrease in the number of nose pokes. Taken together, these results show that the accuracy of delayed matching performance can be modulated in opposite ways by the BZR full agonist lorazepam and a low dose of the BZR partial inverse agonist, FG 7142.     

Regression of endometrial hyperplasia after treatment with the gonadotrophin-releasing hormone analogue triptorelin: a prospective study

Endometrial hyperplasia is thought to be caused by the prolonged, unopposed oestrogenic stimulation of the endometrium. The regression of hyperplastic back to normal endometrium is the main purpose of any conservative treatment in order to prevent development of adenocarcinoma. The aim of this study was to evaluate the regression of hyperplastic to normal endometrium in patients with various forms of endometrial hyperplasia after treatment with the gonadotrophin-releasing hormone analogue (GnRHa) triptorelin for 6 months. Fifty-six patients with endometrial hyperplasia were enrolled in this trial; 39 patients (group I) presented simple hyperplasia, 14 (group II) complex hyperplasia and three (group III) atypical complex hyperplasia. All patients were treated with triptorelin for 6 months. Bleeding control during treatment was excellent. A post-treatment curettage for estimation of endometrial histology was performed on 54 out of 56 patients 100.1 +/- 44.7 days after the last triptorelin dose, following the restoration of pituitary function. Regression of hyperplastic to normal endometrium was observed in 32 (86.5%) out of 37 patients in group I and in 12 (85.7%) out of 14 in group II. Persistence of simple hyperplasia was found in five (14.5%) out of 37 patients in group I. Persistence of complex hyperplasia was found in 1 (7.1%) out of 14 patients and progression to atypical complex hyperplasia in another one (7.1%) woman in group II. In some of these cases, the presence of risk factors such as obesity, diabetes mellitus and ovulatory disturbances may contribute to the disease persistence despite therapy. On the other hand, in group III, none of the three patients had normal post-treatment endometrial histology. It seems, therefore, that in cases of endometrial hyperplasia without atypia, the administration of the GnRHa triptorelin is associated with high regression rates to normal endometrium. Conversely, the presence of atypia seems to be a poor prognostic factor. Treatment tolerance and bleeding control during therapy is excellent.     

The effect of etonogestrel on VEGF, oestrogen and progesterone receptor immunoreactivity and endothelial cell number in human endometrium

Contraceptive use often leads to disrupted endometrial bleeding patterns in women. In this study, two different contraceptive regimes (Mircette, a monophasic oral contraceptive and Implanon, a long-acting gestagen) were used and their effects on the immunoreactivity of vascular endothelial growth factor (VEGF), oestrogen receptor (ER), progesterone receptor (PR) and endothelial cell number were determined. During the untreated normal cycle, there was a significant increase (P = 0.005) in glandular VEGF immunoreactivity and a significant decrease (P < 0.05) in PR immunoreactivity in the mid- and late secretory phases compared with the proliferative phase. There was a significant positive correlation (gamma = 0.38, P = 0.046) between stromal VEGF immunoreactivity and endothelial cell number. This correlation was also apparent during treatment with Implanon, but not with Mircette. Disrupted bleeding patterns were associated with Implanon and, to a lesser extent, with Mircette. Both contraceptives significantly reduced glandular VEGF immunoreactivity. Implanon significantly increased (P = 0.016) glandular PR staining, but Mircette significantly reduced (P = 0.027) stromal PR staining when compared with secretory before-treatment biopsies. There were no changes in endothelial cell number or glandular or stromal ER during the normal cycle, or with use of either contraceptive. There was no association between the parameters measured with bleeding patterns and histological category.