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Etiologic Analysis of 57 Cases of Female Genital Fistula

目的：探讨女性生殖道瘘的病因及预防措施。方法：回顾性分析我院妇产科2000年1月至2005年12月收治入院的57例女性生殖道瘘病例的病因。结果：产伤和妇科手术占女性生殖道瘘病因的前两位，分别占56.1%（32/57）和33.3%（19/57）。结论：产伤和妇科手术是引起女性生殖道瘘的主要原因。加强围产期保健、积极处理产科合并症以及提高妇科手术技术是降低女性生殖道瘘发生率的关键因素。

Clinical Evaluation of ChlorquinaldolPromestriene Vaginal Tablets on the Vaginal Mucosa Restoration in Parturent Women

目的:评价氯喹那多普罗雌烯阴道片对产后阴道黏膜修复及防治生殖道感染的作用。方法:对212例产后6～8周复诊患者随机分为实验组92例和对照组120例。实验组给予氯喹那多普罗雌烯阴道片阴道上药,每日一片共18日;对照组仅给予温盐水清洁阴部。治疗前后检查两组的阴道分泌物情况。结果:用药前实验组与对照组比较生殖道状况均无统计学差异(Pgt;005)。用药后实验组生殖道状况正常为80%,而对照组正常仅为36%,两组比较差异有显著性(Plt;005)。实验组生殖道感染12例,无真菌和滴虫感染,均为非特异性阴道炎,患病率1304%,有效率8695%。对照组生殖道感染84例,有效率3000%,患病高低顺序依次为非特异性阴道炎4167%,真菌性阴道炎2083%,滴虫性阴道炎 750%。结论:氯喹那多普罗雌烯阴道片能有效治疗生殖道非特异性炎症,真菌性、滴虫性阴道炎,促进产后的阴道黏膜修复,防治产后生殖道感染。

Construction Workers Among Migrants- A Vulnerable Population for Accessing Reproductive Health ServicesQualitative Situation Analysis in Chengdu Construction Sites for Project YOLAMI

目的：调查了解成都市建筑工地工作的流动人口工人的生殖健康现状，为项目的干预打下基础。方法：采用定量调查和定性研究相结合的方法获取相关数据和信息。结果和结论：流动人口中的建筑工人的确是一个获取生殖健康知识和服务方面十分脆弱的人群：1)流动人群中的建筑工人们的健康状况不容乐观。他们大都看似健康，但健康知识贫乏、不重视自身生殖健康、寻求健康服务的行为单一且不安全；2)建筑公司和工地基本不允许女工在工期怀孕；除特殊工种外，工人没有体检；一般只给工人买工伤险，但没有医疗保险；3)流动人群中的建筑工人们对性与生殖健康方面的需求是迫切的。但他们求医难，寻求性与生殖健康服务更难。

Research on the Diagnostic Value of Ultrasonography in Examining Oblique Vaginal Septum Syndrome

【摘要】　目的　探讨超声检查对阴道斜隔综合征的诊断价值，分析超声图像特点，提高诊断率，为临床选用最佳的手术方式提供依据。　方法　回顾性分析2008年1月-2010年6月经手术确诊为阴道斜隔综合征的15例患者的临床资料及超声检查结果，总结阴道斜隔综合征的声像图特点。　结果　15例经临床确诊为阴道斜隔综合征的患者，超声诊断14例，均表现为双子宫、双宫颈、阴道或宫颈积液/血，9例左肾缺如，5例右肾缺如。误诊1例，为单子宫伴一侧附件巨大囊肿。　结论　超声具有诊断准确、简便、无创、重复性好、价格实惠等优点，对于临床诊断生殖系统畸形具有十分重要的意义，应列为首选检查方式。【Abstract】　Objective　To investigate the diagnostic value of ultrasonography in examining oblique vaginal septum syndrome, analyze the characteristics of ultrasound image to improve the ultrasound diagnosis rate, in order to provide guidance for clinical surgeries.　Methods　We retrospectively analyzed the clinical data and ultrasound examination results of 15 patients diagnosed to have oblique vaginal septum syndrome in our hospital, and summarized their ultrasonographic characteristics.　Results　Among the 15 patients, 14 were diagnosed to have the disease by ultrasound examination. The ultrasound image showed a double uterus, double cervix, and vaginal or cervical fluid or blood for all the patients among whom 9 had absent left kidney, and 5 had absent right kidney. One patient was misdiagnosed to have single uterus with giant cysts on one side.　Conclusions　Ultrasound diagnosis is simple, noninvasive, reproducible, affordable and accurate in diagnosing. It is very useful in clinical diagnosis of reproductive system abnormalities and should be listed as the preferred way of examinations.

CLITOROPLASTY FOR GENITAL VIRILIZATION IN GIRLS WITH CONGENITAL ADRENAL HYPERPLASIA

ObjectiveTo investigate the effectiveness of clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate for genital virilization in girls with congenital adrenal hyperplasia (CAH). MethodsBetween June 2000 and October 2015, 27 girls with genital virilization were treated with clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate. The chromosomal karyotype was 46, XX in all patients, whose age ranged from 3 to 11 years (mean, 3.9 years). According to Parder's virilization scale, 5 cases were classified as stage Ⅱ, 18 cases as stage Ⅲ, and 4 cases as stage Ⅳ. The hormone tests showed decreased cortisol level and increased testosterone and 17-hydroxyprogesterone levels. They were diagnosed with non-salt-wasting CAH. ResultsAll of the patients underwent clitoroplasty successfully. The mean operation time was 74 minutes (range, 58-95 minutes). Incision healed primarily. The patients were followed up 6 months to 10 years (median, 19 months). The external genitalia had good appearance, without necrosis of flap and the glans clitoris, abnormal sensation of the glans clitoris, or clitorism recurrence. Five girls had breast development and normal menstrual cycle during adolescence, and 1 patient who was followed up for 10 years gave birth to a son. ConclusionClitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate is a relatively ideal method for treating genital virilization in girls. It has less complications, good aesthetic and functional results. There are satisfactory outcomes when combining with the endocrine treatment.

细节管理在生殖医学中心护理管理中的应用

目的总结细节管理在生殖医学中心的实施与效果。 方法2011年8月－2012年7月，通过增强护士细节管理意识；完善护理常规、制度及各项技术操作规范；优化就诊环境、就诊流程；科学设置护理岗位；加强健康宣教；主动用心服务等措施实施细节管理。 结果加强细节管理后，护理服务质量得以提升，患者满意度较实施前的89%提升至97%，细节管理成效明显。 结论实施细节管理可有效提高护理质量，让患者获得更好的优质服务。

氟尿嘧啶湿敷治疗女性尖锐湿疣

【摘要】目的观察氟尿嘧啶(FU)注射液湿敷治疗女性生殖器尖锐湿疣(CA)的临床疗效。方法治疗组54例女性生殖器CA患者用FU湿敷,2次/d,每次30 min,共3 d,间隔7 d为1个疗程,共3个疗程(4周);对照组52例用电灼联合重组 α2b干扰素局部注射治疗,每次200万U, 1次/周,共4次。结果治疗组治愈率为827%,复发率为140%;对照组治愈率为740%,复发率为135%;两组比较,差异无统计学意义(Pgt;005)。结论用FU湿敷治疗女性生殖器CA复发率低。

Chinese practice guideline on the assisted reproductive technology (ART) strategies for women with advanced age

EFFECTIVENESS OF POSTERIOR SAGITTAL ANORECTOPLASTY AND TOTAL UROGENITAL MOBILIZATION IN TREATMENT OF CLOACAL MALFORMATION

ObjectiveTo investigate the effectiveness of posterior sagittal anorectoplasty (PSARP) and total urogenital mobilization in treatment of cloacal malformation. MethodsThree girls with cloacal malformation were admitted between June 2010 and June 2013. The age was 2 years, 5 months, and 4 months, respectively. All patients received previous separated sigmoid colostomy. PSARP and total urogenital mobilization were performed to correct the malformation. Colostomy stoma was closed after confirming the patent of rectum and anus. Dilation of anus was sustained for 6 months after anorectoplasty. ResultsOperations were successfully completed in 3 cases. The durations of operation were 3 hours and 40 minutes, 4 hours and 20 minutes, and 3 hours and 50 minutes; the blood loss was 10, 20, and 10 mL; and the time of colostomy stoma closure was 3, 5, and 3 months, respectively. Three cases were followed up 13, 18, and 4 months, respectively; no anal stenosis or rectal prolapse occurred. They had normal micturition; the B ultrasonic examination showed that the residual urine volume was less than 10 mL. At 12 months after anorectoplasty, the Wexner scores were 1 and 5 in 2 cases followed up 13 and 18 months; according to Krickenbeck postoperative effect, 2 cases had defecation and no constipation; 1 case had soiling (grade 1). ConclusionPSARP and total urogenital mobilization should be the first choice in treatment of cloacal malformation with common channel less than 3 cm.

干细胞治疗卵巢功能低下性不孕的研究进展和挑战

不孕不育发病率在世界范围内逐年增加，其中女性不孕患者50%～60%，其可能与生活环境及生活方式的改变有关。由于妇科恶性肿瘤发生率有逐年增加及年轻化趋势，卵巢功能缺陷或卵巢结构缺如导致生殖细胞缺陷的患者可能终身不孕，但干细胞移植治疗为这类患者带来了新的希望。干细胞是具有自我更新及多向分化潜能的未分化细胞，存在于胚胎、胎儿或成年各阶段，这些特点使其成为细胞治疗及再生医学领域的研究热点。理论上，在适宜条件下，干细胞能分化为包括雌性生殖细胞在内的三胚层不同类型细胞，进而形成机体不同组织及器官。现今，多能干细胞诱导分化为雌性生殖细胞的实验研究取得了一定的成果，因此，干细胞转分化为雌性生殖细胞从而进行细胞移植治疗及卵巢组织再生可能作为未来治疗不孕不育的新方法。此综述旨在总结干细胞向雌性生殖细胞转分化的研究进展及其应用于生殖医学所面临的挑战。