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Objective:To observe the effect of low-dose mifepristone combined with dydrogesterone tablets on uterine volume and dysmenorrhea in patients with adenomyosis.Methods:From January 2019 to January 2020, 82 patients with adenomyosis who were diagnosed and treated in the department of obstetrics and gynecology of the People's Hospital of Changxing County were selected and divided into two groups according to the random number table method, with 41 cases in each group.The observation group was treated with low-dose mifepristone combined with dydrogesterone tablets, and the control group was treated with levonorgestrel intrauterine system.The clinical efficacy of the two groups after treatment was observed, and the uterine volume, dyenorrhea, estradiol(E 2), luteinosin(LH), serum follicle-stimulating hormone(FSH) and carbohydrate antigen 125(CA125) before and after treatment were counted. Results:After treatment, the total effective rate of the observation group was higher than that of the control group(80.49% vs.97.56%, χ 2=6.116, P<0.05). Before treatment, the uterine volume between the two groups had no statistically significant difference ( t=0.165, P>0.05). After treatment, the uterine volume of both two groups was reduced compared with before treatment ( t=17.541, 36.940, all P<0.001). And the uterine volume of the observation group was significantly smaller than that of the control group ( t=-39.506, P<0.001). Before treatment, the degree of dysmenorrhea between the two groups had no statistically significant difference ( t=0.603, P>0.05). After treatment, the degree of dysmenorrhea in both two groups was reduced compared with before treatment ( t=26.100, 46.610, all P<0.001). The score of dysmenorrhea in the observation group was significantly lower than that in the control group( t=20.327, P<0.001). Before treatment, the levels of E 2, LH, FSH and CA125 between the two groups had no statistically significant differences( t=0.124, 0.502, 0.222, 0.084, all P>0.05). After treatment, the levels of E 2, LH, FSH and CA125 in the two groups were improved.And the E 2 and CA125 levels of the observation group were better than those of the control group ( t=-3.392, 6.171, 2.619, 18.728, -9.889, 4.582, 2.572, 23.629, all P<0.05), while the LH and FSH levels of the two groups had no statistically significant differences ( t=6.064, 1.108, 1.166, -7.392, all P>0.05). Conclusion:The treatment of adenomyosis with mifepristone combined with dydrogesterone tablets is effective, it can effectively reduce the uterine volume, reduce dysmenorrhea, improve the sex hormone levels of patients, which is worthy of clinical promotion.
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Objective To establish a HPLC method for simultaneously determining the content of dexamethasone ace-tate ,camphor and phenol in compound cream .Methods The separation was performed on a SHIADZU-GL Inertsil? ODS-3 RP C18 analytical column with the mobile phase consisting of methanol-water (60:40) .The flow rate was 1 .0 ml/min .The detection wave length was 285 nm and the column temperature was 40 ℃ .Results Dexamethasone acetate ,camphor and phe-nol showed good linearity (r> 0 .9995 , n= 7) within the concentration range of 4 .024-40 .24 ,101 .7-2033 and 10 .38-425 .2 μg/ml ,respectively . The average recovery of dexamethasone acetate ,camphor and phenol was 101 .2％ (RSD was 0.56％ ) ,99 .89％ (RSD was 0 .72％ ) ,100 .2％ (RSD was 0 .97％ ) ,respectively .Moreover ,the RSDs were less than 1 .5％ in the repeated tests .Conclusion The method was simple ,quick and accurate .It is suitable for the quality control of dexametha-sone acetate camphor and phenol cream .
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Objective:To investigate the relationship of CYP2C19 gene polymorphisms and clopidogrel resistance in the patients with coronary atherosclerotic heart disease ( CAHD) accepted percutaneous coronary intervention ( PCI) in Chinese Han population from north Sichuan. Methods:The patients with CAHD undergoing PCI were recruited. The fluorescence in situ hybridization ( FISH) technology was used to detect the CYP2C19 gene polymorphisms in all the patients. According to the different genotypes, the patients were divided into different groups. The platelet maximum aggregation rate ( MAP) induced by ADP was detected before and after the administration of clopidogrel. Results:The 110 patients were divided into three groups:52(47. 3%) patients were divided into the fast metabolism group, 42(38. 1%) patients were in the moderate metabolism group and 16(14. 6%) patients were in the slow metab-olism group. Before the administration, there was no significant difference in the basic values of the platelet aggregation rate among the groups with various metabolism type (P=0. 873). In 24 hours after the administration of 300mg clopidogrel, there was notable differ-ence in the platelet aggregation rate (17. 74% ± 5. 87% vs 21. 44% ± 8. 71% vs 27. 05% ± 8. 83%, P=0. 044) and the decrease de-gree (20. 08% ± 5. 94% vs 18. 87% ± 4. 72% vs 11. 54% ± 2. 94%, P=0. 01) among the three groups. The moderate metabolism group and slow metabolism group had higher MAP with lower decrease degree than the fast metabolism group. Totally 21 patients (19. 1%)were with CR, and among them, 2 patients (3. 8%) were in the fast metabolism group,12 patients (28. 6%) in the moder-ate metabolism group and 7 ones (43. 8%) in the slow metabolism group, and the difference of CR distribution among the three groups was significant (P<0. 001). The moderate metabolism group and slow metabolism group were more likely to have clopidogrel resist-ance, especially the slow metabolism group. Conclusion: There is a certain relationship of CYP2C19 gene polymorphisms and clopi-dogrel resistance in the patients with CAHD accepted PCI in Chinese Han population from north Sichuan, and those with slow metabo-lism genotype are more likely to have clopidogrel resistance with reduced efficacy.
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Objective To compare in vitro fertilization and embryo transfer( IVF-ET ) outcome of gonadotropin-releasing hormone( GnRH ) antagonist protocol and GnRH agonist long protocol in patients with polycystic ovary syndrome ( PCOS)and to provide reference for rational selection of ovulation stimulation protocol for PCOS patients. Methods One hundred and four patients with PCOS who underwent IVF-ET were randomly divided into two groups. In the study group,41 patients were subjected to the GnRH antagonist protocol;In the control group,63 patients were subjected to a long protocol of GnRH agonist. Doses and duration of gonadotropin therapy,the thickness of endometrium and the profile of hormone level on the day of HCG administration,the number of retrieved oocytes,the ratio of fertilization,the ratio of cleavage,the ratio of the good quantity embryos,implantation rate of embryo,pregnancy rate,the cycle cancellation rate and the incidence rate of ovarian hyperstimulation syndrome( OHSS)were recorded. Results The IVF-ET outcome of the two groups was similar with respects to the number of oocytes,the ratio of fertilization,the ratio of cleavage,implantation rate of embryo and the pregnancy rate( P﹥0. 05). Significant differences were found(P﹤0. 05)between the two groups regarding to the doses and duration of gonadotropin therapy,the levels of serum E2 and LH on the day of HCG administration,and the cycle cancellation rate. The incidence rate of OHSS was not significantly different ( 2. 44% vs. 12. 70%) between the two groups. Conclusion The duration of gonadotropins administration,the cycle cancellation rate,incidence of OHSS and the financial burdern are reduced in patients treated with GnRH antagonist. The growth of follicle,the ratio of fertilization,the ratio of cleavage,implantation rate of embryo and the pregnancy rate are not different between the two methods. The GnRH antagonist protocol is optimal for patients with PCOS.
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Objective:To investigate the application of drug utilization evaluation( DUE) as a kind of clinical pharmacy work model in the antibacterial drug special rectification. Methods: Following the steps of DUE schedule,retrospective method was conducted to collect the data of the use of vancomycin in one institution and the model of clinical drug use was improved by the evaluation result. Re-sults:The rationality of vancomycin use was improved in the institution. The index of drug use reasons and key disease course indica-tors was improved significantly. The qualification rate of indications and drug indications was increased from 79. 5% to 95. 0%,and the qualification rate of antibacterial drugs classification management was increased from 63. 3% to 92. 7%. The qualification rate of dosing frequency was increased from 72. 5% to 96. 0%. Conclusion:As a program for continual improvement of new clinical pharmacy work mode and medical care quality,the mode plays an important role in the institution and improves the rational use of vancomycin.