宫腔镜联合B超诊治合并子宫假道的宫腔病变23例临床分析

目的探讨宫腔镜联合B超在诊治合并子宫假道的宫腔内病变的临床价值。方法选择2010年12月~2013年12月应用宫腔镜联合B超诊治合并子宫假道宫腔病变的患者23例,年龄22~65岁。其中异常阴道出血5例,闭经1例,不孕症2例,胚物残留8例,宫内节育器取出失败5例,宫腔粘连2例。行宫腔镜联合B超检查明确诊断,必要时随即行宫腔镜电切术或取环术。结果 23例患者均在宫腔镜联合B超下明确子宫假道的诊断,随即行宫腔镜下胚物残留电切术8例,宫腔镜下取环术5例,宫腔镜下宫腔粘连电切术2例,腹腔镜下子宫假道缝合1例。手术时间为5~40 min;术中出血量5.0~30.0 m L。无子宫穿孔、空气栓塞及经尿道前列腺电切术(TURP)综合征等并发症发生。结论宫腔镜联合B超检查是确诊子宫假道的方法,对合并子宫假道患者的宫腔镜手术在严密监护下谨慎快速完成操作是可行的、安全的。     

宫腔镜诊治继发不孕110例分析

目的探讨宫腔镜对继发不孕患者宫腔内病变的诊断和治疗作用。方法110例继发不孕症患者,行宫腔镜检查及治疗。结果110例中宫腔异常情况为80例（72.7%）,宫腔镜下异常病理情况分别为：宫腔粘连42例,其中轻度粘连24例,中度粘连14例,重度粘连4例;子宫内膜息肉19例;子宫内膜增生17例;粘膜下肌瘤2例。术后1年内妊娠72例（65.5%）,术后2年内妊娠12例。结论宫腔内因素是造成继发不孕的主要原因之一,宫腔镜检查、治疗是诊治继发不孕的一种微创有效的治疗技术。     

宫腔镜检查对子宫异常出血的诊断价值

目的探讨宫腔镜检查对异常子宫出血的诊断价值。方法回顾分析2005年6月至2006年6月就诊于我院的非阴道及宫颈因素所致异常子宫出血患者148例,行宫腔镜检查并取活检进行病理诊断。结果宫腔镜检查发现宫颈管息肉25例,子宫内膜息肉47例,粘膜下肌瘤7例,胚物残留4例,子宫内膜炎4例,疑似子宫内膜癌6例,子宫畸形2例,宫腔粘连5例,阳性率67.5%。病理诊断子宫内膜单纯增生70例,单纯伴复杂增生2例,局灶非典型增生3例,子宫内膜癌2例,子宫内膜息肉32例,子宫内膜炎5例,蜕膜样变4例,内膜息肉样增生1例,病理结果异常发生率为80.4%。结论宫腔镜检查异常子宫出血,同时病理诊断对宫内病变的诊断及治疗具有非常重要的价值,值得推广应用。     

宫腔镜检查术对异常子宫出血的诊断价值

本文总结了我院自1988年4月至1995年12月应用西德生产wolf宫腔镜检查异常子宫出血共103例,均为已婚妇女,年龄为25～66岁间,平均42.5岁。其中月经过多、不规则83例,绝经后出血20例。结果:月经过多伴子宫肌瘤33例、子宫内膜息肉30例,子宫内膜癌2例、子宫内膜肥厚14例,4例未见异常。绝经后出血20例中,子宫内膜萎缩8例、子宫肌瘤6例,内膜息肉5例,内膜肥厚1例。 本组结果说明宫腔镜检查由于直视下观察宫腔及内膜病变、对于宫腔占位病变仍可作出明确诊断,对于子宫内膜增生症在病理的辅助下亦可做出明确诊断,并且还可以在直视下对于小的子宫内膜息肉准确地彻底地刮宫。对于绝经后出血,宫腔镜检吏此分段诊刮更有优越性,通过全面观察宫腔镜可以弥补因诊刮导致内膜癌的漏诊,另外可以对于子宫内膜萎缩,避免不必要的刮宫术,因此宫腔镜检查是一种非常理想的妇科检查及治疗方法和手段。     

经阴道超声联合宫腔镜检查在不孕不育患者诊疗中的临床应用价值

目的探讨经阴道超声联合宫腔镜检查在不孕不育患者诊疗中的临床应用价值。方法选择行宫腔镜检查的575例女性患者,年龄23~35岁,平均年龄30.25岁。其中拟实施体外受精-胚胎移植(IVF-ET)治疗的不孕症患者547例和有2次以上反复自然流产(RSA)史的患者28例,在自然周期经阴道超声监测子宫内膜情况后进行宫腔镜检查。结果 547例拟IVF-ET治疗患者经阴道超声监测子宫内膜的异常发现率为70.93%(388/547),宫腔镜的阳性发现率是92.69%(507/547)。阴道超声显示子宫内膜异常的患者中95%以上经宫腔镜检查有异常发现,严重异常的比例在75%以上。28例RSA患者宫腔镜检查提示宫腔粘连者比例为53.57%(15/28)。结论经阴道超声监测不孕不育患者的子宫内膜对于诊断宫腔内病变简单、必要、诊断率较高,可作为IVF-ET患者治疗前初步筛查子宫内膜病变的方法,宫腔镜检查可以提供更加准确可靠而全面的诊断与治疗。对于IVF-ET失败或RSA的患者非常有必要进行宫腔镜检查。     

宫腔镜诊治绝经后出血的临床应用

目的探讨宫腔镜检查在诊治绝经后子宫出血的作用。方法回顾分析159例行宫腔镜检查的绝经后子宫出血患者，总结镜下所见，进行临床与病症分析。结果子宫内膜正常105例，异常35例，其中有高危因素的30例病人中有不典型增生者6例，子宫内膜癌的7例，其中有5例子宫内膜厚度小于5mm，病理为子宫内膜癌。结论宫腔镜检查是诊断绝经后子宫出血的最准确可靠的方法。     

宫腔镜诊治输卵管近端梗阻53例

目的探讨宫腔镜对输卵管近端阻塞的诊断和治疗作用。方法53例输卵管近端阻塞的继发不孕症患者,行宫腔镜检查及治疗。结果宫腔镜发现宫腔内异常病理变化46例,主要异常病理变化为：宫腔内膜性粘连25例（54.3%）,子宫内膜息肉12例（26%）,子宫内膜增生6例（13%）,纤维性粘连3例（6.5%）;宫腔镜治疗后输卵管通畅46例,再通成功率为86.7%;术后1年宫内妊娠41例（77.4%）。结论宫腔内因素是造成输卵管近端阻塞的主要原因之一,宫腔镜检查、治疗是诊治输卵管性近端梗阻性不孕的一种微创有效的治疗技术。     

宫腔镜检查516例分析

目的 探讨宫腔镜检查的优势及价值.方法 对2010年1月～2010年8月在郑州市妇幼保健院行宫腔镜检查的516例患者的临床资料进行回顾性分析.结果 异常子宫出血组中子宫内膜息肉所占比例最高,达42.2%,不孕症检查异常者达67.2%,7例宫内节育环嵌顿均完整取出,闭经患者中83.8%有不同程度的宫腔粘连.结论 宫腔镜检查安全、有效且可在门诊进行,是诊断宫内病变的"金标准".     

宫腔镜诊治92例妇产科不孕不育症的临床研究

目的 探讨宫腔镜在诊治不孕不育症中的临床应用价值.方法 2008年2月～2009年3月收治的92例妇产科不孕不育患者采用宫腔镜进行临床诊断与治疗,取得了良好疗效,现将结果报道如下.结果 本文对收治的92例不孕不育症患者的进行宫腔镜检查发现异常共52例,其中子宫内膜惠肉及息肉样增生占首位,其次为子宫内膜炎和宫腔粘连.宫腔镜检查结果与术后的病理诊断结果进行比较发现二者诊断符合率较高,本文宫腔镜检查异常并行官腔镜手术的24例.结论 随着宫腔镜的飞速发展和长足的进步,不孕不育患者在治疗前,最好能先做宫腔镜检查,更有利于不孕不育症的治疗.     

宫腔镜诊治子宫内膜息肉30例临床分析

目的探讨宫腔镜下诊治子宫内膜息肉(EP)的临床效果。方法对30例宫腔镜下诊治子宫内膜息肉的资料进行总结。结果术前B超宫腔内异常回声,术后病理证实为EP7例,诊断符合率23.33%,镜下诊断EP30例,病理证实为28例,诊断符合率为93.33%,两者比较差异有显著性(P<0.05)。对30例镜下诊断子宫内膜息肉者,经宫腔镜定位后用刮匙对准息肉部位进行刮取,诊刮不能摘除息肉者,及术后药物治疗欠佳者13例行宫腔镜电切术。术后随访总有效率达100%。结论宫腔镜是诊治子宫内膜息肉的有效方法。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.