Genetic and environmental factors affecting peak bone mass in premenopausal Japanese women

The purpose of this study was to examine the relationships between peak bone mass and genetic and environmental factors. We measured whole-body bone mineral density (BMD), lumbar spine BMD, and radius BMD with dual-energy X-ray absorptiometry (DXA) and analyzed eight genetic factors: vitamin D receptor (VDR)-3′, VDR-5′, estrogen receptor (ER), calcitonin receptor (CTR), parathyroid hormone (PTH), osteocalcin (OC), apolipoprotein E (ApoE), and fatty acid binding protein 2 (FABP2) allelic polymorphisms using polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLPs). We also surveyed menstrual history, food intake, and history of physical activity using questionnaires. After adjusting for age, body mass index (BMI), current smoking status, current Ca intake, alcohol intake, menoxenia, and physical activity, the mean BMD in subjects with the HH/Hh genotype was significantly higher than that of subjects with the hh genotype for whole-body BMD (mean±SD, 1.20±0.10 vs. 1.18±0.09 g/cm²; HH/Hh vs. hh, p=0.04) and at lumbar spine BMD (mean±SD, 1.18±0.14 vs. 1.14±0.12 g/cm²; HH/Hh vs. hh, p=0.02) in OC allelic polymorphism. Furthermore, the results of multiple regression analyses taking the 8 genetic factors plus the 7 environmental factors listed above into account showed that the strongest factor contributing to BMD was BMI at any site (whole-body and lumbar BMD p<0.0001, radius BMD p=0.0029). In addition, OC polymorphism (p=0.0099), physical activity (p=0.0245), menoxenia (p=0.0384), and PTH polymorphism (p=0.0425) were independent determinants for whole-body BMD, and OC polymorphism (p=0.0137) and physical activity (p=0.0421) were independent determinants for lumbar BMD and radius BMD, respectively.     

舒尔经片调经作用的实验研究

目的探讨舒尔经片对摘除卵巢大鼠雌激素水平、血液流变学、子宫系数的影响以及对大鼠离体子宫平滑肌的影响。方法手术摘除大鼠卵巢复制病理模型,连续灌胃给药10 d后,放射免疫法检测大鼠血清中雌二醇和孕酮含量,血液粘度计检测全血及血浆粘度,压积管离心法测红细胞压积,显微观察子宫和阴道的病理形态学改变;缩宫素复制大鼠离体子宫平滑肌痉挛模型,离体子宫测定仪测定舒尔经片对正常及痉挛的子宫平滑肌的频率和强度变化。结果舒尔经片（1.12、0.56、0.28 g·kg^-1）具有提高去卵巢大鼠血清中雌二醇和孕酮的含量,改善血液流变性,能明显增加子宫系数,改善子宫和阴道的病理学变化;舒尔经片降低大鼠正常子宫活动的频率,但对其强度无明显改变;可显著抑制缩宫素引起子宫平滑肌收缩的频率以及收缩强度。结论舒尔经片具有较强的调经作用。     

重度宫腔粘连特殊子宫内膜形态的案例报道

宫腔粘连是指由于宫腔操作、炎症等多种原因导致的子宫内膜损伤、子宫前后壁粘连、宫腔容积缩小等改变.任何可引起子宫内膜破坏的因素均可导致宫腔粘连.目前,临床上重度宫腔粘连并不少见,宫腔镜下常表现为粘连带肥厚,部分宫腔及双侧宫角闭锁,甚至宫腔完全消失.该个案重度宫腔粘连患者的子宫内膜呈现特殊形态,子宫表面弥漫性肌性条索状组织与其下方的内膜样组织呈交错"桥梁型"结构,以往较少报道.分析其有可能系子宫内膜损伤修复失代偿过程的一种表征模型,而对其进一步的深入研究也许会为揭示宫腔粘连的分子机制提供线索.     

A Randomized Trial of Chinese Medicine Lirukang Granule (利乳康颗粒) Combined with Psychological Intervention for Cyclomastopathy and Menoxenia

Objective:To observe the influence of therapy with Chinese medicine Lirukang Granule（利乳康颗粒）,LRKG) combined with psychological intervention on anxiety states and sex hormones in patients with cyclomastopathy and menoxenia.Methods:A total of 470 subjects were randomly assigned to three groups by the net-central randomization system,the treatment group（161 patients,treated with LRKG and psychological intervention）,the Chinese medicine group（157 patients,treated with LRKG）,and the psychological intervention group（152 patients,treated with psychological intervention）.The dose of LRKG was 12 g three times per day; psychological intervention included establishing relations,cognitive intervention and psychological persuasion, 30-40 min per session,once a week.The therapy duration for all groups was three months.The efficacy was compared and anxiety state/State-Trait Anxiety Invertory（STAI） scoring was measured before and after treatment.The serum estradiol（E₂）,progesterone（P）,prolactin（PRL） and follicle stimulating hormone（FSH） levels of 60 patients selected randomly from each group during the luteal phase were measured before and after treatment,and a group of 20 healthy women were evaluated for comparison.A follow-up was arranged for one year after treatment.Results:Thirty subjects were lost to follow-up.（1） Comparison of efficacy:the markedly effective rate and the total effective rate of the treatment group were 86.67%（131/150） and 98.00%（147/150）, respectively;of the Chinese medicine group,64.58%（93/144） and 90.27%（130/144）,respectively;and of the psychological intervention group,0%（0/146） and 3.42%（5/146）,respectively.The markedly effective rate and the total effective rate in the treatment group were significantly higher than those in the Chinese medicine and psychological intervention groups（P<0.05）.（2） Comparison of STAI scoring:STAI scoring was decreased dramatically in the treatment group after treatment compared with that of the Chinese medicine group（P<0.01）, but there was no significant difference compared with the psychological intervention group.（3） Comparison of levels of sex hormones:E₂,P,PRL and FSH of the three patient groups were disordered before treatment,and significantly different from healthy women（P<0.01）.After treatment,the levels of P and FSH of the treatment group were significantly increased（P<0.01）,E₂ and PRL were significantly reduced,which were also significantly decreased compared with the psychological intervention groups（P<0.01）.（4） Follow-up:the markedly effective rate and the total effective rate of the treatment group remained higher than those of the other two groups after one year of treatment（P<0.05）.（5） Adverse reactions:no obvious adverse reactions were found among the three groups.Conclusions:Therapy with Chinese medicine combined with psychological intervention was effective for short-term and long-term treatment of cyclomastopathy and menoxenia.The mechanism might be related to the regulation of sex hormones.     

中药分期治疗放环后月经不调的临床观察

目的:观察中药分期疗法治疗放环后月经不调的疗效.方法:78例患者,分出血期、非出血期给予中药分期治疗.结果:78例中治愈48例,显效19例,有效率为85.90%.结论:中药分期疗法治疗放环后月经不调,疗效显著.     

妇舒颗粒治疗气虚、寒凝之妇产科血瘀症400例临床疗效观察

目的:观察妇舒颗粒(当归、蒲黄、五灵脂等)治疗产后妇女恶露不行或行而不尽、腹痛拒按及妇科月经不调、痛经、闭经等属气虚、寒凝所致之妇产科血瘀症的临床疗效。方法:将400例此类妇产科血瘀症患者随机分为两组:治疗组250例以自制妇舒颗粒治疗;对照组150例以单味益母草膏治疗;两组均以7 d为1疗程。结果:总有效率治疗组为92.8%,对照组为82.0%。两组比较,差异有非常显著性意义(P<0.01)。结论:妇舒颗粒治疗气虚、寒凝之妇产科血瘀症疗效显著。