加德纳菌影响女性生育的实验研究

目的：探讨阴道加德纳菌对不孕不育女性患者生育的影响,分析经过系统治疗阴道加德纳菌转阴后的怀孕几率。方法：选择2010年3月至2013年4月来我院就诊的不孕不育女性患者,阴道加德纳菌涂片检查阳性并且经过系统治疗后的女性患者50例作为实验组。其中以检测阴道加德纳菌涂片检查阳性,没有接受系统治疗的50例作为阳性对照组。以同时期在孕前检查为正常健康女性,在其孕前检查时取标本,婚前检测及婚后1年中每个月来我院检查一次阴道加德纳菌为阴性者,入选50例为阴性对照组。通过免疫荧光法检测两组女性阴道分泌物的加德纳菌。结果：实验组的成功生育几率为90%（45/50）,阳性对照组的生育几率为30%（15/50）,阴性对照组的生育几率为96%（48/50）。阳性对照组与实验组比较有统计学意义P〈0.01,阴性对照组与实验组比较无统计学意义P〉0.05。结论：阴道加德纳菌对女性的生育有严重的影响。     

167例STD患者加德纳细菌检测结果分析

阴道加德纳细菌(Gardeneralla vaginalisGV)所致的细菌性阴道病(Bacterial vagi-nalis BV)是近年来新认识的一种性传播疾病(STDs)。该病在广州地区鲜有报道,现将我科 STDs 门诊的167例 STD 患者加德纳菌的检测结果分析报告如下:     

309例阴道涂片检查与细菌性阴道病关系探讨

目的 以阴道分泌物涂片检查诊断细菌性阴道病及阴道菌群动态观察，探讨其间关系。方法 对309例患者行阴道分泌物涂片直接镜检、革兰氏染色及宫颈粘液镜检，进行线索细胞、细菌定性计数和支原体检查。结果 线索细胞阳性率为55.0%（170／309），支原体为83.6%(204／244）；线索细胞阳性者；乳酸杆菌阴性率为71.8(122/170)，上皮细胞检出率为94.1（160／170）。结论 以线索细胞为诊断和治疗细菌性阴道病的主要依据，阴道常在乳酸杆菌显著减少为辅助指标，白细胞明显不增多，上皮细胞减少，与支原体感染有一定关系。     

细菌性阴道病诊断方法的研究进展

细菌性阴道病是导致育龄期妇女白带异常的常见原因,未经治疗或治疗不及时可致多种并发症.目前细菌性阴道病病因尚不明确,诊断以Amsel临床标准或Nugent评分法为主,但均存在主观性较强、费时费力、需要有相应知识的技术人员操作的缺点.近年来对细菌性阴道病快速检测及分子生物学诊断研究有了较大进展,主要以细菌定量为诊断依据,尚需进一步检验其诊断效能,尚未广泛应用于临床.     

阴道加德纳菌抗体检测的临床应用

阴道加德纳菌抗体检测的临床应用吕文和，李玉华，于秀英，陈颖，于永兰，张惠芹青岛医学院附属医院检验科（邮政编码２６６００３）细菌性阴道病（ＢａｃｔｅｒｉａｌＶａｇｉｎｏｓｉｓ，ＢＶ）过去称非特异性阴道炎。由于该病致病菌阴道加德纳菌（Ｇａｒｄ－ｎｅｒａｌ...     

细菌性阴道病的研究现状

细菌性阴道病是育龄期妇女常见的阴道感染性疾病之一,可经性途径传播,在不同人群中患病率不同。阴道加德纳菌是主要病原体,与某些厌氧菌混合感染引起阴道微生态环境紊乱。诊断方法与技术的改进,多项指标联合检测,为广泛深入研究细菌性阴道病提供了依据。     

对加德纳菌阴道炎的调查分析

细菌性阴道病是近年来被确定的与性传播有关的疾病。其病原体为阴道加德纳菌,随着性病病原体感染谱的变化,发病率有逐年增高的趋势。目前对加德纳菌的实验诊断,主要的还是直接涂片找线索细胞。我们对187名年龄在20～29岁的已婚妇女,均无不良性行为,夫妻性生活正常,对其宫颈分泌物检测。     

阴道加德纳菌和细菌性阴道病相关性研究

为了解阴道加德纳菌（ Gardnerella vaginalis,Gv)与细菌性阴道病（ Bv）的相关性,采用荧光标记抗体染色技术对 150例临床诊断为细菌性阴道病的患者分泌物涂片和 100例正常对照者的分泌物涂片进行 Gv的检出;结果显示,患病组 Gv检出率（ 59％）明显高于对照组（ 25％）, P< 0.01;患病组分泌物湿片“线索细胞”阳性的涂片（ 140例）中, 96％（ 135/140）的“线索细胞”周围显示吸附的细菌是 Gv,提示 Gv和 Bv之间有密切的联系, Cv是 Bv的病原菌之一。     

女性下生殖道解脲脲原体感染的检测及与其他感染相关分析

目的: 了解海口地区解脲脲原体(UU)感染情况及其与四种常见女性阴道炎、宫颈炎的关系.方法: 对606例女性就诊患者采样进行淋病、阴道念珠菌病、滴虫性阴道炎、细菌性阴道病病原体和UU进行检测.结果: UU总感染率为51.16%(310/606);606例患者中混合感染占210例,其中UU感染135例占混合感染检出率的64.29%;淋病、阴道念珠菌病、滴虫性阴道炎时宫颈UU检出率差异无统计学意义(P＞0.05);细菌性阴道病时宫颈UU检出率差异有统计学意义(P＜0.01)UU检测≥104ccu/mL者,其单独感染率(67.1%)较UU检测菌最＜104ccu/mL者(45.4%)高,混合感染率(32.9%)较UU检测菌量＜104ccu/mL者(54.6%)低,差异有显著性(P＜0.01).结论: 海口地区女性就诊患者UU感染及其与阴道炎、宫颈炎混合感染相当普遍;细菌性阴道病可能是女性UU感染的诱因和易感因素之一.     

应用荧光免疫法检测阴道加德纳细菌

应用荧光免疫法检测阴道加德纳细菌刘彦平，赵淑兰，邵嘉会，黎莉青海医学院微生物教研室（邮政编码８１０００１）阴道加德纳细菌（ＧＶ）所引起的细菌性阴道病已成为许多国家和地区常见的性传播疾病。经我室采用荧光标记的单克隆抗体对９３例妇科门诊患者进行ＧＶ检测，...     

性交出血与宫颈癌及癌前病变的关联

目的：讨论性交出血与宫颈癌及癌前病变的关系.方法：2011年1月至2012年11月我院妇科门诊在自愿接受宫颈癌筛查的患者中选取有性交出血史的631例患者均进行液基细胞学检查、电子阴道镜下宫颈四象限多点活检＋宫颈管搔刮术（ECC）,然后病理诊断,对临床资料进行回顾性分析.结果：TCT阳性率55.47％,其中LSIL 194例,占30.75％,ASC-US 76例（12.04％）,ASC-H 31例（4.91％）,HSIL 48例（7.61％）,AGC 1例（0.16％）.阴道镜下活检病理结果,宫颈上皮内瘤变（CIN） 176例（27.89％）,其中CINⅡ＋CINⅢ101例（57.39％）;宫颈癌19例（3.01％）.结论：性交出血是宫颈病变的警示,我们要重视有性交出血的患者,重点随访.为了降低其宫颈癌及癌前病变漏诊率及误诊率,要采用积极的检查手段.     

Why do different criteria for 'cure' yield different conclusions in comparing two treatments for bacterial vaginosis?

OBJECTIVE: The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis (BV) led to markedly different conclusions about treatment efficacy in a randomized trial comparing metronidazole gel versus metronidazole/nystatin ovules. STUDY: We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14, 42, and 104 days after initiating treatment. RESULTS: Compared with gel, ovules more effectively eliminated amines, clue cells, and Gardnerella, Prevotella, or Mobiluncus morphotypes from vaginal fluid, thus achieving cure based on "usual" criteria (absence of BV by Amsel or Nugent criteria), but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH, thus not meeting Federal Drug Administration (FDA) criteria for cure. CONCLUSION: Because early vaginal recolonization by lactobacilli was poor after both gel and ovules, FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella, clue cells, and amines. Cure defined more "usually" may give more useful information.     

Evaluation of a new rapid diagnostic kit (FemExam) for bacterial vaginosis in patients with vaginal discharge syndrome in The Gambia

BACKGROUND: Diagnosis of bacterial vaginosis (BV) in resource-poor primary health care settings is often overlooked; there is a need for a cheap, rapid, objective point-of-care diagnostic test. GOAL: The goal was to determine the prevalence of BV and to evaluate the performance of a new commercial diagnostic test kit in a developing country environment. STUDY DESIGN: Vaginal and cervical swabs were collected from 230 consecutive women attending a genitourinary medicine clinic with reported symptoms of vaginal discharge and/or itching. Etiological testing was carried out. BV was diagnosed on the basis of the Nugent score, the Amsel clinical criteria, and results of FemExam card tests. Card 1 is for pH and amines, and card 2 measures proline iminopeptidase (PIP) activity. RESULTS: BV prevalence was 47.9% according to the Nugent score. When compared with the Nugent score, the Amsel clinical criteria had a sensitivity of 77.9% and specificity of 58.4%, FemExam card 1 had a sensitivity of 71.4% and specificity of 72.8%, FemExam card 2 had a sensitivity of 70% and specificity of 81.0%, and FemExam cards 1 and 2 combined had a sensitivity of 91.0% and specificity of 61.5%. Cost per patient and cost per true case detected ranged from US $0.74 and US $1.54, respectively, for Gram stain diagnosis, to US $8.32 and US $18.49 for the FemExam two-card method. CONCLUSIONS: In a setting where BV was frequently associated with vaginal discharge, the FemExam test compared favorably with conventional clinical diagnosis, and it has the advantage of being rapid, less subjective, and easily performed. Cutting its cost would provide wider accessibility in developing countries.     

15例隆突性皮肤纤维肉瘤临床及病理分析

目的:分析15例隆突性皮肤纤维肉瘤(DFSP)患者的临床、病理表现。方法:对我院近20年来明确诊断的15例隆突性皮肤纤维肉瘤患者资料进行回顾性分析,分析其临床和病理组织学特点及治疗情况。结果:15例DFSP中男∶女为13∶2,平均年龄38.4岁,肿瘤为单发或多发性结节。最基本的组织学特点是病变在真皮,皮下组织内浸润性生长,瘤细胞形成典型的席纹状结构;免疫组化标记示vimentin阳性率100%(15/15)、CD34阳性率100%(15/15)、肿瘤细胞Ki-67阳性率大于10%比率为60%(9/15),CK、S-100、FVⅢa、CD68均阴性。其中12例行局部切除术,3例行扩大切除加植皮或转移皮瓣修补术。全组病例复发8例(53.3%),均为行局部切除术者。结论:DFSP是一种好发于真皮的低度恶性软组织肿瘤,免疫组化标记有助于明确诊断,外科手术是其主要的治疗方法,但局部切除常易复发。     

The prevalence of interdigital erythrasma in southern region of Turkey

Background Erythrasma is a skin infection which is caused by Corynebacterium minutissimum. Interdigital erythrasma is the most common form. Objective The aim of this study was to detect the frequency and risk factors of interdigital erythrasma in patients with clinically suspected tinea pedis. Methods This study was conducted between June and December 2010 and included 122 patients who had interdigital foot lesions. All patients were examined using a Wood’s lamp. The smears were stained using Gram’s method. Direct examination was performed using 20% potassium hydroxide. Sabouraud dextrose agar and brain heart infusion agar were used for cultures. Moreover, the demographical characteristics of patients, concomitant diseases and clinical findings were also recorded. Cases that were found to be positive on Wood’s lamp examination and/or Gram staining/culture were considered as erythrasma. Results The rate of erythrasma was found to be 46.7%. The mean age was 43.6 years, and the disease was more prevalent in men. The most common clinical finding was desquamation. Mycological examination was found as positive in 40.35% of the patients. No growth was observed in bacteriological cultures. It was found that using only Wood’s lamp examination or Gram staining resulted in 11 (9%) and 19 positive patients (15.6%), respectively, whereas using both Wood’s lamp examination and Gram staining concurrently resulted in 27 positive patients (22.1%). Conclusion Interdigital erythrasma is a commonly seen condition and can clinically mimic tinea pedis. A Wood’s lamp is a good diagnostic tool, but Gram staining, particularly in those with a negative Wood’s lamp result, may be a useful method.     

慢性前列腺炎相关性性功能障碍的研究

目的：通过对已确诊为慢性前列腺炎（CP）的患者性功能及焦虑等调查,了解CP对性功能的影响。方法：通过对已经确诊为CP患者进行问卷式调查,包括文化程度、焦虑自评量表（SAS）、性功能障碍采用勃起功能国际指数问卷（IIEF）调查,进一步了解患者确诊慢性前列腺炎后性功能障碍的因素,找出其中的相关性。结果：调查160例患者,回收有效问卷152份。在有效的152问卷中,存在着不同程度的焦虑。SAS评分40～55分者43例（28.3%）,56～66分者89例（58.55%）,〉67分者20例（13.16%）;而性功能障碍类型分布情况如下：所有患者均有性欲障碍及性满意度下降,勃起功能障碍41例（26.63%）,插入障碍12例（7.9%）,射精障碍79例（51.97%）,早泄63例（41.45%）,逆行射精13例,不射精3例。SAS测评程度与文化程度呈负相关（r=0.72,P〈0.05）,而与性功能障碍呈正相关（r=1.23,P〈0.05）。结论：慢性前列腺炎后焦虑是导致前列腺炎相关性性功能障碍的主要因素之一。     

129例未经治疗的早期梅毒患者脑脊液检测结果的分析

目的:探讨未经治疗的早期梅毒脑脊液各项检测的意义及其对神经梅毒的诊断价值。方法:对129例未经治疗的早期梅毒患者脑脊液进行细胞计数和蛋白定量、VDRL、FTA-ABS、RPR、TPPA检测以及RT-PCR检测TP,并分析不同RPR滴度组及不同RT-PCR结果组脑脊液异常率的差异。结果:脑脊液细胞或蛋白异常者30例(23.26%),VDRL阳性2例(1.55%),FTA-ABS阳性3例(2.33%),RPR阳性5例(3.88%),TPPA阳性10例(7.75%),RT-PCR阳性32例(24.81%)。2例(1.55%)确诊为神经梅毒。血清RPR滴度≤1∶16组与≥1∶32组患者CSF异常率差异有统计学意义(2=8.37,P=0.004)。脑脊液RT-PCR检测阳性与阴性组脑脊液异常率差异有统计学意义(2=4.49,P=0.034)。结论:血清RPR滴度≥1∶32者脑脊液异常率较高,临床中应引起重视。单纯对于未经治疗的早期梅毒而言,用PCR检测脑脊液中TP含量的方法对神经梅毒的诊断不具有明显价值。     

吸毒人群细菌性阴道病的调查

目的：了解细菌性阴道病(BV)在女性吸毒者中的感染率。方法：对399例女性静脉吸毒者进行阴道分泌物涂片，用革兰染色细菌形态计分法进行BV的诊断和菌群分析。结果：在调查的399例女性吸毒者中，确诊BV150例，占37．59％，其中G^ 大杆菌缺如的144例，占96％。在136例中度菌群失调者中G 大杆菌缺如者120例，占88．24％。结论：作为我国HIV感染干预的重点人群一女性吸毒者中BV的发病率高达37．59％。     

宫内妊娠误诊为异位妊娠的原因及对策

目的：探讨宫内妊娠误诊为异位妊娠的原因及对策。方法：对两家医院1998年1月-2008年12月,10年间宫内妊娠误诊为异位妊娠218例及同期确诊为异位妊娠218例采用病例对照方法进行回顾性分析。结果：症状：宫内妊娠组停经史例数及平均停经天数与异位妊娠组均无显著差异（P〉0．05）;阴道流血例数两组有显著差异（P〈0．01）;腹痛例数两组无显著差异（P〉0．05）。体征：宫内妊娠组腹部压痛、宫颈举痛和附件区压痛例数显著低于异位妊娠组。B超检查：宫内膜增厚例数两组之间差异无统计学意义（P〉0．05）。宫内妊娠组附件包块例数少于异位妊娠组（P〈0．05）。宫内妊娠组盆腔积液例数显著少于异位妊娠组（P〈0．01）。β—HCG值：两组入院时血β—HCG平均值差异无统计学意义（P〉0．05）。结论：医师的诊治思维,过分依赖辅助检查等是误诊的主要原因。对有疑问的病例,在患者生命体征平稳的情况下,加强动态观察和期待疗法是必要的。