天津地区女性生殖道感染病原学分析

目的:了解天津地区性病门诊和妇科门诊女性患者的细菌性阴道病(BV)及其他性病患病情况及相关致病因素。方法:根据Biswas标准对546例女性患者进行细菌性阴道病的诊断及相关致病因素调查,同时进行其他性病病原学、血清学及组织学检测。结果:细菌性阴道病在性病门诊就诊人群的患病率为27.2%,在妇科门诊就诊人群的患病率为22.0%,两者间差异无统计学意义(P>0.05);混合感染共83例(63.4%);合并感染最多的为解脲脲原体(29.8%);流产史、宫内节育器使用、有多个性伴3个因素与BV发生有相关性。结论:细菌性阴道病不仅是妇科常见病之一,也是与性传播有关的疾病,发病率高且常合并其他性传播病原体感染,故应在高危人群中积极开展筛查工作。     

家政服务从业人员1843名健康检查情况分析

目的了解家政服务从业人员健康状况，为规范保姆市场管理提供客观依据。方法分别用金标法及湿片镜检法对1843名上岗前保姆血清梅毒、乙肝表面抗原及白带念珠菌、滴虫进行检查。结果1843名保姆中梅毒感染者21例，占1．14％；乙肝表面抗原阳性70例，占3．80％；阴道念珠菌感染38例，占2．06％；阴道滴虫感染82例，占4．45％。结论加强外来务工人员卫生知识普及教育及健康检查工作事关全民健康大事，政府职能部门应针对家政服务新兴行业制订相关的体检标准，将血清梅毒、乙肝表面抗原及阴道念珠菌、滴虫检查纳入其中，严把保姆体检关，有效杜绝新兴产业给社会带来的危害。     

腹股沟疝解剖学特点与临床诊治

为了加深医学院校学生对腹股沟斜疝和鞘膜积液的理解,并提高临床医生术中寻找疝囊或腹膜鞘状突的技能,本文对斜疝和鞘膜积液的形成机理、分类及相互关系从解剖学的角度进行了相关探讨.强调了鞘状突等于疝,其壁即是腹膜这一观点,从而有利于提高斜疝和鞘膜积液术前诊断、术中操作的准确性,减少术后复发的可能性.     

Testicular descent

Sixty male rats were treated twice weekly from birth with either oestradiol benzoate (E₂B) or sesame oil (controls) to see if oestrogen caused cryptorchidism by inhibition of gubernacular migration between 3 and 10 days after birth. Dissection was carried out at 10, 15, or 28 days, the processus vaginalis measured using a probe, and the weight of the testis recorded. The length of the processus was used as a measure of the length of migration of the hollow gubernaculum. Although E₂B affected testicular weight significantly at 15 days, the length of the processus vaginalis was not significantly different from controls during the normal time of gubernacular migration (3–10 days of age). Histology confirmed this observation, with the gubernaculum within but slightly higher in the scrotum in E₂B-treated males than in 15-day controls. Similar findings were found in a second group of 10 rats subjected to orchidectomy at birth to remove the androgen source. By 28 days all E₂B-treated animals were found to be cryptorchid, although the gubernaculum had completed its migration to mid-scrotal level. It is proposed that pubertal testicular descent in the rodent is inhibited by E₂B by mechanisms other than inhibition of gubernacular migration between birth and 10 days of age, which may be preprogrammed before birth.     

附睾及睾丸鞘膜血管平滑肌瘤

目的 :提高对附睾及睾丸鞘膜血管平滑肌瘤的认知水平。方法 :回顾性复习了二例临床罕见的附睾及睾丸鞘膜血管平滑肌瘤的诊治资料。结果 :肿瘤行手术切除 ,术后病理证实为血管平滑肌瘤。随访至今 ,无复发。结论 :附睾及睾丸鞘膜血管平滑肌瘤的术前诊断较困难 ,确诊需经病理学检查 ,手术切除是最佳治疗方法     

Is the use of laparoscopy to determine presence of contralateral patent processus vaginalis justified in children greater than 2 years of age?

Purpose

Contralateral inguinal hernia exploration in cases of unilateral inguinal hernia remains a controversial topic. The authors have been using the in-line laparoscopic technique of contralateral evaluation for unilateral inguinal hernia in children less than 2 years of age. Because of the case of the procedure and lack of morbidity, we decided to expand the use of this procedure up to age 8 years in January 2000. The purpose of this study is to evaluate if the incidence of contralateral hernia in children greater than 2 years justifies the procedure.

Methods

This is a retrospective study of all children who underwent contralateral exploration for unilateral inguinal exploration over a 20-month period. The procedure was offered routinely to all patients up to age 8 years. During the repair, the contralateral inguinal ring was examined laparoscopically using the in-line technique for the presence of a contralateral hernia. The incidence of contralateral hernia was determined, and the results were stratified by age. Patients who underwent unilateral inguinal hernia repair without laparoscopic contralateral exploration or bilateral inguinal hernia repair without laparoscopic contralateral explorations were excluded from the study.

Results

A total of 284 laparoscopic explorations were performed. Positive explorations were seen in 65 of 171 (38%) of children less than 2 years of age, 19 of 101 (20%) of children 2 to 8 years of age, and 1 of 12 children greater than 8 years of age (8%). There were no operative complications.

Conclusions

Laparoscopic contralateral exploration is safe and effective. Because of the low morbidity, the risk to benefit ratio warrants its use in children up to 8 years of age. This sample size is too small to make any meaningful statement in children older than 8 years.     

The development of the gubernaculum and inguinal closure in the marsupial Macropus eugenii

This study reports the developmental anatomy of testicular descent and inguinal closure of the tammar wallaby (Macropus eugenii) from birth to maturity. In females the ovary migrated caudally between days 10 and 20 after birth. The gubernaculum differentiates into the round ligament in the abdomen and extra-abdominally as the ilio-marsupialis muscle of the mammary glands. In males the testes migrated to the internal inguinal ring by day 20 post partum (pp), coinciding with the enlargement of the gubernaculum, and from the internal inguinal ring to the scrotum between days 20 and 65 pp. During descent there was an increase in the hyaluronic acid concentration in cells of the gubernaculum and scrotum. Development of the cremaster muscle began by day 10 pp on the periphery of the gubernaculum and its basic structure was completed by day 60 pp. After descent the inguinal canal closed between days 50 and 60 pp, but a small irregular lumen persisted, somewhat similar to that seen in the congenital scrotal hydrocoele of humans. Tammars have a hopping mode of locomotion and, like humans, are essentially bipedal. We suggest that inguinal closure evolved in these two species because their upright posture may otherwise lead to a high incidence of inguinal hernias.     

Adopt a wait-and-see attitude for patent processus vaginalis in neonates

Purpose: The purpose of this paper is to describe the ultrasonographic findings of the patent processus vaginalis (PPV) in neonates.Methods: The patency of the processus vaginalis was examined by ultrasonography in 117 neonates. The ultrasonographic findings, with increment and decrement of the intraabdominal pressure, were categorized into 6 types as follows: type I, the intraabdominal organ is observed; type II, cystic PPV; type III, the PPV is widened with abdominal pressure increment, the length is ≥20 mm; type IV, the PPV contains moving fluid without PPV widening; type V, the PPV is widened with abdominal pressure increment, the length is less than 20 mm; type VI, others. The authors we regarded types I to IV as PPV with inguinal hernia.Results: Twenty-two of 40 neonates with a birth weight under 2,500 g had PPV, including 8 with type I. Twenty of 37 premature neonates 22 to 37 gestational weeks had PPV, including 8 with type I. Eighty-one percent (13 of 16) of PPV in low-birth-weight neonates and 91% (10 of 11) in premature neonates closed spontaneously. The median ages at the time of spontaneous regression of PPV were 242 days in low birth weight neonates and 262 days in premature neonates.Conclusions: Most premature or low-birth-weight neonates with PPV regress spontaneously. The inguinal hernia in neonates (especially in premature or low-birth-weight neonates) should be observed until at least 9 months of age without attempting hernia repair.     

蛇床子素对体外阴道毛滴虫的杀灭研究

目的观察蛇床子素对体外阴道毛滴虫的杀灭效果及安全性。方法以蛇床子素的终浓度为0．56～4．48mg／ml作用于体外培养的阴道毛滴虫。结果1．12mg／ml为蛇床子素体外杀阴道毛滴虫的最低有效浓度。结论蛇床子素对体外阴道毛滴虫有杀灭效果。     

3942例妇女非常见模式阴道清洁度分析

目的:探讨非常见模式妇女阴道清洁度的判断。方法:分析3942例妇科患者阴道分泌物清洁度,对各种常见和非常见模式患者进行清洁度判定。结果:除4种常见清洁度模式(占妇科病人的19.4%)外,主要为其它7种非常见的清洁度模式(占80.6%),且都与假丝酵母菌孢子、假菌丝、阴道毛滴虫、线索细胞及革兰氏阴性双球菌密切相关。结论:常见的4种清洁度模式不能全面反映阴道清洁度的判断,需要对更多模式进行探讨,并清楚界定各种模式下阴道的清洁度。