雷洛昔芬对绝经后女性子宫肌瘤的抗增殖促凋亡效应观察

Objective: To study the cell effects of raloxifene on uterine and leiomyoma tissue in postmenopausal women. Design: Prospective, randomized, double-blind, placebo-controlled study. Setting: Department of Obstetrics and Gynecology, University “ Magna Graecia” of Catanzaro, Italy. Patient(s): Forty postmenopausal women affected by uterine leiomyomas and selected for hysterectomy. Intervention(s): Treatment for three cycles of 28 days with raloxifene at a dose of 180 mg/day orally (raloxifene group) or placebo tablets (3 tablets/day orally)-(placebo group). Main Outcome Measure(s): Uterine and leiomyoma dimensions were measured in each subject at entry and before surgery. On leiomyomas and homologous myometrium the proliferating cell nuclear antigen (PCNA)--positive cells/total cells (PCNA/TC) and the Bcl-2-positive cells/Bax-positive cells (Bcl-2/Bax) ratios (% ), as proliferation and apoptotic indexes, respectively, were measured. Result(s): After treatment, uterine and leiomyoma sizes were significantly changed in comparison with baseline and the placebo group. PCNA/TC and Bcl-2/Bax ratios were significantly higher in leiomyomas than in homologous myometrium. A significant difference was detected in PCNA/TC between the myometrium of the raloxifene and control groups, whereas no difference was observed in the Bcl-2/Bax ratio. A significant difference in PCNA/TC and Bcl-2/Bax ratios was detected in leiomyoma tissue between the raloxifene group and controls. Conclusion(s): In postmenopausal women, raloxifene administration reduces uterine leiomyomas by exerting a cell antiproliferative and proapoptotic action.

布比卡因与肾上腺素在腹腔镜辅助子宫肌瘤切除术中的应用:一项随机安慰剂对照试验

OBJECTIVE: To evaluate the effectiveness of the injection of bupivacaine plu s epinephrine before laparoscopic myomectomy. METHODS: Sixty premenopausal women w ith uterine leiomyomata were enrolled in a randomized controlled design and intr aoperatively treated with injection of bupivacaine plus epinephrine (group A) or saline solution (group B) during laparoscopic myomectomy. Uterine size and volu me, number of leiomyomata, hematological parameters, total operative time, enucl eation time of each myoma, suturing time of the myomectomy, blood loss, degree o f surgical difficulty, and postoperative pain were evaluated. Just before and af ter the injection of vasoconstrictive or saline solution, systolic and diastolic blood pressure and heart rate were recorded in each subject. RESULTS: Blood los s, total operative and enucleation time, and degree of surgical difficulty was s ignificantly (P < .05) lower in group A than in group B. No difference was obser ved between groups in suturing time of the myomectomy. The number of vials of pa in medication used postoperatively was significantly (P < .05) lower in group A than in group B. No differences in systolic and diastolic blood pressure or hear t rate was recorded between the 2 groups. CONCLUSION: The injection of bupivacai ne plus epinephrine during laparoscopic myomectomy is effective in reducing bloo d loss, total operative and enucleation time, degree of surgical difficulty, and postoperative pain.

比较子宫内膜癌早期患者行腹腔镜或开腹手术后生活质量的一项前瞻性随机对照研究:关注生活质量

Objective: This study was undertaken to compare the quality of life (QoL) in women with early stage endometrial cancer treated with 2 different surgical approaches. Study design: Eighty-four women with clinical stage I endometrial cancer were enrolled in a prospective randomized controlled trial design and treated with laparoscopic or laparotomic approach. Another 40 women matched for demographic characteristics were studied as controls. In patients, before and after surgery, and in their matched controls, QoL was evaluated by using the Short-Form Healthy Survey (SF-36) and the climacteric symptoms using the Kupperman Index (KI). Results: After randomi-zation, no difference was detected in data recorded between the groups. At entry, QoL was similar in both treatment groups but significantly (P < .05) worse in comparison with controls. Throughout the study, QoL was significantly (P < .05) higher in laparoscopic group versus laparotomic group. After KI adjustment our data did not change. Conclusion: In early stage endometrial cancer, the laparoscopic approach provides significant benefits compared with laparotomy in terms of QoL.

多囊卵巢综合征患者经腹腔镜卵巢打孔与二甲双胍治疗后其纤溶酶原激活剂抑制物-1与流产的研究

In women with polycystic ovary syndrome, metformin administration, not laparoscopic ovarian drilling, reduces plasminogen activator inhibitor 1 (PAI-1) activity. The lack of a decrease in PAI-1 activity is related to a high risk for miscarriage.