比较不同方法治疗原因不明复发性流产的疗效

目的比较注射淋巴细胞主动免疫治疗、注射丙种球蛋白被动免疫治疗、肌内注射HCG安胎保守治疗3种方法对原因不明复发性自然流产(URSA)的临床疗效;为URSA的治疗寻求有效的治疗方案。方法 120例原发性URSA患者随机分为3组,A组40例,接受淋巴细胞注射主动免疫治疗;B组40例,接受丙种球蛋白注射被动免疫治疗;C组40例,予HCG肌内注射保守治疗。结果治疗后A组妊娠成功率为90.0%,B组为85.0%,C组为27.5%,A组与C组比较差异有显著性(P<0.05);B组与C组比较差异有显著性(P<0.05),A组与B组比较差异无显著性(P>0.05)。结论注射淋巴细胞主动免疫治疗方法与注射丙种球蛋白被动免疫治疗方法在治疗原因不明复发性自然流产中疗效显著,二者的有效率明显高于单纯肌内注射HCG的保守治疗方法。     

Defining the rise of serum HCG in viable pregnancies achieved through use of IVF

BACKGROUND: We aimed to characterize the rate of HCG rise associated with viable IVF pregnancies, and to evaluate the association between HCG rise and potentially influential factors. METHODS: We performed a retrospective cohort analysis of all viable pregnancies achieved through IVF at two centres between January 1999 and March 2004. RESULTS: Of the 455 pregnancies resulting in live births, 391 met inclusion criteria and contributed a total of 1052 HCG values. Using random effects models, the best pattern to describe the rise of log HCG was quadratic with the rate of increase slowing at 24 days post-oocyte retrieval. Limiting the analysis to measurements below the discriminatory zone, the linear model adequately characterized the profile. The average slope was 0.403, yielding a predicted increase of 1.50 (50% increase) in 1 day and 2.24 (124%) in 2 days. In the final model, absolute HCG values, but not rate of rise, were significantly higher for twins and triplets and significantly lower for patients with BMI>30 kg/m2. CONCLUSIONS: The HCG profile of viable pregnancies conceived with IVF is quadratic with an earlier plateau than has been reported for non-IVF pregnancies. The average rate of rise is comparable to previous estimates in symptomatic spontaneous conceptions.     

克罗米芬结合人绒毛膜促性腺激素治疗多囊卵巢综合症的临床分析

目的观察克罗米芬结合人绒毛膜促性腺激素（HCG）治疗多囊卵巢综合症的疗效。方法将56例多囊卵巢综合症肥胖患者随机分为两组,分别用克罗米芬和克多米芬加人绒毛膜促性腺激素促排卵治疗。结果治疗组28例治疗后血清胰岛素水平明显降低（P〈0.01）,血睾酮、胰岛素抵抗指数有显著降低（P〈0.05）,而对照组治疗前后无明显变化。两组都无明显不良反应。结论克罗米芬结合人绒毛膜促性腺激素（HCG）治疗多囊卵巢综合症能明显改善多囊卵巢综合症的临床症状,提高妊娠率,改善肥胖,值得临床推广。     

血清孕酮及绒毛膜促性腺激素的检测在早期先兆流产中的临床意义

目的 分析探讨怀孕早期孕妇的血清孕酮及绒毛膜促性腺激素水平在早期先兆流产中具有的临床意义和价值. 方法 选取孕龄6-9周的孕早期孕妇221例,根据妊娠的结果将其分为继续妊娠组92例、最终流产组61例和健康对照组68例,采用全自动化学发光免疫分析仪分别对血清中的孕酮P和绒毛膜促性腺激素β-HCG水平进行检测. 结果 孕6~9周继续妊娠组各孕周P及β-HCG水平均显著低于健康对照组,最终流产组各孕周P及β-HCG水平均显著低于继续妊娠组（P〈0.05）差异有统计学意义,孕酮水平变化同β-HCG,差异有统计学意义. 结论 孕6~9周时血清P和β-HCG水平检测是孕妇早期先兆流产判定的有效手段,两者联合应用对先兆流产的临床诊断具有重要意义.     

CA125、β-HcG、CA724、CA199联合检测对宫颈癌的诊断价值

目的探讨采Ⅲ肿瘤标志物CA125、β-HCG、CA724、CA199联合检测对宫颈癌的诊断价值。方法我院从2007～2012年病理检测确诊的宫颈癌患者36例、良性宫颈肿瘤患者32例和健康妇女46例,对其采取CA125、β—HCG、CA724、CA199联合检测,观察各指标单向检测和联合检测阳性准确率以及联合检测的准确性和敏感性．结果宫颈癌组患者的CA125、β—HCG、CA199水平与健康组比较,有显著性差异（P〈0．05）;宫颈良性肿瘤组各指标与健康组比较,无显著性差异（P〉0．05）。各组血清CA125、B—HCG、CA724、CA199单项检测及联合检测阳性率比较,由有显著性差异（P〈0．05）。联合检测的敏感性和准确性显著高于各单项检测（P〈0．05）。结论采用肿瘤标志物CA125、β—HCG、CA724、CA199联合检测对宫颈癌的诊断具有重要意义,值得临床推广。     

阴道液HCG与pH定性检测在胎膜早破中的诊断价值

目的探讨阴道液HCG与pH定性检测在诊断胎膜早破中的应用价值。方法选取2011年8月至2012年8月淮安市第二人民医院妇产科收治的胎膜早破患者78例,分别对其阴道液进行HCG与pH定性检测。结果阴道液HCG定性检测与pH检测的灵敏度分别为97．00％、96．34％,差异无统计意义（P〉0．05）,在检测的准确度、阳性预测值以及特异性上有一定的差别,同时阴道液HCG检测效果优于pH检测,但两种方法联合使用具有较好的效果。结论阴道液HCG与pH定性检测均是胎膜早破的检测手段,且这两种方法简单易行,创伤小,联合检测特异性及准确率高。     

子宫颈鳞状细胞癌组织中LncRNA HCG11和miR-590-3p的表达及其与预后的关系

 目的 探讨LncRNA HCG11和miR-590-3p在子宫颈鳞状细胞癌组织及配对的癌旁组织中的表达情况,以及二者表达水平与患者临床资料和预后的相关性。方法 收集58例子宫颈鳞状细胞癌和配对的癌旁正常组织标本,运用qRT-PCR法检测58对子宫颈鳞状细胞癌组织及相应的癌旁组织中的LncRNA HCG11和miR-590-3p的表达,分析与宫颈鳞状细胞癌临床病理和预后的相关性,并评价其临床意义。结果 荧光定量PCR显示宫颈鳞状细胞癌组织中LncRNA HCG11的表达比癌旁组织明显下调（P<0.05）,miR-590-3p的表达比癌旁组织明显上调（P<0.05）;二者在核酸表达水平上呈负相关（r=-0.642, P=0.000）。 LncRNA HCG11和miR-590-3p的表达均与宫颈癌淋巴结转移、组织大小及临床分期之间存在显著的相关性,且与预后相关（P<0.05）。Cox回归多因素分析发现LncRNA HCG11和miR-590-3p分别可作为宫颈鳞状细胞癌患者独立的预后因子。结论 LncRNA HCG11和miR-590-3p可作为宫颈鳞状细胞癌独立的预后标志物和潜在的治疗靶点,LncRNA HCG11可能通过调控miR-590-3p的表达量从而发挥抑癌基因的作用。     

Vascular cell adhesion molecule-1 in normal, failed, and ectopic pregnancy

PROBLEM: Vascular cell adhesion molecule-1 (VCAM-1) is involved in early pregnancy establishment. This study sought to determine whether soluble VCAM-1 (sVCAM-1) serum levels differ among normal, failed, and ectopic pregnancy, its capacity to serve as a marker for pregnancy viability or ectopic pregnancy, and its correlation with serum progesterone and beta human chorionic gonadotrophin (PHCG) levels. METHOD OF STUDY: Maternal serum samples were obtained from 20 women with ectopic, 10 with normal, and 10 with failed intra-uterine pregnancy, all of comparable gestational age. Samples were assayed for sVCAM-1, progesterone, and betaHCG by specific assays. RESULTS: The median serum level of sVCAM-1 was comparable between the three pregnancy types (normal: 578.3 ng/mL, range 434.4-699.5 ng/mL; failed: 567.8 ng/mL, range 401.9 669.5 ng/mL; and ectopic: 470.7ng/mL range, 328.2-1151.1 ng/mL). Serum levels sVCAM-1 were not significantly correlated with betaHCG or progesterone levels. CONCLUSION: sVCAM-1 is not appropriate to serve as a marker for pregnancy viability or ectopic pregnancy.