调周法联合促排卵治疗不孕症的临床疗效观察

目的观察调周法配合促排卵治疗不孕症的临床疗效。方法将以排卵障碍为主的不孕症患者110例,随机分为两组,每组55例。对照组单纯应用西药克罗米芬促排卵治疗。治疗组在对照组的基础上联合中药调周法治疗。观察两组患者临床疗效及临床各项相关指标情况。结果总有效率治疗组96.4%,对照组78.1%,两组疗效比较有显著性差异（P〈0.05）;治疗组妊娠率与对照组比较有显著性差异（P〈0.05）;治疗后排卵期子宫内膜厚度比较有显著性差异（P〈0.05）,治疗前后组内比较有非常显著差异（P〈0.01）。治疗后卵泡发育与排卵率比较有显著性差异（P〈0.05）。结论调周法联合克罗米芬治疗无排卵性不孕,在改善子宫内膜、提高排卵率方面明显优于对照组,从而提高妊娠率,疗效显著。     

调周汤联合氯米芬治疗112例排卵障碍性不孕的临床观察

目的:观察促排卵中药调周汤联合氯米芬治疗排卵障碍性不孕的疗效。方法:将112例排卵障碍性不孕患者,随机分为中药调周汤联合氯米芬组(治疗组)60例,氯米芬组(对照组)52例,治疗2个疗程后用B超监测排卵及子宫内膜厚度和受孕情况,停药后继续随访3个月再统计2组受孕情况。结果:治疗组优势卵泡直径明显大于对照组,排卵期子宫内膜较治疗前明显增厚(P<0.05),对照组子宫内膜治疗前后无明显差异(P>0.05)。治疗组与对照组两组治疗2个疗程及随访3个月妊娠率比较有显著差异(P<0.05)。结论:中药调周汤联合氯米芬治疗排卵障碍性不孕,疗效优于单纯用氯米芬。     

针刺促排卵法联合中药补肾调周法治疗排卵障碍性不孕症的疗效观察

目的：探讨针刺促排卵法联合中药补肾调周法治疗排卵障碍性不孕症的临床疗效。方法：将我院2013年1月～2015年1月收治的90例排卵障碍性不孕症患者随机分为两组,每组45例。观察组给予针刺促排卵法联合中药补肾调周法治疗,对照组给予克罗米芬治疗,比较两组治疗效果。结果：观察组治疗总有效率为91.11%,对照组为62.22%,观察组明显高于对照组（P<0.01）。结论：针刺促排卵法联合中药补肾调周法治疗排卵障碍性不孕症疗效显著,值得临床推广。     

补肾化瘀调周法治疗高原地区多囊卵巢综合征120例疗效观察

目的:观察中药补肾化瘀调周法治疗高原地区多囊卵巢综合征(PCOS)的疗效。方法:采用以中药人工周期疗法为主,在经后期滋阴益肾,填补冲任(1号方);经间期益肾助阳,理气化瘀(2号方);经前期温阳补肾,阴阳双调(3号方);月经期以理气活血,化瘀调经(4号方)治疗多囊卵巢综合征120例,口服3月观察疗效。结果:总有效率90%,总治愈率40.83%。结论:补肾化瘀调周法可治疗高原地区多囊卵巢综合征,调理脏腑气血阴阳,调节冲任,从而使脑-肾-冲任-胞宫生殖轴的调节功能恢复正常。     

左炔诺孕酮宫内缓释系统对无排卵性子宫出血患者疗效观察

目的:观察左炔诺孕酮宫内缓释系统(曼月乐)对无排卵性子宫出血患者的影响。方法:67例无排卵性子宫出血患者应用曼月乐,记录治疗前后患者月经量、子宫内膜厚度、血红蛋白、子宫内膜的内皮素(ET)含量和并发症变化情况。结果:治疗12个月后,患者月经量和子宫内膜厚度明显下降,血红蛋白明显升高(P<0.01)。子宫异常出血比例明显下降,子宫内膜ET含量明显降低(P<0.05),且随着治疗时间的延长子宫内膜的ET含量降低更明显。并发症率由治疗前的50.74%降低到7.46%。结论:应用曼月乐治疗无排卵性子宫出血患者效果显著。     

克罗米芬配伍来曲唑治疗多囊卵巢综合征患者促排卵临床分析

目的评价采用克罗米芬配伍来曲唑治疗多囊卵巢综合征患者的疗效。方法选取本院妇产科在2006年6月-2012年7月收治的100例PCOS患者,随机均分为观察组和对照组,观察组患者采用克罗米芬配伍来曲唑进行促排卵治疗,对照组患者单用克罗米芬进行促排卵治疗。以7d为1个疗程,在2个疗程后观察患者的排卵率、单卵泡率与子宫内膜厚度。结果患者治疗2个疗程后,观察组患者排卵率、单卵泡率与子宫内膜厚度等各项数据明显高于对照组,两组患者比较具有显著性差异,P〈0.05。结论采用克罗米芬配伍来曲唑治疗PCOS患者,降低流产、多胎妊娠危险,值临床推广。     

米非司酮治疗围绝经期功能性子宫出血的疗效分析

目的 观察分析米非司酮治疗围绝经期功能性子宫出血的临床疗效,为该治疗方法 的临床使用提供数据支撑。方法 选择2012年3月至2013年6月于我院治疗的的围绝经期患者51例,给与米非司酮片进行治疗,治疗剂量10 mg/d,需清晨空腹服药,连续治疗1个月为1个疗程,所有患者均治疗3个疗程以上。治疗期间对患者的子宫内膜厚度以及血清中雌二醇、孕酮、卵泡生成素和黄体生成激素水平进行监测,比较治疗前后的差异。结果 经治疗,患者闭经率为100%,血清中雌二醇和孕酮水平显著降低(P<0.05),子宫内膜厚度无增厚。结论 采用米非司酮治疗围绝经期功能性子宫出血疗效肯定,能够改善患者的临床症状,提高治愈率以及患者的满意程度,降低疾病对于患者日常生活和身心的影响,应该在临床治疗过程中大力推广使用。     

促排卵过程中应用小剂量阿司匹林对改善子宫内膜发育的研究

目的:分析采用小剂量阿司匹林治疗对促排卵期间改善子宫内膜发育的临床价值。方法:收集50例因排卵功能低下而不孕女性患者,分为研究组与对照组,各25例。对照组采用克罗米酚治疗,研究组在克罗米酚治疗的基础上采用阿司匹林(75 mg·d-1)治疗。结果:排卵前1 d,研究组的血栓素A2(TXA2)水平与TXA2/前列环素(PGI2)比值均显著低于对照组;与对照组对比,研究组排卵前1 d的子宫动脉血流RI明显更低,内膜厚度更明显(P<0.05);与对照组对比,研究组排卵后的子宫内膜厚度明显更高(P<0.05);与对照组对比,研究组排卵后10 d的子宫内膜面积、间质面积、腺腔周长及腺/间比值明显更大(P<0.05);与对照组对比,研究组排卵后10 d的子宫内膜ER、子宫内膜PR明显更高(P<0.05)。结论:在排卵期间,采用小剂量阿司匹林治疗,有利于增加子宫血流供应,能有效促进子宫内膜发育、增厚,有利于提高妊娠率。     

山莨菪碱合用氯米芬对子宫内膜发育和子宫血流影响的研究

目的经阴道超声观察山莨菪碱合用氯米芬治疗无排卵性不孕患者时的子宫血流量和子宫内膜厚度的变化,研究山莨菪碱合用氯米芬治疗无排卵性不孕患者时提高妊娠率的价值。方法山莨菪碱合用氯米芬治疗无排卵性不育妇女16名,经阴道超声监测子宫内膜发育情况、子宫动脉血流（RI）,并与对照组比较,同时跟踪其妊娠情况。结果山莨菪碱合用氯米芬能够增加子宫内膜厚度和子宫血流量,妊娠率41.67%,有效提高妊娠率。结论在氯米芬促排卵治疗中合用山莨菪碱能增加子宫内膜厚度和子宫血流量,改善氯米芬促排卵时所致子宫内膜发育不良的状况,是一种解决目前促排卵治疗中高排卵率、低妊娠率的方法。     

通瘀促孕汤对子宫内膜异位症不孕患者排卵功能的影响

目的 探讨通瘀促孕汤治疗子宫内膜异位症不孕的疗效及其对排卵功能的影响.方法 将60例子宫内膜异位症不孕患者随机分为治疗组(30例)和对照组(30例).治疗组用中药通瘀促孕汤治疗,对照组用孕三烯酮治疗.结果 经6个月经周期治疗,治疗组2年累计受孕率为50.0%,对照组为33.3%,两组差异无统计学意义(P＞0.05);治疗组治疗后最大卵泡直径、成熟卵泡数目均呈增长态势,与治疗前比较差异有统计学意义(P＜0.01),对照组仅最大卵泡直径与治疗前比较差异有统计学意义(P＜0.01);治疗组卵泡未破裂黄素化综合征(LUFS)的发生率治疗后呈下降趋势,与治疗前比较差异有统计学意义(P＜0.05),而对照组LUFS发生率治疗前后差异无统计学意义.结论 通瘀促孕汤能促进卵泡发育,增加排卵而增加受孕率.     

卡马西平联用尼美舒利相关粒细胞缺乏症

1例78岁男性患者因带状疱疹神经痛、慢性阻塞性肺疾病合并感染,给予头孢唑肟钠（2.25 g静脉滴注,1次/d）、卡马西平（0.2 g口服,2次/d）、尼美舒利（100 mg口服,2次/d）、二羟丙茶碱（0.5 g静脉滴注,1次/d）、甲钴胺（0.5 mg口服,3次/d）、地塞米松（5 mg,静脉滴注1次）、盐酸哌替啶（25 mg,肌内注射1次）和盐酸布桂嗪（100 mg,肌内注射3次）等药物治疗。第7天,停用头孢唑肟钠,改为磷霉素钠（8 g静脉滴注,1次/d）。第11天,血常规检查示白细胞计数1.6×10^9/L,中性粒细胞0.03,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.9×10^9/L。立即停用所有药物,给予对症支持治疗。第15天,外周血白细胞计数0.9×10^9/L,中性粒细胞0.02,中性粒细胞绝对值0.1×10^9/L,淋巴细胞绝对值0.7×10^9/L。行骨髓穿刺检查,诊断为粒细胞缺乏症。第17天患者出现右肺气胸、肺不张。第20天出现急性呼吸衰竭、多脏器衰竭合并重症感染,经抢救无效死亡。     

颅脑损伤患者并发肺部感染的护理体会

目的：为了使并发肺部感染的病人更多、更好、更早的痊愈。方法：通过对32例颅脑外伤并发肺部感染病人的严密观察,采取更换体位、超声雾化、有效排痰训练等有效的护理措施干预,从而控制了肺部感染。结果：痊愈17例,占53.1%;显效12例,占37.5%,无效2例,占6.2%;死亡1例,占3.1%;实践证明,有效的护理干预对提高患者治疗成功率有着重要意义。     

Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Genomic profiling associated with recurrence in patients with rectal cancer treated with chemoradiation

PURPOSE: Stage II and III adenocarcinoma of the rectum has an overall 5-year survival rate of approximately 50%, and tumor recurrence remains a major problem despite an improvement in local control through chemotherapy and radiation. The efficacy of chemoradiation therapy may be significantly compromised as a result of interindividual variations in clinical response and host toxicity. Therefore, it is imperative to identify those patients who will benefit from chemoradiation therapy and those who will develop recurrent disease. In this study, we tested whether a specific pattern of 21 polymorphisms in 18 genes involved in the critical pathways of cancer progression (i.e., drug metabolism, tumor microenvironment, cell cycle regulation, and DNA repair) will predict the risk of tumor recurrence in rectal cancer patients treated with chemoradiation. PATIENTS AND METHODS: A total of 90 patients with Stage II or III rectal cancer treated with chemoradiation were genotyped using polymerase chain reaction (PCR)-based techniques for 21 polymorphisms. RESULTS: A polymorphism in interleukin (IL)-8 was individually associated with risk of recurrence. Classification and regression tree analysis of all polymorphisms and clinical variables developed a risk tree including the following variables: node status, IL-8, intracellular adhesion molecule-1, transforming growth factor-beta, and fibroblast growth factor receptor 4. CONCLUSION: Genomic profiling may help to identify patients who are at high risk for developing tumor recurrence, and those who are more likely to benefit from chemoradiation therapy. A larger prospective study is needed to validate these preliminary data using germline polymorphisms on tumor recurrences in rectal cancer patients treated with chemoradiation.     

甘草酸单铵结合氦-氖激光治疗银屑病62例

目的用甘草酸单铵结合低能量氦-氖激光,观察治疗银屑病患者。方法62例寻常型银屑病患者,分为两组,A组用低能量氦-氖激光血管内照射,同时用甘草酸单铵静脉滴注,共36例;B组仅用甘草酸单铵,共26例。通过30d治疗。结果总有效率82.2%,其中A组有效率88.9%,B组73.1%(经Ridit检验,U＝2.76,P＜0.01),两组差异有极显著性意义。结论甘草酸单铵结合氦-氖激光治疗银屑病,比单用甘草酸单铵效果好。     

A fetus with meckel-gruber syndrome associated with isomerism

Abstract. Meckel-Gruber syndrome (MKS) is an autosomal recessive lethal malformation. As far as we know, the rate of incidence for the syndrome is 0.02 per 10,000 births. It is estimated that Meckel-Gruber syndrome accounts for 5% of all neural tube defects in Finland. Objective. The aim of this study is to present a case of a fetus with Meckel-Gruber syndrome associated with complete left isomerism. Method. The fetus was obtained after medical interruption of the pregnancy during the fifteenth gestational week. The mother was 36 years old and in a consanguineous marriage. The antenatal ultrasound examination revealed a polymalformative syndrome, leading to a postmortem examination. The fetopathological study of the fetus was conducted at the Centre for Maternity and Neonatology, Tunis, Tunisia, in 2008. Results. The female fetus had a significantly deformed ballooning abdomen, pes equinovarus, flexion of the wrist and a total posterior cleft palate. The central nervous system abnormalities were occipital encephalocele, cystic dilatation of the fourth ventricle, agenesis of corpus callosum and hydrocephalus. The study of the internal organs found dextrocardia, irregular lobulation of the lungs, left isomerism, and polysplenia. The microscopic examination revealed bilateral cystic dilation of the kidneys, fibrous proliferation of the liver and ectasic dilatation of the billiary ducts, representing a ductal plate malformation of the liver. Conclusion. The case is diagnosed with Meckel-Gruber syndrome associated with complete left isomerism, cleft palate and possibly Dandy-Walker syndrome.