多囊卵巢综合征患者C-反应蛋白、血脂与临床内分泌特点相关性研究

目的通过对多囊卵巢综合征(PCOS)患者和年龄、体重相匹配的正常妇女进行C-反应蛋白(CRP)、血脂的检测寻找多囊卵巢综合征妇女易患心血管疾病的风险因素。方法64例PCOS和20例年龄、体重匹配的正常健康妇女进行体重指数(BMI)计算、葡萄糖耐量试验(OGTT)、血清胰岛素(INS)、血脂和CRP的测定,比较肥胖、非肥胖;胰岛素抵抗、非胰岛素抵抗;高雄激素、雄激素正常的血脂、C-反应蛋白血中水平。结果PCOS患者总胆固醇(CHO)、CRP明显高于正常对照组,而高密度脂蛋白(HDL)却低于对照组;肥胖的PCOS患者CHO、CRP明显高于非肥胖PCOS患者和对照组,PCOS患者超敏C-反应蛋白(SCRP)水平高于对照组,肥胖的PCOS患者高密度脂蛋白(HDL)低于非肥胖PCOS患者和对照组;胰岛素抵抗的PCOS患者CRP、甘油三酯(TG)明显高于非胰岛素抵抗的PCOS患者,而HDL却低于非胰岛素抵抗者,SCRP高于对照组;高雄激素PCOS患者血清CRP、SCRP水平明显高于雄激素正常组,高雄激素PCOSTG高于雄激素正常组和对照组,而HDL却低于这两组。CRP与肥胖关系最为密切。结论PCOS患者的心血管疾病的风险不是某一个因素决定的,而是多种代谢异常综合作用的结果。肥胖、胰岛素抵抗、高雄激素均是PCOS患者易患心血管疾病的风险因素,但是肥胖与CRP的关系更为密切。     

The construction and reconstruction of the vagina with the colocecum

Absence of the vagina is a distressing problem. In this study, we present the results for 13 patients treated by vaginal replacement using an isolated colocecal segment. There were no important surgical complications, and none of the patients had stenosis of the neovagina. At the time of this report, seven patients had regular and satisfactory intercourse, and none of the remaining patients thought that they were incapable. It is concluded that the colocecal segment provides an acceptable substitute for the vagina and that this procedure is appropriate for the more complex instances of congential and acquired vaginal atresia.     

Leiomyoma of the ovary with ascites and hydrothorax

A case is described in which a leiomyoma of the ovary was accompanied by hydrothorax. There was no reaccumulation of fluid after oophorectomy.     

Initial experiences with the determination of neopterin in the urine of females with genital and breast tumors

The quantitative analysis of urinary neopterin was carried out ahead of the operation by means of high performance liquid chromatography (HPLC). The sample included 98 women with genital or breast neoplasias. Significant differences have been found between the patients with benign or preinvasive neoplasias as well as women with malignancies (p less than 0.001) as compared to a control group of healthy females. The neopterin levels of the malignant tumors were definitely higher than those of the benign tumors (p less than 0.01). As far as genital tract cancer ist concerned, the neopterin levels found were in 51.5 per cent of the cases above the estimated limit with a specificity of 95.1 per cent in healthy patients and 79.5 per cent within the group of nonmalignant gynecologic lesions. The neopterin levels established in patients with genital tract malignancies appear to be related with the stage of the development of the disease (i.e. levels and positive rate are significantly higher in stages III and IV as compared to stages I and II; p less than 0.01). Tests of women with breast cancer showed the smallest number of raised neopterin levels. The average level of the last mentioned cases didn't differ greatly from the levels of the benign breast tumors. Tests of the patients with cancer after treatment showed in 68.8 per cent of all cases neopterin levels corresponding to the clinical findings. However, cases of smaller recurrent tumors may be accompanied by normal neopterin levels as well.(ABSTRACT TRUNCATED AT 250 WORDS)     

Perforation of the uterus and the urinary bladder with the Lippes loop

A 25 year old patient, wearer of a Lippes Loop, required removal of the device 10 months after insertion complaining of pain. Endouterine exploration, hysterometry and laparosocpy failed to detect the device. Finally laparotomy was performed and the IUD, which had perforated the uterus and the urinary bladder, was found in the vesical cavity. This occurrence is very rare; it might, however, be avoided by choosing a different IUD type.     

Trials with the FEMCEPT method of female sterilization and experience with radiopaque methylcyanoacrylate

A previous report described the development of a blind method to deliver methylcyanoacrylate (MCA) transcervically. Using 0.6 ml of a stable MCA whose polymerization time was closely controlled, we reported a 78% bilateral tubal closure rate in 23 cases with hysterosalpingographic control. Subsequent to the previous report, we initiated a study in which patients were randomly assigned to one of three treatment groups: a single MCA injection, a single MCA injection after uterine lavage, or two MCA injections 1 month apart. In addition, a radiopaque MCA has been developed with which it is possible to determine tubal entry after its application by means of the FEMCEPT device. Patients treated with radiopaque MCA have been studied to determine whether it is possible to predict tubal closure on the basis of tubal entry and distribution patterns. The results of these studies and their implications for contraceptive effectiveness of the FEMCEPT/MCA system will be reported.     

易栓症导致复发性流产因素的检测和治疗

本文主要探讨复发性流产与易栓症的关系,阐述易栓症导致复发性流产的病因分类、诊断和治疗方案。     

LMP2基因多态性及夫妻共享率与重度子癎前期的相关性研究

目的测定重度子癎前期(severe pre-eclampsia,S-PE)患者和正常孕妇多功能蛋白酶(1arge multifunctional protease,LMP2)基因多态性及夫妻共享率,探讨该基因与S-PE发病的相关性.方法选择102例S-PE患者及其配偶为研究对象,随机选择200例正常孕妇及其配偶作为对照.所选孕妇均为单胎初孕,孕35～40周.各取2 ml外周静脉血抽提DNA,应用PCR-RFLP方法进行LMP2基因分型. 结果 LMP2R/H在S-PE患者中的分布频率显著高于正常孕妇组(53.9%和35.5%,P＜0.01),LMP2R/R在S-PE患者中的分布频率显著低于正常孕妇组(41.2%和58.5%,P＜0.01).LMP2R/H在S-PE组的夫妻共享率与正常孕妇组的相比显著增高(24.5%和10.5%,P＜0.01). 结论 LMP2R/H很可能为S-PE发病的易感基因;而LMP2R/R可能是S-pE的保护基因.     

Difference in the size of the placenta and umbilical cord between women with natural pregnancy and those with IVF pregnancy

Purpose

The purpose of this study was to compare the sizes of the placenta and umbilical cord in women with natural pregnancy versus those undergoing in vitro fertilization (IVF).

Methods

Overall, 1610 cases of uncomplicated single pregnancies with vaginal delivery at ≥?37 weeks of gestation were included in this study. The patients were divided into two groups: natural pregnancy group (n?=?1453) and IVF pregnancy not including intracytoplasmic sperm injection (ICSI) treatment (n?=?157). The groups were compared in terms of gestational week, maternal age, parity, maternal weight gain, prepregnancy maternal BMI, infant weight at birth, infant head circumference, placental weight, cross section of the placenta, cross section of the umbilical cord, insertion site of the umbilical cord, and umbilical cord length. Stepwise selection and multivariate logistic regression were used for statistical analysis to correct the result as an independent factor.

Results

There was no difference in the size of the placenta and umbilical cord between women with natural pregnancy and with IVF, but the incidence of velamentous insertion of the cord was significantly increased in women with IVF pregnancy (adjusted odd ratio [AOR] 1.72, 95% confidence interval [CI] 1.08–2.72, p?=?0.026).

Conclusions

Although there is no difference in placental weight and cord size, velamentous insertion of the umbilical cord increases in IVF pregnancy and needs careful observation during the delivery process.

     

Long-term effects of hyperthermia combined with chemotherapy and irradiation for the treatment of patients with carcinoma of the esophagus

Hyperthermia combined with irradiation and chemotherapy was prescribed for patients with resectable or unresectable squamous cell carcinoma of the esophagus. The long term results were compared between two groups of patients; one group was treated with chemotherapy, radiotherapy and hyperthermia (HCR), and the other was treated with chemotherapy and radiotherapy, but not hyperthermia (CR). The five year survival rates of patients with resectable carcinoma, given preoperative HCR or CR, were 43.2 and 14.7 per cent, respectively; the difference was statistically significant (p less than 0.05). The two year survival rates of those with unresectable carcinoma and receiving HCR or CR were 15.5 and 1.2 per cent, respectively. In particular, for the patients classified as TNM Stages I and II, a significantly longer survival period was obtained with HCR. As severe side effects in patients given hyperthermia were nil, this treatment deserves serious consideration when treating patients with a malignant lesion of the esophagus.     

肝内型持续性右脐静脉胎儿预后及与门静脉变异的关系

目的:探讨产前超声诊断肝内型持续性右脐静脉(PRUV)胎儿在一般孕妇人群中的发生率、预后及与门静脉变异的关系。方法:回顾性分析2011年1月至2015年7月在上海交通大学附属第六人民医院产前检查并分娩或终止妊娠的诊断为PRUV胎儿的孕妇49例的临床资料。结果:PRUV胎儿49例均为肝内型,发生率0.32%(1:313)。其中,单纯型肝内型PRUV胎儿45例,占91.84%,预后都良好;4例(8.16%)合并胎儿畸形,其中2例合并严重心血管畸形并中孕引产,2例分别合并室间隔缺损及结肠闭锁,新生儿期手术治疗,预后良好。49例PRUV胎儿肝内门静脉的形态发生变异,门静脉左支如正常胎儿的右支呈分枝状,而门静脉右支如正常胎儿左支呈"工"字型。结论:绝大部分肝内型PRUV胎儿预后良好,但门静脉有变异。     

Carcinoma of the colon and rectum with liver involvement

The records of 126 patients with adenocarcinoma of the colon and rectum who presented with liver involvement were reviewed. Prognosis was determined by the amount of metastases to the liver, which was usually extensive of ascites or a raised alkaline phosphatase level was present. The longest survival period was achieved with resection of the primary tumor along with hepatic lesions confined to a single lobe, especially those due to direct tumor infiltration. If liver deposits were found bilaterally, palliative resection of the primary lesion relieved intestinal symptoms. This may also prolong the survival time, because a fixed primary tumor appeared to diminish the outlook among patients with comparable liver disease. Palliative resection in the presence of ascites resulted in a high mortality, and the survival rate was no better than that after diversion procedures. We recommend resection without anastomosis for carcinoma of the rectosigmoid in patients with ascites and unresectable secondary lesions of the liver.     

Researching the effectiveness and the relevancy of combined therapy with Polygynax and Pharmatex in the cases with proved HPV infection or suspicion of such infection

The HPV infection is the most frequent sexually transmitted disease. It can be estimated that approximately 80% of young women would be infected with it till their fiftieth anniversary. When there is a HPV infection in the zone of the external sexual organs and the introitus, in 90% of the cases, the cervix is also engaged. In the majority of the cases, there is a parallel fungal infection with often presence of bacterial component which sets the low local immunity and creates ideal environment for HPV infection. This fact serves as basis for the application of the therapeutic combination of Polygynax+Pharmatex at this first stage. Relying on the virucide action of the local non-hormonal contraception - Pharmatex and the wide action range of Polygynax, the present clinical research confirmed the rightfulness of our thesis and the efficiency of the suggested therapeutic model.