INTRODUCTION:The human papillomavirus (HPV) vaccine is crucial in preventing cervical cancer, and a significant number of women in 135 countries worldwide may have unknowingly received the vaccine during peri-pregnancy or pregnancy due to a lack of regular pregnancy testing. Previous studies on the safety of pregnancy outcomes with vaccination before and after pregnancy have not reached definitive conclusions. Thus, we subdivided the vaccination time frame and conducted an updated study to further examine whether exposure to the HPV vaccine during pregnancy or the periconceptional period increases the likelihood of adverse pregnancy outcomes. MATERIAL AND METHODS:The clinical trials and cohort studies published before August 1, 2023, were retrieved from PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials. The Newcastle-Ottawa Scale and Cochrane risk of bias assessment tool were adopted to evaluate the risk of bias in the included studies. In addition, the quality assessment was carried out using the Review Manager 5.4 Software, and a meta-analysis was conducted using the Stata 16 Software. RESULTS:Eleven studies were located. The results showed that receiving 4vHPV during the periconceptional or gestational period had no relationship with an increased risk of spontaneous abortion, stillbirth, preterm birth, birth defects, small for gestational age, and ectopic pregnancy. Neither receiving 2vHPV nor 9vHPV was associated with a higher risk of stillbirth, preterm birth, birth defects, small for gestational age, and ectopic pregnancy; however, receiving 2vHPV during the period from 45 days before last menstrual period (LMP) to LMP and 9vHPV during the period from 90 days before LMP to 45 days after LMP seemed to be related to an increased risk of spontaneous abortion (RR = 1.59, 95% CI: 1.04-2.45, RR = 2.04, 95% CI: 1.28-3.24). CONCLUSIONS:In conclusion, the likelihood of an elevated risk of spontaneous abortion caused by HPV vaccination during the periconceptional or gestational period could not be completely ruled out. Given the lack of evidence, further research is needed to examine the effect of HPV vaccination on spontaneous abortion.

Menopausal syndrome refers to a range of physical and psychological symptoms caused by fluctuations or decreases in hormones in women around menopause. Insomnia, also known as sleeplessness, is a common symptom, and modern western medical treatment is mainly based on sedatives and melatonin agonists. Professor Guo Weiqin has unique insights on and valuable clinical experience in insomnia. She believes that in the treatment of menopausal insomnia based on syndrome differentiation, we should distinguish between deficiency and excess and then between zang-fu organs. Excess insomnia is mostly caused by the stagnation and exuberance of liver qi transforming into fire, while deficiency insomnia is mainly related to the deficiency of heart, spleen, liver, kidney, qi, blood and yin essence. Boasting many years’ clinical experience in syndrome differentiation and treatment of insomnia, Professor Guo proposes that the treatment should focus on both manifestation and root cause, and she makes prescriptions in a flexible manner, achieving desirable curative effect.

Objective To analysis the research status and development trend of traditional Chinese medicine in the treatment of endometrial cancer through bibliometrics. Methods The relevant literatures on the treatment of endometrial cancer by traditional Chinese medicine collected from CNKI, Wanfang Data, and VIP from inception to December 2021 were searched by computer. Cite Space 5.8 software was used to analyze the number of articles published, the cooperation between authors and institutions, the co-occurrence of keywords, clustering and emergence, and corresponding maps were drawn to explore the research hotspots and trends in this field. Results A total of 162 literatures were included, and the number of publications showed an increasing trend. A total of 303 authors were included in the collaborative network atlas, and the largest team was a multi-person team represented by Xue Xiaoou. A total of 156 institutions were included in the atlas of institutional cooperation network, and Dongzhimen Hospital, Beijing University of Chinese Medicine published the most papers. Key words cluster graph showed that the hot spots of traditional Chinese medicine in the treatment of endometrial cancer mainly focus on related disease research, traditional Chinese medicine pathogenesis and syndrome type, traditional Chinese medicine clinical experience, curative effect observation, and traditional Chinese medicine mechanism research.Conclusion Research on the treatment of endometrial cancer by traditional Chinese medicine has been on the rise, and the research hotspot tends to be traditional Chinese medicine, prescription and medicine, clinical observation, and mechanism research. It is suggested to strengthen institutional cooperation in the future, carry out high-quality clinical research, and mechanism research, and further explore the clinical application value of traditional Chinese medicine in the treatment of endometrial cancer.

目的 研究普洱茶素Ⅱ对高脂血症诱发动脉硬化ApoE基因敲除小鼠(ApoE-/-)的治疗效果及作用机制.方法 ApoE-/-小鼠通过喂养高脂饲料建立动脉粥样硬化动物模型,造模成功后将小鼠随机分为对照组、模型组、阿托伐他汀(30 mg/kg)组和普洱茶素Ⅱ低、高剂量(50、100mg/kg)组,给药6周后检测小鼠血浆总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)和非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol,non-HDL-C)水平,以及主动脉流出道斑块面积等指标的差异.体外培养人脐静脉内皮细胞HUVEC和人外周血单核细胞THP-1,检测普洱茶素Ⅱ对氧化低密度脂蛋白(oxidized low density protein,ox-LDL)诱发单核与内皮细胞黏附的影响,利用Western blotting对蛋白激酶B(protein kinase B,Akt)/核因子-κB(nuclear factor-κB,NF-κB)/血管细胞黏附因子(vascular cell adhesion molecule-1,VCAM-1)通路相关蛋白表达进行检测.结果 普洱茶素Ⅱ显著抑制了高脂饮食诱导ApoE-/-小鼠的体质量、肝脏质量、肝脏指数、附睾脂肪质量和附睾脂肪指数(P＜0.05、0.01),降低血浆TC、TG、non-HDL-C水平(P＜0.05、0.01),升高HDL-C水平(P＜0.05),减少主动脉流出道脂质沉积.体外实验证实,普洱茶素Ⅱ显著抑制HUVEC与THP-1细胞间的黏附(P＜0.05),抑制ox-LDL诱导的HUVEC细胞中VCAM-1、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)和Akt/NF-κB通路相关蛋白表达(P＜0.05、0.01).结论 普洱茶素Ⅱ能够显著改善ApoE-/-小鼠的肥胖、脂代谢紊乱、主动脉斑块沉积,通过调控Akt/NF-κB/VCAM-1通路抑制内皮细胞与单核细胞的黏附,进而抑制动脉粥样硬化的发生与发展.

目的 优选开心散最佳60Co-γ射线辐照灭菌工艺,并对比不同灭菌方式对开心散的灭菌效果及质量的影响.方法 以西伯利亚远志糖A5、西伯利亚远志糖A6、远志(唺)酮Ⅲ、3,6'-二芥子酰基蔗糖、人参皂苷Rb1、β-细辛醚、α-细辛醚、去氢茯苓酸的含量和灭菌率的综合评分为指标,采用层次分析(analytic hierarchy process,AHP)法确定各指标权重系数,考察开心散不同辐照剂量的灭菌效果,优化开心散辐照灭菌工艺参数;通过微生物限度检测、指标成分含量及特征图谱检测,并结合灭菌后的制剂性状,对比辐照灭菌、湿热灭菌、干热灭菌和乙醇灭菌的灭菌效果和对开心散质量的影响.结果 按照确定的权重系数进行综合评价,确定开心散最佳60Co-γ射线辐照灭菌工艺条件为辐照剂量6kGy;不同方式灭菌样品的微生物限度检查均符合药典规定;与未灭菌制剂相比,经辐照灭菌后样品中西伯利亚远志糖A6、3,6'-二芥子酰基蔗糖含量降低,人参皂苷Rb1、β-细辛醚和α-细辛醚含量增加;与辐照灭菌相比,经干热灭菌后多种指标成分含量降低,经乙醇灭菌后多种指标成分含量增加;特征图谱结果显示,各种灭菌方式样品与未灭菌样品相比相似度皆＞0.99.结论 60Co-γ射线辐照剂量在6 kGy及以上时能完全杀灭制剂中的微生物,工艺稳定可行、重复性好,且辐照灭菌法与其他灭菌方法相比,在保证灭菌效果的同时能更大程度地保留开心散制剂中的主要成分,得到符合规定的开心散制剂.

那是一个风和日丽的下午,她满脸焦虑地来到诊室.她刚一坐下,眼泪就止不住地往下淌,大家不明所以,劝导好一阵,她才慢慢讲述了缘由. "我刚结婚一个月,每次同房都非常痛,还会有出血.我老公的阴茎也不能完全插进阴道.因此,至今我俩尚没有一次成功的性生活.我对性生活感到很恐怖.看到我那么痛苦,我老公也不敢跟我同房了.他建议我,还是来医院看看.医生,您帮我查查."我给她做妇科检查时发现,她阴道内有一个横隔,使阴道变得短而窄,同房的时候,阴茎刺激横隔,造成横隔损伤而出现出血、疼痛.她这种情况属于生殖道畸形,需要手术治疗.

目的:研究血竭石油醚提取物(SDPEF)对人胃癌HGC-27和MGC-803细胞增殖、凋亡、体外迁移能力及自噬的影响,并阐明其分子作用机制.方法:采用细胞增殖与活性检测(CCK-8)法检测SDPEF(0,20,40,60,80 mg·L-1)作用24,48,72 h时,对人胃癌HGC-27和MGC-803细胞体外增殖的影响.借助Hoechst染色实验观察不同浓度的SDPEF作用48 h后对HGC-27和MGC-803细胞凋亡的影响.采用流式细胞术检测不同浓度SDPEF作用48 h,对HGC-27和MGC-803细胞凋亡率的影响.采用细胞划痕实验观察不同浓度SDPEF在不同作用时间点对人胃癌HGC-27和MGC-803细胞体外迁移能力的影响.借助吖啶橙染色实验检测不同浓度SDPEF对HGC-27和MGC-803细胞自噬的影响.利用蛋白免疫印迹法检测SDPEF作用人胃癌HGC-27和MGC-803细胞48 h后对信号通路相关蛋白表达水平的调控作用.结果:与空白组比较,SDPEF(30 mg·L-1)组人胃癌HGC-27和MGC-803细胞的增殖和体外迁移能力明显降低(P＜0.05),且具有浓度与时间依赖性;SDPEF(60 mg·L-1)还能够诱导人胃癌HGC-27和MGC-803细胞凋亡(P＜0.01)和自噬的发生.与空白组比较,SDPEF(60 mg·L-1)能够下调磷酸化哺乳动物雷帕霉素靶蛋白(p-mTOR)表达(P＜0.05,P＜0.01),且能够下调磷酸化信号传导与转录激活因子3(p-STAT3)蛋白表达水平(P＜0.01),提示SDPEF可能是通过抑制mTOR/STAT3信号通路来抑制人胃癌HGC-27和MGC-803细胞的增殖、迁移并诱导其发生凋亡和自噬.结论:mTOR/STAT3信号通路下调可能参与了 SDPEF的抗胃癌作用.该研究能够为血竭抗肿瘤作用研究提供一定的参考.

目的 探讨杞月茶治疗卵巢储备功能下降大鼠的潜在机制.方法 2021年3—5月于北京中医药大学东直门医院中心实验室进行实验.6周龄SD大鼠24只,随机数字表法分为空白组、模型组、杞月茶组、戊酸雌二醇片(补佳乐)组,每组6只.除空白组外,其余大鼠腹腔注射VCD 160 mg/kg制备卵巢储备功能下降(DOR)模型,造模成功后,杞月茶组予杞月茶24 g/kg剂量灌胃,补佳乐组予补佳乐0.12 mg/kg灌胃,空白组及模型组予生理盐水3 ml/kg灌胃,连续灌胃4周.干预结束后,ELISA检测各组大鼠血清促卵泡激素(FSH)、雌二醇(E2)、抗苗勒管激素(AMH)的含量,取卵巢组织采用HE染色观察卵巢形态,免疫组织化学法检测卵巢Bax与Bcl-2蛋白表达,蛋白印迹法检测卵巢Bcl-2/Bax表达水平.结果 与空白组比较,模型组大鼠中初次级卵泡减少,闭锁卵泡增多;杞月茶组及补佳乐组初次级卵泡及成熟卵泡较多,闭锁卵泡较模型组减少.与空白组比较,模型组卵巢体质量指数、AMH水平降低,FSH水平升高(P<0.05);与模型组比较,杞月茶组及补佳乐组卵巢体质量指数、AMH水平升高,FSH水平降低(P<0.05).Bax蛋白主要表达在颗粒层细胞、黄体及间质,模型组大鼠较空白组表达升高,杞月茶组及补佳乐组较模型组表达降低(P<0.05).模型组Bcl-2/Bax比值较空白组降低(P<0.05);杞月茶组及补佳乐组Bcl-2/Bax比值高于模型组(P<0.05).结论 杞月茶可降低DOR大鼠血清中FSH水平、升高AMH水平,与下调卵巢组织中细胞凋亡因子Bax的表达有关.

Five new iridoid glucosides, cannabifolisides A-E (1 - 5), together with nine analogues (6 - 14), were isolated from the leaves of Vitex negundo var. cannabifolia. Their structures were elucidated by spectroscopic data (NMR, UV, IR, and MS) analyses and comparison of their spectroscopic and physical data with the literature values. The protective effect of isolated compounds on human gastric epithelial cells were evaluated by measuring the enhanced cell viability of GES-1 cell insulted by TCA. Among these, compounds 4, 6, 8, 10, 12, and 14 remarkably increased the cell viability in a concentration-depend manner.

目的 研究血人参中异甘草素的抗炎作用及其机制.方法 采用四唑盐比色法(MTT assay,MTT)检测异甘草素对小鼠巨噬细胞的细胞毒;利用脂多糖(lipopolysaccharide,LPS)诱导巨噬细胞和中性粒细胞活化模型,给予无细胞毒剂量的异甘草素处理细胞;通过格里斯法(Griess)检测异甘草素对巨噬细胞释放一氧化氮(nitric oxides,NO)的影响;实时荧光定量聚合酶链反应(real-time fluorescence quantitative PCR,qRT-PCR)检测异甘草素对巨噬细胞炎症因子mRNA转录的影响;酶联免疫吸附法(enzyme linked immuno sorbed assay,ELISA)检测异甘草素对巨噬细胞分泌炎症因子的影响;利用流式细胞术检测异甘草素对中性粒细胞活化和释放活性氧的影响;蛋白质印迹法(western blot,WB)检测异甘草素对巨噬细胞中受体激活蛋白(receptor activator of NF-κB,NF-κB),丝裂素活化蛋白激酶(mitin-activated protein kinase,MAPKs)、干扰素调节因子3(interferon regulator factor 3,IRF3)和信号传导及转录激活蛋白家族(signaling and transcription activator proteins family,STATs)信号通路活化的影响.结果 异甘草素在无细胞毒剂量下能显著抑制巨噬细胞释放NO,能抑制肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1β,IL-1β)、巨噬细胞炎症蛋白-1α(macrophage inflammatory protein-1,MIP-1α)、单核细胞趋化因子-1(monocyte chemotactic protein-1,MCP-1)和干扰素-β(interferon-β,IFN-β)等炎症因子的mRNA转录,同时抑制炎症因子TNF-α、IL-6、MCP-1和IFN-β的分泌;另外对中性粒细胞释放活性氧也具有显著抑制作用;Western blot结果显示异甘草素能够抑制应激活化蛋白激酶1/2(stress-activated protein kinase 1/2,JNK1/2)、细胞外调节蛋白激酶(extracellular regulated protein kinase1/2,ERK1/2)和信号转导和转录活化因子1(signaling and transcription activator proteins 1,STAT1)的磷酸化.结论 血人参中异甘草素能够通过抑制JNK1/2、ERK1/2和STAT1信号通路抑制巨噬细胞和中性粒细胞的功能,从而发挥抗炎作用.

总结郭志强教授基于崇阳理论治疗妇科疾病的特色用药经验.郭志强教授认为现代妇人"阴常不足,阳亦常虚",主张治疗妇科疾病注重"阴阳相济,阴基阳主",遣方用药时注重顾护阳气,活用各类温阳药物.通过整理郭志强教授临床医案,基于郭志强教授调治妇科疾病用药特色总结出温阳五法,即温补脾肾、温经通阳、温阳活血、温经止血、引火归元,为临床治疗妇科疾病提供借鉴.

风药味辛质轻性走散,通及全身上下,是具有风之升、散、行、透、动等多种特性的一类药物,可以治疗各类复杂多变的疾病.首都国医名师郭志强教授尤擅妇人经带胎产疾病的诊治,临床遣方用药时常考虑风药特性与妇人生理病理相应,紧扣不同妇科病种的病因病机特点选用风药进行个体化治疗.湿浊带下可用清热燥湿药物配伍风药防风、白芷祛风止痒;妇人腹痛可用活血化瘀药物配伍风药桂枝、水蛭活络止痛;月经紊乱可用健脾益肾药物配伍风药柴胡、羌活等疏肝开郁,活血调经;胎动不安可应用补肾固胎药配伍风药防风、葛根等调达气血;妊娠恶阻时应用风药苏叶、陈皮降逆止呕;妇人郁证可用滋补肝肾药配伍风药柴胡、白芍柔肝疏肝;宫颈癥瘕常用解毒抗癌药物配伍风药蜈蚣、水蛭攻通邪结.

正常和谐的性生活是夫妻生活的重要组成部分,但若是同房不合时宜,双方不仅无法获得幸福感,还可能损害身体健康.现在就来介绍一下,女性在哪些时候不适合过性生活. 特殊生理期 1.月经期 许多年轻人"小别胜新婚",在月经期产生"冲动"时仍会同房,甚至以经期同房作为避孕方法.这种行为对女性的健康危害极大,因为月经期大脑皮层兴奋性降低,身体抵抗力下降,这个时段同房会带来很多妇科疾病.

目的 利用皮质酮诱导大鼠肾上腺髓质嗜铬瘤分化细胞株PC12损伤,模拟糖皮质激素诱发神经功能障碍的病理过程,探讨沉香提取物对神经细胞的保护作用及其机制.方法 采用400 μmol/L皮质酮诱导的PC12细胞作为神经元损伤模型,给予沉香提取物(5、10、20μg/mL)干预细胞24h后,利用CCK-8试剂盒检测细胞存活率;采用Hoechst 33258染色和流式细胞术检测细胞凋亡率;通过Western blotting检测凋亡相关蛋白半胱氨酸天冬氨酸蛋白酶-3(cystein-asparate protease-3,Caspase-3)、cleaved Caspase-3、聚腺苷酸二磷酸核糖转移酶[poly(ADP-ribose)polymerase,PARP]、cleaved PARP 表达情况.结果 与对照组比较,皮质酮处理PC12细胞24h后细胞存活率显著降低(P＜0.01),细胞凋亡率显著升高(P＜0.01),cleaved PARP/PARP和cleaved Caspase-3/Caspase-3蛋白表达水平显著升高(P＜0.01).与模型组比较,给予沉香提取物24 h后细胞存活率显著升高(P＜0.05、0.01),凋亡率显著降低(P＜0.01),cleaved PARP/PARP 和 cleaved Caspase-3/Caspase-3蛋白表达水平显著降低(P＜0.01).结论 沉香提取物通过调控Caspase-3/PARP通路改善皮质酮诱导的PC12细胞凋亡,从而保护神经元.

目的 观察循经拍打操锻炼联合葛杞方调节围绝经期综合征患者生活质量的疗效.方法 选取2021年12月—2022年1月就诊于北京中医药大学东直门医院的围绝经期综合征女性90例作为本次研究对象.按照随机数表法分为循经拍打组、葛杞方组和循经拍打联合葛杞方组,每组30例.循经拍打组进行经络拍打操的锻炼,每周5次,每次半小时;葛杞方组服用葛杞方配方颗粒,每日一剂;联合治疗组同时采用以上两种治疗方法,疗程均为12周,观察治疗前后改良Kupperman评分量表、生活质量量表(SF-36)、围绝经期综合征中医证候积分、性激素三项(E2、FSH、LH)及骨密度的变化,评价疗效.结果 干预后,葛杞方组、循经拍打组及联合组均可对患者改良Kupperman评分、SF-36评分、中医证候积分及性激素水平有所改善(P＜0.01),且联合干预效果更显著(P＜0.01);各组骨密度差异无统计学意义(P＞0.05).结论 循经拍打法联合葛杞方可以有效的改善围绝经期综合征妇女的不适症状,提高围绝经期综合征女性患者的生存质量,效果显著,安全便捷.

年近五旬的李女士,一向自觉年富力强、精力充沛,但是近一年来,因更年期影响,身体频频出现问题.如深受阵热困扰,晚上经常被热醒,天气越冷,烘热汗出的症状发作越频繁,尤其在人多的场合容易出现脸红、大汗的情况,十分尴尬.除此之外,她还经常失眠,辗转反侧入睡后,半夜又会盗汗,醒后再难以入睡,忽冷忽热.到了早晨起床时,还会出现头晕头痛、心慌憋气、胸闷的情况.有一天就差点儿晕倒,被医生诊断为更年期高血压病.

1770年全世界第1例人工授精成功,标志着人类辅助生殖技术(ART)的开始.1978年路易斯·布朗的诞生,标志着体外授精-胚胎移植技术(IVF-ET)成为治疗不孕症的手段之一.此后,随着社会的发展,居住环境的变化,生活压力的加大,年轻夫妇不孕症的发病率不断增高,使得ART快速进步并广泛应用.IVF-ET技术是目前治疗不孕症的最有效手段,有关资料显示,目前全世界已经有800万试管婴儿诞生.

和谐的性爱是夫妻关系和睦的重要组成部分.而同房过程不顺利会让两人不欢而散,甚至影响夫妻感情. 在日常生活中,我经常能够遇见有些女性明明自己也有生理需要,却无法顺利同房,甚至产生抗拒的行为.询问之下得知,都是阴道干涩惹的祸!今天我们从女性阴道环境方向讨论一下,同房时阴道干涩怎么办?

原发性痛经为临床常见病、多发病,西药治疗以改善即时症状为主,无法治愈疾病,中医药治疗本病有着标本兼治的优势.郭志强教授从中医崇阳思想出发,提出妇人之体"阴常不足,阳亦常虚"之说,形成了以"阴阳相济,阴基阳主"为核心的崇阳理论,认为脾肾阳虚是原发性痛经的发病之本,瘀血为重要的病理产物.治疗上以温补扶阳准则,经期重视温经散寒、祛瘀止痛,非经期强调健脾补肾、补其真元,效如桴鼓.

总结郭志强教授治疗宫颈癌前病变的经验.郭志强教授提出了"宫颈微癥瘕"的学术理论,认为宫颈癌前病变系由正气亏虚,湿、热、毒、瘀之邪共同蕴结于子门,日久形成宫颈微癥瘕,临床采用扶正祛毒之法治疗此病,标本同治,疗效显著.