Diagnosis and Management of Bladder Outlet Obstruction in Women

Bladder outlet obstruction (BOO) should be considered when a woman complains of voiding difficulty, abdominal straining to void, or refractory storage symptoms. Diagnosis of female BOO is not straightforward and usually requires invasive (video)urodyanmic study. A diagnostic algorithm is recommended for making optimal diagnosis. Female BOO can be classified as having anatomical and functional origins, and each contains several sub‐classifications. Literatures published between 1988 and 2013 were reviewed and summarized for the diagnosis and therapy in each subtype of female BOO.     

妊娠不同时期孕妇对运动的认知及现状调查

目的了解妊娠不同时期孕妇对运动的认知程度及运动方式,为进一步有针对性地指导孕妇合理运动提供依据。方法采用便利抽样的方法,选取成都市某妇女儿童专科医院门诊进行产前检查的妊娠早期、中期、晚期孕妇各396例,采用自行设计的问卷进行运动认知及运动方式调查。结果 55.30%孕妇能认识到孕期不合理运动的危害,82.36%能认识到孕期合理运动的好处,55.73%有信心进行孕期运动,但同时也面临着不同程度的障碍,如个人习惯、工作太忙、对运动知识不了解等;散步和爬楼梯是孕妇最主要的运动方式;不同妊娠时间孕妇散步、慢跑、游泳参与率比较,差异有统计学意义(P<0.05,P<0.01)。结论大多数孕妇能认识到孕期合理运动的好处以及不合理运动的危害,且有信心进行运动,但仍受多种因素的影响;同时,孕妇的运动方式过于单一,存在安全顾虑。医护人员应加大孕期运动安全的指导,结合孕妇的实际情况,指导其选择安全、有效的孕期运动方式。     

孕妇TORCH感染后IgM抗体检测分析诊断评估

为探讨产前筛查孕妇TORCH感染后IgM抗体检测诊断评估的可行性分析,应用酶联免疫法(ELISA)检测孕妇TORCH感染后血清中IgM抗体,以正常体检者为对照组,进行对比分析.结果显示,1800例产前筛查的孕妇TORCH感染后的TOX-IgM、RV-IgM、CMV-IgM和HSV-IgM阳性率分别为5.11%、1.94...     

Comparison of pelvic floor muscle strength evaluations in nulliparous and primiparous women: a prospective study

OBJECTIVE:

This study aimed to compare the pelvic floor muscle strength of nulliparous and primiparous women.

METHODS:

A total of 100 women were prospectively distributed into two groups: Group 1 (G1) (n = 50) included healthy nulliparous women, and Group 2 (G2) (n = 50) included healthy primiparous women. Pelvic floor muscle strength was subjectively evaluated using transvaginal digital palpation. Pelvic floor muscle strength was objectively assessed using a portable perineometer. All of the parameters were evaluated simultaneously in G1 and were evaluated in G2 during the 20^th and 36^th weeks of pregnancy and 45 days after delivery.

RESULTS:

In G2, 14 women were excluded because they left the study before the follow-up evaluation. The median age was 23 years in G1 and 22 years in G2; there was no significant difference between the groups. The average body mass index was 21.7 kg/m² in G1 and 25.0 kg/m² in G2; there was a significant difference between the groups (p = 0.0004). In G2, transvaginal digital palpation evaluation showed significant impairments of pelvic floor muscle strength at the 36^th week of pregnancy (p = 0.0006) and 45 days after vaginal delivery (p = 0.0001) compared to G1. Objective evaluations of pelvic floor muscle strength in G2 revealed a significant decrease 45 days after vaginal delivery compared to nulliparous patients.

CONCLUSION:

Pregnancy and vaginal delivery may cause weakness of the pelvic floor muscles.     

Elevated serum chemerin in Chinese women with hyperandrogenic PCOS

Objectives: To compare serum chemerin levels between women with classic hyperandrogenic PCOS, euandrogenic PCOS and matched control subjects.

Research design and methods: This study was carried out at the Second XiangYa Hospital between July 2012 and April 2013. Sixty-seven women with PCOS and 20 controls were included. Blood pressure, body mass index (BMI), waist to hip ratio (WHR), fasting insulin, fasting plasma glucose and blood serum hormone and blood lipid were measured. Transvaginal ultrasound was performed. Serum chemerin was measured by ELISA.

Results: Serum chemerin was significantly higher in classic hyperandrogenic PCOS compared with euandrogenic PCOS and controls (311.07?±?141.87?ng/mL versus 228.03?±?119.66?ng/mL and 225.87?±?86.44?ng/mL, p?p?Conclusions: Serum chemerin level was increased in Chinese women with classic hyperandrogenic PCOS. Serum chemerin measurement offers a relatively moderate diagnostic potency with a sensitivity of 80.0% and a specificity of 47.6% at 200.94?ng/mL. This suggested that chemerin may be involved in the development of the metabolic syndrome of classic PCOS.     

晚期妊娠，胎盘病理见印戒细胞

张震宇（主持人,朝阳医院妇产科主任）今天邀请首都医科大学妇产科学系各临床学院负责人,本院各相关科室(消化科、血液科、呼吸重症医学科、病理科、超声医学科、核医学科) 专家参加我科收治的1 例晚期妊娠,胎盘病理发现印戒细胞的病例讨论,旨在通过回顾性分析,深入探讨患者诊治方面的经验与教训,以期进一步提高诊疗水平。首先请主管医师介绍病史和诊治情况。     

妊娠期血清中FT3、FT4、TT3、TT4和TSH的变化范围对孕妇甲状腺功能诊断的参考

目的 通过检测妊娠期血清中FT3、FT4、TT3、TT4、TSH的动态变化从而探究此变化范围对妊娠期孕妇甲状腺疾病诊断的影响.方法 通过对269例不同妊娠期的孕妇及80例对照组不同甲状腺激素含量测定,用SPSS 19.0软件对数据结果分析,并采用95％可信区间表示妊娠期特异参考值范围,并根据不同参考值范围统计甲状腺疾病患病率的区别.结果 所选取研究对象的孕次及年龄对研究无影响(年龄F=0.627,P=0.074＞ 0.05;孕次F=1.076,P＞0.05);在孕期间,FT4水平随孕期进程呈下降趋势,组间均数差异有统计学意义(F=8.527,P＜0.05);FT3的含量在妊娠开始后缓慢下降,各组两两比较差异并无统计学意义(F=2.436,P＞0.05);在整个妊娠期,早期TSH水平最低,之后逐渐回升,最终妊娠晚期到达最高水平,各组的血清TSH均数的差别有统计学意义(F=17.624,P＜0.05);在妊娠过程,TT4和TT3的量都为上升趋势;采用95％可信区间建立了FT3、FT4、TSH的参考值范围;妊娠各期两种参考值范围所得亚临床甲减患病率比较差异具有统计学意义(P＜0.05).结论 在妊娠期间,加强监测孕妇的各甲状腺激素变化,并制定出针对临床妊娠期甲状腺激素的正常参考值范围,将对正常妊娠和胎儿健康发育以及临床诊断都大有裨益.     

血管紧张素转换酶和血管紧张素原基因多态性及其与青海妊娠高血压疾病的相关性

目的探讨血管紧张素转换酶(ACE)和血管紧张素原(AGT)基因表达、基因多态性与青海孕产妇妊娠高血压疾病的相关性。方法选择210例妊娠高血压患者(HDCP组)和220例正常孕妇(CK组),运用限制性内切酶片段长度多态性聚合酶链反应(PCR-RFLP)方法检测AGT M235T、ACE I/D基因多态性。结果CK组ACE基因DD、ID、Ⅱ所占比例分别为28.18%、47.73%、24.09%,HDCP组分别为33.81%、51.90%、14.29%(P<0.05,故两组的ACE基因分布有差异),HDCP组和对照组ACE I/D多态性等位基因I和D频率分布有差异(P<0.05),HDCP组D等位基因频率高于对照组(χ^2=5.188,P<0.05),ACE基因型分布符合Hardy-Weinberg遗传平衡(χ^2=0.423,df=2,查表χ^2界值表,P>0.05,达到遗传平衡);CK组AGT基因MM、MT、TT所占比例分别为24.09%、43.64%、32.27%,HDCP组分别为15.71%、42.86%、41.43%(P<0.05,故两组的AGT基因分布差异有统计学意义),HDCP组和对照组AGT M235T多态性等位基因M和T频率分布有差异性(P<0.05),HDCP组T等位基因频率高于对照组(χ^2=6.796,P<0.05),AGT基因型分布符合Hardy-Weinberg遗传平衡(χ^2=3.242,df=2,查表χ^2界值表,P>0.05,达到遗传平衡)。结论ACE I/D多态性和AGT M235T多态性与青海省汉族妊娠期高血压疾病有关,D等位基因和T等位基因可能是妊娠高血压疾病的易感基因。     

亚甲基四氢叶酸还原酶基因多态性与青海汉族妊娠期高血压疾病的相关性

目的 探讨亚甲基四氢叶酸还原酶（MTHFR）基因-677C/T（rs1801133）多态性与青海汉族妇女妊娠期高血压疾病（HDP）的相关性。 方法 选择青海省HDP患者 139 例（HDP组）,正常妊娠孕妇 145 例（对照组）,应用限制性内切酶片段长度多态性聚合酶链反应（PCR-RFLP）方法,检测HDP组和对照组MTHFR-677C/T多态性分型并测序验证。 结果 HDP组和对照组MTHFR基因CC、CT、TT基因型频率分别为54.68%、35.25%、10.07% 和69.66%、22.06%、8.28%,CC基因型频率HDP组54.68%低于对照组69.66%（P<0.05）,CT基因型频率HDP组35.25%高于对照组22.06%（P<0.05）,而TT基因型频率HDP组和对照组之间差异无统计学意义（P>0.05）;HDP组和对照组MTHFR-677C/T多态性C和T等位基因频率分布有差异（P<0.05）,HDP组T等位基因频率高于对照组（χ²=5.568,P<0.05）。 结论 MTHFR基因-677C/T多态性与青海汉族HDP相关,MTHFR基因-677C/T多态性中T等位基因可能是HDP的易感基因,CT基因型为HDP的易感基因型。