阴道B超检测绝经后阴道出血患者子宫内膜病变的价值

目的通过经阴道超声对绝经后阴道出血患者子宫内膜病变的超声声像图的分析,确定子宫内膜病变的程度。方法选取48例绝经后阴道出血患者为研究对象,在诊刮术前常规行阴道B超检查,测量子宫内膜厚度,观察病灶范围,然后行诊刮术,诊刮标本送病理检查。结果在48例患者中,有34例绝经后阴道出血患者的子宫内膜≥5mm,其中18例(52.9%)经病理确诊为子宫内膜癌;14例子宫内膜厚度<5mm者,病理检查未发现1例子宫内膜癌。结论阴道B超检测子宫内膜无创痛,可作为绝经后阴道出血患者进行诊刮术前的一种筛选手段。     

阴道超声对绝经后子宫出血的诊断价值

目的:通过经阴道超声对绝经后子宫出血患者子宫内膜病变的超声声像图的分析,确定子宫内膜病变的程度。方法:选取130例绝经后子宫出血患者为研究对象,在诊刮术前常规行阴道B超检查,测量子宫内膜厚度,观察病灶范围,然后行诊刮术,诊刮物送病理检查。结果:在130例患者中,有78例绝经后子宫出血患者的子宫内膜>5mm,其中10例经病理确诊为子宫内膜癌,52例子宫内膜厚度≤5mm者,病理检查未发现1例子宫内膜癌。结论:阴道超声检查可作为绝经后子宫出血患者进行诊刮术前的一种筛选手段。     

绝经后妇女子宫内膜超声检查结果分析367例

目的:评价超声检查在绝经后妇女子宫内膜疾病筛查中的应用价值.方法:分析2009年3月～2010年3月甘州区城镇55岁以上女职工体检,接受妇科超声检查,查出子宫内膜厚度≥5mm,并做诊刮术送病理检查.结果:共超声检查55以上岁妇女367例,均为绝经后妇女,查出子宫内膜厚度≥5mm的绝经后妇女87例,并做诊刮术送病理检查;其中有31例有雌激素替代治疗史,11例仍然还在应用.87例子宫内膜厚度≥5mm的绝经后妇女分为有症状组34例和无症状组53例两组.病理检查结果:有症状组34例;正常绝经后子宫内膜改变21例,良性病变10例,恶性病变3例.无症状组53例,正常绝经后子宫内膜改变44例,良性病变8例,子宫内膜不典型增生1例.结论:超声检查对子宫内膜厚度≥5mm的绝经后妇女,采取积极诊治措施,以达到早诊断、早治疗的目的,对绝经后妇女有重要的筛查作用.     

B超在绝经后阴道出血诊断中的意义

目的 评估对绝经后阴道出血患者应用B超检测子宫内膜厚度,以减少不必要的诊断性刮宫术的价值。方法 对52例绝经后阴道出血患者,于诊刮术前行B超检查,测量子宫内膜厚度,然后诊刮,诊刮标本送病理检查。结果 B超检测发现,有41例绝经后阴道出血患者的子宫内膜≥5mm,其中24例（58.6%）经病理确诊为子宫内膜癌;而11例子宫内膜＜5mm者,病理检查未发现一例子宫内膜癌（P＜0.01）。结论 阴道B超检测子宫内膜无创无痛,可作为绝经后出血患者进行诊刮术前的一种筛选手段,当超声检测内膜厚度＜5mm时,再结合其它临床检查可考虑避免诊刮。当内膜厚度≥5mm,要高度警惕子宫内膜癌的可能。     

阴道超声用于筛查绝后妇女子宫内膜病变的效果观察

目的 :探讨阴道超声筛查绝经后妇女子宫内膜病变的效果。方法 :对绝经后阴道不规则流血患者 78例及绝经后无阴道流血组 10 0例 ,行阴道超声 (TVS)检查 ,测量子宫内膜厚度 ,并对绝经后无阴道流血组而超声检查发现内膜厚达 5mm的可疑病例及绝经后阴道不规则流血组行诊断性刮宫取内膜做组织学检查。结果 :绝经后无阴道出血组子宫内膜厚度为 1～ 4mm者 98例 ,5mm者 2例 ,此 2例内膜活体组织检查结果为萎缩型子宫内膜。绝经后阴道不规则出血组 ,萎缩型子宫内膜 18例 ,子宫内膜厚度范围 3～ 5mm ;子宫内膜不典型增生 2例 ,内膜厚度范围 8～ 2 0mm ;子宫内膜癌 9例 ,内膜厚度范围 15～ 4 8mm ;宫腔积液 10例 ,内膜厚度范围 9～ 2 6mm ;子宫内膜增生 2 0例 ,内膜厚度范围 6～ 2 3mm ;子宫内膜息肉 19例 ,内膜厚度范围 6～2 0mm。病灶内血流检查发现 ,RI<0 4 0 ,提示为恶性病变 ;RI在 0 4～ 0 5提示为可疑病变。结论 :TVS测量子宫内膜厚度优于腹部超声 ,能显示子宫内膜清晰 ,超声检查子宫内膜 <5mm ,无行诊刮术必要。子宫内膜≥ 5mm应作诊刮术 ,进一步病理检查明确诊断 ,对早期发现内膜恶性病变将起到积极作用     

阴道超声诊断绝经后出血子宫内膜病变的价值

目的　探讨阴道超声检查对绝经后阴道流血妇女子宫内膜病变的诊断价值。方法　对 68例绝经后出血患者用阴道超声测量子宫内膜厚度并行诊刮术。将阴道超声检查结果与子宫内膜组织病理结果进行比较。结果　萎缩性子宫内膜厚度为(3 5 0± 0 67)mm ,内膜癌的内膜厚度为 (18 0 0± 4 2 4)mm ,病变组的内膜均显著厚于萎缩组 ;以内膜厚度 5mm作为阴道超声判断绝经后子宫内膜有无病理改变的临界值 ,其敏感度、特异度、阳性预测值和阴性预测值分别为 94.74%、 86.67%、90 .0 0 %和 92 .86%。结论　以 5mm为临界值 ,阴道超声测量子宫内膜厚度可以协助诊断绝经后出血妇女的子宫内膜病变。     

220例绝经后阴道出血子宫内膜病变的临床与病理分析

目的：探讨绝经后阴道出血子宫内膜病变与绝经年限、B超下子宫内膜增厚和病理类型的关系。方法：分析220例绝经后阴道出血子宫内膜病变患者腹部和阴道超声检查,诊断性刮宫或分段诊刮、子宫切除患者的临床和病理资料。结果：绝经后阴道出血子宫内膜病变的主要病理诊断分别是：功能性子宫内膜102例、子宫内膜炎34例、子宫内膜增生52例、子宫内膜息肉14例、子宫内膜癌18例。B超检测子宫内膜厚度≤4mm时,99%的内膜属于良性病变。结论：绝经后阴道出血子宫内膜病变以功能性子宫内膜居首位,依次为内膜增生性病变、子宫内膜癌。绝经年限长,子宫内膜厚度在5mm以上的妇女,子宫内膜癌的发生率较高。当B超检测子宫内膜厚度≤4mm时,可以结合临床考虑免除部分诊刮手术,以减轻病人的痛苦。     

绝经后阴道出血行诊刮术前B超检测的价值

目的：评估绝经后阴道出血患者应用B超检测子宫内膜，以减少不必要的诊刮术的价值。方法：对6例绝经后阴道出血患者于诊刮术前进行B超检查，测量子宫大小及子宫内膜厚度，然后行诊刮术，标本送病理检查。结果：4例子宫内膜厚度小于或等于4mm者，子宫内膜属于生理性改变；2例内膜厚度大于5mm者为子宫内膜癌。结论：运用B超检测，可作为绝经后阴道出血患者行诊刮术前的一种筛选手段，当超声检测内膜厚度小于或等于4mm时应考虑避免诊刮术。     

经阴道彩色多普勒超声对绝经后阴道流血的诊断价值

目的探讨经阴道二维及彩色多普勒对绝经后阴道流血妇女诊断价值。方法应用经阴道超声对绝经后阴道流血194例妇女子宫、卵巢进行二维及彩色多普勒检查，对超声声像图特征及子宫内膜厚度、结构及血流动力学变化进行分析，并与病理检查比较。结果经阴道超声测量内膜厚度〈3mm时可不做诊刮，定期进行观察；恶性内膜病与良性内膜病，在子宫内膜厚度形态及血流动力学上差异有统计学意义（P〈0.05）。结论经阴道超声对子宫内膜病变有较高诊断率，可作为绝经后阴道流血检查方法。     

阴道超声检查绝经后阴道出血结果分析

目的：分析阴道超声在绝经后阴道出血的诊断价值。方法对89例绝经后阴道出血的患者采用经阴道超声诊断,统计子宫内膜厚度与病理检查结果。结果89例患者中, B 超诊断子宫内膜厚度<5 mm 者32例,超声显示内膜较薄,回声均匀;子宫内膜厚度(5~10) mm 者49例,超声显示内膜增厚、回声欠均匀,部分患者可见小囊腔病变,行刮诊确诊;子宫内膜厚度>10 mm 者8例,超声表明内膜明显增厚,且呈现不均匀高回声,子宫内膜形态不规则,行刮诊确诊。主要诊断结果为子宫内膜癌(3.37%)、内膜炎性渗出(9.10%)、内膜息肉(9.10%)及宫颈糜烂(58.43%)。其中,子宫并内膜厚度≥10 mm 组子宫内膜癌的发生比例高于子宫内膜厚度为5~10 mm 组,且两组比较差异有统计学意义(P<0.05)。结论绝经后经阴道出血的致病原因较多,但多数患者均为良性病变。经阴道超声可通过对子宫内膜厚度的判断并结合病理检查确定阴道出血的原因,为子宫内膜病变的筛查提供参考。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…