人工流产术前宫颈及子宫内膜麻醉的镇痛效果探讨

目的　探讨宫颈与子宫内膜两部位联合麻醉、普鲁卡因与利多卡因两药物配合应用在人工流产术中的镇痛效果。方法　人工流产术前对麻醉组 10 6例行普鲁卡因宫颈浸润麻醉和利多卡因子宫内膜表面麻醉。术中记录受术者腹痛程度、无阻力插入宫颈内口的扩张器号、出血量、人流综合征例数等指标。按照世界卫生组织规定疼痛标准及人工流产综合征反应进行评价 ,同期选择按传统机械扩宫法 10 4例做对照。结果　麻醉组镇痛有效率95 3% ,宫口松驰有效率 95 3% ,人流综合征无 1例发生。两组比较P均 <0 0 0 1。两组出血量比较无差异 ,无利多卡因毒性反应发生。结论　人工流产术前普鲁卡因宫颈浸润麻醉和利多卡因子宫内膜表面麻醉镇痛效果显著 ,可大大降低人流综合征的发生 ,避免利多卡因的毒性反应     

剖宫产术中大出血的原因分析与治疗

目的探讨剖宫产术中大出血的原因及治疗.方法回顾性分析39例剖宫产术中出血≥1000ml作为研究组,出血＜1 000ml,且＞500ml者作为对照组1,出血≤500ml者600例作为对照组2.结果研究组中出血首位原因主要为前置胎盘和低置胎盘,占53.85%(21/39),显著高于对照组1中的10.67%(27/253),P＜0.01.在药物控制出血失败后,11例子宫动脉结扎中8例治疗成功、29例宫腔填塞纱条中28例治疗成功,得以保留子宫,2例行子宫切除术.结论前置胎盘和低置胎盘是剖宫产术中大出血的主要原因,宫腔填塞纱条治疗剖宫产术中大出血有良好效果.     

人文医疗在阴式全子宫切除术联合阴道后壁修补术治疗子宫脱垂合并肠疝患者中的应用

目的探究人文医疗在阴式全子宫切除术联合阴道后壁修补术治疗老年子宫脱垂合并肠疝(阴道后壁膨出)患者中的应用效果。方法选择2018年1月至2019年12月期间天长市中医院收治子宫脱垂合并肠疝患者120例作为研究对象。全部入选病例均行阴式全子宫切除术联合阴道后壁修补术治疗,采用随机数字表法将病例分为对照组和观察组,各60例。对照组给予常规护理,观察组给予人文医疗护理。对比2组患者中文版知觉压力量表(CPSS)评分、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分、心理弹性量表-简表(RS-14)、护理服务满意度、皮质醇(Cor)、心率及平均动脉压。结果护理前,2组CPSS、SDS、SAS及RS-14评分组间比较的差异无统计学意义(P>0.05);护理7 d后,2组CPSS、SDS、SAS及RS-14评分均较护理前降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。观察组患者的满意度(96.67%)较对照组高(80.00%),差异有统计学意义(P<0.05)。观察组手术结束时2组患者的Cor、心率及平均动脉压较对照组低,差异有统计学意义(P<0.05)。结论人文医疗应用于子宫脱垂合并肠疝患者护理中,能够改善其不良情绪,缓解心理压力,减少手术的应激反应,提高患者对护理满意度。     

HPV genotyping in biopsies of HSIL and invasive cervical cancers in women living with HIV: A cohort- and a nested -case control study

ObjectiveTo characterize HPV genotype distribution in HSIL and ICC- biopsies, of WLWH, in Europe, as compared to HIV-negative women.DesignCohort- and nested -case control study.MethodWe characterized HPV genotype distribution by performing PCR on HSIL and ICC biopsies from WLWH (n = 170); 85 cases were compared to 85 HIV-negative matched controls. The proportion of patients that might be protected by HPV vaccines was estimated.ResultsAmong WLWH (median age 36 years-old, median duration of HIV infection 70,5 months, 79% under cART): the most frequently detected HPV were HPV16 (30%), HPV35 (16%), HPV58 (14,7%), HPV31 (13,5%), and HPV52 (11,7%). HPV16 was less frequently found in WLWH, originating from Central Africa (20,5%) compared to other African regions (35,5%) (p = 0,05) or world regions (38,8%) (p = 0,007). Multiple versus single high-risk HPV infections were associated with younger age (≤35 years)(odds ratio (OR) 2,65 (95%IC: 1,3–5,2,p = 0,002), lymphocyte CD4 count < 350 cells / µL (OR 2,7 (95%IC: 2–8,5; p = 0,005), use of cART for < 18 month OR 2,2 (95%IC: 1,1–4,5),p = 0,04) or a cumulative time with undetectable HIV viral load of less than 12 months (OR 4,2 (95%IC: 2–8.5,p = 0,001). HPV 31, 33 and 35 were more frequently detected in samples from WLWH than in HIV-negative controls (p < 0,05). The 9-valent vaccine would increase HPV protection, in HIV-positive and negative women (p < 0,001).ConclusionWLWH are more frequently infected with high-risk HPV other than 16 and 18 than HIV-negative ones. The use of 9-valent vaccine may prevent HSIL or ICC in up to 85% of the women. Adding HPV 35 to the HPV vaccine panel, might improve vaccine effectiveness in WLWH.     

Biofluid Aspects of Embryo Transfer

Embryo transfer (ET) is the last stage of extracorporal fertilization during which the embryo is placed in the uterine cavity with a medium-filled catheter 2–3 days after in vitro fertilization. While fertilization in the laboratory occurs at very high rates (>:90%), the overall success of the procedure (i.e., take home baby) is still very low (<25%) and assumed to be mainly due to implantation failure. A computational model was developed to simulate ET within the uterine cavity by a fluid-filled catheter inserted into a two-dimensional channel with oscillating walls. The results showed that the speed at which the embryos are injected from the catheter dominates the procedure and controls the velocity of their transport within the uterine cavity. ET at excessively high injection speeds may lead to ectopic pregnancies, while uterine peristalsis affects transverse dispersion only during injection at low injection speeds. The presence of the catheter within the uterus does not affect flow patterns downstream of its tip. The potential risks to implantation failure due to mechanical factors involved in the ET processes are discussed. © 2003 Biomedical Engineering Society. PAC2003: 8719-j, 8710+e     

应用经阴道彩色多普勒对健康育龄妇女子宫卵巢动脉血流状况的研究

目的 研究育龄妇女子宫、卵巢动脉血流变化规律。方法 应用经阴道彩色多普勒对４６０例妇女子宫、卵巢动脉血流在不同月经周期进行搏动指数（ＰＩ）、阻力指数（ＲＩ）检测。结果 血流参数在四个周期间有非常显著性差异（Ｐ〈０．０１）,同时功能侧子宫动脉与卵巢动脉阻抗参数也有差异（Ｐ〈０．０５）。结论 通过检测子宫、卵巢动脉血流有助于对妇科疾患的诊断提供帮助。     

宫内节育器与兔子宫内膜生成内皮素的研究

自制金属单环放入兔左侧子宫角腔内,有明显抗生育效果,此为动物模型。选10只成年雌兔分为二组,将节育环放入每只兔左侧子宫角腔内,右侧为对照。一个月,三个月取子宫内膜,进行形态学观察,内皮素免疫组化定位及内膜组织中内皮素含量的测定。结果显示:内膜形态无明显改变,只在少数局部淋巴细胞略多。内皮素免疫组化定位显示左侧子宫角阳性反应比右侧强,一个月和三个月结果相似。放射免疫测定的内膜组织中内皮素含量左侧明显高于右侧。揭示金属单环引起内膜组织生成内皮素增加。     

Decrease of some metabolic and physiologic effects of diazoxide by propranolol in rat

Summary Diazoxide significantly decreased the blood pressure and relaxed the uterine muscle in anaesthetized normotensive rats. A marked elevation of blood glucose followed the intravenous injection of diazoxide. The hyperglycemic and the uterine relaxing response could be significantly decreased by injection of propranolol prior to diazoxide. The hypotensive effect was not diminished by propranolol, however. In liver and uterus the content of cAMP was increased following diazoxide treatment in vivo. The rise in cAMP could be completely inhibited by propranolol, indicating a -receptor stimulation being the cause of the cAMP elevation.     

Electron microscopy and X-ray microanalyses of uterine epithelium from lead-injected mice in an experimental delay of implantation

Mice in experimental delay of implantation were injected intravenously with 75 g · g^–1 body weight of lead chloride, corresponding to a dose of lead of about 56 g · g^–1 body weight. Delay of implantation was obtained by ovariectomy 3 days after mating followed by a depot dose of progesterone every fifth day. Electron microscopy showed that the uterine lumen, which was closed in control mice, was opened in lead-injected mice. This morphology suggested that lead caused an increase in uterine secretion. X-ray microanalysis of pyroantimonate precipitates in the uterine epithelium of injected mice demonstrated lead in the precipitates, suggesting that lead could have a direct effect on the function of the uterine epithelium and that lead also could be secreted into the uterine lumen and affect the blastocysts.     

应用B超与子宫内膜病理检查联合诊断异常子宫出血232例分析

目的探索子宫异常出血症的B超声象与子宫内膜病理检查的关系.方法对232例子宫异常出血患者采用B超检查后做子宫内膜活组织病理检查,对B超显示子宫内膜增厚≥5mm或者有异常回声者作观察组,B超正常者为对照组.结果观察组190例中病理检查显示正常子宫内膜21例(11.05%),异常子宫内膜169例(88.95%),其中不全流产33例、子宫内膜炎12例、子宫内膜增生过长及分泌不良98例、子宫内膜息肉及粘膜下肌瘤15例、子宫内膜恶性病变11例;对照组42例中有4例(9.53%)为不全流产外,其余无病理征.结论先采用B超探查子宫内膜,对有异常声象作诊括术进行病理检查是诊断子宫异常出血症较为方便、简捷、有效的方法.