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外阴阴道糜烂型扁平苔癣局部使用氯倍他索及他克莫司治疗后患者满意度的调查研究

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 19-20页

作者： Jensen J.T. Bird M. LeClair C.M. 张剑萍 dept.of obstetrics and gyne cology Oregon Health and Science University Portland Ore dept. Obstet. G. L as VegasNV United States Dr.

Objective The purpose of this study was to compare patient satisfacti on with t he topical immune system modulator tacrolimus to topical clobetasol during treat ment for vulvovaginal erosive lichen planus. Study design Subjects who had been diagnosed with vulvovaginal erosive lichen planus between June 2000 a nd May 2001 received a mail survey regarding clinical satisfaction and response to treatment with clobetasol and tacrolimus. Satisfaction was assessed with a 10 0-mm visual analogue scale (very unsatisfied, 0; very satisfied, 100). Satisfac tion was compared with the use of a paired t-test. Results Nineteen subjects me t the inclusion criteria; 17 subjects (89%) returned completed surveys. Sixteen of the 17 women reported clobetasol therapy, and 11 of the 17 subjects acknowle dged the use of tacrolimus therapy. All but 1 of the women who received tacrolim us had been treated previously with clobetasol therapy. All subjects reported ex periencing sexual pain before their initial examination. After treatment with cl obetasol, 2 of 16 women reported pain-free intercourse. Two additional women re ported pain-free intercourse after switching to tacrolimus therapy. Ten subject s who had used both treatments rated tacrolimus therapy as significantly more sa tisfactory than clobetasol therapy (63 vs 38 mm; P=.03). Conclusion The use of t opical tacrolimus improves satisfaction and may result in better clinical outcom es than therapy with clobetasol for the treatment of vulvovaginal erosive lichen planus.

关键词：外阴阴道糜烂型扁平苔癣氯倍他索性交痛意度视觉模拟免疫抑制剂统计学方法满意度评估

应用促性腺激素释放激素拮抗剂后血清黄体生成素浓度对体外受精-胚胎移植妊娠率无显著影响

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 29-30页

作者： Merviel P. Antoine J.-M. Mathieu E. 闫坤 Department of gyne cology Obstetrics and Reproductive Medicine Hˇopital Tenon Paris France Dr.

Objective To determine the impact of circulating LH concentrations du ring cont rolled ovarian hyperstimulation on the outcome of IVF. Design Retrospective stud y. Setting University hospital. Patient(s) Two-hundred seventy women who had a short stimulation protocol with GnRH antagonist and ovarian stimulation with rec ombinant FSH (rFSH). Intervention( s)GnRHantagonist and rFSH were administered S C; blood samples were collected on the day of GnRH antagonist administration, 1 day after, and on the day of hCG administration. Main outcome measure(s) A thres hold of 0.5 IU/L on the day of hCG was chosen to discriminate between women with LH concentrations ≤0.5 IU/L (group A, n = 119) or >0.5 IU/L (group B, n = 151) . Result(s) The two groups were comparable with regard to the clinical parameter s. In group A, significantly lower LH concentrations were observed on day 9 of t he cycle and on the day of hCG administration. The numbers of oocytes retrieved, embryos obtained, and embryos cryopreserved were significantly higher in group A compared with group B. The proportion of clinical pregnancieswas similar in th e two groups (21.1%vs. 22.7 %per ET). Conclusion(s) In GnRH antagonist and rFS H protocols, suppressed serum LH concentrations do not have any influence on the final stages of follicular maturation, pregnancy rates, or outcomes.

关键词：黄体生成素体外受精诱发排卵卵泡刺激素卵泡成熟卵母细胞冷藏胚胎拮抗剂皮下给药受孕率

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经腹子宫肌瘤切除术前后生育能力的回顾分析

世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 32-33页

作者： Marchionni M. Fambrini M. Zambelli V T.Susini 朱晓明 Department of gyne cology Perinatology and Human Reproduction University of Florence Florence I taly Dr.

Objective To evaluate the results of abdominal myomectomy for intramu ral and s ubserosal fibroids and to identify factors that influence the reproductive outco me after surgery. Design Retrospective analysis of a case series. Setting An aca demic department specializing in gynecologic surgery. Patient(s) A total of 72 w omen with intramural and subserosal fibroids submitted to abdominal myomectomy w ho wished to conceive after surgery. Intervention(s) Data were collected on clin ical characteristics, surgical features, and obstetric history before and after surgery. Main outcome measure(s) Conception rate, pregnancy loss, and live birth rate before and aft er surgery, as well as postoperative probability of conception according to sele cted clinical and fibroid characteristics. Result(s) Conception rate was 28%bef ore myomectomy and 70%after surgery. The corresponding figures were 69%and 25 %for pregnancy loss and 30%and 75%for live birth rate, respectively. Age < 30 years and number of fibroids removed were the only significant and independent predictors of obstetric outcome by multivariate analysis. Conclusion(s) Our resu lts suggest that abdominal myomectomy might improve reproductive outcome in pati ents with intramural and subserosal fibroids. The reproductive performance was p articularly good when the patientswere younger than 30 years and had a single my oma to remove.

关键词：子宫肌瘤切除术活产率手术指征孕产史受孕率专业科室预测术多元回归分析

双胞胎和三胞胎与单胎比较:多胎和发育对新生儿结局的影响

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世界核心医学期刊文摘（妇产科学分册） 2005年第2期1卷 7-8页

作者： Garite T.J. Clark R.H. Elliott J.P. Thorp J.A. 兰玲 dept.of obstetrics and gyne colog y University of CaliforniaIrvine Me dical Center101The City DrOrang eCA 92863-1491Unit ed States Dr.

Objective Information on outcome by gestational age fromlarge numbers of twins and triplets i s limited and is im-portant for counseling and decision-making in obstetric *** reviewed one of the larg est available neonatal databases to describe mortality and morbidity rates and growth in newborn infants from multiple gestations and compared these data with data for sin *** design Data from a large prospectively recorded neonatal database that incorporated neonatal records from January 1997to July 2002were *** evaluate d birth weight and neonatal mortality and morbidity ra tes that affected long -term outcome for each week of gestational age from 23to35weeks of gestation for all nonanom olous inborn twins and triplets who were admitted to the neonatal intensive care unit and compared these data to all singletons who met similar criteria during the same tim e *** Therewere 12,302twin and 2155triplet bir ths that met the entry *** data for these newborn infants were compared with 36,*** bir th weights at each gestational week were similar for all gestational ages until29weeks of gestation for triplets an d 32weeks of gestation for *** these gestational ages,the entire difference between twins and singletons was due to the weight of the smaller twin;the larger twins’mean weights were similar to singletons at all weeks that were s *** order at each week also did not affect neonata l mortality rates,even when corrected for route of delivery and antenatal *** morbidities associated wi th adverse long -term outcomes(intraventricular hemorrhage,reti nopathy of prematurity,necrotizing enteroco litis)were also not dif-ferent between multiple infants and *** growth restriction(IUGR)was associated with increased mortality rates at all gestational ages,but in the absences of IUGR,discordance was *** Data on a large number of twins and triplets provide reass

关键词：新生儿结局新生儿死亡率单胎妊娠平均出生体重生长发育情况数据库资料视网膜疾病脑室内出血咨询指导胎孕

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卵巢交界性肿瘤是否可以安全使用腹腔镜治疗

世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 47-47页

作者： Maneo A. Vignali M. Chiari S. 程广艳 Department obstetrics and gyne cology S. Gerardo Hosp.-Univ.Milano-B.Milan Italy

*** evaluate the risk of the laparoscopic approach to patie nts with borderline ovarian tumors compared to the laparotomic management. Methods. We tr eated or followed in our institution 479 women with borderline ovarian tumor. Si xtytwo patients had fertility-sparing surgery followed by restaging or follow- up intervention: 30 operated by laparoscopy, 32 by laparotomy. Restaging surgery was performed in five cases and second-look surgery in 57. Results. The diamet er of the cyst is significantly lower in patients treated by laparoscopy, especi ally in womenwho underwent cystectomy (4.7 cm) compared to oophorectomy (10 cm, P = 0.008). Rupture of the cyst and stage IC were more frequent in the laparosco pic group. After a median follow-up of 61 months for the laparoscopic group and 77 months for the laparotomic group, we observed 11 patients (37%) with persis tent disease after primary laparoscopy (adnexa, five cases; peritoneal implants, three cases; both patterns, three cases). After primary laparotomy, no patients showed early persistence of tumor, and ovarian relapses were diagnosed in seven women (22%) 33-138 months after laparotomy. The univariate analysis for the r isk of neoplastic persistence after primary laparoscopy shows that patients with cysts greater than 5 cm have a higher risk (odds ratio 9.7, P = 0.02) compared to smaller cysts. No other factors proved significant, but the odds ratios for p atients with serous tumor (5.8), stage IC (2.0), and those undergoing cystectomy (1.9) suggest a relationship to the probability of persistence. Conclusion. Lap aroscopic treatment in borderline ovarian tumors should be reserved to masses no t greater than 5 cm. When conservative therapy is desired, the entire affected o vary should be removed. If the neoplasia is bilateral, cystectomy could be allow ed in women who wish to preserve fertility, although they are at high risk of re lapse.

关键词：卵巢交界性肿瘤腔镜治疗肿物直径腹腔镜手术患侧卵巢探察术开腹手术肿物切除术腹腔种植卵巢切除术

Chromohysteroscopy—A new technique for endometrial biopsy in Abnormal Uterine Bleeding (AUB)

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Open Journal of obstetrics and gynecology 2013年第5期3卷 11-14页

作者： Nisha Singh Bharti Singh Department of obstetrics & gynecology King George Medical University Lucknow India

Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB. Design: Cross sectional interventional study. Materials and Methods: This study was conducted on 60 women with AUB in dept. of Obst. & gyne at King George Medical University, Lucknow over a period of one year. All cases underwent diagnostic hysteroscopy followed by chromohysteroscopy using 2% methylene blue dye. Hysteroscopic guided biopsy was taken from stained and unstained areas followed by an endometrial aspiration biopsy from whole uterine cavity. The histopathology results of three samples were compared and analyzed in relation with staining pattern and type of AUB. Data analysis was done on SPSS version 15 of windows 2007. Results: Out of 60 cases, 11cases were found to have non hormonal pathology after chromohysterosopic biopsy. Eight (72.72%) cases were diagnosed by stained endometrial tissue, one (9.09%) by unstained tissue and three (27.27%) by endometrial aspiration. The diagnostic ability of stained tissue biopsy was significantly higher (p = 0.006) than unstained biopsy and endometrial aspiration. Conclusion: Chromohysteroscopy is a simple and effective technique for diagnosing endometrial pathology in cases of AUB.

关键词： Endometrial Biopsy Endometrial Aspiration Hysteroscopy Menstrual Abnormality Methylene Blue Dye

Combined effects of MPA and EBRT in stage Ic endometrial cancer patients

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The Chinese-German Journal of Clinical Oncology 2008年第11期7卷 650-657页

作者： Rumana Jafarey Wei Zhang Sun Jing Department of gynecology and obstetrics Renmin Hospital of Wuhan University Wuhan 430060 China Department of Health Statistics School of Public Health Wuhan University Wuhan 430072 China

Objective： To report the comparative effect of combined medroxyprogesterone acetate （MPA） and external beam pelvic radiotherapy （EBRT） with EBRT alone on local or distant recurrences, overall survival and treatment related toxicities in patients with stage Ic grade 3 endometrial cancer. Methods： A retrospective review of 80 International Federation of gyne- cology and obstetrics （FIGO） stage Ic grade 3 endometrial carcinoma patients treated between October 1994 and October 2004 at Renmin Hospital, Wuhan University, China was performed. All patients underwent surgery, of which 40 patients in arm I received combined MPA and EBRT while in arm II 40 patients received only adjuvant EBRT after surgery. The median dose of EBRT in arm I was 50 Gy （range 36-54 Gy） and in arm Ⅱ was 45.2 Gy （range 43.2-50.4 Gy）. Multivariate analysis was performed for the prognostic factors and Kaplan-Meier method was used for overall survival. Results： Of the 80 eligible patients, 40 in each group could be evaluated. The follow-up times ranged from 4-98 months with a median of 45 months. The overall survival rates at five years were 73% among patients treated with combined MPA and EBRT and 28.2% among patients treated with EBRT alone （P 〈 0.001）. The rate of distant metastasis was significantly higher among patients treated with EBRT alone group than combined MPA and EBRT （55% vs 25%, P = 0.006） while no difference in Ioco regional recurrence rates was observed in both treatment groups. Most of the side effects observed in the combined MPA and EBRT group. Age （P 〈 0.001） and the presence of progesterone receptors （P = 0.003） were independent significant prognostic factors for overall surviva} in multiple regression analysis. Conclusion： We has been concluded that the addition of progestagen to external beam pelvic radiotherapy significantly improved survival and reduced distant metastasis among women with stage Ic grade 3 endometrial cancer.

关键词： endometrial carcinoma FIGO stage Ic grade 3 medroxyprogesterone acetate (MPA) external beam pelvicradiotherapy (EBRT)