血府逐瘀丸对双侧颈总动脉永久结扎致慢性脑缺血大鼠的保护作用及对脑部NOX表达的影响

目的探讨血府逐瘀丸对双侧颈总动脉永久结扎所致慢性脑缺血大鼠的保护作用及对脑部NOX表达的影响。方法将50只SD大鼠随机分为空白组、模型组、血府逐瘀丸低剂量组、血府逐瘀丸中剂量组及血府逐瘀丸高剂量组,每组10只。除空白组进行假手术外,其余组均采用双侧颈总动脉永久性结扎法进行慢性脑缺血造模,于造模后第3天,血府逐瘀丸低、中、高剂量组分别给予血府逐瘀丸0. 93 g/kg,1. 87 g/kg,3. 74 g/kg灌胃,1次/d,连续21 d。末次给药24 h后,采用Morris实验检测各组大鼠的学习记忆能力,并对各组大鼠海马体进行尼氏染色及TUNEL染色,采用免疫组化法检测各组大鼠海马体中NOX4表达情况并进行半定量分析。结果训练第2—5天,模型组大鼠逃避潜伏期均明显长于空白组(P均<0. 05),血府逐瘀丸各剂量组均明显短于模型组(P均<0. 05);第6天,模型组大鼠第3象限活动时间和穿越平台次数均明显低于空白组(P均<0. 05),血府逐瘀丸各剂量组均明显高于模型组(P均<0. 05)。血府逐瘀丸各剂量组大鼠海马体中神经细胞核核仁不清晰及细胞形态异常程度均明显轻于模型组,仅有呈散在的少量阳性染色神经元,海马体中NOX4阳性表达均明显弱于模型组,且NOX4相对表达量均明显低于模型组(P均<0. 05)。结论血府逐瘀丸对双侧颈总动脉永久性结扎所致慢性脑缺血大鼠具有较好的神经保护作用,有效抑制海马体中NOX4的表达可能是其主要机制。     

五淋丸对大鼠异丙肾上腺素性缺血心肌的保护作用及其机制探讨

目的：观察五淋丸对异丙肾上腺素（Iso）诱发的大鼠心肌缺血的保护作用。方法：采用腹腔注射诱导大鼠致急性心肌缺血的动物模型。实验大鼠随机分为Iso模型组,阳性对照组和五淋丸大、中、小剂量组,观察各组大鼠心电图ST-iunction（J点）的位移、血清酶及血流动力学变化。结果：五淋丸大、中、小剂量组大鼠心电图J点的位移明显低于模型组（P〈O．05或P〈0．01）;血清肌酸激酶（（K）及乳酸脱氢酶（LDH）活性低于模型组（P〈O．01）;血流动力学指标：左心室收缩压（LVSP）、左心室舒张末压（LVEDP）、左心室等容期压力最大变化速率（土dp／dtmax）显著高于模型组（P〈O．05或P〈0．01）。结论：五淋丸对异丙肾上腺素所致大鼠缺血心肌具有保护作用,其机制可能与其改善心肌缺血大鼠心脏的舒缩功能有关。     

Encephalopathy and psychosis following administration of the combined oral contraceptive pill in an 11-year-old female

We report herein the first case of psychosis after short-term use of the combined oral contraceptive (COC) pill in a young patient with no previous psychiatric history. An 11-year-old girl was placed on the COC pill for treatment of menorrhagia, 5 months after her menarche. She developed an initial encephalopathy, which progressed to psychosis. The estrogenic component of the COC pill is the most likely cause of this psychosis. COC pills should be used with caution in patients with an already high estrogenic state as occurs near menarche.     

The Coraliance study: non-compliant behavior. Results after a 6-month follow-up of patients on oral contraceptives

Objectives This follow-up study was planned to establish the frequency with which women miss their contraceptive pill, and to observe their behavior when they forget it. In those women who changed from a continuous cycle to an interrupted type of cycle, or vice versa, the study also aimed to evaluate the impact of this change on the pattern of omission of pills. Methods The longitudinal, prospective cohort study included healthy women of child-bearing age for whom a change of pill was being prescribed by their gynecologist. Data were recorded during the 6 months preceding inclusion in the study, and for the 6 months of follow-up; the women were asked to complete a diary in which they recorded the number and exact times of pill omission, and their behavior at each omission. Results A total of 617 gynecologists included 3316 women into the study; of these, a group of 2418 (73%) revisited the same gynecologist at follow-up. The groups who either visited the same or a different gynecologist were similar with respect to age, oral contraception type, omission type and frequency. A large non-compliance rate and women's difficulties in maintaining safe contraception after missing a pill were observed in the group with follow-up. Women were never risk-free when they missed a pill; they turned to numerous sources for discordant or conflicting information; 15% of 'not-forgetting' women at the pre-inclusion cycle recorded at least one omission at the last cycle of the 6-month follow-up period. Omission fluctuations during the observational period make it difficult to designate 'forgetful' or 'non-forgetful' classes of women. Administration of the pill in a continuous cycle, and probably 'study' and 'auto-questionnaire' effects, contributed to an improvement in compliance. In the group taking the continuous cycle pill, the omission number slightly decreased, particularly on the first day and week of the cycle, irrespective of the initial cycle type. Conclusions The importance of the phenomenon of non-compliance rate is confirmed as well as women's difficulties in knowing how to maintain contraceptive safety. The continuous cycle regimen is likely to improve women's compliance during the critical period of the cycle.     

A double-blind study comparing the contraceptive efficacy,acceptability and safety of two progestogen-only pills containing desogestrel 75 μg/day or levonorgestrel 30 μg/day: Collaborative Study Group on the Desogestrel-containing Progestogen-only Pill

Objective To compare the contraceptive efficacy, bleeding pattern, acceptability and safety of desogestrel 75 μg/day (Cerazette®) as a progestogen-only formulation to levonorgestrel 30 μg/day in healthy female subjects.

Methods In a double-blind, randomized, group-comparative, multicenter trial, 989 subjects were randomized to desogestrel 75 μg/day and 331 to levonorgestrel 30 μg/day. The women were observed during 13 consecutive treatment periods of 28 days.

Results The Pearl indices for in-treatment pregnancies, excluding gross non-compliance, were 0.14 (one pregnancy in 727 woman-years) in the desogestrel group and 1.17 (three pregnancies in 257 woman-years) in the levonorgestrel group. Using the 90-day reference period for assessing the bleeding pattern, desogestrel users had a higher incidence of amenorrhea and infrequent bleeding on the one hand, and of frequent bleeding and prolonged bleeding on the other hand, at the beginning of the study period. In contrast to the levonorgestrel group, a tendency towards less bleeding over time was observed in the desogestrel group. The frequency and pattern of adverse experiences were comparable for desogestrel 75 μg/day and levonorgestrel 30 μg/day.

Conclusions Desogestrel 75 μg/day is a reliable and safe progestogen-only pill with a contraceptive efficacy superior to levonorgestrel 30 μg/day. There was a similar overall acceptability of desogestrel 75 μg/day and levonorgestrel 30 μg/day.     

三联法加心理干预治疗便秘型肠易激综合征的临床观察

摘要为探讨莫沙必利加补脾益肠丸和培菲康三联法配合心理干预治疗便秘型肠易激综合征（IBS-C）的疗效,根据罗马Ⅲ标准确诊IBS-C型患者100例,并将其分成两组进行随机对比试验,每组50例。治疗组口服莫沙必利加补脾益肠丸和培菲康,并对50例患者进行心理干预;对照组单纯口服莫沙必利,两组均治疗4周为1个疗程。结果显示,治疗1个疗程后两组总有效率治疗组明显高于对照组（92．0％VS74．0％,P〈0．05）。两组腹痛缓解情况在第1、2周末的比较差异无统计学意义（P〉0．05）,第3、4周末两组差异有统计学意义（P〈0．05）,而排便频率和粪便性状在第1、2、3、4周末,两组比较差异均有统计学意义（P〈0．05）。结果表明,莫沙必利加补脾益肠丸和培菲康三联法配合心理干预治疗IBS-C较单纯口服莫沙必利效果明显。     

复方丹参滴丸治疗冠心病心绞痛合并高脂血症80例疗效观察

目的探讨复方丹参滴丸治疗冠心病心绞痛合并高脂血症的临床疗效。方法将我院收治的80例冠心病心绞痛合并高脂血症患者随机分为两组,每组各40例,对照组采取常规综合治疗,观察组在此基础上加用复方丹参滴丸,比较两组临床疗效及治疗前后血脂水平变化。结果观察组心绞痛治疗有效率为92.50%,显著高于对照组的77.50%（P〈0.05）;观察组治疗后TG、TC、HDL-C和LDL-C水平分别为（3.52±0.47）mmol/L、（1.31±0.29）mmol/L、（2.52±0.34）mmol/L和（1.87±0.30）mmol/L,均较治疗前和对照组显著改善（P〈0.05）。结论复方丹参滴丸治疗冠心病心绞痛合并高脂血症疗效显著,可有效改善患者心绞痛症状及血脂水平,具有较好的临床应用价值。     

复方丹参滴丸对不稳定型心绞痛患者血小板活化功能的影响

目的探讨复方丹参滴丸治疗冠心病心绞痛的临床疗效及其对血小板活化功能的影响。方法选择本院2012年8月～2013年10月收治的不稳定型心绞痛患者90例,随机分为两组,两组均给予抗凝、降脂、扩血管治疗,研究组患者在常规治疗的基础上给予复方丹参滴丸治疗。观察两组治疗效果,治疗前后采集静脉血,检测CD62p、GMP-140水平,评估患者治疗前后患者血小板活化功能的变化情况。结果两组心绞痛治疗总有效率比较,研究组明显高于对照组,差异有统计学意义（P〈0．05）。两组治疗前CD62p、GMP-140差异均无统计学意义,治疗后两组CD62p、GMP-140均较治疗前降低,但研究组CD62p、GMP-140均明显低于对照组（P〈0．05）。结论复方丹参滴丸辅助治疗不稳定型心绞痛疗效较好,并且可以有效抑制血小板活化功能的异常,值得应用。     

虎潜丸对去势大鼠骨密度及BMP-2水平影响的研究

目的：探讨虎潜丸干预对去势大鼠骨密度及骨组织中BMP－2水平的影响。方法6个月龄的40只雌性SD大鼠随机分为手术模型组、雌激素组、虎潜丸组和假手术组。确定造模成功后,虎潜丸组给予虎潜丸煎剂浓缩液灌胃,每天一次;雌激素组给予尼尔雌醇悬浊液灌胃,每周一次;手术模型组和假手术组给予蒸馏水灌胃,每天一次。灌胃治疗12周后测量各组大鼠的骨密度及骨组织中BMP－2含量。结果虎潜丸组及雌激素组与手术模型组相比较,全身骨密度和腰椎骨密度都得到了一定提高,差异具有统计学意义（P＜0．05）;骨组织中BMP－2的水平也都有显著升高,差异具有统计学意义（P＜0．05）。结论虎潜丸对切除卵巢后所致的骨质疏松症有明显的治疗作用,其机制可能是在一定程度地提高了组织中BMP－2的水平,从而抑制骨组织的吸收,促进骨组织的形成。