Reproductive Function in Epilepsy

Summary: : The hypothalamic-pituitary-gonadal axis is a complex system within which both positive and negative feedback occur among its elements and higher brain systems. The occurrence of seizures and changes in the secretion of pituitary hormones can affect the feedback loop. Both seizures and antiepileptic drugs can affect the hypothalamic-pituitary-gonadal axis of males and females and cause changes in hormones and sexuality. Reproductive dysfunction has a social impact because of reduced fertility. Once conception occurs, live birth rates are not diminished. Prospective studies of men and women with epilepsy are needed.     

INTRAUTERINE CANDIDA INFECTION IN PREMATURE BABY

An autopsy case of pulmonary candidiasis occurring in a neonatal girl was reported. The mycological examination of the lung taken at autopsy revealed only Candida albicans and followed by the elucidation under the microscopic sections prepared with special stains; periodic acid-Schiff and methenamine silver, in the lung, stomach, umbilical cord, and amnion. The presence of Candida vaginitis in her mother supported the concept that Candida albicans was the etiological agent of the pulmonary candidiasis.     

Nomenclature of the gonane progestins

The use of gonane nomenclature can be traced back to the early 1960s, when the first compound submitted for trial, the carbon-18 homologue of the anabolic agent Nilevar was named bisnortestosterone. However, the confusion about how this compound was named led scientists to introduce the gonane system for naming bisnortestosterones and structurally related compounds. Use of the terms gonane and estrane to classify the levonorgestrel and norethindrone families of progestins, respectively, originates from the systemic name of these compounds. Levonorgestrel is 17beta-hydroxy-17alpha-ethinyl-13beta-ethyl-4-gonen-3-one, while norethindrone is 17beta-hydroxy-17alpha-ethinyl-4-estren-3-one. The term gonane signifies that levonorgestrel and the related progestins are a separate class of steroids that differ from other steroids. Levonorgestrel and the related progestins form a structural category of 18-homologated 19-nortestosterones. Thus, it would be better to categorize levonorgestrel and the structurally related progestins such as desogestrel, norgestimate, gestodene as carbon-18-homologated 19-nortestosterones. Alternatively, it is simpler to refer to these compounds as the levonorgestrel family of progestins. In a similar manner, norethindrone and the related progestins can be referred to as the norethindrone (norethisterone) family of progestins.     

10年间剖宫产率及指征变化与围生儿死亡率的关系

目的：探讨剖宫产率及剖宫产指征变迁对围生儿死亡率的影响。方法：对10年间剖宫产病例资料进行回顾性分析。结果：1992－1996年剖宫产率为36．50％，显著低于1997－2001年的47．78％，两者比较，差异有极显著性（P＜0．01）。在剖宫产指征中，妊娠并发（合并）症始终处于第1位，社会因素上升为第2位，难产为第3位，胎儿窘迫为第4位。围生儿死亡率1992－1996年为17．88‰，1997-2001年为22．23‰，两者比较，差异无显著性（P＞0．05）。结论：剖宫产率升高在一定范围内降低了围生儿死亡率，但随着剖宫产率的进一步升高，围生儿死亡率并未随之下降。因此，应合理掌握剖宫产指征，降低剖宫产率。     

妊娠高血压综合征患者血清sICAM-1含量测定及其在妊高征发病中的作用

目的　探讨可溶性细胞间粘附分子 1(soluble intercellular adhesion molecule- 1,s ICAM- 1)在妊娠高血压综合征 (简称妊高征 )发病中的作用。　方法　应用酶联免疫吸附法 (EL ISA)测定 6 5例妊高征患者 (妊高征组 ,包括轻度 15例 ,中度 2 4例 ,重度 2 6例 )及 2 5例同期正常妊娠孕妇(对照组 )外周血清中 s ICAM- 1的含量 ;应用化学发光酶联免疫分析法测定两组孕妇血清中白细胞介素 1(interleukin- 1,L I- 1β)及肿瘤坏死因子 (tum or necrosing factor alpha,TNF- α)含量 ;并记录新生儿体重及妊娠结局。　结果　轻、中、重度妊高征组母血清中 s ICAM- 1的含量 [(36 8.5 6± 6 2 .81) μg/L、(6 0 6 .6 3± 10 5 .0 4 ) μg/ L、(85 9.36± 2 0 0 .92 ) μg/ L]均显著高于对照组 [(2 36 .6 9± 96 .33) μg/ L](P<0 .0 5 ,P<0 .0 1,P<0 .0 1) ,中、重度妊高征组母血清中 IL- 1β及 TNF- α的含量均显著高于对照组(P<0 .0 5 ,P<0 .0 1) ;中、重度妊高征组 s ICAM- 1的水平与相应 IL- 1β及 TNF- α的水平呈显著的正相关 (r=0 .6 97,P<0 .0 1;r=0 .74 6 ,P<0 .0 1)。重度妊高征组伴胎儿生长受限 (fetal growth restric-tion,FGR)者血中 s ICAM- 1含量显著高于同组其他孕妇之含量 (P<0 .0 5 )。妊高征组     

子宫切除术后盆腔包块30例分析

目 的探讨 因 良 性 疾病 行 子 宫 切除 术 后 盆 腔包 块 形 成 的原 因 、临床 特 征 及 治疗 。 方 法 收 集 并分 析３０例 子 宫 切 除术 后 盆 腔 包 块 的 两 次 手 术 前 后 情 况 、包 块 的 性 质 、二 次 手 术 前 后 情 况 、包 块 的 性 质 、二 次 手 术方 式、治疗 效果 及 随访 结果 。 结果 ３０例 患者 在子 宫 切除 时 均保 留了 一 侧或 两侧 附 件，５３％ 病 例包 块 以 体 检或 自查 方式 发现 ，４７％ 有 症 状；大 多 数病 程长 、包 块 大、活动 差、以囊 性为 主 、用 抗 生素 治 疗 或 中药 治 疗 无 效；Ｂ超４３％ 有分 隔，ＣＡ 在 正常 范 围。７０％ 病 例与 粘 连性 囊 肿有 关，原子 宫 切除 时有 粘 连者１１例 在 本次 手术 时 均有 粘连 ，３８％ 粘 １２５连 性囊 肿于 子 宫切 除术 后６个月 内 出现 包块 ，６２％ 术 后２年内 出现 包 块，卵巢 囊肿 均 为术 后１年以 上 发现 包块 。二 次手 术时 腹腔 镜 手术 比开 腹 手术 出血 量 少，但医 疗费 用 高，平 均 住院 日及 手 术时 间差 异 无显 著 性，总复 发率２６％ 。结论 粘 连性 包 块多 数术 后２年 内 发 现 ，卵 巢 囊肿 大 多１年 以 后 发 现；保 留附 件 是 再 次形 成 包 块 中 液体 的     

Prognostic value of serial CA125 measurements during chemotherapy for patients with advanced ovarian cancer

Serum CA125 concentrations measured before and during chemotherapy may provide additional information for prognostic assessment of patients with epithelial ovarian cancer (EOC), and enable discrimination between patients who are likely to benefit from further therapy and those who will not. Medical records of 40 patients with advanced EOC, treated at the Department of Obstetrics and Gynecology of the University Hospital Nijmegen between July 1984 and April 1993, were examined. All patients had primary cytoreductive surgery followed by platinum-based chemotherapy. Serum samples were obtained before surgery and during chemotherapy. Follow-up information and patient and tumor characteristics were abstracted from medical records until December 1, 1994. By using multivariate Cox proportional hazards models for disease-free and overall survival it was evaluated whether outcome prediction was improved by inclusion of serum CA125 quantitations.
  Only FIGO stage and extent of residual tumor were significant independent prognostic factors before the start of chemotherapy. When such regression models were constructed after subsequent courses of chemotherapy, serum CA125 measurements conducted after each of the first three chemotherapy courses improved the prediction of disease-free survival. Prediction of overall survival was improved by inclusion of serum CA125 measurements after courses 1–6. Inclusion of serum CA125 measurements during chemotherapy improved prognostic assessment of patients with advanced EOC.     

Diagnosis of ectopic pregnancy after in vitro fertilization and embryo transfer

Objective: The combination of transvaginal sonography and serum hCG measurement is reliable in the diagnosis of ectopic pregnancy (EP) in spontaneous pregnancies. In patients who became pregnant through IVF-ET, transfer of multiple embryos after IVF could be responsible for the different performance of these tests. We evaluated the discriminative capacity of transvaginal sonography in combination with hCG measurement in the diagnosis of EP after IVF-ET.

Design: Prospective cohort study.

Setting and Patient(s): Consecutive patients, pregnant through IVF-ET, who presented with clinically suspected EP.

Intervention(s): Transvaginal sonography, serum hCG measurement at 6, 9, and 15 days after ET and after a negative transvaginal sonography.

Main Outcome Measure(s): Ectopic pregnancy confirmed at laparoscopy.

Result(s): Between September 1993 and May 1996, 86 women were included in the study, of whom 24 had an EP. Transvaginal sonography identified 46 intrauterine pregnancies and 5 EPs, but serum hCG could not diagnose EPs in patients in whom transvaginal sonography did not show a gestational sac. Serum hCG measurement 9 days after ET could identify pregnancy failure with 100% specificity at a cut-off value of 18 IU/L, but it could not identify patients with EP with enough certainty to justify immediate treatment.

Conclusion(s): We recommend single serum hCG measurement 9 days after ET to discriminate between viable and nonviable pregnancies. Transvaginal sonography can be postponed until 5 weeks after ET, except for patients with abdominal pain and/or vaginal bleeding, or patients with a serum hCG level of <18 IU/L.     

黄秋葵多糖调控p73反义RNA 1T对宫颈癌细胞增殖和凋亡的影响

目的 探讨黄秋葵多糖调控p73反义RNA 1T(TP73-AS1)对宫颈癌细胞增殖和凋亡的影响,及其作用机制.方法 实验分为对照组(正常DMEM培养基),低、中、高剂量实验组(分别用含0.6,1.2,1.8 mg·mL-1黄秋葵多糖的DMEM培养基)、si-NC组(转染TP73-AS1阴性对照质粒)、si-TP73-A...