Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome
胆汁酸谱在肺炎和肺癌鉴别诊断中的应用价值
文章编号：1673-8640（2021）01-001-07 中图分类号：R446.1 文献标志码：A DOI：10.3969/j.issn.1673-8640.2021.01.001胆汁酸谱在肺炎和肺癌鉴别诊断中的应用价值徐润灏1，邹 琛1，张 洁2，李 敏2，张舒林1（1.上海交通大学医学院，上海 200025；2.上海交通大学医学院附属仁济医院检验科，上海 200001）摘要：目的探讨肺癌患者血清胆汁酸谱的变化及其在肺炎与肺癌鉴别诊断中的价值。
方法 采用液相色谱-串联质谱法（LC-MS/MS）检测80例肺炎患者（肺炎组）、108例肺癌患者（肺癌组）和106名体检健康者（正常对照组）血清胆汁酸谱[5种游离胆汁酸，包括胆酸（CA）、鹅脱氧胆酸（CDCA）、脱氧胆酸（DCA）、石胆酸（LCA）、熊脱氧胆酸（UDCA）；10种结合胆汁酸，包括甘氨胆酸（GCA）、甘氨鹅脱氧胆酸（GCDCA）、甘氨脱氧胆酸（GDCA）、甘氨石胆酸（GLCA）、甘氨熊脱氧胆酸（GUDCA）、牛磺胆酸（TCA）、牛磺鹅脱氧胆酸（TCDCA）、牛磺脱氧胆酸（TDCA）、牛磺石胆酸（TLCA）、牛磺熊脱氧胆酸（TUDCA）]，同时检测血清总胆汁酸（TBA）及肿瘤标志物[糖类抗原（CA）125、CA19-9、癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA 21-1）、神经元特异性烯醇化酶（NSE）]。
采用二元Logistic回归分析筛选指标并建立诊断模型。
采用受试者工作特性（ROC）曲线分析各项指标及诊断模型鉴别诊断肺炎与肺癌的效能。
结果与正常对照组比较，肺炎组血清游离胆汁酸DCA、LCA、UDCA水平及结合胆汁酸GDCA、GLCA、TDCA、TLCA水平降低（P<0.01），血清结合胆汁酸GCDCA、TCDCA水平升高（P<0.01）；肺癌组血清游离胆汁酸CA、CDCA水平及结合胆汁酸GCDCA、TCDCA水平升高（P<0.01），血清结合胆汁酸TDCA、TLCA水平降低（P<0.01）。
连续应用特立帕肽对正常和去势小鼠骨代谢的影响
连续应用特立帕肽对正常和去势小鼠骨代谢的影响李明翰; 何友华; 童国军; 杨德鸿【期刊名称】《《南方医科大学学报》》【年(卷),期】2019(039)009【总页数】7页(P1045-1051)【关键词】甲状旁腺素; 连续刺激; 骨质疏松【作者】李明翰; 何友华; 童国军; 杨德鸿【作者单位】南方医科大学南方医院脊柱骨科广东广州 510515【正文语种】中文特立帕肽（TPTD）主要作用于骨骼、肾小管和肠道等系统，调节血清钙盐的稳态［1-3］。
基础和临床研究证明间断小剂量的TPTD显著成骨［4］，用于治疗严重骨质疏松。
但大剂量持续应用时，犹如甲状旁腺素亢进状态，显著促进皮质骨和松质骨吸收［5］。
研究如何降低TPTD破骨作用，保留或者促进成骨活性是有关PTH研究的一个重要方向［6-7］，而TPTD的皮下持续泵入模型常常被用来研究其破骨作用。
我们在研究hPTH（1-34）及其模拟肽的破骨作用时，意外观察到hPTH（1-34）增加去势小鼠松质骨量，与之前广泛报道的TPTD促进骨吸收的结果不符合。
TPTD在去势小鼠的成骨作用或促进骨缺损愈合的研究常选用间断给药的方式，而不采用持续灌注的给药方式［8］。
以往TPTD持续灌注促骨吸收的结果来自于正常小鼠的研究，但在去势后TPTD连续灌注是否还保持相同的促骨吸收作用并不明确。
本文探讨TPTD的破骨作用在正常或去势小鼠并不完全相同，TPTD持续灌注的给药方式在去势小鼠身上可能没有显现促骨吸收的作用并分析可能的机制。
1 材料和方法1.1 TPTD微量缓释泵的制备TPTD（重组人PTH（1-34））由广州特立生物科技有限公司合成，0.1%三氟乙酸（TFA）溶解成10-3mol/L备用。
用生理盐水将TPTD储存液按40 μg （kg·d），共14 d量配制成0.2 mL，注入植入式胶囊渗透泵（ALZET）。
空白对照渗透泵注入等量生理盐水。
1.2 微量泵持续泵入小鼠分组及模型的制备24只6周龄小鼠，适应性喂养1周后，随机分成2组，每组有12只小鼠，进行卵巢切除（OVX）或假手术处理（SHAM）。
低分子肝素钠治疗D-二聚体升高复发性流产患者的临床研究
·184·药品评价 Drug Evaluation 2021,18（03）复发性流产（recurrent spontaneous abortion，RSA）指的是和同一性伴侣发生自然流产（连续2次及以上），与生殖道感染、免疫功能异常、遗传等因素有一定关联性，其中免疫因素为主要原因，占50%~70%［1-2］。
高凝状态于流产中起重要作用，机体高凝状态可通过D-二聚体（D-D）表达反映［3］。
临床针对D-D升高RSA患者多以激素类药物保胎治疗，可预防流产，改善预后，但治疗效果无法达到临床预期，多需联合其他药物治疗［4］。
低分子低分子肝素钠治疗D-二聚体升高复发性流产患者的临床研究张华丽周口市第一人民医院，河南 周口 466700［摘要］目的：探究低分子肝素钠+注射用绒促性素+黄体酮肌注治疗D-二聚体（D-D）升高复发性流产（RSA）患者的效果。
方法：选取2018年3月至2019年3月周口市第一人民医院收治的298例D-D升高RSA患者作为研究对象，按照随机抽签法分为观察组（n=149）和对照组（n=149）。
对照组采用注射用绒促性素+黄体酮肌注治疗，观察组采用低分子肝素钠+注射用绒促性素+黄体酮肌注治疗。
比较两组分娩成功率、妊娠并发症发生情况、治疗前和妊娠12周时血清雌二醇（E2）、人绒毛膜促性腺激素（HCG）、孕酮（P）、D-D水平。
结果：观察组分娩成功率80.54%高于对照组68.46%，差异有统计学意义（P<0.05）；两组妊娠12周时血清HCG、P、E2水平较治疗前高，且观察组较对照组高，差异有统计学意义（P<0.05）；观察组妊娠并发症发生率5.37%低于对照组18.12%，差异有统计学意义（P<0.05）；观察组D-D水平低于对照组，差异有统计学意义（P<0.05）。
结论：低分子肝素钠+注射用绒促性素+黄体酮肌注治疗D-D 升高RSA可有效提高分娩成功率，减少妊娠并发症发生，调节性激素水平，降低血清D-D水平。
美国内分泌学会临床实践指南成人垂体机能减退症激素补充治疗(第一部分)中英对照(全文)
美国内分泌学会临床实践指南:成人垂体机能减退症激素补充治疗(第一部分)中英对照（全文）美国内分泌学会临床实践指南成人垂体机能减退症激素补充治疗Maria Fleseriu,Ibrahim A. Hashim, Niki Karavitaki, Shlomo Melmed, M. Hassan Murad, Roberto Salvatori and Mary H. Samuels. J ClinEndocrinol Metab, 101(11), pp. 3888–3921(DOI: /10.1210/jc.2016-2118)根据循证医学方法，由美国内分泌学会、美国临床化学协会、垂体学会、欧洲内分泌学会专家讨论，本指南针对成人垂体机能减退症的严重问题，涉及成人垂体机能减退症的评估和治疗，包括合理的生化评估、激素补充过量、激素补充不足、妊娠期垂体机能减退症的治疗、垂体手术或其他手术时的处理。
CK要点：Essential Points该指南阐述了可能影响垂体功能减退症患者治疗的特殊情况，包括妊娠护理、垂体或其他手术的手术后治疗、联合抗癫痫药物时的治疗以及垂体卒中后的治疗。
指南的建议包括但不限于：需要检测游离甲状腺素和促甲状腺激素来评估是否存在中枢性甲状腺功能减退症，中枢性甲减的甲状腺由于TSH的不足导致甲状腺的分泌减少。
中枢性甲状腺功能减退症患者应接受左旋甲状腺素治疗，剂量足以将游离甲状腺素（FT4）水平提高至参考范围的中上水平。
应使用生长激素的刺激试验来诊断疑似生长激素缺乏症的患者。
已经证实有生长激素缺乏症且无禁忌症的患者应接受生长激素替代治疗。
绝经前妇女如存在中枢性性腺功能减退（低促性腺激素性性腺功能减退），这种情况下性腺不产生或只产生极少量的激素，如无禁忌，可以接受相关的激素治疗。
产生异常大量稀释尿液的患者应考虑到中枢性尿崩症，并应通过相关的额检验检查进行诊断，确诊的患者如无禁忌应进行相应的治疗对于糖皮质激素水平低的患者，氢化可的松可以每日单次或分次给药。
调经促孕丸联合来曲唑治疗排卵障碍性不孕症的临床研究
[16]皮达.药典所载四种陈皮的比较研究[D].南昌：江西中医药大学，2019.[17]王芳芳.中药贴敷神阙穴对严重脓毒症胃肠功能障碍的疗效观察[D].广州：广州中医药大学，2011.[18]常卫东.中医综合疗法治疗脓毒症胃肠功能障碍的临床研究[D].广州：广州中医药大学，2017.[19]安丽娅.胃肠快速康复治疗对腹部中大手术患者术后肠麻痹和临床结局影响的研究[D].昆明：昆明医科大学，2016.[20]姚淑雯，许卓谦，王华，等.康复干预措施对ICU 机械通气患者胃肠功能改善的研究[J].齐齐哈尔医学院学报，2019，40（12）：1558-1560.（收稿日期：2023-02-17） （本文编辑：陈韵）*基金项目：江西省卫生健康委科技计划项目（202310733）①赣南医学院第一附属医院 江西 赣州 341000通信作者：赵颖调经促孕丸联合来曲唑治疗排卵障碍性不孕症的临床研究*赵颖① 郑文宇① 王琴① 刘朝霞①【摘要】 目的：探究调经促孕丸联合来曲唑治疗排卵障碍性不孕症的临床效果。
方法：选取2021年6月-2022年1月赣南医学院第一附属医院收治的80例排卵障碍性不孕症患者，随机分为两组，各40例。
对照组采用来曲唑治疗，观察组采用调经促孕丸联合来曲唑治疗。
比较两组卵泡发育情况、注射注射用绒促性素（hCG）日子宫内膜厚度、应用尿促性素（HMG）的总剂量、排卵后1周血清雌二醇（E 2）及孕酮（P）水平、宫颈黏液评分、排卵率及妊娠率。
结果：治疗后，两组主卵泡直径比治疗前高，观察组比对照组高（P <0.05）。
观察组注射hCG 日子宫内膜厚度比对照组高，观察组应用HMG 的总剂量比对照组少（P <0.05）。
排卵后1周，观察组E 2、P 水平均比对照组高（P <0.05）。
治疗后，两组子宫颈黏液评分比治疗前高，观察组比对照组高（P <0.05）。
观察组的排卵率、妊娠率均比对照组高（P <0.05）。
性激素、血清胆固醇和胆囊胆固醇结石的相关性研究
性激素、血清胆固醇和胆囊胆固醇结石的相关性研究（作者:___________单位: ___________邮编: ___________）【摘要】目的探讨血清雌激素、雄激素、孕激素及血清胆固醇水平与胆囊胆固醇结石的关系。
方法对100例女性和50例男性胆囊胆固醇结石患者进行血清雌二醇（E2）、血睾酮（T）、血孕酮（P）及血清胆固醇（Cho）的测定，并分别与100例女性和50例男性健康对照组比较。
结果男、女性胆固醇结石组的E2、E2/T、Cho水平均显著高于同性别对照组（P＜0.05），而T水平较对照组低（P＜0.05），女性胆固醇结石组的孕酮水平与对照组比较差异无统计学意义（P＞0.05）。
结论血清雌激素、雄激素水平和血清胆固醇水平的异常与胆囊胆固醇结石的形成有一定关系。
【关键词】性激素；胆固醇；胆囊胆固醇结石Abstract: Objective To analyze the relationship between serum estrogen,serum androgen，serum progesterone,serum cholesterol and gallbladder cholestrol stone.Methods Serum estradiol(E2),testosterone(T)，progesterone(P) and serumcholosterol(Cho) in 100 female cases and 50 male patients with cholesterol gallstone were compared with 100 female and 50 male healthy controls.Results The level of serum E2,Cho in patients were higher than those in controls（P＜0.05）; compared women’s progesterone levels of cholesterol gallstone group with those of controls,no significant differrence was found.Conclusion The abnormal serum estrogen,serum androgen and serum cholesterol levels in human body have relation to the formation of gallbladder cholestrol stone.Key words:sex hormone;serum cholesterol;gallbladder cholestrol stone胆囊结石主要为胆固醇结石或以胆固醇为主的混合性结石，成因复杂，与年龄、性别、肥胖、高脂饮食、妊娠、女性激素等多种因素有关。
绝经前后成年女性肾结石患者发病特点分析要点
表２绝经前后肾结石患者合并泌尿系疾病情况对比
岁，中位年龄５１岁。其中２１例为子宫切除术后，７ 例因乳腺恶性肿瘤服用雌激素，因无法判断其绝经 期，在分析不同年龄段肾结石发病情况后，排除该部 分病例，剩余１
二、方法
１６６例，其中绝经前４６４例
其中，４０～５９岁发病的患者超过总人数的一半
［６５３例（５４．６９％）］，总体发病率随年龄增加而上
升，于５０～５９岁（３１．６６％）达到高峰后逐渐下降。 二、绝经前后肾结石合并泌尿系疾病情况分析 本组１ １６６例患者中，泌尿系统相关的合并疾
关报道结果相符‘４ ｏ。本组患者肾结石发病有明显
万方数据
主堡鲨星处型苤查！Ｑ！！生！旦筮！！鲞筮！塑￡！也』型翌！：垒趔！！！！！：！！！：！！：堕！：堡
前后呈现不同的发病特点，绝经后合并泌尿系感染、 。肾功能不全的比例增加，均与雌激素的保护作用降 低有关，泌尿系感染引起肾结石的患病风险增加，同
时绝经后尿钙排泄增多。１０｜，进一步增加了肾结石的 患病风险。因此，女性绝经后更应注意通过适当运
病原因及伴随疾病等方面呈现不同女性肾结石的预
ｓｉｇｎｉｆｉｃａｎｔ ｄｉｆｆｅｒｅｎｔ（Ｐ＞０．０５）．Ｍｕｌｔｉｐｌｅ ｆａｃｔｏｒｓ Ｌｏｇｉｓｔｉｃ ａｎａｌｙｓｉｓ ｉｎｄｉｃａｔｅｄ ｔｈａｔ ａｇｅ ａｎｄ ｕｒｉｎａｒｙ ｉｎｆｅｃｔｉｏｎ
ｗｅｒｅ
ｓｔａｔｉｓｔｉｃａｌｌｙ ｓｉｇｎｉｆｉｃａｎｔ ｆａｃｔｏｒｓ ｉｎ ｔｈｅ Ｔｈｅ
ＣＴ检查，肾盂积水、输尿管结石、泌尿系统畸形根据 ＣＴ报告初步诊断，术中进一步证实后列为确定诊
断；泌尿系感染根据患者尿常规和尿培养确诊；肾功 能不全根据血肌酐水平确诊。本研究中各种并发疾 病均以病案首页中出院诊断（即确定诊断）为统计
同种异体子宫内膜异位症大鼠模型用于GnRH激动剂类药物的药效评价研究
DOI:10.12300/j.issn.1674-5817.2023.150实验动物与比较医学 Laboratory Animal and Comparative Medicine Apr .2024, 44(2)朱 焰，博士，研究员，上海市生物医药技术研究院，生殖药理研究组组长，复旦大学生殖药理专业硕士生导师，国家卫生健康委员会生育调节药械重点实验室课题组组长，中国药理学会生殖药理专委会主任委员、中药与天然药物药理专委会委员，中国优生优育协会生育力保护与修复专委会委员，上海市药理学会生殖药理专委会主任委员，《中药药理与临床》杂志编委。
擅长不孕不育治疗、避孕节育以及子宫内膜异位症、卵巢功能早衰等生殖系统疾病和生殖器官肿瘤动物模型的构建，同时开展药效评价及药理机制研究。
参与“十一五”～“十三五”国家支撑和重点研发项目，负责上海市自然科学基金等多个研究项目。
主持和参与完成50余项药物治疗效果和代谢动力学研究，以及30余项临床前药物安全性评价工作。
发表论文近100篇，其中SCI论文近30篇；获8项专利授权；参编《药理实验方法学》等著作3部。
同种异体子宫内膜异位症大鼠模型用于GnRH 激动剂类药物的药效评价研究钟瑞华1, 李国停1, 杨文捷1, 郭湘洁1, 周洁芸1, 胡颖怡1, 倪其承1,2, 杨野1,2, 张敏3, 朱焰1(1. 国家卫生健康委员会生育调节药械重点实验室, 上海生殖健康药具工程技术研究中心, 上海市生物医药技术研究院生殖药理组, 上海 200237; 2. 复旦大学药学院, 上海 200032; 3. 长春金赛药业有限公司, 长春 130012)[摘要] 目的 用同种异体移植的方法构建大鼠子宫内膜异位症模型，并评价促性腺激素释放激素（gonadotropin-releasing hormone，GnRH ）激动剂GenSci006对实验大鼠子宫内膜异位症模型的影响。
方法 取供体SPF 级雌性SD 大鼠的子宫内膜移植于受体雌性大鼠的腹腔壁上，构建同种异体的子宫内膜异位症模型。
211237987_戊酸雌二醇预处理联合宫腔镜手术治疗中重度宫腔粘连的效果
[16] WU Z，YANG J，LIU J，et al.The relationship betweenmagnesium and osteoarthritis of knee：A MOOSE guided systematic review and meta-analysis[J/OL].Medicine （Baltimore），2019，98（45）：e17774.https:///31702629/.[17]李晶晶，马卫兰，邓立琴，等.全膝关节置换术老年患者术后认知功能障碍的危险因素[J].中华麻醉学杂志，2019，39（2）：158-161.[18]黎阳，刘金凤，李春莲，等.全膝关节置换术老年患者围术期镇痛管理的优化方案[J].中华麻醉学杂志，2019，39（12）：1456-1460.[19]熊冰朗，林天烨，杨鹏，等.同期或分期双侧全髋关节置换临床疗效及围手术期安全性综合比较Meta 分析[J].海南医学院学报，2022，28（17）：1327-1334，1342.[20]赵中溢，李勇阵，陈峰，等.同期双侧全膝关节置换和单髁置换治疗创伤性关节炎的比较[J].中国组织工程研究，2021，25（6）：854-859.（收稿日期：2023-01-15） （本文编辑：田婧）*基金项目：惠州市科技计划项目（20210403）①广东省惠州市第一妇幼保健院 广东 惠州 516007通信作者：欧阳彦兰戊酸雌二醇预处理联合宫腔镜手术治疗中重度宫腔粘连的效果*欧阳彦兰①【摘要】 目的：探讨戊酸雌二醇预处理联合宫腔镜手术在治疗中重度宫腔粘连的临床应用。
方法：前瞻性选取惠州市第一妇幼保健院2021年3月-2022年1月收治的56例中重度宫腔粘连患者，按照随机数字表法分为常规组和联合组，每组28例。
两组均接受宫腔镜手术治疗，常规组在术后予以戊酸雌二醇治疗，联合组在常规组基础上予以戊酸雌二醇预处理治疗，观察两组患者子宫形态恢复情况、子宫内膜血流、细胞因子水平、月经恢复正常时间及宫腔再粘连发生率。
妊娠49周孕妇血清雌二醇变化与妊娠结局的关系
异维A酸联合阿奇霉素及阿达帕林凝胶治疗中重度痤疮的疗效及安全性分析
异维A酸联合阿奇霉素及阿达帕林凝胶治疗中重度痤疮的疗效及安全性分析作者：禚欣欣顾丽娟周晓晗来源：《中国美容医学》2024年第03期[摘要]目的：探讨异维A酸联合阿奇霉素、阿达帕林凝胶治疗中重度痤疮的疗效及安全性。
方法：选取2020年1月-2020年12月笔者医院收治的中重度痤疮患者99例，采用随机数字表法分为对照1组（33例）、对照2组（33例）和观察组（33例）。
对照1组采用局部外涂0.1%阿达帕林凝胶治疗，对照2组采用阿达帕林凝胶联合阿奇霉素治疗。
在对照2组的基础上，观察组联合异维A酸软胶囊治疗，三组均治疗4周。
统计三组治疗后的临床疗效、患者满意率及治疗期间不良反应发生情况，比较三组治疗前后血清性激素水平及皮肤屏障功能。
结果：治疗4周后，观察组总有效率及总满意率均高于对照1组、对照2组（P＜0.05）。
治疗后，观察组血清睾酮（Testosterone，T）、孕酮（Progesterone，P）、性激素结合蛋白（Sex hormone binding protein，SHBG）水平均降低，且低于对照1组、对照2组（P＜0.05）；观察组血清雌二醇（Estradiol，E2）、促卵泡激素（Follicle stimulating hormone，FSH）水平升高，且高于对照1组、对照2组（P＜0.05）；三组角质层含水量均升高，观察组高于对照1组、对照2组，三组经皮水分丢失量、痤疮综合分级系统（Acne comprehensive grading system，GAGS）积分、红斑评分、色素沉着评分均降低，观察组低于对照1组、对照2组（均P＜0.05）。
观察组患者满意率高于对照组（P＜0.05）。
三组不良反应发生率比较，差异无统计学意义（P＞0.05）。
结论：异维A酸联合阿奇霉素、阿达帕林凝胶可有效改善中重度痤疮患者血清性激素水平及皮肤屏障功能，提高患者满意率，临床疗效较好，且不会增加不良反应的发生。
来曲唑在卵巢过度刺激综合征高风险患者中的应用研究
来曲唑在卵巢过度刺激综合征高风险患者中的应用研究惠雅梦，汤秀明，耿颖春，祁秀娟*（青岛大学附属医院生殖医学科，山东青岛 266100）【摘要】目的 探讨卵巢过度刺激综合征（OHSS）高风险患者取卵后口服来曲唑预防早发型OHSS的效果。
方法 将OHSS高风险行全胚冷冻的患者（n=101）随机分为实验组和对照组，实验组（n=52）自取卵日起连续口服来曲唑5天，5mg/d；对照组不添加药物干预（n=49）。
测定两组患者hCG注射后第1天、口服来曲唑后第3天与第5天血清雌二醇（E2）、血管内皮细胞生长因子(VEGF)水平，观察OHSS发生率。
结果 实验组患者用药后第3天、第5天的血清E2、VEGF水平显著低于对照组（P＜0.05）；实验组中重度OHSS发生率（5.76%）显著低于对照组（16.32%, P＜0.05）。
结论 OHSS高风险患者取卵后应用来曲唑可以降低血清E2、VEGF水平及中重度OHSS发生率，临床上可以考虑用来曲唑预防OHSS的发生。
【关键词】来曲唑；血管内皮生长因子；卵巢过度刺激综合征；IVF/ICSI【中图分类号】R711.6 【文献标识码】A 【文章编号】ISSN.2095-8803.2019.5.53.04The effect of Letrozole on patients with high riskof ovarian hyperstimulation syndromeHui Ya-Meng, Tang Xiu-Ming, GENG Ying-Chun, Qi Xiu-Juan*(The Affilited Hospital of Qingdao University,Qingdao Shandong 266100,China)【Abstract】Objective To explore the preventive effect on ovarian hyperstimulation syndrome (OHSS) of letrozole among the high risk patients of OHSS after oocyte retrieval.Methods A total of 101 patients who had to cancel the fresh cycle of embryo transfer due to the OHSS risk factors were randomly divided into the experimental group and the control group.The experimental group (n=52) treated with 5mg/d of letrozole on the date of retrieval for five consecutive days, while the patients in control (n=49) were not treated with letrozole.The proportion of the incidence of OHSS was observed,and the levels of serum estradiol and VEGF were measured on the first day after human chorionic gonadotropin (hCG) injection and on the third,fifth day after the oral administration of letrozole. Results The levels of estradiol and VEGF in experimental group were significantly lower than control group on the third and fifth day after the oral administration of letrozole(P＜0.05).The incidences of moderate and severe OHSS in experiment group (5.76%) were significantly lower than those in control group (16.32%,P＜0.05). Conclusion Providing letrozole for the high risk patients of OHSS after oocyte retrieval can reduce the level of estradiol, VEGF and the incidences of moderate and severe OHSS effectively. Letrozole can be used in the later clinical practice as the prevention of OHSS.【Key words】Letrozole;VEGF;Ovarian hyperstimulation syndrome;In vitro fertilization/Intracytoplasmic sperm injection卵巢过度刺激综合征（Ovarian hyperstimulation syndrome，OHSS）是辅助生殖技术中控制性超促排卵（Contral ovarian stimulation，COS）引起的一种较常见的医源性并发症，发生率约0.5-2%[1]。
依折麦布联合瑞舒伐他汀对ldl-c未达标急性冠脉综合征患者斑块的影响
tion genetic screening (PGS) show increased aneuploidy rates but
can lead to live births with single thawed euploid embryo trans鄄
fer渊STEET冤咱J暂.J Assist Reprod Genet,2016,33(11)院1501轧1505.
Mod Diagn Treat 现代诊断与治疗 2019 Oct 30渊20冤
窑3511窑
综上所述袁在冻融囊胚移植中袁四种内膜准备方 案均能达到较好的妊娠结局袁选择何种方案应根据 患者的具体情况实施袁权衡利弊袁采取个体化方案遥 但对于 35耀40 岁的高龄患者袁降调后人工周期准备内 膜似乎能达到更好的妊娠结局遥 因此袁在临床中对于 该年龄段的患者袁可倾向于选择降调人工周期准备 内膜进行冻融囊胚移植遥
咱7暂MAGDI Y,DAMEN A,FATHI A,ABDELAZIZ AM,et al.Revisiting the management of recurrent implantation failure through freezeall policy咱J暂.Fertil Steril 2017,108(1)院72轧77.
咱2暂陈攀宇袁李婷婷袁贾 磊袁等.全囊胚培养在高龄低储备不孕患者中 的应用分析咱J暂.中山大学学报袁2017,38渊6冤院878轧885.
咱3暂DECLEER W,OSMANAGAOGLU K, MEGANCK G,et al.Slightly lower incidence of ectopic pregnancies in frozen embryo transfer cycles versus fresh in vitro fertilization embryo transfer cycles院a retrospective cohort study咱J暂.Fertil Steril,2014,101(1)院162轧165.
尿失禁——精选推荐
Menopause:The Journal of The North American Menopause SocietyVol.18,No.12,pp.1268Y1269DOI:10.1097/gme.0b013e318238e157*2011by The North American Menopause SocietyE DITORIALUrine leakage:menopause or normal aging?B D octor,I just thought my leaking urine was nor-mal at my age I isn_t it normal?[We know thatthe answer to this question is not always simple because urinary continence has rather complex physiology. Urinary continence is an ability to store urine with conve-nient and socially acceptable voluntary emptying.Continence requires a complex coordination of multiple components that include muscle control(contraction and relaxation),appropri-ate connective tissue support,and communication of structures of the urinary tract achieved through innervation and central nervous system oversight.Urinary incontinence(UI)is a com-plaint of involuntary loss of urine.1Two of the most common UI manifestations are described:stress urinary incontinence (SUI),which is loss of urine that is associated with an increase in intra-abdominal pressure as with sneezing,coughing,or phys-ical activity,and urge urinary incontinence(UUI),which is in-voluntary loss of urine associated with a sudden,compelling sensation of urge to void that is difficult to defer.From observational studies,we know that approximately a quarter of young women,more than half of middle-aged and postmenopausal women,and nearly three quarters of older women in nursing homes experience some degree of UI.More-over,70%of postmenopausal women with UI relate the onset of these symptoms to their final menstrual period.2Indeed, the prevalence of UI and other lower urinary tract symptoms (urinary urgency,frequency,and nocturia)seems to steadily increase starting with menopause.Therefore,is the prevalence of UI a normal part of aging?There is an ongoing debate on whether the mechanism of this observed increase is related to aging,hormonal deficiency,or both.The actual mechanism by which hormonal deficiency could affect UI and urinary symp-toms is not well understood.Many studies aimed to explore the relationship between UI and menopausal state.Most of this literature focuses on under-standing urinary symptoms and urinary continence in the con-text of hormone therapy.For many years,systemic estrogen hormone therapy was believed to improve lower urinary tract symptoms and UI.The latest data,however,challenge this be-lief and suggest that an opposite trend may exist.The2010 Cochrane review3found that systemic use of estrogen alone (estrogen therapy;synthetic and conjugated equine estrogens) can worsen any UI compared with placebo(RR,1.32;95% CI,1.17-1.48).Combination hormone estrogen and proges-terone therapy produced similar results when compared with placebo(RR,1.11;95%CI,1.04-1.18).Furthermore,continent women who received systemic estrogen alone or in combina-tion with progesterone were more likely to report the de-velopment of new UI.These findings,however,were heavily weighted by the data from the Women’s Health Initiative,4in which only conjugated equine estrogens were studied.On the other hand,locally administered vaginal estrogen may have a different affect on urogenital symptoms.The same Cochrane review3also found evidence that locally used estrogen(creams or tablets)improve incontinence(RR,0.74;95%CI,0.64-0.86) symptoms.Women treated with local estrogen were reporting one to two less voids in24hours and nocturnally and less frequency and urgency.The Cochrane review did not separate UI by type.Earlier work by Cardozo et al5aimed to clarify the role of estrogen in overactive bladder(OAB),a syndrome that includes UUI and multiple associated symptoms:urinary urgency,daytime fre-quency,and nocturia.Six parameters that are thought to be important in OAB syndrome were explored:diurnal frequency, nocturnal frequency,urgency,incontinence episodes,first sen-sation to void,and bladder capacity.The meta-analysis in-cluded11randomized controlled trials(n=430)exploring the impact of vaginal versus systemic estrogen administration. Local estrogen administration provided greater symptomatic relief in all the parameters of OAB syndrome.Systemic estro-gens were found to improve first sensation to void and reduce incontinence episodes compared with placebo.These meta-analyses could still create confusion.Some-times,data showing statistical improvement are derived from combining nonstatistically significant data that may not easily translate into clinical improvement and hence into clinical practice.Moreover,most of the trials included in the meta-analyses were not designed to investigate incontinence and were thus powered to assess a different outcome.Furthermore, all meta-analyses are subject to publication bias.The incon-sistency of estrogen preparations and dosages as well as the heterogeneity of objective and subjective criteria of UI im-provement and cure adds difficulty to result interpretation.In the current issue of Menopause,the article by Waetjen et al6aims to enhance our understanding of the relation-ship between serum hormone levels and urinary symptoms in women during the menopausal transition.In the longitudi-nal analysis of a large cohort of women during perimeno-pause,no correlation was found between annually measured serum estradiol levels and development or worsening of incon-tinence.In addition,no association was found between follicle-stimulating hormone,testosterone,or dehydroepiandrosterone sulfate levels and the development or worsening of inconti-nence.These findings suggest that serum concentrations of endogenously and physiologically produced estrogens are not1268Menopause,Vol.18,No.12,2011responsible for maintaining continence.Perhaps during the menopausal transition,it is not the changes in the serum hor-mone levels but rather the changes in the end-tissue effect of hormones that modulate urinary symptoms.The precise mechanism through which estrogens and per-haps other hormones affect continence is poorly understood. Compromise in urogenital connective tissue is one of the com-mon pathogeneses of SUI and is the focus of SUI research.7 Data are conflicting on the effects of estrogens on urogenital tissue composition.Estrogen has also been proposed to in-crease urethral resistance,to raise the sensory threshold of the bladder,to increase urethral smooth muscle>-adrenergic re-ceptor sensitivity,and to promote A-3adrenergic receptor V the mediation relaxation of the detrusor muscle.8Sharing a common embryologic origin,lower urinary and female genital tracts are similarly sensitive to the effects of female sex steroids.High-affinity estrogen receptors(ERs) and progesterone receptors have been found in the connective tissue,smooth muscle and neuronal tissue of vagina,urethra, bladder trigone,and pelvic floor musculature.9,10Some inves-tigators demonstrated that the urogenital tissues of women with UI have an altered concentration of ERs.Women with SUI had lower ER concentrations in pelvic floor tissues(pelvic floor muscles and connective tissue).11The concentration of anterior vaginal wall ER-A was found to be lower in post-menopausal women with SUI.12Other investigators propose that genetic susceptibility to UI development may contribute to the interaction between sex steroids and UI.Cornu et al13 found that androgen receptor polymorphism is linked to ge-netic susceptibility to UI.The interaction of urinary continence,menopause,and aging is still unclear;however,evidence points to some im-pact of menopausal hormonal deficiency on the prevalence of UI,urogenital tissues status,and function.Serum levels of hormones do not correlate with the development of UI. Moreover,systemic hormone(or estrogen)therapy may be detrimental to urinary continence.The precise interaction of hormonal deficiency and urinary continence is not well elu-cidated and remains an important area of research.One thing is clear,UI in of all its manifestations is multifactorial and among other influences is affected by the hypoestrogenic state of menopause.For postmenopausal women with UI,it is reasonable to assess for signs of urogenital atrophy and consider topical estrogen,whereas systemic hormone replace-ment would not be advisable.Therefore,is urinary leaking just part of normal aging?Perhaps indirectly.Financial disclosure/conflicts of interest:None reported.Milena M.Weinstein,MDVincent Obstetrics and Gynecology ServiceMassachusetts General HospitalBoston,MassachusettsREFERENCES1.Abrams P,Cardozo L,Fall M,et al.The standardisation of terminol-ogy of lower urinary tract function:report from the Standardisation Sub-committee of the International Continence Society.Am J Obstet Gynecol 2002;187:116-126.2.Iosif CS,Bekassy Z.Prevalence of genito-urinary symptoms in the latemenopause.Acta Obstet Gynecol Scand1984;63:257-260.3.Cody JD,Richardson K,Moehrer B,Hextall A,Glazener CM.Oestrogentherapy for urinary incontinence in post-menopausal women.Cochrane Database Syst Rev2009;4:CD001405.4.Hendrix SL,Cochrane BB,Nygaard IE,et al.Effects of estrogen withand without progestin on urinary incontinence.JAMA2005;293:935-948.5.Cardozo L,Lose G,McClish D,Versi E.A systematic review of theeffects of estrogens for symptoms suggestive of overactive bladder.Acta Obstet Gynecol Scand2004;83:892-897.6.Waetjen LE,Johnson WO,Xing G,Feng WY,Greendale GA,Gold EB.Serum estradiol levels are not associated with urinary incontinence in mid-life women transitioning through menopause.Menopause2011;18: 1283-1290.7.Edwall L,Carlstrom K,Jonasson AF.Markers of collagen synthesis anddegradation in urogenital tissue from women with and without stress urinary incontinence.Neurourol Urodyn2005;24:319-324.8.Matsubara S,Okada H,Shirakawa T,Gotoh A,Kuno T,Kamidono S.Estrogen levels influence A-3-adrenoceptor-mediated relaxation of the female rat detrusor muscle.Urology2002;59:621-625.9.Iosif CS,Batra S,Ek A,Astedt B.Estrogen receptors in the humanfemale lower uninary tract.Am J Obstet Gynecol1981;141:817-820. 10.Batra SC,Iosif CS.Progesterone receptors in the female lower urinarytract.J Urol1987;138:1301-1304.11.Zhu L,Lang J,Feng R,Chen J,Wong F.Estrogen receptor in pelvicfloor tissues in patients with stress urinary incontinence.Int Urogynecol J Pelvic Floor Dysfunct2004;15:340-343.12.Xie Z,Shi H,Zhou C,Dong M,Hong L,Jin H.Alterations of estrogenreceptor->and-A in the anterior vaginal wall of women with urinary incontinence.Eur J Obstet Gynecol Reprod Biol2007;134:254-258. 13.Cornu JN,Merlet B,Cussenot O,et al.Genetic susceptibility to urinaryincontinence:implication of polymorphisms of androgen and oestrogen pathways.World J Urol2011;29:239-242.Menopause,Vol.18,No.12,20111269EDITORIAL。
烯丙雌醇片与地屈孕酮片联合治疗先兆流产对患者症状缓解时间、血清孕酮及β-HCG水平的影响
系统医学 2024 年 2 月第 9 卷第 3期烯丙雌醇片与地屈孕酮片联合治疗先兆流产对患者症状缓解时间、血清孕酮及β-HCG水平的影响王晓梅，牟晓斐，周爱红，孙建玲甘肃省武威市人民医院产科，甘肃武威733000[摘要]目的探讨烯丙雌醇片与地屈孕酮片联合治疗先兆流产对患者症状缓解时间、血清孕酮及人绒毛膜促性腺激素（β-humanchorionicgonadotrophin, β-HCG）水平的影响。
方法选取2021年3月—2023年4月武威市人民医院诊治的120例先兆流产患者为研究对象，按照随机数表法分为对照组和观察组，每组60例。
对照组口服地屈孕酮片治疗，观察组在对照组基础上加用烯丙雌醇片治疗。
对比两组患者的症状缓解时间、血清性激素指标、不良反应。
结果观察组腹痛缓解时间（3.44±1.12）d、腰酸缓解时间（4.01±0.96）d、出血停止时间（3.89±1.68）d均短于对照组（5.41±1.29）d、（6.17±1.24）d、（6.39±2.47）d，差异有统计学意义（P均<0.05）。
治疗后，观察组的孕酮、β-HCG、雌二醇水平均高于对照组，差异有统计学意义（P均<0.05）。
两组不良反应发生率比较，差异无统计学意义（P>0.05）。
结论在先兆流产患者中应用烯丙雌醇片联合地屈孕酮片治疗效果显著，能够促进患者机体内血清性激素水平改善，缩短症状缓解时间，且安全可靠。
[关键词]先兆流产；地屈孕酮片；烯丙雌醇片；性激素指标；不良反应；症状缓解[中图分类号]R711 [文献标识码]A [文章编号]2096-1782（2024）02(a)-0161-04Effects of Allylestradiol Tablets and Dydrogesterone Tablets on Symptom Remission Time, Serum Progesterone and β-HCG Levels in Patients with Threatened AbortionWANG Xiaomei, MU Xiaofei, ZHOU Aihong, SUN JianlingDepartment of Obstetrics, Wuwei People′s Hospital, Wuwei, Gansu Province, 733000 China[Abstract] Objective To investigate the effects of allylestradiol tablets and dydrogesterone tablets on symptom remis⁃sion time, serum progesterone and β-human chorionic gonadotrophin (β-HCG) levels in patients with threatened abor⁃tion. Methods A total of 120 patients with threatened abortion diagnosed and treated in Wuwei City People′s Hospital from March 2021 to April 2023 were selected as the study objects and divided into control group and observation group according to random number table method, with 60 cases in each group. The control group was treated with dy⁃drogesterone tablets, and the observation group was treated with allylestradiol tablets on the basis of control group. Symptom remission time, serum sex hormone indexes and adverse reactions were compared between the two groups of patients. Results Abdominal pain relief time (3.44±1.12) d, lumbar acid relief time (4.01±0.96) d and bleeding cessa⁃tion time (3.89±1.68) d in the observation group were shorter than those in the control group (5.41±1.29) d, (6.17±1.24) d and (6.39±2.47) d, and the differences were statistically significant (all P<0.05). After treatment, the levels of progesterone, β-HCG and estradiol in the observation group were higher than those in the control group, and the dif⁃ferences were statistically significant (all P<0.05). There was no significant difference in the incidence of adverse reac⁃tions between the two groups (P>0.05). Conclusion In patients with threatened abortion, the application of allylestra⁃DOI：10.19368/ki.2096-1782.2024.03.161[作者简介] 王晓梅（1980-），女，本科，主治医师，研究方向为围产医学方面。
口服氨甲环酸联合超分子水杨酸换肤治疗黄褐斑的疗效及对血清MDA与E2的影响
口服氨甲环酸联合超分子水杨酸换肤治疗黄褐斑的疗效及对血清MDA与E2的影响作者：项倩彤崔伟张慧来源：《中国美容医学》2024年第01期[摘要]目的：探讨氨甲环酸联合超分子水杨酸换肤治疗黄褐斑临床疗效及对血清丙二醛（MDA），雌二醇（E2）水平的影响。
方法：将2019年12月-2021年12月合肥市第二人民医院皮肤科经治的116例黄褐斑患者随机分为对照组（58例，口服氨甲环酸片）和觀察组（58例，口服氨甲环酸片联合30%超分子水杨酸治疗），两组患者均治疗20周。
比较两组患者临床疗效[医生整体评价（Physician's global assessment，PGA）、黄褐斑面积和严重指数（Melasma area and severity index，MASI）、皮损评分、经表皮水分流失及皮肤角质层含水量]、主观指标（满意度、睡眠及精神状态）及血清MDA、E2水平。
结果：观察组有效率93.10%高于对照组63.79%（P＜0.05）；两组治疗后MASI、皮损评分、经表皮水分流失及血清MDA、E2水平均较治疗前下降，且观察组改善优于对照组（P＜0.05）；两组治疗后角质层含水量均升高，且观察组升高更显著（P＜0.05）。
观察组PGA评分低于对照组（P＜0.05）。
观察组治疗后治疗满意度评分、睡眠评分、精神状态评分显著高于对照组（P＜0.05）。
两组治疗期间均未出现不良反应。
结论：氨甲环酸联合超分子水杨酸换肤治疗黄褐斑效果显著，并可改善患者氧化应激反应及雌激素水平。
[关键词]黄褐斑；氨甲环酸；超分子水杨酸；换肤；丙二醛；雌二醇[中图分类号]R758.4+2 [文献标志码]A [文章编号]1008-6455（2024）01-0095-04Observation of Curative Effect of Tranexamic Acid Combined with Supramolecular Salicylic Acid Peeling in the Treatment of Melasma and Its Influences on Serum MDA and E2XIANG Qiantong，CUI Wei，ZHANG Hui[Department of Dermatology，the Second People's Hospital of Hefei（Hefei Hospital Affiliated to Anhui Medical University），Hefei 230011，Anhui，China]Abstract： Objective To investigate the therapeutic effect of tranexamic acid combined with supramolecular salicylic acid peeling on melasma and its influences on serum malondialdehyde （MDA） and estradiol （E2） levels. Methods From December 2019 to December 2021， 116 patients with melasma who were admitted to the department of dermatology of hefei second people's hospital were randomly divided into the control group （58 cases， oral tranexamic acid tablets）and the observation group （58 cases， salicylic acid peeling treatment on the basis of the control group）， 20 weeks were treated every group. the clinical efficacy， skin lesions [including physician's global assessment （PGA）， melasma area and severity index （MASI） skin lesion score， transepidermal water loss and stratum corneum water content]， subjective indicators （including treatment satisfaction， sleep and mental states）， adverse reactions and serum MDA and E2 levels were compared between the two groups. Results The effective rate of 93.10% in the observation group was higher than 63.79% in the control group （P＜0.05）; After treatment，MASI， skin lesion score， transepidermal water loss， and serum MDA and E2 levels decreased in both groups compared to before treatment， and the improvement in the observation group was better than that in the control group （P＜0.05）; The moisture content of the stratum corneum increased after treatment， and the observation group showed a more significant increase （P＜0.05）. The PGA score of the observation group was lower than that of the control group （P＜0.05）. The satisfaction score， sleep score， and mental state score of the observation group after treatment were significantly higher than those of the control group （P＜0.05）. No adverse reactions occurred during the treatment of both groups. Conclusion Tranexamic acid combined with supramolecularsalicylic acid peeling has a significant therapeutic effect on melasma， and can improve the oxidative stress and estradiol level in patients.Key words： melasma; tranexamic acid; supramolecular salicylic acid; peeling; malondialdehyde; estradiol黄褐斑是一种皮肤色素沉着疾病，多见于中青年女性群体及肤色较深人群，不仅影响患者面部美观，造成其心理压力，严重影响患者日常生活、正常社交及情绪状态[1-2]。
丹栀逍遥散结合炔雌醇环丙孕酮治疗女大学生多囊卵巢综合征的效果
丹栀逍遥散结合炔雌醇环丙孕酮治疗女大学生多囊卵巢综合征的效果作者：谢莉王娟赵井苓李成银来源：《中国医药科学》2022年第08期[摘要]目的探讨使用丹栀逍遥散结合炔雌醇环丙孕酮片（Diane-35）治疗在校女大学生肝郁血热型多囊卵巢综合征（PCOS）的持续性疗效。
方法选取2018年12月至2020年1月于湖北中医药大学黄家湖医院妇科就诊的符合肝郁血热型 PCOS 在校女大学生60例作为研究对象，随机分为西药组（30例）和中西药组（30例）。
西药组采用口服炔雌醇环丙孕酮片（Diane-35），中西药组采用口服丹栀逍遥散结合炔雌醇环丙孕酮片（Diane-35）。
3个月经周期为1个疗程。
观察两组满1个疗程停药后第1个月经周期和第3个月经周期的月经正常率、中医症状及内分泌水平的变化，并观察安全性。
结果停药后第1个月经周期，两组月经周期正常率比较，差异无统计学意义（P >0.05）;停药后第3个月经周期，中西药组的月经周期正常率高于西药组（P <0.05）。
停药第1个及第3个月经周期，中西药组部分中医临床症状改善情况高于西药组（P <0.05）。
停药后第1个月经周期，两组血清促卵泡激素（FSH）均升高，且中西药组的 FSH 低于西药组，差异有统计学意义（P <0.05）;两组血清性激素促黄体激素（LH）、LH/FSH、睾酮（T）均下降，且中西药组的 LH、LH/FSH、T 高于西药组，差异有统计学意义（P <0.05）。
停药后第3个月经周期，中西药组的血清性激素 LH、LH/FSH、T 均低于西药组， FSH 高于西药组，差异有统计学意义（ P <0.05）。
两组血常规、肝肾功能、凝血功能未见明显异常，且无明显过敏反应。
结论丹栀逍遥散结合炔雌醇环丙孕酮片（Diane-35）治疗女大学生肝郁血热型 PCOS，不仅能显著改善患者肝郁血热的中医症状、恢复月经周期，还能降低性激素水平，具有较高的临床应用价值，值得在临床上推广应用。
血府逐瘀片联合米非司酮对血瘀型子宫腺肌症患者痛经积分、激素水平及CA125_的影响
·全科医疗和社区护理·血府逐瘀片联合米非司酮对血瘀型子宫腺肌症患者痛经积分、激素水平及CA125的影响沈媛媛1 庄康璐1陈义芳2李海林2（1.上海市浦东新区三林康德社区卫生服务中心妇科，上海 200124；2.上海杨思医院妇科，上海 200126）摘 要 目的：观察血府逐瘀片联合米非司酮对血瘀型子宫腺肌症患者痛经积分、激素水平及CA125的影响。
方法：收集2014年1月至2018年6月诊治的子宫腺肌症患者80例，随机分为对照组和观察组各40例。
对照组口服米非司酮片25 mg，1次/d；观察组在对照组基础上加服血府逐瘀片6片，2次/d；两组均干预12周。
观察并比较两组痛经积分、血清CA125、孕酮（P）、血清雌二醇（E2）、黄体生成素（FSH）、促卵泡刺激素（LH）水平等变化情况。
结果：对照组和观察组分别有3例和2例失访。
干预后，观察组痛经积分较对照组显著降低（P＜0.05），CA125水平较对照组明显下降（P＜0.05），P、E2、FSH、LH水平均较对照组下降（P＜0.05）。
结论：与单用米司非酮相比，血府逐瘀片联合米非司酮治疗血瘀型子宫腺肌症可以减轻患者的痛经程度，降低患者血清CA125水平，调节患者激素水平，值得临床推广。
关键词子宫腺肌症；血瘀证；米非司酮；血府逐瘀片中图分类号：R71 文献标志码：A 文章编号：1006-1533（2022）16-0038-04引用本文沈媛媛, 庄康璐, 陈义芳, 等. 血府逐瘀片联合米非司酮对血瘀型子宫腺肌症患者痛经积分、激素水平及CA125的影响[J]. 上海医药, 2022, 43(16): 38-41.Effect of Xuefu zhuyu tablets combined with mifepristone on dysmenorrhea score, hormone level and CA125 in patients with blood stasis type adenomyosisSHEN Yuanyuan1, ZHUANG Kanglu1, CHEN Yifang2, LI Hailin2(1. Department of Gynecology of Sanlinkangde Community Health Service Center of Pudong New District, Shanghai 200124, China; 2.Department of Gynecology, Shanghai Yangsi Hospital, Shanghai 200126, China)ABSTRACT Objective: To observe the effect of Xuefu zhuyu tablets combined with mifepristone on dysmenorrhea score, hormone level and CA125 in patients with blood stasis type adenomyosis. Methods: Eighty patients with adenomyosis diagnosed and treated from January 2014 to June 2018 were collected, and randomly divided into a control group and an observation group with 40 cases in each group. The control group took mifepristone tablets 25 mg, once a day; on the basis of the control group the observation group took 6 Xuefu zhuyu tablets, twice a day; both groups were intervened for 12 weeks. The changes of dysmenorrhea score, serum CA125, progesterone(P), serum estradiol(E2), luteinizing hormone(FSH), and follicle-stimulating hormone(LH) levels were observed and compared between the two groups. Results: There were 3 cases in the control group and2 cases in the observation group lost to follow-up, respectively. After the intervention, the dysmenorrhea scores in the observationgroup were significantly lower than that in the control group(P<0.05), the CA125 level in the observation group was lower than that in the control group(P<0.05), the levels of P, E2, FSH and LH in the observation group were lower than those in the control group(P<0.05). Conclusion: Compared with the use of misestenone alone, Xuefu zhuyu tablets combined with mifepristone in the treatment of blood stasis type adenomyosis can reduce the degree of dysmenorrhea, to reduce the serum CA125 level and regulate the hormone levels of the patients, which is worthy of clinical promotion.KEY WORDS adenomyosis; blood stasis syndrome; mifepristone; Xuefu zhuyu table通信作者：庄康璐。
辅助生殖技术实验室的建设及其质量控制黄国宁
［25］Sallam H ，Garcia-Velasco J ，Dias S ，et al．Long-term pituitarydown-regulation before in vitro fertilization （IVF ）for women with endometriosis ［J ］．Cochrane Database Syst Rev ，2006，CD004635.［26］Forman R ，Fries N ，Testart J ，et al．Evidence for an adverseeffect of elevated serum estradiol concentrations on embryo im-plantation ［J ］．Fertil Steril ，1988，49：118-122.［27］Urman B ，Tiras B ，Yakin K．Assisted reproduction in the treat-ment of polycystic ovarian syndrome ［J ］．Reproductive Bio-Medicine Online ，2004，8：419-430.［28］Kadoch I．Natural cycle IVF （nIVF ）in women with implanta-tion failure ［J ］．Journal of Gyneacology Obstetrics Biology and Reproduction （Paris ），2004，33：S33-S35.［29］Almog B ，Shalom-Paz E ，Dufort D ，et al．Promoting implanta-tion by local injury to the endometrium ［J ］．Fertil Steril ，2010，［Epub ahead of print ］［30］Sallam HN．Embryo transfer ：factors involved in optimizing thesuccess ［J ］．Curr Opin Obstet Gynecol ，2005，17：289-298.［31］Coroleu B ，Barri PN ，Carreras O ，et al．The infl uence of thedepth of embryo replacement into the uterine cavity on implanta-tion rates after IVF ：a controlled ，ultrasound-guided study ［J ］．Hum Reprod ，2002，17：341-346.［32］Pope CS ，Cook EKD ，Arny M ，et al．Infl uence of embryo trans-fer depth on in vitro fertilization and embryo transfer outcomes ［J ］．Fertil Steril ，2004，81：51-58.［33］Lee TH ，Wu MY ，Chen MJ ，et al．Nitric oxide is associatedwith poor embryo quality and pregnancy outcome in in vitro fer-tilization cycles ［J ］．Fertil Steril ，2004，82：126-131.［34］Gong Fei ，Tang Yi ，Zhang Hong ，et al．Modified super-longdown-regulation protocol improved the outcome of in vitro fertili-zation-embryo transfer in infertile patients ［J ］．Central South University （Med．Sci ），2009，34（3）：185-189.（2010－06－20收稿2010－07－05修回）文章编号：1005－2216（2010）10－0755－04辅助生殖技术实验室的建设及其质量控制黄国宁，刘东云，韩伟作者单位：重庆市妇幼保健院生殖与遗传研究所，重庆400010电子信箱：dongyunliu@摘要：文章概述了体外受精与胚胎移植（IVF-ET ）实验室的建立、设计及实验室质量控制体系，实验室是辅助生殖技术中的重要组成，实验室质量控制的目的是为了维持IVF 过程的稳定性，保障使用的仪器、设备、培养基、耗材的稳定性而制定的一系列措施，是质量保障的基础。
乳癖散结胶囊联合小剂量他莫昔芬片治疗对乳腺增生患者血清雌、孕激素的影响及疗效分析
中外医疗China &Foreign Medical TreatmentDOI:10.16662/ki.1674-0742.2019.30.112乳癖散结胶囊联合小剂量他莫昔芬片治疗对乳腺增生患者血清雌、孕激素的影响及疗效分析朱丽文,胡韬,张颂文昆山市第一人民医院甲乳外科,江苏昆山215300[摘要]目的讨论乳癖散结胶囊联合小剂量枸橼酸他莫昔芬片治疗对乳腺增生患者血清雌、孕激素的影响及疗效。
方法方便选择2018年1—6月至该院就诊并诊断为乳腺增生女性患者94例,将所有患者随机分成两组,每组47例;对照组患者接受乳癖散结胶囊治疗,观察组患者接受乳癖散结胶囊联合小剂量枸橼酸他莫昔芬片治疗;连续用药2个月,比较两组患者临床疗效,血清雌、孕激素变化[血清雌二醇(E2)、黄体生成素(LH)、孕酮(P)]。
结果治疗后,观察组患者临床总有效率(95.74%)明显高于对照组(82.98%),差异有统计学意义(χ2=4.029,P<0.05);两组患者E2水平均较治疗前降低,差异有统计学意义(P<0.05),LH、P 水平均较治疗前升高,差异有统计学意义(P<0.05);观察组E2水平明显低于对照组,LH、P 水平明显高于对照组,差异有统计学意义(t (E2)=17.057、t (LH)=12.929、t (P)=21.503,P<0.05)。
结论乳癖散结胶囊联合小剂量枸橼酸他莫昔芬片治疗乳腺增生的疗效显著,安全性较高,且能有效改善患者雌、孕激素水平,对女性身体健康的意义重大,在临床上具有较高的应用价值。
[关键词]乳癖散结胶囊;枸橼酸他莫昔芬片;乳腺增生;临床疗效;安全性[中图分类号]R655[文献标识码]A[文章编号]1674-0742(2019)10(c)-0112-03Effect of Rupi Sanjie Capsule Combined with Low-dose Tamoxifen Tablet on Serum Estrogen and Progesterone in Patients with Hyperplasia of Mam⁃mary Gland and Its Curative Effect AnalysisZHU Li-wen,HU Tao,ZHANG Song-wenDepartment of Breast Surgery,Kunshan First People's Hospital,Kunshan,Jiangsu Province,215300China[Abstract]Objective To discuss the effect and efficacy of Rupi Sanjie Capsule combined with low-dose tamoxifen citrate tablets on serum estrogen and progesterone in patients with breast hyperplasia.Methods A total of 94female patients withbreast hyperplasia who were diagnosed in the hospital from January to June 2018were conveniently selected into the study.All patients were randomLy divided into two groups,47in each group.The control group received chylomicron capsule treatment.Patients in the observation group received chylorrhea capsules combined with low-dose tamoxifen citrate tablets;continuous treatment for 2months,comparing the clinical efficacy of the two groups of patients,serum estrogen and proges⁃terone changes [serum estradiol (E2),corpus luteum Producin (LH),progesterone (P)].Results After treatment,the totalclinical effective rate (95.74%)of the observation group was significantly higher than that of the control group (82.98%),thedifference was statistically significant (χ2=4.029,P<0.05).The E2level of the two groups was lower than that before treat⁃ment,the difference was statistically significant (P<0.05),LH,P levels were higher than before treatment,the difference was statistically significant (P<0.05);E2level in observation group was significantly lower than that in control group,LH and Plevels were significantly higher than control group,the difference was statistically significant (t (E2)=17.057,t (LH)=12.929,t (P)=21.503,P<0.05).Conclusion Rupi Sanjie Capsule combined with low-dose tamoxifen citrate in the treatment of breasthyperplasia has a significant effect,high safety,and can effectively improve the levels of estrogen and progesterone in pa⁃tients,which is of great significance to women's health.It has a high application value.[Key words]Rupi Sanjie Capsule;Tamoxifen citrate tablets;Breast hyperplasia;Clinical efficacy;Safety[作者简介]朱丽文(1986-),男,江苏苏州人,硕士,主治医师,研究方向:甲状腺、乳腺疾病。