Analysis of the effect and safety of levonorgestrel-releasing intrauterine system on patients with breast cancer who take tamoxifen / 中国基层医药

Objective:To analyze the effect and safety of levonorgestrel-releasing intrauterine system(LNG-IUS) for the premenopausal patients with breast cancer who took tamoxifen as adjuvant therapy.Methods:From June 2014 to June 2016, 84 patients with breast cancer who met the inclusion criteria in the First People′s Hospital of Xiaoshan District were randomly divided into two groups according to the digital table.The treatment group (39 cases) underwent LNG-IUS insertion, while the control group (45 cases) received no LNG-IUS insertion.The general condition of patients before the use of tamoxifen and LNG-IUS was evaluated.Transvaginal ultrasound was used to measure the thickness of endometrium, hysteroscope was used for pathological examination of endometrium and the measurement of ER/PR expression, and blood lipid level was also detected.All above was done before the treatment of tamoxifen and LNG-IUS, 1 year after treatment and 2 years after treatment.Results:Before the therapy, there were no statistically significant differences between the two groups in general condition and uterine cavity condition(all P>0.05). After 1 year, the incidences of endometrial polyp, endometrial hyperplasia/secretion, benign lesion and endometrial atrophy in the treatment group were 2.6%, 5.1%, 15.4%, 76.9%, respectively, which in the control group were 6.7%, 20.0%, 17.8%, 55.6%, respectively.the differences between the two groups were statistically significant(χ 2=4.06, 4.22, all P<0.05). After 2 years, the incidences of endometrial polyp, endometrial hyperplasia/secretion, benign lesion and endometrial atrophy in the treatment group were 0.0%, 2.6%, 84.6%, respectively, which in the control group were 11.1%, 15.6%, 60.0%, respectively, the differences between the two groups were statistically significant(χ 2=4.608, 4.092, 6.203, all P<0.05). Conclusion:LNG-IUS can prevent the benign endometrial lesions of breast cancer patients caused by tamoxifen therapy after surgery, and can decrease the incidence of endometrial polyp and endometrial hyperplasia/secretion, while increase the incidence of endometrial atrophy, without increasing the recurrence risk of breast cancer.

Exploration on the system construction of hospital scientific research project management based on risk prevention and control / 中华医学科研管理杂志

Objective:In a relatively "loose" macro policy environment, formulate highly operational implementation management methods for scientific research at institutional level to optimize the research management services, improve risk prevention and control, and at the same time play a role of "relaxing" scientific researchers.Methods:Combining with practical management issues, this article takes Southwest Hospital affiliated to The Third Medical University as an example, focuses on the existing problems and risk points in the institutionalization of scientific research management in hospitals. Discussions are carried out, including establishment and improvement of labor charge management, scientific research financial assistant system through labor dispatching service, catalogued reagents and consumable procurement mode, and out-put and in-put of warehouse management. In addition, specific solutions pertinent to the potential problems arising in institutionalization are proposed, especially in the ambiguity zone of higher-level policies.Results:Based on the analysis of problems existed in the practice, we puts forward some concrete solutions, and suggests " institutionalization" should replace the " inertia" management to make sure compliance. Improve labor management practices, more refined payment range on the basis of relevant national policies, specifically issuing qualifications of different categories of staff and set according to the local yearbooks a more appropriate standard for payment; explore research finance assistant institutional foundation dispatch mode, in order to make up the shortcomings of financial assistants include low salaries and the short employment periods. Establish a cataloged reagent and consumables procurement management mode and storage system. It is recommended to use information management measures to achieve visual management of procurement and use of various links.Conclusions:The institutional reform and innovation can stimulate the vitality of scientific research and improve academic integrity.

Therapeutic Effect and Mechanism of Hydrotalcite on Experimental Gastric Ulcer / 胃肠病学

Background:Hydrotalcite has been used in the treatment of gastric ulcer,but its mechanism is not clear. Aims:To investigate the efficacy and mechanism of hydrotalcite on experimental gastric ulcer in rats. Methods:Experimental acetic acid-induced gastric ulcer model was established in rats. Model rats were randomly assigned into control group,low and high dose hydrotalcite groups,and 0. 9% NaCl solution,880 mg·kg - 1 ·d - 1 ,1 230 mg·kg - 1 ·d - 1 hydrotalcite were intragastrically administrated,respectively. After 14 days,macroscopic examination was performed;and HE staining, CD31 staining and VG staining were used to evaluate the histological maturity,AB-PAS staining,level of hexosamine, immunohistochemical staining,serum levels of epidermal growth factor( EGF),prostaglandin E2( PGE2 )were used to evaluate the functional maturity. Results:Compared with control group,ulcer index(UI)was significantly decreased in high dose hydrotalcite group(P < 0. 05). Thickness of restored mucosa was significantly increased(P < 0. 05),number of cystically dilated gland was significantly decreased(P < 0. 01),microvessel density(MVD),collagen fiber,secretion of mucus,level of hexosamine,expressions of EGF,EGR receptor(EGFR)and PGE2 ,serum levels of EGF and PGE2 were significantly increased in low and high hydrotalcite groups( P < 0. 05,P < 0. 01). Conclusions:Hydrotalcite could obviously improve the histological and functional maturity of regenerative mucosa,as well as the quality of ulcer healing. The mechanism might be related to the neutralization of gastric acid,enhancement of mucus-HCO3 - barrier and up-regulation of expressions of EGF and PGE2 .

Efficacy of tepronone and folic acid in the treatment of chronic atrophic gastritis evaluated by the marking targeting biopsy / 中华消化杂志

Objective To explore the efficacy of tepronone and folic acid in the treatment of chronic atrophic gastritis (CAG) evaluated by the marking targeting biopsy (MTB).Methods A total of 224 H.pylori negative CAG patients were selected and divided into group A (n 96,tepronone 50 mg/time,folic acid 10 mg/time,three times/day),group B (n=23,tepronone 50 mg/time,three times/day),group C (n=74,unspecific treatment) and group D (n=31,no treatment).The treatment course lasted for one year.The clinical symptoms improvement of each group was observed before and after treatment.The pathological improvement of gastric mucosa by MTB was inspected before and after treatment.The chi square test was performed for the comparison between groups.Results The total efficacy rates of group A,B,C and D were 43.8％ (42/96),39.1％ (9/23),33.8％(25/74) and 32.3％ (10/31) respectively,there was no significant difference between groups (x2 =2.328,P =0.507).For the significant efficacy rate of gastric mucosa pathological improvement,group A was compared with group D,group A was compared with group C and group B was comparedwith group D,the differences were significant (x2 =14.520,14.628 and 8.995,all P＜0.01).In the total efficacy rate of gastric mucosa pathological improvement,group A (49.8％,131/263) was compared with group D (24.2％,16/66),group A was compared with group C (35.9％,66/184)and group B (44.7％,21/47) was compared with group D,the differences were significant (x2 =13.953,8.535 and 5.207,all P＜0.05).Conclusion Teprenone alone or teprenone and folic acid combination can obviously improve pathological changes of CAG patients.

Clinical Studies on Effect of Allergic Rhinitis Oral Liquid on Perennial Allergic Rhinitis / 广州中医药大学学报

[Objective] To observe the effect of Allergic Rhinitis Oral Liquid (AROL) on perennial allergic rhinitis (PAR) and to explore its therapeutic mechanism. AROL, composed of modified Guizhi Tang and Yupingfeng San, has the actions of strengthening spleen and lung, replenishing Qi and consolidating superficies and dispelling pathogens and dredging orifices. [Methods] One hundred and twenty-nine cases of confirmed PAR were randomized into Group A (n=43), Group B (n=43) and Group C (n=43). Group A was treated with AROL, Group B with Biyankang Tablets and Group C with normal saline. Three groups were treated for 4 weeks as one treatment course, and another treatment course was carried out one week after interval. Therapeutic effect were observed after treatment and serum levels of interleukin-4 (IL-4) and specific IgE antibody were detected. [Results] The total effective rate was 93.02% in Group A (P