A newly developed instrument of microbubble test for evaluation of fetal lung maturity

A new instrument for Pattle's microbubble test was devised in order to improve the diagnosis of fetal lung maturity. This instrument consists of 4 needles fixed at 8mm intervals and an air pump. Microbubbles were produced in 175 microliter of amniotic fluid placed on a slide glass by injecting 10 ml of air at 400 ml/h with an air pump through 22 gage needles. After 4 minutes, the number of stable microbubbles less than 15 um in diameter were counted in 5 microscope fields. When over 6 microbubbles were observed, fetal lung maturity was diagnosed as positive. 72 samples of amniotic fluids were tested by our method as well as the other 5 methods. The percentage of accurate diagnostic results was 97.2% with our method, 93.1% with the L/S ratio, 83.3% with the DSPC method, 86.1% with the PG method, 93.1% with the shake method, and 94.4% with the Pattle's original method. It is concluded that ours is a reliable, rapid and simple method for evaluating fetal lung maturity.     

Ovulation induction by step-down administration of purified urinary follicle-stimulating hormone in patients with polycystic ovarian syndrome

The step-down method can be an alternative method of ovulation induction in women with PCOS. This protocol can induce ovulation with a smaller dose of FSH and with lower incidence of excessive ovarian enlargement in comparison with the traditional fixed-dose administration method.     

Determining the time of the urinary luteinizing hormone surge. Does it facilitate the interpretation of endometrial biopsy results?

Recent data suggest that endometrial maturation correlates highly with the postovulatory day as determined by ultrasound or identification of the urinary luteinizing hormone (LH) surge. A study was performed to determine the level of correlation between two methods of endometrial biopsy (EB) interpretation. Method 1 correlated histology with the onset of the next menstrual period; method 2 correlated it with the postovulatory day relative to the LH surge. Forty EBs were analyzed. Both methods agreed that 20/40 EBs were in phase and 6/40 EBs were out of phase (greater than a two-day lag between histologic endometrial maturation and chronologic dating). Of the remaining 14 EBs, 8 were in phase by method 1 and out of phase by method 2, and 6 were out of phase by method 1 and in phase by method 2. Thus, 35% of EBs were considered in phase by one method and out of phase by the alternative method. This implies that 35% of management decisions regarding whether to repeat an EB or treat an out-of-phase EB may be influenced by the method of interpreting EBs.     

Comparing two methods of umbilical artery catheter placement

This study compared the conventional method of umbilical artery catheter placement with a side-entry method. Criteria for comparison were: (1) frequency of correct placement; (2) time required for placement; and (3) incidence of bleeding. Newborn infants less than 3 hours of age who required placement of a umbilical artery catheter were admitted into the study with parental consent. The sample size was 32 catheter attempts (16 conventional method and 16 side-entry method). The side-entry method resulted in more successful catheter placements and required less time without incidence of bleeding. With the conventional method, there were five failures to place the catheter and three incidents of bleeding, resulting in a total blood loss of 14 cc.     

Ultrasound examination of caesarean section scars during pregnancy

Summary Two hundred and sixteen transverse caesarean section scars were examined sonographically near term by a conventional method (175 scars) and a new method (41 scars). The new method consisted of obtaining a transabdominal longitudinal scan by the conventional method and also by a 3M conductor, a transabdominal frontal scan to give a surface view of the scar, and transperineal and transvaginal longitudinal scans. The new method was used from 16 weeks of gestation onwards. Of 41 scars scanned by the new method, 31 showed good healing, being more than 2 mm in thickness throughout; 10 scars showed poor healing with a thickness of less than 2 mm and loss of continuity. Of 31 patients with good healing, 8 delivered vaginally and the remaining 23 patients had repeat caesarean sections for other obstetric indications. All patients with ultrasound evidence of poor healing had repeat caesarean sections. At operation the thickness of the lower uterine segment was measured with ophthalmic calipers. There were 4 false negative results (4/83: 4.8%) and 1 false positive result (1/43: 2.3%) with conventional ultrasound and no false positives or false negatives with the new method.     

改良头位分娩评分法识别头位难产临床应用价值的研究

目的:探讨改良头位分娩评分法用于识别头位难产的可行性及临床应用价值。方法:应用改良头位分娩评分法对625例足月分娩的初孕产妇适时评分,采取相应措施,选择正确分娩方式。结果:改良头位分娩评分法与头位分娩评分法比较,其识别头位难产的敏感性和特异性较高,误诊和漏诊较少。影响头位分娩的诸因素中先露下降、宫口扩张、胎位、宫缩强度、活跃期长短与难产相关性较大;改良法临产评分≤50分者, 69. 5%需行剖宫产术, >50分者, 94. 82%经阴道分娩,与头位分娩评分法比较,改良法与分娩结局更吻合;不同分娩方式处理后,改良法评分均有不同程度地提高,提高越明显,自然分娩几率越高。结论:改良头位分娩评分法将影响分娩的诸因素进行量化评分,能更及时、准确地判断头位顺产或难产,正确选择分娩方式,减少了产科并发症。     

两种不同方法固定胃管的比较研究

目的：比较2种固定胃管方法的效果。方法 40例留置胃管患者随机分为对照组和实验组各20例,对照组胃管固定采用新的法,对照组采用传统法,观察2组胃管脱出情况。结果观察组胃管脱出率为0明显低于对照组。结论新的胃管固定法较传统固定法有较大优越性。     

The Misgav-Ladach method for cesarean section compared to the Pfannenstiel technique

OBJECTIVE: The aim of the study was to evaluate the outcome of two different methods of cesarean section. To determine whether the Misgav-Ladach caesarean technique can offer benefits when compared with conventional Pfannenstiel caesarean section technique. STUDY DESIGN: This study describes operative details and the postoperative course of 110 patients who underwent caesarean section in May 2000 to December 2000 in Department of Gynecology and Obstetrics in Regional Hospital in Slupsk, Poland. METHOD: One group (50 women) was operated with the Misgav-Ladach method for caesarean section and the other group (60 women) with Pfannenstiel method. RESULTS: Operating time was significantly different between the two methods, with an average of 20.2 minutes with the Misgav-Ladach method and 47.3 minutes with the Pfannenstiel method (p < 0.001). Time of child delivery was with average 1.1 minutes with the Misgav-Ladach method and 3.8 minutes with the Pfannenstiel method (p < 0.001). The amount of blood loss different significantly, with 336 ml and 483 ml respectively (p < 0.001). No significant difference was found in Apgar scores. No difference was found in overall postoperative complications, wound infection, febrile illness, febrile morbidity, wound dehiscence affected by the new technique. Significantly less suture material was used during Misgav-Ladach caesarean section compared to Pfannenstiel technique (p < 0.001). CONCLUSION: The Misgav-Ladach method of caesarean section has advantages over the Pfannenstiel technique by being significantly quicker to perform, with the reduced amounts of bleeding and suture material. The women were satisfied with the appearance of their scars. In this study no negative effects of the new operation technique were discovered.     

改良筛网法分离培养人子宫内膜细胞

目的:探索一种能获得较高纯度和较多数量子宫内膜细胞的分离培养方法。方法:取12例患者各1mg新鲜子宫内膜组织,经0.25%Ⅰ型胶原酶(含有0.005%DNA酶)消化后,将所得细胞悬液一分为二,分别采用传统筛网法和改良筛网法(二次筛网过滤和低速离心相结合)分离并记录所得细胞数;体外培养后采用光学显微镜观察,用免疫细胞化学和免疫荧光化学方法鉴定纯度,比较两种方法分离子宫内膜细胞的纯度和数量。结果:两种方法均有11例组织分离培养成功。传统筛网法分离的子宫内膜腺上皮细胞和间质细胞的纯度分别为(89.54±3.75)%和(92.82±1.60)%,细胞数分别为(0.47±0.09)×105个和(23.73±5.37)×105个。改良筛网法分离的腺上皮细胞和间质细胞纯度分别为(91.95±0.47)%和(99.28±0.21)%,细胞数分别为(8.09±1.24)×105个和(27.23±0.50)×105个。改良筛网法分离的腺上皮细胞数量和间质细胞纯度均明显高于传统筛网法,有统计学差异(P均=0.000)。结论:改良筛网法操作简单,能获得较高纯度的子宫内膜间质细胞及较多的子宫内膜腺上皮细胞。     

安神化痰法配合耳穴埋豆治疗小儿多动症疗效观察

目的观察中医安神化痰法配合耳穴埋豆治疗小儿多动症的临床效果。方法 2012年10月至2015年10月陕西省礼泉县计划生育服务站收治小儿多动症患儿53例,随机分为观察组26例和对照组27例。观察组采用中药配合耳穴埋豆治疗,对照组采用单纯中药治疗,治疗3个月,观察两组治疗效果。结果观察组总有效率为96.2%(25/26),显著高于对照组66.7%(18/27),差异有统计学意义(P0.05)。结论中医安神化痰法配合耳穴埋豆治疗小儿多动症疗效显著。     

改良脑脊液处理方法和优化PCR检测系统对结核性脑膜炎患儿的诊断价值

目的 改良脑脊液样本处理方法和优化PCR检测系统，提高结核性脑膜炎诊断阳性率。方法 建立微波-碱性非离子型表面活性剂-氯仿法，并用二甲基亚砜(DMSO)优化结核杆菌插入序列IS 6110 PCR检测系统；分别用微波-碱性非离子型表面活性剂-氯仿法和简易氯仿法处理1998年7月至2004年11月间华中科技大学同济医学院同济医院收集的108份脑脊液样本，经5%DMSO优化的PCR诊断系统扩增，将结果进行比较。结果 微波-碱性非离子型表面活性剂-氯仿法处理脑脊液模板PCR诊断结核性脑膜炎阳性率为88%，简易氯仿法为71%,假阳性率均为0。结论 微波-碱性非离子型表面活性剂 氯仿法和5%DMSO优化的IS 6110 PCR检测系统可有效提高结核性脑膜炎诊断的阳性率。 Abstract Objective To improve the diagnosing level of tuberculosis meningitis (TBM) by means of modified preparation of cerebrospinal fluid (CSF) and optimized IS6110 PCR system.Methods Establishing the modified template preparing method of microwave/ alkaline nonionic detergent/ chloroform and using dimethyl sulphoxide (DMSO) to optimize the PCR system of tubercle bacillus(TB) gene IS6110.Preparing the template from 108 CSF specimens with the microwave/alkaline nonionic detergent/ chloroform method and amplifying IS 6110 gene with DMSO modified system,comparing with the simple chloroform method.ResultsThe modified IS 6110 PCR assay with microwave/alkaline nonionic detergent/chloroform method showed the positive rate of 88%,while the rate of simple chloroform method was 71%.Both false positive rates were 0%. Conclusion The method of preparing the template with the microwave/alkaline nonionic detergent/chloroform method and modifying TB IS 6110 PCR system with 5%DMSO is an effective way to increase the positive rate of TBM diagnosis. Key words Tuberculosis meningitis;Cerebrospinal fluid;Dimethylul sphoxide;Polymerase chain reaction     

Detection of HTLV-I genome in infants born to HTLV-I seropositive mothers by polymerase chain reaction

We developed a new method to detect human T cell leukemia virus type I (HTLV-I) provirus by amplifying the pX region of the HTLV-I genome by means of the polymerase chain reaction (PCR) method. This new method was used to examine babies delivered by HTLV-I carrier women for HTLV-I vertical transmission. It was found that intra-uterine infection with HTLV-I can occur, though rarely, and some babies carry HTLV-I provirus despite their negative response to HTLV-I antibody, and, noticeably, some of the babies found negative by the conventional antigen detection method may be positive when tested by the PCR method. It was also confirmed with the PCR method that the incidence of vertical transmission of HTLV-I can be reduced to about 1/5 by replacing breast feeding with bottle feeding and frozen mother's milk feeding. It was also found that vertical transmission of HTLV-I can occur at high incidence rates even when the duration of breast feeding is 3 months or less.     

Incorporating problem-based learning into an obstetrics/gynecology clerkship: impact on student satisfaction and grades

OBJECTIVE: The purpose of this study was to describe the effect of the problem-based learning method on student grade and on student and faculty satisfaction. STUDY DESIGN: The problem-based learning method was instituted at 2 of 5 obstetrics/gynecology clerkship sites. Students and faculty were surveyed, with the use of a Likert scale, regarding aspects of satisfaction with the clerkship. Responses were compared according to problem-based learning usage. Student performance was also assessed according to problem-based learning usage, with a comparison of several grade components. Statistical analysis involved t-tests and Kendall's tau-C. RESULTS: For the year that was assessed, 54 of 156 students used the problem-based learning method. Mean student satisfaction responses were significantly higher for students who used the problem-based learning method. Faculty satisfaction was also significantly higher for the problem-based learning method, compared with other teaching methods. Mean scores on the National Board of Medical Examiners subject examination were higher for problem-based learning but did not reach statistical significance. Grade distribution was not significantly different for the groups. CONCLUSION: The problem-based learning method was associated with improved student and faculty satisfaction and did not affect student grades negatively.     

低渗介导抽提牛精子线粒体DNA

目的:建立一种通过低渗介导的简便、有效的抽提冷冻牛精子线粒体DNA(mtDNA)的方法。方法:低渗处理牛精子,结合去污剂破膜释放精子线粒体,饱和酚去蛋白,无水乙醇沉淀DNA,设计线粒体特异性引物进行PCR分析以及通过NlaⅢ酶切对抽提获得的mtDNA作酶切鉴定,并以水解法作对照。结果:低渗法获得的mtDNA的PCR产物电泳分析和酶切鉴定都清楚地显示与预期相符的目的条带,而对照组水解法抽提冷冻牛精子mtDNA存在稳定性差及重复性差等缺点。结论:低渗介导是一种抽提精子mtDNA的有效方法。     

A simple and rapid crystal violet uptake sensitivity test for anticancer agents

Hitherto, the selection of anticancer drug has been based on clinical experience. But to succeed for chemotherapy to succeed, effective drugs must be selected for individual patients with cancer. We have developed the following new in vitro micromethod. Method. In brief, tumor cells obtained by surgery were incubated with anticancer drugs for 48 hrs at 37 degrees C in 5% CO2 in a microplate. After incubation, the surviving cells were fixed with methanol and stained with crystal violet. Then the stained cells were solubilized with 1% lauryl sulfate and the absorbance of each well was measured at 540 nm with a multiscan spectrophotometer. In this method, cytotoxicity was quantitated by the absorbance. The method is simple, rapid (48 hrs) and reproducible, and it requires only a small amount of cells (5 X 10(3) approximately 1 X 10(4]. This method correlates well with sensitivity tests using isotopes. We have examined the chemosensitivity of 22 specimens from gynecologic malignancies by this method. The success rate is 77% and higher than with any other in vitro method. This method will be widely utilized in several fields of cancer treatment in the near future.     

不同方法对剖宫产术后出血量的估计及出血量大于500ml的危险因素分析

目的:通过比较3种常用的估计产后出血量的方法,选择相对快速、准确估计剖宫产术后出血量的方法;同时对术后出血量500 ml的患者进行相关因素分析。方法:回顾性分析2014年1-12月在我院行剖宫产手术患者583例的临床资料,分别用目测法、血细胞比容(HCT)法、公式计算3种方法对患者的出血量进行评估,以公式计算为标准对出血量500 ml患者的危险因素进行分析。结果:583例患者中,目测法估算出血量500 ml的23例(3.95%),公式计算法估算出血量500 ml的133例(22.81%),HCT法估算出血量500 ml的116例(19.90%)。3种方法相比较,HCT法估算出血量大于500 ml的发生率与公式计算法相近(P0.05),目测法与其他两种方法差异较大(P0.05)。出血量500 ml与HCT术前后变化值呈正相关;出血量大于500 ml时,HCT法在估计产后出血量的灵敏度、准确性上明显高于目测法(76.69%、87.93%与12.78%、73.91%)。产程异常、子宫肌瘤、胎盘因素、巨大儿为出血量500 ml的危险因素。结论:HCT法估计剖宫产术后出血量更接近于公式计算法,尤其在出血量大于500 ml时;HCT法比公式计算法更简便,比目测法更准确。HCT法可在临床中作为初步估计出血量的标准,而更加精确的估计出血量的方法仍应用公式计算法。巨大儿、产程异常等患者更易发生剖宫产术后大量出血。     

Modified reduction surgery for adenomyosis. A preliminary report of the transverse H incision technique

We describe the preliminary clinical results of a modified method of reduction surgery for easy approach and effective removal of lesions in women with adenomyosis. Old classical reduction surgery was performed in 5 women with imaging diagnosis of adenomyosis who were selected retrospectively among 104 patients undergoing conservative surgery. A transverse H incision method in the reduction surgery was applied to 6 of 83 patients wishing to preserve fertility. Benefit in operative procedure, complications, patients' compliance, and pregnancy outcome were analyzed and compared between 5 women with the classical method and 6 women with the H incision method for adenomyosis. No apparent difference was observed in the operation time, blood loss and volume of excised specimens between these two groups. The major complication of perforation during surgery occurred in 2 patients (40%) by the classical method and in only 1 patient (17%) by the H incision technique. The subjective relief of pain was relatively more evident in the modified than in the classical group. There was no case of pregnancy in the classical group; however, 1 patient conceived spontaneously 4 months after operation by this H incision procedure. Our H incision technique may be considered a useful method for an easy surgical approach and satisfactory removal of adenomyotic lesions and may be better than the old classical method of reduction surgery.     

Evaluation of urinary estriol by latex agglutination inhibition reaction

The urinary estriol values of a morning sample determined by a new semiquantitative method was correlated with the total 24 hour estriol excretion determined by colorimetric method on patients with normal and pathologic pregnancy. The correlation coefficient, calculated on 240 assays operated on urine samples obtained from 70 normal pregnant women, is highly significant statistically (P less than 0.001). The profiles of the serial assays, obtained by these two procedures on patients with pathologic pregnancy, show a very strong analogy. The Authors believe that such a method, just for its simple and rapid realization, may be applied alternatively to RIA assay or colorimetric method for the cases which are believed to be in need of rapid evaluation of estriol and/or when another method is unfeasible.     

Fundamental and clinical studies on human papillomavirus infection in the uterine cervix especially by Vira Pap (dot blot) method

Female genital organs infected with human papillomavirus (HPV) have drawn attention as STD and in connection with the mechanism of carcinogenesis. Recently, we used a simplified HPV detection kit, Vira Pap method in clinical tests. To estimate the usefulness of the Vira Pap method in clinical application, a comparison was made between the results of the Vira Pap method and those of the conventional method. Furthermore, an investigation was made of the relationship between uterine-cervical lesions and the types of HPV. The following findings were obtained: 1. It was demonstrated that the Vira Pap method was superior to the conventional methods and was almost equal to the Southern blot method. 2. The cases in which HPV infection were confirmed by the Vira Pap method were further analyzed and HPV typed by the Southern blot method. And, types 6, 11, 18, 31, 33, 35 and unclassifiable types were found. 3. HPV 16, 18, and 33, which are said to be closely related to carcinoma, were detected in cases of chronic cervicitis as well. In these cases, further investigation seems to be required.     

Unappreciated HLA antibodies in adult immune thrombocytopenic purpura.

BACKGROUND/PURPOSE: Immune thrombocytopenic purpura (ITP) is an autoimmune disease. Platelet refractoriness is frequently seen in patients with ITP. Platelets express platelet-specific antigens and human leukocyte antigens (HLA). Platelet antibodies to platelet-specific antigens and HLA may be present, but HLA antibodies in patients with ITP have rarely been reported. METHODS: Sera from 44 adult patients with ITP were screened for platelet antibodies by two flow cytometric assays. In method I, platelets from normal donor platelets were used as target cells to screen both platelet-specific antibodies and HLA class I antibodies. In method II, the FlowPRA Class I Screening Test kit was used to screen HLA class I antibodies. Fluorescein isothiocyanate (FITC)-conjugated sheep anti-human IgG Fc was used as the staining reagent in both methods. The negative serum control was from one of the normal males with AB blood group who had never received a transfusion. Sera from a pool of five highly sensitized patients were used as the positive control. RESULTS: Of the 44 sera from patients with ITP, 31 (70.5%) were method I positive, and 28 (63.6%) were method II positive. There was no significant difference between the results of method I and method II (p = 0.439). The distribution of the results of these two tests was: both tests positive in 22 sera, method I positive and method II negative in nine sera, method I negative and method II positive in six sera, and both tests negative in seven sera. The mean platelet counts of patients with positive (41.0 +/- 40.0 x 10(9)/L) and negative (40.4 +/- 26.8 x 10(9)/L) tests by method I did not differ significantly (p = 0.643). The mean platelet counts of patients with (36.7 +/- 31.5 x 10(9)/L) and without (48.1 +/- 43.6 x 10(9)/L) HLA class I antibodies did not differ significantly (p = 0.59). CONCLUSION: HLA class I antibodies are frequently found in ITP. The screening of platelet antibodies including platelet-specific antibodies and unappreciated HLA class I antibodies is warranted in patients with ITP.