CO2激光联合重组人干扰素α-2b凝胶外用治疗尖锐湿疣40例

目的 观察应用CO2激光联合重组人干扰素α-2b凝胶外用治疗尖锐湿疣(CA)疗效、复发率及副作用.方法 80例CA患者,其中男性46例,女件34例,年龄17～56岁,平均年龄28.6岁.分成治疗组40例和对照组40例,两组患者均采用CO2激光去除全部疣体.治疗组患者加用消毒棉签将干扰素涂于皮损及周围,每天4次,连用8周.对照组激光治疗后不再应用任何药物治疗.治疗后2周进行检查,以后每月复查1次,共3个月.结果 经CO2激光治疗后,疣体小者一般4～7 d愈合,面积较大者1～2周痊愈.治疗组复发4例(占10.0%);其中第1、2、3个月分别复发为2例、1例、1例.对照组复发11例(占27.5%).其中第1、2、3个月分别复发6、3、2例.治疗组复发率明显低于对照组.结论 采用CO2激光联合重组人干扰素α-2b凝胶外用治疗CA可明显降低复发率,提高了疗效,且不良反应轻微,值得临床推广.     

微波治疗阴道尖锐湿疣56例

在微波治疗基础上 ,联合使用免疫制剂治疗阴道尖锐湿疣 (ＨＰＶ) 56例 ,现报告如下。资料与方法1 .一般资料 ,本组 56例 ,年龄 1 8岁～ 53岁 ,病程 ,1ｗ～4ｗ ,病变位于阴道入口或阴道壁 ,大小由米粒至大花生米不等 ,呈散在乳头状或菜花状 ,醋酸试验阳性。2 .治疗方法 ,微波治疗 56例 ,对疣体大于花生米 ,分 1～ 2次进行微波治疗[1 ] ,另丘疹型及小米粒大用 50 %三氯醋酸局部外涂 ,较小的 1次即可 ,4天涂药治疗一次 ,疣体全部脱落后停药 ,治疗由医生执行。同时 45例肌注α -干扰素1 0 0ｍｇ ,每天 1次 ,连续 7天。3 .结果 7～ 1 0天后复诊疣…     

5%咪喹莫特乳膏联合微波治疗尖锐湿疣疗效观察

目的：观察和分析5%咪喹莫特乳膏联合微波治疗尖锐湿疣(CA)的疗效及不良反应。方法选取我院2010年3月~2013年4月患尖锐湿疣的90例患者，其中治疗组50例实施微波祛除疣体后，再将5%咪喹莫特乳膏涂于患处，2d/1次，持续用8w。对照组40例患者实施单纯的微波祛除疣体手术，随诊3个月，观察疗效和复发情况。结果5%咪喹莫特乳膏联合微波治疗尖锐湿疣的疗效好，其复发率明显比微波疗法低(<0.01)。结论5%咪喹莫特乳膏联合微波治疗尖锐湿疣具有显著的疗效，复发率较低，并且方便安全，值得推广。     

安福隆局部注射联合捷抚外用治疗尖锐湿疣的临床观察

目的观察重组人干扰素α-2b局部注射及喷雾剂外用治疗尖锐湿疣的疗效及复发率。方法96例患者按数字表法分成对照A、对照B及治疗组各32例。A组采用CO2激光去除疣体至亚临床皮损达真皮浅层,同时口服先锋Ⅵ胶囊0.25g,每天2次×7d。B组在A组治疗方法基础上,于皮损基底部注射安福隆100万U,2次/周,共10次。治疗组在B组治疗方法基础上,应用捷抚喷雾剂喷涂创面,3次/日,连用4周。疗程结束后评价疗效及随访6个月观察复发率。结果治愈率A组为43.75%(14/32),B组为68.75%(22/32),治疗组为90.63%(29/32),三组比较有统计学意义(P<0.05);复发率A组42.86%(6/14),B组13.64%(3/22),治疗组为10.34%(3/29),A组与B组、A组与治疗组比较均有统计学意义(P<0.05),B组与治疗组比较无统计学意义(P>0.05)。结论重组人干扰素α-2b局部注射联合其喷雾剂外用及CO2激光治疗尖锐湿疣治愈率提高,部分病例可延迟复发。     

自体疣移植治疗复发性尖锐湿疣

生殖器尖锐湿疣为性病常见病 ,治疗方法有刮除、CO2 激光、冷冻等 ,但术后均有较高的复发率。近二年我科对复发型尖锐湿疣给予疣刮除加自体疣移植术 ,并与单纯疣刮除进行比较 ,取得了较好疗效 ,现报道如下。1　材料与方法1 1　研究对象　全部病例均来自我科门诊。共 5 0例 ,男 30例 ,女 2 0例 ,年龄 2 2～ 5 8岁 ,平均 32岁。病程 1月至 3年 ,平均 6个月。皮损 2～ 2 5颗。复发 1次 2 0例 ,复发 2次 19例 ,复发 3次 8例 ,复发 4次 3例。发病部位女性以大小阴唇为主 ,少数为尿道口周围及阴道壁 ;男性以包皮、冠状沟为多见 ,少数为肛周 ,均具…     

苦参碱注射液对婴儿巨细胞病毒性肝炎患者肿瘤坏死因子-α（TNF-α）的影响

目的苦参碱注射液对婴儿巨细胞病毒性肝炎患者肿瘤坏死因子-α（TNF-α）的影响。方法将42例婴儿巨细胞病毒（CMV）肝炎患儿随机分为苦参碱治疗组（n=22）与更昔洛韦对照组（n=20）。两组均予以常规保肝降酶治疗为基础。苦参碱治疗组用苦参碱注射液20-25mg/d静脉滴注,每日1次,连用14天;间隔7-10天后20-25mg/kg.d静脉滴注,每日1次,连用5天,共2-3个疗程。更昔洛韦对照组用更昔洛韦5mg/kg.d静脉滴注,每日2次,连用14天;间隔7-10天后5mg/kg.d静脉滴注,每日1次,连用5天,共2-3个疗程。观察两组TNF-α水平变化。结果治疗前、后苦参碱注射液对血TNF-α、TBIL、ALT的变化。（P〈0.01）。结论苦参碱注射液治疗婴儿巨细胞病毒性肝炎疗效确切,可能与抑制TNF-α释放有关。     

尖锐湿疣联合治疗的临床效果观察

<正>尖锐湿疣(Condyloma Acuminatum,CA)是临床常见的性传播疾病,治疗方法多,疗效也较为满意。易复发是该病的特点,针对其易复发性,本院采用电灼祛除疣体,5-氟尿嘧啶局部浸润,干扰素肌肉注射,治疗CA 120例,临床观察疣体祛除彻底,复发率低。联合治疗1个疗程治愈率91.67%,为治疗CA简单有效实用的方法,现报告如下。1资料与方法1.1临床资料2009年3月至2013年1月,本科收治CA患者120例,均为     

不同剂量干扰素治疗尖锐湿疣近期疗效观察

目的 观察不同剂量α-2β干扰素治疗尖锐湿疣的近期疔效. 方法对107例尖锐湿疣患者随机开放分为a、b、c三组, 每次分別肌注100万u、300万u、500万u α-2β干扰素,均为每二天一次,共15次,持续1个月.结果 三组的治愈率分别为0%、2.77%、2.86%,有效率8.33%、11.11%、11.42%,P>0.05,未愈者用激光除去疣体,复发率降低,且与剂量大小无关.     

温热疗法与10%聚维酮碘联合激光治疗复发性尖锐湿疣

目的：探讨温热疗法与10%聚维酮碘联合激光治疗复发性尖锐湿疣的有效性及安全性。方法：将60例复发性尖锐湿疣患者随机分为A、B组,每组30例。A组应用温热疗法与10%聚维酮碘联合激光治疗;B组应用激光治疗;小于1 cm疣体的复发性尖锐湿疣患者30例作为C组,应用光动力治疗。每组观察6个月然后判定疗效。结果：A组治愈27例,复发3例;B组治愈19例,复发11例;C组治愈26例,复发4例;A组疗效优于B组（χ2=5.963,P=0.015）;而A组与C组的疗效比较差异无统计学意义（χ2=0.162,P=0.688）。A组治疗期间出现可耐受不良反应。结论：温热疗法与10%聚维酮碘联合激光治疗复发性尖锐湿疣有效而安全,优于单纯激光治疗,与光动力治疗疗效相当。     

甲氨蝶呤配伍米非司酮治疗异位妊娠42例

目的探讨甲氨蝶呤配伍米非司酮治疗异位妊娠的疗效。方法治疗组42例,甲氨蝶呤20mg,臀部肌肉注射,每日1次,连用5天,同时给予米非司酮50mg·d,po,连服3d;对照组36例,仅用甲氨蝶呤20mg,臀部肌肉注射,每日1次,连用5天,两组用药后每周复查血绒毛膜促性腺激素一次,直至降至正常。结果血β-hcG转阴所需时间治疗组较对照组短,差异有高度统计意义(P<0.01)。第1疗程治疗组治愈率为61.9%,对照组为33.3%,两组比较差异有统计意义(P<0.05);结论甲氨蝶呤联合米非司酮保守治疗异位妊娠,提高了疗效,减少了副作用。     

B超引导下羊膜腔穿刺术2种方法在产前诊断中的应用比较研究

目的探讨妊娠中期B超声引导下行羊膜腔穿刺术抽取羊水的安全性。方法回顾性分析在桂林医学院附属医院进行产前诊断并知情选择的孕妇资料。共298例孕妇在超声引导下经腹羊膜腔穿刺抽取羊水,做细胞培养,检查胎儿染色体核型。有两组分组,A组为凸阵型探头引导下徒手穿刺,B组为凸阵型探头安装附加穿刺装置引导下进行穿刺（亦称实时超声引导）,比较两组首次穿刺成功率、羊水血污染率及手术并发症发生率。结果首次穿刺成功率由90%上升为97%,效果显著;羊水母血污染率由16%下降为3%。急症分娩率的比较无明显差异。结论实时超声引导直视下经腹羊膜腔穿刺抽取羊水成功率高、方法简便、安全、羊水质量高,可使多数孕妇能够接受,获得明确的诊断,。     

Evaluation of maternal infusion therapy during pregnancy for fetal development

The aim of this project was to study the possible association between maternal infusion treatments during pregnancy and variables of fetal development as well as the occurrence of congenital abnormalities (CA) in a case-control design. The large population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA) was evaluated based on the medically recorded infusion treatment during pregnancy. Of 22,843 case pregnant women who had newborns or fetuses with congenital abnormalities, 112 (0.5%), while of 38,151 control pregnant women who had newborn infants without any defects, 262 (0.7%), had infusion treatment during pregnancy. Infusion treatment was more frequent in the control group than in the case group with congenital abnormalities (adjusted POR with 945 95% CI: 0.7, 0.6-0.9) and there was no higher rate of maternal infusion treatments in any congenital abnormality group. Mean gestational age was shorter and mean birth weight was smaller in control newborn infants without CA born to mothers with infusion treatment during pregnancy than in the babies of mothers without infusion treatment. The prevalence of mild intrauterine growth retardation was more frequent in the fetuses of pregnant women with hyperemesis gravidarum treated with infusion. The results of the study suggest that infusion treatment of pregnant women did not associate with a higher risk of congenital abnormalities. In addition, the intravenous infusion of drugs has some, but limited efficacy to prevent the adverse effects of hyperemesis gravidarum and threatened preterm delivery.     

乳杆菌活菌胶囊治疗妊娠期细菌性阴道病的临床观察

目的 调查妊娠期细菌性阴道病（BV）的发病情况，观察乳杆菌活菌胶囊治疗细菌性阴道病的疗效。方法对不同孕周的926名孕妇进行BV筛查，确定妊娠期细菌性阴道病的发病率。取BV患者164例，乳杆菌活菌胶囊治疗82例，孚舒达栓治疗82例，用药10d，停药1w后复查。结果妊娠期BV的检出率为17．71％。乳杆菌活菌胶囊治疗BV有效率89．02％，孚舒达栓治疗BV有效率87．80％，二者差异无显著性（P〉0．5）。结论妊娠期BV有较高的发病率，乳杆菌活菌胶囊是治疗BV的安全有效药物。     

Diagnosis of ovarian tumor by measuring tumor markers]

Values of CA125, CA19-9, TPA, CA72-4, BFP and LDH in sera were detected in 148 malignant ovarian tumors, 41 borderline malignant ovarian tumors, 71 benign ovarian tumors and 64 benign uterine diseases. A new cut-off value was determined by ROC graph for distinguishing malignant and borderline ovarian tumors from benign ovarian tumors. CA125 (cut off: 30 U/ml) was a highly sensitive marker for malignant and borderline malignant ovarian tumors, the value being 88.1% (52/59) and 81.8% (9/11), respectively. On the other hand, in 37 benign ovarian tumors, the positive rate was 21.6% and in 21 benign uterine diseases it was 52.4%. CA19-9 (cut off: 150 U/ml) was inferior to CA125, but it was an effective marker for mucinous ovarian tumors. TPA (cut off: 40 U/ml) was also a sensitive (84.7%, 50/59) marker of malignant ovarian tumors. CA72-4 (cut off: 4 U/ml) was a highly specific (87.0%, 60/69) marker of malignant ovarian tumors. Combination assays of CA125/CA19-9, CA125/TPA and CA125/CA72-4 were not effective. Usefulness of BFP for early malignant ovarian tumors was suggested. Seven cases of dysgerminoma showed extremely elevated LDH levels (1,248 +/- 886 IU/1/37 degrees C). Malignancy and histological type of ovarian tumors could be decided by combination assay of these tumor markers, before surgical operation.     

定君生胶囊用于妊娠期细菌性阴道病的临床观察

目的调查妊娠期细菌性阴道病(BV)的发病情况,观察定君生胶囊治疗细菌性阴道病的有效性。方法采用珠海市银科生物技术应用研究所生产的细菌性阴道病快速检测卡,对不同孕周的1500名孕妇进行BV筛查,确定妊娠期细菌性阴道病的发病率。对确诊为BV的孕妇266例,随机分为两组。定君生组:136例,给予定君生胶囊(乳杆菌活菌胶囊)阴道给药治疗;孚舒达组:130例,给予孚舒达栓(复方甲硝唑栓)阴道给药治疗。两组均连续用药10d,停药7d后复查。结果妊娠期BV的检出率为17.73%。定君生胶囊治疗BV的总有效率为92.65%,孚舒达栓治疗BV的总有效率为91.53%,二者差异无显著性(P>0.5)。结论妊娠期BV的发病率较高。定君生胶囊能有效改善阴道内生态环境,治疗妊娠期细菌性阴道病安全、有效,易为孕妇所接受。     

妊娠合并甲状腺功能亢进32例临床分析

目的探讨妊娠合并甲状腺功能亢进的处理原则及对母体造成的影响。方法回顾分析我院2004年1月~2006年12月住院分娩的妊娠合并甲状腺功能亢进32例患者资料。结果妊娠合并甲亢占同期住院分娩数的0.22%。1例患者中因胎盘早剥,大出血,急诊剖宫产术中出现甲亢危象,抢救无效死亡,合并妊娠高血压综合征5例(重度2例),其中发生心衰1例。结论甲亢危象是妊娠合并甲状腺功能亢进患者死亡的主要原因;出血,手术可诱发甲亢危象,去除诱因,合理用药是预防甲亢危象有效的方法;甲亢合并妊娠高血压综合征时注意防治心衰;妊娠期间甲亢治疗首选丙基硫氧嘧啶。     

心理支持疗法对孕妇分娩过程的影响

目的探讨心理支持疗法对孕妇分娩过程的影响。方法将应用焦虑自评量表(SAS)、抑郁自评量表(SDS)在分娩前2周内测评出有焦虑、抑郁情绪的90例孕妇,随机分为治疗组(45例)与对照组(45例),对治疗组给予心理支持治疗,比较两组分娩情况。结果治疗组:剖宫产率低、产程短、新生儿窒息和产后出血少,两组差异有显著性(P<0.05或P<0.01)。结论心理支持疗法对孕妇分娩过程起积极的促进作用,应在产科领域积极推广、应用.     

Depression symptoms during pregnancy

Summary Pregnancy impacts common symptoms of major depressive disorder (MDD), such as energy, appetite, weight change, and sleep and somatic complaints. However, it is not known whether the presentation of depression during pregnancy is different from that at other times in women’s lives. This study compares the severity of symptoms of depression in 61 pregnant women with MDD (PD), 50 nonpregnant women with MDD (D), and 41 pregnant women without MDD (P). Despite equivalent overall depression severity, PD women had lower scores on suicidality, guilt, and early insomnia and higher scores on psychomotor retardation than D women. The severity of other depressive symptoms was similar in the two depressed groups. As expected on the basis of the selection criteria, overall depression severity and the severity of individual symptoms were significantly higher in the PD group than in the P group but effect sizes for somatic symptoms were smaller than for psychological symptoms. The results suggest that the profile of depression symptoms of women with MDD who are pregnant does not differ much from that of depressed nonpregnant women. Depressive symptoms, particularly psychological symptoms of depression, during pregnancy should be taken seriously and not be dismissed as a normal part of the pregnancy experience. Correspondence: Rachel Manber, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road Suite 3301, Stanford, CA 94305, USA     

Metformin reduces pregnancy complications without affecting androgen levels in pregnant polycystic ovary syndrome women: results of a randomized study

BACKGROUND: Investigation of a possible effect of metformin on androgen levels in pregnant women with polycystic ovary syndrome (PCOS). METHODS: A prospective, randomized, double-blind, placebo-controlled pilot study was conducted. Forty pregnant women with PCOS received diet and lifestyle counselling and were randomized to either metformin 850 mg twice daily or placebo. Primary outcome measures were changes in serum levels of dehydroepiandrosterone sulphate, androstenedione, testosterone, sex hormone-binding globulin, and free testosterone index. Secondary outcome measures were pregnancy complications and outcome. Two-tailed t-tests and chi2-tests were used. RESULTS: Maternal androgen levels were unaffected by metformin treatment in pregnant women with PCOS. While none of the 18 women in the metformin group experienced a severe pregnancy or post-partum complication, seven of the 22 (32%) women experienced severe complications in the placebo group (P = 0.01). CONCLUSIONS: Metformin treatment did not reduce maternal androgen levels in pregnant women with PCOS. In the metformin-treated group we observed a reduction of severe, pregnancy and post-partum complications. Metformin treatment of pregnant PCOS women may reduce complications during pregnancy and in the post-partum period.     

Early pregnancy factor in cervical mucus of pregnant women

PROBLEM: This study was carried out to determine the presence of early pregnancy factor (EPF) activity in cervical mucus of pregnant women and explore the relationship between EPF activity in sera suggested it and in cervical mucus. METHOD OF STUDY: Cervical mucus and sera were collected from 60 pregnant women in different terms and 25 non-pregnant women, respectively. EPF activity was detected by rosette inhibition assay. RESULTS: EPF activity did exist in cervical mucus of pregnant women and was similar both in cervical mucus and sera. CONCLUSIONS: We report here for the first time the EPF activity in cervical mucus of pregnant women. The parallel change observed in sera suggested it might be another useful index in evaluating embryo viability.