产程中阴道检查代替肛门检查的临床观察

目的 探讨在产程的观察过程中使用碘伏消毒行阴道检查替代肛门检查的临产观察.方法 在产程观察过程中使用使用-山东利尔康碘伏消毒液,其有效碘含量在4.5~5.5/15%的碘伏消毒会阴部行阴道检查(以下用5%的碘伏或碘伏表示).结果 310例产妇无一人感染,可靠率100%.结论 在产程观察过程中,使用5%的碘伏消毒会阴部行阴道检查替代肛门检查在临产上是可以使用的.     

中药膏剂对钳刮术患者术后阴道流血的作用

目的 观察中药膏剂贴敷于相关穴位对行人工流产钳刮术患者术后阴道流血的改善情况。方法 将来我院妇科行人工流产钳刮术的患者分为对照组87例和观察组82例，对照组患者按照常规人工流产钳刮术后护理方式护理；观察组同时采用中药（包括当归、川芎、三七、炮姜）制作的膏药贴敷于相关穴位（包括神阙、气海、中极穴位），观察两组患者术后不同时间阴道流血量和流血持续时间。结果 与对照组相比，观察组患者术后1h、2h及6h阴道流血量和术后阴道流血持续时间均减少（P〈0．05）。结论 采用此中药膏剂贴敷于相关穴位能减少人工流产钳刮术患者术后出血量和出血时间，促进患者术后康复。     

Multivariate normal tissue complication probability modeling of vaginal late toxicity after brachytherapy for cervical cancer

PurposeTo explore the best variables combination for a predictive model of vaginal toxicity in cervical cancer patients undergoing brachytherapy (BT).Methods and MaterialsClinical and 3-dimensional dosimetric parameters were retrospectively extracted from an institutional database of consecutive patients undergoing intracavitary BT after external beam radiation therapy from 2006 to 2013 for a cervical cancer. A least absolute shrinkage and selection operator selection procedure in Cox's proportional hazards regression model was performed to select a set of relevant predictors for a multivariate normal tissue complication probability model of Grade ≥2 vaginal late toxicity. Outcomes reliability was internally assessed by bootstrap resampling method.ResultsOne hundred sixty-nine women were included in the present study with a median followup time of 3.8 years (interquartile range [IQR], 1.9–5.6 years). The 2 years and 5 years cumulative incidence rates of Grade ≥2 late vaginal toxicity were 19.9% and 27.5%, respectively. Among 31 metrics and six clinical factors extracted, the optimal model included two dosimetric variables: V70_Gy and D5_% (the percentage volume that received a dose greater or equal to 70 Gy and the minimum dose given to the hottest 5% volume, respectively). Area under the ROC curve at 2 and 5 years of followup were 0.85 and 0.91, respectively. Regarding internal validation, median area under the ROC curve of bootstrap predictions was 0.83 (IQR, 0.78–0.88) and 0.89 (IQR, 0.85–0.93) at 2 and 5 years of followup, respectively.ConclusionsA multivariate normal tissue complication probability model for severe vaginal toxicity based on two dosimetric variables (V70_Gy and D5_%) provides reliable discrimination capability in a cohort of cervical cancer treated with external beam radiation therapy and BT.     

Multiplex quantitative polymerase chain reaction assay for the identification and quantitation of major vaginal lactobacilli

Lactobacilli play a key role in promoting vaginal health. Depletion of these bacteria is associated with bacterial vaginosis (BV), the most common vaginal disorder. Here we describe the development and laboratory validation of a novel single-tube multiplex TaqMan quantitative polymerase chain reaction (qPCR) assay for the identification and quantitative assessment of the four major vaginal Lactobacillus species: L. crispatus, L. jensenii, L. gasseri, and L. iners. The assay utility was evaluated by the analysis of lactobacilli in non-cultured clinical vaginal swab specimens collected from BV patients and healthy individuals. As confirmed by the assay, L. crispatus, L. jensenii, and to a lesser extent L. gasseri, are common in the vagina of healthy women, whereas L. iners dominance is associated with BV. The major assay limitation was preferential detection of dominant Lactobacillus species in samples with mixed lactobacilli resulting in lower sensitivity for minor species. The multiplex qPCR assay described here is an advance in the detection and quantitation of the major vaginal lactobacilli, potentially facilitating the molecular diagnosis of BV and post-therapy restoration of the vaginal microflora.     

宫颈高危型HPV持续感染与细菌性阴道病和阴道微生态相关性研究

目的探究宫颈高危型HPV持续感染与细菌性阴道病和阴道微生态的相关性。方法在2018年4月-2019年4月于该院妇科进行体检的318例女性中,根据宫颈液基细胞学检测、高危HPV检测及阴道微生态的结果,将纳入研究的女性分为HPV阳性组与HPV阴性组,对HPV阳性组患者持续回访并分析HPV持续感染与阴道微生态的相关性。结果HPV阳性组患者的细菌性阴道病与不同类型阴道炎例数显著高于HPV阴性组(P<0.05);阴道微生态四项指标中,两组患者pH值差异无统计学意义(P>0.05),HPV阳性组患者白细胞酯酶、唾液酸苷酶、H2O2三项指标的阳性例数与四项指标全部阳性均显著高于HPV阴性组(P<0.05),HPV阴性组阴道微生态正常例数显著高于HPV阳性组(P<0.05);HPV阴性组无病变与不典型鳞状细胞例数显著高于HPV阳性组(P<0.05),两组患者低度鳞状上皮内病变例数比较,差异无统计学意义(P>0.05),HPV阳性组高度鳞状上皮内病变与鳞状细胞癌例数显著高于HPV阴性组(P<0.05)。结论阴道微生态指标的异常变化与高危型HPV持续感染呈现相关性,控制微生态的动态平衡,是预防女性生殖道疾病的关键。