经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

LEEP术对妊娠结局影响的病例—对照研究

目的探讨宫颈环行电切术（1oop electrical excision procedure,Leep）,对子宫颈上皮内瘤样病变（cervical intraep ithelial neop lasia,CIN）患者妊娠结局的影响。方法采用病例-对照研究的方法,回顾性分析2008年1月至2011年1月在我院确诊的子宫颈上皮内瘤样病变CINⅡ～Ⅲ级并行宫颈环切术的治疗后妊娠者37例,根据患者的年龄、孕产次数、经济收入进行1∶2匹配同期分娩的健康孕妇74例作为对照组。观察两组的妊娠天数、胎膜早破发生率（premature rupture of membrance,PROM）、剖宫产比例、早产儿比例、新生儿出生体重和低体重初生儿比例。结果病例组和对照组妊娠天数分别为（266.6±22.9vs277.9±24.8,t=4.28P〈0.0001）;新生儿体重为（3223.9±771.2vs3556.8±867.6,t=3.65P=0.0003）PROM发生率（10.8%vs1.4%,χ^2=5.13P=0.02）;早产儿比例（18.9%vs6.8%,χ^2=4.11P=0.03）;低体重新生儿比例（18.9%vs5.4%,χ^2=5.05P=0.02）,两组比较差别有统计学意义。剖宫产率（43.2%vs40.5%,χ^2=0.07P=0.79）;新生儿病死率均为零,两组比较差别无统计学意义。结论 LEEP术增加孕妇早产率、PROM率和低体重新生儿发生率,对有生育要求的患者应充分告知风险。     

宫腔镜与腹腔镜联合诊治不孕症132例疗效观察

目的 探讨应用宫腔镜及腹腔镜联合手术诊治不孕症的临床价值.方法 回顾性分析我院2002年1月至2006年12月收治的132例女性不孕症患者行宫、腹腔镜联合诊断和治疗的临床资料.结果 慢性盆腔炎、子宫内膜异位症及多囊卵巢综合征分别占不孕症的54.55%、21.21%及14.40%,前者多为继发性不孕症的病因,而后两者多为原发不孕症的病因.手术后妊娠率为41.96%.结论 宫、腹腔镜联合手术对女性不孕症的诊治具有重要的价值.     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

广东省中山市3838例城区妇女宫颈癌筛查情况分析

目的:探讨在城市社区进行液基薄层细胞学制片技术(TCT)筛查早期宫颈癌的必要性。方法:对筛查妇女中TCT阳性(细胞学TBS分类为不典型鳞状细胞以上)者进行hc2-HPV检测、阴道镜及镜下多点活组织检查,分析城市社区人群的筛查比例、TCT检查阳性率及子宫颈癌前病变患病率。结果:中山市东区共有3 838例妇女参加筛查,筛查率为19.39%。共检出TCT阳性61例(1.59%),31～40岁36例,41～50岁25例;阴道镜检查结果显示异常27例(44.26%);活检结果 CINⅠ15例(24.60%),CINⅡ6例(9.84%),CINⅢ6例(9.84%)。结论:城市社区妇女宫颈癌筛查率较低,在城市社区开展宫颈癌防治的宣传教育及筛查有着巨大的社会需求。     

650例未婚人工流产女性生殖健康状况及需求调查分析

目的了解未婚女性的性行为及避孕方式、生殖健康知识水平及服务需求,为实施干预提供依据。方法 2009年8月~10月期间,对650例前来就诊的未婚女性进行匿名自填式问卷,内容涉及性行为、避孕方式、生殖健康知识的掌握程度和服务需求等。结果首次性交年龄<18岁者219例(33.7%),≥18岁者431例(66.3%);365例妇女(56.2%)本次妊娠是由于未采取避孕措施,285例妇女(43.8%)是由于避孕失败;生殖健康知识测试平均得分为6.2分,既往是否采用避孕措施与健康知识水平存在相关性(P=0.003<0.05),而与本次是否采用避孕措施和健康知识水平不存在相关性(P=0.646>0.05)。358例(55.1%)未婚女性希望得到避孕节育的知识咨询和指导,291例(44.8%)未婚者希望通过医生提供一对一的咨询指导。结论未婚女性对相关的生殖健康知识知晓率不高,医生应提供个性化的多方面流产后服务。     

经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的临床观察

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.     

ATP肿瘤体外药敏试验研究进展

肿瘤是1个异质性、多态性、分化不均的细胞群体，同一组织类型的肿瘤对同一药物敏感性存在着差异，以及肿瘤多药耐药(MDR)的普遍存在，这些都会影响肿瘤化疗效果。而针对肿瘤患者对化疗药物的敏感性选择用药进行个体化疗，可望提高疗效，减少不良反应，并可防止多药耐药的发生。近半个世纪以来，相继建立的各种体外药敏试验为肿瘤的临床个体化治疗提     

上皮性卵巢癌ATP肿瘤体外药物敏感性试验的临床应用可行性

背景与目的：由于肿瘤存在异质性，患同种肿瘤的不同患者对化疗药物具有不同对敏感性，研究显示，近年发展起来的ATP肿瘤体外药敏试验（ATP-TCA）对肿瘤患者对个体化治疗具有较大的指导价值。本研究探讨ATP-肿瘤体外药敏试验（ATP-TCA）应用于卵巢癌化疗的可行性，比较PEOC手术标本对5种化疗药物的体外敏感性。方法：采用ATP-TCA法对24例原发卜皮性卵巢癌患者于术切除的新鲜癌组织进行体外约物敏感性测定，分别检测对紫杉醇（泰素）、顺铂、吉西他滨（健择）、多柔比旱（阿霉素）、拓扑替康5种化疗药物的敏感性。结果：24例上皮性卯巢癌手术标本中，ATP-TCA可评价率95．83％，所测标本对药物的体外敏感率依次为泰素91．30％，吉西他滨86．96％、多柔比星65．22％、拓扑替康47．83％、顺铂21．74％。按ATP-TCA药敏结果进行个体化化疗，近期疗效较好，肿瘤缓解率高。结论：ATP-TCA是一种简便、敏感、标准化的方法，在卵巢癌临床化疗筛选用药方面值得进一步研究。