原发女性生殖道恶性黑色素瘤21例临床分析

目的探讨原发性女性生殖道恶性黑色素瘤的临床特点、治疗及预后。方法回顾分析本院1986年1月至2006年3月收治的原发性女性生殖道恶性黑色素瘤患者21例。其中外阴8例、阴道10例、阴道及宫颈1例、外阴及阴道1例、盆腔1例。结果患者中位年龄50(21~71)岁。临床表现主要为阴道流血、流液及发现外阴或阴道肿物。本资料阴道恶性黑色素瘤发病率高于外阴恶性黑色素瘤。按照国际妇产科联盟(FIGO)分期,期别和预后呈负相关。治疗以手术为主,手术方式由根治性切除逐渐衍变为扩大局部切除。随访:21例患者中随访率为67%(14/21),随访时间6~96个月,死亡7例,随访期间的死亡率为50%。结论女性生殖道恶性黑色素瘤发病率低,预后差。肿瘤厚度和淋巴结转移是其主要的危险因素。应采用手术基础上的综合治疗,治疗方案个体化。     

超声及临床特征对附睾局灶性病变的鉴别价值

目的:评价超声及临床特征在附睾局灶性病变鉴别诊断中的应用价值。方法:回顾性分析附睾局灶性病变48例,包括非特异性附睾炎、附睾结核和附睾精液囊肿。分析附睾局灶性病变大小、形态、位置、回声强度及均一性,鞘膜腔是否有积液;病灶血流的程度以及患者年龄、病程和阴囊压痛程度。结果:附睾结核病灶平均面积比非特异性附睾炎病灶大(P<0.05),并多可见钙化斑。非特异性附睾炎病灶的血流信号比附睾结核(P<0.05)及附睾精液囊肿(P<0.01)丰富;非特异性附睾炎病程比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)短;非特异性附睾炎病灶的压痛比附睾结核(P<0.01)和附睾精液囊肿(P<0.01)明显。附睾局灶性病变发生位置及有无鞘膜积液无明显区别(P>0.05)。结论:超声和临床特征对附睾局灶性病变鉴别诊断具有重要的价值,为临床诊断、治疗附睾疾病及评价疗效提供客观依据。     

非淋菌性泌尿生殖系感染1186例支原体检测及药敏分析

了解非淋菌性泌尿生殖系感染患者的支原体感染情况及耐药性。方法： 对1186例就诊的患者采集标本进行支原体的培养检测和药敏试验。结果： 通过对1186例就诊患者的支原体检测，芰原体感染的阳性率为51．6％，单纯Uu、Mh感染及混合感染者分别占36.2％，3．0％和12．4％；Uu和Mh的阳性率分别为48．7％和15.3％，美满霉素、交沙霉素和阿奇霉索可作为治疗的首选药物。结论： 美满霉素、交沙霉素和阿奇毒素可作为支原体所致泌尿生殖系感染的首选药物     

女性生殖道不同部位检测支原体的序贯试验分析

目的探讨解脲脲原体和人型支原体在女性生殖道的主要寄生部位.方法采用载量一致的标准无菌棉拭子分别于女性阴道穹窿和宫颈口采样,用法国生物梅里埃ID试剂进行解脲脲原体和人型支原体的培养鉴定及半定量计数,按照双向质反应开放型序贯试验设计,对检测结果进行比较分析.结果阴道穹窿部位标本中两种支原体的总阳性数和≥10^4ccu/ml半定量阳性数均高于宫颈口标本.结论对女性进行生殖道支原体感染的检测时应采集阴道穹窿标本,以提高检出率.     

上海地区女性生殖道人乳头瘤病毒感染的检测

应用地高辛甙元标记人乳头瘤病毒(HPV)-6,11,16和18探针,通过核酸杂交法检测上海地区女性患者HPV的感染。计活检组织标本128例,阴道脱落细胞130例,同时取样34例。斑点杂交结果表明活检组织中四种类型HPV的总阳性率:宫颈癌44％,宫颈间变66.7％,有间变史28.6％,外阴尖锐湿疣63％和慢性宫颈炎5.6％。阴道脱落细胞的各阳性率与之相近,同时取样的检测符合率为91.2％。Southern转移杂交结果提示:宫颈癌以HPV-16型为主,尖锐湿疣中的HPV为6和11型     

Specific and sensitive diagnosis of syphilis using a real-time PCR for Treponema pallidum

A real-time PCR assay with a Taqman probe was developed that targeted the polA gene of Treponema pallidum. The test was validated using an analytical panel (n = 140) and a clinical panel of genital samples (n = 112) from patients attending a sexually transmitted infections clinic. High sensitivities and specificities of 94-100% were achieved using two real-time PCR platforms, the Rotor-Gene and the iCycler. The assay can be completed within 2 h, enabling reporting in <8 h. This fast and robust assay is suitable for implementation in routine laboratories for diagnosing primary syphilis.     

Hypothalamic-pituitary-gonadal function in two infants with Smith-Lemli-Opitz syndrome

We report on the hypothalamic-pituitary-gonadal function in 2 male infants with the Smith-Lemli-Opitz (SLO or RSH) syndrome. Both infants had abnormal external genitalia. Basal and LHRH stimulated plasma gonadotropins were normal for age (1 month). Plasma testosterone, androstenedione, and dehydroepiandrosterone sulfate were normal for age and sex. Some forms of congenital adrenal hyperplasia (17,20-desmolase deficiency, 17α-hydroxylase deficiency, and 3β-hydroxysteroid dehydrogenase deficiency) were ruled out by hormonal studies. The endocrinological findings indicate a normal hypothalamic-pituitary-gonadal function and a normal adrenal steroid biosynthesis in these 2 patients. A partial androgen receptor defect causing the genital malformations seems possible in one patient. Whether 5α-reductase deficiency is the cause of the male pseudohermaphroditism in SLO syndrome remains the subject of future studies. © 1992 Wiley-Liss, Inc.