Persistent infection with high‐risk human papillomavirus (hrHPV) is a major cause of cervical cancer. Current management of low‐grade squamous intraepithelial lesions (LSIL) primarily involves monitoring, though some cases progress to cervical precancer or cancer, requiring timely intervention. This study aimed to evaluate the efficacy of 5‐aminolevulinic acid photodynamic therapy (ALA‐PDT) in treating cervical LSIL with hrHPV infection. A total of 155 women with LSIL and hrHPV infection were enrolled and randomly assigned to either the treatment group, which received six sessions of ALA‐PDT, or the control group, which underwent routine follow‐up. Outcomes were assessed at 6 and 12 months using hrHPV testing, cytology, colposcopy, and biopsy. Results showed that ALA‐PDT significantly improved lesion regression and hrHPV clearance rates at both 6 and 12 months. At 6 months, the lesion regression rate in the treatment group was 80.43% versus 56.10% in the control group ( p = 0.0203), and the hrHPV clearance rate was 61.96% versus 29.27% ( p = 0.0005). At 12 months, both rates remained significantly higher in the treatment group. Age was found to influence hrHPV clearance, with younger women (<45 years) showing significantly higher clearance rates. ALA‐PDT was well tolerated, with only minor side effects, such as localized pain and pruritus, reported. The study suggests that ALA‐PDT is a safe, effective, and non‐invasive treatment option for patients with cervical LSIL and hrHPV infection who require active intervention.

目的 研究高危型人乳头状瘤病毒(HR-HPV)感染与阴道微生态的关系.方法 纳入2020年8—12月就诊于河南省人民医院妇产科门诊的177例患者,根据HPV 23分型结果将其分为HPV阴性组(103例)和HR-HPV阳性组(74例).通过χ2检验及多因素logistic回归分析研究HR-HPV与阴道微生态的关系.结果 HR-HPV阳性组霉菌、加德纳菌、乳杆菌、过氧化氢酶、清洁度、唾液酸苷酶、脯氨酸氨基肽酶异常率高于HPV阴性组(P<0.05),两组滴虫、pH值、白细胞酯酶、乙酰氨基葡萄糖苷酶异常率差异无统计学意义(P>0.05).多因素logistic回归分析结果显示,霉菌、加德纳菌、过氧化氢酶与HR-HPV感染独立相关(P<0.05).结论 HR-HPV感染与阴道微生态环境密切相关,维持阴道微生态平衡对预防及治疗HPV感染具有积极意义.

目的 探讨超声介入穿刺术治疗卵巢囊肿的临床效果.方法 将2018年6月至2020年6月我院收治的48例卵巢囊肿患者按照治疗方式的不同分为对照组(24例,腹腔镜下卵巢囊肿剥除术)和观察组(24例,超声介入穿刺术).比较两组的手术指标、血清创伤指标、卵巢及生育功能、并发症发生情况.结果 观察组的手术时间、术后排气时间短于对照组,术中出血量少于对照组,术后第1、3天的疼痛评分低于对照组(P<0.05).术后1 d,观察组的皮质醇(Cor)、胰岛素(Ins)、去甲肾上腺素(NE)水平低于对照组(P<0.05).术后1个月,观察组的卵泡刺激素(FSH)、抗卵巢抗体(AoAb)、抗透明带抗体(AzpAb)水平低于对照组,抗苗勒管激素(AMH)水平高于对照组(P<0.05).两组的并发症总发生率无明显差异(P>0.05).结论 两种术式治疗卵巢囊肿均安全可靠,超声介入穿刺术的治疗效果更好.

目的 对慢性炎症与多囊卵巢综合征(PCOS)的相关性进行meta分析.方法 检索PubMed、Cochrane Library、Scopus、中国知网、万方和维普数据库,搜集国内外慢性炎症与PCOS的相关文献,检索时限2000年1月至2020年9月.由2名研究员独立检索,筛选文献,提取资料,评价纳入研究质量,应用RevMan 5.3软件进行meta分析.结果 共纳入12个临床研究,1248个研究对象.meta分析结果:BMI≥25 kg·m-2时,PCOS患者C-反应蛋白(CRP)[SMD=0.81,95％CI(0.26～1.36),P<0.01]、白细胞计数[SMD=0.65,95％CI(0.39～0.91),P<0.01]均高于对照组(CON组).BMI<25 kg·m-2时,PCOS患者CRP水平较CON组升高,但差异无统计学意义[SMD=0.53,95％CI(-0.09～1.14),P=0.09];白细胞计数高于CON组,差异有统计学意义[SMD=0.5,95％CI(0.25～0.75),P<0.01].肥胖型PCOS患者CRP水平高于非肥胖患者[SMD=-1.19,95％CI(-1.38～-1.00),P<0.01].按人种、血清炎症因子检测方法等对不同组别PCOS患者血清CRP水平进行亚组分析,所纳入的研究仍存在较大异质性.结论 PCOS与慢性炎症有关,肥胖可能加剧PCOS患者炎症状态.

目的 观察5-氨基酮戊酸光动力疗法(ALA-PDT)治疗宫颈低级别鳞状上皮内病变(LSIL)合并高危人乳头瘤病毒(HR-HPV)感染的临床疗效和安全性.方法 选取132例宫颈组织学LSIL患者,其中实验组88例给予ALA-PDT治疗,对照组44例不进行任何治疗.分别于治疗后第6、12个月时随访,比较2组患者的疗效.结果 治疗后6个月,实验组治疗有效率为80.68％,对照组治疗有效率为20.45％,2组比较差异具有统计学意义(P＜0.05);治疗后12个月,实验组治疗有效率为84.10％,对照组治疗有效率为27.27％,2组比较差异具有统计学意义(P＜0.05);且实验组HR-HPV转阴率均高于对照组,差异具有统计学意义(P＜0.05).结论 ALA-PDT治疗宫颈LSIL疗效显著,且具有安全、无创、可重复治疗,为预防宫颈癌的发生和早期进行干预及保护女性的生育功能提供了重要手段.

目的 探讨5-氨酮戊酸光动力疗法(ALA-PDT)治疗女性外阴硬化性苔藓(VLS)的临床疗效及安全性,探索VLS的安全有效且副作用小的治疗方法.方法 采用回顾性病例对照研究,收集因VLS就诊于河南省人民医院妇科门诊的120例患者,其中实验组41例给予光动力治疗,对照组79例给予聚焦超声治疗.采用相关量表评估治疗效果并对比2组的临床疗效以及不良反应.结果 2组患者疗程结束后及随访3个月、6个月的瘙痒程度、皮肤弹性、皮肤颜色、病变范围评分与治疗前比较,差异有统计学意义(P＜0.05).疗程结束后及随访3个月、6个月,实验组的瘙痒程度、皮肤颜色评分均明显低于对照组,差异有统计学意义(P＜0.05);实验组疗程结束后及随访3个月皮肤弹性、病变范围评分与对照组比较,差异有统计学意义(P＜0.05),但随访6个月比较,差异无统计学意义(P＞0.05);随访6个月,2组有效率分别为100％和92.40％;实验组无复发,对照组复发率为13.92％,2组均未发生明显的不良反应.结论 ALA-PDT治疗外阴硬化性苔藓疗效高,复发率低,安全性良好,值得临床推广应用.

Objective:To find the optimal transplantation route by comparing the local ovarian injection and tail vein injection, and the distribution, migration and proliferation of umbilical cord mesenchymal stem cells (UCMSCs) in mice models of ovarian injury via the in vivo imaging system. Methods:A total of 200 mg/kg cyclophosphamide and 30 mg/kg busulfan were injected intraperitoneally to establish the mice models of ovarian injury. Lentiviral transfection was done to construct UCMSCs labeled with luciferase (Luc). The mice models of ovarian injury were randomly divided into two groups: tail vein injection group (2×10 6 cells) and unilateral ovarian local injection group (2×10 5 cells). The distribution, migration and proliferation of UCMSCs in the mice models of ovarian injury were observed by the in vivo imaging system. Results:Luc-UCMSCs injected unilaterally into the ovary showed a gradual increase in the fluorescence signal on the second day to the fourth day after transplantation, and no fluorescence signal was found in the other parts of the body. On the fifth day after transplantation, the fluorescence signal disappeared. In the tail vein injection group, fluorescence signals were not observed in all parts of the body at 7th day after transplantation.Conclusion:UCMSCs can aggregate and proliferate in damaged ovarian organs of mice through local ovarian injection. The local ovarian injection may achieve better therapeutic effect than the tail vein injection.

目的 探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗子宫颈低级别鳞状上皮内病变(LSIL)合并高危型人乳头瘤病毒(HR-HPV)感染患者的有效性和安全性.方法 选取LSIL合并HR-HPV感染的60例女性患者为研究对象,按照随机数字表法分为观察组和对照组,每组30例.对照组给予常规药物治疗,观察组给予ALA-PDT治疗.比较2组治疗效果、HR-HPV转阴率、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分.结果 治疗后6个月,观察组治疗总有效率为83.33％,高于对照组的53.33％,差异有统计学意义(P＜0.05).观察组HR-HPV转阴率高于对照组,差异有统计学意义(P＜0.05).治疗前,2组SAS和SDS评分差异无统计学意义(P＞0.05);治疗后,观察组SAS和SDS评分低于对照组,差异有统计学意义(P＜0.05).2组均未发生明显不良反应.结论 ALA-PDT治疗LSIL合并HR-HPV感染的患者临床疗效显著,安全性良好,有利于改善患者焦虑、抑郁状态.

目的 建立人卵巢癌裸鼠皮下移植瘤模型.方法 将30只裸鼠随机分为两组,实验组15只,对照组15只.培养人卵巢癌细胞系SKOV3细胞,并将浓度调制2×107个·mL-1,取0.2 mL注射于实验组裸鼠右侧肩胛背部皮下,接种后每日观察两组裸鼠精神、活动、摄食、排便、体质量等情况,是否有肿瘤生长和肿瘤生长速度等.每3d使用游标卡尺测量肿瘤最长径和最短径,计算肿瘤体积.于接种后第42天将荷瘤裸鼠处死,剥出肿瘤,测量瘤体长径和短径,称取瘤体质量,取肿瘤组织切片后行HE染色,观察肿瘤病理变化.结果 细胞注射法可成功建立卵巢癌裸鼠移植瘤模型,瘤体出现时间为3～7 d,成瘤率为93.33％.实验组裸鼠的体质量、精神、活动等情况与对照组无明显差异.共有2例瘤体表面出现破溃.观察结束后,处死裸鼠后完整剥除瘤体,测得肿瘤平均体积为(416.21±134.67)mm3,肿瘤平均质量为(0.88±0.19)g.剖开瘤体,发现4例可见瘤体中间有坏死液化,取移植瘤组织进行病理检查,肿瘤组织大体表现符合人卵巢癌的特点.结论 初步建立了人卵巢癌裸鼠皮下移植瘤模型,为卵巢癌的进一步研究奠定了基础.

目的 研究人脐带间充质干细胞(human umbilical cord mesenchymal stem,hUC-MSCs)对卵巢癌皮下移植瘤生长及CD34和VEGF表达的影响.方法 培养SKOV3细胞及hUC-MSCs细胞,并建立15只裸鼠卵巢癌皮下移植瘤.成瘤后随机分为对照组、实验组1及实验组2,每组5只.向个实验组卵巢癌荷瘤裸鼠背部瘤体内分别注射hUCMSCs 1×106和2×106个,每隔1周注射1次,一共注射3次,正常对照组注射生理盐水.实验开始后每隔3天观察瘤体体积变化.直至观察结束将裸鼠处死并取出肿瘤组织.免疫组化法检测CD34,VEGF的表达水平.结果 实验组肿瘤体积在整个观察期间均小于对照组,且在一定浓度范围内,hUC-MSCs浓度越高其体积越小,差异具有统计学意义(P＜0.05).实验组CD34和VEGF表达量较对照组相比均明显降低,且在一定的浓度范围内随浓度增高而降低,差异具有统计学意义(P＜0.05).结论 hUC-MSCs可抑制卵巢癌皮下移植瘤的生长及CD34和VEGF的表达.为治疗卵巢癌提供了新思路.

Objective :To investigate the effects of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) on apoptosis and proliferation of human ovarian cancer SKOV3 cells and to explore mechanism. Methods :hUC-MSCs were isolated and cultured by tissue block adherent culture method. The hUC-MSCs phenotype were identified by flow cytometry. The hUC-MSCs lysate and conditioned medium,directly combine were used to treat SKOV3 cells.The effects on the proliferation，apoptosis，mechanism of SKOV3 cells were examined by cell counting kit-8(CCK-8)，Annexin V-FITC/PI，quantitative real time polymerase chain reaction(RT-qPCR) and spheroid formation assays.Establish ovarian cancer xenograft models，1X 10 6 hUC-MSCs and 2 X 10 6 hUC-MSCs were administrated into the mice t rear back tumor tissue. After three injections of hUC-MSCs, the nude mice were sacrificed after 1 week of observation.Remove tumor tissue. Observed tumor volume changes every 3 days after the start of the experiment. The expression of CD34 and VEGF were detected by immunohistochemistry. Results :Human umbilical cord mesenchymal stem cells were cultured and isolated from tissue block. Flow cytometry results revealed that the hUC-MSCs marks CD44 and CD29, but not CD45 and CD34 were expressed on obtained cells. The apoptosis of SKOV3 cells was induced by hUC-MSCs lysate, conditioned medium and Transwell co-culture method in SKOV3 cells, and the apoptosis rate was higher with increasing concentration. hUC-MSCs conditioned medium and Transwell co-culture method can inhibit cell proliferation. After adding experimental factors, the conditioned medium and Transwell co-culture method can down-regulate the transcription of PI3KCA, AKT and BCL-2 genes in SKOV3 cells, and up-regulate the Caspase-3 gene.The tumor volume of the experimental group was smaller than that of the control group during the observation period. The expression levels of CD34 and VEGF in the experimental group were significantly lower than those in the control group(P<0.05). Conclusion : The conditioned medium of hUC-MSCs and the co-culture method of hUC-MSCs and SKOV3 can significantly inhibit the proliferation of SKOV3 cells, which is mainly achieved by inhibiting PI3K/AKT signaling pathway. hUC-MSCs can inhibit the growth of subcutaneous subcutaneous transplantation and the expression of CD34 and VEGF in ovarian cancer. It provides a new idea for the treatment of ovarian cancer.

目的 探讨循环肿瘤细胞(Circulating Tumour Cell,CTC)与上皮性卵巢癌(epithelial ovarian cancer,EOC)患者临床病理特征之间的关系及其在EOC中的临床诊断价值.方法 选择2018年7月-2019年8月在河南省人民医院就诊的EOC患者24例为观察组,另选择同时期就诊的卵巢良性肿瘤患者和健康受试者24例作为对照组,分析CTC水平与卵巢癌患者临床病理特征之间的关系及其诊断价值.结果 卵巢癌患者CTC阳性率明显高于卵巢良性疾病的患者和健康受试者(P＜0.05).观察组中卵巢癌晚期患者外周血CTC阳性率明显高于早期的患者(P＜0.05),病理分级G3级患者外周血CTC阳性率明显高于G1和G2期的患者(P＜0.05),淋巴结转移阳性的患者外周血CTC阳性率明显高于无淋巴结转移的患者(P＜0.05),HE4高水平组(＞140 pmol/mL)的患者外周血CTC阳性率明显高于低水平组(＜140 pmol/mL)的患者(P＜0.05).CTC单独用于诊断卵巢癌的灵敏度、特异度及阳性预测值分别为79.2％,91.6％,90.5％,均高于单独应用CA125 (75％,37.5％,54.5％)和HE4 (79.2％,50％,61.2％),且CTC和HE4联合诊断卵巢癌的灵敏度及特异度(70.8％,91.7％)高于CA125和HE4联合诊断卵巢癌的灵敏度及特异度(62.5％,70.8％).结论 卵巢癌患者外周血CTC阳性率与临床病理特征具有相关性;与CA125和HE4相比,CTC在诊断卵巢癌方面具有较好的特异度和阳性预测值,有可能成为临床诊断卵巢癌的一种检测指标.

A total of 62 female patients who underwent ALA-PDT at the Gynecology Department of Henan Province People's Hospital in 2018 were retrospectively assessed. Lesions included 24 case of LSIL, 13 case of HSIL, 12 case of VAIN, 2 case of VIN and 11 case of VL. Three-six sessions of ALA-PDT were carried out at intervals of ten days. The treatment efficacy was evaluated by colposcopy, TCT and HPV dectection. After one month follow-up, The effective rate of LSI, HSIL, VAIN, VIN and VL were 70.8%, 84.6%, 83.3%, 100% and 100%. After three month follow-up, The effective rate of LSIL, HSIL, VAIN, VIN and VL were 83.3%, 92.3%, 83.3%, 100% and 100%. After six month follow-up, The effective rate of LSIL, HSIL, VAIN, VIN and VL were 87.5%, 92.3%, 91.7%, 100% and 100%. Our experience show that ALA-PDT is an effective treatment modality for female genital precancerous lesions. Keywords: 5-aminolevulinic acid photodynamic therapy, Low-grade cervical squamous intraepithelial lesions,

目的 基于医疗信息系统,探索运用大数据技术建立卵巢癌单病种数据库的方法,并建立卵巢癌单病种数据库.方法 通过前期基础建设,搭建卵巢癌数据库架构.将临床诊疗资料灌注架构中,通过数据挖掘、数据检索、人工随访、人工数据核对和数据质量控制,建立卵巢癌单病种数据库,较完整的收录了患者临床诊疗信息,并初步分析库中的病例特点.结果 建立2011-2016年河南省人民医院住院系统收住入院的877例原发性卵巢癌单病种数据库,并分析数据库中卵巢癌患者的病例特点.结论 运用大数据技术建立基于医疗信息系统的卵巢癌单病种数据库具有可行性,并探索出建立单病种数据库的方法.

Objective: To investigate the distribution of ALA in Cervical lesion tissue by tissue frozen section and fluorescence microscopy. Methods : 20% of 5-ALA were topically applied to the cervix.Biopsies were taken from the lesions for histology examination,Fluorescence microscopy was performed methods in these frozen section of cervical tissue to observe the distribution of ALA and the result was analyzed semi-quantitatively. Results : The maximal Protoporphyrin IX ( PpIX) fluorescence was observed in the most serious tissue with cervical lesions .fluorescence photometry corroborated these results.Conclusion: ALA is selectively accumlated in cervical lesions, and the more severe the lesion, the easier it is to accumulate.

目的：探讨阴道封闭术和阴道纵膈成形术治疗老年中盆腔器官脱垂患者的效果。方法选择郑州大学人民医院2014年1月至2015年1月中盆腔器官脱垂需行手术治疗的患者30例。16例行阴道封闭术为 A 组，14例行阴道纵膈成形术为 B 组，对两组患者手术治疗的手术时间、术中出血量、术后并发症等进行对比分析。结果两组手术时间、并发症发生率差异无统计学意义（P ＞0.05），B 组术中出血量少于 A 组（P ＜0.05）。两组术后随访半年均无复发，无下腹坠胀、宫颈、子宫及附件病变发生。结论阴道纵膈成形术治疗老年中盆腔器官脱垂患者与阴道封闭术相比具有术后出血量少，术后仍可进行性生活的优势。

目的:探讨阴式全子宫切除术的方法及临床上的应用及效果。方法:回顾分析我院2008年1月～2011年6月期间收治的子宫脱垂患者(Ⅱ、Ⅲ度)16例的临床资料。结果:16例患者入院后经阴式全子宫切除术,全部治愈出院,无并发症。结论:阴式全子宫切除术是治疗子宫脱垂最佳的办法。

目的:探讨输卵管妊娠破裂导致休克的手术治疗的方法及效果。方法:回顾分析我院2009年8月~2012年8月我院收治的输卵管妊娠破裂导致休克患者34例临床资料,全部患者在积极纠正休克后,对21例患者采用腹腔镜下手术,对13例患者行剖腹探查术。结果:34例患者全部转危为安,无1例死亡,无并发症。结论:积极抗休克同时手术是抢救输卵管妊娠流产或破裂患者成功的关键。

目的:探讨胎盘早剥的预防、早期诊断及治疗。方法:回顾性分析我院2006～2010年42例胎盘早剥病例,分析其原因、症状、体征、分娩方式及母婴结局。结果:胎盘早剥发生率0.9%,产后出血、DIC、子宫切除等并发症发生率、剖宫产率及围产儿死亡率均明显高于同期住院分娩的发病率。结论:胎盘早剥对母儿威胁大,应尽早诊断,尽快积极处理,以降低孕产妇并发症及减少围产儿死亡率。

目的:分析产后出血的高危因素,探讨产后出血的防治措施。方法:对2007年～2009年我院分娩5438例产妇中90例产后出血患者的临床资料进行回顾性分析。结果:剖宫产、妊娠并发症及有流产史者的产后出血发生率及产后出血量均高于无上述高危因素者,2者比较有显著差异。宫缩乏力为产后出血的主要原因,占49.44%,但出血量≥2000ml的病例中胎盘因素所占比例大于出血量<1000ml的病例,两者比较有统计学差异。90例产后出血中70例经常规方法即能有效止血,占77.8%。不同出血量之间处理方法比较,随着出血量的增加,特殊方法所占比例明显增加,各组间比较有统计学差异。结论:剖宫产、妊娠并发症及有流产史为产后出血的高危因素。出血原因中胎盘因素仍应引起高度重视。严格掌握剖宫产指征,降低剖宫产率是减少产后出血的有效措施;加强围产保健监测,对高危孕妇在分娩前制定预防及治疗产后出血的方案,做到有备无患是成功处理产后出血的关键;对于难治性产后出血,在综合治疗的同时,及时采用B-Lynch缝合、子宫动脉结扎、介入栓塞术等措施明显有效,如经保守治疗无效果断行子宫切除术则为挽救孕产妇生命的有效措施。