经阴道超声联合子宫内膜活检对绝经后子宫出血的诊断

目的:探讨经阴道超声(TVS)联合子宫内膜活检病理对绝经期子宫出血(PMB)的诊断.方法:回顾性分析2011-01 ～2012-12经TVS观察PMB子宫内膜的变化并且进行子宫内膜活检的131例患者的临床资料.结果:阴道超声PMB的131例患者内膜厚度在4.0mm-23mm之间,然后进行子宫内膜活检,5例未能获得子宫样本或所获组织不足病理诊断3.8％,71例子宫内膜单纯性增生54.2％,9例子宫内膜复杂性增生6.9％,1例子宫内膜不典型增生0.8％,2例子宫内膜癌1.5％,24例子宫内膜息肉18.3％,9例子宫内膜炎6.9％,2例粘膜下子宫肌瘤1.5％,8例正常子宫内膜6.1％.结论:TVS监测可作为子宫内膜病变的初筛方法,PMB应及早做子宫内膜活检病理检查以进一步确诊,提高子宫内膜病变的检出率.     

宫腔细胞取材在筛查子宫内膜癌中的应用

目的：观察一次性宫腔组织吸引管用于不孕患者子宫内膜组织学检查在子宫膜癌中的应用价值。方法：宫腔组织吸引管对80例不孕患者于月经周期25～28d取子宫内膜细胞检验支原体病理检查（吸引管组）。80例不孕患者于月经周期25～28d常规诊刮子宫内膜检验支原体病理检查（诊刮组）。结果：吸引管组子宫内膜阳性率60例占75%,MH5例占6%,病理报告40例,显示子宫内膜组织炎症改变30例,正常子宫内膜8例,子宫内膜腺体发育欠缺,2例未见子宫内膜;诊刮组子宫内膜感染支原体55例,占68.7%,MH4例占5%,病理检查子宫内膜感染41例51%,正常子宫内膜31例,子宫内膜腺体发育欠缺7例,3例未见子宫内膜。结论：在不孕症子宫内膜取材中,宫腔组织吸引管具有无疼痛出血少的优点,比常规金属刮更有利,值得临床推广。     

子宫内膜腺癌中MMP-2、MMP-9的表达及意义

目的探讨MMP-2、MMP-9与子宫内膜腺癌的关系。方法应用免疫组织化学法检测MMP-2、MMP-9在不同子宫内膜中的表达情况。结果MMP-2、MMP-9在子宫内膜腺癌中的阳性表达率明显高于正常子宫内膜和子宫内膜单纯性增生组织,并与子宫内膜腺癌组织学分级、浸润深度和淋巴结转移有关。结论MMP-2、MMP-9在子宫内膜腺癌中的表达呈正相关,可作为检测子宫内膜腺癌恶性程度的指标。     

子宫内膜间质肉瘤的影像表现

目的:总结分析子宫内膜间质肉瘤的影像表现.方法:回顾性分析20例经手术及病理证实的子宫内膜间质肉瘤患者的临床及影像资料,并与病理结果对照分析.结果:20例子宫内膜间质肉瘤均经病理证实,其中低级别子宫内膜间质肉瘤11例,低级别子宫内膜间质肉瘤局部伴性索间质样分化1例,高级别子宫内膜间质肉瘤6例,低级别混合性子宫内膜间质-...     

胚胎移植周期中子宫内膜搔刮术的应用价值

目的探讨子宫内膜搔刮术对胚胎移植周期中临床妊娠率的影响。方法回顾性分析行体外受精助孕胚胎移植1 879例患者,促排卵前均行超声检查。根据子宫内膜回声及子宫内膜厚度分为子宫内膜正常组及子宫内膜异常组两组。对子宫内膜异常者行子宫搔刮术,比较子宫内膜正常组与异常组及子宫内膜搔刮组与未搔刮组两组患者的临床妊娠率。结果子宫内膜正常组患者的年龄明显较子宫内膜异常组轻(30.56与32.77,P<0.01),临床妊娠率也较异常组明显增高(49.26%与41.87%,P<0.05)。对子宫内膜异常者行搔刮术后,搔刮组与未搔刮组两组之间年龄仍有显著性差异(33.11与31.41,P<0.01),但妊娠率无明显差异(53.72%与50.06%,P>0.05)。结论 (1)随着女性年龄的增大,子宫内膜回声异常机会增多;(2)子宫内膜异常者行搔刮术后可提高胚胎移植周期的临床妊娠率。     

子宫内膜活检对子宫异常出血的诊断价值

目的　探讨子宫内膜活检对子宫异常出血的临床价值。方法　对 392例临床诊断功能性子宫出血可能的异常子宫出血病人 ,通过诊断性刮宫 ,子宫内膜活检进行分析。结果　其中 15 8例子宫内膜有功能性的改变 ;16 2例与正常月经周期各期内膜相似 ;其余 72例子宫内膜有器质性病变。结论　诊断性刮宫 ,子宫内膜活检 ,可准确判断不同期的子宫内膜改变 ,为临床诊断和治疗提供重要的依据     

经阴道超声及宫腔镜对子宫内膜病变的诊断价值

目的：探讨经阴道超声表现与宫腔镜检查对子宫内膜病变的诊断价值。材料和方法：对86例临床疑为子宫内膜病变的患者行阴道超声及宫腔镜检查,并行摘除、活检或刮宫,与病理结果对照分析。结果：病理诊断子宫内膜息肉39例,子宫黏膜下肌瘤9例,子宫内膜增生过长14例,子宫黏膜下肌瘤伴息肉4例,子宫内膜癌4例,正常子宫内膜16例,宫腔镜检查与阴道超声检查对各类子宫内膜病变的诊断准确性相当,两者无统计学差异（P〉0.05）。结论：阴道超声是筛选子宫内膜病变的简便、经济而有效的方法,宫腔镜下活检是可靠的诊断方法,联合检查是目前诊断子宫内膜病变的理想方法。     

超声观察绝经后子宫内膜的临床意义

目的：探讨超声观察绝经后子宫内膜的临床意义。材料与方法：超声观察自１９９０年１月以来就诊的７８例绝经后妇女子宫内膜的声像图特征，与诊刮病理结果对照。，子宫内膜声像图分为四型，分析其与病理结果的关系。结果：超声图像为Ⅰ、Ⅱ型的（内膜厚度＜５ｍｍ）５５例，病理全部证实为萎缩的子宫内膜，超声图像为Ⅲ、Ⅳ型的（内膜厚度＞５ｍｍ）２３例，２例为萎缩的子宫内膜，１０例为子宫内膜息肉，５例为子宫内膜增生，６例为子宫内膜腺癌。结论：声像图呈Ⅰ、Ⅱ型提示绝经后萎缩的子宫内膜，Ⅲ、Ⅳ型反映子宫内膜的肥厚状态     

宫腔镜检查诊断子宫异常出血1245例临床分析

目的探讨宫腔镜技术诊治子宫异常出血的效果和安全性。方法选取2008年6月—2014年2月我院收治的子宫异常出血患者1 245例,按绝经及婚育史分为:绝经组476例,育龄有妊娠史组537例,育龄未孕组232例。并分别进行宫腔镜检查和治疗。结果 (1)绝经组:检出子宫内膜息肉146例,子宫内膜癌23例,子宫内膜不典型增生15例,子宫内膜复杂增生39例,子宫内膜单纯增生98例,子宫肌瘤26例。宫腔镜阳性诊断率为72.9%。(2)育龄有妊娠史组:检出子宫内膜息肉128例,子宫内膜癌19例,子宫内膜不典型增生17例,子宫内膜复杂增生48例,子宫内膜单纯增生86例,子宫肌瘤36例,胚物残留5例,宫腔镜阳性诊断率为63.1%。(3)育龄未孕组:检出子宫内膜息肉101例,子宫内膜癌6例,子宫内膜不典型增生8例,子宫内膜复杂增生6例,子宫内膜结核8例,宫腔镜阳性诊断率为55.9%。结论宫腔镜检查技术的临床应用对于子宫异常出血患者的诊断及指导治疗有重要意义。     

腹部超声和宫腔镜检查绝经后子宫出血的诊断价值

目的超声和官腔镜联合检查诊断绝经后子宫出血的病因。材料与方法经腹部超声检查测量子宫内膜厚度,超声和宫腔镜联合检查观察子宫腔内病变并在超声监导下诊断性刮宫。结果75例患者中,子宫内膜厚度>5mm者55例,其中子宫内膜息肉、子宫粘膜下肌瘤、以及子宫内膜息肉合并粘膜下肌瘤43例,子宫内膜癌5例,萎缩子宫内膜7例。子宫内膜厚度<5mm者20例,其中子宫内膜息肉3例,息肉直径<5mm,宫颈息肉7例,刮宫后子宫内膜厚度>5mm者为萎缩的子宫内膜息肉或萎缩的子宫粘膜下肌瘤。结论超声检查可以作为绝经后子宫出血患者的首选检查方法,超声和官腔镜联合检查可进一步提高病因诊断。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

颈动脉斑块患者血液流变学指标变化探讨

颈动脉斑块形成是动脉硬化的明显特征,可作为观察全身动脉硬化病变的窗口。近年来,颈动脉斑块发病率越来越高,有关这方面的文献报道也较多。颈动脉位置表浅、运动较少,又是动脉粥样硬化的好发部位,故此处的粥样斑块比较容易检测。本研究随机抽取了2005年12月～2007年10月我院住院患者249例,分析其颈动脉病变的超声检查结果与血液流变学指标,探讨颈动脉硬化、斑块形成与血液黏度的相关性。     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,