女性难治性膀胱过度活动症患者心理弹性及保护性因素研究

目的探讨女性难治性膀胱过度活动症患者心理弹性状况及保护性因素，为改善其身心健康提供依据。方法采用心理弹性量表、症状自评量表、艾森克人格问卷、社会支持量表、焦虑及抑郁量表对80例女性难治性膀胱过度活动症患者进行问卷调查。结果女性难治性膀胱过度活动症患者心理弹性得分为（54.10±8.27）分，显著低于国内常模（P＜0.05）。患者的一般情况（病程、年龄、文化程度）对心理弹性的预测作用不明显（R2=0.14，F=18.10），当社会支持、SCL-90、人格特质、SAS、SDS进入方程后，对患者的心理弹性具有较明显的预测作用（R2=0.67，△R2=0.46，F=115.22）。结论女性难治性膀胱过度活动症患者心理弹性较差，社会支持、SCL-90、人格特质、焦虑抑郁情绪是其重要的影响因素，应重视患者存在的心理问题，发掘心理弹性的保护性因素并积极干预，促进其身心健康。     

Sexual function in patients presenting to a urogynecology practice

The purpose of this study was to evaluate sexual function in women referred to a urogynecology practice. All new patients were mailed an optional female sexual function index (FSFI) in conjunction with their history forms; other sexual function information was obtained during the physician interview. Over 6 months, four hundred fifty new patients were enrolled. Of these, 243 (54%) were not sexually active. Reasons listed for sexual inactivity included partner problems/no partner (32%), low desire (14%), prolapse (10%), and pain (10%). There were several differences between sexually active and non-sexually active participants; however, after a multivariate analysis, only age, marital status, and stage/grade 1–2 of prolapse remained significant. One hundred nine sexually active patients completed the FSFI; the majority was sexually active two to four times per month. Female sexual dysfunction was noted in 70 (64%) patients. Lowest scores were noted for the domain of desire, followed by arousal, orgasm, lubrication, satisfaction, and pain. Reduced frequency of intercourse was the only factor significantly associated with dysfunction. Ninety-four percent were not embarrassed by the survey. Overall, sexual inactivity is common in patients presenting for urogynecologic care. Those that are sexually active report low rates of sexual activity and high rates of sexual dysfunction. Most sexually active patients will accept a sexual function questionnaire as part of their routine assessment.This research was presented at the American College of Obstetricians and Gynecologists annual clinical meeting, May 10, 2005, San Francisco, CA, USA.     

老年女性2型糖尿病肾病的骨密度及相关因素分析

2型糖尿病(T2DM)和骨质疏松症的发病率越来越高,它们之间有无关系越来越引起人们的重视,本研究探讨了老年女性2型糖尿病肾病(DN)的骨矿物质密度(BMD)变化与相关因素,报道如下。1对象与方法1.1研究对象按1999年WHO诊断标准确诊为T2DM的≥60岁女性114例,年龄60～75岁,平均(66.3±     

Gender ratio of migraine without aura: observations over time

Abstract Migraine without aura is typically considered a female condition. The purpose of this study was to determine if there have been any changes in the female-to-male ratio of the disease over time. We included in the study all patients with migraine without aura (n=3457) referred to the Parma University Headache Centre between 1976 and 1995. They were divided into subgroups with respect to gender and year-range of onset of migraine (before 1960, in the 1960s, in the 1970s, in the 1980s, and between 1990 and 1995). Gender ratio ranged from 3.6:1 (in patients with onset before 1960) to 2.8:1 (in patients with onset in the 1980s), with no statistically significant changes during the observation period.     

Investigation and treatment of urinary incontinence

Female urinary incontinence is a common but underreported condition. Initial investigation and treatment can in most cases be undertaken without urodynamic or other detailed tests. History by the use of validated symptom and quality of life questionnaires is key to the initial investigation. Initial treatment includes pelvic floor muscle training (PFMT) regardless of the type of incontinence; lifestyle interventions and bladder retraining, anticholinergics and serotonin/noradrenaline reuptake inhibitors (e.g. duloxetine) are also included depending on the type of symptoms. In mixed incontinence the predominant symptom should be treated first. When this initial treatment is ineffective, further investigation should be offered prior to specialised treatment. Urodynamics should be considered for all patients prior to surgery. Imaging and cystoscopy to exclude pathology, for example in elderly patients with an overactive bladder, are also necessary. Newer surgical interventions should be offered after careful consideration of the risk:benefit ratio for each individual woman and the amount of evidence that is currently available to support their use.     

性服务工作者性病和艾滋病的干预研究

目的 了解性工作者的性病/艾滋病知识、态度、信念、行为等现状,积极探索对该人群进行预防性病、艾滋病及行为干预的有效办法,为今后在更大范围的高危人群中进行干预提供科学依据.方法 成立专职高危干预队伍,设计借鉴其他地区经验,深入目标人群进行系列外展服务,利用干预前后封闭式调查问卷评价干预效果.结果 发放干预前后问卷各522份,收回前后有效问卷387份.通过外展服务,娱乐场所从业人员对性病史滋病预防知识知晓率明显提高,对安全套及安全性行为预防性病艾滋病的传播的信念和态度有明显转变.结论 对娱乐场所从业人群开展系列专业外展服务可以提高该人群的防病意识,提升对性病史滋痛的知晓率,是高危人群干预的有效方法.     

应用膀胱三角区壁瓣成形尿道治疗女性外伤性尿道缺损(附5例报告)

目的：探讨膀胱三角区壁瓣成形尿道治疗女性外伤性尿道损伤的疗效。方法：自膀胱颈后唇向上，取梯字形壁瓣，形成锥状管，经膀胱颈口，自阴道前壁外拉至外阴部，在原尿道外口处固定，替代尿道。结果：3例随访8年，1例6年，1例5年，平均随访7年，均排尿通畅，无尿失禁和尿道狭窄。结论：女性外伤性尿道缺损，应用膀胱三角区壁瓣形成锥状管替代尿道法治疗，手术简单，对患者打击小，成功率高，远期效果好。     

后腹腔镜联合经尿道电切镜治疗上尿路移行细胞癌(附83例报告)

目的 探讨后腹腔镜联合经尿道电切镜治疗上尿路移行细胞癌的效果和安全性. 方法 2003年3月～2006年7月,我院采用后腹腔镜联合经尿道电切镜治疗83例上尿路移行细胞癌.经尿道袖状电切患侧输尿管口周围1.5 cm范围膀胱壁达膀胱外脂肪组织,采用后腹腔镜切除肾及全长输尿管.术后留置导尿管7 d.11例术后辅助放疗. 结果 83例手术均成功.手术时间115～205 min,平均156 min.术中出血50～150 ml,平均80 ml.无术中并发症.术后住院7～11 d,平均8.5 d.病理报告：82例上尿路移行细胞癌,1例肾盂上皮中～重度不典型增生.术后随访3～38个月,平均10.8月.术后12个月内行膀胱镜检查发现膀胱肿瘤6例,其中5例行经尿道膀胱肿瘤电切,1例行腹腔镜根治性膀胱全切术、左侧输尿管皮肤造口术.2例肾盂肿瘤（pT3 G3和pT2 G3）于术后3个月肝转移.2例输尿管中段肿瘤（pT3 G3和pT3 G2～3）术后6个月原位复发并肺转移.1例输尿管下段肿瘤（pT3 G3）术后6个月骨转移.失访1例.其余71例均未发现肿瘤复发、切口转移及远处转移. 结论 对于上尿路移行细胞癌,采用后腹腔镜联合经尿道电切镜行肾、输尿管全切及膀胱袖套状切除具有创伤小、安全、恢复快等优点,值得临床推广应用.     

《傅青主女科》调经特色探讨

从条目、辨证、治法、制方、用药几个方面探讨了<傅青主女科>调经的特色.指出傅青主治疗月经病善抓主症,辨证精要,治法注重扶正,善补肝血疏肝郁,制方严谨,主次分明,用药纯和,强调炮制以增药效等特点,并加以举例说明,对临床有一定指导意义.