不同机制介导怀牛膝兴奋未孕大鼠子宫平滑肌的峰电活动

在 5 0只Wistar雌性未孕大鼠子宫角浆膜面上沿子宫纵轴埋植 1对Ag -AgCl双极电极 ,腹腔注射阿托品或异搏定或消炎痛后 ,观察注射怀牛膝 0 .6mL对未孕大鼠子宫平滑肌峰电活动的影响 ,探讨其兴奋的途径。结果表明 ,阿托品阻断胆碱能M受体后 ,腹腔注射怀牛膝水煎剂 ,子宫平滑肌峰电活动表现出明显的兴奋效应 ;异搏定阻断L型Ca2 通道 (L VDCC)后 ,腹腔注射怀牛膝水煎剂 ,暴发波的最大振幅等 4项指标均无明显变化 (P >0 .0 5 ) ,而单波的正波最大振幅和峰面积则有明显增加 (P <0 .0 5 ) ,单波的负波最大振幅则无显著变化 (P >0 .0 5 ) ;腹腔注射前列腺素合成酶抑制剂消炎痛后 ,注射怀牛膝水煎剂 ,暴发波的最大振幅等 4项指标变化不明显 (P >0 .0 5 ) ,单波的正波最大振幅等 3项指标均有明显升高 (P <0 .0 5 )。结果提示 ,怀牛膝对未孕大鼠子宫平滑肌峰电活动的兴奋作用是通过胆碱能M受体以外的其他途径实现的 ,部分可能与子宫平滑肌细胞膜上的异搏定敏感的L型Ca2 通道有关 ,部分可能与刺激前列腺素合成与释放有关     

温肾养血方对无排卵模型大鼠卵巢质量和形态的影响

目的 探讨温肾养血方对无排卵大鼠子宫指数、卵巢指数及卵巢组织形态的影响。方法 采用丙酸睾酮皮下注射法复制无排卵大鼠模型。将模型大鼠分为模型组,西药组,温肾养血方大、中、小剂量组,分别给予生理盐水,枸橼酸氯米芬,温肾养血方大剂量（52 mg/kg）、中剂量（26 mg/kg）、小剂量（13 mg/kg）灌胃。另选22日龄大鼠作为正常组。连续灌胃21 d后,测定各组大鼠体质量、子宫指数和卵巢指数,光镜下观察卵巢组织形态。结果 与正常组比较,模型组大鼠体质量无明显变化（P>0.05）,子宫指数和卵巢指数显著降低（P<0.05）。与模型组比较,各给药组大鼠体质量和子宫指数、卵巢指数无明显变化（P>0.05）。温肾养血方大、中剂量组卵巢形态近似正常组,结构明显改善,多数卵巢可见发育期的各级卵泡,可见卵丘、卵细胞及典型黄体形成。西药组和温肾养血方小剂量组卵巢形态类似模型组,卵巢体积较小,卵巢表面苍白,无斑点,色泽苍白,卵泡数目少,卵泡较小,且形状不规则,多呈囊性扩张,无黄体。结论 温肾养血方能改善卵巢结构和促进卵泡发育。     

Dysfunctional state institutions,trust, and governance in areas of limited statehood

Areas of limited statehood where the state is absent or dysfunctional are rarely ungoverned or ungovernable spaces. The provision of rules and regulations, as well as of public goods and services – governance – does not necessarily depend on the existence of functioning state institutions. How can this be explained? To begin with, we identify functional equivalents to state institutions that fail to govern hierarchically. Moreover, we focus on informal institutions based on trust that are endogenous to areas of limited statehood. Personalized trust among community members enables actors to overcome collective action problems and enhances the legitimacy of governance actors. The main challenge in areas of limited statehood, which are often characterized by social heterogeneity and deep social and cultural cleavages (particularly in post‐conflict societies) is to move to generalized trust beyond the local level and to “imagined communities among strangers,” despite dysfunctional state institutions. We propose two mechanisms: First, the more group‐based identities are constructed in inclusive ways and the more group identities are cross‐cutting and overlapping, the more they lead to and maintain generalized trust. Second, experiences with fair and impartial institutions and governance practices – irrespective of whether state or non‐state – also lead to generalized trust beyond the local level and allow for the upscaling of governance.     

Unnecessary bleeding,unnecessary suffering: normalcy and necessity of menstruation in promoting NovaSure®

NovaSure® is an endometrial ablation procedure that destroys the inner lining of uterus to stop heavy bleeding. It is performed mostly on women entering menopause who are experiencing irregular and heavy bleeding. In this article, this biotechnology, promoted for women approaching the end of their reproductive life, is analyzed. The analysis is informed by a feminist science studies and medical anthropology background. The discourse of ‘normal’ menstruation and representations of menstruation in the promotional materials for NovaSure® are explored through a textual analysis of the NovaSure® website and patient brochure. The themes in the materials analyzed include the idea of getting back to life, ‘normal’ bleeding, and having a choice among different medical procedures and interventions. The possibility of getting rid of embarrassment that accompanies heavy bleeding is also emphasized. It will be argued that NovaSure® contributes to the redefinition of what is ‘natural’ and ‘necessary’ by combining the ‘unnecessary period’ idea of pills such as Seasonale®, which is aimed toward women in their reproductive years, with the ‘unnecessary suffering’ idea related to menopausal complaints. While advertising the procedure, NovaSure® promotional materials co-construct the ideal user for the technology and reproduce the taboos and embarrassment that accompany menstruation.     

祛瘀补肾法治疗青春期功能失调性子宫出血临床观察

目的 观察祛瘀补肾法治疗青春期功能失调性子宫出血的临床疗效。方法 将120例青春期功能失调性子宫出血肾虚血瘀型患者随机分为两组，分别采用补肾活血中药和西药性激素进行治疗，并比较两组疗效。结果 中药组在临床综合疗效、近期止血疗效和症状疗效（阴道流血量、腰膝酸软）方面显著优于西药组(P<0.05，或P<0.01)；中药组复发率显著低于西药组（P<0.01）。结论 祛瘀补肾法治疗青春期功能失调性子宫出血具有较好的临床疗效。     

Inferior Vena Cava Tumor Thrombosis Secondary to Metastatic Uterine Cancer: A Rare Cause of Sudden Unexpected Death

Pulmonary tumor thromboembolus (PTTE) secondary to uterine cancer is a rare cause of sudden unexpected deaths in the elderly population. Additionally, tumor extension to the inferior vena cava (IVC) makes it rarer. No such cases have been previously reported in the forensic literature. We report this phenomenon in a previously healthy 70‐year‐old woman with no other known risk factors for the development of deep vein thrombosis. The deceased was found dead while watching television with her relatives. Autopsy examination revealed that her death was attributed to a saddle embolus lodged in the main pulmonary arteries. A uterine tumor was discovered, and microscopic examination revealed low‐grade endometrial stromal sarcoma with angiolymphatic invasion. The tumor cells were also found in the embolus and the remnant thrombosis attached to the inner wall of the IVC. This case demonstrates a sudden unexpected death caused by acute PTTE following seeding of uterine cancer into the IVC and raises awareness of such events.     

谈现场急救中的冷处理

文章对冷处理方法的适用范围、冷处理的作用机制、冷处理的操作方法及体会进行了阐述。冷处理方法在运动损伤、急性软组织挫伤、烧烫伤、中暑及某些疾病发作等情况下可能用到,可以根据不同的伤病情和现场的条件灵活地采取有效的方法实施自救和互救。     

Problematical Parents and Critical Children: What Is the Significance of Gunnar and Alva Myrdal's Chequered Family History?

This short article considers four questions about the lives led by Gunnar Myrdal and Alva Myrdal, world-famous Swedish social scientists. What were the social conditions for the development of their ideas? What implications (if any) did their developing social science theories have for their personal lives? Is consistency a necessary requirement in matching words and deeds? Is there any necessary relationship between the public and private lives of eminent scholars and public figures? All three of their children, Jan, Sissela, and Kaj, have written autobiographical accounts which, directly or indirectly, suggest that the Myrdal family was dysfunctional. The implications of this are explored.     

现场血迹推断出血点位置的研究进展

血迹是命案现场最常见的痕迹之一,对血迹形态的分析是一种重建犯罪现场的有效方法,而根据现场血迹推断出血点位置则是血迹形态分析的主要任务之一。随着血迹研究的不断发展,出现了许多不同的方法（如传统拉线法、三角函数法、绘图法、计算机程序法、公式计算法、回归方程法等）用于推断出血点位置。通过结合国内外相关文献,对不同的方法进行了综述,以期为相关研究提供参考。     

益真胶囊序贯治疗肾阴虚型经间期出血疗效观察

目的 观察仙子益真胶囊和仙芪益真胶囊序贯治疗肾阴虚型经间期出血的临床疗效。 方法 将90例患者随机分为对照组和治疗组，每组45例，对照组患者口服补佳乐片，治疗组患者口服益真胶囊（仙芪益真胶囊、仙子益真胶囊）以接受周期序贯治疗，连续治疗3个月经周期后观察两组患者的阴道出血时间评分、临床疗效及止血疗效。 结果 治疗2、3个月后，治疗组阴道出血时间评分显著低于对照组（P<0.05），且两组出血时间评分均显著低于治疗前和治疗1个月后（P<0.05）；治疗组止血疗效及临床疗效均优于对照组（P<0.05）。 结论 仙芪益真胶囊和仙子益真胶囊序贯治疗肾阴虚型经间期出血具有较好的疗效。