《妇人大全良方》妇科疾病诊治特色

介绍《妇人大全良方》诊治妇科疾病特色：提出妇科疾病的诊治纲领;按生理规律辨治月经病和按五色辨治带下;立胎产生育注意事项;治疗尤重冲任二脉,并提出以“四物汤”为通用方论治妇科多种疾病。     

The Effectiveness of Tranexamic Acid at Reducing Blood Loss and Transfusion Requirement for Women Undergoing Myomectomy: A Systematic Review and Meta-analysis

BackgroundThe surgical removal of fibroids can be associated with excessive blood loss requiring transfusion.ObjectiveThis review sought to determine the effectiveness of tranexamic acid (TA) in reducing perioperative blood loss in women undergoing myomectomy.MethodsElectronic bibliographic databases were searched from inception until June 3, 2017. The review included RCTs of women of reproductive age with uterine fibroids who were undergoing myomectomy and who received TA or a comparator. Two independent reviewers extracted relevant data, and meta-analysis was performed.ResultsThree studies included women undergoing abdominal myomectomy. TA significantly reduced intraoperative blood loss by a mean difference of 213.1 mL (95% CI ?242.4 to ?183.7) and postoperative blood loss by a mean difference of 56.3 mL (95% CI ?67.8 to ?44.8) compared with control arms. However, no significant differences were seen in blood transfusion requirement (relative risk 0.58; 95% CI 0.33–1.00). In one study for women undergoing hysteroscopic myomectomy, TA was not associated with improved outcomes in transfusion requirement and resulted in reduced postoperative hemoglobin levels compared with oxytocin.ConclusionAmong women undergoing abdominal myomectomy, TA is effective at reducing perioperative blood loss compared with no treatment or placebo. For women undergoing hysteroscopic myomectomy, TA compared with oxytocin is not associated with improved outcomes in transfusion requirement and resulted in reduced postoperative hemoglobin levels.     

Betel Nut Chewing Is Associated With Reduced Tacrolimus Concentration in Taiwanese Liver Transplant Recipients

Purpose

Studies have shown that arecoline, the major alkaloid component of betel nuts, alters the activity of enzymes in the cytochrome P450 (CYP-450) family. Tacrolimus, an immunosuppressant that protects against organ rejection in transplant recipients, not only is mainly metabolized by CYP3A enzymes but also has a narrow therapeutic range. We aimed to investigate whether dose-adjusted blood trough levels of tacrolimus differed over time between betel nut-chewing and non–betel nut-chewing liver transplant recipients.

三七3-羟基-3-甲基戊二酸单酰辅酶A还原酶基因的克隆和生物信息学分析

目的克隆三七总皂苷甲羟戊酸合成途径中的1个关键酶3-羟基-3-甲基戊二酸单酰辅酶A还原酶(3-hydroxy-3-methylglutaryl coenzyme-A reductase,HMGR)基因,为进一步研究HMGR蛋白的功能及开展三七皂苷的合成生物学研究奠定基础。方法根据NCBI上已公布的同属人参的HMGR基因全长序列(登录号GU565097.1)设计特异性引物。利用RT-PCR技术,以三七愈伤组织总RNA反转录的cDNA为模板扩增基因片段;并对其编码的蛋白进行生物信息学预测和基因表达分析。结果序列分析表明,获得的三七HMGR(命名为PnHMGR)基因的cDNA序列大小为1 893 bp,该序列与人参、刺五加和杜仲中HMGR基因的一致性分别达到98%、93%、80%,且含有大小为1 725 bp的开放阅读框,经Genbank查询为一新的cDNA。生物信息学预测PnHMGR基因编码蛋白包含2个跨膜区,不含信号肽,具有HMGR催化作用的活性中心结构域。实时荧光定量PCR检测到PnHMGR基因在三七细胞生长30 d表达量最高。结论首次从药用植物三七中克隆得到HMGR基因的编码区序列,为进一步鉴定PnHMGR的功能和开展三七皂苷的合成生物学研究奠定了基础。     

人参属植物高温蒸制前后人参皂苷含量的变化和细胞毒活性研究

目的 研究人参属植物人参Panax ginseng、三七P.notoginseng和西洋参P.quinquefolium高温蒸制前后主要人参皂苷的含量变化,并测定高温蒸制前后样品对4株肿瘤癌细胞的细胞毒活性.方法 采用HPLC建立了测定22种皂苷含量的分析方法,测定这些皂苷在人参属植物及其高温蒸制品中的含量.用MTT法...     

Indwelling Urinary Catheter for Total Joint Arthroplasty Using Epidural Anesthesia

BackgroundThe objective of this study was to evaluate if not placing an indwelling urinary catheter leads to a higher potential for adverse genitourinary (GU) issues after total joint arthroplasty (TJA) under epidural anesthesia.MethodsThree hundred thirty-five consecutive patients who underwent primary TJA using epidural anesthesia were retrospectively reviewed. The initial 103 patients received a preoperative urinary catheter, which was maintained until the morning of postoperative day 1. The subsequent 232 patients did not receive a preoperative urinary catheter. Demographics, medical complications, GU complications, and length of stay were compared between groups.ResultsCompared between catheter and noncatheter groups, there were no differences in demographics including age, gender, or laterality of surgery. There was a difference in type of surgery (total knee arthroplasty vs total hip arthroplasty) (P = .008). There was no difference in American Society of Anesthesiologists score, but with a difference in body mass index (P = .01). There were no differences in GU complications among patients with benign prostatic hyperplasia or prostate cancer. However, among patients with a history of prostate disorders (benign prostatic hyperplasia or prostate cancer), urinary tract infection rate was higher in catheter group (P = .023). Postoperative GU complications were associated with increased median age in years and increased average length of stay in days.ConclusionPatients undergoing TJA under epidural anesthesia demonstrate no increased risk of postoperative urological complications without the placement of preoperative indwelling urinary catheter. The routine use of preoperative catheters can be reconsidered for this mode of anesthesia.Level of EvidenceLevel II, retrospective comparative study.     

三七HPLC指纹图谱及5种成分测定

目的建立三七HPLC指纹图谱,并测定5种成分的含有量。方法三七70%甲醇提取物的分析采用Waters XBridge C₁₈色谱柱(4.6 mm×250 mm,5μm);流动相乙腈-水,梯度洗脱;体积流量1.5 mL/min;柱温25℃;检测波长203 nm。结果 15批样品指纹图谱中有5个共有峰,相似度均大于0.99。三七皂苷R₁、人参皂苷Rg₁、人参皂苷Re、人参皂苷Rb₁和人参皂苷Rd分别在0.000 76～0.567 64(r=0.999 9)、0.002 69～2.017 43(r=0.999 8)、0.000 38～0.283 82(r=1.000 0)、0.002 83～2.124 83(r=0.999 8)、0.000 78～0.582 98 mg/mL(r=0.999 8)范围内线性关系良好,平均加样回收率分别为101.78%、97.22%、102.14%、98.96%、101.73%,RSD分别为1.58%、1.31%、2.17%、1.55%、1.80%。结论该方法简便、快速、准...