氟他胺与螺内酯联合达英35治疗特发性多毛症临床疗效比较的随机对照研究

To compare the effectiveness of flutamide and spironolactone plus Diane 35 in the treatment of idiopathichirsutism (IH). Design: Prospective randomized clinical study. Setting: Social Security Agency, Aegean Obstetrics and Gynecology Teaching Hospital, Department of Reproductive Endocrinology and Infertility, a tertiary referral center. Patient( s): Eighty women with IH who had been admitted to our center. Intervention(s): Patients were randomly and equally assigned to receive flutamide (250 mg/d for the first 10 days of the cycle) and spironolactone plus Diane 35 (spironolactone 100 mg/d; Diane 35 is a combination tablet of 2 mg cyproterone acetate and 35 μ g ethinylestradiol/d) for 9 months. Main Outcome Measure(s): Modified Ferriman-Gallwey (F-G) score and hormonal profile before treatment and at the end of treatment. Result(s): In spite of the fact that there were no statistically significant differences in modified F-G scores in between the two groups, a significant decrease in modified F-G scores was observed in the flutamide (from 19.93 ± 4.31 to 15.58 ± 4.28)-and spironolactone plus Diane 35 (from 18.77 ± 3.76 to 14.54 ± 3.29) groups. There were also no differences between the two groups with respect to hormonal profiles including serum FSH, LH, free T, 17- OH-progesterone, and DHEAS levels. No major side effect, including liver toxicity, was observed in either group. Conclusion(s): Our data suggest that both therapies have similar effectiveness in the treatment of IH.

既往成功肾移植患者的妊娠

To evaluate the risk factors affecting pregnancy, perinatal outcomes, and short-term graft condition in women who underwent renal transplantation. Method: Between May 1998 and January 2005, the histories of 20 pregnancies in 17 renal transplant recipients were reviewed retrospectively at the Ministry of Health Aegean Obstetrics and Gynecology Teaching Hospital. Result: There were significant associations between high serum creatinine level (>1.5 mg/dL) prior to pregnancy and preterm delivery (P = 0.04), and between short interval between transplantation and pregnancy ( < 2 years) and increased rate of cesarean sections (P = 0.04). There were no significant changes in serum creatinine levels during pregnancy in these women, and there were no acute rejection and graft loss during pregnancy or in the 6 months following delivery. Conclusion: These findings suggest that, although pregnancy does not adversely affect short-term renal allograft function, the rates of obstetric and perinatal complications are increased. Risk factors present before conception are a short interval between renal transplantation and pregnancy and poor renal function.

高血压孕妇血浆一氧化氮、内皮素-1和尿一氧化氮及cGMP水平

To compare serum levels of nitric oxide (NO) and endothelin- 1 (ET- 1), and urinary concentrations of NO and cyclic guanosine monophosphate (cGMP) between preeclamptic and normotensive pregnant women. Method: Ninety-one preeclamptic (48 mild, 43 severe) and forty healthy normotensive pregnant women above 32 gestational weeks were recruited into study. Chemiluminesence technique was used for measuring plasma and urinary NO levels, and radioimmunoassay was used to determine plasma ET- 1 and urinary cGMP levels. Result: Plasma and urinary NO, and urinary cGMP levels were significantly lower in preeclamptics than in the control group (respectively, p < 0.001, p < 0.001, p < 0.01). Plasma ET- 1 levels were significantly higher in the preeclamptics than in the control group (p < 0.001). There were significant negative correlations between plasmaET- 1, plasma NO and urinary NO and cGMP in all groups. There were positive correlations between plasma NO, urinary NO and cGMP in all groups. Conclusion: The imbalance between NO and ET- 1 may play a significant role in the pathophysiology of preeclampsia.