目的:探讨当归芍药散对羊水过多患者的影响.方法:将155名羊水过多孕妇随机分为对照组和治疗组.治疗组给予当归芍药散治疗,对照组给予同等剂量无药物成分的安慰剂.比较2组患者治疗前后宫高、腹围、羊水指数及不良妊娠结局的发生情况.结果:与对照组相比,治疗组孕妇腹围、羊水指数明显降低,妊娠期高血压疾病及早产发生率降低,组间比较差异有统计学意义(P<0.05).当归芍药散对年龄大于35岁高龄孕妇及孕前体质量指数(BMI)>24的人群有效.结论:当归芍药散能改善羊水过多孕妇腹围、羊水指数,能降低不良妊娠结局发生率.

目的:评价卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)各危险因素的预测价值.方法:选取2012-01～2017-12我院治疗的不孕症患者569例,其中发生中、重度OHSS者46例(OHSS组),未发生OHSS者523例(对照组),记录患者信息并进行神经网络预测分析.结果:治疗中不同时点的预测模型结果表明,基础促黄体生成素与卵泡雌激素比值(luteinizing hormone/follicle stimulating hormone,LH/FSH)、窦卵泡计数(antral follicle count,AFC)、注射人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)、日血清雌二醇(estradiol,E2)水平与获卵数是OHSS发生的主要危险因素.结论:利用现有危险因素预测OHSS的准确性仍有待提高,需进一步深入研究OHSS的发病机制.

目的 探讨抗苗勒管激素(AMH)联合抑制素B(INHB)在高龄妇女卵巢储备功能评估中的应用价值,为高龄妇女卵巢储备功能的评估提供理论依据.方法 选取2015年1月-2016年5月在该院进行孕前检查的高龄妇女105例为研究对象,按卵巢储备功能分为正常组35例、卵巢功能减退(DOR)组38例和卵巢早衰(POF)组32例,其中正常组按照1年内是否成功受孕分为妊娠组和非妊娠组.统计3组受试者基础内分泌激素及血清AMH和INHB水平的差异并进行相关性分析,统计妊娠组和非妊娠组受试前卵巢储备功能相关激素水平的差异.结果 3组受试者血清AMH和INHB水平比较差异有统计学意义(P＜0.05);受试者窦卵泡计数(AFC)和雌二醇(E2)与AMH和INHB水平均呈正相关关系(P＜0.05);卵泡刺激素(FSH)和黄体生成素(LH)与AMH和INHB水平均呈负相关关系(P＜0.05);而受试者血清AMH和INHB水平呈正相关关系(r=0.582,P=0.000).正常组成功妊娠率为68.57％,妊娠组和非妊娠组AFC和血清FSH、LH、E2水平差异无统计学意义(P＞0.05),而妊娠组AMH和INHB水平均明显高于非妊娠组,差异均有统计学意义(P＜0.05).结论 高龄妇女血清AMH和IN-HB水平是预测卵巢储备功能的有效指标,其与AFC及血清FSH、LH和E2等激素水平具有明显的相关性,采取AMH和INHB联合检测能更准确的评估妇女卵巢储备功能.

目的 研究输卵管阻塞性不孕症介入再通术后输卵管通畅率的影响因素.方法 选择行输卵管阻塞性不孕症介入再通术患者100例,随机平均分为对照组和治疗组.术前调查年龄、病程、流产史、异位妊娠史等.两组手术方法相同,对照组疏通液包括地塞米松、庆大霉素、α-糜蛋白酶、生理盐水;治疗组增加复方丹参注射液.术后6个月复查输卵管选择性造影,比较术后通畅率与各因素的相关性.结果 复查发现不同年龄、不同病程、有无流产史、有无异位妊娠史患者间通畅率无统计学差异(P＞0.05).治疗组通畅率显著高于对照组(P＜0.05),无盆腔操作史者通畅率显著高于有盆腔操作史(P＜0.05),原发性不孕症患者通畅率显著低于继发性不孕症患者(P＜0.05),输卵管间质及峡部阻塞者通畅率最高(100.00％)、壶腹部次之(97.50％)、伞部最低(65.22％);治疗方法(OR=3.823)、不孕症类型(OR=3.234)、阻塞部位(OR=3.527),盆腔操作史(OR=0.179)均与通畅率相关(P＜0.05).结论 输卵管阻塞性不孕症介入再通术后通畅率与是否联合应用丹参注射液、有无盆腔操作史、原发性/继发性不孕、输卵管阻塞部位等因素相关;与年龄、病程、流产史、异位妊娠史无明显相关性.

Objective:To investigate the rate and the distribution of TORCH infection of infertile women in our hospital.Methods:From 2013 to 2016,940 cases of infertile women in our hospital were detected by enzyme-linked immunosorbent assay (ELISA) of TORCH-IgM antibody.470 cases were set as observation group,and 470 cases as control group.The clinical data of two groups were analyzed retrospectively.Results:The positive rate of TORCH-IgM antibody infection in infertile women in our hospital ranging from high to low was 10.4％ in cytomegalovirus,8.7％ in herpes simplex virus,4.6％ in toxoplasma and 1.8％ in rubella virus.The total infection rate of TORCH was 25.5％.Conclusion:There is a certain proportion of TORCH-IgM antibodies in infertile women.By virus specific antibody screening for this population,it helps to reduce the adverse pregnancy outcomes caused by TORCH infection,reduce birth defects,and improve population quality.

Objective:To discuss therapeutic effects and the safety of modified DangGui ShaoYao powder for hydramnion. Method: All 155 patients were randomized into 86 cases of the treatment group and 69 cases of the control group. The treatment group received modified DangGui ShaoYao powder and the control group received nothing, the symptoms and the changes of amniotic fluid indexes were analyzed before and after treating, the end of pregnancy was followed up to analyze the safety. Result:The comparison between both groups had statistical differ-ence after treating in amniotic fluid indexes and the scales of clinical symptoms (P<0.05), it also showed differences in the incidences of gestational diabetes mellitus and premature rupture of fetal membranes (P<0.05), it had no dif-ference in the incidences of gestational hypertension, abnormal labor, postartum hemorrhage and cesarean section (P>0.05). Conclusion:Modified DangGui ShaoYao powder is effective, safe and reliable for hydramnion.

目的:探讨妊娠期糖尿病的治疗时机及其与母婴预后的关系。方法:将34例在怀孕期间(34周前)确诊为妊娠期糖尿病并予以治疗的患者作为观察组,选取同期34例未行孕期保健或孕中期血糖筛查、于入院后(34周后)确诊妊娠期糖尿病的患者作为对照组,分析比较两组的母婴预后情况。结果:观察组的母婴预后情况优于对照组。观察组患者的妊娠期高血压、羊水过多、产后感染的发生率明显低于对照组(P<0.05),观察组巨大儿、早产儿、新生儿窒息、低血糖新生儿、呼吸窘迫的发生率明显低于对照组(P<0.05)。结论:妊娠期糖尿病治疗时机的选择与母婴预后具有显著的相关性,及早诊治能够有效控制并发症的发生,有利于母婴的预后发展。

目的:探讨子痫前期孕妇血清、胎盘组织MMP-9及NGAL表达的变化情况。方法:回顾性分析100例子痫前期孕妇的临床资料,依据临床分型不同分为早发型组40例,晚发型组60例。另选同期正常妊娠妇女50例作为对照组。结果:早发型组和晚发型组的血清中MMP-9、NGAL的表达均明显高于对照组(t=18.00,t=19.55,P<0.05),且早发型组高于晚发型组(t=10.33,P<0.05)。早发型组和晚发型组的胎盘组织中MMP-9 mRNA、NGAL mRNA均低于对照组(t=17.45、t=16.88,P<0.05),早发型组亦低于晚发型组(t=20.22,P<0.05)。结论:子痫前期孕妇血清MMP-9、NGAL水平的上升和胎盘组织MMP-9、NGAL mRNA的表达下降可能通过不同途径共同参与子痫前期的病理生理过程。

目的观察茵栀黄颗粒治疗ABO母儿血型不合的临床疗效。方法对729例ABO母儿血型不合的孕妇给予茵栀黄颗粒治疗,治疗半月后观察疗效。结果 729例患者中治愈539例,显效131例,无效59例,总有效率91.9%。结论茵栀黄颗粒治疗ABO母儿血型不合临床疗效显著。

Objective To examine the expression of cyclooxygase-2 (COX-2) in cervical carcinoma,and to reveal its relationship with the microvessel density (MVD) and vascular endothelial growth factor (VEGF).Methods The expressions of COX-2 and VEGF,as well as the MVD,were detected immunohistochemically in 54 patients with cervical cancer.Ten cervical intraepithelial neoplasia (CIN) and 10 normal cervixes served as control group.Results The positive rates of COX-2 were 56 7%,66 7% and 77 8% in cervical cancer stage Ⅰ,Ⅱ and Ⅲ,respectively.The positive rates of VEGF were 76 7%,81 3% and 92% in stage Ⅰ,Ⅱ and Ⅲ,respectively.There was no significant difference of COX-2 expression among the stages ( P 0 05).Significant difference of VEGF between stage Ⅰ and Ⅲ ( P 0 05) was observed,yet no difference between stage Ⅰ and Ⅱ ( P 0 05).The expressions of VEGF and COX-2 were positively related to MVD,while not related to pathological differentiation ( P 0 05).Conclusions VEGF,COX-2 and MVD play very important roles in the tumorigenesis and the development of cervical carcinoma,so they can be used as indexes of cervical carcinomas for diagnosis,clinical staging and therapy.

胎膜早破是产科常见的并发症,是由多种原因引起的,易并发宫内感染、早产等.本文测定胎膜早破患者IL-6、IL-8水平,分析其与胎膜早破、绒毛膜羊膜炎的关系.

The objective of the paper is to probe the relations between fetal distress and interleukin-1,interleukin-6 and interleukin-8,and to reveal the influence on the mode of delivery and the length of labour.Umbilical cord blood samples have been collected in a chosen group of 128 odd neonates of a pregnancy between 37 weeks and 42 weeks in a normal gestation.The group was divided into four subgroups according to the fetal distress and the mode of delivery.The serum levels of interleukin-1,interleukin-6,interleukin-8 and of tumor necrosis factor-α were determined by the means of irradiation immunoassays.The length of labour and the mode of delivery were correspondingly analyzed.The serum levels of interleukin and the pH in the cord blood of fetal distress neonates were also investigated to make sure whether there exists a correlativity among them.The results show that the presence or absence of fetal distress neither has influence on interleukin-1 levels.The IL-6 and IL-8 levels of the groups with the presence of fetal distress were significantly higher than that in the groups without fetal distress (P=0.01,P0.001),while the cord blood TNF-α levels significantly decreased.Labour increased IL-8,but had no impact on IL-6.The IL-6 and IL-8 levels increased while TNF-α level decreased in the case of fetal distress and the labour.There was no correlation between interleukin and pH.So the IL-6 and IL-8 levels of the groups with fetal distress were significantly higher than that in the groups without fetal distress ,while the cord blood TNF-α levels significantly decreased.