目的:評價氯喹那多普羅雌烯陰道片對產后陰道黏膜修復及防治生殖道感染的作用。方法:對212例產后6～8周復診患者隨機分為實驗組92例和對照組120例。實驗組給予氯喹那多普羅雌烯陰道片陰道上藥,每日一片共18日;對照組僅給予溫鹽水清潔陰部。治療前后檢查兩組的陰道分泌物情況。結果:用藥前實驗組與對照組比較生殖道狀況均無統計學差異(Pgt;005)。用藥后實驗組生殖道狀況正常為80%,而對照組正常僅為36%,兩組比較差異有顯著性(Plt;005)。實驗組生殖道感染12例,無真菌和滴蟲感染,均為非特異性陰道炎,患病率1304%,有效率8695%。對照組生殖道感染84例,有效率3000%,患病高低順序依次為非特異性陰道炎4167%,真菌性陰道炎2083%,滴蟲性陰道炎 750%。結論:氯喹那多普羅雌烯陰道片能有效治療生殖道非特異性炎癥,真菌性、滴蟲性陰道炎,促進產后的陰道黏膜修復,防治產后生殖道感染。
ObjectiveTo investigate the potential causal relationship between four types of reproductive behaviors and rheumatoid arthritis (RA), with the goal of establishing a theoretical foundation for clinical prevention and treatment strategies. MethodsPooled gene-wide association study (GWAS) data were obtained from large publicly searchable databases. Four characteristics like menarche, menopause, the age of first pregnancy and the age of last pregnancy, which related to reproductive behavior were selected as the exposure factors and RA as the outcome factors. Single nucleotide polymorphisms (SNPs), which were strongly correlated with the phenotype of the exposure factors, were screened as the instrumental variables, and two-sample Mendelian randomization analyses were used to assess the potential causal relationship between the exposure and the disease. Results① The Mendelian randomization analysis utilizing the inverse variance weighted method on two distinct samples revealed a significant negative correlation between the age of first pregnancy and last pregnancy with the risk of RA (OR=0.91, 95%CI 0.85 to 0.98, P=0.011; OR=0.54, 95%CI 0.31 to 0.93, P=0.026). Conversely, no causal relationship was observed between menarche and menopause with RA. Sensitivity analysis confirmed the robustness of the causal relationship, while MR Egger intercept analysis did not identify any potential horizontal pleiotropy (Page of first gestation -RA=0.169, Page of last gestation -RA=0.283). ② Reverse Mendelian randomization analysis revealed a significant positive causal association between RA and the age of first pregnancy, while no causal relationship was observed with the age of last pregnancy (OR=1.07, 95%CI 1.02 to 1.11, P=0.001). ③ Multivariate Mendelian randomization analysis demonstrated that both the age of first pregnancy and last pregnancy in women were inversely associated with the risk of RA (OR=0.88, 95%CI 0.80 to 0.97, P=0.010; OR=0.68, 95%CI 0.48 to 0.97, P=0.033). ④ There existed a negative correlation between the age of pregnancy in women and the risk of developing RA, suggesting a potential protective effect. ConclusionPregnancy age may have a negative causal relationship with the risk of RA, while menarche and menopause have no causal relationship with RA.
【摘要】 目的 探討顱內原發生殖細胞瘤的臨床特征。方法 收集華西醫院腦外科2000年1月—2009年3月119例顱內原發生殖細胞瘤的臨床資料進行回顧性分析。結果 發病率約占同期顱內腫瘤的 1.1%。男〖DK〗∶女=1.64〖DK〗∶1,平均發病年齡15.4歲。臨床表現主要為顱內高壓癥狀及視力視野改變,分別為61、56例；腫瘤主要來源于松果體區及鞍區；64例患者行放療或放療加化療,隨訪45例。55例患者行手術治療(其中術后行單純放療19例,放療加化療5例),隨訪36例。隨訪時間3~94個月,平均29.7個月。行放療和放化療的患者3、5年生存率明顯高于單純行手術治療的患者。結論 顱內原發生殖細胞瘤多見于兒童及青少年,男性多見,腫瘤大多位于松果體區及鞍區。臨床表現位于松果體區者主要為顱內高壓癥狀等,位于鞍區者主要為視力視野改變、尿崩等。放療聯合化療是主要治療手段。
【摘要】 目的 探討超聲檢查對陰道斜隔綜合征的診斷價值，分析超聲圖像特點，提高診斷率，為臨床選用最佳的手術方式提供依據。 方法 回顧性分析2008年1月-2010年6月經手術確診為陰道斜隔綜合征的15例患者的臨床資料及超聲檢查結果，總結陰道斜隔綜合征的聲像圖特點。 結果 15例經臨床確診為陰道斜隔綜合征的患者，超聲診斷14例，均表現為雙子宮、雙宮頸、陰道或宮頸積液/血，9例左腎缺如，5例右腎缺如。誤診1例，為單子宮伴一側附件巨大囊腫。 結論 超聲具有診斷準確、簡便、無創、重復性好、價格實惠等優點，對于臨床診斷生殖系統畸形具有十分重要的意義，應列為首選檢查方式。【Abstract】 Objective To investigate the diagnostic value of ultrasonography in examining oblique vaginal septum syndrome, analyze the characteristics of ultrasound image to improve the ultrasound diagnosis rate, in order to provide guidance for clinical surgeries. Methods We retrospectively analyzed the clinical data and ultrasound examination results of 15 patients diagnosed to have oblique vaginal septum syndrome in our hospital, and summarized their ultrasonographic characteristics. Results Among the 15 patients, 14 were diagnosed to have the disease by ultrasound examination. The ultrasound image showed a double uterus, double cervix, and vaginal or cervical fluid or blood for all the patients among whom 9 had absent left kidney, and 5 had absent right kidney. One patient was misdiagnosed to have single uterus with giant cysts on one side. Conclusions Ultrasound diagnosis is simple, noninvasive, reproducible, affordable and accurate in diagnosing. It is very useful in clinical diagnosis of reproductive system abnormalities and should be listed as the preferred way of examinations.
目的：探討女性生殖道瘺的病因及預防措施。方法：回顧性分析我院婦產科2000年1月至2005年12月收治入院的57例女性生殖道瘺病例的病因。結果：產傷和婦科手術占女性生殖道瘺病因的前兩位，分別占56.1%（32/57）和33.3%（19/57）。結論：產傷和婦科手術是引起女性生殖道瘺的主要原因。加強圍產期保健、積極處理產科合并癥以及提高婦科手術技術是降低女性生殖道瘺發生率的關鍵因素。
Microsurgical varicocelectomy (MVC) is the current gold standard for the treatment of varicocele. Studies have shown that MVC can bring certain clinical benefits to patients with varicocele and male infertility. In today’s era of assisted reproduction, MVC is clinical used usually to improve ART outcomes before treatment with assisted reproductive technology (ART). This article summarizes the efficacy evaluation and cost-effectiveness of MVC combined with ART. Although there is a lack of prospective evidence supporting MVC before ART, many large retrospective studies have shown that operating MVC before using ART may improve ART outcomes. However, large-scale and standardized clinical trials are still needed to further verify the effectiveness and feasibility of MVC before ART.