Objective To investigate the clinical efficacy and safety of black cohosh preparation on peri - menopausal symptoms. Methods 51 early postmenopausal women with peri-menopausal symptoms in Daqing Longnan Rehabilitation Hospital and The Third Affiliated Hospital of Soochow University from July 2010 to March 2014 were enrolled. They were divided into 2 groups randomly. The therapeutic strategy in black cohosh group (26 cases) was to take black cohosh 0.28 g,bid for 12 weeks, while tibolone 2.5 mg qd for 12 weeks in the tibolone group(25 cases). Kupperman menopause index (KMI) total score and hot flash/sweating scores were the main curative indicators, and were compared before treatment and at 4, 8, and 12 weeks of treatment. At the same time, the changes of liver and kidney function, blood lipids, endometrial thickness and serum sex hormone levels were measured before and 12 weeks after treatment. The incidence of adverse reactions in the two groups was recorded. Results ① There were no significant differences in KMI score, hot flash/sweating scores, liver and kidney function, blood lipids, serum sex hormone levels and endometrial thickness between the two groups before treatment (P>0.05);②At the 4th, 8th, and 12th week of treatment, the scores of KMI and hot flash/sweating scores were significantly lower than those before treatment ( P<0.05), but there was no significant difference between the two groups (P>0.05).③ There were no significant differences in liver and kidney function and blood lipid levels between the two groups before and after treatment ( P >0.05 ). ④ There was no significant difference in the endometrial thickness between the two groups before and after treatment ( P>0.05). ⑤ The post-therapeutic serum FSH and E2 level had no significant change in comparison of the initial level in black cohosh group ( P>0.05), while in tibolone group , the level of E2 was higher than that pre- therapeutic and black cohosh group, and the FSH level was lower than that before treatment and also lower than that in the black cohosh group ( P<0.05).⑥ The incidence of vaginal bleeding, breast distending pain in black cohosh group is remarkably lower than tibolone group (P<0.05). Conclusion Compared with tibolone, black cohosh had similar clinical efficacy for peri-menopausal symptoms in early postmenopausal women, and under short-term administration it had no obvious influence on liver and renal functions, blood lipid profile, serum sex hormone levels, and endometrial thickness,and had lower incidence of the adverse events such as vaginal bleeding and breast distending pain.

妊娠期间，羊水量超过2000ml者称羊水过多(polyhydramnios)。发生率为0.5％～1.6％。如羊水量增加缓慢，数周内形成羊水过多者，往往症状轻微，称慢性羊水过多；若羊水在数日内迅速增加，压迫症状严重，称为急性羊水过多。

Objective Subject Discussion the expression of hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in the case of patients with missed abortion. Method 80 patients in the Daqing Longnan Hospital from January 2012 to December 2013 were dividerd into 2 groups:,the missed abortion, the control group,consisted of 40 patients with unplanned pregnancy and planed to conduct abortion. The villi groups of all patients were first taken after dilatation and curettage and then immunohistochemical staining, lastly, compared its expressions of HIF-1α and VEGF in the two groups. Results The expressions of HIF-1α and VEGF in missed abortion group were 7 cases (17.5%), 28 cases (70%). The expressions in the control group were 24 cases (60%), 40 cases (100%), the expressions of HIF-1αand VEGF cases of missed abortion group was significantly lower than the control group,with statistical significance. (χ2=20.43,P<0.01;χ2= 50.82,P<0.01). Conclusions The low expression of HIF-1α and VEGF may be related to the occurrence of missed abortion.

贫血是妊娠期最常见的合并症。由于妊娠期血容量增加，且血浆增加多于红细胞增加，致使血液稀释。关于妊娠期贫血的诊断国内外有一定的差别，世界卫生组织规定孕妇外周血血红蛋白<110g/L及血细胞比容<0.33为妊娠期贫血。我国多年来一直沿用的标准是血红蛋白＜100g/L、红细胞计数<3.5×1012/L或血细胞比容＜0.30。最近W H O资料表明，50%以上孕妇合并贫血，以缺铁性贫血最常见，巨幼红细胞性贫血较少见，再生障碍性贫血更少见。

Objective Subject To explore metastasis associated gene 1 (MTA1) and midkine(MK) expression in cervical cancer tissue. Method from 55 cases of cervical cancer respectively stage IA2, IB1 and IIA1 January 2012 to December 2013 in the Daqing Long Nan Hospital were included. Immunohistochemistry was used to detect cervical lesions and tissue expressions of MTA1.and MK and the histological type, depth of invasion, histological grade, lymph node metastasis and cancer tissue vascular invasion of expression were compared. Results 1. There were no significant differences in the expression of MTA1 (69.77% vs 58.33%) and MK (90.70% vs 66.67%) cervical squamous cell carcinoma and adenocarcinoma. (χ2=0.16,P=0.69;χ2=2.64,P=0.10); 2 MTA1 and MK in the depth of invasion ≤1/2 expression (48.39% and 33.33%) was significantly lower than that in the depth of invasion>1/2(χ2=5.60,P=0.02;χ2=14.05,P<0.01)3. In pathological grading, the expression of MTA1 and MK in that were G1 (83.33%and 100%) significantly lower than in the G2-G3 (51.28%and 71.79%)(χ2=4.94,P=0.03;χ2=5.65,P=0.02).4. Comparison of lymph node metastasis, lymph node metastasis MK and MTA1 expression (86.96%and 95.65%) was significantly higher than those without lymph node metastasis (50% vs 65.63%).(χ2=8.08,P<0.01;χ2=5.42,P=0.02)5. Comparison of vascular invasion, the expression of vascular invasion were significantly higher than MTA1 (90.48%vs 52.94%) and MK (95.24%vs 44.12%) were no vascular invasion.(χ2=8.31,P<0.01;χ2=12.53,P<0.01). Conclusions Abnormal expression of MTA1 and MK may be involved in the development of cervical cancer.

妊娠期间各种内分泌腺处于活跃状态，各器官系统均会发生一系列的生理变化，对甲状腺功能均会产生直接或间接的影响。妊娠合并甲亢较非孕期难以诊断，治疗上亦涉及母体与胎儿的特殊情况，与非孕期不尽相同。

宫口开全后，胎膜多已自然破裂。若仍未破裂，常影响胎头下降，应行人工破膜。破膜后，宫缩常暂时停止，产妇略感舒适，随后宫缩较前增强，每次持续1分钟或更长，间歇1～2分钟。当胎头下降压迫盆底组织时，产妇有排便感，并不自主地产生向下用力屏气的动作；会阴膨隆和变薄，肛门括约肌松弛。胎头于宫缩时露出于阴道口，在宫缩间歇期胎头又回缩至阴道内，称胎头拨露；宫缩间歇期胎头也不再回缩，称胎头着冠[1]。产程继续进展，胎头娩出，接着出现胎头复位及外转旋，随后前肩和后肩相继娩出，胎体很快娩出，后羊水随之涌出经产妇第二产程短，有时仅需几次宫缩即可完成胎头娩出。

目的:了解人工流产现状,提供优质人工流产服务,降低重复流产率,保护妇女生殖健康。方法:采用自行设计的问卷匿名调查,共发放问卷600例,回收有效问卷600例,回收率100%。结果:人群特征趋于年轻化,未婚,流动人口占比例较大,重复流产率高,普遍缺乏避孕知识,对人工流产危害了解少,对人流后计生服务需求迫切。结论:各级计生部门有责任和义务提供优质人工流产服务,包括术前术中术后,术前术中优质人工流产服务,已得到普遍重视,并已取得卓越成效,应积极开展流产后优质计划生育服务,普及避孕知识,扩大教育覆盖面,减少意外妊娠和重复流产。

Objective To explore the effects of radiofrequency ablation of endometrium in the treatment of dysfunctional uterine bleeding.Methods A retrospective analysis was made for 65 patients with abnormal uterine bleeding from January 2011 to December 2012.Patients were divided into radiofrequency ablation of endometrium group(33 cases) and roller-boll endometrial ablation group(32 cases).The effects of the two procedures were compared.Results VAS score of the radiofrequency ablation of endometrium group was significantly lower than that of the roller-boll endometrial ablation group [(2.1±0.7)points vs.(3.8±1.2)points,t=-7.003,P=0.000].Menstrual conditions in the radiofrequency ablation of endometrium group 6 months after operation: 17 patients had amenorrhea;8 had very slight bleeding;6 had spotting;2 had normal bleeding.The effective rate was 100%.Menstrual conditions in the roller-boll endometrial ablation group: 16 patients had amenorrhea;8 had very slight bleeding;7 had spotting;1 had normal bleeding.The effective rate was 100%.No significant difference between the 2 groups was found(Z=-0.057,P=0.955).Menstrual conditions in the radiofrequency ablation of endometrium group 12 months after operaton: 15 patients had amenorrhea;7 had very slight bleeding;7 had spotting;4 had normal bleeding.The effective rate was 100%.Menstrual conditions in the roller-boll endometrial ablation group: 15 patients had amenorrhea;6 had very slight bleeding;8 had spotting;3 had normal bleeding.The effective rate was 100%.No significant difference was found between the 2 groups(Z=-0.105,P=0.916).Conclusion Radiofrequency ablation of endometrium is effective and safe in the treatment of patients with dysfunctional uterine bleeding and without fertility requirements.

目的:研究中西医结合治疗慢性盆腔炎的临床效果,前后症状积分诊治完善状况。方法:将80例病患随机分成对照组和治疗组,治疗组在对照组的根本上授予生脉注射液辅助诊治,并同时授予针灸、中药灌肠中医诊治。结果:治疗组40例,治愈28例(70%),显效7例(17.5%),有效4例(10%),无效1例(2.5%),共有效率97.5%,对照组40例,治愈6例(15%),显效14例(35%),有效10例(25%),无效10例(25%),共有效率75%,两组间共有效率相比有统计学价值(P<0.05),两组诊治后的临床病症均有显著完善:诊治后,治疗组病症积分由诊治前的(12.54±3.93)分降为(6.39±2.14)分(P<0.01);对照组病症积分由诊治前的(12.87±4.11)分降为(9.41士2.09)分(P<0.05)。诊治后,治疗组病症积分显著低于对照组积分(P<0.05)。结论:运用中西医结合诊治办法能够有效完善慢性盆腔炎病患的临床病症,效果明显,值得临床推广。

目的探讨药物流产的临床效果及安全性。方法回顾性分析2008年10月至2009年4月在门诊自愿药物终止早孕无药物禁忌证的患者280例的临床资料进行分析总结。结果完全流产254例,占90.71%;不完全流产20例,占7.14%;流产失败6例,占2.14%。结论药流过程中及时观察并正确处理出现的症状,排除不安全因素的干扰,为孕妇的身体提供保障。

目的探讨微波治疗慢性宫颈炎的临床效果。方法对2008年2月至2009年3月收治的慢性宫颈炎患者186例的临床资料进行回顾性分析。结果通过微波的高热效应,使蛋白凝固原理治疗慢性宫颈炎,1次痊愈170例,有效16例,治愈率91.4%,总有效率100%。结论采用微波治疗慢性宫颈炎的物理疗法,是一种操作简单,安全可靠,患者无痛苦,见效快,效率高的理想方法。

Objective:To discuss the cause for the increase in the rate of caesarean sections and the key for its reduction. Methods:Retrospectively determine the changes in the rate and indications of Caesarean sections in the past fourteen years in our hospital. Results:Between 1992 and 1996,the rate of Caesarean sections was relatively stable,averaging 26.013%. It rose above 30% in 1997,and increased to 57.12% in 2002. Post 2004,societal factors were controlled,and the incidence decreased to 54.71%,and to 49.74% in 2006. Conclusion:Societal factors and over diagnosis are important contributors to the rise in the rate of Caesarean sections. Reinforcing pregnancy education and our understanding of their indications are key for reducing the rate of Caesarean sections.

目的探讨宫腔镜联合腹腔镜技术治疗妇科疾病的安全性、可靠性及有效性。方法在全麻下行宫、腹腔镜检查明确盆腔内疾病并在腔镜下进行治疗。结果38例患者共施行70项手术,子宫粘膜息肉切除术14例,子宫粘膜下肌瘤切除术12例,子宫不全纵隔切除术3例,子宫内膜切除术3例,卵巢囊肿7例,子宫浆膜下肌瘤5例,盆腔子宫内膜异位症电灼术3例,输卵管系膜囊肿切除术4例,盆腔粘连松解术、输卵管粘连松解术、造口术6例,美蓝通液术10例,多囊卵巢打孔术2例,均无手术并发症发生,手术时间平均46分钟,术中平均出血量20毫升,术后无须镇痛,术后1天均肛门排气。结论宫、腹腔镜联合手术适用于怀疑宫腔、腹腔同时存在病变的病例,可提高宫腔镜手术治疗的安全性及有效性,同时实施宫腔内与盆腔内疾病的诊断与治疗,体现了微创手术的优越性。

前置胎盘是胎盘附着位置异常引起的高危妊娠,可致晚期妊娠大量出血,如处理不当将危及母儿生命.现将大庆龙南医院2001年2月-2005年12月分娩的51例前置胎盘做回顾性分析如下.

我院于 2001年 1月～ 2001年 7月经超声和宫腔镜联合检查诊断子宫内病变 110例 ,通过手术及病理结果 ,探讨超声与宫腔镜联合诊治子宫内膜病变的应用价值.

患者女,32岁,停经4月余,下腹部隐痛2月余.超声检查:子宫形态增大,为 8.2 cm×7.4 cm×6.4 cm ,内膜增厚,宫腔内未见胎儿回声.于子宫上方见一成形胎儿,双顶径 4.7 cm,胎心146次/min,节律规整,脊柱及四肢发育正常;因胎囊内羊水缺乏,胎儿颅骨形态不规则,四肢不能伸展,与躯体挤压呈团状,胎盘位于胎儿的右上方,卷曲成团状(图1).彩色多普勒超声显示胎盘内有数条彩色血流信号,呈放射状分布.超声诊断:宫外孕(中期腹腔活胎妊娠).

本文对108例药物诱发排卵周期的排卵监测,探讨超声监测对其诊断及治疗的价值,现报道如下:1 资料与方法本组108例已婚妇女,不孕年限2～15年.监测所有患者均经妇科有关检查,排除非排卵障碍所致不孕因素.