OBJECTIVE:To provide reference for the standardization of the instruction of levonorgestrel emergency contraception. METHODS:Instruction of levonorgestrel emergency contraception in the market was compared with the national regulations and foreign instruction of the same kind of productions in order to discover the problems in domestic specification. RESULTS:The major problems of domestic instruction of levonorgestrel emergency contraception included instructions without population limits, unclear frequency and interval of drug use,without attention to ADR of levonorgestrel emergency contraception,lack of pharmacy research data. CONCLUSIONS:The problems existing in domestic instruction of levonorgestrel emergency contraception are shortage of items and warnings of drug safety. Related administration departments and enterprises are suggested to modify and perfect the instruction of levonorgestrel emergency contraception.

BACKGROUND: Previous studies have indicated that hyperhomocysteinemia can induce atherosclerosis by enhancing oxidative stress, whereas Ginkgo biloba extract (GbE) can scavenge oxygen-derived free radicals.OBJECTIVE: To observe the role of reactive oxygen species (ROS) and nuclear factor-kappa B (NF-κB) in the expression of cell adhesion molecules (CAMs) induced by homocysteine (Hcy), and investigate the effect of GbE.DESIGN: A randomized controlled animal trial.SETTING: Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERrALS: Twenty-four healthy male rabbits of 6 months old. Dl-methionine (Sigma Chemical, Co.,Ltd.); GbE (Guizhou Yibai Pharmaceutical Company; powder).METHODS: The experiment was accomplished in the Laboratory of Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2003 to April 2004. ① After adaptive feeding for 2 weeks, the rabbits were randomly divided into three groups: Model group (n =12): The rabbits were treated with subcutaneous injection of dl-methionine (80 mg/kg per day); GbE group (n =8): The rabbits were administrated with GbE (mixed with feed, 50 m/kg per day) at 1 hour before the subcutaneous injection of dl-methionine; Control group (n=4): The rabbits were injected with equivalent sodium chloride. They were administrated for 7 weeks continuously. ②Histological changes were observed under light and electron microscopes: ROS level was determined with colorimetries (721 visible spectrophotometer); The expressions of CAMs and NF-κB in endothelial cells were detected with immunohistochemical methods; The concentration of plasma Hcy was measured with high-performance liquid chromatography.MAIN OUTCOME MEASURES: Histological changes, ROS level and expressions of CAMs and NF-κB in endothelial cells.RESULTS: All the 24 rabbits were involved in the analysis of results. ① ROS level: After administration, the ROS level in the model group was obviously increased (2.92±0.20,2.48±0.26, P ＜ 0.05), whereas those in the GbE group and control group (2.41±0.23, 2.43±0.20) had no obvious differences as compared with those before administration (2.31±0.27,2.47±0.32, P ＞ 0.05). ② Histological changes: Aortas of rabbits in the model group presented initial changes of atherosclerosis, including shedding or necrosis of endothelial cells and nuclear pyknosis or standing in a clutter of smooth muscle cells. There were scarcely any changes in the GbE group and control group. ③ Expressions of CAMs and NF-κB in endothelial cells: After treatments, the expressions of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and NF-κB in the model group were obviously higher than those in the control group (P ＜0.05), and there were no significant differences between the GbE group and control group (P ＞ 0.05). ④ Concentration of plasma Hcy: After 7 weeks, the concentration of plasma Hcy was higher in the model group and GbE group than in the control group [(25.01±6.80), (26.71±2.36), (16.85± 1.64) μmol/L, P ＜ 0.05].CONCLUSION: Hcy-induced oxidative stress plays an important role in NF-κB activation. GbE might suppress the activation of NF-κB and expression of CAMs by reducing ROS.

OBJECTIVE:To provide the reference for verifying and improving the usage criteria and guidelines of compound oral contraceptives(COCs)in China. METHODS:The usage criteria and guidelines of COCs were introduced and compared issued by WHO,US and European Union(EU). RESULTS&CONCLUSIONS:WHO has established 4 standards and guidelines for COCs, i.e. Medical Eligibilitu Criteria for Contraceptive Use(MEC),Selected Practice Recommendations for Contraceptive Use(SPR), Decision-making Tool for Family Planning Clients and Providers,Family Planning:A Global Handbook for Providers. According to the specific circumstances of the user,MEC has been divided into 4 levels according to the situation of users,i.e. suitable for use,use cautiously,relative contraindication,absolute contraindication. SPR mainly describes the specific issues of how to use vari-ous contraception methods safely and effectively. The reading card mode for Decision-making Tool for Family Planning Clients and Providers can query specific methods and steps of contraceptive informed choice fast. Family Planning:A Global Handbook for Providers can provide practical guide for the family planning service providers in the first line. On the basis of WHO MEC and SPR,some projects are modified and added in the US MEC and SPR,including the classification of breast feeding,the risk grade of DVT/PE recurrence,etc. EU have formulated COCs criteria and guidelines earlier than WHO and US;the key points and specif-ic varieties of COCs are prompted and updated based on the latest evidence- based medicine,including a new assessment of the risk of thrombosis after using the COCs,the special safety tips for the use of Diane 35? and its generics. Concerning the optimal ev-idences of current COCs usage of WHO,US and EU,combined with domestic situation,our country may provide the clear and up-to-date usage criteria and guidelines of COCs for its users and medical staff.

Objective:To observe the effects of different doses of advanced glycosylation end products ( AGEs ) on bFGF expression of cultured rabbit M üller cells in vitro.Methods:Immunocytochemistry and transmission electron microscopy methods were used identified cultured M üller cell.Immunocytochemistry method was used to semi-quantitate bFGF expression of retinal Müller cells at 640 μl/2 000 μl AGEs conditions.We observed effects of AGEs and PKC inhibitor Calphstion C on bFGF mRNA expression .Results:640 μl/2 000 μl AGEs stimulate bFGF expression of retinal Müller cell.Calphostin C inhibits bFGF mRNA increase stimulated by AGEs,and inhibition achieves strongest at concentration 50 nmol/L.Conclusion:AGEs can stimulate bFGF expression of Müller cell to exert the role of angiogenesis .bFGF mRNA expression may be regulated by activation of PKC pathway .

Objective To evluate the efficacy of ureteroscope and holmium laser in the treatment of ureteral stones. Methods 48 cases of ureteral stones were ureteroscopicaly treated by the use of the above mentioned lithotripter from February 2001 to August 2001. Results 98%(47/48)of the stones being expelled within 5 days after the double J tube were pulled out.No complicaticons occurred. Conclusions Treatment of the ureteral stones by the use of ureteroscope and holmium laser is safe and effective.

Objective To study the preoperative application value of the three-dimensional angiography in surgical strategy for the elderly patients with meningioma. Methods Forty-two elderly patients aged 60 years and over with meningioma were examined preoperatively with multi-slice spiral CT angiography(MSCTA) and (or) 3 dimensional contrast-enhancement MR angiography(3D CE-MRA)as simulation group.In three-dimensional post-processing workstation,the oppression and invasion degree of the intracranial important blood vessels,nervous running zone and sinus,as well as surgical risks were evaluated. 28 elderly patients without the above examination were as control group. The operation time, blood transfusions and postoperative complications were compared between the two groups. Results All 42 cases of simulation group completed reasonable surgical plan and approach.The incidence of postoperative complications were lower in simulation group than in control group (35.7％ vs.50.0％,P＞0.05),intra-operative blood transfusion were significantly decreased in simulation group as compared with control group [(5301.0± 150.6) ml vs.( 621.4±226.7)ml,t=2.01,P=0.049],operation time after three-dimensional simulation were reduced as compared with control group [(257.1 ±72.6) min vs.(307.5±88.2)min,t=2.61,P=0.011].Conclusions Application of three-dimensional angiography in elderly patients with meningioma to evaluate the operative risk may help make reasonable surgical strategy,thus reducing the surgical trauma and complications.

AIM: In order to study the relationship of the activation of ERK and delayed cardioprotection of 11,12-EET.METHODS: A rat ischemia/reperfusion(I/R) model was replicated by ligating left anterior descending coronary artery 30 min followed by 60 min.The expression of ERK was detected with Western blotting,and the change of heart function during reperfusion was observed.RESULTS: The difference of myocardial function was prominent at (24 h) in I/R group compared with sham group,EET+I/R and EET+PD098059+I/R group.The activity of ERK at(24 h) in EET+I/R group was higher than sham group, and the activity of ERK in EET+PD098059+I/R group was lower than that in EET+(I/R) group;the expression of phosphorylated ERK1/ERK2 at(24 h) in EET+I/R group was more than that in I/R group,and the expression of phosphorylated ERK1/ERK2 in EET+PD098059+I/R group was less than EET+I/R group.CONCLUSION: 11,12-EET has a delayed cardioprotection effect,and this protection effect is involved in the activity of ERK and expression of phosphorylated ERK1/ERK2.

Objective To probe the value of multi-slice spiral CT angiography (MSCTA) in decreasing surgical trauma of the cranial base meningioma. Methods Thirty-two patients with cranial base meningioma were examined preoperatively with MSCTA to observe the shape and the relationship with the adjacent vessels and the skull base. Three-dimensional images were reconstructed to imitate the approach of operation and compared with surgical findings. Meanwhile, 22 patients withnot MSCTA were selected randomly as control group. The amount of blood transfusion and the occurrence rate of complications were compared between the two groups. Results MSCTA depiceted clear three dimensional images of the meningioma and the relationship with the adjacent vessels and the skull base, corresponded very well to the surgery. By imitating the operation, all patients were designed the incision size of bone appropriately, the vessels of peritumoral were kept off effectively and the risk of the embedded vascular were assessed accurately. The conventional surgical approach and method were changed in 9 patients, 4 formulated the planning of the sub-total resection and radiotherapy preoperatively. Compared with control group, the amount of blood transfusion reduced significantly (P<0.05) and postoperative complications decreased. Conclusion MSCTA can imitate the surgical operations in multi-angle and supply the vital information for choosing the proper surgical approach, thereby reducing surgical trauma and postoperative complications.

Objective To investigate the role of MMPs expression in the invasion and metastasis of bladder cancer.Methods 50 patients with bladder cancer were selected as observation group .30 healthy people were selected as control group.ELISA method was used to detect the serum contents of MMP -2 and MMP -9.The distribution and expression of MMP -2 and MMP-9 were detected by immunohistochemical SP method .The results of the two groups were compared .Results The serum levels of MMP-2 and MMP-9 between bladder cancer with lymph node metastasis group and control group had statistically significant differences (t =7.532,6.358,all P <0.05 ) , and the differences between bladder cancer with lymph node metastasis group and bladder cancer without lymph node metastasis group were statistically significant (t =5.486,6.225,all P <0.05),and the differences between bladder cancer without lymph node metastasis group and normal control group were statistically significant (t=9.687,8.425,all P<0.05).The expression of MMP -2 and MMP-9 in bladder epithelial tissues of normal control group was negative , MMP-2 and MMP-9 expression in tumor cells and stromal cells of 50 patients with bladder cancer metastasis was positive ,mainly expressed in tumor cells ,MMP-2 positive expression in 37 patients, MMP-9 positive expression in 49 patients.With the increase of tumor grade and lymph node metastasis , the expression of MMP-2 and MMP-9 increased obviously,the differences were statistically significant (χ2 =9.268, 11.258,8.412,6.354,all P<0.05).MMP-2 and MMP-9 levels were associated with tumor histological grade and lymph node metastasis in bladder cancer cell metastasis (χ2 =11.742,P<0.05).Conclusion Serum contents and expression of MMP-2 and MMP-9 are closely related with invasion and metastasis of bladder cancer ,which can be used as objective indicators that estimate the prognosis of bladder transitional cell carcinoma .

OBJECTIVE: To determine the value of high-resolution three dimensional contrast enhanced magnetic resonance venography (3D CE-MRV) in evaluating sinus meningiomas in the region of interest (ROI). METHODS: Twenty patients with sinus meningiomas underwent 3D CE-MRV with ROI preoperatively (including 9 patients postoperatively). We observed the changes of venous sinus adjacent the tumor. RESULTS: All patients received high-resolution image, the single acquisition time was about 11.4 s, and the voxel value was about 1.3 mm3. The images of 20 patients showed the change of the sinus clearly, 6 of which with integral sinus, 14 with sinus invaded at various degrees, including 5 with sinus occlusion and 9 with stenosis. CE-MRV also showed 4 patients with clear sinuses, 1 with narrow sinus, partial interruption, and 4 with sinus removed after the surgery. CONCLUSION Application of high-resolution 3D CE-MRV in ROI in sinus meningiomas may help obtain a series of high-resolution images in a short time, show the relationship between the tumor and venous sinus, display the degree of invasion of venous sinus clearly, provide information for the surgical treatment, and evaluate the change of sinus after the surgery.
Adult ; Aged ; Aged, 80 and over ; Cranial Sinuses ; pathology ; Female ; Humans ; Image Enhancement ; methods ; Imaging, Three-Dimensional ; Magnetic Resonance Angiography ; methods ; Male ; Meningeal Neoplasms ; diagnosis ; Meningioma ; diagnosis ; Middle Aged ; Phlebography ; methods