注重心灵的沟通——妇产科学留学生临床实习教学体会

留学生教育已成为高等医学教育的重要组成部分,临床实习是培养留学生的必由之路.语言和文化的双重差异、国内医疗环境、妇产科专业的特殊性使留学生在妇产科临床实习中面临诸多问题和困难.教师敢说、多说和会说,用心沟通,做留学生和患者沟通的桥梁;提高留学生汉语水平,使之融入中国社会,提高妇产科学留学生临床实习的教学质量.     

人血清激肽释放酶6在上皮性卵巢癌诊断及监测中的意义

Objective The aim of this study was to investigate the clinical value of human serum Kallikrein 6 for the diagnosis and monitor of pithelial ovarian cancer. Methods Serum levels of KLK6 were analyzed with ELISA in 30 cases of epithelial ovarian carcinoma, 20 cases of benign ovarian tumor and 30 cases of healthy women. In the meantime, serum CAi25 was determined with chemiluminescence. Furthermore, serum levels of KLK6 and CA125 were also detected in 12 case of epithelial ovarian carcinoma with the same methods one week and the 3rd month postoperation of follow-up. Results Serum levels of KLK6 in epithelial ovarian carcinoma was higher than that in benign ovarian tumor and healthy women (P < 0.05). KLK6 also showed positive correlation with clinical stage, cytological grade, pelvic lymph node metastasis, recurrent or dead disease (P < 0. 05). On the contrary, KLK6 showed no significant correlation with pathological types (P >0. 05). After surgery of follow-up, KLK6 and CA125 were significantly decreased in 12 case of epithelial ovarian carcinoma (P < 0. 05). Furthermore, the total sensitivity and specificity of KLK6 in the diagnosis of epithelial ovarian carcinoma was 73.3% and 85.0% respectively, followed by the sensitivity to be 50. 0% and 88. 9% for the diagnosis of stage Ⅰ-Ⅱand Ⅲ-Ⅳ disease. Conclusion Our resuits showed KLK6 may be one of the reliable indexes for the diagnosis and monitor of ovarian cancer.     

杀鼠剂中毒致阴道出血及腹腔出血

杀鼠剂按其作用的快、慢可分为两种:急性杀鼠剂与慢性杀鼠剂。前者指老鼠进食毒饵后在数小时至1天内死亡的杀鼠剂,如毒鼠强、甘氟等急性剧毒药,由于给社会造成了极大的负面影响,我国已明令禁止使用急性杀鼠剂,目前急性剧毒鼠药的     

会阴侧切围术期抗生素应用疗效观察

目的探讨全身预防性应用抗生素对正常分娩会阴侧切术切口的影响。方法将我院2004年10月-2006年9月术前无感染征象正常分娩行会阴侧切术的152例产妇，随机分为治疗组72例，对照组80例；对照组行常规会阴切开及缝合，治疗组手术当日加用抗生素。比较两组会阴术后切口感染、切口愈合情况、术后住院日。结果治疗组、对照组切口感染率分别为2．8％、3．7％，两组会阴切口愈合情况、术后住院日差异无统计学意义（P〉0．05）。结论正常分娩产妇会阴侧切术预防性应用抗生素对切口疗效不明显，关键是良好的助产技术和严格的无菌操作技术。     

人血清激肽释放酶6在上皮性卵巢癌诊断及监测中的意义

Objective The aim of this study was to investigate the clinical value of human serum Kallikrein 6 for the diagnosis and monitor of pithelial ovarian cancer. Methods Serum levels of KLK6 were analyzed with ELISA in 30 cases of epithelial ovarian carcinoma, 20 cases of benign ovarian tumor and 30 cases of healthy women. In the meantime, serum CAi25 was determined with chemiluminescence. Furthermore, serum levels of KLK6 and CA125 were also detected in 12 case of epithelial ovarian carcinoma with the same methods one week and the 3rd month postoperation of follow-up. Results Serum levels of KLK6 in epithelial ovarian carcinoma was higher than that in benign ovarian tumor and healthy women (P < 0.05). KLK6 also showed positive correlation with clinical stage, cytological grade, pelvic lymph node metastasis, recurrent or dead disease (P < 0. 05). On the contrary, KLK6 showed no significant correlation with pathological types (P >0. 05). After surgery of follow-up, KLK6 and CA125 were significantly decreased in 12 case of epithelial ovarian carcinoma (P < 0. 05). Furthermore, the total sensitivity and specificity of KLK6 in the diagnosis of epithelial ovarian carcinoma was 73.3% and 85.0% respectively, followed by the sensitivity to be 50. 0% and 88. 9% for the diagnosis of stage Ⅰ-Ⅱand Ⅲ-Ⅳ disease. Conclusion Our resuits showed KLK6 may be one of the reliable indexes for the diagnosis and monitor of ovarian cancer.     

阴道斜隔4例报道

阴道斜隔是指双子宫、双宫颈、双阴道、一侧阴道完全或不完全闭锁的先天性畸形 ,多数伴有闭锁阴道侧的肾脏缺如。由于临床上比较少见 ,往往对此类畸形认识不足而致误诊。现将我院收治的 4例阴道斜隔报道如下。1　病例报告例 1,2 4岁 ,因孕 5月 ,发现双子宫 2月 ,腹痛 4天入院。患者平时月经规则 ,有轻度痛经 ,白带较多 ,有时呈脓性。孕 3月时B超检查发现双子宫 ,一侧子宫妊娠。近 1月来阴道分泌物增多且有臭味 ,经多个医院检查未发现明显异常 ,抗炎治疗无效果。最近 4天出现下腹疼痛 ,并逐渐加剧 ,入院前晚上胎动消失 ,阴道少量流血。入院…     

人血清激肽释放酶6在上皮性卵巢癌诊断及监测中的意义

Objective The aim of this study was to investigate the clinical value of human serum Kallikrein 6 for the diagnosis and monitor of pithelial ovarian cancer. Methods Serum levels of KLK6 were analyzed with ELISA in 30 cases of epithelial ovarian carcinoma, 20 cases of benign ovarian tumor and 30 cases of healthy women. In the meantime, serum CAi25 was determined with chemiluminescence. Furthermore, serum levels of KLK6 and CA125 were also detected in 12 case of epithelial ovarian carcinoma with the same methods one week and the 3rd month postoperation of follow-up. Results Serum levels of KLK6 in epithelial ovarian carcinoma was higher than that in benign ovarian tumor and healthy women (P < 0.05). KLK6 also showed positive correlation with clinical stage, cytological grade, pelvic lymph node metastasis, recurrent or dead disease (P < 0. 05). On the contrary, KLK6 showed no significant correlation with pathological types (P >0. 05). After surgery of follow-up, KLK6 and CA125 were significantly decreased in 12 case of epithelial ovarian carcinoma (P < 0. 05). Furthermore, the total sensitivity and specificity of KLK6 in the diagnosis of epithelial ovarian carcinoma was 73.3% and 85.0% respectively, followed by the sensitivity to be 50. 0% and 88. 9% for the diagnosis of stage Ⅰ-Ⅱand Ⅲ-Ⅳ disease. Conclusion Our resuits showed KLK6 may be one of the reliable indexes for the diagnosis and monitor of ovarian cancer.     

妈富隆联合宫腔镜治疗子宫内膜息肉

目的 探讨妈富隆联合宫腔镜在子宫内膜息肉中的治疗价值.方法 回顾性86例子宫内膜息肉患者的临床病理资料,均接受了宫腔镜下子宫内膜息肉钳夹或电切术,术后病理诊断均为良性子宫内膜息肉,其中46例术后口服妈富隆治疗3～6个月,另40例未服药患者为对照组,随访3～24个月.记录患者子宫内膜息肉的复发情况、月经恢复、超声下内膜厚度及再次宫腔镜检查结果 等,并作组间比较.结果 服用妈富隆组患者月经过多状况恢复正常,超声或再次宫腔镜检查有3例(3/46)内膜息肉复发,服药组患者月经中期内膜厚度均显著小于对照组(均P＜0.05),而同期接受宫腔镜治疗的未服药组,则有10例(10/40)内膜息肉复发.结论 宫腔镜下子宫内膜息肉手术联合服用妈富隆可有效改善月经过多状况.减少内膜厚度及内膜息肉复发.     

人血清激肽释放酶6在上皮性卵巢癌诊断及监测中的意义

Objective The aim of this study was to investigate the clinical value of human serum Kallikrein 6 for the diagnosis and monitor of pithelial ovarian cancer. Methods Serum levels of KLK6 were analyzed with ELISA in 30 cases of epithelial ovarian carcinoma, 20 cases of benign ovarian tumor and 30 cases of healthy women. In the meantime, serum CAi25 was determined with chemiluminescence. Furthermore, serum levels of KLK6 and CA125 were also detected in 12 case of epithelial ovarian carcinoma with the same methods one week and the 3rd month postoperation of follow-up. Results Serum levels of KLK6 in epithelial ovarian carcinoma was higher than that in benign ovarian tumor and healthy women (P < 0.05). KLK6 also showed positive correlation with clinical stage, cytological grade, pelvic lymph node metastasis, recurrent or dead disease (P < 0. 05). On the contrary, KLK6 showed no significant correlation with pathological types (P >0. 05). After surgery of follow-up, KLK6 and CA125 were significantly decreased in 12 case of epithelial ovarian carcinoma (P < 0. 05). Furthermore, the total sensitivity and specificity of KLK6 in the diagnosis of epithelial ovarian carcinoma was 73.3% and 85.0% respectively, followed by the sensitivity to be 50. 0% and 88. 9% for the diagnosis of stage Ⅰ-Ⅱand Ⅲ-Ⅳ disease. Conclusion Our resuits showed KLK6 may be one of the reliable indexes for the diagnosis and monitor of ovarian cancer.     

外阴HPV感染患者中宫颈HPV分型检测

目的：研究外阴尖锐湿疣（Condyloma acuminata，CA）和外阴鲍温样丘疹病（Bowenoid papulosis，BP）患者宫颈细胞人乳头瘤病毒（HPV）的检出情况，尝试为此类患者群的宫颈病变筛查或宫颈癌的防治提供流行病学依据。方法：选取自2007年1月至6月间在我院妇科门诊首次就诊的44例外阴CA和7例外阴BP患者，采集宫颈细胞应用导流杂交基因芯片技术（凯普HPV分型）行21种HPV—DNA亚型检测；同期检测54例慢性宫颈炎患者作对照。结果：外阴CA组和BP组的宫颈高危型HPV检出率分别为56．82％和85．71％，均显著大于对照组（20．37％），P〈0．01；外阴HPV感染组较对照组更易发生高危型HPV的多重感染（P〈0．05），其中以二重和三重感染为主；外阴CA患者的宫颈HPV感染以低危型11、6亚型为主，高危型HPV感染中以58、16、52亚型位居前三位，其中检出CINⅡ级1例；外阴BP组中宫颈HPV感染以16亚型为主，检出CINⅠ级、Ⅱ级共2例。结论：外阴CA和BP患者，临床体征明显，易于诊断，但可能会伴发宫颈高危型HPV感染，从而导致宫颈上皮内瘤变（CIN）甚至宫颈癌的发生。