目的 探讨在妊娠高血压孕妇中,口服米索前列醇联合阴道放置单硝酸异山梨酯与口服米索前列醇在宫缩过频、剖宫产率及阴道分娩时间方面的效果.方法 收集2020年4月至2021年3月在西电集团医院妇产科收治的妊娠晚期高血压疾病患者,按照随机数法将符合条件的妊娠高血压孕妇以1:1的比例随机分配到联合组(口服米索前列醇联合阴道放置单硝酸异山梨酯)或单药组(口服米索前列醇).主要结局指标是宫缩过频及剖宫产率,次要结局指标为治疗后12 h Bishop评分及阴道分娩时间.结果 本研究最终纳入140例妊娠期高血压孕妇,其中联合组69例,单药组71例.与单药组相比,联合组宫缩过频的频率降低(OR=0.388,95％CI:0.169～0.891,P=0.026).同时,联合组剖宫产率显著低于单药组(OR=0.391,95％CI:0.175～0.873,P=0.022).单药组分娩时间显著长于联合组[(10.1±3.0)h vs.(9.3±1.5)h],差异具有统计学意义(P<0.001).两组治疗后12 h Bishop评分差异无统计学意义(P=0.711).结论 在接受引产的妊娠高血压孕妇中,与口服单药米索前列醇相比,米索前列醇和单硝酸异山梨酯联用可减少宫缩过频的频率,降低剖宫产率并减少分娩时间.

目的 探讨彩色多普勒(以下简称彩超)检测胎儿大脑中动脉(MCA)血流动力学联合胎心监护对晚期妊娠胎儿窘迫的预测价值,为晚期妊娠胎儿窘迫早期预测提供参考.方法 采用数字随机表法对我院2019年5月至2019年12月收治的80例晚期妊娠孕妇,确诊为晚期妊娠胎儿窘迫的孕妇40例设为观察组,同期正常分娩孕妇40例设为对照组,比较两组孕妇彩超检测胎儿MCA血流动力学联合胎心监护参数结果.结果 (1)两组胎儿MCA血流动力学参数RI、PI及S/D值,观察组均明显低于对照组,比较差异有统计学意义(P＜0.05);(2)观察组MCA血流动力学参数S/D值异常率42.5％,胎心监护异常率25％,明显高于对照组MSA血流动力学参数S/D值异常率7.5％,胎心监护异常率10％,比较差异有统计学意义(P＜0.05);③单一胎心监护Youden指数为0.463低于彩超检测胎儿MCA血流动力学联合胎心监护Youden指数0.787,彩超检测胎儿MCA血流动力学联合胎心监护灵敏度及特异度均优于单一胎心监护.结论 彩超检测胎儿MCA血流动力学联合胎心监护,对胎儿宫内氧饱和度及胎儿窘迫早期预测准确率显著提高,减少了不必要的干预,改善胎儿不良预后降低新生儿死亡率.

目的 探讨反向添加疗法联合醋酸亮丙瑞林在子宫内膜异位症(EM)病灶切除术后的应用效果及对机体Th1/Th2漂移现象的影响.方法 选取2016年6月至2018年1月本院收治的96例EM患者作为研究对象,采用随机抽签法将其分为对照组(46例)与观察组(50例).两组均接受腹腔镜下EM病灶切除手术,术后,对照组给予皮下注射醋酸亮丙瑞林治疗,观察组给予反向添加疗法联合醋酸亮丙瑞林治疗.比较两组的治疗效果.结果 治疗后,两组的血清LH、AMH和腰椎BMD水平均明显下降,但观察组高于对照组(P<0.05).治疗后,两组的血清IFN-γ水平及IFN-γ/IL-4均升高,IL-4水平均降低,观察组优于对照组(P<0.05).随访18个月,观察组复发率明显低于对照组(P<0.05).结论 反向添加疗法联合醋酸亮丙瑞林应用于EM病灶切除术后,可有效纠正机体生殖激素表达,减少骨量丢失,促进患者卵巢功能恢复,纠正Th1/Th2漂移现象,预防疾病复发.

目的 研究硝苯地平联合保胎灵治疗先兆早产的疗效及安全性.方法 选取我院收治的先兆早产患者84例,随机分为观察组和对照组,每组42例.对照组患者实施盐酸利托君治疗,观察组患者采用硝苯地平联合保胎灵治疗.比较两组临床效果.结果 两组患者的药物起效时间和保胎成功率比较,差异无统计学意义(P>0.05);两组患者的延长妊娠时间及足月分娩率比较,差异有统计学意义(P<0.05);观察组新生儿的Apgar评分明显高于对照组,出生窒息率、低体重儿率和围产儿死亡率明显低于对照组(P<0.05);观察组患者不良反应总发生率为9.52%,不良反应停药率为2.38%,明显低于对照组的38.09%、16.67%(P<0.05).结论 给予先兆早产患者硝苯地平和保胎灵联合治疗具有较高的安全性和有效性,值得临床推广和应用.

Objective:To explore the expressions and significances of α1-antitrypsin (ox-AAT),high mobility group box-1 protein (HMGB1) and matrix metalloprotein-9 (MMP-9) in pregnant women with premature rupture of membranes and provide references for the early diagnosis and treatment of premature rupture of membranes.Methods:76 cases of pregnant women with premature rupture (TPROM) 44 cases of preterm premature rupture of membranes (PPROM) and 50 cases of normal pregnant women in our hospital from January 2016 to January 2017 were selected as the research object,ELISA method was used to detect the maternal and neonatal umbilical cord blood ox-AAT,HMGB1 and MMP-9 levels,ox-AAT,HMGB1,MMP-9 protein expressions in the fetal membranes were detected by by immunohistochemistry,the ox-AAT,HMGB 1,MMP-9 expressions in the maternal blood and neonatal cord blood and fetal tissue were compared between three groups.Re,sults:The ox-AAT HMGB1,maternal blood MMP-9 in the maternal blood and neonatal cord blood and fetal tissue of TPROM group and PPROM group,were significantly higher than those of the control group (P ＜ 0.05),which were significantly higher in the PPROM group than those of the TPROM group (P＜0.05).The expression of MMP-9 in fetal membranes was positively correlated with ox-AAT (r=0.779,P＜0.05 and HMGB1 expressions (r=0.811,P＜0.05).Conclusions:The ox-AAT,HMGB1 and MMP-9 expressions were correlated with the incidence of PROM and preterm birth.The ox-AAT,HMGB1,MMP-9 expressions in the fetal tissue could be used as reference index for the diagnosis and the evaluation of therapeutic effect of clinical premature rupture of membranes.

Objective To investigate the efficacy and safety of periaortic lymph node dissection in the treatment of early endometrial cancer. Methods A total of 62 patients with early endometrial cancer were retrospectively analyzed. According to the style of lymph node dissection,they were divided into group A ( pelvic lymph node dissection) and group B ( pelvic lymph node dissection+periaortic lymph node dissection) . The operative condition,expression levelof sex hormone,recurrence and metastasis rate,1-year survival rate and complication rate were compared between the 2 groups. Results The operation time of group B was longer than that of group A,and the number of lymph node dissection was higher than that of group A(P<0. 05),but there was no significant difference between the 2 groups (P>0. 05). There was no significant difference in progesterone and estrogen levels between the 2 groups before operation(P>0. 05). The expression levels of progesterone increased significantly and the estrogen level decreased significantly after operation,and the change of group B was more significant(P<0. 05). The recurrence and me-tastasis rate of group A was significantly higher than that of group B(P<0. 05). 1-year survival rate of group B was slightly higher than that of group A,but the difference was not significant(P>0. 05). The incidence of complications in group A was lower than that in group B,but the difference was not significant(P>0. 05). Conclusion The periaortic lymph node dissection is beneficial to the lymph node dissection,which can stimulate the improvement of sex hormone level and reduce the recurrence and metastasis rate of early endometrial carcinoma. The safety is still feasible.

Objective To investigate the curative effect of laparoscopic surgery and laparotomy for patients with endometrial carcinoma.Methods 65 patients with endometrial cancer were randomly divided into 2 groups,laparotomy group(33 cases)was treated by laparotomy,and laparoscopic group(32 cases)treated by laparoscopy surgery.The operation indexes,Hs-CRP level in serum before and after surgery,complications during the 1 month follow-up of the 2 groups were analyzed,to estimate the curative effect of laparoscopic surgery and laparotomy on endometrial carcinoma.Results In laparoscopic group,after surgery the drainage tube indwelling time and hospital stay,and the time of using antibiotics were shorter than the laparotomy group(P<0.05),the amount of bleeding in the laparoscopic group was less than the control group during the operation(P<0.05).But there was no significant difference between the 2 kinds of operation methods on cleaning lymph nodes(P>0.05),the operative time of laparoscopic group was longer than laparotomy group(P<0.05).There had no statistical difference in Hs-CRP levels(P>0.05).After 24h operation,the serum level of Hs-CRP of the 2 groups decreased significantly(P<0.05),but the serum level of Hs-CRP between the 2 groups had no significant difference(P>0.05).The total incidence of complications in laparoscopic group was lower than laparotomy group(P<0.05).Conclusion Laparoscopic surgery for endometrial cancer has smaller surgical trauma,the time of recovery is shorter,the ability of cleaning lymph nodes is similar with laparotomy.After surgery the level of Hs-CRP significantly reduced and patients have good prognosis.Laparoscopic surgery is an ideal surgical treatment for early endometrial cancer.

目的 研究孕前体重指数和孕期血浆同型半胱氨酸水平对妊娠高血压疾病发生的影响.方法 研究对象为56例妊娠高血压疾病的单胎初产妇(病例组)及56例孕晚期正常妊娠单胎初产妇(对照组),用荧光偏振免疫分析法检测其血浆同型半胱氨酸水平,并统计两组孕妇孕前年龄、孕周、身高、体重并分析其BMI.结果 妊娠高血压疾病组血浆同型半胱氨酸水平(13.61±5.3)μmol/L,明显高于正常妊娠组(11.14±3.31)μmol/L,差别有统计学意义(P＜ 0.05).病例组体重指数(BMI) (23.68±2.82) kg/m2,也明显高于对照组(22.60±2.6)kg/m2,差别有统计学意义(P＜0.05).结论 孕前体重指数、血浆同型半胱氨酸水平偏高可增加妊娠高血压疾病的发生风险,早期检测血浆同型半胱氨酸水平可预测妊娠高血压疾病的发生.

目的：探讨孕妇牙周状况、血清PC T水平与早产的关系。方法：选择无明显早产危险因素的207例早产妇女为早产组，218例正常产健康妇女为足月产组，对两组妇女进行口腔检查及血清降钙素原（PC T ）水平检测。以社区牙周指数（C PI ）作为牙周评判标准，比较两组的牙周状况、血清PC T 水平以及两组不同牙周状况的血清PC T 水平。结果：早产组牙周炎占比明显高于足月产组（69．57％，22．48％，P＜0．05）；早产组PC T 水平明显高于足月产组（0．32±0．46 ng/m l ，0．06±0．05，P＜0．01）；而且早产组中不同牙周状况的PC T 水平有显著差异（ P＜0．01），随着牙周炎程度加重PCT 水平升高，CPI与血清PCT 水平pearson相关性分析显示正相关关系（r＝0．740，P＜0．01）。结论：孕妇牙周炎是早产危险因素，血清PC T 水平可能在一定程度上反映孕妇牙周炎程度以及早产风险。

Objective:To investigate the inhibition ratio of proliferation of Hela cell line by Cisplatin and Tubeimoside.Methods:Hela cells were cultured in vitro,MTT assay was used to assess the antiproliferative effect of Tubeimoside with or without DDP on Hela cells.Flow cytometry(FCM) was used to study the effects of Tubeimoside with or without DDP on cell cycle of Hela cells.Results: Tubeimoside groups(20,40,80μg/ml),Cisplatin group(10μmol/L) and combine group(10μmol/L cisplatin+40μg/ml tubeimoside) inhibited the proliferation of Hela cells.Inhibition of tubeimoside to the growth of Hela was increasing with time and concentration and using tubeimoside and cisplatin at the same time the inhibition to the growth of Hela was highter compared with using cisplatin group and tubeimoside group.The results of Flow cytometry analysis: Hela cells treated with tubeimoside at 20,40,80μg/ml,10μmol/L cisplatin and 40μg/ml tubeimoside+ 10μmol/L cisplatin for 24h were arrested in G2/M phase.Conclusion:Tubeimoside could inhibit the growth of Hela cells on a time-and dose-depending manner.Tubeimoside and cisplatin have synergic effect and can induce the dose of cisplatin;Tubeimoside and cisplatin could block cell cycle arrest at the G2/M phase and induce human carcinoma cell lines Hela apoptosis at 24 hour.