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目的 观察定坤丹治疗子宫内膜薄型不孕的临床效果,为优化子宫内膜薄型不孕的治疗方案提供参考。方法 选取187例子宫内膜薄型不孕患者,在保证组间基本特征匹配原则上,利用计算机软件产生的随机数,按照1∶1的比例分为对照组(93例)和观察组(94例)。对照组给予雌二醇+地屈孕酮干预,观察组在对照组的基础上加用定坤丹。比较治疗3个周期后两组患者的子宫内膜厚度、孕激素浓度及临床妊娠率。结果 观察组患者排卵期平均子宫内膜厚度显著高于对照组(P<0.01),黄体期孕激素浓度显著高于对照组(P<0.01),累计临床妊娠率显著高于对照组(P<0.05)。结论 定坤丹可以明显改善子宫内膜薄型不孕患者排卵期子宫内膜厚度,提高黄体功能,改善妊娠结局。  相似文献   
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Ultrasound is a key non-invasive imaging modality in gynaecology, and its widespread use and availability in past three decades has drastically changed clinical practice. This article provides an overview of the contribution of ultrasound examination to the evaluation of gynaecological conditions by summarizing the basic physics of ultrasound, and ultrasound features.  相似文献   
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Sampling of the endometrium, via biopsy or dilation and curettage, is an important diagnostic tool in a wide variety of clinical scenarios, ranging from infertility and abnormal uterine bleeding to cancer surveillance in high-risk populations. This review describes the most common methods for endometrial sampling used currently and discusses the issue of specimen adequacy from an evidence-based perspective. It also focuses on select benign conditions involving the endometrium in the setting of abnormal uterine bleeding, ranging from anatomic/structural lesions to patterns indicative of a dysfunctional menstrual cycle. The topic of endometrial sampling evaluation in the context of recurrent pregnancy loss is also discussed, with insights on documentation of endometrial changes during the ovulatory phase and the diagnosis of endometritis.  相似文献   
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The current management of all gynaecological malignancy requires complex multidisciplinary investigation and discussion, leading to multi-modality treatment. The delivery of systemic therapy or radiotherapy can have different aims depending on the type of cancer, clinical context and patient wishes. This review explores the systemic treatment options and radiotherapy that form part of the standard management of this group of tumours and looks at current research that may help shape the treatment of the future.  相似文献   
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ABSTRACT

Introduction: Steroid hormones are responsible for specific changes in the endometrium during the menstrual cycle, when they are sequentially secreted and, because of this, in the early days sequential combined oral contraceptive regimens were utilized. The same basic concept has been utilized with multi-phasic regimens, in order to produce endometrial pictures mimicking the normal cycle.

Areas covered: The Endometrial effects of progestins and estrogens; combined monophasic high- (50 μg), medium- (30 μg), low- (20 μg), ultralow- (15 μg) estrogen content; sequential regimens; multiphasic combinations; treatment schedules.

Cervical effects of combined high-dose and sequential combinations, including evidence for an increase in malignant lesions.

Expert opinion: Overall, combined oral contraceptives (COCs) inhibit normal proliferative changes and the endometrium becomes thin, narrow, with widely spaced glands and pre-decidual changes in the stroma. During the first few cycles the progestin induces a coexistence of proliferative and secretory features; with time, the picture changes because the progestin induces a down-regulation of estrogen receptors, resulting in tortuous glands similar to those in the secretory phase, but characterized by a quiescent, atrophic glandular epithelium.

In the cervical epithelium, under the influence of high-dose COCs, endocervical glands became hypersecretory and in some instances, distinctive type of atypical polypoid endocervical hyperplasia is found.  相似文献   
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《Genes & development》2015,29(16):1707-1720
Inactivation of phosphatase and tensin homology deleted on chromosome 10 (PTEN) is linked to increased PI3K–AKT signaling, enhanced organismal growth, and cancer development. Here we generated and analyzed Pten knock-in mice harboring a C2 domain missense mutation at phenylalanine 341 (PtenFV), found in human cancer. Despite having reduced levels of PTEN protein, homozygous PtenFV/FV embryos have intact AKT signaling, develop normally, and are carried to term. Heterozygous PtenFV/+ mice develop carcinoma in the thymus, stomach, adrenal medulla, and mammary gland but not in other organs typically sensitive to Pten deficiency, including the thyroid, prostate, and uterus. Progression to carcinoma in sensitive organs ensues in the absence of overt AKT activation. Carcinoma in the uterus, a cancer-resistant organ, requires a second clonal event associated with the spontaneous activation of AKT and downstream signaling. In summary, this PTEN noncatalytic missense mutation exposes a core tumor suppressor function distinct from inhibition of canonical AKT signaling that predisposes to organ-selective cancer development in vivo.  相似文献   
10.
目的:探讨养精种玉汤治疗反复移植失败肾阴虚证的临床效果,探讨其机制。方法:选择山东中医药大学附属医院中西医结合生殖与遗传中心行体外受精-胚胎移植(IVF-ET)的反复种植失败(RIF)肾阴虚证患者70例,随机分为观察组、对照组,各35例。所有患者均行常规长方案进行超促排卵,观察组于移植前1个月的月经周期第5~14天服用养精种玉汤,并于移植当月月经周期第5天继续服用至移植日,对照组不服用中药。观察两组治疗后的中医证候积分;两组人体绒膜促性腺激素(HCG)日子宫内膜厚度、分型、子宫动脉搏动指数(PI)和阻力指数(RI);子宫内膜分泌物白血病抑制因子(LIF),血管内皮生长因子(VEGF),白细胞介素-1β(IL-1β)和单核细胞趋化蛋白-1(MCP-1);获卵数、受精率及胚胎移植结果。结果:治疗后,观察组中医证候积分较单纯西药组明显改善(P 0. 05);治疗后两组子宫内膜厚度差异无统计学意义,A型内膜占比观察组明显高于对照组(P 0. 05); PI两组间差异无统计学意义; RI观察组明显低于对照组(P 0. 05);移植日观察组VEGF,IL-1β及LIF水平均高于对照组,MCP-1水平低于对照组(P 0. 05);两组获卵数、受精率比较差异无统计学意义;观察组临床妊娠率明显高于对照组(P 0. 05)。结论:养精种玉汤可显著缓解RIF肾阴虚证患者的临床症状,有效提高了RIF患者A型子宫内膜形态,降低子宫动脉血流阻力,优化子宫内膜种植条件,显著提高临床妊娠率。  相似文献   
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