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81.
辅助生殖技术的迅速发展使众多不孕症患者借助体外受精-胚胎移植(IVF-ET)及其衍生技术获得了后代。然而很大一部分妇女经历多次优质胚胎移植亦不能获得妊娠,反复种植失败(RIF)已经成为阻碍妊娠率进一步提高的瓶颈问题,且日益受到生殖医学界的广泛关注。就目前的条件而言,对RIF患者给予药物或者机械操作以提高子宫内膜容受性,行宫腹腔镜检查排除宫腔及盆腔病变以改善胚胎种植环境,通过辅助孵化、选择性囊胚移植、植入前胚胎遗传学筛查、共培养等技术提高胚胎着床能力都有可能改善和提高其种植率及妊娠率。RIF成为了我们亟待解决的问题,现综述近年有关反复种植失败的相关对策新进展。 相似文献
82.
目的:探讨经颅多谱勒超声(TCD)在颈椎病(椎动脉型)所致位置性缺血性眩晕中的诊断价值.方法:利用TCD对颈椎病所致位置性缺血性眩晕76例患者进行双侧大脑后动脉(PCA)的平均血流速度分析,并结合转颈试验,探测双侧PCA平均血流速的动态变化情况.结果:颈椎病所致位置性缺血性眩晕患者当头侧向转动时,双侧PCA的平均血流速度暂时性降低,当头转回中立位时,平均血流速度逐渐回升.结论:TCD有助于识别位置性眩晕中的真性位置性缺血患者,是一种无创、简便、价廉、可靠,并可床旁操作和提供实时动态血流动力学资料的重要检查方法. 相似文献
83.
内蒙古自治区智力残疾现患率调查及病因分析 总被引:1,自引:0,他引:1
目的:了解内蒙古自治区智力残疾(mental retardation.MR)的现患率及其分布特点,分析其主要致残原因构成特点,探讨预防治疗措施。方法:采用概率比例、多阶段分层整群抽样方法进行现况调查及病例对照研究,根据年龄分别使用丹佛发育筛查测验及《7岁以上人群残疾筛查问卷》筛查,分别使用Gesell发育诊断量表及韦氏儿童智力量表简式(WISC-CR),韦氏成人智力量表简式(WAIS-RC)进行智力诊断,采用SPSS11.0软件对数据进行统计分析。结果:①内蒙古自治区智力残疾患者的现患率为4.95‰,男性MR现患率高于女性(χ2=6.28,df=1,P<0.05),农村MR的现患率明显高于城市(χ2=60.035,df=1,P<0.01)。②内蒙古自治区智力残疾致残原因以疾病(29.26%)和遗传因素(23.79%)为主。③在18岁之前(智力发育期)发现智力残疾的占74.53%,且以0~3岁发现智力残疾的人数比例最高(48.84%)。结论:智力残疾的防治重点应在农村,预防应以疾病(主要包括脑疾病、内分泌障碍、惊厥性疾病)及遗传因素为主。强调早期发现、早期干预。 相似文献
84.
Y Y Lee I W Dimery P Van Tassel C De Pena J B Blacklock H Goepfert 《Archives of otolaryngology--head & neck surgery》1989,115(4):503-511
Twenty-four patients with advanced paranasal sinus tumors were treated with combined superselective intra-arterial and systemic chemotherapy, yielding an immediate satisfactory tumor response rate of 91%, significantly better than previously reported. Eight patients had craniofacial surgery circumvented because of complete or near complete response. Repetitive uncomplicated catheterization of the pterygoid segment of the internal maxillary artery using a coaxial system is the cornerstone of successful induction chemotherapy. Strenuous screening of medical status is mandatory for this aggressive introduction chemotherapy. 相似文献
85.
We reviewed the records of all patients with previously untreated squamous cell carcinomas of the supraglottic larynx who presented to The University of Texas M.D. Anderson Cancer Center from 1974 to 1987. Of 404 patients, 60 (15%) underwent supraglottic laryngectomy and functional anterior neck dissection as a primary modality of therapy; these patients were studied. Fifty of the 60 patients (83%) received adjunctive postoperative radiotherapy. Tumor-free survival was 96% at 2 years and 91% at 5 years. There were no local failures, 4 regional failures, and 3 distant metastases. Second cancers, mostly of the lung, occurred in 9 patients (15%). Three patients required completion laryngectomies for intractable aspiration. Analysis of deglutition and tracheal decannulation rehabilitation revealed a higher incidence of complications in patients who underwent arytenoidectomies. 相似文献
86.
87.
I W Dimery L A Jones R P Verjan A K Raymond H Goepfert W K Hong 《Archives of otolaryngology--head & neck surgery》1987,113(10):1082-1085
To access for possible hormone dependence, 19 samples of normal salivary gland tissue and 14 samples of salivary gland carcinoma were quantitatively analyzed for estrogen receptor (ER) content. A receptor protein content of greater than or equal to 1 fmol/mg of cytosol protein was considered positive. Ten (77%) of 13 histologically normal samples, and four (80%) of five tumor samples obtained from male patients contained ER by this criterion, as did five (83%) of six normal samples and eight (88%) of nine tumor samples obtained from female patients. Mean ER concentrations plus or minus SE in male-derived samples were 2.02 +/- .42 fmol/mg of cytosol protein for normal tissue and 4.35 +/- 1.5 fmol/mg of cytosol protein for tumor tissue; mean ER concentrations in female-derived samples were 3.48 +/- 1.1 fmol/mg of cytosol protein for normal tissue and 12.64 +/- 6.4 fmol/mg of cytosol protein for tumor tissue. Four of eight tumors in women had levels considered to be "hormonally dependent" in breast carcinoma. These findings indicate that salivary gland carcinomas may be hormone-dependent. 相似文献
88.
CARLO LA VECCHIA SILVIA FRANCESCHI FABIO PARAZZINI ELENA COLOMBO FABIO COLOMBO ALESSANDRO LIBERATI COSTANTINO MANGIONI 《BJOG : an international journal of obstetrics and gynaecology》1983,90(7):654-661
Summary. Between 1970 and 1976, 290 patients with endometrial cancer were treated at the 1st Obstetrics and Gynecology Clinic of the University of Milan. The median age was 62 years. Surgery was completed in 262 (90.3%) patients. Abdominal hysterectomy was used in 158 (70.9%) stage I and 40 (71.4%) stage II/III patients; vaginal hysterectomy in 55 (24.7%) stage I and nine (16.1%) stage II/III patients. Resection of the upper vagina was performed in 168 patients. Postoperative external beam radiotherapy was used in stage II/III patients and in 44 (19.7%) stage I high-risk patients. Ten-year survival, determined by the life-table method, was 84.8% in stage I (223 patients), 53.4% in stage II (37 patients), 64.4% in stage III (19 patients), and 9.1% in stage IV (11 patients). Factors associated with poorer prognosis were: late age at diagnosis (P<0.001); deep myometrial invasion (P<0.001); poorly differentiated histological grade ( P =0.11); lack of resection of the upper vagina ( P = 0.13). The role and importance of surgery is discussed, with special emphasis on the selective use of the vaginal route in aged, obese and medically high-risk patients. 相似文献
89.
Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design 总被引:11,自引:3,他引:8
Apfel CC Kranke P Katz MH Goepfert C Papenfuss T Rauch S Heineck R Greim CA Roewer N 《British journal of anaesthesia》2002,88(5):659-668
Background. Despite intensive research, the main causes of postoperativenausea and vomiting (PONV) remain unclear. We sought to quantifythe relative importance of operative, anaesthetic and patient-specificrisk factors to the development of PONV. Methods. We conducted a randomized controlled trial of 1180children and adults at high risk for PONV scheduled for electivesurgery. Using a five-way factorial design, we randomly assignedsubjects by gender who were undergoing specific operative procedures,to receive various combinations of anaesthetics, opioids, andprophylactic antiemetics. Results. Of the 1180 patients, 355 (30.1% 95% CI (27.532.7%))had at least one episode of postoperative vomiting (PV) within24 h post-anaesthesia. In the early postoperative period (02h), the leading risk factor for vomiting was the use of volatileanaesthetics, with similar odds ratios (OR (95% CI)) being foundfor isoflurane (19.8 (7.751.2)), enflurane (16.1 (6.241.8))and sevoflurane (14.5 (5.637.4)). A doseresponserelationship was present for the use of volatile anaesthetics.In contrast, no dose response existed for propofol anaesthesia.In the delayed postoperative period (224 h), the mainpredictors were being a child (5.7 (3.010.9)), PONV inthe early period (3.4 (2.44.7)) and the use of postoperativeopioids (2.5 (1.73.7)). The influence of the antiemeticswas considerably smaller and did not interact with anaestheticor surgical variables. Conclusion. Volatile anaesthetics were the leading cause ofearly postoperative vomiting. The pro-emetic effect was largerthan other risk factors. In patients at high risk for PONV,it would therefore make better sense to avoid inhalational anaesthesiarather than simply to add an antiemetic, which may still beneeded to prevent or treat delayed vomiting. Br J Anaesth 2002; 88: 65968 相似文献
90.
LA Cox 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(S406):84-85
A series of hand and wrist radiographs was assessed manually by two individuals and by a fully automated computer system for determining bone age. Assessments were repeated after 1 month to determine variability between and within the methods of bone age assessment. There was slight intra-observer variation, but complete reproducibility when assessments were made by computer. The variation between the human assessors was less than that between human and computer assessments. The difference between overall maturity scores made by the human observer and the computer system was, however, acceptably small, and the majority of assessments were the same. It is concluded this computer system for assessing bone age in normal children is reliable and accurate, but that it needs to be validated against a much larger set of radiographs. 相似文献