B超检测子宫内膜厚度及分型对人工授精后妊娠结局的预测价值

为探讨人工授精周期影响妊娠率的因素,本文对56例人工授精妇女的卵泡发育及子宫内膜进行动态B超监测。子宫内膜小于7mm的11例无妊娠发生(0％),子宫内膜厚度大于8mm的45例有18例临床妊娠(40％),经X~2检验P值为0.008。在子宫内膜厚度大于8mm的45例中,子宫内膜呈Ⅰ型的39例,18例妊娠(46.2％),内膜呈Ⅱ型的无妊娠发生(0％),两组比较P=0.036。研究结果揭示,子宫内膜的厚度及B超分型对妊娠结局具有预测价值。     

50例宫腔粘连B超改变

目的：研究B超在宫腔粘连诊断与治疗中的应用。方法：总结50例宫腔粘连患者声像图表现及治疗过程中B超的应用。结果：50例宫腔粘连患者声像图表现为子宫内膜菲薄(≤5mm),回声不连续或宫腔积血,经阴道B超能更清楚地显示内膜情况及积血部位。B超可实时监测宫腔粘连分离术解除粘连情况,了解避孕环放置部位。结论：B超尤其是经阴道B超在宫腔粘连诊断中有重要价值。B超监测能更准确地实施分离术,防止子宫穿孔的发生。     

不同促排卵方案宫颈黏液中IL-6与卵泡发育、排卵的相关性

目的:探讨不同促排卵方案患者宫颈黏液(CM)中IL-6水平与卵泡发育及排卵的相关性.方法:选择36例不孕妇女为研究对象,15例正常月经周期妇女为对照组.实验组分三组,分别采用克罗米酚(CC)、尿促性素(HMG)及超促排卵(COH).于月经早卵泡期、围排卵期及黄体高峰期收集CM及血清,采用双抗RIA测定IL-6水平及FSH, LH, E2, P水平,同时行阴道B型超声监测卵泡发育、子宫内膜厚度及排卵情况.结果:① CM中IL-6在正常月经周期及促排卵周期中存在周期性变化,卵泡期开始上升,围排卵期达高峰,黄体期下降,三期中围排卵期CM IL-6水平最高,差异有统计学意义(P＜0.05).② CM中IL-6与卵泡大小呈正相关(r=0.792, P＜0.05),与子宫内膜厚度、宫颈黏液评分无相关.③排卵组与未排卵组CM中IL-6比较,排卵组IL-6水平明显高于未排卵组,差异有统计学意义(P＜0.05).结论:① CM中IL-6在正常月经周期及促排卵周期中存在周期性变化,排卵期达高峰,有望作为预测排卵的新指标.② HMG促排卵组和IVF-ET COH组CM中IL-6水平高于对照组,可能与促性腺激素对IL-6的上调作用及激活生殖道局部细胞免疫有关.③ IL-6在卵泡发育及排卵过程中起重要作用.     

正常与异位子宫内膜Bcl-2与PCNA的表达

目的：探讨B细胞淋巴瘤/白血病-2(Bcl-2)蛋白和增殖细胞核抗原（PCNA）蛋白与正常及异位子宫内膜的关系。 方法：应用免疫组化法检测46例正常月经周期子宫内膜和15例卵巢子宫内膜异位症患者的异位子宫内膜中的Bcl-2蛋白和PCNA蛋白。 结果：Bcl-2蛋白和PCNA蛋白在正常月经周期子宫内膜增生期升高(两组均为61.5%),分泌期低落(22.2%和5.5%),月经期消失(0和33.3%);在异位内膜中的表达(均为100%)高于增生期（P<0.05）。 结论：正常月经周期子宫内膜中Bcl-2蛋白和PCNA蛋白表达有周期性变化,且与异位子宫内膜中的表达不同,异位子宫内膜通过多种方式获得生存优势。     

来曲唑联合GnRH-a治疗用于PCOS患者的研究

目的探讨来曲唑(LE)以及促性腺激素释放激素激动剂(GnRH-a)用于多囊卵巢综合征(PCOS)患者的治疗效果。方法 50例不孕症常规检查确诊为PCOS并接受促排卵及宫腔内人工授精(IUI)的不孕患者,随机分为来曲唑组(24例):口服LE;HMG组(26例):注射HMG。两组分别于月经周期第3～7天每天口服来曲唑5.0mg或HMG75IU肌内注射,分别监测月经周期第10天子宫内膜厚度,直径≥10mm卵泡个数,记录GnRH-a注射日子宫内膜的厚度、形态,直径≥16mm卵泡(成熟卵泡)个数,直径≥14卵泡(优势卵泡)个数,血清黄体生成素(LH)、雌激素(E2)、睾酮(T)水平,分别统计排卵率及妊娠率,多胎率,卵巢过度刺激综合征(OHSS)发生率。结果与HMG组相比,来曲唑组月经周期第10天子宫内膜厚度薄(P=0.00);GnRH-a注射日血清中E2水平低(P=0.00),T水平高(P=0.004),优势卵泡数少(P=0.02),OHSS发生率低(P=0.04),但临床妊娠率无明显差异(P=0.78)且多胎率低(P=0.02)。结论对PCOS患者,用LE或HMG促排卵,临床妊娠率无差异,用LE联合GnRH-a治疗可以降低HCG日血清中雌激素水平,减少OHSS的发生率,以及多胎率,可望成为一线促排卵药。     

子宫腔灌注人绒毛膜促性腺激素对多囊卵巢综合征患者植入窗期子宫内膜容受性的影响

目的探讨子宫腔灌注人绒毛膜促性腺激素(h CG)对多囊卵巢综合征(PCOS)患者植入窗期子宫内膜容受性的影响。方法选择2016年4月至2018年4月新乡医学院第三附属医院收治的已婚PCOS患者31例为研究对象,对患者的连续2个月经周期进行自身对照试验,第1个月经周期为对照周期,第2个月经周期为灌注周期,其中对照周期28例(3例因无排卵予以排除),灌注周期29例(2例因无排卵予以排除)。患者2个月经周期的第5～9天均给予来曲唑2. 5 mg,口服;从月经周期第10天开始,连续阴道超声卵泡监测直至排卵,分别于第2个月经周期的排卵前2日及排卵日子宫腔灌注h CG 500 IU(0. 5 m L)。于排卵后第6～8天(植入窗期)检测患者血清雌激素(E2)和黄体酮(P)水平,并使用一次性S型子宫腔组织吸引管抽取少许子宫内膜组织,S-3500N扫描电子显微镜下观察子宫内膜胞饮突发育情况。结果对照周期与灌注周期的植入窗期患者血清E2水平比较差异无统计学意义(t=0. 501,P>0. 05);灌注周期的植入窗期患者血清P水平显著高于对照周期(t=3. 193,P <0. 05)。对照周期和灌注周期有子宫内膜成熟胞饮突的患者分别为9例(32. 14%)、17例(58. 62%),灌注周期有成熟胞饮突患者比例显著高于对照周期(χ2=4. 032,P <0. 05)。结论 PCOS患者植入窗期胞饮突发育不良,宫腔灌注h CG可增加成熟胞饮突数量,提高血清P水平,改善子宫内膜容受性。     

阿胶对诱导排卵周期子宫内膜容受性的作用

目的探讨阿胶对诱导排卵助孕周期子宫内膜容受性的作用。方法将56例68周期在诱导排卵周期中接受夫精人工授精(AIH)或指导同房助孕治疗的患者随机分为A、B两组,A组为对照组,B组自月经周期第7天开始给予阿胶口服治疗,每天用生胶量30g,至下次月经或证实临床妊娠为止。结果月经周期第7天至排卵日的子宫内膜厚度增长值A组为(3.10±1.32)mm,B组为(3.88±1.54)mm,两组之间差异有统计学意义(P<0.05)。两组子宫内膜厚度每日增加数分别为(0.49±0.23)mm和(0.62±0.26)mm,差异有统计学意义(P<0.05)。阴道彩色B超监测排卵日的子宫动脉血流阻力指数和搏动指数B组较A组明显下降(P<0.05)。结论阿胶能增加诱导排卵助孕周期子宫内膜的厚度,加速子宫内膜的增长并改善子宫动脉血供。     

戊酸雌二醇联合坤灵丸对子宫内膜影响的观察

目的观察戊酸雌二醇联合坤灵丸对子宫内膜生长的影响。方法55例20-43岁妇女,连续2周期排卵日B超提示内膜〈7mm,检测子宫内膜、子宫动脉搏动指数（pulsatility index,PI）、子宫动脉血流阻力指数（resistive in-dex,RI）。对照组月经周期第3日使用戊酸雌二醇至排卵日,排卵日B超检测子宫内膜厚度、类型、PI及RI。治疗组系同一患者于下一月经周期第3日至排卵日给予戊酸雌二醇及坤灵丸,排卵日B超检测子宫内膜厚度、类型、P1及RI。结果治疗组排卵日B超检测子宫内膜厚度、类型、PI及RI与治疗前差异有统计学意义（P〉0.05）,治疗后明显获益。对照组差异无统计学意义（P〉0.05）。结论戊酸雌二醇联合坤灵丸可改善子宫内膜血供,明显改善子宫内膜类型,增加子宫内膜厚度。     

自拟增膜助孕方联合地屈孕酮对肾虚血瘀型薄型子宫内膜不孕患者的临床疗效观察

【目的】探究自拟增膜助孕方联合地屈孕酮对肾虚血瘀型薄型子宫内膜不孕患者的疗效。【方法】将60例肾虚血瘀型薄型子宫内膜不孕患者随机分成研究组和对照组,每组各30例。2组患者均于月经第5天给予口服戊酸雌二醇治疗,对照组患者于阴道B超监测排卵后给予口服地屈孕酮治疗,研究组患者在对照组的基础上给予自拟增膜助孕方治疗,1个月经周期为1个疗程,共治疗3个月经周期并随访1年。观察2组患者治疗前后子宫内膜厚度、A型子宫内膜形态占比及黄体期雌激素(E2)、孕酮(P)和促卵泡生成素(FSH)水平的变化情况,比较2组患者1年内妊娠率及足月分娩率。【结果】(1)治疗后,2组患者的子宫内膜厚度均较治疗前显著增厚(P0.01),且研究组患者的子宫内膜厚度明显厚于对照组,差异有统计学意义(P0.01)。(2)治疗后,2组患者的A型子宫内膜形态占比均较治疗前明显升高(P0.01),且研究组患者的A型子宫内膜形态占比明显高于对照组,差异有统计学意义(P0.05)。(3)治疗后,2组患者血清E2、P水平均较治疗前明显升高,FSH水平均较治疗前明显降低,差异均有统计学意义(P0.05),且研究组患者血清E2、P水平明显高于对照组,FSH水平明显低于对照组,差异均有统计学意义(P0.01)。(4)治疗后,研究组患者的1年内妊娠率和足月分娩率分别为56.67%(17/30)和88.24%(15/17),明显高于对照组的30.00%(5/30)和55.56%(5/9),其中,2组1年内妊娠率比较,差异均有统计学意义(P0.05),而2组足月分娩率比较,差异无统计学意义(P 0.05)。【结论】自拟增膜助孕方联合地屈孕酮治疗肾虚血瘀型薄型子宫内膜不孕的疗效显著,可有效改善患者子宫内膜状态,提高患者妊娠率。     

超声监测卵泡发育及子宫内膜厚度在不孕症治疗中的价值

目的 探讨超声下监测卵泡发育及子宫内膜厚度在不孕症治疗中的价值.方法 选取2011年1～12月期间在我院门诊诊治的87例不孕症妇女为观察对象,从月经周期的第9天开始检测卵泡发育及子宫内膜厚度,直至排卵或月经周期第18天止.连续监测3个月经周期.结果 87例患者子宫内膜处于增殖早期时两侧卵巢均有直径3～6 mm的小卵泡在生长发育,后继续监测有62例继续增长,25例未继续增长,通过对患者采取促卵泡发育及促卵泡破裂治疗,3个月后有56例患者怀孕,比较妊娠孕妇与非妊娠患者孕前子宫内膜及卵泡直径,差异具有统计学意义(P＜0.05).结论 阴道超声下监测卵泡发育及子宫内膜厚度能有效监测卵泡发育情况,且通过比较子宫内膜增厚程度与卵泡发育情况,对患者不孕的原因诊断更为准确,有利于指导妇科医师临床用药.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.