经腹与腹腔镜下Vechitti阴道成形术临床效果比较

目的对经腹与腹腔镜Vechitti阴道成形术的临床应用效果进行对比。方法将同期收治的57例先天性无阴道患者分为观察组27例和对照组30例,分别行经腹Vechitti阴道成形术和腹腔镜Vechitti阴道成形术。观察两组手术时间、术中出血量、膀胱损伤、术后排气时间、手术失败率,随访其阴道成形效果。结果观察组手术时间及术后排气时间均显著短于对照组（P〈0．05）,手术失败率显著低于对照组（P〈0．05）,两组术中出血量及膀胱损伤情况无显著差异;随访1a,两组阴道成形效果相似。结论腹腔镜下Vechitti阴道成形术比经腹术式具有明显优势,有推广价值。     

腋下小切口在肺癌手术中的应用

目的探讨腋下小切口用于原发性肺癌手术的效果。方法将98例肺癌患者随机分为观察组和对照组各49例。两组均根据具体病情实施放疗、化疗及基础治疗后行肺癌根治术。术中观察组行腋下小切口术,对照组采用传统的后外侧标准切口。比较两组开胸时间、关胸时间、开胸出血量,术后引流量、肩部活动障碍发生情况及1、3a生存率。结果观察组开胸时间、关胸时间睨显短于对照组,开胸出血量和术后引流量均显著低于对照组（P均〈0．05）;观察组肺部炎症、肩关节活动障碍发生率明显低于对照组（P〈0．05）。观察组1、3a生存率均明显高于对照组（P〈0．05）。结论腋下小切口治疗肺癌较传统切口损伤轻、出血少,功能恢复好。     

单极电钩凝切剥离肿瘤法在腹腔镜子宫肌瘤剔除术中的应用

将62例拟行腹腔镜子宫肌瘤剔除术的患者随机分为观察组30例和对照组32例，术中分别采用单极电钩凝切法及分离钳剥离肌瘤。观察两组手术时间、术中出血量、中转开腹率、术后肛门排气时间、并发症发生率及术后住院时间。结果观察组术中出血量、中转开腹率均明显低于对照组，P分别〈0．05、〈0．01；两组手术时间、术后肛门排气时间、并发症发生率及术后住院时间比较无显著差异。认为单极电钩凝切剥离法治疗子宫肌瘤效果确切，操作方便，可明显减少术中出血量，降低中转开腹率，值得临床推广应用。     

腹腔镜下宫颈癌根治术32例疗效观察

目的进一步提高宫颈癌的治疗效果。方法将64例宫颈癌患者随机分为观察组和对照组各32例,分别行腹腔镜下及开腹根治术,比较两组手术效果。结果观察组术中出血量及并发症发生率明显低于对照组,淋巴结切除数明显高于对照组（P均〈0．05）,手术时间和术后住院时间两组无差异。结论腹腔镜下手术治疗宫颈癌切口小、术中出血少、并发症少。     

妇科急腹症腹腔镜与开腹手术的临床效果比较

目的探讨腹腔镜技术在妇科急腹症中的临床应用价值。方法120例妇科急腹症患者,其中58例（观察组）实施腹腔镜手术,62例（对照组）实施常规剖腹手术,对两组术中、术后情况进行比较。结果两组均顺利完成手术,均未出现并发症,与对照组比较,观察组虽然手术时间明显增加,但术中出血量减少（P〈0．05）。观察组术后疼痛程度、肠道功能恢复及住院时间等明显优于对照组,有显著性差异（P〈0．05）。结论腹腔镜手术为妇科急腹症治疗理想方法,但要严格掌握指征;术中发现粘连严重或病情复杂者,应中转开腹手术。     

催产素加新生化颗粒用于缩短药物流产后出血的疗效观察

目的研究催产素加新生化颗粒用于缩短药物流产后阴道出血时间及出血量的观察。方法选择我站门诊自愿药流的健康妇女400例,随机分为研究组与对照组各200例,研究组在孕囊排出后肌注催产素20U,1次／d,连用3d并同时口服新生化颗粒12g／次,2次／d,连用7d。对照组在孕囊排出后口服抗生素预防感染。结果两组完全流产率比较差异无统计学意义（P〉0．05）。两组平均出血时间比较差异有统计学意义（P〈0．05）。两组患者阴道出血量间差异有统计学意义（P〈0．05）。结论催产素加新生化颗粒用于药物流产可以缩短阴道出血时间、减少出血量,有临床应用价值。     

胫骨平台骨折关节镜下微创治疗的疗效分析

目的观察关节镜下微创治疗胫骨平台骨折的临床疗效。方法将2010-02—2012-06收治的112例胫骨平台骨折患者随机分为两组,对照组给予常规手术治疗,观察组在关节镜下微创手术治疗。结果观察组的疗效优于对照组（P〈0．05）,优良率也高于对照组（P〈0．05）;切口长度、术中出血量和愈合时间均少于对照组（P均〈0．01）;而两组患者的手术时间比较差异无统计学意义（P〉0．05）。结论对于胫骨平台骨折患者采取关节镜下微创治疗具有损伤小、术后恢复快的优点,临床效果较好,值得在临床中推广应用。     

垂体后叶素在腹腔镜下子宫肌瘤剔除术中的应用

目的 探讨垂体后叶素在腹腔镜下子宫肌瘤剔除术中的应用价值。方法将120例子宫肌瘤患者随机分为观察组和对照组各60例,均行腹腔镜下子宫肌瘤剔除术,切开浆膜层前分别于子宫肌层注射垂体后叶素6U＋生理盐水10ml、缩富素20U。观察两组术中出血量及手术时间。结果观察组术中出血量、手术时间均显著小于对照组（P〈0．01、0．05）。结论子宫肌瘤剔除术中宫体注射垂体后叶素可减少术中出血量、缩短手术时间。且不良反应少。     

LC、胆总管探查及一期胆管缝合术治疗胆囊结石合并胆总管结石

目的观察腹腔镜胆囊切除术（Lc）、胆总管探查及一期胆管缝合术治疗胆囊结石合并胆总管结石的疗效。方法将85例胆囊结石合并胆总管结石患者随机分为观察组45例和对照组40例,对照组行LC、胆总管探查及T管引流术,观察组行Lc、胆总管探查及一期胆管缝合术。结果观察组术中出血量为（100±15）ml,手术时间为（136．5±25．0）min,住院时间为（10．5±2．0）d;对照组分别为（110±20）ml、（152．0±27．5）min、（13．5±2．5）d。两组比较,P均〈0．05。结论LC、胆总管探查及一期胆管缝合术治疗胆囊结石合并胆总管结石可有效减少术中出血量,缩短手术和住院时间。     

体外循环下先天性心脏病矫治术中改良超滤技术的应用

将52例行先天性心脏病（CHD）矫治术患儿随机分为两组。观察组27例术中于体外循环（CPB）中采用改良超滤技术（MUF），对照组不接受超滤，观察两组手术效果。结果观察组术后早期红细胞压积（HCT）迅速升高，库血用量、24h引流量、24h尿量、心率明显低于对照组（P均〈0．05）；呼吸机辅助时间和监护室滞留时间明显短于对照组（P均〈0．05），证实CPB中应用MUF可提高手术效果，改善患儿预后。     

阴道后壁“桥式”修补结合盆底筋膜缝合治疗阴道后壁缺陷临床分析

目的探讨阴道后壁＂桥式＂修补结合盆底筋膜缝合治疗阴道后壁缺陷的临床疗效。方法回顾性分析我院行阴道后壁＂桥式＂修补结合盆底筋膜缝合术患者83例,比较手术前后盆腔器官脱垂定量（POP-Q）分度的变化,以了解术后患者的盆底解剖学恢复情况,通过观察患者排便情况评价患者手术前后排便功能失调的改善情况,通过盆腔器官脱垂-尿失禁患者性生活调查问卷（PISQ-12）评价患者手术前后的性生活质量。结果单纯行＂桥式＂缝合的平均手术时间15 min,无手术并发症。术后1例后壁膨出复发,复发率为1.2%,术后排便症状改善率为81.2%,性交痛的发生率为2.63%,PISQ-12评分术前（79.57±6.56）分,术后（78.62±6.40）分,手术前后比较差异无显著性。结论阴道后壁＂桥式＂修补近期疗效确切,能改善部分患者的便秘症状,对患者性生活质量也无明显影响。     

The alteration and potential relationship of vaginal microbiota and chemokines for unexplained recurrent spontaneous abortion

The diagnosis and treatment of unexplained recurrent spontaneous abortion (URSA) is an important and hot topic in the field of obstetrics and gynecology. During our clinical investigation (observation), we have found that URSA patients usually experience recurrent vaginitis or vaginal dysbacteriosis during periods of non-pregnancy, pregnancy, and post-abortion. However, there is no research on vaginal dysbacteriosis''s influence on URSA. Using women with normal induced abortion as a control group, and using 16S rRNA sequencing, which helps to screen differentially expressed flora, this study discusses the relevance between differential bacteria at the genus level and the incidence of URSA. Another aim of this study is to determine whether certain pathogenic genera can cause an imbalance in immune tolerance of the maternal and fetal interface through regulatory chemokines, which leads to recurrent spontaneous abortion. This article has explored URSA pathogenesis from the perspective of differentially expressed vaginal flora, which has great theoretical significance for the early diagnosis and treatment of URSA.     

乳酸菌阴道胶囊辅助甘精胰岛素治疗2型糖尿病合并阴道炎的临床疗效及对预后的影响

目的 研究2型糖尿病合并阴道炎患者通过乳酸菌阴道胶囊辅助甘精胰岛素治疗的效果及对预后的影响.方法 抽取该院于2018年1月—2020年1月内就诊的2型糖尿病合并阴道炎患者共86例,将其依循双盲随机法分为对照组(43例,采用单纯甘精胰岛素治疗方式)与观察组(43例,采用乳酸菌阴道胶囊辅助甘精胰岛素治疗方式),研究比对患者...     

Bovine Pineal Tripeptide Threonylseryllysine Retards Puberty in Female Rats

When injected into rodents, the bovine pineal tripeptide threonylseryllysine (TSL) elicits diverse antireproductive effects in a number of animal models. Extensive studies of its effects on pubertal development have not been carried out, however. In the present study, 1.0 microgram of T-S-L was administered daily to female Charles River CD rats throughout the peripubertal period, and effects on vaginal opening time, ovarian histology, and serum luteinizing hormone (LH) levels were observed. Since TSL is known to alter the action of luteinizing hormone releasing hormone (LHRH), it was postulated that this antireproductive tripeptide would delay the time of vaginal opening associated with first ovulation. Two hundred eighty-seven weanling females were housed at 22 degrees C under a 14L:10D photoperiod. They were divided into three groups for daily intraperitonal injections of either saline (SAL), 1.0 micrograms TSL, or 5.0 micrograms melatonin (aMT) beginning on the 23rd day of life. Subgroups of nine to ten rats from each treatment group were sacrificed on days 28, 30, 32, 33, 34, 35, 36, 37, 38, and 40. Although the body weights of all animals increased significantly during the course of the study, no significant differences were observed in this parameter among rats treated with saline, aMT, or TSL. Vaginal opening time was significantly delayed by TSL between days 32 and 40, and uterine weights were significantly lower in this group. Prepubertal increases in serum levels of LH were also significantly reduced. At the dose utilized, aMT was without significant effects on these parameters.(ABSTRACT TRUNCATED AT 250 WORDS)     

Safety of vaginal delivery in women with placental chorioangiomas diagnosed by prenatal ultrasound: A retrospective cohort study

This study aimed to examine the maternal and neonatal outcomes in different mode of delivery in pregnant women with placental chorioangiomas, in order to determine the safety of vaginal delivery.We conducted a retrospective study of 54 women with placental chorioangioma diagnosed by prenatal ultrasound and subsequently proven histologically, excluding those who underwent cesarean section for obstetric indications. The mode of delivery was divided into a vaginal delivery group (23 women) and a cesarean section group (31 women). The indication of cesarean section group was only for placental chorioangioma, no other obstetric indications. The maternal characteristics, pregnancy outcomes and the color doppler imaging characteristics of placental chorioangioma of the 2 groups were compared, and the clinical characteristics of women in the vaginal delivery group were described in detail.The incidence of placental chorioangioma was nearly 0.43‰ in our study. There was no significant difference in the maternal characteristics and pregnancy outcomes between the 2 groups. 82.6% (19/23) of the women successfully delivered vaginally and 4 failed who turned to cesarean section in the vaginal delivery group; among them, 17 women had giant chorioangiomas (>4 cm in diameter). The direct cause of vaginal delivery failure was fetal distress, persistent occiput posterior fetal position and cephalopelvic disproportion.Pregnant women with placental chorioangiomas and no other obstetric indications for cesarean section may attempt a vaginal delivery, even with giant chorioangiomas. If there are risk factors of vaginal delivery failure, the progress of labor needs to be closely monitored.     

内镜全程直视引导沙氏探条扩张治疗高位食管癌术后吻合口狭窄的临床分析

目的：探讨胃镜全程直视引导食管沙氏扩张探条扩张治疗高位食管癌术后吻合口狭窄的临床应用价值。方法50例高位食管癌术后吻合口狭窄病例随机分为2组各25例,一组为对照组,行非全程胃镜引导下的食管扩张术,另一组为观察组,行全程胃镜下引导的食管扩张术,并对上述两组病例在操作成功率、扩张后食管腔直径增大值等指标进行比较分析。结果对照组扩张成功率为84.00%,观察组扩张成功率为96.00%,明显高于对照组（P〈0.05）。研究显示在24例全程胃镜引导下的食管扩张术可使食管直径增大（6.7±1.3）mm,而21例非全程胃镜引导下的食管扩张术可使食管直径增大（4.1±1.1）mm,两组食管腔直径增大值比较差异显著（P〈0.05）。结论在高位食管吻合术后吻合口狭窄的扩张治疗中,全程胃镜下引导的食管扩张术可以直视扩张部位进行操作,方法较传统的非全程胃镜引导下的食管扩张术的更具优势。     

Recent Advances in the Excipients Used in Modified Release Vaginal Formulations

The formulation of an ideal vaginal drug delivery system (DDS), with the requisite properties, with respect to safety, efficacy, patient compliance, aesthetics, harmonization with the regulatory requirements, and cost, requires a meticulous selection of the active ingredients and the excipients used. Novel excipients defined by diversity and multifunctionality are used in order to ameliorate drug delivery attributes. Synthetic and natural polymers are broadly used in pharmaceutical vaginal formulations (solid, semi-solid dosage forms, implantable devices, and nanomedicines) with a promising perspective in improving stability and compatibility issues when administered topically or systemically. Moreover, the use of biopolymers is aiming towards formulating novel bioactive, biocompatible, and biodegradable DDSs with a controllable drug release rate. Overviewing vaginal microenvironment, which is described by variable and perplexed features, a perceptive choice of excipients is essential. This review summarizes the recent advances on the excipients used in modified vaginal drug delivery formulations, in an attempt to aid the formulation scientist in selecting the optimal excipients for the preparation of vaginal products.     

Effects of primary suture and fibrin sealant on hemostasis and liver regeneration in an experimental liver injury

AIM： To investigate the effects of fibrin sealant on hemostasis and liver regeneration and intra-abdominal adhesions in an experimental liver injury. METHODS： Thirty-six Wistar rats were randomly divided into primary suture group （n = 15）, fibrin sealant group （n = 15） and control group （n = 6）. A wedge resection was performed on the left lobe of the liver. In primary suture group, liver was sutured using polypropylene material, while fibrin glue was administrated on the liver surface in fibrin sealant group. RESULTS： More intra-abdominal adhesions were observed in the primary suture group compared to the fibrin sealant group on 3rd （2.50 ± 0.5 vs 0.25 ± 0.5, P = 0.015）, 10^th （2.75 ± 0.5 vs 0.50 ± 0.6, P = 0.06） and 20^th （1.75 ± 0.5 vs 0.70 ± 0.5, P = 0.015） postoperative days. Histopathological scores were better in the fibrin sealant group in comparison with the primary suture group on 3rd （8.75 ± 0.5 vs 6.75 ± 0.5, P = 0.006）, 10th （7.50 ± 1.0 vs 5.5 ±0.6, P = 0.021） and 20th （6.40 ± 1.7 vs 3.20 ± 1.6, P = 0.025） postoperative days. CONCLUSION： Out data suggest that fibrin sealant is preferred over primary suture in appropriate cases including liver trauma since it causes less intra-abdominal adhesions while allowing shorter hemostasis time as assessed in experimental liver trauma.     

Effects of cesarean section on mean platelet volume

Mean platelet volume (MPV) is a risk factor for cardiovascular complications, cerebrovascular disorders, and low-grade inflammatory conditions prone to arterial and venous thromboses. Cesarean delivery is the most important risk factor for pulmonary embolism, stroke, and intracranial venous thrombosis. The hypothesis is that increase in the prevalence of cesarean section and high MPV may be associated with cardiovascular complications such as stroke along with intracranial complications in addition to known systemic and surgical complications. In this study, platelet counts and MPV for postpartum women who delivered by cesarean section and normal vaginal parturition are compared. The subjects were divided in two groups, one was study group consisting of 118 patients giving birth by cesarean section and the other was the control group consisting 94 patients giving birth by normal vaginal parturition. Peripheral venous blood samples in EDTA tubes were collected from all the subjects 1 week before and after the delivery for their prenatal and postpartum periods, respectively. The values were compared between the groups and also before and after the delivery. In the cesarean group, while the MPV level was 8.60 (1.64) fl in the prenatal period, it increased to 9.10 (2.00) fl in the postnatal period (p?<?0.001). Group effect, time effect (independent from group effect), and group*time interaction effect were statistically significant for MPV variable (p?=?0.032, p?<?0.001, and p?=?0.012, respectively). This study concluded that MPV, along with several other factors, may be used as a prognostic, independent, and therapeutic marker in patients who are inclined to thrombotic events after cesarean section.     

Effect of Second Vaginal Delivery on Anal Function in Patients at Risk of Occult Anal Sphincter Injury after First Forceps Delivery

Purpose  The study was designed to determine the effect of further vaginal delivery on anal sphincter function in women after apparently uncomplicated primiparous forceps delivery. Methods  Fifty-two secundigravid women whose first child was forceps-assisted were compared with a control group of 20 women who had undergone spontaneous first vaginal delivery. Both groups were studied antenatally and again at 12 weeks after second delivery using a standardized bowel function questionnaire, endoanal ultrasound, and anal manometry. The primary outcome was fecal incontinence score after second delivery. Results  Before second delivery, 20 of 52 (39 percent) of the forceps group and 3 of 20 (15 percent) control subjects (P = 0.103) reported minor alteration in fecal incontinence. Endoanal ultrasound was more frequently abnormal (38/52 (73 percent) vs. 6/20 (30 percent); P = 0.002), and median anal canal squeeze (71 vs. 104 mmHg; P = 0.004) and resting pressures (43 vs. 58 mmHg; P = 0.004) were lower in the forceps group. There was no difference in continence score between first and second delivery for the forceps group (P = 0.19) group or control subjects (P = 0.18). However, 10 of 38 (26 percent) women with an abnormal endoanal ultrasound after first forceps delivery developed new or worsening symptoms after second delivery. Conclusions  One-quarter of women with occult anal sphincter injury after first forceps delivery experienced some minor alteration in fecal continence after the second delivery. Presented at the 23^rd annual meeting of the Society for Maternal Fetal Medicine, San Francisco, California. Supported by the Irish Health Research Board.