宫腹腔镜联合手术诊治不孕症150例分析

目的:探讨宫腹腔镜联合手术在诊治不孕症中的应用。方法:对150例不孕症患者行宫腹腔镜联合手术,对不孕症病因进行诊断,同时行治疗。结果:盆腔粘连和输卵管阻塞是不孕症的主要原因。子宫内膜息肉和正常盆腔占次要比例。子宫内膜异位症和多囊卵巢也是主要病因。150例同时行宫腹腔镜输卵管通液和各种疾病的治疗。联合手术后妊娠率为48.8%。结论:腹腔镜联合手术,在一次麻醉下,可以对不孕的原因全面评价和明确诊断,在诊断同时进行治疗,对不孕症的诊断和治疗有重大的意义,值得推广。     

Compensation for light loss resulting from filtering by macular pigment: relation to the S-cone pathway.

PURPOSE: Macular pigment (MP) filters short-wavelength light before it reaches the visual pigments. At peak absorbance (460 nm), transmission of light through MP can range from almost 100% transmission to as little as 3%. As a result of the uneven topographic distribution of MP, spatial nonuniformities in visual perception would result if the visual system did not compensate for filtering differences across the central retina. This study characterizes compensation for different densities of MP. METHODS: Sixteen young subjects (aged 24-40 years) with a wide range of MP density were studied. Increment thresholds were measured at 440 and 500 nm in the center of the fovea and at 6 degrees to 7 degrees eccentricity using conditions chosen to isolate the pi-1 mechanism. For six of the subjects, increment thresholds were also obtained for eccentricities of 1 degrees , 1.75 degrees , and 3 degrees . MP density was measured using heterochromatic flicker photometry at the same locations as the increment thresholds. RESULTS: Peak sensitivity of the short-wavelength pathway across the central retina was constant despite MP density differences as large as 1.0 log unit. CONCLUSIONS: These results suggest that the visual system increases gain of the S-cone pathway to offset light absorption by MP.     

Acute respiratory distress during Caesarean section under spinal anaesthesia A probable case of anaphylactoid reaction to Syntocinon

A case of life-threatening respiratory distress during a Caesarean section under spinal anaesthesia is reported. Possible causes of the event including anaphylactoid reactions and the methods of their diagnosis are discussed. The most likely cause of the episode was felt to be an anaphylactoid reaction to Syntocinon.     

The Rigiflex TTS: A New Method to Dilate Benign Esophageal Stenosis

Abstract: This paper dicusses the use of esophageal dilatation with a Rigiflex TTS balloon. This method was used 45 times on 11 patients affected by anastomotic or a severe grade peptic esophageal stenosis. Fluoroscopic guidance was used in 36 procedures (80%) without effecting the mean duration of the treatment (12 minutes). The results were considered satisfactory when these goals had been achieved: a) dilatation of the stenosis over 15 mm; b) a dysphagia free-time of more than 6 months. A satisfactory result was achieved in 10 patients (90.9%), without deaths and major complications. 5 patients received 1 dilatation and the other 5 needed, 3-3-4-7–11 procedures respectively to obtain a satisfactory result. On these basis we consider that its great efficacy, security and tolerability depend on the following characteristics of the Rigiflex TTS balloon: 1) “radial” dilatation; 2) the possibility of introducing the balloon through the operative channel of the fiberscope; 3) direct visualization of the stenosis during dilatation. The following disadvantages with this method are: the absence of a tactile sensation of dilatation and the elevated cost of the instrument. We conclude that the Rigiflex TTS balloon is an important alternative to guide-wire techniques, especially for the treatment of severe esophageal strictures.     

妊娠肝内胆汁淤积症患者血清一氧化氮和内皮素的变化及意义

目的：探讨妊娠肝内胆汁淤积症（ICP）患者外周静脉血清、新生儿脐静脉血清中一氧化氮（NO）、内皮素（ET）、丙二醛（MDA）和超氧化物歧化酶（SOD）含量的变化及在ICP发病中的作用。方法：以ICP组28例为研究组，测定其外周静脉血清及新生儿脐静脉血清中的NO、ET、MDA和SOD，以年龄相近的24例正常孕妇作为对照组。结果：ICP患者的MDA和ET含量较正常晚期妊娠显著增高（P＜0．01），ICP患者的NO和SOD含量与对照组相比无显著性差异（P＞0．05）。母血清中NO、ET、MDA含量均较新生儿脐静脉血清中的含量高，差异有显著性（P＜0．01）。结论：妊娠期体内氧化和抗氧化失衡及ET水平的增高可能与ICP的发生、发展有关。     

Effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with parkinson's disease

This study investigated whether domperidone could improve gastrointestinal symptoms in patients with Parkinson's disease who were receiving levodopa therapy. A total of 11 patients were studied. Following a baseline gastric emptying test, patients were treated with a starting dose of domperidone 20 mg p.o. q.i.d. A follow-up gastric emptying test was repeated at least 4 months after starting domperidone therapy. At the beginning and at each 3-month follow-up visit, symptoms of nausea, vomiting, anorexia, abdominal bloating, heartburn, regurgitation, dysphagia, and constipation were evaluated and scored on a scale of 0–3. The overall mean follow-up period was 3 years. Compared with their baseline evaluation, patients experienced a significant improvement in all symptoms (p < 0.05) except dysphagia and constipation. Gastric emptying of an isotope-labeled solid meal was significantly faster, with a baseline result of 60.2 ± 6.4% retention of isotope 2 h after the meal compared with 37.0 ± 2.2% retention during domperidone therapy (p < 0.05). Patients' global assessment of Parkinson's disease remained stable or improved. Serum prolactin was elevated in all patients after domperidone therapy (p < 0.05). Domperidone therapy significantly reduces upper gastrointestinal symptoms and accelerates gastric emptying of a solid meal, but does not interfere with response to antiparkinsonism treatment.     

Dopamine denervation does not alter in vivo 3H-spiperone binding in rat striatum: implications for external imaging of dopamine receptors in Parkinson's disease

Striatal particulate preparations, both from rats with lesion-induced striatal dopamine (DA) loss and from some striatal dopamine (DA) loss and from some patients with Parkinson's disease, exhibit increased 3H-neuroleptic binding, which is interpreted to be the mechanism of denervation-induced behavioral supersensitivity to dopaminergic compounds. After intravenous 3H-spiperone (3H-SP) administration to rats with unilateral nigral lesions, we found no differences in accumulation of total or particulate-bound 3H-SP in dopamine-denervated compared with intact striata. 3H-SP in vivo binds to less than 10% of striatal sites labeled by 3H-SP incubated with striatal particulate preparations in vitro. Quantitative autoradiography of 3H-SP binding to striatal sections in vitro also failed to reveal any effects of dopamine denervation. 3H-SP bound to striatal sites in vivo dissociates more slowly than that bound to striatal particulate preparations labeled in vitro. Striatal binding properties of 3H-SP administered in vivo are quite different from the same kinetic binding parameters estimated in vitro using crude membrane preparations of striatum. In addition, striatal binding of in vivo-administered 3H-SP is not affected by prior lesion of the substantia nigra, which results in profound ipsilateral striatal dopamine depletion. Thus, behavioral supersensitivity to dopaminergic compounds may not be associated with altered striatal binding properties for dopamine receptor ligands in vivo.