内江地区妇女生殖道感染状况调查分析

目的了解内江地区妇女生殖道感染情况,为妇女的生殖健康保健提供依据。方法采用问卷调查了解一般情况;妇科检查宫颈、阴道情况;采用3种生殖道分泌物检查方法对内江市1000例妇女的一般情况和生殖健康状况进行横断面调查,其中包括500例围绝经期妇女。结果围绝经期妇女的阴道炎、宫颈炎的患病率高于非围绝经期妇女。围绝经期妇女病原体感染主要是加德纳菌、念珠菌、支原体。结论为做好生殖道感染的防治工作,广泛开展对围绝经期妇女的生殖道感染知识的健康教育,提高围绝经期妇女的自我保健意识尤为重要。     

已婚已育女性放置宫内节育器后生殖道感染的危险因素及对策分析

目的分析已婚已育女性放置宫内节育器(IUD)后生殖道感染的危险因素,并探讨预防生殖道感染的对策。方法回顾性分析2016年1月至2019年1月在我院放置IUD的200例已婚已育女性的临床资料,根据其放置IUD后是否发生生殖道感染分为观察组(发生生殖道感染)与对照组(未发生生殖道感染),对放置IUD后生殖道感染的危险因素进行分析。结果在放置IUD后1年内,生殖道感染发生率为14.50%。两组的年龄、糖尿病、贫血、IUD放置时间、术后预防性应用抗生素、术后1个月内盆浴、术后1个月内性生活、性伴侣数量等资料比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、糖尿病、贫血、IUD放置时间、术后预防性应用抗生素、术后1个月内盆浴、术后1个月内性生活、性伴侣数量是已婚已育女性放置IUD后生殖道感染的独立影响因素(P<0.05)。结论已婚已育女性放置IUD后受到年龄、糖尿病、贫血、宫内节育器放置时间、术后未预防性应用抗生素、多个性伴侣、术后1个月内盆浴及性生活等因素的影响,易发生生殖道感染,临床上应根据其危险因素采取针对性干预对策,以减少IUD放置后生殖道感染的发生。     

Transrectal ultrasonography for problem solving after transvaginal ultrasonography of the female internal reproductive tract.

OBJECTIVE: To report the value of transrectal ultrasonography of the female internal reproductive tract as a complementary problem-solving technique after transvaginal ultrasonography in selected patients. To date, transrectal ultrasonography of the female internal reproductive tract has been advocated in lieu of transvaginal ultrasonography for women in whom transvaginal ultrasonography cannot be performed for various reasons. METHODS: Ten illustrative cases are presented of women for whom transrectal ultrasonography performed after transvaginal ultrasonography provided additional clinically important information regarding the female internal reproductive tract. RESULTS: Transrectal ultrasonography was helpful in 2 scenarios: (1) women with a retroverted uterus in whom the endometrial stripe was virtually parallel to the ultrasound beam and thus could not be properly measured on transvaginal ultrasonography, and (2) women in whom normal or pathologic adnexal findings were distant from the vagina or obscured by intervening structures during transvaginal ultrasonography but were near the rectum or not obscured during transrectal ultrasonography. In 1 case, transrectal ultrasonography yielded a diagnosis of ectopic pregnancy that was missed prospectively on transvaginal ultrasonography because pain severely limited the examiner's ability to manipulate the transvaginal ultrasound transducer. CONCLUSIONS: Transrectal ultrasonography of the female internal reproductive tract can provide clinically useful information to complement transvaginal ultrasonography in selected patients.     

2009～2011年广东省台山市农村妇女宫颈癌筛查结果分析

目的:了解广东省台山市农村妇女宫颈癌的发病情况,以制定有效的防治宫颈癌措施,促进妇女健康.方法:分析2009～2011年广东省台山市57113例35～59岁有性生活的农村妇女宫颈癌的检查筛查资料.结果:57113例中患各种妇科疾病14118例(24.719%),其中生殖道感染12875例(22.543%),癌前病变584例(1.023%),浸润癌32例(0.056%);原位癌4例(0.007%).结论:广东省台山市农村妇女生殖道感染和癌症患病率较高,防治生殖道感染及早发现宫颈癌前病变与早期癌症应成为台山市妇女保健工作的重要内容,是关注公共卫生和提高妇女健康水平的重要举措.     

农村育龄女性生殖道感染影响因素的路径分析

目的 探讨农村育龄女性生殖道感染(RTIs)的影响因素.方法 通过随机整群抽样选择1062例15～49岁的农村育龄女性,采用问卷调查和妇科检查收集资料,进行路径分析.结果 RTIs相关健康行为是RTls感染的直接影响因素;健康信念、自我效能和行动线索是影响RTIs健康行为的直接因素,也是RTIs感染的间接影响因素;RTIs相关知识受文化程度、经济状况、年龄的影响,是RTIs健康信念的直接影响因素.结论 RTIs的发生受多种因素的影响,各因素之间有逻辑关系.     

Identification and management of DES-exposed women

Diethylstilbestrol (DES), a synthetic estrogen compound, was prescribed to many women with history of miscarriage between the years 1940 and 1971. As a result of prolonged use of DES in gynecological practice, an estimated 1 million to 1.5 million women were exposed prenatally, resulting in multiple upper and lower genital tract abnormalities. These anomalies may affect reproductive function and place women at greater risk for developing clear cell adenocarcinoma (peak incidence at age 19) and squamous cell carcinoma of the vagina and cervix (peak incidence at ages 35 to 40). Emphasis has been placed on screening for clear cell adenocarcinoma rather than squamous cell carcinoma and reproductive alterations. Despite the previous emphasis during the 1970s and a subsequent decline in public and practitioner awareness, women are at risk for the known effects of DES exposure until the year 2010. Greater effort must be made by practitioners to identify and screen for DES exposure in their practices, as well as to educate the public regarding the health risks posed by DES exposure so that affected women may be reached and receive care.     

育龄妇女生殖道健康相关信念量表的研制

目的 研制适用于测量育龄妇女的生殖道健康相关信念的评价工具,并进行信度和效度检验.方法 收集500例育龄妇女相关数据,以健康信念模式为框架编制量表,分析量表信度和效度.结果 量表由2个分量表组成,内容效度均为1.0.生殖道感染相关健康信念分量表提取出4个因子,累计解释变异量为75.91%;生殖道健康相关自我效能分量表提取出4个因子,累计解释变异量为68.19%,量表数据统计结构与设计结构相符.各维度Cronbach'sα系数、重测信度、折半信度均＞0.70.结论 本量表具有较好的信效度,可用于育龄妇女生殖道感染相关健康信念评估.

Abstract：

Objective To develop a suitable instrument for measuring health beliefs related to reproductive tract infections (RTIs) and testing its reliability and validity. Methods Within the framework of the Health Belief Model, 500 questionnaires of health beliefs related to RTIs were collected, its reliability and validity was analyzed. Results The instrument contained two subscales, all content validity index(CVI)were 1.0. RTIs-related health belief subscale extracted four factors, the cumulative variance was 75.91%;RTIs-related self-efficacy subscale extracted four factors,the cumulative variance was 68.19%. Scale statistics consisted with the structure and design structure. The dimensions Cronbach's α coefficient, test-retest reliability, split half reliability were greater than 0.70. Conclusions This scale has good reliability and validity and can be used for measuring health beliefs related to reproductive tract infections in women of childbearing age.     

氯喹那多—普罗雌烯阴道片用于产后阴道黏膜修复的临床观察

目的：评价氯喹那多-普罗雌烯阴道片对产后阴道黏膜修复及防治生殖道感染的作用。方法：对212例产后6～8周复诊患者随机分为实验组92例和对照组120例。实验组给予氯喹那多-普罗雌烯阴道片阴道上药,每日一片共18日;对照组仅给予温盐水清洁阴部。治疗前后检查两组的阴道分泌物情况。结果：用药前实验组与对照组比较生殖道状况均无统计学差异（P〉0.05）。用药后实验组生殖道状况正常为80%,而对照组正常仅为36%,两组比较差异有显著性（P〈0.05）。实验组生殖道感染12例,无真菌和滴虫感染,均为非特异性阴道炎,患病率13.04%,有效率86.95%。对照组生殖道感染84例,有效率30.00%,患病高低顺序依次为非特异性阴道炎41.67%,真菌性阴道炎20.83%,滴虫性阴道炎7.50%。结论：氯喹那多-普罗雌烯阴道片能有效治疗生殖道非特异性炎症,真菌性、滴虫性阴道炎,促进产后的阴道黏膜修复,防治产后生殖道感染。     

Managing pregnancy in women with urinary diversion

The number of individuals undergoing urinary tract reconstruction, particularly for congenital abnormalities, has increased significantly over the years. Many types of urinary tract reconstruction are carried out on children and young women who have the potential to have reproductive capability (Hensle et al, 2004). Surgical procedures included in this group include enterocystoplasties, neobladder, Mitrofanoff pouch, ileal conduit and Sigma Mainz II (rectal bladder). The common factor in each of these procedures is the use of bowel to create a reservoir for urine. This article describes the different types of urinary diversion in relation to pregnancy, and presents a case study to illustrate the recommendations made.     

胎膜早破孕妇生殖道无乳链球菌血清型分型和耐药基因分析

目的 了解胎膜早破孕妇生殖道B 族链球菌（group B Streptococcus，GBS）的血清型分型和耐药基因分布。方法 收集2020 年1 月～ 2021 年12 月西北妇女儿童医院产科分娩的胎膜早破孕妇生殖道的50 株GBS，使用全自动微生物分析系统对分离株进行鉴定和药敏实验，通过聚合酶链反应（polymerase chain reaction, PCR）检测血清型和耐药基因。结果 50 株GBS 以血清型Ⅲ型（24 株，48.0%）为主，其次为Ⅰ b 型（12 株，24.0%）和Ⅰ a 型（10 株，20.0%）；对青霉素、头孢曲松、万古霉素和利奈唑胺全部敏感；对红霉素、克林霉素和左氧氟沙星的耐药率分别为80.0%，74.0% 和56.0%；在红霉素耐药分离株中，85.0% 为大环内酯类- 林可酰胺结构型耐药，且ermB 基因携带率高达75%；对左氧氟沙星耐药表现为gyrA，partC 和 artE 的三种基因突变引起的DNA 解螺旋酶和拓扑异构酶的双改变。结论 西安地区胎膜早破孕妇生殖道GBS 以血清型Ⅲ型为主，对大环内酯类、林可酰胺类和喹诺酮类药物具有高水平的耐药性，青霉素仍为分娩时GBS 感染预防和治疗的首选药物。     

导流杂交基因芯片检测人乳头状瘤病毒21种亚型的应用评价

目的了解基因芯片检测人乳头状瘤病毒(HPV)21种亚型感染的临床应用价值。评价导流杂交基因芯片技术(凯普导流杂交)HPV DNA检测法(HybriMax)在女性生殖道HPV感染检测中的临床效用,初步探讨最常见的HPV基因型。方法利用标记有生物素的HPV通用引物进行PCR扩增,扩增产物变性后与固定在尼龙膜上21种HPV特异性分型探针进行反向斑点杂交检测HPV亚型。结果 591例患者标本中,基因芯片阳性率69.2%,其中单一亚型感染266例,重叠感染143例。共检出亚型20种。结论基因芯片一次试验可联合检测多种HPV亚型感染并分型,可研究HPV感染型别的分布,提高由HPV引起的肿瘤防治水平。     

4823例妊娠早期妇女生殖道感染情况分析

目的调查了解妊娠早期妇女生殖道感染情况,为进一步开展综合防治提供依据。方法选择2010年1～12月在成都市妇女儿童中心医院产科门诊建卡行初次产前检查的妊娠早期妇女4 823例（妊娠时间小于或等于12周）,取阴道及宫颈分泌物进行外阴阴道假丝酵母菌病（VVC）、滴虫（T）、细菌性阴道病（BV）、支原体（Uu或Mh）、衣原体（CT）检测。结果妊娠合并生殖道感染（RTI）总患病率为35.9%,其中Uu、BV、VVC、CT、T的患病率分别为17.0%、12.3%、8.5%、7.9%、1.0%,且患病率与是否进行过孕前检查有关。结论孕前检查与否和妊娠合并RTI关系极大,故加强孕前检查是降低妊娠妇女RTI患病率的有效方法。     

Women in the HIV epidemic.

In the United States, the majority of women with HIV/AIDS are women whose lives have been touched by injection drug use--their own or that of their sexual partners. The pattern of opportunistic infections in women is more similar to that of injection drug users than that of homosexual men. Specific complications associated with a woman's reproductive tract include persistent Candida vaginitis, human papillomavirus infections, cervical dysplasias, and, possibly, pelvic inflammatory disease. Childbearing decisions for women with HIV infection are complex and culturally mediated. Meeting the challenge of providing high quality services to women with HIV infection requires major changes in the service delivery system.     

Sexually transmissible vaginal infections in pregnancy. 1. Common infections

Infections of the reproductive tract in women of childbearing age menace not only the mother but also the offspring. Syphilis and gonorrhea may be lethal to the fetus. Candidiasis, trichomoniasis, and condylomata acuminata have less drastic effects on the fetus but if untreated are often troublesome to both the mother and child.     

Use of vaginal pH in diagnosis of infections and its association with reproductive manifestations

Increase in vaginal secretion pH is an indicator of bacterial vaginosis (BV), but is yet to be in use as a diagnostic tool by clinicians. Similarly, no reports are available on the effect of cervical chlamydia infection and different reproductive manifestations on vaginal secretion pH. This study evaluated the use of vaginal pH for screening of BV, the effect of Chlamydia trachomatis (C. trachomatis) infection, and different reproductive manifestations on vaginal pH of women attending the gynecology outpatient department of a general hospital. Vaginal pH was recorded while diagnosing infections in 358 women, among which 45 were with repeated spontaneous abortion, 79 with infertility, 185 had sign and symptoms of lower genital tract infection, and 49 had no history or symptom of any complications or infections. Normal vaginal pH, BV, and C. trachomatis infection were observed in 72.6, 21.5, and 10.1% of women, respectively. BV and C. trachomatis were observed in 78.6 and 4.1% of women, respectively, with high vaginal pH; 12.3% of women with normal vaginal pH had C. trachomatis infection. C. trachomatis infection or different reproductive manifestations do not lead to change in vaginal pH but high vaginal pH correlated with BV and should be used as a simple tool for its diagnosis.     

The amiloride-inhibitable Na+ conductance is reduced by the cystic fibrosis transmembrane conductance regulator in normal but not in cystic fibrosis airways.

Cystic fibrosis (CF) airway cells, besides their well-known defect in cAMP-dependent Cl- conductance, are characterized by an enhanced Na+ conductance. In this study we have examined the Na+ conductance in human respiratory tract by measuring transepithelial voltage and resistance (Vte, Rte) and by assessing membrane voltages (Vm) of freshly isolated airway epithelial cells from CF and non-CF patients. Basal amiloride inhibitable (10 micromol/liter) equivalent short circuit current (Isc = Vte/Rte) was significantly increased in CF compared with non-CF tissues. After stimulation by forskolin (10 micromol/liter) a significant depolarization of Vm corresponding to the cAMP-dependent activation of a Cl- conductance was observed in non-CF but not in CF airway cells. In non-CF tissue but not in CF tissue the effects of amiloride and N-methyl-D-glucamine on Vm were attenuated in the presence of forskolin. Also the amiloride-inhibitable Isc was significantly reduced by forskolin (1 micromol/liter) and isobutylmethylxanthine (IBMX; 100 micromol/liter) only in non-CF tissue. We conclude that cystic fibrosis transmembrane conductance regulator acts as a downregulator of epithelial Na+ channels in human airways. This downregulation of epithelial Na+ channels is absent in CF airways, leading to hyperabsorption and to the characteristic increase in mucus viscosity.     

湘西少数民族育龄妇女生殖健康认知调查

目的探讨在湘西少数民族地区开展生殖健康教育工作的新模式。方法2005年8月,采用自行设计的问卷,随机对8 527名少数民族育龄妇女进行了调查。结果少数民族育龄妇女的卫生保健知识水平、就医行为均普遍偏低、个人卫生习惯较差;易接受的生殖健康教育方式前3位分别是"看CD光盘或电视"(95.2%)、"发放宣传手册及相关书籍"(89.7%)、"办墙报或宣传栏"(76.8%);当前最急需了解的生殖健康相关知识是家庭保健常识。结论应加大少数民族地区预防生殖道感染的宣传普及力度,选择合适的健康教育方式和干预措施,增强少数民族育龄妇女生殖健康的自我保健意识和能力,提高生殖健康水平。     

多普勒超声右室流出道血流参数评价肺心病右室收缩功能

目的：探讨多普勒超声右室流出道血流参数对评价肺心病右室收缩功能的价值。方法：在22例肺心病患者中,利用脉冲多普协超声记录右室流出道（RVOT）血流频谱参数,与放射性核素心室造影测算的右室射血分数（RVEF）对比分析。结果：在RVOT血流参数中右室收缩时间间期（STI）,射血期流速积分（VTI）和平均血流速度（Vm)与核素造影所测RVEF仅有轻度相关,其余测值无相关。结论：肺心病患者的RVOT血流参数难以反映右室收缩功能情况。     

Transvaginal hydrolaparoscopy, its history and present indication.

The investigation of the infertile couple by hysterosalpingography and laparoscopy is currently a highly debated issue. The purpose of this paper is to review whether transvaginal hydrolaparoscopy (THL), a new culdoscopic approach, in combination with minihysteroscopy and chromopertubation test can be offered as a complete one-stop endoscopic exploration. The technique allows complete endoscopic exploration of the reproductive tract in an office or outpatient setting and has been validated during the past years for its accuracy, safety and patient tolerance. Although further prospective randomized studies are required to prove the superiority and cost-benefit of transvaginal hydrolaparoscopy as diagnostic tool in comparison with hysterosalpingography (HSG) and laparoscopy, the technique can be proposed as a safe first-line investigation predicting the fertility outcome in women.     

Gut microbiota and nutrient interactions with skin in psoriasis: A comprehensive review of animal and human studies

The intestinal tract(i.e.,the gut),is where the body’s nutrients are absorbed,and is simultaneously inhabited by numerous microbes.An increasing body of literature suggests a crucial role for the gut microbiome in modulating systemic inflammatory disease.Psoriasis is a chronic systemic inflammatory disease and its pathogenesis is related to the interaction between genetic susceptibility,immune response and environmental triggers.The omics era has allowed physicians to assess different aspects of psoriasis pathogenesis such as the microbiome,infectome,and autoinfectome.Furthermore,diet appears to play an important role in modulating disease activity,perhaps by influencing gut microbes.Given these observations,we aimed to summarize the current knowledge regarding skin-microbiome-gut-nutrients and psoriasis.