腹膜播散性平滑肌瘤病(leiomyomatosis peritonealis disseminate, LPD)是一种极罕见的发生在盆腹腔的良性肿瘤,大多数表现为平滑肌瘤结节弥散分布、种植于盆腹腔腹膜、输卵管系膜、肠系膜、大网膜、肠管、直肠子宫陷凹、卵巢及腹腔镜Tr...腹膜播散性平滑肌瘤病(leiomyomatosis peritonealis disseminate, LPD)是一种极罕见的发生在盆腹腔的良性肿瘤,大多数表现为平滑肌瘤结节弥散分布、种植于盆腹腔腹膜、输卵管系膜、肠系膜、大网膜、肠管、直肠子宫陷凹、卵巢及腹腔镜Trocar口。LPD多见于育龄期女性,发病机制尚不明确,主要有医源性学说、腹膜下间充质干细胞化生学说、性激素学说和遗传学说。患者大多缺乏典型的临床表现和体征,常在影像学检查或术中探查偶然发现,临床误诊率较高,且易与恶性肿瘤相混淆,导致临床过度治疗。国内外多为个案报道,且大多与医源性腹腔镜下肌瘤粉碎术后,肌瘤碎片播散有关,而非腹腔镜下子宫肌瘤剔除术后腹膜播散性平滑肌瘤病合并子宫内膜异位症鲜有报道。因此,该文报道一例非腹腔镜下子宫肌瘤剔除术后LPD合并子宫内膜异位症的病例,通过探讨患者的诊疗过程,总结诊疗经验,加深临床医生对该病的认识。Leiomyomatosis peritonealis disseminate (LPD) is an extremely rare benign tumor occurring in the pelvic cavity. The most common manifestations were diffuse distribution of leiomyoma nodules, and implantation in peritoneum, mesosalpinx, mesentery, omentum, bowel, rectum, excavatio rectouterina, ovaries, and laparoscopic Trocars. LPD tends to occur in fertile women, and its pathogenesis is still unclear, mainly including iatrogenic theory, subperitoneal mesenchymal stem cell metaplasia theory, sex hormone theory and genetic theory. Most of the patients lack specific clinical manifestations and signs, which are often accidentally found in imaging examinations or intraoperative exploration, and the clinical misdiagnosis rate is high, and it is easy to be confused with malignant tumors, leading to clinical overtreatment. Most cases have been reported at home and abroad, and most of them are related to the spread of fibroid fragments after iatrogenic laparoscopic uterine myomectomy, while there are few reports of peritoneal disseminated leiomyomatosis complicated with endometriosis after non-laparoscopic surgery. Therefore, this article reports a case of LPD complicated with endometriosis after non-laparoscopic surgery. By discussing the diagnosis and treatment process of the patient, summarizing the diagnosis and treatment experience, and deepening the clinician's understanding of the disease.展开更多
盆底功能障碍性疾病(pelvic floor dysfunction, PFD)是女性常见病,由于妊娠、分娩等因素导致盆底损伤时可引起盆腔器官脱垂(pelvic organ prolapse, POP)、尿失禁、粪失禁、性功能障碍等影响患者生活质量的一系列病症。该类疾病诊治较...盆底功能障碍性疾病(pelvic floor dysfunction, PFD)是女性常见病,由于妊娠、分娩等因素导致盆底损伤时可引起盆腔器官脱垂(pelvic organ prolapse, POP)、尿失禁、粪失禁、性功能障碍等影响患者生活质量的一系列病症。该类疾病诊治较为复杂,目前国内尚缺乏相应的诊治指南。本文对客观定量数据的相关研究进行了分析和简要总结。检索了从2000年到2024年7月,在Web of Science、Pub Med、MEDLINE、知网、维普、万方,中华医学期刊全文和相关的最新期刊上检索了用客观测量方法评估的怀孕和分娩对盆底功能检测的文章。将盆底肌电评估、盆底超声(US)、磁共振成像(MRI)、盆腔器官脱垂量化(POP-Q)、尿流动力学、盆底针肌电/神经生理等进行系统评估。产后6周至6月的客观测量可以早期识别出在以后的生活中容易出现盆底功能障碍的女性,并为咨询和预防性治疗策略提供机会。Pelvic floor dysfunction (PFD) is a common disease in women. Due to pregnancy, childbirth and other factors, pelvic floor injury can cause pelvic organ prolapse (POP), urinary incontinence, fecal incontinence, sexual dysfunction and other diseases that affect the quality of life of patients. The diagnosis and treatment of this kind of disease is complicated, and there is still a lack of corresponding diagnosis and treatment guidelines in China. This paper analyzes and briefly summarizes the related research of objective quantitative data. From 2000 to July 2024, we searched the full text of Web of Science, Pub Med, MEDLINE, CNKI, VIP, Wanfang, Chinese Medical Journal and related latest journals to retrieve articles on the detection of pelvic floor function in pregnancy and childbirth evaluated by objective measurement methods. Pelvic floor electromyography assessment, pelvic floor ultrasound (US), magnetic resonance imaging (MRI), pelvic organ prolapse quantification (POP-Q), urodynamics, pelvic floor needle electromyography/neurophysiology were systematically evaluated. Objective measurement from 6 weeks to 6 months after delivery can early identify women who are prone to pelvic floor dysfunction in later life and provide counseling.展开更多
国内将流产(Abortion Miscarriage)定义为妊娠未达到28周、胎儿体重不足1000 g而终止者。近年来,妊娠相关血浆蛋白A、胎盘生长因子、可溶性FMS样激酶、巨噬细胞抑制因子-1、超声等预测流产受到研究者的关注,文章阐述现有的流产预测方法...国内将流产(Abortion Miscarriage)定义为妊娠未达到28周、胎儿体重不足1000 g而终止者。近年来,妊娠相关血浆蛋白A、胎盘生长因子、可溶性FMS样激酶、巨噬细胞抑制因子-1、超声等预测流产受到研究者的关注,文章阐述现有的流产预测方法及其应用价值,以期为临床提供参考。Domestic abortion (abortion miscarriage) is defined as pregnancy does not reach 28 weeks and fetal weight is less than 1000 g. In recent years, pregnancy-related plasma protein A, plasma growth factor, soluble FMS-like kinase, macrophage inhibitory factor-1, and ultrasound have attracted the attention of researchers. This paper expounds the existing abortion prediction method and its application value, in order to provide reference for clinical practice.展开更多
围绝经期异常子宫出血(AUB)发病率高,病因多样,极为复杂,其临床表现大多为月经紊乱即月经的周期频率、规律性、经期长度、经期出血量与正常月经不同,严重者导致患者贫血甚至休克,明确诊断其病因对指导临床个体化治疗尤为重要。随着诊疗...围绝经期异常子宫出血(AUB)发病率高,病因多样,极为复杂,其临床表现大多为月经紊乱即月经的周期频率、规律性、经期长度、经期出血量与正常月经不同,严重者导致患者贫血甚至休克,明确诊断其病因对指导临床个体化治疗尤为重要。随着诊疗的规范化,门诊医生根据患者的临床表现、妇科查体以及实验室检查能大致了解其基本情况,但明确其病因还需影像学检查以及病理学检查。阴道超声、诊断性刮宫以及宫腔镜检查被广泛应用于围绝经期AUB患者病因诊断中,现就以上三种诊断方式的临床效用进行综述,为临床医生选择个体化诊断方式提供一定参考。The incidence of abnormal uterine bleeding in perimenopause is high, the etiology is varied and extremely complicated. Its clinical manifestations are menstrual disorders, that is, menstrual cycle frequency, menstrual length, menstrual bleeding is different from normal menstruation. Severe cases can lead to anemia and even shock. The clear diagnosis of its etiology is very important to guide clinical individualized treatment. With the standardization of diagnosis and treatment, the outpatient doctor can get a general idea of the condition based on the patient’s clinical manifestations, gynecological examination and laboratory examination. However, the definitive cause of the patient depends on imaging and pathological examination. Vaginal ultrasound, diagnostic curettage and hysteroscopy are widely used in the etiological diagnosis of abnormal uterine bleeding in perimenopausal patients. This article summarizes the clinical effectiveness of the above three diagnostic methods in order to provide some references for clinicians to choose individualized diagnostic methods.展开更多
目的:了解盆腔静脉内平滑肌瘤(Intrapelvic Venous Leiomyoma, IVL)的临床特点,鉴别诊断和治疗方法。方法:回顾性分析我院2024年1月住院手术并经病理证实的1例静脉内平滑肌瘤病例。结果:患者以“腹痛5天,加重半天”之主诉入院。于我院...目的:了解盆腔静脉内平滑肌瘤(Intrapelvic Venous Leiomyoma, IVL)的临床特点,鉴别诊断和治疗方法。方法:回顾性分析我院2024年1月住院手术并经病理证实的1例静脉内平滑肌瘤病例。结果:患者以“腹痛5天,加重半天”之主诉入院。于我院行腹腔镜下盆腔粘连松解 + 全子宫双附件切除术。取标本送病理检查,病理诊断:考虑静脉内平滑肌瘤(病理号:24-00729)妇科B超示:宫颈肥大,回声不均匀(5.2 × 4.6 cm)。术后切口愈合良好。结论:静脉内平滑肌瘤是一类罕见的妇科良性肿瘤,大多数为隐匿性起病,IVL的镜下组织结构与子宫肿瘤类似,临床上往往被误诊、漏诊,因此,对子宫肌瘤或子宫肌瘤手术史的患者,出现盆腔包块、阴道壁肿物、下腔静脉或心腔内肿物时,均应考虑本病的可能性,一旦发现应尽早手术切除,避免其继续进展。To understand the clinical characteristics, differential diagnosis and treatment of leiomyoma in the pelvic vein. Method: Retrospective analysis of our institute A case of intravenous leiomyoma confirmed by hospitalization in January 2024. Results: The patient was admitted to the hospital with “abdominal pain for 5 days, aggravated for half a day”. Laparoscopic pelvic adhesion loosening + total uterine double accessory resection was performed in our hospital. Take specimens and send them for pathological examination, pathological diagnosis: consider intravenous leiomyoma (pathological number: 24-00729). B-ultrasound: cervical hypertrophy, uneven echo (5.2 × 4.6 cm). The postoperative incision heals well. Conclusion: Intravenous leiomyoma is a rare gynecological benign tumor, most of which are occult onset. The microscopic tissue structure of IVL is similar to that of uterine tumors. Clinically, it is often misdiagnosed and missed. Therefore, for patients with a history of surgery for uterine fibroids or uterine fibroids, there are pelvic mass, wall tumors, inferior vena cava or heart. When there is a tumor in the cavity, the possibility of the disease should be considered. Once it is found, it should be surgically removed as soon as possible to avoid its continued development.展开更多
随着医疗技术的进步和人们健康意识的提高,对胎儿健康的关注日益增加。胎儿窘迫作为孕期的紧急医疗状况,长久以来一直是围产医学领域关注的焦点,不仅影响胎儿的健康发育,还可能导致不良的围产儿结局。胎儿窘迫的发生受多种高危因素的影...随着医疗技术的进步和人们健康意识的提高,对胎儿健康的关注日益增加。胎儿窘迫作为孕期的紧急医疗状况,长久以来一直是围产医学领域关注的焦点,不仅影响胎儿的健康发育,还可能导致不良的围产儿结局。胎儿窘迫的发生受多种高危因素的影响,主要包括母体的健康状况、脐带、胎盘异常、羊水污染、过期妊娠、胎位异常、缩宫素使用不当、胎膜早破等。其中,母亲的慢性疾病如高血压、糖尿病,以及胎盘早剥、脐带绕颈等是导致胎儿窘迫的主要风险因素。本文对近年来国内外文献进行总结,并结合研究结果,探讨胎儿窘迫发病的高危因素,旨在针对胎儿窘迫的高风险因素进行早期识别和干预,降低新生儿窒息、死亡等不良事件的发生率。With the progress of medical technology and the improvement of people’s health awareness, the attention to fetal health is increasing. Fetal distress, as an emergency medical condition during pregnancy, has long been the focus of attention in the field of perinatal medicine, which not only affects the healthy development of the fetus, but also may lead to adverse perinatal outcomes. The occurrence of fetal distress is related to many factors, including maternal health, placental function, abnormal umbilical cord, and improper use of oxytocin. Among them, the mother’s chronic diseases such as hypertension, diabetes, placental abruption, umbilical cord around the neck, etc. are the main risk factors leading to fetal distress. This paper summarizes the literature at home and abroad in recent years, and combined with the research results, discusses the high-risk factors of fetal distress, aiming at early identification and intervention of the high-risk factors of fetal distress, and reducing the incidence of neonatal asphyxia, death and other adverse events.展开更多
泛素蛋白酶体途径(Alterations in the ubiquitin-proteasome system UPS),是由泛素介导的一种高度复杂的蛋白降解系统,普遍参与各种生物学功能,例如细胞生长,细胞周期进程,DNA转录、损伤、修复和信号转导及自噬,因此在体内各种调节蛋...泛素蛋白酶体途径(Alterations in the ubiquitin-proteasome system UPS),是由泛素介导的一种高度复杂的蛋白降解系统,普遍参与各种生物学功能,例如细胞生长,细胞周期进程,DNA转录、损伤、修复和信号转导及自噬,因此在体内各种调节蛋白的降解和整体细胞的稳态中发挥着至关重要的作用。UPS的表达功能异常或改变可能导致蛋白质的积累,与人类多种疾病相关,包括恶性肿瘤、血液系统疾病等。其中泛素化是泛素蛋白酶体系统途径的关键步骤,PSMD2 (proteasome 26S subunit, non-ATPase 14)位于蛋白酶体26S亚基,是一种非ATP酶组分,是泛素–蛋白酶体的重要组成部分之一。近年来,其在疾病发生发展中的作用越来越受到关注,本文将对PSMD2的结构、作用机制及在不同疾病中的研究进展进行综述。展开更多
目前对于预测葡萄胎恶变的各相关因素已取得了很大的发展,但临床仍使用为期2年的HCG随访和影像学随访,因其随访时间较长,患者依从性下降,易导致葡萄胎恶变未被及时发现,从而导致病情恶化,延误治疗。本研究主要了解现阶段对预测葡萄胎恶...目前对于预测葡萄胎恶变的各相关因素已取得了很大的发展,但临床仍使用为期2年的HCG随访和影像学随访,因其随访时间较长,患者依从性下降,易导致葡萄胎恶变未被及时发现,从而导致病情恶化,延误治疗。本研究主要了解现阶段对预测葡萄胎恶变各相关因素的研究进展。为临床预测葡萄胎恶变,以期早期进行预防干预,降低恶变率提供一定的临床帮助。At present, significant progress has been made in predicting various factors related to the malignant transformation of hydatidiform moles. However, a 2-year HCG follow-up and imaging follow-up are still used in clinical practice. Due to their long follow-up time and decreased patient compliance, it is easy for the malignant transformation of hydatidiform moles to not be detected in a timely manner, leading to worsening of the disease and delayed treatment. This study mainly aims to understand the current research progress on various related factors for predicting the malignant transformation of hydatidiform mole. To provide clinical assistance in predicting the malignant transformation of hydatidiform mole and early preventive intervention to reduce the incidence of malignant transformation.展开更多
目的探讨不同分娩方式对剖宫产术后再次妊娠产妇分娩结局以及新生儿结局的影响。方法回顾性分析2013年5月至2014年5月延安大学附属医院收治的单胎、足月、头位待产的剖宫产术后再次妊娠的产妇90例,其中50例行剖宫产术(观察组),40例自然...目的探讨不同分娩方式对剖宫产术后再次妊娠产妇分娩结局以及新生儿结局的影响。方法回顾性分析2013年5月至2014年5月延安大学附属医院收治的单胎、足月、头位待产的剖宫产术后再次妊娠的产妇90例,其中50例行剖宫产术(观察组),40例自然分娩(对照组)。观察并记录产妇分娩结局以及新生儿结局。结果观察组产妇出血量、住院时间显著高于对照组[(322.1±10.9)m L比(240.5±15.9)m L、(10.7±2.5)d比(5.2±1.9)d](P<0.05)。观察组产妇新生儿1 min Apgar评分显著低于对照组[(8.2±0.3)分比(9.4±0.4)分](P<0.05)。观察组产妇羊水污染发生率明显高于对照组[42.0%(22/50)比22.5%(9/40)](P<0.05)。两组患者新生儿产瘤发生率差异无统计学意义(P>0.05)。观察组产妇分娩后产褥感染、产后出血等并发症的总发生率显著高于对照组[28.0%(14/50)比10.0%(4/40)](P<0.05),新生儿并发症如新生儿窒息、肺炎等并发症总发生率也显著高于对照组[32.0%(16/50)比10.0%(4/40)](P<0.05)。结论对于剖宫产后再次妊娠的产妇建议选用自然分娩方式,不仅能减少手术带来的损伤,促进产妇身体恢复,而且有利于减少新生儿产科并发症。展开更多
文摘腹膜播散性平滑肌瘤病(leiomyomatosis peritonealis disseminate, LPD)是一种极罕见的发生在盆腹腔的良性肿瘤,大多数表现为平滑肌瘤结节弥散分布、种植于盆腹腔腹膜、输卵管系膜、肠系膜、大网膜、肠管、直肠子宫陷凹、卵巢及腹腔镜Trocar口。LPD多见于育龄期女性,发病机制尚不明确,主要有医源性学说、腹膜下间充质干细胞化生学说、性激素学说和遗传学说。患者大多缺乏典型的临床表现和体征,常在影像学检查或术中探查偶然发现,临床误诊率较高,且易与恶性肿瘤相混淆,导致临床过度治疗。国内外多为个案报道,且大多与医源性腹腔镜下肌瘤粉碎术后,肌瘤碎片播散有关,而非腹腔镜下子宫肌瘤剔除术后腹膜播散性平滑肌瘤病合并子宫内膜异位症鲜有报道。因此,该文报道一例非腹腔镜下子宫肌瘤剔除术后LPD合并子宫内膜异位症的病例,通过探讨患者的诊疗过程,总结诊疗经验,加深临床医生对该病的认识。Leiomyomatosis peritonealis disseminate (LPD) is an extremely rare benign tumor occurring in the pelvic cavity. The most common manifestations were diffuse distribution of leiomyoma nodules, and implantation in peritoneum, mesosalpinx, mesentery, omentum, bowel, rectum, excavatio rectouterina, ovaries, and laparoscopic Trocars. LPD tends to occur in fertile women, and its pathogenesis is still unclear, mainly including iatrogenic theory, subperitoneal mesenchymal stem cell metaplasia theory, sex hormone theory and genetic theory. Most of the patients lack specific clinical manifestations and signs, which are often accidentally found in imaging examinations or intraoperative exploration, and the clinical misdiagnosis rate is high, and it is easy to be confused with malignant tumors, leading to clinical overtreatment. Most cases have been reported at home and abroad, and most of them are related to the spread of fibroid fragments after iatrogenic laparoscopic uterine myomectomy, while there are few reports of peritoneal disseminated leiomyomatosis complicated with endometriosis after non-laparoscopic surgery. Therefore, this article reports a case of LPD complicated with endometriosis after non-laparoscopic surgery. By discussing the diagnosis and treatment process of the patient, summarizing the diagnosis and treatment experience, and deepening the clinician's understanding of the disease.
文摘盆底功能障碍性疾病(pelvic floor dysfunction, PFD)是女性常见病,由于妊娠、分娩等因素导致盆底损伤时可引起盆腔器官脱垂(pelvic organ prolapse, POP)、尿失禁、粪失禁、性功能障碍等影响患者生活质量的一系列病症。该类疾病诊治较为复杂,目前国内尚缺乏相应的诊治指南。本文对客观定量数据的相关研究进行了分析和简要总结。检索了从2000年到2024年7月,在Web of Science、Pub Med、MEDLINE、知网、维普、万方,中华医学期刊全文和相关的最新期刊上检索了用客观测量方法评估的怀孕和分娩对盆底功能检测的文章。将盆底肌电评估、盆底超声(US)、磁共振成像(MRI)、盆腔器官脱垂量化(POP-Q)、尿流动力学、盆底针肌电/神经生理等进行系统评估。产后6周至6月的客观测量可以早期识别出在以后的生活中容易出现盆底功能障碍的女性,并为咨询和预防性治疗策略提供机会。Pelvic floor dysfunction (PFD) is a common disease in women. Due to pregnancy, childbirth and other factors, pelvic floor injury can cause pelvic organ prolapse (POP), urinary incontinence, fecal incontinence, sexual dysfunction and other diseases that affect the quality of life of patients. The diagnosis and treatment of this kind of disease is complicated, and there is still a lack of corresponding diagnosis and treatment guidelines in China. This paper analyzes and briefly summarizes the related research of objective quantitative data. From 2000 to July 2024, we searched the full text of Web of Science, Pub Med, MEDLINE, CNKI, VIP, Wanfang, Chinese Medical Journal and related latest journals to retrieve articles on the detection of pelvic floor function in pregnancy and childbirth evaluated by objective measurement methods. Pelvic floor electromyography assessment, pelvic floor ultrasound (US), magnetic resonance imaging (MRI), pelvic organ prolapse quantification (POP-Q), urodynamics, pelvic floor needle electromyography/neurophysiology were systematically evaluated. Objective measurement from 6 weeks to 6 months after delivery can early identify women who are prone to pelvic floor dysfunction in later life and provide counseling.
文摘国内将流产(Abortion Miscarriage)定义为妊娠未达到28周、胎儿体重不足1000 g而终止者。近年来,妊娠相关血浆蛋白A、胎盘生长因子、可溶性FMS样激酶、巨噬细胞抑制因子-1、超声等预测流产受到研究者的关注,文章阐述现有的流产预测方法及其应用价值,以期为临床提供参考。Domestic abortion (abortion miscarriage) is defined as pregnancy does not reach 28 weeks and fetal weight is less than 1000 g. In recent years, pregnancy-related plasma protein A, plasma growth factor, soluble FMS-like kinase, macrophage inhibitory factor-1, and ultrasound have attracted the attention of researchers. This paper expounds the existing abortion prediction method and its application value, in order to provide reference for clinical practice.
文摘围绝经期异常子宫出血(AUB)发病率高,病因多样,极为复杂,其临床表现大多为月经紊乱即月经的周期频率、规律性、经期长度、经期出血量与正常月经不同,严重者导致患者贫血甚至休克,明确诊断其病因对指导临床个体化治疗尤为重要。随着诊疗的规范化,门诊医生根据患者的临床表现、妇科查体以及实验室检查能大致了解其基本情况,但明确其病因还需影像学检查以及病理学检查。阴道超声、诊断性刮宫以及宫腔镜检查被广泛应用于围绝经期AUB患者病因诊断中,现就以上三种诊断方式的临床效用进行综述,为临床医生选择个体化诊断方式提供一定参考。The incidence of abnormal uterine bleeding in perimenopause is high, the etiology is varied and extremely complicated. Its clinical manifestations are menstrual disorders, that is, menstrual cycle frequency, menstrual length, menstrual bleeding is different from normal menstruation. Severe cases can lead to anemia and even shock. The clear diagnosis of its etiology is very important to guide clinical individualized treatment. With the standardization of diagnosis and treatment, the outpatient doctor can get a general idea of the condition based on the patient’s clinical manifestations, gynecological examination and laboratory examination. However, the definitive cause of the patient depends on imaging and pathological examination. Vaginal ultrasound, diagnostic curettage and hysteroscopy are widely used in the etiological diagnosis of abnormal uterine bleeding in perimenopausal patients. This article summarizes the clinical effectiveness of the above three diagnostic methods in order to provide some references for clinicians to choose individualized diagnostic methods.
文摘目的:了解盆腔静脉内平滑肌瘤(Intrapelvic Venous Leiomyoma, IVL)的临床特点,鉴别诊断和治疗方法。方法:回顾性分析我院2024年1月住院手术并经病理证实的1例静脉内平滑肌瘤病例。结果:患者以“腹痛5天,加重半天”之主诉入院。于我院行腹腔镜下盆腔粘连松解 + 全子宫双附件切除术。取标本送病理检查,病理诊断:考虑静脉内平滑肌瘤(病理号:24-00729)妇科B超示:宫颈肥大,回声不均匀(5.2 × 4.6 cm)。术后切口愈合良好。结论:静脉内平滑肌瘤是一类罕见的妇科良性肿瘤,大多数为隐匿性起病,IVL的镜下组织结构与子宫肿瘤类似,临床上往往被误诊、漏诊,因此,对子宫肌瘤或子宫肌瘤手术史的患者,出现盆腔包块、阴道壁肿物、下腔静脉或心腔内肿物时,均应考虑本病的可能性,一旦发现应尽早手术切除,避免其继续进展。To understand the clinical characteristics, differential diagnosis and treatment of leiomyoma in the pelvic vein. Method: Retrospective analysis of our institute A case of intravenous leiomyoma confirmed by hospitalization in January 2024. Results: The patient was admitted to the hospital with “abdominal pain for 5 days, aggravated for half a day”. Laparoscopic pelvic adhesion loosening + total uterine double accessory resection was performed in our hospital. Take specimens and send them for pathological examination, pathological diagnosis: consider intravenous leiomyoma (pathological number: 24-00729). B-ultrasound: cervical hypertrophy, uneven echo (5.2 × 4.6 cm). The postoperative incision heals well. Conclusion: Intravenous leiomyoma is a rare gynecological benign tumor, most of which are occult onset. The microscopic tissue structure of IVL is similar to that of uterine tumors. Clinically, it is often misdiagnosed and missed. Therefore, for patients with a history of surgery for uterine fibroids or uterine fibroids, there are pelvic mass, wall tumors, inferior vena cava or heart. When there is a tumor in the cavity, the possibility of the disease should be considered. Once it is found, it should be surgically removed as soon as possible to avoid its continued development.
文摘随着医疗技术的进步和人们健康意识的提高,对胎儿健康的关注日益增加。胎儿窘迫作为孕期的紧急医疗状况,长久以来一直是围产医学领域关注的焦点,不仅影响胎儿的健康发育,还可能导致不良的围产儿结局。胎儿窘迫的发生受多种高危因素的影响,主要包括母体的健康状况、脐带、胎盘异常、羊水污染、过期妊娠、胎位异常、缩宫素使用不当、胎膜早破等。其中,母亲的慢性疾病如高血压、糖尿病,以及胎盘早剥、脐带绕颈等是导致胎儿窘迫的主要风险因素。本文对近年来国内外文献进行总结,并结合研究结果,探讨胎儿窘迫发病的高危因素,旨在针对胎儿窘迫的高风险因素进行早期识别和干预,降低新生儿窒息、死亡等不良事件的发生率。With the progress of medical technology and the improvement of people’s health awareness, the attention to fetal health is increasing. Fetal distress, as an emergency medical condition during pregnancy, has long been the focus of attention in the field of perinatal medicine, which not only affects the healthy development of the fetus, but also may lead to adverse perinatal outcomes. The occurrence of fetal distress is related to many factors, including maternal health, placental function, abnormal umbilical cord, and improper use of oxytocin. Among them, the mother’s chronic diseases such as hypertension, diabetes, placental abruption, umbilical cord around the neck, etc. are the main risk factors leading to fetal distress. This paper summarizes the literature at home and abroad in recent years, and combined with the research results, discusses the high-risk factors of fetal distress, aiming at early identification and intervention of the high-risk factors of fetal distress, and reducing the incidence of neonatal asphyxia, death and other adverse events.
文摘泛素蛋白酶体途径(Alterations in the ubiquitin-proteasome system UPS),是由泛素介导的一种高度复杂的蛋白降解系统,普遍参与各种生物学功能,例如细胞生长,细胞周期进程,DNA转录、损伤、修复和信号转导及自噬,因此在体内各种调节蛋白的降解和整体细胞的稳态中发挥着至关重要的作用。UPS的表达功能异常或改变可能导致蛋白质的积累,与人类多种疾病相关,包括恶性肿瘤、血液系统疾病等。其中泛素化是泛素蛋白酶体系统途径的关键步骤,PSMD2 (proteasome 26S subunit, non-ATPase 14)位于蛋白酶体26S亚基,是一种非ATP酶组分,是泛素–蛋白酶体的重要组成部分之一。近年来,其在疾病发生发展中的作用越来越受到关注,本文将对PSMD2的结构、作用机制及在不同疾病中的研究进展进行综述。
文摘目前对于预测葡萄胎恶变的各相关因素已取得了很大的发展,但临床仍使用为期2年的HCG随访和影像学随访,因其随访时间较长,患者依从性下降,易导致葡萄胎恶变未被及时发现,从而导致病情恶化,延误治疗。本研究主要了解现阶段对预测葡萄胎恶变各相关因素的研究进展。为临床预测葡萄胎恶变,以期早期进行预防干预,降低恶变率提供一定的临床帮助。At present, significant progress has been made in predicting various factors related to the malignant transformation of hydatidiform moles. However, a 2-year HCG follow-up and imaging follow-up are still used in clinical practice. Due to their long follow-up time and decreased patient compliance, it is easy for the malignant transformation of hydatidiform moles to not be detected in a timely manner, leading to worsening of the disease and delayed treatment. This study mainly aims to understand the current research progress on various related factors for predicting the malignant transformation of hydatidiform mole. To provide clinical assistance in predicting the malignant transformation of hydatidiform mole and early preventive intervention to reduce the incidence of malignant transformation.
文摘目的探讨不同分娩方式对剖宫产术后再次妊娠产妇分娩结局以及新生儿结局的影响。方法回顾性分析2013年5月至2014年5月延安大学附属医院收治的单胎、足月、头位待产的剖宫产术后再次妊娠的产妇90例,其中50例行剖宫产术(观察组),40例自然分娩(对照组)。观察并记录产妇分娩结局以及新生儿结局。结果观察组产妇出血量、住院时间显著高于对照组[(322.1±10.9)m L比(240.5±15.9)m L、(10.7±2.5)d比(5.2±1.9)d](P<0.05)。观察组产妇新生儿1 min Apgar评分显著低于对照组[(8.2±0.3)分比(9.4±0.4)分](P<0.05)。观察组产妇羊水污染发生率明显高于对照组[42.0%(22/50)比22.5%(9/40)](P<0.05)。两组患者新生儿产瘤发生率差异无统计学意义(P>0.05)。观察组产妇分娩后产褥感染、产后出血等并发症的总发生率显著高于对照组[28.0%(14/50)比10.0%(4/40)](P<0.05),新生儿并发症如新生儿窒息、肺炎等并发症总发生率也显著高于对照组[32.0%(16/50)比10.0%(4/40)](P<0.05)。结论对于剖宫产后再次妊娠的产妇建议选用自然分娩方式,不仅能减少手术带来的损伤,促进产妇身体恢复,而且有利于减少新生儿产科并发症。
