HeartCode BLS混合式教学模式在心肺复苏实训课程中的应用研究

目的 探究AHA HeartCode BLS混合式教学模式在心肺复苏实训课程中的应用与影响。方法 研究对象为广西中医药大学医学生,随机分为对照组和观察组,观察组给予AHA HeartCode BLS混合式教学模式,对照组给予常规带教方式,观察两组教学后的心肺复苏技能和理论评分,最后采用在线问卷调查进行满意度评分并进行对比。结果 观察组的理论评分、技能评分、满意度评分高于对照组(P<0.05)。结论 AHA HeartCode BLS混合式教学模式有助于提高医学生的心肺复苏能力,适合在教学中开展应用。

Bowel endometriosis:Recent insights and unsolved problems

Bowel endometriosis affects between 3.8% and 37% of women with endometriosis.The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis.Transvaginal ultrasonography is the first line investigation in patients with suspected bowel endometriosis and allows accurate determination of the presence of the disease.Radiological techniques (such as magnetic resonance imaging and multidetector computerized tomography enteroclysis) are useful for estimating the extent of bowel endometriosis.Hormonal therapies (progestins,gonadotropin releasing hormone analogues and aromatase inhibitors) significantly improve pain and intestinal symptoms in patients with bowel stenosis less than 60% and who do not wish to conceive.However,hormonal therapies may not prevent the progression of bowel endometriosis and,therefore,patients receiving long-term treatment should be periodically monitored.Surgical excision of bowel endometriosis should be offered to symptomatic patients with bowel stenosis greater than 60%.Intestinal endometriotic nodules may be excised by nodulectomy or segmental resection.Both surgical procedures improve pain,intestinal symptoms and fertility.Nodulectomy may be associated with a lower rate of complications.

Acute abdominal pain from ovarian endometriosis

Endometriosis is a common,estrogen-dependent,inflammatory,gynecologic disease process in which normal endometrial tissue is abnormally present outside the uterine cavity.[1]Endometriosis is a common cause of chronic pain,dyspareunia,dysmenorrhea,and infertility.Most commonly,endometriosis is found within the pelvis,specifically on the ovaries.Because of rupture,bleeding,infection,or torsion,ovarian endometriosis(OMA)may cause acute abdominal pain,which is similar to acute abdominal pain caused by other reasons and is not easy to diagnose.[2,3]Determining the clinical and pathological features of OMA is crucial for accurate assessment,diagnosis,and treatment.

SERUM SOLUBLE E—CADHERIN LEVEL IN PATIENTS WITH ENDOMETRIOSIS

Objective.To investigate the serum sE cadherin level in patients with endometriosis and the alterations of that level in healthy control during the menstrual cycle.Methods.Thirty two patients with endometriosis and 30 healthy women were tested for serum sE cadherin levels by enzyme linked immunosorbent assay.Results.The serum sE cadherin levels in healthy control did not vary throughout the menstrual cycle,which were lower than those in patients with endometriosis.Conclusions.E cadherin might be involved in endometrial shedding during menstruation in endometriosis patients.The serum sE cadherin assay might be helpful as a serum marker for the diagnosis and management of endometriosis.

Distinct molecular targets of ProEGCG from EGCG and superior inhibition of angiogenesis signaling pathways for treatment of endometriosis

Endometriosis is a common chronic gynecological disease with endometrial cell implantation outside the uterus.Angiogenesis is a major pathophysiology in endometriosis.Our previous studies have demonstrated that the prodrug of epigallocatechin gallate(ProEGCG)exhibits superior anti-endometriotic and anti-angiogenic effects compared to epigallocatechin gallate(EGCG).However,their direct binding targets and underlying mechanisms for the differential effects remain unknown.In this study,we demonstrated that oral ProEGCG can be effective in preventing and treating endometriosis.Additionally,1D and 2D Proteome Integral Solubility Alteration assay-based chemical proteomics identified metadherin(MTDH)and PX domain containing serine/threonine kinase-like(PXK)as novel binding targets of EGCG and ProEGCG,respectively.Computational simulation and BioLayer interferometry were used to confirm their binding affinity.Our results showed that MTDH-EGCG inhibited protein kinase B(Akt)-mediated angiogenesis,while PXK-ProEGCG inhibited epidermal growth factor(EGF)-mediated angiogenesis via the EGF/hypoxia-inducible factor(HIF-1a)/vascular endothelial growth factor(VEGF)pathway.In vitro and in vivo knockdown assays and microvascular network imaging further confirmed the involvement of these signaling pathways.Moreover,our study demonstrated that ProEGCG has superior therapeutic effects than EGCG by targeting distinct signal transduction pathways and may act as a novel antiangiogenic therapy for endometriosis.

Endometriosis beyond the Pelvis: A Case Series of Cutaneous Endometriosis and Literature Review

Introduction: Cutaneous endometriosis is an uncommon but well-known skin disorder that represents about 0.5% to 1% of all endometriosis. The objective of this case series is to report clinical presentation, diagnosis, and management of various forms of cutaneous endometriosis. Material and Methods: It was an observational, retrospective and descriptive review of cases presenting with cutaneous endometriosis among Cameroonian women managed at the gynaecological outpatient department of Yaounde Gynaeco-Obstetric and Pediatric Hospital. All the following parameters were analysed: age, parity, previous pelvic surgery, presenting symptoms and duration, associated symptoms, localizations, imaging, size of the lesion, other localization of endometriosis, management and histopathological results. Results: we reported 4 cases of cutaneous endometriosis, with 3 umbilical endometriosis and 1 abdominal scar endometriosis. Patient age ranged from 28 to 39 years with an average of 33 years. All patients described infertility (two primary and two secondary) and two had a history of abdominal surgery. All patients presented local cyclical signs such as pain, swelling, color change and bleeding. The duration of symptoms varied from 2 to 3 years and the size of lesions ranged from 2 to 3.5 cm for umbilical lesions and was 9 cm for abdominal scar endometriosis. In all cases, no imaging was required for the diagnosis, which was suspected on the basis of patient’s history and the cyclical nature of local signs, followed by wide surgical excision and confirmation on histopathology. Conclusion: Cutaneaous endometriosis is a rare benign condition. Umbilical endometriosis seems to be the main cutaneous localization and can be described as primary or secondary. Even if its diagnosis must be confirmed by histopathology, it should be considered in patient with cutaneous cyclic signs such as pain, swelling or bleeding with or without history of abdominal surgery.

CHANGES OF SOLUBLE FAS AND SOLUBLE FAS LIGANDIN SERUM AND PERITONEAL FLUID OF INFERTILEPATIENTS WITH ENDOMETRIOSIS

Objective To evaluate the relationship between levels of soluble Fas(sFas)and soluble Fas ligand(sFasL)in serum and peritoneal fluid of endometriosis-associated infertility. Methods The soluble Fas ligand and soluble Fas levels in serum and peritoneal fluid of 20 infertile patients with endometriosis were assessed with enzyme-linked immunosorbent assay, and were compared with 14 infertile patients due to chronic pelvic infectious disease and 16 fertile controls. Results The sFasL levels were significantly higher in infertile patients with endometriosis(175.09 ± 80.55 pg/mL in serum and 284.50 ± 152.38 pg/mL in peritoneal fluid)than those of infertile controls (88.47 ± 43.55 pg/mL in serum and 17.30 ± 9.62 pg/mL in peritoneal fluid)and fertile controls(16.13 ± 11.75 pg/mL in serum and 8.84 ± 2.31 pg/mL in peritoneal fluid). In contrast, as for the sFas levels, infertile patients with endometriosis(828.60 ± 429.65 pg/mL in serum and 349.61 ± 288.89 pg/mL in peritoneal fluid)did not show any significant difference compared with those in infertile patients resulting from pelvic infectious disease(868.75 ± 570.48 pg/mL in serum and 181.76 ± 157.78 pg/mL in peritoneal fluid)and fertile control(822.26 ± 129.12 pg/mL in serum and 318.42 ± 145.16 pg/mL in peritoneal fluid). Conclusions Based upon these results, high level of sFasL in serum and peritoneal fluid and thus apoptosis mediated by it may be implicated in the mechanism involved in endometriosis-related infertility.

The remedial effect of soluble interleukin-1 receptor type Ⅱ on endometriosis in the nude mouse model

Objective： Recent studies have shown that the local expression of soluble interleukin （IL） -1 receptor type Ⅱ （slL-1 R Ⅱ ） in endometrial tissue of women with endometriosis is decreased, and the depression of IL-1 R Ⅱ was more significant in infertile women than that in fertile women with endometriosis. In this research, we investigated the remedial effect of slL-1-R Ⅱ administration on endometriosis in the nude mouse model. Methods： Nineteen nude model mice with endometriosis were randomly divided into three groups： group A was treated by intraperitoneal administration with only slL-1 R Ⅱ for two weeks, group B was similarly treated with only IL- 1, and group C （control） was administered saline. After 2 weeks, the size of the ectopic endometrial lesions was calculated, and the expression of vascular endothelial growth factor （VEGF） and B-cell lymphoma leukemia-2 （Bcl- 2） were detected by immunohistochemistry. The IL-8 and VEGF levels in the peritoneal fluid （PF） and serum were also measured by enzyme-linked immunosorbent assay （ELISA）. Results： The mean size of ectopic endometrial lesion did not differ between the three groups （P 〉 0.05）. Compared with the control, the expression of VEGF and Bcl-2 was significantly lower in group A, and higher in group B. In the three groups, the levels of IL-8 in the PF and serum were highest in group A, and lowest in group B. Conclusion： slL-1 R Ⅱ may suppresse hyperplasia of ectopic endometriosis, perhaps by reducing the expression of certain cytokines, such as VEGF, IL-8, and Bcl-2, which could provide a new clinical strategy for the treatment of endometriosis.

Comparison of ovarian preservation versus oophorectomy on fertility outcomes in patients with endometriosis post-laparoscopic surgery:A prospective study

BACKGROUND Endometriosis is a chronic inflammatory condition affecting a significant proportion of women of reproductive age.Although laparoscopic surgery is commonly the preferred treatment,the decision to preserve or remove the ovaries remains controversial.Previous studies have yielded inconsistent results regarding the impact of ovarian preservation vs oophorectomy on fertility outcomes and disease recurrence.This prospective study aimed to address this knowledge gap by comparing the effects of these surgical approaches on spontaneous pregnancy rates,time to pregnancy,recurrence rates,and postoperative pain in patients with endometriosis.AIM To compare the reproductive outcomes and recurrence rates between ovarian preservation and oophorectomy in women undergoing laparoscopic surgery for endometriosis.METHODS This study was conducted at a tertiary care hospital between January 2019 and December 2023.A total of 312 women aged 18 to 40 years,diagnosed with endometriosis and undergoing laparoscopic surgery,were included.The patients were categorized into the ovarian preservation group(n=204)and the oophorectomy group(n=108).The primary outcome measure was the achievement of spontaneous pregnancy within 24 months post-surgery.Secondary outcomes included time to spontaneous pregnancy,recurrence rates,and postoperative pain scores.RESULTS The ovarian preservation group exhibited a significantly higher spontaneous pregnancy rate than that in the oophorectomy group(43.6%vs 28.7%,P=0.006).Moreover,the median time to spontaneous pregnancy was shorter in the ovarian preservation group(8.2 months vs 11.4 months,P=0.018).Nonetheless,endometriosis recurrence was more prevalent in the ovarian preservation group(22.1%vs 11.1%,P=0.014).The postoperative pain scores demonstrated similar improvements in both groups,with no significant differences observed.Subgroup analyses indicated that the benefit of ovarian preservation on spontaneous pregnancy rates was more evident among younger women(≤35 years)and those with advanced-stage endometriosis.CONCLUSION Ovarian preservation is associated with a high spontaneous pregnancy rate and a short time to pregnancy.However,because of the increased risk of recurrence,the decision should be based on age,fertility aspirations,and disease severity.

Analysis of risk factors for postoperative anxiety and depression in endometriosis patients with reproductive intention

BACKGROUND The occurrence of postoperative depression and anxiety in patients with endomet-riosis(EMS)not only causes psychological distress,but may also harm their physical health.AIM To explore the postoperative depression status,and its influencing factors,of EMS patients with reproductive intention.METHODS A total of 321 EMS patients with reproductive intent were included.Using the self-rating anxiety scale and self-rating depression scale,EMS patients with anxiety or depression were distinguished.A clinical model for predicting anxiety or depression in EMS patients was constructed and evaluated using a nomogram,receiver operating characteristic curve,and calibration curve.RESULTS The results of the single factor analysis showed that smoking,coffee,EMS stage,chronic pelvic pain,and sexual discomfort may be related to anxiety.Further,smoking,drinking,spouse,annual household income and EMS stage may be related to depression in EMS patients.Multivariate logistic regression illustrated that smoking,coffee,chronic pelvic pain and sexual discomfort may be inde-pendent risk factors for anxiety in EMS patients,while smoking,EMS stage(Phase III and Phase IV),spouse and high annual household income may be independent risk factors for depression in EMS patients.Additionally,the models used to predict the risk of anxiety or depression in EMS patients have good predictive value.CONCLUSION The anxiety and depression of EMS patients may be related to many factors.In clinical treatment,additional attention should be paid to the psychological status of EMS patients.

Effect of dienogest treatment on uterine fibroid volume in patients with endometriosis or adenomyosis complicated by uterine fibroids

BACKGROUND Currently,the use of dienogest in clinical practice has increased significantly,and many studies have focused on its effectiveness and safety in the treatment of endometriosis and adenomyosis;however,the effects of treatment with dienogest on uterine fibroid size in patients with endometriosis or adenomyosis have not been investigated.AIM To explore changes in fibroid size in patients with concomitant uterine fibroids undergoing dienogest treatment for endometriosis or adenomyosis and to evaluate the effectiveness and safety of the drug.METHODS The clinical data of patients with uterine fibroids treated with dienogest for endometriosis or adenomyosis at Peking University First Hospital from January 2021 to January 2023 were retrospectively analyzed.RESULTS The maximum uterine fibroid diameter and volume increased after 3 months,6 months and 1 year of dienogest treatment compared with those before treatment(P<0.01).The maximum diameter and volume of the uterine adenomyoma increased after 3 months of dienogest treatment but decreased after 6 months and 1 year of treatment compared with those before treatment,but the difference was not significant(P>0.05).Endometrial thickness and antigen 125 levels were significantly thinner and decreased,respectively,after dienogest treatment(P<0.01).Pearson's correlation analysis revealed that the increase in uterine fibroid volume after 3 months of dienogest treatment was positively correlated with the basic uterine fibroid volume(r=0.792,P<0.01).Among 64 patients with dysmenorrhea,63 experienced significant relief of dysmenorrhea after 6 months of treatment with dienogest,and all patients experienced significant relief of dysmenorrhea after 12 months.Patients were able to tolerate the drugs,with an average drug tolerance score of 8.73.CONCLUSION The use of dienogest in patients with endometriosis or adenomyosis combined with uterine fibroids can effectively relieve the patient's pain symptoms and significantly reduce the sizes of ovarian endometriotic cysts,but it cannot inhibit uterine fibroid growth.

Can Tibetan medicine Honghua Ruyi pills relieve endometriosisassociated dysmenorrhea?Protocol for a randomized placebocontrolled trial

Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

Gallbladder endometriosis as a cause of occult bleeding

A 17-year-old girl with colicky abdominal pain andchronic anemia presented to the gastrointestinal serviceof the University Hospital of Essen. In the routineworkup, there were no pathological findings despitethe anemia. Because of the fluctuation of symptomswith a climax at the time of menstruation, consecutiveultrasound studies were performed revealing a visiblemass inside the gallbladder. This finding was confirmedby a magnetic resonance imaging (MRI) study performedat the same time. Because of the severe anemia by thattime, a cholecystectomy was performed, and histologyreconfirmed the diagnosis of isolated gallbladderendometriosis. The patient recovered well and has hadno recurrence of the disease to date.

Blood tests for prediction of deep endometriosis:A case-control study

BACKGROUND Deep endometriosis(DE)is the most aggressive subtype of endometriosis.The diagnosis may be challenging,and no biomarkers that can discriminate women with DE from those without DE have been developed.AIM To evaluate the role of blood hemostatic parameters and inflammatory indices in the prediction of DE.METHODS This case-control study was performed at the Women’s Hospital,Zhejiang University School of Medicine between January 2015 and December 2016.Women with DE and women with benign gynecologic disease(control group)eligible for gynecological surgery were enrolled.Routine plasma hemostatic parameters and inflammatory indices were obtained before surgery.Univariate and multivariate analysis were performed.Receiver operating characteristic(ROC)curves were generated,and areas under the curve(AUC)were calculated to assess the predictive values of the selected parameters.RESULTS A total of 126 women were enrolled,including 31 with DE and 95 controls.Plasma fibrinogen(Fg,P<0.01),international normalized ratio(P<0.05),and Creactive protein levels(P<0.01)were significantly higher in women with DE compared with controls.Plasma hemoglobin(HB)levels(P<0.05)and shortened thrombin time(P<0.05)were significantly lower in women with DE than in controls.Plasma Fg levels[adjusted OR(aOR)2.12,95%confidence interval(CI):1.31-3.75]and plasma HB levels(aOR 0.48,95%CI:0.29-0.78)were significantly associated with DE(both P<0.05).ROC analysis showed that the diagnostic value of Fg or HB alone for DE was limited.The AUC of the combination of both markers as a dual marker index was 0.773 with improved sensitivity(67.7%)and specificity(78.9%)at cutoffs of 3.09 g/L and 126 g/L,respectively.CONCLUSION The combination of Fg and HB was a reliable predictor of DE.A larger study is needed to confirm the findings.

The Role of Ankaferd Blood Stopper and Oxytocin as Potential Therapeutic Agents in Endometriosis:A Rat Model

To evaluate the potential effect of Ankaferd Blood Stopper(ABS)and oxytocin(OT)in an experimental endometriosis model,18 female Sprague Dawley rats were used in this study.The animals were divided randomly into three groups after surgical induction of endometriosis:group 1:control group(isotonic NaCl,1 mL/kg/day,intramuscular,n=6);group 2:OT group(OT,80 U/kg/day,intramuscular,n=6);group 3:ABS group(ABS,1.5 mL/kg/day,intraperitoneal,n=6).Each group was treated for four weeks(two times per week).Volumes of endometriotic explants were measured in biopsy samples for histopathological analysis.Vascular endothelial growth factor(VEGF),monocyte chemotactic protein-1(MCP-1),and tumour necrosis factor(TNF-α)levels were measured in plasma and peritoneal fluid.Endometriotic explant volumes were significantly decreased after OT administration(P<0.0001).The epithelial score was significantly decreased in both treatment groups compared to the control group(P<0.05).TUNEL immunohistochemistry showed more apoptotic changes in the endometriosis foci(gland epithelium and surrounding tissue)in the OT group than in the control group(P<0.05).The levels of VEGF,MCP-1,and TNF-αwere significantly reduced in the OT group(P<0.05),whereas no significant changes in protein levels were found in the ABS-applied group.The results indicate that OT has greater potential as a therapeutic agent in experimentally induced peritoneal endometriosis,where ABS,which is a VEGF modulator,appears to act through different mechanisms to show its palliative effects on a rat model of peritoneal endometriosis.

Hupo powder promotes autophagy of menstrual blood-derived stem cells from patients with endometriosis

Objective:To explore the effect of Hupo powder(HP)on autophagy in menstrual blood-derived stem cells(MenSCs)with endometriosis(EMT).Methods:EMT MenSCs(E-MenSCs)and healthy MenSCs(H-MenSCs)were isolated from the menstrual blood of patients with EMT and healthy female participants,respectively.We identified their stem cells’characteristics via adipogenic and osteogenic differentiation.Twelve male SpragueeDawley rats received 0.9% NaCl and HP-dispensing granules by gastric irrigation to prepare blank serum and medicated serum,respectively.We used serum concentrations of 5%,10%,and 20%,each at administered times of 12,24,and 48 h to select the best condition.These cells were divided into three groups:blank serum of the control group,blank serum of the model group,and medicated serum of the HP group.H-MenSCs were used in the control group,while E-MenSCs were used in the model and HP groups.We analyzed cell viability using a cell counting kit-8 assay,observed cell morphology,evaluated the amounts of auto-phagosomes and autolysosomes by transmission electron microscopy,and detected the protein expression of autophagy markers(LC3-II and Beclin1)by Western blot.Results:E-MenSCs and H-MenSCs became long fusiform with a diffuse radial pattern,forming lipid droplets and calcium nodules after adipogenic and osteogenic differentiation.We then used the best conditiond 20% serum and 48 hdfor the subsequent experiments.In contrast to the model group,the HP group exhibited lower cell viability(=0.007),larger amounts of autophagosomes and autolysosomes(P<0.001 and P=0.001,respectively),and higher expression of LC3-II and Beclin1(P=0.021 and P=0.019,respectively).Conclusion:Hupo powder can promote autophagy in E-MenSCs,which might be one of the mechanisms underlying its therapeutic effects.

Immune pathway through endometriosis to ovarian cancer

Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.

Vaginal endoscopy combined with gonadotropin-releasing hormone agonist successfully treated a patient with cervical endometriosis:a case report

A 36-year-old unmarried woman with no sexual history presented with 12 days of uncontrollable yellowish vaginal discharge,bloating,lower back pain,frequent urination,and urgency.Her menstrual cycles were regular with moderate flow and worsening dysmenorrhea.Ultrasound and magnetic resonance imaging identified uterine and cervical masses.Laparoscopic surgery and postoperative gonadotropin-releasing hormone agonist injections led to significant lesion reduction.The patient is currently on oral dienogest acetate with ongoing follow-up.

免疫抑制继发艰难梭菌相关性腹泻C57BL/6小鼠模型的建立方法研究

目的:建立免疫抑制继发艰难梭菌相关性腹泻(CDAD)C57BL/6小鼠模型,为今后新药研究提供更有针对性的动物模型选择。方法:采用C57BL/6小鼠,分为空白组、免疫抑制CDAD模型组(DXMS+MOD组)、免疫正常CDAD模型组(MOD组)、地塞米松组和混合抗菌药物组。在造模后第1、8日2个时间点取材,通过脾脏和胸腺指数、血常规检测、免疫细胞占比、细胞因子分泌水平以及分泌型免疫球蛋白A(sIgA)含量分析各组小鼠免疫状态情况;通过体重变化率、死亡率、临床评分、粪便黏稠度评分、毒素水平检测和结肠病理变化评价模型组小鼠的CDAD病情。结果:与MOD组比较,DXMS+MOD组小鼠造模后第1、8日的脾脏指数(P<0.001,P<0.05)、胸腺指数(P<0.001)显著降低;白细胞计数(P<0.01)、淋巴细胞百分比(P<0.001)显著降低,中性粒细胞百分比(P<0.001)显著升高;B细胞(P<0.001)、CD4^(+)T细胞(P<0.001,P<0.01)比例和CD4^(+)/CD8^(+)(P<0.001)显著降低,CD8^(+)T细胞比例(P<0.001)显著升高,上述差异均有统计学意义。与MOD组比较,DXMS+MOD组小鼠造模后白细胞介素6(第1日:P<0.001;第8日:P<0.01)、单核细胞趋化蛋白1(第1日:P<0.001)、肿瘤坏死因子α(第8日:P<0.01)和γ干扰素(第8日:P<0.01)水平显著降低,差异均有统计学意义。造模后第1、8日,DXMS+MOD组小鼠sIgA含量较MOD组呈现降低趋势,但差异无统计学意义(P>0.05)。相比于MOD组,DXMS+MOD组小鼠体重降低更明显,且两组在造模后第2日(P<0.01)、第3日(P<0.05)和第4日(P<0.05)的差异有统计学意义。造模后,DXMS+MOD组小鼠的粪便黏稠度评分(第5日:P<0.05)、临床症状评分(第1日:P<0.05;第3、5和7日:P<0.001)始终高于MOD组,差异均有统计学意义。造模后第1、8日,DXMS+MOD组的艰难梭菌负载量较MOD组显著升高,差异有统计学意义(P<0.01)。结肠病理结果显示,DXMS+MOD组肠道屏障破坏更严重且出现死亡情况。结论:DXMS+MOD组小鼠可在整个造模过程以及造模完成后7 d内保持免疫低下状态,其CDAD症状相比MOD组更加严重,毒素水平更高,肠道屏障破坏更严重。本研究建立了符合临床特点的免疫抑制继发CDAD动物模型,为今后的相关科学研究提供了更有针对性的动物模型选择。

Clinical Effectiveness of Dienogest in the Treatment of Endometriosis

Objective:This paper aims to investigate the efficacy of desogestrel in the treatment of endometriosis.Methods:In this study,61 patients with endometriosis in our hospital from January 2023 to December 2023 were selected and divided using the random sampling method.All the patients were treated with desogestrel and the pain symptom scores and HDL-C(high-density lipoprotein cholesterol)levels of the patients were compared before and after the treatment.The treatment effects and adverse effects during the administration of the drug were closely observed.Results:After the patients were treated with desogestrel,the effective rate of treatment was as high as 98.36%,and the incidence of adverse reactions during treatment was 6.55%.Compared with the pre-treatment period,the scores of various pain symptoms were significantly reduced and the HDL-C level was improved after treatment,with P<0.05.Conclusion:Desogestrel showed significant efficacy in the treatment of endometriosis,effectively relieving patients’pain while elevating HDL-C levels.In addition,the incidence of adverse reactions to this drug is relatively low,which is worth utilizing.