三维超声容积成像对多囊卵巢综合征的诊断价值

目的探讨三维超声容积成像对多囊卵巢综合征（PCOS）的诊断价值。方法检测60例PCOS患者和60例正常者的卵巢三维容积、二维面积、血流动力学指标。应用受试者工作特征曲线（ROC）比较以上指标的诊断价值。结果PCOS组的卵巢容积、间质容积、卵泡容积、卵巢面积、间质面积及间质面积与卵巢面积之比显著大于对照组；卵巢间质内动脉阻力指数显著低于对照组，收缩期峰值血流速度显著高于对照组；ROC曲线分析表明卵巢容积诊断PCOS的准确率最高。结论三维超声容积成像测量卵巢容积有重要的辅助诊断PCOS的价值，可以作为超声诊断PCOS的指标之一。     

腹腔镜卵巢电凝术治疗多囊卵巢综合征不孕46例分析

目的探讨腹腔镜卵巢电凝术治疗多囊卵巢综合征（PCOS）不孕的临床应用价值。方法我院收治多囊卵巢综合征不孕患者46例,行腹腔镜卵巢电凝术治疗,观察其术前、术后血液中激素变化情况及术后排卵和妊娠情况。结果腹腔镜卵巢电凝术治疗PCOS术后所有患者LH、LH／FSH和T水平与术前相比均显著性降低（P〈0．01）,术后排卵率82．6％,妊娠率为45．7％。结论腹腔镜下卵巢电凝术治疗PCOS具有创伤小、恢复快、疗效好的特点,尤其适合对克罗米芬（CC）抵抗的PCOS无排卵患者。     

多囊卵巢综合征致不孕患者的相关因素分析

目的 探讨多囊卵巢综合征（PCOS）致不孕患者的相关因素.方法 选择2008年1月至2012年12月因不孕症来我院就诊确诊为PCOS患者98例（PCOS组）,在同期因不孕症就诊、无PCOS表现且腹腔镜检查卵巢组织结构正常的患者中随机选取280例作为对照组,回顾性分析两组患者的一般资料、生育相关因素、腹腔镜探查情况.结果 PCOS组初潮年龄在13岁以下者51例（52.0％）,对照组113例（40.4％）,组间比较差异有统计学意义（x2=4.03,P＜0.05）;PCOS组月经不规律11例（11.2％）,对照组12例（4.3％）,组间比较差异有统计学意义（x2 =6.12,P＜0.05）;PCOS组盆腔粘连60例（21.1％）,对照组224例（40.4％）,组间比较差异有统计学意义（x2 =13.70,P＜0.05）.月经不规律是不孕女性PCOS发生的危险因素（OR=1.770,95％ CI为1.09～2.88,P=0.002）.结论 临床应加强对青春期月经初潮提前及月经不规律且有PCOS相关症状人群的关注,早期筛查、早期发现,早期预防、早期治疗,从而降低PCOS致不孕的发生率,降低远期并发症.     

多囊卵巢综合征的胰岛素抵抗特征及相关因素分析

目的探讨多囊卵巢综合征与胰岛素抵抗的特点及其相关影响。方法对48名多囊卵巢综合征患者与20名健康女性进行比较研究。按体重指数分为Ⅰ组（正常非肥胖组）．Ⅱ组（正常肥胖组）,Ⅲ组（综合征非肥胖组）,Ⅳ组（综合征肥胖组）。比较体重指数、腰臀围比、OGTT试验及胰岛素释放。血脂、血压、肝功、肾功、稳态模型胰岛素抵抗指数。结果空腹胰岛紊值、稳态模型胰岛素抵抗指数Ⅲ组与Ⅰ、Ⅳ组。Ⅳ组与Ⅱ组间比较差异均有显著性（P〈0．05）;空腹血糖、收缩压、TG、TC值Ⅲ组与Ⅳ组间比较差异有显著性（P〈0．05）;LDL、HDL值各组间比较差异均无显著性（P〉0．05）。稳态模型胰岛素抵抗指数与体重指数、腰臀围比、空腹胰岛素值均呈显著正相关（P〈0．01）。结论胰岛紊抵抗是多囊卵巢综合征患者代谢异常的基本特征,肥胖是引起胰岛素抵抗、多囊卵巢综合征的危险因素之一。     

Effectiveness of yoga on arterial stiffness: A systematic review

ObjectivesArterial stiffness is a major cardiovascular (CV) risk and an independent strong predictor of CV morbidity and mortality. The aim of this systematic review is to evaluate the clinical or interventional studies that assessed the effectiveness of yoga on arterial stiffness in participants of any age or sex, healthy or with any conditions.DesignSystematic review of clinical trials or interventional studies.Data sourcesCochrane Library, Medline/PubMed, Scopus, and Google Scholar databases.Review methodsDatabases were searched till July 2019 for clinical trials or interventional studies whether controlled or uncontrolled, randomized or non-randomized studies assessing the effects of yoga on arterial stiffness. Quality of the studies was assessed by using Physiotherapy Evidence Database (PEDro) Scale.ResultsSeven full-text articles (total number of participants = 362) that evaluated the effect of yoga on arterial stiffness were included in this review. There were three randomized controlled studies and four were non-controlled studies (single group studies). Four studies have shown significant reduction in arterial stiffness, while three studies did not find any significant change in arterial stiffness. The beneficial effects of yoga intervention on arterial stiffness in young adults and elderly hypertensive patients are encouraging. Methodological quality was good for one study, moderate for two studies and poor for four studies.ConclusionsThis review shows that yoga practice is effective in preventing or reducing the arterial stiffness in young healthy and obese, and elderly hypertensive patients. As the methodology of many studies is of low quality and safety measures were not reported, there is a need of quality randomized controlled trials of yoga effects on arterial stiffness among high risk individuals.     

青春期和成年期多囊卵巢综合征胰岛素抵抗情况分析

目的：探讨青春期和成年期多囊卵巢综合征（polycystic ovarian syndrome,PCOS）患者的胰岛素抵抗（insulin resistance,IR）情况。方法：采用空腹血糖与空腹胰岛素比值和稳态模式评估法评估胰岛素抵抗指数来评价30例青春期PCOS患者（青春期组）及30例成年期PCOS患者（成年组）的IR情况。结果与结论：青春期组患者空腹、餐后1h、餐后2h和餐后3h的血糖水平较成年组低,而胰岛素水平较成年组高（均为P〈0．05）;青春期组的IR发生率为63％,成年组的IR发生率为33％,2组比较差异有统计学意义（P〈0．05）。青春期PCOS患者IR发生率高,提示对青春期PCOS患者应及早行IR检测,以及时确诊与治疗。     

储继军治疗多囊卵巢综合征致不孕经验

多囊卵巢综合征为妇科生殖内分泌领域常见病、疑难病症,是导致育龄妇女无排卵性不孕的常见病因,治疗棘手。储继军副主任医师根据自己多年的临床经验,认为该病病机以肾虚、脾虚为本,血瘀、痰湿、肝郁为标,肾虚血瘀、脾虚痰湿、肝气郁结引起冲任失调导致不孕,治以补肾活血、健脾除湿、补肾疏肝为法,并坚持中医辨证论治与西医多学科管理相结合,医患共同参与,调经助孕,取得了较好疗效。     

Effects of yoga on eating disorders—A systematic review

BackgroundThe question of whether yoga practice ameliorates or even aggravates eating disorders is currently under debate. The aim of this review was to systematically assess and the effectiveness and safety of yoga in patients with eating disorders.MethodsMedline/PubMed, PsycINFO, and the Psychological and Behavioral Science Collection were screened through July 2018 for randomized controlled trials, non-randomized controlled trials and longitudinal observational studies on yoga for patients with eating disorders and other individuals with disordered eating and/or body dissatisfaction. Risk of bias was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa Quality Assessment Scale.ResultsEight randomized trials and four uncontrolled trials involving a total of 495 participants were included. Risk of bias was mixed. Comparing yoga to untreated control groups, effect sizes ranged from negligible effects of d = 0.02 to very large effects of d = 2.15. However, most effects were small to moderately sized and in most cases not significant. No safety-related data were reported.ConclusionsThere is limited evidence on the effectiveness and safety of yoga in patients with eating disorders. Yoga can be preliminarily considered as an additional treatment option in multimodal psychiatric treatment programs.     

腹腔镜卵巢电凝术治疗难治性多囊卵巢综合征的效果

目的 评价腹腔镜下卵巢电凝术治疗难治性多囊卵巢综合征(PCOs)的效果.方法 应用电视腹腔镜对65例促排卵方案治疗无效的PCOS患者行卵巢电凝术,观察患者的月经情况、排卵和受孕情况,比较术后血清促卵泡生成素(FSH)、黄体生成素(LH)、睾酮(T)、雌二醇(E2)水平的变化.结果 术后LH 、T水平较术前明显降低(P＜0.05);随访2年,月经情况明显改善;该术式治疗PCOS的自然恢复排卵率为92.31％,术后2年累积受孕率为67.7％,无并发症发生.结论 腹腔镜治疗PCOS简单易行、创伤小、恢复快,为难治性PCOS患者提供了新的治疗途径.     

多囊卵巢综合征患者促排卵周期子宫内膜甾体激素受体的表达

目的 探讨多囊卵巢综合征(PCOS)患者促排卵后子宫内膜甾体激素受体[雌激素受体(ER)、孕激素受体(PR)]的周期性变化,并探讨其临床意义.方法 选择PCOS患者108例作为病例研究对象,随机分为3组,每组各36例,分别为病例增生中期组、病例排卵期组和病例分泌中期组;同时选取因输卵管性原因而不孕的患者96例为对照者,随机分为3组,每组各32例,分别为对照增生中期组、对照排卵期组和对照分泌中期组.各小组分别在月经干净后5d时的增生期、排卵期、排卵后7d的分泌中期取各自内膜组织,采用免疫组化方法测定ER、PR的表达.结果 正常对照者月经周期中ER、PR阳性表达有明显改变,增生中期[ER(0.89±0.22) kU/L和(0.72±0.25) kU/L;PR(1.65±0.42) kU/L和(1.43±0.42) kU/L]、排卵期[ER(0.69±0.35) kU/L和(0.55±0.24) kU/L;PR(0.97±0.32) kU/L和(0.69±0.30) kU/L]阳性腺体明显减少、分泌中期[ER(0.92 ±0.29) kU/L和(0.87±0.34) kU/L; PR(1.68±0.42) kU/L和(1.56 ±0.30)kU/L].PCOS组子宫内膜间质和腺体上ER表达在各期均明显高于对照组,并且无明显曲线相改变[增生中期(1.73±0.22) kU/L和(1.89±0.38) kU/L;排卵期(0.75±0.32)kU/L和(0.63 ±0.28) kU/L;分泌中期(1.79 ±0.31) kU/L和(1.90±0.30)kU/L];PR的表达较正常组降低,并且无明显上升[增生中期(0.93±0.36) kU/L和(0.85±0.56)kU/L;排卵期(0.77±0.26)kU/L和(0.56 ±0.41)kU/L;分泌中期(0.98±0.36) kU/L和(0.88±0.47)kU/L];各组相比差异均有统计学意义(P均＜0.05).结论 PCOS不孕症患者促排卵者周期中子宫内膜ER,PR表达异常,内膜容受性较正常自然周期差,改善子宫内膜甾体激素的整体表达是促进PCOS患者妊娠的方法之一.     

多囊卵巢综合征超排卵前腹腔镜治疗临床价值分析

目的探讨多囊卵巢综合征(polycystic ovarian syndrome，PCOS)不孕症患者超排卵前腹腔镜手术对其超排卵结果的影响。方法对符合PCOS标准的接受体外受精-胚胎移植(IVF-ET）的69例不孕症患者的资料进行回顾性分析，超排卵前行腹腔镜手术20例，未行腹腔镜手术49例，观察两组促排卵药物用量，用药天数，所取卵子数目，卵巢过度刺激综合征(ovarian hyperstimulation Syndrome，OHSS)发生情况，以及手术组前后FSH、LH、T、E2的变化。结果腹腔镜手术组促排卵药物用量、用药天数明显多于未手术组，重度OHSS发生率显著降低，手术组术后LH、T浓度均较术前明显降低。结论PCOS患者超排卵前腹腔镜手术治疗可降低OHSS风险。降低取消移植比例，为超排卵困难的PCOS患者提供了新的治疗途径。     

腹腔镜卵巢打孔联合药物治疗难治性 多囊卵巢综合征临床分析

目的探讨腹腔镜卵巢打孔术(LOD)结合来曲唑(LE)对难治性多囊卵巢综合征(PCOS)不孕的治疗效果。方法将72例患者随机分成研究组和对照组各36例,所有患者进行LOD。手术前后分别测血黄体生成激素(LH)、卵泡刺激素(FSH)、睾酮(T)及雌二醇(E2)水平,术后第9天起监测患者卵泡发育和排卵共3个周期,并记录妊娠数和流产数。结果两组患者术后LH和T水平与术前相比均有显著性下降(P<0.05),两组E2水平术后均较术前降低,但研究组治疗后降低更为显著(P<0.05)。3个治疗周期内研究组排卵率明显高于对照组(P<0.05)。结论 LOD后结合氯米芬(CC)能明显改善难治性PCOS患者的排卵和受孕机会。     

Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials

ObjectiveTo determine whether the odds of positive conclusions in randomized controlled trials (RCTs) of yoga, differ between yoga styles.DesignSystematic review of yoga RCTs. Medline/PubMed, Scopus, the Cochrane Library, IndMED and the tables of content of specialist yoga journals, not listed in medical databases, were screened up to 12 February, 2014 for RCTs comparing yoga interventions to non-yoga interventions. The RCTs’ conclusions were classified as positive (yoga is helpful for a respective condition) or not positive; and these were compared between different yoga styles using the Chi squared test and multiple logistic regression analysis.ResultsA total of 306 RCTs were included. These applied 52 different yoga styles, the most commonly used of which were: hatha yoga (36 RCTs), Iyengar yoga (31 RCTs), pranayama (26 RCTs), and the integrated approach to yoga therapy (15 RCTs). Positive conclusions were reached in 277 RCTs (91%); the proportion of positive conclusions did not differ between yoga styles (p = 0.191).ConclusionRCTs with different yoga styles do not differ in their odds of reaching positive conclusions. Given that most RCTs were positive, the choice of an individual yoga style can be based on personal preferences and availability.     

腹腔镜卵巢打孔术治疗多囊卵巢综合征80例临床分析

目的探讨采用腹腔镜卵巢打孔术治疗多囊卵巢综合征(PCOS)的临床疗效和安全性。方法回顾性分析2009年7月至2011年7月采用腹腔镜卵巢打孔术治疗的80例PCOS患者的临床资料,并将采用内科保守治疗的80例患者作为对照组,比较两组患者的治疗效果和安全性。结果观察组72例患者实现正常排卵,53例6个月内妊娠,8例流产,治疗效果明显优于对照组,两组间比较差异具有统计学意义(P<0.05)。观察组治疗时间和治疗费用均低于对照组,两组间比较差异具有统计学意义(P<0.05)。结论采用腹腔镜卵巢打孔术治疗PCOS安全有效,患者术后恢复快,值得临床推广应用。     

二甲双胍联合经阴道B超卵泡穿刺术对耐氯米芬PCOS患者胰岛素抵抗、排卵率和妊娠率的影响——附33例报告

目的:探讨二甲双胍联合经阴道B超卵泡穿刺术治疗耐氯米芬多囊卵巢综合征(polycystic ovarian syndrome,PCOS)对胰岛素抵抗、排卵率、妊娠率的影响.方法:66例耐氯米芬PCOS患者,分为二甲双胍口服联合经阴道B超卵泡穿刺术治疗组(联合组,33例)和单纯经阴道B超卵泡穿刺术治疗组(单纯组,33例),观察2组治疗后的排卵率及胰岛素抵抗情况,并随访2组的自然妊娠情况.结果:2组治疗后的排卵率均比治疗前升高(均为P＜0.01).单纯组治疗后胰岛素抵抗情况无明显变化;联合组治疗后胰岛素敏感指数比治疗前及单纯组明显改善(P＜0.05),胰岛素抵抗指数降低(P＜0.05).2组排卵率比较差异无统计学意义(P＞0.05).单纯组妊娠率为24%,联合组为39%,2组比较差异有统计学意义(P＜0.05).结论:二甲双胍联合经阴道卵泡穿刺可提高耐药PCOS患者的排卵率,同时能明显改善胰岛素抵抗并提高妊娠率.     

Evidence on yoga for health: A bibliometric analysis of systematic reviews

ObjectiveTo support the research agenda in yoga for health by comprehensively identifying systematic reviews of yoga for health outcomes and conducting a bibliometric analysis to describe their publication characteristics and topic coverage.MethodsWe searched 7 databases (MEDLINE/PubMed, Embase, PsycINFO, CINAHL, AMED, the Cochrane Database of Systematic Reviews, and PROSPERO) from their inception to November 2019 and 1 database (INDMED) from inception to January 2017. Two authors independently screened each record for inclusion and one author extracted publication characteristics and topics of included reviews.ResultsWe retrieved 2710 records and included 322 systematic reviews. 157 reviews were exclusively on yoga, and 165 were on yoga as one of a larger class of interventions (e.g., exercise). Most reviews were published in 2012 or later (260/322; 81 %). First/corresponding authors were from 32 different countries; three-quarters were from the USA, Germany, China, Australia, the UK or Canada (240/322; 75 %). Reviews were most frequently published in speciality journals (161/322; 50 %) complementary medicine journals (66/322; 20 %) or systematic review journals (59/322; 18 %). Almost all were present in MEDLINE (296/322; 92 %). Reviews were most often funded by government or non-profits (134/322; 42 %), unfunded (74/322; 23 %), or not explicit about funding (111/322; 34 %). Common health topics were psychiatric/cognitive (n = 56), cancer (n = 39) and musculoskeletal conditions (n = 36). Multiple reviews covered similar topics, particularly depression/anxiety (n = 18), breast cancer (n = 21), and low back pain (n = 16).ConclusionsFurther research should explore the overall quality of reporting and conduct of systematic reviews of yoga, the direction and certainty of specific conclusions, and duplication or gaps in review coverage of topics.     

腹腔镜卵巢打孔术治疗多囊卵巢综合征60例临床分析

目的探讨腹腔镜卵巢打孔术治疗多囊卵巢综合征的效果。方法对60例多囊卵巢综合征患者行腹腔镜下卵巢打孔术。结果术后患者月经情况改善,术后促黄体生长激素及睾酮与术前相比明显下降,术后排卵率为86.7%,妊娠率为75.0%。结论腹腔镜卵巢打孔术具有损伤小、粘连轻、恢复快、疗效高的特点,是治疗多囊卵巢综合征的有效方法。     

经直肠三维超声诊断未婚青少年多囊卵巢综合征的应用

目的 探讨经直肠三维超声诊断未婚青少年多囊卵巢综合征（PCOS）的价值。方法 采用经直肠三维超声对45例PCOS患者、30例单纯卵巢多囊性改变（PCO）患者和25例正常者进行观察，分别测量其卵泡数、卵巢体积、卵巢总面积（TA）、髓质面积（SA）和髓质面积与卵巢总面积的比值（SA／TA）。结果 经直肠三维超声对未婚青少年卵巢细致结构的显示优于经腹超声，且无创、方便、清晰、敏感。PCOS患者SA、SA／TA明显高于PCO及正常对照组，差异有统计学意义（P〈0．05或P〈0．01）。结论 经直肠三维超声提高了对未婚青少年PCOS的诊断水平，与经腹超声联合应用能提高诊断准确性，减少漏诊率。SA／TA可作为辅助诊断PCOS的指标。     

Role of yoga for patients with type II diabetes mellitus: A systematic review and meta-analysis

To understand the role and efficacy of yoga in the management of type 2 diabetes mellitus, this meta-analysis was conducted. Electronic data bases searched were PubMed/Medline, ProQuest, PsycINFO, IndMED, CENTRAL, Cochrane library, CamQuest and CamBase till December 17, 2014. Eligible outcomes were fasting blood sugar (FBS), post prandial blood sugar (PPBS) and glycosylated haemoglobin (HBA1C). Randomized controlled trials and controlled trials were eligible. Studies focussing only on relaxation or meditation or multimodal intervention were not included. A total of 17 RCTs were included for review. Data from research articles on patients, methods, interventions- control and results were extracted. Mean and standard deviations were utilized for calculating standardized mean difference with 95% confidence interval. Heterogeneity was assessed with the help of I² statistics. χ² was used to rule out the effects of heterogeneity due to chance alone. Beneficial effects of yoga as an add-on intervention to standard treatment in comparison to standard treatment were observed for FBS [Standardized Mean Difference (SMD) −1.40, 95%CI −1.90 to −0.90, p ˂ 0.00001]; PPBS [SMD −0.91, 95%CI −1.34 to −0.48, p ˂ 0.0001] as well as HBA1C [SMD −0.64, 95%CI −0.97 to −0.30, p ˂ 0.0002]. But risk of bias was overall high for included studies. With this available evidence, yoga can be considered as add-on intervention for management of diabetes.