Regulation Effect and Clinical Efficacy of Addition and Subtraction Therapy of Jinkui Shenqiwan Combined with Buzhong Yiqitang on Immune Inflammatory Factors of Patients with Postmenopausal Osteoporosis and Deficiency of Spleen and Kidney / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of addition and subtraction therapy of Jinkui Shenqiwan combined with Buzhong Yiqitang to postmenopausal osteoporosis （PMO） with deficiency of spleen and kidney， and to investigate its regulation effect on immune inflammatory factors. Method:One hundred and sixty patients were randomly divided into observation group and control group， with 80 cases in each group. Both groups got comprehensive western medicine treatment measures. Patients in control group additionally got Zhuanggu Zhitong capsule， 4 capsules/time， 3 times/day. Patients in observation group additionally got addition and subtraction therapy of Jinkui Shenqiwan combined with Buzhong Yiqitang， 1 dose/day. The treatment was continued for 24 weeks. Before and after treatment， lumbar L2-4 bone mineral density （BMD） was detected by Dual energy X-ray absorptiometry （DXA） and lumbar BMD was detected by quantitative CT （QCT）. Scores of traditional Chinese medicine（TCM） syndromes and Chinese osteoporosis-targeted quality of life questionnaire （COQOL） were graded. Levels of Estradiol （E₂）， type Ⅰ procollagen amino terminal pro peptide （PINP）， serum osteocalcin （OC）， osteoprotegerin （OPG）， type Ⅰ collagen cross-linked C-terminal peptide （S-CTX）， tartrate resistant acid phosphatase （TRACP） and urinary pyridinoline （PYD） were detected. Levels of CD4⁺ T cells， CD8⁺ T cells， interleukin-17 （IL-17）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， <italic>γ-</italic>interferon（IFN-<italic>γ</italic>） and interleukin-4 （IL-4） were calculated. The proportion of T helper cell （Th）17 and regulatory T cell （Treg） in CD4⁺ T cells was calculated. Besides， the safety was evaluated. Result:Bone density was detected by DXA in observation group， and its T-value and bone density detected by QCT were all higher than those in control group （<italic>P</italic><0.01）. After treatment， scores of TCM syndrome and COQOL were lower than those in control group （<italic>P</italic><0.01）. Levels of PINP， OC， S-CTX， TRACP and PYD/Cr were all lower than those in control group （<italic>P</italic><0.01）. Levels of OPG， CD8⁺ and Treg were higher than those in control group （<italic>P</italic><0.05）， levels of Th17， Th17/Treg， CD4⁺/CD8⁺， IL-17， TNF-<italic>α</italic> and IFN-<italic>γ </italic>were lower （<italic>P</italic><0.01）， and levels of IL-4 and E₂ were higher than those in control group （<italic>P</italic><0.01）. The clinical efficacy in observation group was better than that in control group （<italic>Z</italic>=2.103， <italic>P</italic><0.05）. Conclusion:On the basis of calcium and vitamin D supplementation， Jinkui Shenqiwan combined with Buzhong Yiqitang can improve levels of E₂ and bone density， reduce clinical symptoms， improve quality of life， regulate bone metabolism index and immune inflammation reaction， with better clinical efficacy and safety.

Vaginal anatomical and functional outcomes of 49 patients with Mayer-Rokitansky-Küster-Hauser syndrome undergoing modified laparoscopic sigmoid vaginoplasty / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the anatomy and sexual outcomes of patients with Mayer-Rokitansky-KüsterHauser(MRKH)syndrome undergoing modified laparoscopic sigmoid vaginoplasty.METHODS: From January 2010 to January 2017,49 MRKH syndrome patients underwent the modified laparoscopic sigmoid vaginoplasty in Guangdong Women and Children's Hospital.Analysis of the anatomy and the sexual outcomes of the neovagina was conducted.The sexual functional outcomes were assessed using the Female Sexual Function Index(FSFI)questionnaire.45 cases of similar-aged women with normal sexual life were selected as controls.RESULTS: Modified laparoscopic sigmoid vaginoplasty was successfully performed in all 49 patients.The mean operative time and intraoperative blood loss was(186±53.7)minutes and(63.8±10.6)mL respectively.The mean length and width of the neovagina at the 6-month followup examination was(12.9±1.56)cm and(3.32±0.33)cm respectively.FSFI score between the MRKH group and the control group:Desire[(4.40±0.59)vs.(4.04±0.71),P0.05],Lubrication[(4.90 ± 0.58)vs.(4.67 ± 0.79),P>0.05],Orgasm[(4.29 ± 0.70)vs.(4.20 ± 0.79),P>0.05],Satisfaction[(4.51 ± 0.82)vs.(4.45 ± 0.91),P>0.05],Comfort[(4.71 ± 0.81)vs.(4.78 ± 0.72),P>0.05],Total score[(27.08 ± 2.83)vs.(26.53 ± 2.98),P>0.05].CONCLUSION: Modified laparoscopic sigmoid vaginoplasty is an effective and safe technique for MRKH syndrome patients,which provides a nearly normal sexual function for patients with MRKH syndrome.

The study of adrenomedulin in breast cancer / 肿瘤研究与临床

Adrenomedulin is an angiogenesis peptide that was found recently.It plays a critical role as an autocrine/paracrine tumor cell survival factor.Recently,adrenomedulin has been proved that it is overex- pressed in tumor,such as breast cancer.It may have a significant role in tumor progression and differentiation by stimulating mitogenic activities,inhibiting immune response,inhibiting apoptosis and enhancing angiogen- esis.We may realize targeted therapy tumor by intervening adrenomedulin,its receptor,and the signal con- duction pathway.