目的 探讨小檗碱联合复方左炔诺孕酮对多囊卵巢综合征(PCOS)及肠道菌群的影响.方法 选取2018年7月至2021年6月该院妇科收治的90例PCOS患者,采用随机数字表法分为对照组和观察组,每组45例.对照组给予复方左炔诺孕酮片,观察组在对照组基础上联合小檗碱片,比较2组临床疗效及血清激素指标、炎症因子指标及糖脂代谢指标变化情况,同时对2组肠道菌群分布情况及不良反应发生率进行分析.结果 观察组治疗后总有效率显著高于对照组,差异有统计学意义(P=0.036).2组治疗后血清睾酮、促黄体生成素(LH)、LH/促卵泡素、硫酸脱氢表雄酮、游离雄性激素指数及性激素结合球蛋白水平优于治疗前,且观察组各指标优于对照组,差异有统计学意义(P<0.05).2组治疗后空腹血糖、空腹胰岛素、糖化血红蛋白(HbA1c)、胰岛素抵抗指数、甘油三酯、高密度脂蛋白胆固醇、肿瘤坏死因子-α、超敏C反应蛋白及白细胞介素-6水平及低于治疗前,且观察组各指标(HbA1c除外)低于对照组,差异有统计学意义(P<0.05).观察组治疗后乳酸杆菌和双歧杆菌菌落数高于对照组,而肠杆菌菌落数低于对照组,差异有统计学意义(P<0.05).观察组肠道菌群丰度、Shannon-Wiener指数高于对照组,差异有统计学意义(P<0.05).2组不良反应发生率比较,差异无统计学意义(P=0.777).结论 小檗碱与复方左炔诺孕酮联合用药可有效提高治疗PCOS的疗效,显著改善患者生殖激素水平失调、糖脂代谢异常、慢性低度炎症状态,其机制可能与小檗碱改善肠道菌群紊乱有关.

目的 探讨程序性细胞死亡蛋白1（PD-1）单链抗体（ScFv）溶瘤病毒对卵巢癌裸鼠模型免疫活性、肿瘤生长及存活率的影响。方法 C57BL/6小鼠右前腋下注射SKOV-3细胞构建卵巢癌裸鼠模型，分别以0、5×10~5PFU、1×10~6PFU、5×10~6PFU、1×10~7PFU、5×10~7PFU、1×10~8PFU 滴度的PD-1 Sc Fv 溶瘤病毒瘤内注射，检测小鼠肿瘤体积，筛选最佳作用滴度。构建好的卵巢癌模型裸鼠随机分为模型组、PD-1抗体组、单独溶瘤病毒组、PD-1 Sc Fv溶瘤病毒组，每组8只，再选8只小鼠右前腋下注射等量细胞培养液作为对照组。测定小鼠脾指数、胸腺指数及肿瘤体积；流式细胞实验检测小鼠外周血 T 淋巴细胞亚群 CD4 + 、CD8 + 比例与CD4 + /CD8 + 比值；以酶联免疫吸附法（ELISA）试剂盒检测小鼠血清白细胞介素（IL）-2、IL-10、γ-干扰素（IFN-γ）水平；检测小鼠外周血白细胞比例；CCK-8实验检测小鼠产生的特异性抗肿瘤细胞杀伤率；检测各组小鼠存活率。结果 与对照组比较，模型组小鼠脾指数与胸腺指数、CD4 + 比例与CD4 + /CD8 + 比值、IFN-γ与IL-2水平、外周血白细胞比例、特异性抗肿瘤细胞杀伤率、存活率降低（P＜0.05）、CD8 + 比例、IL-10水平升高（P＜0.05）；与模型组比较，PD-1 Sc Fv溶瘤病毒组、单独溶瘤病毒组、PD-1抗体组小鼠脾指数与胸腺指数、CD4 + 比例与CD4 + /CD8 + 比值、IFN-γ与IL-2水平、外周血白细胞比例、特异性抗肿瘤细胞杀伤率、存活率均升高（P＜0.05），肿瘤体积、CD8 + 比例、IL-10水平均降低（P＜0.05）；与单独溶瘤病毒组、PD-1抗体组分别比较，PD-1 Sc Fv溶瘤病毒组小鼠脾指数与胸腺指数、CD4 + 比例与CD4 + /CD8 + 比值、IFN-γ与IL-2水平、外周血白细胞比例、特异性抗肿瘤细胞杀伤率、存活率均升高（P＜0.05），肿瘤体积、CD8 + 比例、IL-10水平均降低（P＜0.05）。结论 PD-1 Sc Fv溶瘤病毒可改善卵巢癌裸鼠免疫功能，促进特异性抗肿瘤细胞产生，并增强其对癌细胞杀伤力，抑制肿瘤生长，相比单独应用PD-1抗体或溶瘤病毒疗效能更强。

目的:研究部分可吸收Artisyn-Y型网片用于腹腔镜下阴道骶骨固定术对盆腔脏器脱垂患者尿流动力学、膀胱功能的影响及其疗效评价.方法:选取2018年7月至2020年1月深圳市妇幼保健院收治的盆腔脏器脱垂(POP)患者110例,根据手术方式将患者分为两组:采用部分可吸收性Y型网片行腹腔镜阴道骶骨固定术的患者为观察组(55例);采用传统盆底重建手术(阴式全子宫切除+阴道前后壁修补)的患者为对照组(55例).比较两组患者手术前一般临床资料、手术后尿流动力学、膀胱功能的变化.通过盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)、盆底功能障碍性疾病症状问卷简表(PF-DI-20)等问卷评价术后生活质量、性生活改善情况.结果:观察组的手术时间较对照组长,差异有统计学意义(P<0.05).两组的术中出血量比较,差异无统计学意义(P>0.05).术后半年,两组的平均尿流率、最大尿流率、残余尿量及最大膀胱容量均有所改善,且观察组优于对照组(P<0.05).术后两组的POPDI-6、UDI-6、CRADI-8及PFIQ-7评分均显著改善,观察组术后半年、1年时显著低于对照组(P<0.05).两组患者术后的盆底生活质量、性生活质量评分均较术前改善,且观察组的盆底生活质量、性生活质量高于对照组(P<0.05).结论:部分可吸收性Y网应用于腹腔镜下阴道骶骨固定术治疗盆腔脏器脱垂患者安全有效,可有效改善患者尿流动力学、膀胱功能,值得临床应用及推广.

目的 探讨阴道骶骨固定术对女性尿动力和盆底肌电生理的影响.方法 50例盆腔器官脱垂患者,根据手术方式分为观察组30例和对照组20例,观察组采用阴道骶骨固定术进行治疗,对照组采用传统手术进行治疗.2组手术前、后采用盆腔器官脱垂的定量评分评估解剖复位情况,比较手术前、后尿动力学指标腹压漏尿点压、最大尿流率时逼尿肌压、最大尿道闭合压、膀胱顺应性,比较手术前及手术后3、6、12个月盆底肌电生理变化情况.结果 观察组盆腔器官脱垂的定量评分Aa、Ba、C、Ap、Bp点手术前后差值[(5.01±0.42)、(7.73±0.56)、(12.79±0.41)、(4.60±0.31)、(5.09±0.67)cm]均大于对照组[(3.42±0.39)、(6.13±0.53)、(10.27±0.35)、(3.34±0.27)、(3.62±0.55)cm](P＜0.05);2组术前腹压漏尿点压、最大尿流率时逼尿肌压、最大尿道闭合压及膀胱顺应性比较差异均无统计学意义(P＞0.05);观察组术后腹压漏尿点压[(15.23±2.77)kPa]、最大尿流率时逼尿肌压[(10.01±1.57)kPa]、最大尿道闭合压[(9.77±1.54)kPa]、膀胱顺应性[(410.73±123.42) mL/kPa]均高于对照组[(9.34±2.31)kPa、(5.23±1.65)kPa、(6.50±1.72) kPa、(337.52±120.48) mL/kPa] (P＜0.05);观察组术后3、6、12个月Aa点[(-2.85±0.34)、(-2.24±0.31)、(-1.24±0.27)cm]和C点[(-6.82±0.39)、(-4.88±0.37)、(-3.49±0.42)cm]水平均低于对照组[(-1.02±0.52)、(-0.94±0.34)、(-0.85±0.22)cm,(-4.12±0.41)、(-3.75±0.36)、(-3.01±0.37)cm] (P＜0.05),Ⅰ类肌电位和Ⅱ类肌电位水平与对照组比较差异无统计学意义(P＞0.05).结论 阴道骶骨固定术可明显改善女性尿动力.

目的 探讨槲皮素(Que)对紧密连接蛋白6(CLDN6)的表达及子宫内膜异位症细胞增殖、迁移和侵袭的影响,并初步分析其可能作用机制.方法 选取40例子宫内膜异位症患者为研究对象,活检时切取异位子宫内膜组织,分离与培养异位子宫内膜间质细胞(EcSCs).以不同浓度(0、12.5、25、50 μmol/L) Que干预EcSCs,通过MTT法检测不同浓度Que对EcSCs细胞增殖的影响,Western blot检测增殖细胞核抗原(PCNA)与CLDN6蛋白表达.应用Tran-swell迁移及侵袭实验检测细胞迁移及侵袭情况.EcSCs中转染阴性对照(si-control)、si-CLDN6,并分析沉默CLDN6表达对EcSCs细胞增殖、迁移和侵袭的影响.后续实验分为4组:NC组、Que组、Que+ pcDNA组、Que+ pcDNA-CLDN6组,MTT与Transwell迁移及侵袭实验分别检测各组EcSCs增殖、迁移及侵袭能力,Western blot法检测PCNA、基质金属蛋白酶-2(MMP-2)、MMP-9、上皮-间质转化(EMT)及整合素连接激酶(ILK)信号通路相关蛋白表达.结果 Que干预后EcSCs增殖、迁移及侵袭能力受到抑制,且呈剂量依赖性,可抑制CLDN6、PCNA、MMP-2、MMP-9蛋白表达;沉默CLDN6表达后能够抑制EcSCs增殖、迁移及侵袭能力;Que可抑制神经型钙黏蛋白(N-cadherin)、波形蛋白(Vimentin)、ILK、磷酸化蛋白激酶B(p-AKT)蛋白表达,促进E-cadherin蛋白表达,但转染CLDN6过表达载体后可逆转Que对EcSCs增殖、迁移及侵袭的抑制作用.结论 Que可通过抑制CLDN6表达而抑制子宫内膜异位症细胞增殖、迁移及侵袭,其可能作用机制为抑制ILK信号通路活化及EMT转换进程.

目的:探讨会阴收缩力计联合Kegel运动对中重度盆腔脱垂行腹腔镜阴道骶骨固定术患者盆底功能的影响.方法:以我院152例因中重度盆腔脱垂行腹腔镜阴道骶骨固定术患者为研究对象,根据入组时患者的术后时间分为3组,术后≥2年的患者为A组,1年≤术后<2年的的患者为B组,3个月≤术后<1年的患者为C组.根据术后治疗方法分为对照组(予以盆底肌电刺激及生物反馈治疗)和观察组(在对照组基础上予以会阴收缩力计与Kegel运动配合治疗);比较观察组和对照组干预前后尿失禁调查问卷(ICI-Q-SF)、国际女性下尿路症状调查问卷(ICIQ-FLUTS)、盆腔器官脱垂/尿失禁性生活质量问卷(PISQ-12)得分及盆底肌最大肌电压水平.结果:(1)观察组和对照组干预前ICI-Q-SF、ICIQ-FLUTS、PISQ-12得分及盆底肌最大肌电压比较,差异均无统计学意义(均P>0.05);(2)观察组和对照组干预后各随访时间点的各项评分及盆底肌最大肌电压均优于干预前,差异均有统计学意义(均P<0.05);(3)观察组在干预后各随访时间点的各项评分及盆底肌最大肌电压均优于对照组,差异均有统计学意义(均P<0.05);(4)观察组和对照组中的C组患者术后各项评分及盆底肌最大肌电压优于其他两个时间组.结论:中重度盆腔脱垂行腹腔镜阴道骶骨固定术的患者术后早期采用会阴收缩力计与Kegel运动配合可有效改善患者术后盆底功能,值得推广.

目的 探讨腹腔镜阴道骶骨固定术(LSC)对盆腔脏器脱垂(POP)合并压力性尿失禁(SUI)患者的治疗效果.方法 回顾性分析31例POP合并轻、中度SUI患者,比较患者LSC手术前后POP评价体系(POP-Q)各指示点、盆底功能问卷排尿不适量表(UDI-6)和尿失禁影响问卷简表(IIQ-7)问卷评分、盆底超声指标和尿动力学指标的变化情况.结果 31例患者均成功施行LSC,中位随访时间为22个月,术后随访均无失败或复发病例.手术前后POP-Q各指示点Aa、Ba、C、Ap、Bp点的位置得到显著改善(P<0.05).POP客观治愈率100.00％.手术前后的UDI-6和IIQ-7问卷评分术后均较术前明显下降(P<0.05),提示术后生活质量明显改善.盆底超声提示术后膀胱颈移动度(BND)和膀胱后角(RVA)较术前明显减小(P<0.05),表明术后尿道高活动性降低.其中12例患者术后最大尿流率时逼尿肌压力、功能性尿道长度、最大尿道压及最大尿道闭合压较术前上升(P<0.05).LSC术后SUI治愈率为82.76％.结论 在LSC术后,SUI主观及客观指标均得到改善.因此,不建议在LSC同时对轻、中度SUI患者行预防性抗SUI手术.

Objective:To investigate the effect of hypophysin with laparoscopic surgery in treatment of ovarian endometriosis and its influence on progesterone (P),luteotropic hormone (LH),estradiol (E2),follicle－stimulating hormone (FSH) and anti－Mulle－rian hormone (AMH) level.Methods:From Jul.2015 to Sep.2016,130 patients with ovarian endometriosis were selected and divided into two groups according to the different surgical methods.The observation group used hypophysin with laparoscopic surgery and the control group used laparoscopic direct ovarian cyst dissection.The operative time,intraoperative blood loss ,anal exhaust time and the level of P,LH,E2,FSH and AMH before and after operation were compared between the two groups.Results:The operative time,intra－operative blood loss and anal exhaust time in the observation group were significantly less than those in the control group (P＜0.05). One month after operation,the levels of P,LH,E2and AMH in the two groups were significantly lower than those before operation ,and the level of FSH was significantly increased (P＜0.05).Compared with the control group,the changes of P,LH,E2and FSH in the ob－servation group were significantly less than those in the control group (P＜0.05).Three months after operation,the levels of P,LH,E2 and FSH became normal in the observation group ,but still lower in the control group compared with those before the operation (P＜0.05),the AMH level of the observation group was significantly higher than that of the control group ( P＜0.05).Conclusions:Hy－pophysin with laparoscopic surgery in treatment of ovarian endometriosis can shorten the operation time ,reduce intra－operative blood loss,significantly reduce the changes of P ,LH,E2and FSH levels,effectively reserve ovarian function and improve the quality of life.

目的:分析部分可吸收Y型网片应用于腹腔镜下阴道骶骨固定术(LSC)的临床疗效,评价其对盆腔器官脱垂(POP)治疗的有效性和安全性.方法:回顾分析2014年8月至2016年10月在南方医科大学附属深圳市妇幼保健院因POP使用部分可吸收网片行LSC术的43例患者的临床资料.随访患者术后3、6、9、12个月时的网片暴露、异物感差异,以及手术前、后盆腔器官脱垂定量(POP-Q)分度法各指示点位置,评价总体主观、客观治愈率及复发率.通过盆腔脏器脱垂/尿失禁性功能问卷(PISQ-12)、盆底功能障碍性疾病症状问卷简表(PFDI-20)等相关问卷评价术后生活质量、性生活改善情况.结果:43例患者术后POP-Q各指示点可达解剖复位,总体主观治愈率100％,总复发率2.3％.术后随访3、6、9、12个月时,患者POP-Q各指示点及相关问卷评分比较,差异均无统计学意义(P>0.05),与术前相比,术后阴道长度无明显缩短(P>0.05),CRADI-8评分无明显改变(P>0.05).1例压力性尿失禁(SUI)患者行LSC同时行经耻骨后无张力尿道中段悬吊带术(TVT-E),术后尿失禁治愈;2例SUI、1例急迫性尿失禁(UUI)、1例混合性尿失禁(MUI)未行TVT-E治疗,1例在LSC术后症状消失,3例症状程度无改变.结论:部分可吸收Y型网片应用于LSC的主、客观治愈率高,不仅达到解剖学复位,还能显著提高患者的术后生活质量,术后疗效稳定,术后阴道长度无明显缩短,异物感发生率低.部分可吸收网片为LSC的材料植入提供了一种新的选择.

Objective To explore the clinical effect of Foley balloon and absorbable adhesion barrier(Interceed) on the prevention of the relapse of intrauterine adhesions after hysteroscopic operation among patients with severe intrauterine adhesions.Methods Eighty cases of severe intrauterine adhesions in the Affiliated Shenzhen Maternity and Child Healthcare Hospital of the South Medical University were selected as study subjects,and they were divided into three groups.All the patients were treated with estradiol valerate for 3 months after transcervical resection of adhesions(TCRA).Patients of group A (34 cases) were treated with installed intrauterine device(IUD).Patients of group B(23 cases) were treated with Foley balloon and hyaluronic acid,and after 3 days,Foley balloon was taken out and hyaluronic acid was given again,then IUD installed.In the 1st and 2nd month 3 ～ 5 days after menstruation,take out IUD,install Foley balloon,and after 3 days,take out Foley balloon,then install IUD.Group C (23 cases) were treated with Interceed and IUD.After 3 months,hysteroscopy was performed again to evaluate the treatment effect.Results The total effective rate of group B was 87％,and reached 96％ in Group C,which was remarkably higher than that of group A(62％),the difference being statistically significant (P＜ 0.05).Although,the total effective rate of group C was higher than that of group B,there was no significant difference between them (P＞0.05).Conclusion The Interceed anti-adhesion membranes and Foley balloon are all good for preventing intrauterine adhesions after TCRA.

目的比较体外受精胚胎移植（IVF-ET）后输卵管妊娠和自然受孕输卵管妊娠患者基质细胞衍生因子-1（SDF-1）及CXC趋化因子受体4（CXCR4）mRNA表达的差异,以探讨其在IVF-ET后输卵管妊娠发生中所起的作用及机制。方法分别选取2011年1月至2012年12月10例IVF-ET后输卵管妊娠和10例自然受孕输卵管妊娠患者,在腹腔镜手术的同时抽吸蜕膜、绒毛和输卵管黏膜组织,-70℃冷冻备存;采用荧光定量PCR的方法检测各组织中SDF-1及CXCR4 mRNA表达。结果两组患者胎盘绒毛、输卵管黏膜及子宫蜕膜组织的SDF-1及CXCR4mRNA表达量比较差异均无统计学意义（P均＞0.05）;两组绒毛组织和输卵管黏膜组织均高表达CXCR4与SDF-1mRNA,其表达量显著高于各自的蜕膜组织（P均＜0.05）。显示出受孕方式与输卵管妊娠发生率可能无关。结论输卵管黏膜SDF-1和CXCR4表达亢进,子宫蜕膜SDF-1和CXCR4相对表达不足可能是IVF-ET后胚胎定植于输卵管的重要机制之一。

Objective To analyze the effect of the heating carbon dioxide pneumoperitoneum on blood gas of patients with gynecological laparoscopic surgery and to explore measures of anesthetic intervention. Methods A total of 1 20 cases of gynecological patients who received laparoscopicoperation therapy in our hospital from May 201 2 to May 201 4 were included and were randomly divided into group A and group B with 60 cases in each group.The patients in group A were treated with the heated carbon dioxide while patients in group B were treated with pneumoperitoneum of non-heated carbon dioxide,Changes of blood gas of the patients in the two groups were compared before and after operation. Results The differences in pH,PCO2 ,PO2 and HCO3 were significant before the surgery.After the surgery,the PO2 value in group A was (21 5.60 ±1 5.20)mmHg,which was significantly lower than (31 2.92 ±23.78)mmHg in group B.The PCO2 value in group A was (1 5.1 1 ±0.22)mmHg,which lower than that in group B.The BE value in group A was (-1 0.22 ± 1 .94)mmol/L after the surgery,which was lower than that in group B. Conclusion Heating treatment is the key factor to affect the operation safety of the patients and the incidence of postoperative complications when carbon dioxide pneumoperitoneum is established.Therefore the heating treatment must be closely monitored before the operation in order to maintain body temperature and to reduce the incidence of postoperative shivering after the operation.When carbon dioxide retention occurs,timely blood gas analysis and anesthetic intervention are crucial to the safety of the patients.

目的:观察中重度子宫内膜异位症保守性手术后分别给予GnRH-α、曼月乐、GnRH-α联合曼月乐巩固治疗的疗效.方法:选择中重度子宫内膜异位症腹腔镜保守性手术后、无生育要求的患者115例,随机分为3组,A组(40例)术后采用GnRH-α联合曼月乐治疗,B组(40例)术后采用GnRH-α治疗,C组(35例)术后放置曼月乐治疗.随访18个月,比较手术前、手术后3、6、9、12和18个月的疼痛评分、CA125水平和复发率.结果:3组术后各时间点的疼痛评分均低于术前(P＜0.05);A组和C组术后各时间点的疼痛评分比较差异均无统计学意义(P＞0.05);B组中术后12、18个月疼痛评分均高于术后3、6、9个月(P＜0.05);在术后12、18个月,A组和C组的疼痛评分均低于B组(P＜0.05).3组术后各时间点CA125水平均低于术前(P＜0.05).A组术后各时间点CA125水平比较差异无统计学意义(P＞0.05);B组中术后12、18个月CA125水平均高于术后3、6、9个月(P＜0.05);C组中术后9、12、18个月CA125水平均高于术后3、6个月(P＜0.05);术后9个月C组CA125水平高于A组(P＜0.05),术后12、18个月B组和C组CA125水平均高于A组(P＜0.05).3组复发率分别为0.0％、14.3％和15.6％,A组复发率低于B组和C组(P＜0.05),B组和C组的复发率比较差异无统计学意义(P＞0.05).结论:GnRH-a联合曼月乐治疗可以长时间缓解痛经,降低术后复发率,为无生育要求的中重度子宫内膜异位症患者保守性手术后提供了一种有效的巩固治疗方法.

Objective:To explore the efficacy of GnRH agonist(GnRHa) combined with levonorgestrel intrauterine system(LNG-IUS) in the treatment of moderate to severe endometrosis(EMs) after conservative surgery.Methods:Forty-three patients with moderate to severe EMs after conservative surgery were randomly divided into 2 groups:experimental group in which 23 women were given GnRHa and LNG-IUS therapy,and control group in which 20 women were given GnRHa therapy only.The follow-up period was 12 months.The mean visual analogue scale(VAS) scores of their pains,serum CA125 levels,recurring rate between the two groups and between pre-therapy and post-therapy were compared.Results:In two groups,significant differences(P<0.05) existed in VAS scores at the end of 3-month,6-month,9-month and 12-month treatment when compared with the preoperative situation.In experimental group,there were no differences in VAS scores among difference times after post-operation.In control group,the VAS score at the end of 12-month treatment was significantly higher than that at the end of 3-month,6-month and 9-month treatment(P<0.05).At the end of 12-month treatment,the VAS scores in experimental group were significantly lower than those in control group.In two groups,significant differences(P<0.05) existed in serum CA125 at the end of 3-month,6-month,9-month and 12-month treatment when compared with the preoperative situation.In experimental group,there were no differences in the value of serum CA125 among difference times after post-operation.In control group,the value of serum CA125 at the end of 12-month treatment was significantly higher than that at the end of 3-month,6-month and 9-month treatment(P<0.05).At the end of 12-month treatment,the value of serum CA125 in experimental group was significantly lower than that in control group.After 1-year treatment,the recurrence rate of experimental group was obviously lower than that in control group(0.0% vs 15.0%,P<0.05).Conclusion:GnRHa combined with LNG-IUS is an effective therapy in the treatment of moderate to severe EMs after conservative surgery.

Objective To study the effects of ATRA on the proliferation and chemosensitivity of HeLa/MMC and investigate the mechanism. Methods The proliferation of HeLa/MMC by ATRA was observed, the effect of chemosensitivity of HeLa/MMC was measured by MTT, the apoptosis of HeLa/MMC was detected by FCM, and the expression of bax gene was detected by sentiquantitive RT-PCR. Results ATRA could inhibit the prolifer- ation, improve the sensitivity to MMC,enhance the apoptosis,unregulated the express of bax. Conclusions The chemosensitivity of HeLa/MMC by ATRA were related to enhancing apoptosis and regulating the express of bax.

Objective To explore the value of color doppler ultrasonography combined with pelvic angiography in diagnosis and therapy of uterine arterivenous fistula.Methods Patients with irregular vaginal bleeding or abrupt vaginal hemorrhea that bled after induced abortion or curettage were selected from January 2001 to December 2009.The color doppler ultrasonography were undertaken in these patients,which would demonstrate whether need to undertake the pelvic angiography or not.The patients with uterine arterivenous fistula confirmed by pelvic angiography were treated with uterine artery embolization.Results Total 45 patients were demonstrated with formation of uterine arteriovenous fistula by color doppler ultrasonagraphy,39 cases among them were undertaken pelvic angiography.Finally,28 cases were confirmedwith uterine arteriovenous fistula and treated with uterine artery embolization.Conclusion Color doppler ultrasonography combined with pelvic angiography would be valuable for diagnosis of uterine arterivenous fistula,uterine artery enbolisation could be an effective treatment method.

Objective To evaluate the safety and efficacy of scrubbing autologous blood transfusion for the treatment of intraperitoneal bleeding in ectopic pregnancy.Methods Fifty-one cases of intraperitoneal bleeding patients with ectopic pregnancy were given autologous blood transfusion by using American blood cell saver 5 recycling machine,the components of blood silting in abdominal cavitywere compared before and after treatment of recycling machine.The hematocrit,erythrocyte count,hemoglobin content,blood platelet and coagulation changes in patients were observed before and after transfusion,the adverse reaction was recorded.Results The platelet,fibrinogen,free hemoglobin of blood silting in abdominal cavity were basically eliminated after treating with recycling machine,the hematocrit was obviously increased;the result of bacterial culture was negative.The change of hemoglobin content,blood platelet and coagulation changes in patients had no significant difference before and after transfusion,the hematocrit was decreased after transfusion,no obvious adverse reaction was observed.Conclusion Scrubbing autologous blood transfusion was safety and efficient for the treatment of intraperitoneal bleeding in ectopic pregnancy.

Objective: To understand the present stage of breast feeding on the post parturm mothers who delivery in our hospital,analysis the influential factors why the rate of breat feeding keep still low.Methods:The data were from the same questionnaire answered by the post partum mothers who were visited and the Purperas who come back to hospitalto have a health examination in 42 days after delivery.To analyze and compare awareness of the situation of maternal breast-feeding of different delivery modes,the impact of breast-feeding factors and feeding patterns.Results: The knowledge on breast-feeding of vaginal delivery puerpera was less than cesarean section.Main factors affecting breast-feeding were posture,painn,and so on,these was difference between vaginal delivery and cesarean section.The breast feeding rate of caesarean purpers was obvious lower than the purperas who through vagina give birth to baby.Conclusions:Mother milk's includes various nourishment that an infant need,it is the infant's most ideal food;Breast feeding can promote mother baby's affection,lower mother and baby's fall ill rate.Therefore,we must persist in initiating the breast feeding actively,raise the rate of breast feeding and promote the mother and baby's mind and body to develop.

目的探讨施行以腹膜替代行阴道延长术在宫颈鳞状上皮细胞癌治疗中的作用。方法50例宫颈鳞状上皮细胞癌患者中,研究组24例在常规宫颈癌根治术后以腹膜替代行阴道延长术,对照组26例采用常规宫颈癌根治术,比较两组术中及术后情况。结果50例手术均顺利完成。两组在手术时间、术中出血量和术后恢复时间等方面差异均无统计学意义(P>0.05);而术后6个月测定阴道长度,研究组阴道深7.5～11cm,平均8.1cm,对照组阴道深4～5.5cm,平均4.7cm,两组差异有统计学意义(P<0.05)。术后6～12个月研究组对性生活的满意度均高于对照组(P<0.05)。结论宫颈鳞状上皮细胞癌根治术中施行以腹膜替代行阴道延长手术能使患者术后阴道有足够的长度,有效地改善患者术后性生活质量,并且简便、易行,具有较好的临床应用价值。