妊娠糖尿病与血清胆红素之间关系的研究进展

妊娠糖尿病发生和发展与多种因素有关,目前其发病机制尚不确定。越来越多研究证实,氧化应激在其发挥了重要作用。而胆红素作为有效的脂溶性抗氧化剂,在妊娠糖尿病中发挥了保护作用。本文就胆红素在妊娠糖尿病发生发展中的作用进行综述。     

腹腔镜在子宫颈癌治疗中的应用--附37例分析

目的　探讨腹腔镜下广泛子宫切除和盆腹腔淋巴结切除治疗子宫颈癌的可行性及价值。　方法　采用腹腔镜下广泛子宫切除和盆腔及腹主动脉周围淋巴结切除治疗 37例子宫颈癌。其中有2 5例选择性腹主动脉周围内淋巴结切除。　结果　腹腔镜下手术时间平均 182min ,术中出血平均16 8ml,切除淋巴结数平均 16个 ,术后住院平均 10 2天。术中发生膀胱损伤 1例、静脉损伤 2例 ,均于镜下修补成功 ;1例损伤大肠中转开腹 ;2例出现尿潴留。　结论　腹腔镜下施行广泛子宫切除和盆腹腔淋巴结切除术安全可行 ,且手术创伤小 ,并发症少 ,术后恢复快。     

腹腔镜下宫颈肌瘤剔除术31例分析

目的:探讨腹腔镜剔除子宫肌瘤的手术效果及临床价值。方法:回顾性分析我院2002年1月至2006年1月完成的腹腔镜下宫颈肌瘤剔除术31例。结果:所有病例全部在腹腔镜下完成,手术过程顺利,无一例中转开腹,无手术并发症。手术时间最长180分钟,最短40分钟,平均105±20分钟。术中出血量最多350ml,最少30ml,平均150±18ml。结论:腹腔镜下宫颈肌瘤剔除是一种有效、安全的宫颈肌瘤剔除手术方式。     

腹腔镜下保留盆腔植物神经的解剖性广泛性子宫切除术37例临床分析

Objective To investigate feasibility of laparoscopic anatomical nerve sparing radical hysterectomy (LANSRH) used for locally advanced cervical cancer treatment and evaluate early recovery of bladder function postoperatively. Methods From October 2006 to September 2007, 37 cervical cancer patients with stage Ⅰb1 to Ⅱ a underwent LANSRH(LANSRH group) with pelvic lymphadenectomy matched 25 patients with cervical cancer treated by general laparoscopic radical hysterectomy (LRH,LRH group) with pelvic lymphadenectomy. The data of operating time, blood loss, numbers of lymph node, the length of resected vaginal and paracervix tissue were collected and compared. In the mean time, postoperative recovery of bladder function was evaluated. Results The laparoscopic anatomic nerve-sparing procedure was performed successfully and safely among all patients. (1) There was no remarkable difference in the following clinical parameters between LANSRH and LRH group: median operating time [(175±41) min vs. (178±30) min, P=0.72 ], blood loss [(233±104)ml vs. (218±77) ml, P=0.06], numbers of lymph nodes (13±4 vs. 15±6, P=0.16), resected length of paracervix tissue [(3.6±0.5)cm vs. (3.7±0.6) cm, P=0.43], resected length of vaginal tissue [(3.5±1.0)cm vs. (3.5±0.8) cm, P=0.80]. (2) The mean time of the Foley catheter removed was (10.6±2.7)days(7-17 days)in LANSRH group and (17.2±4.2)days(9-25 days)in LRH group (P=0.02). After Foley catheter removed, 95% (35/37) presented bladder fulfilling sense, 86% (32/37) presented automatic micturition and urination emptying in LANSRH group. However, In LRH group, 88% (22/25) presented bladder fulfilling sense, 76% (19/25) presented automatic micturition and urination emptying. The bladder void function recovery were 68% (25/37) in class 0 and 3% (1/37) in class Ⅱ in LANSRH group, when compared with 40% (10/25) in class 0 and 12% (3/25) in class Ⅱ in LRH group, it reached statistical difference (P<0.05). In the mean time, there was no significant difference in Class Ⅰ bladder void function recovery, which were 24% (9/37) and 48% (12/25). (3) No surgery complications and blood transfusion were observed in LANSRH and LRH group. Postoperative pathology suggested that no tumor cell invasion occurred in paracervix tissue and lymph nodes. During the range of 11 to 19 months follow-up, all patients were alive without tumor recurrence and metastasis. Conclusion LANSRH is safe and feasible surgical management for cervical cancer at early stage and would improve the recovery of bladder voiding function postoperatively by sparing anatomical nerve.     

腹腔镜巨大卵巢冠囊肿剥除1例

患者 ,女 ,2 3岁 ,因体检发现卵巢巨大囊肿 6ｄ入院。 6ｄ前体检时发现腹部巨大囊肿 ,无腹痛 ,无月经改变 ,行Ｂ超提示腹腔巨大囊肿。既往体健 ,月经规律 ,无痛经 ,ＬＭＰ2 0 0 1年 3月 6日。查体 :体温、血压正常 ,营养好 ,偏胖 ,心肺正常 ,腹部稍膨隆 ,可扪及一如孕 6 + 个月的囊性包块 ,活动 ,无压痛。妇查 :外阴阴道 :正常。宫颈 :肥大 ,中度糜烂。宫体 :前位 ,大小正常 ,活动 ,无压痛。附件 :盆腹腔扪及一如孕 6 + 个月包块 ,质软 ,活动 ,无压痛。行Ｂ超检查 :子宫大小形态正常 ,腹腔探及一巨大囊性回声 ,下界在盆腔 ,上界达肝下 ,透声…     

以小鼠精子/睾丸特异性抗原为基础的合成肽免疫避孕效应研究

目的：研制以精子/睾丸特异性抗原为基础的多价嵌合肽避孕疫苗。方法：选择小鼠精子/睾丸特异性抗原Sp17、Gy-ritestin作为对象，采用分子设计的方法与外源性牛核糖核酸酶非选择性T细胞表位组合合成新型嵌合肽-35肽，并对其免疫效应进行研究。结果：该嵌合肽可刺激小鼠产生较高效价的血清和阴道粘膜特异性抗体，诱导脾脏淋巴细胞增殖，促进细胞因子IL-4的分泌；将其与佛氏佐剂混悬，免疫雌性BALB/c小鼠可明显降低受孕率和每胎产仔率，其抗血清可显著抑制体外精-卵结合和融合。结论：新型嵌合肽具有较明确的抗生育作用，提示以分子设计、蛋白质优化方案进行多价避孕疫苗的研究是可行的。     

糖平煎治疗实验性糖尿病的机理研究

目的 :观察糖平煎的降糖机理。方法 :一次性腹腔注射STZ复制大鼠糖尿病模型 ,糖平煎治疗 15d。结果 :糖平煎大、小剂量组和模型组比较FBG下降 (P <0 0 1) ,MDA降低 (P <0 0 5 ) ,血清Ins水平、SOD水平升高 (P <0 0 5 ) ,免疫组化染色显示糖平煎组胰岛B细胞Ins分泌颗粒丰富。结论 :糖平煎可以改善B细胞功能并促进Ins分泌 ,可以抗自由基损伤 ,具有良好的降血糖作用     

单孔腹腔镜技术在妇科恶性肿瘤中的应用

<正>随着腹腔镜技术的进步与普及,妇科肿瘤腹腔镜微创手术治疗取得了较大发展。与开腹手术相比,腹腔镜手术可降低术后并发症率,减轻术后疼痛,缩短住院时间,促进快速康复。近年来,为满足美容与微创的需求,经脐单孔腹腔镜技术(laparoendoscopic single-site surgery,LESS)又应运而生。脐是胚胎时期遗留的天然瘢痕,且为腹壁最薄处,故经脐腹腔镜手术可通过脐部皮肤褶皱遮蔽术后瘢痕,达到近似"无瘢痕"的美容效果。LESS在妇     

围着床期子宫内膜表面形态超微结构的观察

子宫内膜接受性已成为体外受精 胚胎移植 (ＩＶＦ ＥＴ)技术的限速步骤。研究表明 ,人的子宫内膜也存在“着床窗” ,如在着床窗内移植胚胎 ,则可提高胚胎着床率。我们通过对有生育力妇女围着床期子宫内膜表面形态行超微结构观察 ,探讨子宫内膜着床窗的形态标记。一、资料与方法1.研究对象 :选择 1998年 10月至 1999年 12月在我院因子宫浆膜下肌瘤、单纯卵巢囊肿而行手术的患者 5例 ,年龄 2 5～ 4 2岁 ,月经周期规则 ,术前 3个月内未服任何激素类药物 ,于月经周期第 19～ 2 4天刮取少量子宫内膜 ,制成电镜标本 ,部份内膜作石蜡切片 ,ＨＥ染色…     

腹腔镜下保留盆腔植物神经的解剖性广泛性子宫切除术37例临床分析

Objective To investigate feasibility of laparoscopic anatomical nerve sparing radical hysterectomy (LANSRH) used for locally advanced cervical cancer treatment and evaluate early recovery of bladder function postoperatively. Methods From October 2006 to September 2007, 37 cervical cancer patients with stage Ⅰb1 to Ⅱ a underwent LANSRH(LANSRH group) with pelvic lymphadenectomy matched 25 patients with cervical cancer treated by general laparoscopic radical hysterectomy (LRH,LRH group) with pelvic lymphadenectomy. The data of operating time, blood loss, numbers of lymph node, the length of resected vaginal and paracervix tissue were collected and compared. In the mean time, postoperative recovery of bladder function was evaluated. Results The laparoscopic anatomic nerve-sparing procedure was performed successfully and safely among all patients. (1) There was no remarkable difference in the following clinical parameters between LANSRH and LRH group: median operating time [(175±41) min vs. (178±30) min, P=0.72 ], blood loss [(233±104)ml vs. (218±77) ml, P=0.06], numbers of lymph nodes (13±4 vs. 15±6, P=0.16), resected length of paracervix tissue [(3.6±0.5)cm vs. (3.7±0.6) cm, P=0.43], resected length of vaginal tissue [(3.5±1.0)cm vs. (3.5±0.8) cm, P=0.80]. (2) The mean time of the Foley catheter removed was (10.6±2.7)days(7-17 days)in LANSRH group and (17.2±4.2)days(9-25 days)in LRH group (P=0.02). After Foley catheter removed, 95% (35/37) presented bladder fulfilling sense, 86% (32/37) presented automatic micturition and urination emptying in LANSRH group. However, In LRH group, 88% (22/25) presented bladder fulfilling sense, 76% (19/25) presented automatic micturition and urination emptying. The bladder void function recovery were 68% (25/37) in class 0 and 3% (1/37) in class Ⅱ in LANSRH group, when compared with 40% (10/25) in class 0 and 12% (3/25) in class Ⅱ in LRH group, it reached statistical difference (P<0.05). In the mean time, there was no significant difference in Class Ⅰ bladder void function recovery, which were 24% (9/37) and 48% (12/25). (3) No surgery complications and blood transfusion were observed in LANSRH and LRH group. Postoperative pathology suggested that no tumor cell invasion occurred in paracervix tissue and lymph nodes. During the range of 11 to 19 months follow-up, all patients were alive without tumor recurrence and metastasis. Conclusion LANSRH is safe and feasible surgical management for cervical cancer at early stage and would improve the recovery of bladder voiding function postoperatively by sparing anatomical nerve.