G点的流行病学研究

目的:探讨G点存在证据。方法:总结直接研究、阴道和阴蒂手术患者三方面流行病学资料。结果:直接流行病学研究中显示,80%女性感受自身存在G点,但双胎研究未发现G点的遗传学基础;对阴道手术患者的研究发现手术部位的阴道前壁不存在G点;阴蒂手术后患者研究提示除阴蒂头外可能存在其他获得性高潮的性敏感器官。结论:现有的流行病学研究尚不能得出G点存在与否的结论。     

阴道前壁粘膜瓣悬吊术治疗前盆腔器官脱垂的临床疗效评价

目的:探讨阴道前壁粘膜瓣悬吊术治疗前盆腔器官脱垂的临床疗效。方法:回顾性分析2013年1月至2016年1月期间佛山市妇幼保健院应用阴道前壁粘膜瓣悬吊术治疗45例前盆腔器官脱垂患者(悬吊组)的临床资料,并选择同期行传统阴道前壁修补的45例患者(传统组)作为对照,所有脱垂患者均以前壁脱垂为主,POP-Q分度为III度-IV度。通过比较两组患者手术时间,手术出血量,术后病率,住院时间,并发症发生率,手术前后的PFIQ-7,PFDI-20及PISQ量表评分。结果:(1)两组患者的术中出血量,住院时间,术后病率比较,差异无统计学意义(P>0.05)。悬吊组手术时间稍长于传统组,但差异无统计学意义(P>0.05);(2)悬吊组术后6个月的客观治愈为100.00%,术后1年,2年的客观治愈率均为93.33%(42/45);传统组术后6个月的客观治愈率为88.89%(40/45),术后1年为77.78%(35/45),术后2年为75.56%(34/45);悬吊组术后不同时期的客观治愈率均高于传统组,差异有统计学意义(P<0.05)。(3)两组患者术后症状,性生活质量均较术前改善,差异有统计学意义(P<0 05);两组之间术前PFIQ-7,PFDI-20和PISQ量表评分比较,差异无统计学意义(P>0.05);悬吊组术后同时期的PFIQ-7,PFDI-20评分低于传统组,差异有统计学意义(P<0.05);两组患者术后同时期的PISQ量表评分比较,差异均无统计学意义(P>0.05)。结论:阴道前壁粘膜瓣悬吊术治疗前盆腔器官脱垂主,客观治愈率比传统修补术高,复发率低,短期疗效确切,简单,经济,安全,对患者性生活质量的不良影响小,但需要严格把握手术适应症和掌握手术技巧。     

基底细胞癌瘤细胞增殖、凋亡和微血管密度的相关性研究

目的 :　探讨侵袭性基底细胞癌 (A -BCC)与非侵袭性基底细胞癌 (NA -BCC)的瘤细胞凋亡、增殖及瘤间质微血管密度之间的相关性。方法 :　应用免疫组化SP法检测 78例BCC石蜡标本组织 (36例A -BCC ,42例NA -BCC)中的Ki6 7、M30和vWF表达 ;并采用TMVLD测量法检测肿瘤间质中微血管密度。结果 :　A -BCC组的AI、PI和TMVLD的均值皆明显比NA -BCC组的高 (P <0 .0 5 ) ;其中A -BCC组的AI与PI在统计学上具有显著的相关性 (r=0 .45 9,P <0 .0 5 )。未发现BCC的AI和PI与TMVLD在统计学上有相关性。结论 :　不同性质BCC的凋亡与增殖特点不同 ;肿瘤微血管的形成与BCC瘤细胞的凋亡与增殖没有必然联系。     

G点的行为学研究

目的：探讨G点存在的行为学证据。方法：总结现有的性行为学研究资料。结果：阴道前壁局部存在敏感区域,但研究时无法避免对阴蒂的刺激。女性射液现象确实存在。结论：现有的行为学研究尚不能得出G点存在与否的结论。     

人乳头瘤病毒感染患者阴道菌群分布及宫颈局部免疫功能变化的分析

目的 统计分析人乳头瘤病毒(HPV)感染患者阴道菌群的分布情况,并观察其宫颈局部免疫功能指标变化。方法 选取2018年6月至2020年6月衢州市妇幼保健院收治的156例HPV感染患者作为研究对象,将其中宫颈活检正常患者纳入HPV阳性组(n=31),宫颈低级别上皮内瘤变(LSIL)患者纳入LSIL组(n=36),宫颈高级别上皮内瘤变(HSIL)患者纳入HSIL组(n=49),宫颈癌患者纳入宫颈癌组(n=40);另将同期52例HPV阴性且宫颈活检正常女性纳入对照组。比较各组的阴道菌群分布、宫颈局部免疫指标与炎症因子指标水平。结果 宫颈癌组、HSIL组、LSIL组、HPV阳性组的乳酸杆菌异常占比、衣原体及解脲支原体检出率、细菌性阴道病占比与对照组比较,差异具有统计学意义(P<0.05),但滴虫及真菌的检出率与对照组比较,差异无统计学意义(P>0.05);宫颈癌组、HSIL组、LSIL组的CD4⁺/CD8⁺低于对照组,HSIL组、LSIL组的分泌型免疫球蛋白A(SIgA)水平高于对照组,宫颈癌组的SIgA水平低于HPV阳性组、对照组(P&...     

银屑病皮损中VEGF、bFGF的表达及与微血管密度的相关性研究

目的探讨血管内皮生长因子(VEGF)及碱性成纤维细胞生长因子(bFGF)在银屑病患者皮损血管生成机制中的作用。方法采用免疫组化法检测寻常型银屑病患者皮损处VEGF、bFGF及微血管密度(MVD)的表达情况,并与正常皮肤进行比较分析。结果寻常型银屑病患者皮损处VEGF、bFGF的表达及MVD值明显高于正常对照组(P0.05),VEGF与bFGF在银屑病患者皮损中的表达差异有显著相关性(P0.05)。结论 VEGF及bFGF可能引起银屑病患者皮损处血管增生,VEGF与bFGF在银屑病微血管增生过程中发挥正性调节作用且具有协同促进性。     

窄谱中波紫外线对银屑病患者皮损中微血管密度和血清血管内皮生长因子水平的影响

目的探讨窄谱中波紫外线(NB-UVB)对银屑病患者皮损中微血管密度(MVD)和血清血管内皮生长因子(VEGF)水平的影响。方法用血管内皮细胞特异性标志物CD34抗体免疫组化法检测银屑病患者NB-UVB治疗前后皮损中的MVD,用ELISA方法检测患者NB-UVB治疗前后血清VEGF的水平。结果银屑病患者NB-UVB治疗前的MVD明显高于治疗后及正常对照组(P均<0.01)。银屑病患者NB-UVB治疗前的血清VEGF水平明显高于治疗后及正常对照组(P均<0.01)。结论NB-UVB可能通过抗血管新生作用来治疗银屑病。     

阴道分娩对疤痕子宫再妊娠孕妇围产期应激反应和免疫功能的影响

目的探讨阴道分娩对疤痕子宫再妊娠孕妇围产期应激反应和免疫功能的影响。方法选取2013年5月至2017年5来佛山市南海区第四人民医院孕检并分娩的疤痕子宫再妊娠孕妇60例作为研究对象,根据分娩方式将其分为两组,26例成功剖宫产术后经阴道分娩孕妇作为VBAC组,34例择期重复剖宫产孕妇作为ERCS组,分析VBAC成功率,比较两组产前及产后12h、48h外周血皮质醇(Cor)、去甲肾上腺素(NE)、T淋巴细胞水平(CD4~+、CD8~+、CD4~+/CD8~+),并比较两组分娩结果。结果 36例孕妇符合VBAC条件,其中26例(72.22%)按计划顺利完成VBAC。两组产后12h、48 h Cor、NE水平较产前降低,差异具有统计学意义(P0.05),但两组间比较差异无统计学意义(P0.05);两组产后12h、48h CD4~+、CD4~+/CD8~+水平均较产前降低,CD8~+水平较产前升高,差异具有统计学意义(P0.05),且VBAC组产后12h、48 h CD4~+、CD4~+/CD8~+水平略高于ERCS组,CD8~+水平略低于ERCS组,差异具有统计学意义(P0.05);两组新生儿体重及新生儿Apgar评分为8分～10分、产后出血、产褥感染、新生儿窒息、子宫破裂发生几率比较,差异无统计学意义(P0.05);VBAC组24h出血量、住院费用少于ERCS组,住院时间短于ERCS组,差异具有统计学意义(P0.05)。结论与ERCS相比,符合VBAC适应证的疤痕子宫再次妊娠孕妇行VBAC,可减轻产后免疫抑制,显著减少术后出血量、住院费用,缩短住院时间,且对新生儿健康、围产期应激反应无明显影响。     

Oligo基因芯片和小鼠模型研究外阴阴道念珠菌病的发病机制

Objective To investigate the pathogenesis of vulvovaginal candidiasis.Methods Thirty mice were randomly and equally divided into 3 groups,i.e.,infected group treated with estrogen and innoculated with a clinical isolate of C. albicans,negative centrel group treated with estrogen and inoculated with physiological saline.blank control group without any treatment.All mice were kilied on day 7 after inoculation,vaginal tissue samples were obtained and subjected to pathological examination and staining.Total RNA was extracted from these samples as well as Candida isolates and reference strains,and hybridized with self-designed oligonucleotide chips.Then,signal value of vulvovaginal candidiasis-associated factors was compared between infected group and blank control group,and a 2-fold difference was considered as significant.Results Compared with the blank centrol group,the gene expression of 39 factors increased while that of 4 factors decreased in the infeeted group.In the case of host immunity,the expression of inflammatory chemokines generally inereased,and that of regulatory factors of adaptive immunity,including interleukin (IL)-1,IL-4,IL-6,IL-10,IL-12,tumor necrosis factor(TNF)-α,nuclear factor (NF)-κB and transforming growth factor (TGF)-β Was also enhanced to different degrees.TLR4,a humoral component of innate immune response,increased in all specimens from infected group,whereas Toll-like receptor(TLR)2 expression increased only in one third of these speciraens.The expression of virulent factors including EFG1 (a modulatory factor of hyphal formation),secreted aspartic proteinase (SAP)2,SAP4,SAP5,SAP6,SAP10,lipase(LIP)2,LIP4 and HWP(a major cell wall protein)1 increased in pathogenic strains.Among these differentially expressed genes,monocyte chemoattractant protein(MCP)-1,macrophage inflammatory protein(MIP)-1α,MIP-2,IL-1,TLR4,LIP4 and HWP1,which were involved in extracellular hydrolysis,hyphal formation,phenotypic switching and host native immunity,were increased significantly in all specimens from the infected group.Conclusions Both the deficiency of adaptive immunity and increased virulence of pathogen strains are involved in the pathogenesis of vulvovaginal candidiasis,and TLR4 possibly plays an important role in local immunity of hosts with vulvovaginal candidiasis.     

经阴道彩超对子宫内膜癌肌层浸润程度和病理分期的诊断效果研究

目的:探讨经阴道彩超对子宫内膜癌Ⅰ期肌层浸润程度的诊断效果。方法:选取我院2015年收治的子宫内膜癌Ⅰ期患者72例,均进行经阴道彩超检查,分析患者的肌层浸润程度。结果:分级越高的患者肌层的浸润程度更厉害(P0.05),淋巴结转移患者的子宫浸润程度更厉害(P0.05),经阴道彩超筛查子宫内膜癌患者的肌层浸润灵敏度是84.0%,特异度是89.4%,经阴道彩超同病理分期的诊断符合率是72.2%。结论:子宫内膜癌Ⅰ期患者使用经阴道彩超进行诊断的效果比较可靠,并且费用低廉、操作简便,能够为临床上患者的早诊断以及早治疗提供依据,从而改善治疗的效果。     

阴道旁修补联合骶棘韧带固定术治疗阴道前壁脱垂疗效观察

目的:探讨经阴道阴道旁修补(VPVR)联合骶棘韧带固定术(SSLF)在阴道前壁脱垂治疗中的疗效及安全性。方法:回顾性分析柳铁中心医院2008年1月至2012年12月57例经盆腔器官脱垂定量分期法进行分期(POP-Q),确定为子宫及阴道前壁脱垂患者的临床资料,按手术方式的不同分为对照组和观察组。对照组32例行传统经阴道子宫切除术(TVH)及阴道前壁修补术,观察组25例在阴式子宫切除(TVH)基础上行阴道旁修补术(VPVR)及骶棘韧带固定术(SSLF)组合术式。术后定期随访,对手术临床效果及并发症情况进行评估。结果:两组手术时间及术中出血量比较对照组优于观察组(P0.05);术后随防1年,观察组的临床治愈率明显高于对照组(P0.05);术后不适感发生率观察组明显低于于对照组(P0.05);两组均未发生膀胱、尿道损伤及其他部位损伤。结论:阴道旁修补联合骶棘韧带固定术修复阴道顶端及中段旁缺陷,较好恢复原有解剖状态,在治疗阴道前壁脱垂中疗效满意。     

Stimulated growth of human and pig epidermal nerve fibers by tape stripping

Nerve growth studies in adults usually rely upon nerve regeneration that follows axon disruption. In this study elongation of the epidermal nerve fibers occurred in human and pig epidermis stimulated to hypertrophy by removing the stratum corneum with repetitive applications of tape (tape stripping). Epidermal thickening was accompanied by elongation of the epidermal nerve fibers. This study demonstrates that changing the cellular and chemical environment of nerves by tape stripping is a feasible method to study nerve fiber growth in a physiological manner.     

神经性皮炎皮损处神经纤维的数量及其与朗格汉斯细胞关系的研究

目的探讨神经性皮炎患者皮损处神经纤维的数量变化及其与朗格汉斯细胞接触的关系.方法用辣根过氧化物酶结合的链霉亲和素-生物素技术观察24例神经性皮炎患者皮损处神经纤维的表达及数量变化.用免疫荧光双标记及共聚焦激光扫描显微镜技术观察神经性皮炎患者皮损处神经纤维与朗格汉斯细胞接触数量关系.用实时定量PCR方法检测皮损处神经生长因子mRNA的表达情况.结果 神经性皮炎患者皮损处神经纤维长度显著增加,与皮损周边对照(t=6.90,P<0.001)及正常人对照(t=5.71,P<0.001)比较差异有统计学意义.皮损表皮内有神经纤维接触的朗格汉斯细胞占朗格汉斯细胞总数的百分数明显增多,与皮损周边对照(X²=43.91,P<0.001)及正常人对照(X²=46.11,P<0.001)比较差异有统计学意义.皮损处神经生长因子mRNA高表达,与皮损周边对照(t=3.25,P<0.01)及正常人对照(t=3.67,P<0.01)比较差异有统计学意义.结论 神经性皮炎患者皮损处存在高水平活性的NGF导致神经纤维增生.     

寻常性银屑病皮损处神经纤维的数量及其与朗格汉斯细胞关系的观察

目的 观察寻常性银屑病患者皮损处神经纤维的数量变化及其与朗格汉斯细胞的关系.方法采用免疫组化过氧化物酶法观察28例寻常性银屑病患者皮损处神经纤维的数量变化;采用免疫荧光双标记及共聚焦激光扫描显微镜技术观察寻常性银屑病患者皮损处神经纤维与朗格汉斯细胞的关系.结果寻常性银屑病患者皮损处神经纤维长度显著增加,与正常人对照比较有统计学差异(t=4.09,P＜0.001).皮损表皮内神经纤维与朗格汉斯细胞的接触明显增多,与正常人对照比较有统计学差异(t=3.55,P＜0.01).结论寻常性银屑病皮损处神经纤维长度显著增加,表明此部位神经纤维增生明显,并且表皮内神经纤维与朗格汉斯细胞的直接接触明显增加,提示银屑病患者神经系统的免疫调控作用可能是通过改变朗格汉斯细胞的功能实现的。     

Relationship between the distribution of pseudoxanthoma elasticum skin and mucous membrane lesions and cardiovascular involvement

Pseudoxanthoma elasticum (PXE) primarily affects organs that are abundant in elastic fibers, such as the skin, eye and blood vessels, and may eventually cause loss of vision or cardiovascular disease (CVD). Because CVD is a potentially life-threatening complication, its early detection is important for improving the quality of life of PXE patients. To determine the relationship between the distribution of skin and mucous membrane lesions and the prevalence of CVD in patients with PXE, we examined 14 PXE cases who presented between 2004 and 2007. All patients had angioid streaks (AS) and positive pathological findings. The skin lesions in PXE patients are distributed discontinuously and thus the degrees of skin involvement were assessed by determining the presence or absence of PXE skin and mucous membrane lesions in six sites (oral mucosa, neck, periumbilical region, cubital fossa, axillae and inguinal regions). Each site was given a binary score (i.e. present = 1, absent = 0) irrespective of severity and the scores were summed to yield a total distribution score (potential range of 0–6). Four cases had PXE-associated CVD. Their mean distribution score was 5.7, which was significantly higher than the score of the cases without CVD (1.8) ( P  =   0.0049). There was also significant correlation between the high distribution score ( P  =   0.0053) as well as CVD ( P  =   0.029) with the maximum width of AS. A higher distribution score and the presence of oral mucosal lesions were associated with CVD. This scoring method may be useful for predicting the presence of CVD in PXE patients.     

Fibronectin distribution in epithelial and associated tissues of the rat

Summary Specific antiserum was used to investigate the distribution of the extracellular glycoprotein, fibronectin, in rat skin and tongue tissue by light and electron microscopy with immunofluorescence and immunoperoxidase techniques. We conclude that fibronectin is absent from stable, differentiated parts of tissues, such as the sebaceous glands or the matrix, medulla, cortex, and cuticles of the hair and the inner and outer root sheaths, or even in tissues in which there is some cell movement, such as the epidermis. It is, however, characteristic of sites at which cell division is occurring in contact with an extracellular scaffolding, such as basement membrane or loose connective tissue. Conspicuous examples were in the glassy membrane and connective tissue sheath associated with the follicular epithelium, the basement membrane underlying vascular endothelial cells, the connective tissues surrounding and investing nerve and muscle fibre bundles, and the dermal connective tissue where fibronectin was often associated closely with collagen fibres.At the basement membrane of the dermal/epidermal junction, fibronectin occurred at the plasma membrane of the basal cells and in the lamina lucida area. There was no correlation with specific areas of cell-substrate adhesion, such as the hemidesmosomes. The endoplasmic reticulum of fibroblasts stained strongly suggesting that these cells represent a major site of synthesis.     

Expression and modulation of the vitronectin receptor on human dermal microvascular endothelial cells.

Microvascular endothelial cells express a variety of cell-surface integrins in vivo and in vitro with varying affinities for matrix proteins. The vitronectin receptor (VnR), a complex of the alpha v and beta 3 integrin chains, is capable of binding to a variety of matrix proteins that are deposited in injured tissues, including vitronectin, fibrinogen, and thrombin. Staining of frozen sections of human skin with antibodies recognizing the VnR and examination by immunofluorescence microscopy demonstrates staining in a vascular pattern suggesting in vivo expression of the vitronectin receptor on endothelial cells. Examination of pure cultures of human dermal microvascular endothelial cells (HDMEC) by flow-cytometric analysis and enzyme-linked immunosorbent assay confirmed that HDMEC also express cell surface VnR complex in vitro. Stimulation of human dermal microvascular endothelial cells in vitro with agents that stimulate protein kinase C resulted in dose- and time-dependent increases in expression of alpha v and beta 3 integrin chains. Additionally, stimulation with basic fibroblast growth factor induced similar increases, but stimulation with transforming growth factor-beta or interleukin-1 alpha failed to increase VnR expression. Increases in cell-surface VnR expression also correlated with an increased ability of microvascular endothelial cells to bind to vitronectin, but not fibronectin-coated surfaces. Although increases in cell-surface expression of beta 3 paralleled increases in expression of cell-surface alpha v, regulation of mRNA expression was distinct for each chain. These data suggests that microvascular endothelial cells express the VnR complex in vivo, that the cell-surface expression of this integrin on dermal microvascular endothelial cells can be regulated, and that this regulation may be important in cell adherence, cell migration, and wound healing.     

The use of botulinum toxin‐A in the management of neck and anterior chest wall flushing: pilot study

Idiopathic neck and chest wall flushing could cause disabling effects on patients' quality of life. We aimed to evaluate the effectiveness of botulinum toxin‐A (BTA) in the management of idiopathic neck and chest wall flushing. This was a pilot prospective clinical study of patients with severe idiopathic neck and anterior chest wall flushing. Two mouse units of BTA were injected intracutaneously with a maximum dose of 100 units per patient per session. The dermatology life quality index is used as the primary outcome measure. Twenty‐two patients were included in the study (18 women, four men) with an average age of 26 years (range 18–48). Twenty patients (90.9%) had immediate improvement with almost complete resolution of their flushing. At four weeks follow‐up, 18 of 22 patients were included in the final analysis, significant improvement in quality of life was achieved, and mean baseline dermatology life quality index score 7.78 (SD 3.25) improved significantly to 4.23 (SD 3.44) with a mean difference of 3.56 (SD 4.6; 95%, confidence interval 1.27, 5.84) with paired samples t‐test 3.29 (d.f. 17) P < 0.004. BTA may provide an effective treatment in the management of idiopathic neck and chest wall flushing.     

求嗣丹治疗阳痿的临床双盲前瞻性研究

目的:探讨求嗣丹治疗阳痿的临床疗效。方法:以安慰剂对照,将130例阳痿患者随机分为两组,双盲给药。结果:以纯中药制剂求嗣丹治疗功能性阳痿66例,获近期治愈率40·91%,总有效率90·91%,与安慰剂治疗的64例比较,χ2=48·85,P<0·01,两组疗效有显著差异。结论:求嗣丹治疗气虚而又肾精不足所致的功能性阳痿有较好的临床疗效。