Objective To investigate the polypropylene mesh used transvaginal Mesh for improve clinical efficacy and benefit the quality of life of pelvic organ prolapse( POP) .Methods 80 patients with POP were randomly divided into A group and B group,40 cases in each group.A group received vaginal mesh suspension surgery for treatment,B group used traditional vaginal hysterectomy and vaginal wall repair for treatment.The operation situations of the two groups preoperation and postoperation, the quality of life after 6 months were compared.Results In A group,the operative time[(83.32 ±21.34)min],blood loss[(87.43 ±33.52)mL],retention catheter time[(3.23 ± 0.54)d],postoperative hospital stay[(5.32 ±0.69)d]were significantly less than those in group B[(1 084.34 ± 27.88)min,(98.65 ±12.43)mL,(2.9 ±0.87)d,7.97d](all P<0.01),and the physiological function,physical function,bodily pain,general health,vitality,social functioning and mental health and other seven dimensions of A group were significantly improved,compared with group B(P <0.01).Conclusion Trans -vaginal Mesh has obvious therapeutic effect and improves patients'living quality on POP.It is worthy of clinical application.

Objective: To explore the feasibility and effect of nerve sparing radical hysterectomy for cervical cancer.Methods: One hundred and ten patients with cervical cancer were selected as subjects,including of 60 patients as observation group and 50 as control group.The duration of surgery,blood loss,the excision extent,numbers of pelvic lymph nodes and aortic lymph nodes resected,and bladder function between two groups.Results: There were no significant deference on blood loss,the excision extent,numbers of pelvic lymph nodes and aortic lymph nodes resected between two groups(P0.05).The bladder function of observation group after surgery was better than that of control group.the first exhaust time and the first stool time of control group were longer than that of observation group(P0.05).There was no significant difference on urodynamic between two groups(P0.05).Conclusion: Nerve sparing radical hysterectomy for cervical cancer is safe and feasible,and can improve the recovery of postoperative bladder and rectum function.

目的:探讨尿蛋白与肌酐比值(Up/Ugcr)在妊娠期高血压疾病(HDCP)患者中的应用价值.方法:检测 2008～ 2010年盐城市第一人民医院146例HDCP患者(HDCP组)尿Up/Ugcr,并选择同期100例正常妊娠妇女(正常妊娠组)及50例正常非妊娠妇女(对照组)作为对照.结果:HDCP组患者Up/Ugcr明显上升,与正常妊娠组和对照组比较,差异有统计学意义(P＜0.05),且上升程度与病情的严重程度呈正相关关系(P＜0.05).结论:Up/Ugcr的变化反映了HDCP患者的病情程度,可作为反映HDCP患者肾功能的客观指标之一.

目的:回顾分析胎膜早破后残余羊水指数与妊娠结局的相关性。方法:对胎膜早破197例孕产妇进行B超检查了解胎儿宫内发育及胎盘情况,测定羊水指数,确定孕周。比较各组宫内感染率,胎儿窘迫发生率,新生儿窒息发生率及新生儿发病率。结果:羊水过少组破膜孕周(35.27±2.36w)明显早于羊水偏少组(38.07±1.45w)及羊水正常组(38.57±2.26w),差异有统计学意义(P<0.05)。随着残余羊水量减少,宫内感染率、胎儿宫内窘迫率、新生儿窒息率、新生儿发病率逐渐增加,差异有统计学意义(P<0.05)。结论:利用超声波检测残余羊水量,对防治胎膜早破孕妇宫内感染及降低新生儿发病率等有重要意义。

目的:探讨宫颈环形电切术(LEEP)治疗宫颈上皮内瘤变(CIN)后检测高危型人类乳头状瘤病毒(HPV)感染情况的意义。方法:采用HCII法于LEEP术前,术后3月及术后1年分别检测102例CIN患者及98例慢性宫颈炎患者高危型HPV感染情况。结果:术前CINI级,CINII级及慢性宫颈炎患者HPV感染率分别为19.4%,70%,15.8%,差异有统计学意义;术后3月感染率分别为8.1%,32.5%,6.1%,下降明显,差异有统计学意义;术后1年感染率分别为4.8%,17.5%,4.1%,差异有统计学意义;术后持续性高危型HPV感染CINI级复发率为33.3%,CINII级复发率为28.6%,慢性宫颈炎进展为CINI级发生率为50%。结论:LEEP术后监测HPV感染情况对预防CIN复发或进展为宫颈癌具有临床指导意义。

Objective To investigate the significance of exploring the associated protein in serum of the patients with ovarian epithelial malignant tumor-negative CA 125.Methods The serum from the epithelial malignant tumor of ovary-negative CA 125,benign tumor,benign lesion and healthy women were obtained.The differential expression protein in physiological functions and pathologic state were seperated and identified.The differential expression protein with MALDI-TOF-TOF by means of mass spectrographic was analyzed.Results In the better picture of 2DE,the expression picture in the serum in epithelial tumor of ovary which is negative of CA 125 changed.By selecting spot of discrepancy protein and comprehensively analyzing the finger printing of the differential expression protein,and combining outside PI,molecular quality,the amount of matching fragment and the associated documents,we got 8 kinds of protein in negative of CA 125,which were Hpα1,prostasin,calgranulin A and calgranulin B,LPA,PCNA,HSP 60 and HSP 90.Conclusion By using 2-DE-MS on the patients with ovarian epithelial tumor,we can get a good result of the protein in serum.Combining the serum of the patients with the epithelial malignant tumor of ovary-negative CA 125 with Hpα1,prostasin,calgranulin A and calgranulin B,LPA,PCNA,HSP 60 and HSP 90,we can provide the early diagnosis index for the patients with ovarian epithelial tumor.

目的:探讨TCT检测对LEEP治疗CIN疗效的监测价值,以此评估该治疗方法对CIN治疗的有效性。方法:对399例TCT异常、组织学检查证实为CINⅠ～Ⅲ的妇女实行LEEP治疗,治疗后3个月再次行TCT复查好转情况。结果:CINⅠ切净率为98.0%(200/204),切缘阳性率为2.0%(4/204);CINⅡ切净率为89.4%(127/142),切缘阳性率为10.6%(15/142);CINⅢ切净率为58.5%(31/53),切缘阳性率为41.5%(22/53),CINⅠ组治疗后阴转率及病灶彻底切除率均高于CINⅡ组,CINⅡ组治疗后阴转率及病灶彻底切除率又均高于CINⅢ组,统计学分析均有显着意义。3个月后再次复查TCT,其中切缘阳性组中全部为LSIL或HSIL,而切缘阴性组中LSIL和HSIL的检出率计为16.1%。结论:LEEP术可以有效治疗CINⅠ和CINⅡ,而对CINⅢ的效果尚不能肯定,应加大宫颈组织的切除范围和深度;而TCT可以作为评价CIN疗效及追踪随访的有效手段。

Objective To explore the significance of the serum associated protein in patients with CA125 negative ovarian epithelial tumor.Methods Serum was collected in patients with CA125 negative epithelial tumor of ovary,with benign tumor,with benign lesion and in healthy women.Separating and identifying the differential expression protein in physiological functions and pathologic state by two-dimensional electrophoresis,and the differential expression protein was analyzed with MALDI-TOF-TOF.Results The expression pattern in the serum in patients with CA125 negative epithelial tumor of ovary was changed with 2DE.8 kinds of protein in patients with CA125 negative epithelial tumor of ovary were obtained.They were Hpα1,prostasin,calgranulin A and calgranulin B,LPA,PCNA,HSP60 and HSP90.Conclusion 2-DE-MS is stabe in detecting serum protein in patients with CA125 negative epithelial tumor of ovary.The above 8 proteins may be used to diagnose ovarian epithelial tumor early.

慢性盆腔痛(chronic midline pelvic pain,CPP)是指引起任何类型持续6个月或以上的盆腔疼痛.它是一类严重影响患者生活质量的妇科常见症状,由于其病因复杂,药物或物理治疗的有效率较低,成为妇科医师面临的棘手的问题;疼痛的反复发作也给患者带来痛苦.

苗勒管抑制物(MIS)是生育年龄女性卵巢颗粒细胞产生的一种性激素,也称抗苗勒管激素(AMH),是一种双聚体糖蛋白激素,属转化生长因子β(TGF-β)超家族,近年不断发现它和一些不良妊娠结局的产生有关,包括妊娠的各个时期.我们收集了正常早期宫内妊娠者和异常妊娠包括先兆流产、妊娠中止及异位妊娠患者共91例的血清样本,分别测定了MIS水平及其它与妊娠相关的激素如妊娠相关蛋白(PAPP-A)、孕酮(P)及β绒毛膜促性腺激素(β-HCG)初步探讨了它们和早期异常妊娠的关系.

目的:评估消化道闭合器在子宫全切除术中闭合阴道残端的应用。方法:回顾2002～2003年间子宫全切除手术中处理阴道残端的方式,并就手术时间、术中出血量、术后病率及阴道肉芽形成等情况对闭合器闭合阴道残端和传统缝合残端方式进行对比分析。结果:采用闭合器闭合阴道残端较传统缝合手术时间短、出血少、术后病率低、阴道残端肉芽组织的形成减少。结论:闭合器处理阴道残端比传统缝合方式有一定的优越性。

目的探讨即刻Apgar评分、经皮血氧饮和度对新生儿缺氧缺血性脑病(HIE)病情的影响.方法对由我院妇产科转入儿科的HIE患儿进行即刻Apgar评分、经皮血氧饱和度测定.结果即刻Apgar评分与经皮血氧饱和度关系密切.结论经皮血氧饱和度可以客观反映新生儿缺氧程度对监测予后有指导意义.

Objective: To explore long term effect of treatment of hyperbaric oxygenation to children of pregnant women with intrauterine growth retardation, who had been treated by hyperbaric oxygenation. Method： 48 children, normal delivered babies and that of treated pregnant women were divided into 2 groups respectively,postnatal 3,6,9,12 month, follow up was made, to compare indexes of development,body weight, body height, intelligence. Result: The children of treated women by hyperbaric oxygenation were normal, in all observing indexes of baby development,there no difference between two groups. Conclusion: Hyperbaric oxygenation is effective to intrauterine growth retardation, further more in long term.

Objective:To observe the clinical effect of treatment of hyperbaric oxygenation for intrauterine growth retardation(IUGR).Methods:58 cases with intrauterine growth retardation were treated by hyperbaric oxygenation ,to observe the changes of RImcA,RIuA of blood stream in middle cerebral artery.umbilical artery,control group with amino acid was set up;one year follow up had be done for surveying physical development,intelligence after birth.Results:The RImcA of hyperbaric oxygenation group higher control group obviously,near the healthy;but the RIuA was decreased than control group,it is significant.The babies of hyprbaric oxygenation group had good physical,intelligence development,no differentiation with normal baby.Conclusion:The blood stream of cerebral,umbilical arteries was improved by hyperbaric oxygenation,intrauterine anoxia was corrected,so,imbecile,low birth weight was decreased.

目的探讨高压氧治疗胎儿宫内发育迟缓 (IUGR)胎儿的远期疗效 . 方法经高压氧治疗和正常出生的新生儿 48例分 2组在出生后 3, 6, 9, 12个月为期 1年的随访 , 对照新生儿的身长、体重、智能发育情况 . 结果经高压氧治疗后的新生儿发育正常 , 各观察指标与正常出生的新生儿比较无明显差异 . 结论高压氧治疗 IUGR孕妇宫内治疗效果可靠 , 且远期效果好 , 值得推广使用 .

本研究应用彩色多普勒检测子宫胎盘床螺旋动脉,探讨妊高征孕妇血液流变学与子宫胎盘床螺旋动脉相关性,预测妊高征(PIH)的发生、发展及其临床意义.

目的:探讨新生儿缺氧缺血性脑病(HIE)的产科因素及防治措施.方法:回顾性分析27例HIE新生儿的产科临床资料.结果:高危妊娠的新生儿HIE发生率明显高于正常妊娠者;自然分娩与剖宫产的新生儿HIE发生率差异无显著性,而阴道助产术的新生儿HIE发生率明显高于前两者;胎儿窘迫、新生儿窒息与HIE的发生密切相关.结论:加强围生期保健,提高监护技术,作好产前干预,及时处理高危妊娠及胎儿窘迫,选择合适的分娩方式,普及新法复苏,对预防HIE有重要意义.

妊高征(PIH)是产科重要疾病之一,病因极其复杂,其致病因素可导致子宫胎盘床螺旋动脉PI、RI改变,使子宫胎盘血流障碍,对PIH的预测、防治是产科学术界共同关心的问题,它严重危及胎儿生命[1].本文用彩色多普勒检查跟踪随防治疗后的妊高征孕妇,探讨子宫胎盘床螺旋动脉PI、RI的变化,进一步说明检测子宫胎盘床螺旋动脉血流速率变化预测妊高征的临床价值.

近年来,我们在围产保健工作中发现妊娠合并血小板减少症病例较多.为降低孕产妇,围产儿死亡率与病残儿出生率,提高保健工作者对妊娠合并血小板减少症的认识,制订有效防治措施,本文对在本院分娩的175例产妇出血情况与血小板减少症的关系进行分析,以探讨妊娠合并血小板减少症对产后出血的影响.

Objective　To observe pulsative index (PI), resistant index (RI) of placental helicine arteries by colour Doppler, analyses relation between PI, RI and developing of pregnant hypertension. Methods　There were 184 healthy pregnant women, they were normal in cardial, hepatic, nephral function, without hypertension 154 cases in 184 women were normal pregnant course, but 30 cases were with pregnant hypertension, since 32 pregnant weeks,every 2 or 3 weeks, the arteries were examined, more 5 frequency spectrums with same appearance,average of PI, RI were calculated. Results　There are signifiant difference, PI, RI of pregnant hypertension were higher than normal group (P<0.01). Conclusion　It is valuable for the clinics to observe helicine arteries by colour Doppler to predict pregnant hypertention.