宫内节育器异位2例分析

目的:探讨宫内节育器异位的处理与预防.方法:总结宫内节育器异位的原因,根据患者实际情况进行处理,提出预防措施.结果:两例患者成功取出节育器.结论:对宫内节育器异位要做好预防工作.     

三种宫内节育器临床应用的效果分析

目的:观察3种宫内节育器临床应用效果,分析比较计划生育系统常用的几种IUD的脱落、因症取出及带器妊娠,评价其临床效果及适宜人群.方法:收集来我所进行健康体检的620例放置IUD育龄妇女,随机分成三组:活性yIUD 190例、元宫型IUD环200例,TCuC三球型172例,统一使用迈瑞9000 plus超声诊断仪,探头频率3.5mHZ,专门B超医生检查.结果:3种不同IUD带器有效均值比较P>0.05,无显著性差异,带器有效与无效均值比较P<0.01,有显著性差异.元宫型IUD易被育龄群众接受.     

宫内节育环异位2例分析

回顾性分析了2例宫内节育环异位患者的资料,指出导致宫内节育环异位的原因可能与置入技术、指征的掌握有关,并提出了有关预防措施。     

剖宫产史对女性人工流产术后即时放置宫内节育器的影响探究

目的:探讨剖宫产史对女性人工流产术后即时放置宫内节育器的影响。方法:选择390例于2013年7月至2014年11月收治于我院的剖宫产术后行人工流产术后即时放置IUD的妇女,分为三组,其中123例剖宫产术后12个月内的患者称为观察组Ⅰ,92例剖宫产术后12个月以上的患者称为观察组Ⅱ,175例无剖宫产史患者称为对照组Ⅲ。三组患者行人工流产术后即时放置IUD并进行随访观察12个月,对比三组患者治疗后有无发生副作用及避孕效果。结果:三组患者在置入IUD后1、3、6、12个月后发生经期延长、经量增加、闭经、不规则出血、腰腹痛、白带增多等副作用情况均无显著差异(均P>0.05),且均无出现闭经(宫腔粘连)情况;三组患者中,术后6个月随访时的因出血、因疼痛取出率为最高,但差异无统计学意义(P=0.452,P=0.538),三组患者术后12个月随访时并未发现有带器妊娠;除术后1个月随访时观察组Ⅱ有1例出现完全脱落外,其余随访时间段各组均无出现脱落情况;三组患者在术后1、3、6、12个月随访中的累计续用率差异不大,无统计学意义(均P>0.05)。结论:剖宫产手术史对再次妊娠的女性行人工流产术后即时放置IUD的效果和安全性无明显影响,有剖宫产史的妊娠女性可采用人工流产术后放置IUD的方式避免重复妊娠。     

宫内节育器嵌顿发生的影响因素分析

目的:探索宫内节育器嵌顿的危险因素,为减少宫内节育器嵌顿的发生提供依据。方法:选取2009年3月至2014年5月我院收治的宫内节育器嵌顿患者80例作为病例组,同期门诊80名未发生宫内节育器嵌顿者为对照组,分析宫内节育器嵌顿的相关因素。结果:单因素分析,病例组的痛经发生率(57.5%)高于对照组(38.7%),差异有统计学意义(χ2=5.633,P<0.05);病例组与对照组上环时间差异有统计学意义(χ2=10.569,P<0.01);病例组中妇科炎症发生率(52.5%)高于对照组(26.3%),差异有统计学意义(χ2=12.545,P<0.01);病例组带环怀孕发生率为(58.7%)高于对照组(8.8%),差异有统计学意义(χ2=44.724,P<0.01)。经Logistics回归分析痛经、上环时机、妇科炎症、带环时间和带环怀孕是宫内节育器嵌顿的独立危险因素。结论:在放置宫内节育器前综合考虑妇女的综合状态,选择适宜的宫内节育器,严格遵守放置规程,加强术后观察,可减少宫内节育器嵌顿的发生。     

人流术中影响安置宫内节育器的相关因素分析

目的探讨分析人工流产术中影响安置功能节育器(IUD)的相关因素。方法选择在重庆市妇幼保健院进行人工流产术的已婚已育妇女483例,人流术后即刻放置IUD女性185例、未放置IUD女性298例,调查可能影响IUD放置的各因素,并进行单因素和多因素Logistic回归分析。结果单因素分析结果显示,两组女性在年龄、文化程度、孕次、产次、近3年内生育要求、知晓IUD好处以及知晓流产术后可立即放置IUD因素上差异具有统计学意义(P0.05);多因素Logistic回归分析结果显示,近3年内生育要求、产次、年龄、流产术后可立即放置IUD知晓度进入回归模型差异具有统计学意义(P0.05)。结论影响人工流产术后即刻安置宫内节育器的主要因素为女性的生育意愿、产次、年龄以及对宫内节育器的知晓情况,应当加强宫内节育器的宣教力度,降低人工流产率,保障女性生殖健康。     

妈富隆用于改善放置宫内节育器初期子宫异常出血的临床研究

目的:研究妈富隆用于改善放置宫内节育器初期子宫异常出血的临床效果。方法:选取2013年1月至2015年1月在我院放置宫内节育器的避孕妇女108例。采用随机数表法将研究对象分为观察组和对照组,各54例。观察组从放置宫内节育器当天开始每天按时服用妈富隆1片,直至当月生理期第25d停止服药。对照组放置宫内节育器后不服用妈富隆。对两组妇女放置宫内节育器后子宫异常出血时间和月经量增多发生情况进行比较。结果:观察组妇女术后,第一次及第二次月经流血天数均短于对照组,观察组第一次点滴出血与对照组相比明显增加,差异统计学具有意义(P0.05)。观察组第二次月经点滴出血和对照组差异统计学不具有意义(P0.05)。观察组术后第一次和第二次月经量增多妇女例数均少于对照组,差异统计学具有意义(P0.05)。结论:给予放置宫内节育器的妇女妈富隆能够有效改善其子宫异常出血情况,可以在临床上进一步推广和使用。     

不同时期放置吉妮致美宫内节育器的临床观察

目的：探讨不同时期放置吉妮致美宫内节育器的临床效果观察,扩大宫内节育器放置范围,提供安全的避孕方法。方法：人工流产术后自愿要求放置吉妮致美宫内节育器的育龄妇女300例为观察组,300例为对照组,于月经干净后2～3d放置吉妮致美宫内节育器。定期随访观察两组术后宫内节育器的放置情况（1、3、6、12个月）,观察避孕效果及不良反应。结果：观察组300例,失访5例,终止使用3例,其中1例是带器妊娠,2例是宫内节育器脱落,无不良反应取出。对照组300例,失访7例,终止使用1例,1例是宫内节育器脱落。结论：不同时期放置吉妮致关宫内节育器均安全、可靠、成功率高,尤其适宜使用其他类型宫内节育器失败者,也适用于宫腔大者,而且术后不良反应明显降低,值得临床推广使用。     

围绝经期妇女宫内节育器滞留情况及其安全性分析

目的：统计围绝经期妇女宫内节育器的滞留情况,并对其安全性进行探究分析。方法：2012年10月至2013年3月期间对本社区围绝经期妇女进行问卷调查,以了解宫内节育器的滞留情况。随机各抽选200例使用宫内节育器和未使用宫内节育器的女性作为研究对象,并对两类妇女的围绝经期腰部疼痛、月经情况及妇科炎症发生情况进行咨询和健康检查。结果：研究组患者无腰部疼痛者28例,占14.0％;对照组无腰部疼痛者61例,占30.5％,两组间的差异显著（P＜0.05）。研究组和对照组围绝经期妇女的月经量和妇科炎症发生率无明显差异,P＞0.05,不具有统计学意义。结论：围绝经期妇女宫内节育器的滞留与其腰部疼痛相关,但对月经量、妇科炎症发生等无明显影响。     

人工流产同时放置爱母环的临床观察

对我院2005年1月～2005年12月施人工流产术同时自愿放置爱母环宫内节育器(IUD)88例进行观察随访,结果如下。1对象和方法1.1对象观察组:88例,年龄25～38岁,平均(33.1±3.46)岁,均为孕70天内,无手术及放置爱母环IUD禁忌症,希望选用长效方便的避孕方法于手术同时放置爱母环。对照组:同期孕70天无手术禁忌症、术后一个月月经复潮后3至7天重新来院放置爱母环90例,年龄表1两组术后情组别例数第一天出血量(ml)流血观察组8843.5±8对照组9041.5±7两组术后均应用相同抗生素,无发热。观察组8例及对照组90例中均无子宫复旧不良、阴道流血多等症状,…     

经腹B超引导下宫腔操作在子宫穿孔后取宫内节育器中的应用价值

目的:分析子宫穿孔后经腹B超引导下宫腔操作取宫内节育器效果,为临床治疗提供参考。方法:回顾性分析我院取宫内节育器致子宫穿孔患者22例资料,均采取经腹B超引导下宫腔操作,分析应用效果。结果:手术前经B超检查,20例患者做出明确诊断,18例为单纯子宫穿孔,2例患者子宫穿孔同时合并盆腔出血,可见游离液体回声。22例患者行B超引导下取宫内节育器,术前均未采用米索前列醇扩张宫口药物,20例患者手术一次性完成,一次性手术成功率为90.9%,平均操作时间为(22.7±6.8)min,平均出血量(23.7±11.9)m L,2例患者由于子宫小,操作时间超过1h,仍然没有成功,放弃取宫内节育器。术后未出现感染病例,B超复查子宫回声均匀,后穹窿无积液,顺利出院。结论:在子宫穿孔后采用B超引导宫腔操作取宫内节育器安全有效,术后并发症少,值得推广。     

重组人干扰素对提高宫颈癌术后放疗患者性生活质量的价值初探

目的:探讨重组人干扰素对提高宫颈癌术后放疗患者性生活质量的临床价值。方法:选择2011年4月至2015年6月本院收治的宫颈癌术后实施规律放射治疗患者80例,按照随机数字法分为两组,各40例,术后对照组联合放射治疗,观察组则在对照组基础上使用重组人干扰素α-2b栓,对所有患者随访6个月,比较两组恢复性生活时间、性唤起时间、每月性生活频率,两组干预前后焦虑及抑郁评分,两组干预后FSFI评分情况及干预过程中免疫球蛋白变化情况。结果:观察组恢复正常性生活时间显著早于对照组(P0.05),进行性生活时性唤起时间显著快于对照组(P0.05),每月性生活次数显著多于对照组(P0.05),干预后两组焦虑及抑郁评分均显著低于干预前(P0.05),干预后,观察组焦虑及抑郁评分均低于对照组(P0.05),观察组干预后患者女性FSFI评分中性欲、性唤起、性高潮及性心理得分均显著高于对照组(P0.05),干预后,两组Ig M、Ig G和Ig A水平均显著低于干预前(P0.05),且观察组Ig M、Ig G和Ig A水平显著低于干预后对照组(P0.05)。结论:重组人干扰素对提高宫颈癌术后放疗患者性生活质量,促进早日恢复正常性生活,缓解患者不良心理状态,提高免疫能力有积极意义。     

Pulsed ultrasound measurements of depth and regression of basal cell carcinomas after photodynamic therapy: relationship to probability of 1-year local control

BACKGROUND: The regression of clinical basal cell carcinoma (BCC) after photodynamic therapy (PDT) is poorly understood, but is potentially important when, as is increasingly the case, a second treatment is contemplated. High-frequency pulsed ultrasound provides noninvasive information on skin and lesion thickness. OBJECTIVES: To relate pulsed ultrasound measurements before and after PDT to the probability of local control of BCC by PDT. METHODS: Skin thickness and lesion thickness were measured by 20-MHz pulsed ultrasound in 181 patients diagnosed as having BCC. Maximal lesion thickness was determined by repeatedly sampling the BCCs. Measurements were made immediately prior to PDT with aminolaevulinic acid plus 630 nm visible light, and then at 1, 6 and 12 months. RESULTS: Skin thickness in individual patients did not vary with time in this study (mean +/- SD 2.3 +/- 0.6 mm; P = 0.8). In contrast, BCC mean +/- SD maximal thickness 4-6 weeks after PDT was significantly smaller than pretreatment (0.6 +/- 0.8 mm vs. 1.3 +/- 0.8 mm; P < 0.001). The overall probability of 1-year local control fell from 85% when only BCCs 相似文献   

姜黄素对THP-1细胞Toll样受体4信号传导通路中相关因子mRNA水平的影响

目的 研究姜黄素对人单核细胞株THP-1 Toll样受体4(TLR4)信号传导通路中相关因子mRNA水平的影响.方法 用不同浓度姜黄素(50、25、12.5 mg/L)预处理THP-1细胞12 h,0.043 mg/L地塞米松处理组作为阳性对照,继而用1 mg/L脂多糖(LPS)刺激诱导细胞4 h,以不做处理的THP-1作为阴性对照,仅用1 mg/L LPS刺激的THP-1作为LPS刺激组.提取细胞总RNA,用RT-PCR方法检测TLR4信号传导通路中TNF受体相关因子(TRAF)6、IL-1受体相关激酶(IRAK1)、核因子κB(NF-κB)mRNA的表达情况.结果 未经处理的THP-1细胞经LPS刺激4 h,可以显著提高TRAF6、IRAK1、NFκB mRNA的表达,与阴性对照组比较,t值分别为38.69、39.13、23.99(P<0.01). 50、25 mg/L姜黄素可以明显抑制THP-1细胞经LPS诱导后TRAF6、IRAK1、NF-κB mRNA的表达(P值均<0.01),抑制率均在50%以上.结论 一定浓度的姜黄素可以抑制LPS诱导后THP-1细胞TRAF6、IRAK1、NF-κB mRNA的表达,表明姜黄素对TLR4信号传导通路中相关因子mRNA水平有调节作用.     

Adhesion of peripheral blood mononuclear cells and CD4+ T cells from patients with psoriasis to cultured endothelial cells via the interaction between lymphocyte function-associated antigen type 1 and intercellular adhesion molecule 1

BACKGROUND: The adhesion of CD4+ T cells to endothelial cells and their subsequent migration to skin tissue are essential to develop the psoriatic skin lesion. However, few studies have examined the role of adhesion molecules in the binding of T cells from patients with chronic plaque psoriasis to endothelial cells in vitro; thus, the adhesion molecules responsible for the development of skin lesions are still unclear. OBJECTIVES: To identify the responsible adhesion molecules in the interaction between CD4+ T cells in patients with chronic plaque psoriasis and cytokine-stimulated endothelial cells. METHODS: An in vitro adhesion assay between Calcein-labelled peripheral blood mononuclear cells (PBMC) and cytokine-stimulated human endothelial cultures, which exhibit a higher adhesion capacity to PBMC, was established, and the adhesion-inhibitory effects of a panel of antiadhesion molecule antibodies on the adhesion of PBMC from patients with psoriasis to endothelial cells were examined. Then, the inhibitory effects of selected antibodies acting on the interaction between CD4+ T cells from patients with psoriasis (purified by negative magnetic cell sorting) and cultured endothelial cells were examined. RESULTS: A significant increase (P < 0.01) in the adhesion of psoriatic PBMC to both endothelial cultures, human skin microvascular endothelial cells from adults (HMVEC-Ad) and human coronary arterial endothelial cells (HCAEC), compared with healthy PBMC, was demonstrated in our in vitro cell adhesion assay. Pretreatment of both endothelial cultures with tumour necrosis factor (TNF)-alpha (1000 U mL(-1)) induced the most frequent adhesion of PBMC from patients with psoriasis among the three inflammatory cytokines examined, i.e. TNF-alpha, interleukin-1beta and interferon-gamma [TNF-alpha-treated vs. nontreated: P < 0.001 (in both HMVEC-Ad and HCAEC)]. In both endothelial cultures treated with TNF-alpha, PBMC from patients with psoriasis exhibited significantly more frequent adhesion compared with those from healthy individuals (P < 0.001). The TNF-alpha-stimulated HMVEC-Ad, which exhibited the most frequent adhesion of PBMC, were selected for adhesion-inhibition experiments using monoclonal antibodies (mAbs) to adhesion molecules that are upregulated in psoriatic lesions, and the combination of antilymphocyte function-associated antigen type 1 (LFA-1) and anti-intercellular adhesion molecule 1 (ICAM-1) mAbs gave the greatest reduction of adhesion of PBMC from patients with psoriasis (approximately 69% reduction; P < 0.01). This combination of mAbs significantly reduced also the adhesion of CD4+ T cells from patients with psoriasis to TNF-alpha-stimulated HMVEC-Ad (approximately 62% reduction), compared with pretreatment with isotype control mAbs (P < 0.01). CONCLUSIONS: These findings indicate that the LFA-1/ICAM-1 interaction plays a major role in the adhesion of CD4+ T cells to endothelial cells and that TNF-alpha might play an important role for the induction of adhesion molecules on endothelial cells at psoriatic skin lesions.     

Decreased Interleukin-7 and transforming growth factor-beta1 levels in blister fluids as compared to the respective serum levels in patients with bullous pemphigoid: Opposite behavior of TNF-alpha, Interleukin-4 and Interleukin-10

Abstract: This study analyzes both the blister fluid (BF) and serum levels of IL-7 and TGF-beta₁ in samples from 18 patients affected with bullous pemphigoid (BP). These cytokines clearly present lower concentrations ( P <0.001) in BFs than in the sera (1/20 and 1/2, respectively). In contrast, TNF-alpha, IL-10 and IL-4 present increased amounts in BFs that were 12, 12 and 17-fold, respectively. Eighteen sera (and 10 suction BF) from normal individuals were also employed as control. Normal sera presented significantly lower serum IL-7 concentrations than BP, while no significant TGF-beta₁ variations were observed between normal and pathologic serum samples. In addition, the serum levels detected in BP patients were significantly correlated with disease intensity ( r =0.64, P =0.003, evaluated as the number of blisters/erosions for each patient) as well as with the peripheral B-lymphocyte counts ( r =0.80, P <0.001) and antibodies directed against the basement membrane zone ( r =0.65, P <0.005). Although a clear explanation of this phenomenon is lacking, the data presented in this report agree with a strong decrease of IL-7 production at the local level (keratinocyte is known to produce IL-7 and the latter is known to be down-regulated by IL-10, and in other models also by TGF-beta₁ and IL-4, whose levels are elevated in BP BFs) as opposed to an increased peripheral release of the same modulator. The IL-7 reduction may have a biological relevance in controlling a chronic, progressive disease.