腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效分析

目的 探讨腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效及对内分泌的影响.方法 选择2011年1月至2015年12月剖宫产瘢痕妊娠患者57例,其中A组32例患者给予超声引导下清宫术治疗,B组25例患者给予腹腔镜下子宫双侧动脉阻断术联合清宫术治疗,比较两组患者出血量、住院时间、月经复潮时间、术后人绒毛膜促性腺激素(hCG)降至正常时间,并发症情况及术前(T0)、术后第1d(T1)、第3d(T2)神经内分泌激素水平.结果 ①B组患者出血量低于A组,住院时间、月经复潮时间短于A组,比较差异有统计学意义(t出血量=31.85,k院时间=9.36,t月经复t潮时间=16.37,均P＜0.05);②B组患者并发症发生率为8.00％,低于A组的15.63％,比较差异有统计学意义(x2=9.35,P＜0.05);③B组T1、T2血清COR、β-EP、GLU水平低于A组(CORF交互=17.67,β-EPF交互=132.36,6LUF交互=155.38,均P＜0.05).结论 腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠微创优势明显,安全性高,对内分泌影响较轻.     

超声在疤痕妊娠诊断与治疗中的价值

目的 探讨超声在剖宫产疤痕妊娠（cesarean scar pregnancy,CSP）诊断与治疗中的价值。方法 回顾性分析35例CSP声像图特征;在超声引导下,对32例确诊的疤痕处妊娠囊进行抽吸并局部注射甲氨蝶呤（methotrexate,MTX）,观察妊娠囊治疗前后的声像图变化。结果 CSP具有较典型的声像图特征,超声诊断符合率为91.4%（32/35）,1例误诊为宫颈妊娠,2例误诊为自然流产;超声引导下32例疤痕处妊娠囊局部注射MTX均顺利成功;妊娠囊治疗前后有较明显的变化;所有病例保守治疗以后痊愈出院。结论 超声在CSP的诊断和治疗中有重要的价值。     

Uterine Arteriovenous Malformation:Inducedby A Cesarean Scar Pregnancy

Cesarean scar pregnancy (CSP) occurs when a gestation sac is implanted in the previous lower segment cesarean scar. The incidence of CSP is increasing worldwide. Uterine ateriovenous malformation (UAVM) is a rare gynecologic disease. Both of these diseases can cause severe vaginal bleeding and produce high morbidity rate. We describe a case of UAVM induced by a CSP. The patient suffered intermittent vaginal bleeding after two dilatation and curettage (D&C) one month before admission. The suspected diagnosis of CSP and UAVM were made after using transvaginal ultrasound with color Doppler and human chorionic gonadotropin (hCG) examination. Resection of the involved area including the cesarean scar and UAVM by laparotomy was performed successfully and the diagnosis was confirmed by the last pathologic result.     

Width and depth of resection for small colorectal polyps: hot versus cold snare polypectomy

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Monoliths with chiral surface functionalization for enantioselective capillary electrochromatography

The state-of-the-art in CEC enantiomer separations with monolithic capillary columns is comprehensively reviewed. The various types of monolithic columns comprising in situ organic polymer monoliths, molecularly imprinted polymer (MIP) monoliths, silica monoliths and monoliths made from particles are discussed with a focus on materials’ synthesis, chemistry and properties as well as column aspects. Monolithic MIP-type porous layer open-tubular (PLOT) columns are treated herein as well. From this survey of the literature, the authors come to the conclusion that monolithic silica capillaries appear to become the preferred column type for CEC enantiomer separations of low-molecular drugs and other chiral pharmaceuticals or chemicals.     

Using constraint satisfaction for designing mechanical systems

In this paper, we are studying the application of techniques to solve constraint satisfaction problems (CSP) for designing mechanical systems. After situating CSPs within the array of search and combinatorial optimisation techniques, we propose to model the design space in the form of a state graph and demonstrate the suitability of the constraint approach to solve the model. The implementation of a CSP is illustrated by an example of the dimensioning of a cluster of gear wheels in the mechanical engineering industry. Finally, we draw attention to the complementarity of CSPs with other search and solution optimisation techniques and suggest a few integration possibilities.     

子宫切口瘢痕部位妊娠10例诊治分析

目的 总结子宫切口瘢痕部位妊娠(CSP)的诊治体会.方法 将近15年内遇到的10例临床资料作回顾性分析.结果 7例经药物联合治疗与清宫术后好转,1例在腹腔镜下与另2例在开腹下清除瘢痕病灶加修补子宫治愈.无子宫切除病例,住院平均14.5d,10例安全出院.结论 发病因素与子宫手术有关,超声诊断起重要作用,治疗原则根据年龄、孕期、病情、产妇体质等,尽力做到了三保,即保命、保子宫、保生育功能.本组因早孕较多,完全做到三保,结果医患满意.     

Morphological and functional effects of altered cysteine string protein at the Drosophila larval neuromuscular junction

The synaptic vesicle-associated cysteine string protein (CSP) is critical for neurotransmitter release at the neuromuscular junction (NMJ) of Drosophila, where the approximately 4% of mutant flies lacking CSP that survive to adulthood exhibit spastic jumping and shaking, temperature-sensitive paralysis, and premature death. Previously, it has been shown that CSP is also required for nerve terminal growth and the prevention of neurodegeneration in Drosophila and mice. At larval csp null mutant NMJs of Drosophila, intracellular recordings from the muscle showed that evoked release is significantly reduced at room temperature. However, it remained unclear whether the reduction in evoked release might be due to a loss of synaptic boutons, loss of synapses, and alterations in trafficking of vesicles to synapses. To resolve these issues, we have examined synaptic structure and function of csp null mutant NMJs at the level of single boutons. csp null mutations proportionally reduce the number of synaptic boutons of both motor neurons (1s and 1b) innervating larval muscles 6 and 7, while the number of synapses per bouton remains normal. However, focal recordings from individual synaptic boutons show that nerve-evoked neurotransmitter release is also impaired in both 1s and 1b boutons. Further, our ultrastructural analyses show that the reduction in evoked release at low stimulation frequencies is not due to a loss of synapses or to alterations in docked vesicles at synapses. Together, these data suggest that CSP promotes synaptic growth and evoked neurotransmitter release by mechanistically independent signaling pathways.     

No difference in the prevalence of cavum septum pellucidum (CSP) between first-episode schizophrenia patients, offspring of schizophrenia patients and healthy controls

The reported prevalence of cavum septum pellucidum (CSP), is extremely variable (from 0.1% to 85%) depending upon the measurement method or imaging resolution. Higher prevalence of CSP has been found in schizophrenia. In this study, we examined the prevalence of CSP in a large number of first-episode schizophrenia patients, young relatives of schizophrenia patients and healthy controls. We manually measured CSP using 1.5 mm T1 MRI scans from ongoing studies at University of Pittsburgh in 89 first-episode patients with schizophrenia (age=23.8+/-7.4, M/F=61/28), 64 genetically at-risk individuals (offspring and siblings of schizophrenia patients, age 15.2+/-3.7, M/F=29/32) and 120 comparison subjects (n=120, age=22.1+/-7.9, M/F62/50). CSP was present in 64% of the first-episode patients (mean length 1.87+/-2.3 mm), 64.6% of the at-risk individuals (1.64+/-1.96 mm) and 64.2% of the normal controls (1.88+/-2.0 mm). There was no difference in the prevalence of CSP exceeding 4 mm. We also did not find any influence of the sex or age in the presence or size of CSP. Our data cast doubt on the significance of CSP as markers of neurodevelopmental pathology in schizophrenia.     

磷硅酸钠钙对乳牙釉质再矿化作用的研究

目的：研究生物活性材料磷硅酸钠钙（CSP）对人工脱矿的乳牙釉质表面再矿化的作用。方法：收集30颗健康离体乳磨牙,将每颗牙冠沿近远中径和颊舌径分成4个釉质块,每个釉质块随机分为4组（n ＝30）。样本经35％磷酸酸蚀2 min后分别进行如下处理：空白对照（A 组）、0．14％氟化物处理（B 组）、CSP 处理（C 组）、氟化物＋CSP 处理（D 组）,每天循环处理2次。在10、30 d 时扫描电镜观察釉质表面形态并测定釉质表面显微硬度值（SMH）。结果：扫描电镜观察显示,10 d 时A 组表面呈脱矿的蜂窝状表现,B、C 组脱矿不明显,D 组可见明显的矿化物沉积。30 d 时 A 组可见明显釉质脱矿和釉柱溶解表现,B、C 和 D 组可见程度不等的再矿化。10 d 时 D 组的 SMH 值高于 A 组（P ＜0．05）,30 d 时 B、C、D 组 SMH 值均高于 A组（P ＜0．05）,D 组 SMH 值显著高于 B 和 C 组（P ＜0．05）。结论：CSP 和氟化物具有促进乳牙釉质再矿化的作用,CSP 和氟化物联合应用优于二者的单独应用。