乳酸菌阴道胶囊联合雌三醇治疗老年性阴道炎120例疗效观察

老年性阴道炎又称萎缩性阴道炎,是卵巢功能衰退时体内雌激素相对不足在阴道局部的突出表现,常见于绝经后老年妇女。此外,手术切除双侧卵巢、盆腔放疗后、长期闭经、长期哺乳等均可引起该病发生,严重影响病人的生活质量。我科近年来应用乳酸菌阴道胶囊配合雌三醇软膏治疗老年性阴道炎取得较好疗效,现报道如下。     

微生态治疗老年性阴道炎的临床观察

目的探讨采用乳杆菌活菌胶囊治疗老年性阴道炎的临床效果。方法将50例绝经妇女诊断为老年性阴道炎患者随机分成两组,研究组26例每晚清洁外阴后,阴道深部放置乳杆菌活菌胶囊500mg,连续10d。对照组24例每晚阴道内置人甲硝唑500mg,连续10d。两组均在停药后第3-7天复查比较其治愈率、总有效率。两组治愈者均于停药后90d复查,比较其复发率。结果研究组治愈率为73．07％,总有效率为96．14％。对照组治愈率为62．50％,总有效率为91．66％,两组差异无显著性（P〉0．05）。研究组复发率为0,对照组复发率为20．83％,两组差异有显著性（P〈0．05）。结论乳杆菌活菌阴道胶囊恢复阴道微生态平衡,增加阴道黏膜抵抗力。与抗生素药物比较复发率低,又无毒副作用,是治疗老年性阴道炎首进药物。     

女性阴道乳酸杆菌与各种阴道疾病的关系

目的了解本地区女性阴道乳酸杆菌变化与各种阴道疾病的关系。方法采用妇科白带涂片多功能染色液对阴道分泌物做外阴阴道假丝酵母菌病、滴虫、细菌性阴道病（BV）、老年性阴道炎中乳酸杆菌半定量检测。结果外阴阴道假丝酵母菌病、滴虫性阴道炎、细菌性阴道病、老年性阴道炎中乳酸杆菌检出率均低于正常对照组,且乳酸杆菌半定量大部分集中在＋-＋＋范围内,和正常对照组明显不同。其中细菌性阴道病病人的阴道乳酸杆菌检出率最低。结论阴道乳酸杆菌是维持阴道清洁、保持阴道处于酸性环境、预防阴道疾病的重要保障。     

雌二醇联合乳酸菌阴道胶囊治疗老年性阴道炎的临床效果研究

目的:研究雌二醇联合乳酸菌阴道胶囊治疗老年性阴道炎的临床效果,为临床治疗老年性阴道炎提供参考依据。方法:选择2016年1月~2017年5月在我院进行诊治的老年性阴道炎患者94例,随机分为观察组与对照组,每组各47例。对照组给予阴道放置乳酸菌阴道胶囊治疗,每日睡前放置1粒,连续使用一周;观察组联合采用阴道放置戊酸雌二醇治疗,每日睡前放置1片(0.5 mg),连续使用一周。比较两组的临床治疗效果,检测两组患者治疗前后血清孕酮、雌二醇、促黄体生成激素以及促卵泡生成激素水平,并且于治疗后随访观察1年,观察两组的复发率。结果:治疗后,观察组的有效率为95.74%(45/47),明显高于对照组[82.98%(39/47)](P0.05)。两组治疗前后的血清孕酮、雌二醇、促黄体生成激素以及促卵泡生成激素水平比较差异均无统计学意义(P0.05)。治疗后6个月,观察组的复发率为4.25%(2/47),明显低于对照组[14.89%(7/47)](P0.05);观察组治疗后1年的复发率为8.51%(2/47),明显低于对照组[23.40%(11/47)](P0.05)。结论:雌二醇联合乳酸菌阴道胶囊治疗老年性阴道炎的临床效果明显优于单纯使用乳酸菌阴道胶囊治疗,且不会对机体内的激素水平造成影响,并可有效降低其复发率。     

全子宫切除术对阴道菌群的影响

目的研究全子宫切除术后阴道菌群及pH的变化,寻求适当的治疗措施,以提高术后患者的生活质量。方法分别观察术后未发生阴道炎、发生老年性阴道炎及正常近龄妇女3组共90例,进行菌群分析、pH测定,并使用乳杆菌DM9811代谢物脂肪酸组分对发生老年性阴道炎者进行治疗。结果术后妇女检出各种菌的数量少,乳杆菌的数量更少,阴道内没有占绝对优势的菌种;发生阴道炎组乳杆菌数量下降更明显,葡萄球菌及大肠埃希菌数量相对增多。术后阴道pH在5.9~7.3,发生阴道炎组较未发生阴道炎组高;以乳杆菌DM9811代谢物脂肪酸组分阴道用药治疗老年性阴道炎,治愈率为82.14%。结论全子宫切除术后阴道乳杆菌数量下降,pH升高,易发生老年性阴道炎。治疗以乳杆菌DM9811代谢物脂肪酸组分阴道用药效果佳。     

绝经后IUD取器前超声测定环距的意义

目的探讨绝经后妇女IUD取器前超声测定环距是否与取器难度有关。方法对放置IUD绝经后妇女取器前行超声测定环距,分环距>1.5cm,1.5-1.0cm,≤1.0cm三组,比较手术难度,并对绝经≤12月IUD组与对照组的围绝经期综合症、老年性阴道炎、阴道炎、子宫蒌缩情况进行分析。结果环距≤1cm组手术难度显著增加(P<0.05)。绝经≤12个月IUD组与对照组在围绝经综合症、老年性阴道炎、阴道炎、子宫萎缩发生率方面均无显著差异,(P>0.05)。结论绝经后妇女取器前超声测定环距对估计手术难度有一定意义,尤其当环距≤1cm,手术困难明显增加。绝经≤12月IUD对健康没有直接影响。     

定君生与乙底酚治疗老年性阴道炎200例临床观察

老年性阴道炎是绝经后妇女的常见病,且不断并发泌尿系统感染,严重影响老年妇女的生活质量.诸暨市人民医院自2003年1月以来,采用定君生片加乙底酚治疗老年性阴道炎200例,取得较好效果,现将观察结果报告如下.     

绝经前后细菌性阴道病厌氧菌群及耐药性分析

目的了解绝经前后细菌性阴道病患者标本中优势厌氧菌群,检测厌氧菌分离株对5-硝基咪唑类和林可霉素类抗生素的耐药性。方法采集165例未绝经和125例绝经阴道病患者以及84例未绝经和68例绝经正常妇女的阴道分泌物,测定其pH。采用选择性厌氧培养基分离类杆菌、梭杆菌、乳杆菌、优杆菌、消化链球菌和消化球菌,将分离的厌氧菌株鉴定至种。同时采用二倍平皿稀释法,测定塞克硝唑、替硝唑、甲硝唑、林可霉素和克林霉素对760株厌氧菌的最低抑菌浓度。结果100%细菌性阴道病患者、97.6%未绝经和98.5%绝经正常妇女的阴道分泌物中分离出厌氧菌。阴道炎患者标本中,类杆菌属、普氏菌属和紫质单胞菌属厌氧菌分离率高于相应对照组(P<0.05;P<0.01),其中以多毛类杆菌、腐败类杆菌、脆弱类杆菌、产黑普氏菌、不解糖紫质单胞菌为优势菌群;梭杆菌属、优杆菌属、消化球菌属和消化链球菌属厌氧菌分离率与相应对照组比较差异无显著性(P>0.05);乳杆菌属分离率明显低于相应对照组(P<0.01)。未绝经正常妇女和患者及绝经正常妇女和患者阴道分泌物pH分别为4.5±0.2、5.5±0.8、6.5±0.3和6.5±1.0。塞克硝唑、替硝唑和甲硝唑对355株革兰阴性厌氧菌M IC90值为1~8μg/m l,林可霉素和克林霉素则为4~16μg/m l;塞克硝唑、替硝唑和甲硝唑对405株革兰阳性厌氧菌M IC90值为8~32μg/m l,林可霉素和克林霉素则为4~16μg/m l。     

乳酸菌阴道胶囊联合知柏地黄丸治疗老年性阴道炎的疗效观察

目的观察乳酸菌阴道胶囊联合知柏地黄丸治疗老年性阴道炎的疗效。方法将100例老年性阴道炎患者随机分为西药组50例和联合组50例,西药组给予乳酸菌阴道胶囊治疗,联合组同时给予乳酸菌阴道胶囊联合知柏地黄丸治疗,疗程均为20天。观察比较两组治疗前后的症状评分和阴道清洁度评分,检测治疗前后血清E2和FSH的变化,并比较两组患者的治疗效果。结果联合组的治疗总有效率为96.0%,高于西药组的78.0%,组间差异有统计学意义(P0.05)。两组患者的症状评分、阴道清洁度评分、血清E2和FSH均较治疗前明显改善(P0.05),且联合组的改善幅度明显优于西药组(P0.05)。结论乳酸菌阴道胶囊联合知柏地黄丸治疗老年性阴道炎的疗效优于单纯乳酸菌阴道胶囊,值得临床应用。     

电视宫腔镜配合阴道超声检查诊治80例绝经后子宫出血的效果分析

目的:评价宫腔镜配合阴道超声检查对绝经后妇女异常子宫出血的临床价值.方法:回顾性分析80例绝经后妇女异常子宫出血行宫腔镜配合阴道超声检查及相关病理检查的临床资料.结果:阴道超声检查非正常41例,阳性率为51.25%,官腔镜检查非正常58例,阳性率为72.50%,两者比较具有统计学意义(P＜0.01);病理检查非正常54例,符合率为93.10%.结论:阴道超声检查可作为异常子宫出血的常规无创普查手段,宫腔镜检查可对异常患者进一步检查,两者配合检查可提高诊断准确率.     

Current achievements using ProteinChip Array technology

Because of its inherent flexibility, the ProteinChip Array platform has demonstrated utility into basic research as well as clinical research. In the domain of basic research, it has been used to examine protein modifications, characterize protein-protein interactions and study signal transduction and enzymatic pathways. In clinical research, it has been used to elucidate and identify biomarkers of disease, and as a platform for predictive medicine.     

Evidence‐Based Medicine and Women: Do the Principles and Practice of EBM Further Women's Health?

Clinicians and policy makers the world over are embracing evidence-based medicine (EBM). The promise of EBM is to use summaries of research evidence to determine which healthcare interventions are effective and which are not, so that patients may benefit from effective interventions and be protected from useless or harmful ones. EBM provides an ostensibly rational objective means of deciding whether or not an intervention should be provided on the basis of its effectiveness, in theory leading to fair and effective healthcare for all. In this paper I closely examine these claims from the perspective of healthcare for women, using relevant examples. I argue that the current processes of evidence-based medicine contain a number of biases against women. These biases occur in the production of research that informs evidence-based medicine, in the methods used to analyse and synthesise the evidence, and in the application of EBM through the use of guidelines. Finally, the biomedical model of health that underpins most of the medical research used by EBM ignores the social and political context which contributes so much to the ill-health of women.     

中药复方BBYNG对乳腺癌骨转移小鼠的作用观察

目的透过对中药复方BBYNG与西药双磷酸盐OSTAC的动物实验研究,观察中药治疗骨转移的疗效。方法参照文献建立高发骨转移的小鼠乳腺癌动物模型后,分别对不同组别的荷瘤小鼠灌喂相当于临床病人服用剂量的BBYNG或OSTAC,对比观察荷瘤小鼠的肿瘤生长、活动状态、生存时间、骨转移及骨破坏的程度等。结果BBYNG可减慢荷瘤小鼠的肿瘤生长,但不能显著缩小肿瘤的体积;可减轻肿瘤骨转移引起的活动障碍和骨破坏,延长生存时间。此结果与作者已进行的临床观察结果相似。结论BBYNG有减轻动物模型肿瘤引起的骨转移和骨破坏、延长荷瘤小鼠生存时间的作用;值得推广应用及开展用于预防肿瘤骨转移的探讨,并深化对其作用机理的研究。     

Managing expectational language: translational genetic professionals consider the clinical potential of next-generation sequencing technologies

Clinical genetic professionals are used to being flooded by claims about the seemingly endless potential and promise of next-generation sequencing (NGS) in medicine today. This paper is about managing expectations in translational medicine. From 2009 to 2011, we conducted focus groups with genetic and allied professionals concerned with genomics in the clinic to examine their attitudes and perspectives of genetic and genomic tools in this environment. In this paper, we examine and explore some of their discussions, specifically related to NGS and whole genome sequencing tests and their introduction as normal clinical tools. Informed by sociology of expectations (SE), we discuss expectational language in the arena of translational medicine. Through SE, illuminated are some barriers and strategies used by professionals to manage expectations. Further, our work suggests the importance of SE and more nuanced study to understand the discursive realm of translational genomic medicine.     

Effects of Centella asiatica on ethanol induced gastric mucosal lesions in rats

Centella asiatica is a herbal medicine widely used in China and India for wound healing. The aim of this study was to examine its effects on the prevention of ethanol induced gastric lesions in rats. Gastric transmucosal potential difference (PD) was reduced by the application of 50% ethanol in the gastric ex-vivo chamber model and Centella extract (CE) accelerated its recovery. Oral administration of CE (0.05 g/kg, 0.25 g/kg and 0.50 g/kg) before ethanol administration significantly inhibited gastric lesions formation (58% to 82% reduction) and decreased mucosal myeloperoxidase (MPO) activity in a dose dependent manner. These results suggested that CE prevented ethanol induced gastric mucosal lesions by strengthening the mucosal barrier and reducing the damaging effects of free radicals.     

Muscle tension increases impact force but decreases energy absorption and pain during visco-elastic impacts to human thighs

Despite uncertainty of its exact role, muscle tension has shown an ability to alter human biomechanical response and may have the ability to reduce impact injury severity. The aim of this study was to examine the effects of muscle tension on human impact response in terms of force and energy absorbed and the subjects’ perceptions of pain. Seven male martial artists had a 3.9 kg medicine ball dropped vertically from seven different heights, 1.0–1.6 m in equal increments, onto their right thigh. Subjects were instructed to either relax or tense the quadriceps via knee extension (≥60% MVC) prior to each impact. F-scan pressure insoles sampling at 500 Hz recorded impact force and video was recorded at 1000 Hz to determine energy loss from the medicine ball during impact. Across all impacts force was 11% higher, energy absorption was 15% lower and time to peak force was 11% lower whilst perceived impact intensity was significantly lower when tensed. Whether muscle is tensed or not had a significant and meaningful effect on perceived discomfort. However, it did not relate to impact force between conditions and so tensing may alter localised injury risk during human on human type impacts.     

脑胶质瘤治疗相关时空演化机制及其在精准治疗中的应用

胶质母细胞瘤是成人中最恶性的颅内肿瘤,但其治疗方式在过去数十年未有突破. 随着近年精准医学和下一代测序技术的发展,使研究胶质母细胞瘤背后多维基因组学的复杂机制成为可能. 其中继发胶质母细胞瘤及与其配对的原发肿瘤是十分珍贵的数据,可用以分析低级别胶质瘤在时间和空间轴上的演化以及治疗对肿瘤的影响. 本综述阐述胶质母细胞瘤的复杂性,包括各种驱动突变、空间上的异形性和不同的演化方式;此外,会讨论如何将这些基因学上的发现应用在肿瘤预后的预测以及精准治疗上.     

Fluorescent image cytometry: from qualitative to quantitative measurements

Image analysis is being increasingly used in biology and medicine; however, in order to obtain truly quantitative data and thus avoid errors in interpretation, a certain number of precautions must be taken when the image is digitized, well before any attempt is made to analyse or interpret the data. This is particularly true for image microfluorometry. In this article we will examine an image analysis system for fluorescent images composed of a mercury lamp, a microscope, a high sensitivity video camera and an image analyser and evaluate the principal sources of random and non-random errors, various constraints, and their relative importance. A signal correction protocol is proposed to minimize non-random errors during digitalization. A few examples are given to illustrate its efficiency.     

Validity and reliability of the medicine ball throw for kindergarten children

The purpose of this study was to establish validity and reliability evidence for the medicine ball throw test for kindergarten students, an underrepresented group in the literature. The subjects were 105 students, 5-7 years old, BMI 17.44 +/- 3.17 kg x m(-2), 43% female and 57% male. Intraclass correlation coefficients (ICCs) were used to examine reliability, and Pearson correlation coefficients and a paired t-test were used to examine validity. To accomplish this, the kindergarten students completed the medicine ball throw test on two different days and the modified pull-up test, the "criterion" measure, on another day. For the medicine ball throw, each student sat on the floor before throwing the medicine ball forward like a chest pass three times. The medicine ball throw was highly reliable both within 1 day (ICCs = 0.93 and 0.94 for day 1 and day 2, respectively) and across 2 days (ICC = 0.88), with all reliability estimates over the acceptable level of 0.80. The medicine ball throw scores were positively related with height (r = 0.34) and weight (r = 0.34), and there was a significant difference between the 5-year-old group (mean +/- SD; 111.78 +/- 34.93) and the 6-year-old group (135.60 +/- 39.77), t = -3.23, p = 0.002, which supports correlational and known-difference evidence of validity for the medicine ball throw test. Even though no correlation was found between the medicine ball throw test and the modified pull-up test, r = -0.04, other forms of validity evidence (i.e., known-difference and correlational) were apparent. In conclusion, the medicine ball throw test seems to be a valid and reliable measure of upper-body strength for kindergarten children.     

Anthropology at the heart of medicine

Anthropology and medicine share many concerns, but have had trouble collaborating in the past. The anthropologist has had to plead both with his colleagues and physicians to move beyond a < culturalist > vision that would confine him to the study of traditional or alternative medicines and representations of populations and the sick. The anthropologist's approach perceived as intrusive has also raised fears in the medical world. These reciprocal misunderstandings and stereotypes need to be overcome by an anthropology that studies the practices and knowledge of modern medicine as they are elaborated daily. Anthropology will dialogue with medicine without judging it. In its turn, medicine will open its sites of healing and teaching to the anthropologist. Anthropology at the heart of medicine is organized around the idea that the paths and expectations of health professionals reflect the specicifities of the local system of health. The individual dimensions of practices cannot be divorced from the functioning of structures of health and decision. Finally, like any other kind of anthropology, medical anthropology must scrutinize its own methods and ethics in a critical way.