目的  为下一步子宫铣削做好准备，从而提高人正常离体子宫薄层切片数据集的质量。方法 从正常成年女性新鲜尸体上获取子宫标本;对子宫标本行CT 扫描及MRI扫描，扫描间隔分别为1mm和2mm;进行单器官动静脉灌注。结果 ①灌注前CT及MRI扫描均未发现病变。②获取子宫动脉血管网灌注子宫CT扫描图像351张，子宫静脉血管网灌注子宫CT扫描图像341张;子宫动脉血管网灌注子宫MRI扫描图像43张，子宫静脉血管网灌注子宫MRI扫描图像62张。结论 铣削前预处理后子宫动静脉血管网清晰可见，为铣削、铣削切片图像的采集及将来的血管显示打下了良好的基础。Objective To preprocess the specimen before milling for a better quality of thin-slice data set of normal in-vitro uterine. Methods The normal in-vitro uterine specimen was obtained from a fresh adult female corpse. Computer tomography (CT) and magnetic resonance imaging (MRI) were conducted with scanning interval of 1mm and 2mm. Mono-organ arteriovenous perfusion were carried out. Results (1) No lesions were identified by CT and MRI scanning before perfusion; (2) 351 CT images and 43 MRI images were obtained from arterial vascular perfusion phase , 341 CT images and 62 MRI images were obtained from venous

目的:确定羊膜腔穿刺有关核心信息，使内容更加规范、完整，同时也使公众对羊膜腔穿刺有正确的认识。方法:运用特尔菲法进行2轮专家咨询，回收率均为100%。结果:调查表内所有核心信息基本都得到了专家的重视及肯定，最终针对医务人员及公众分别确定了18项及9项核心信息。结论:专家的权威性、积极性及代表性高，所确定的核心信息可作为羊膜腔穿刺的核心信息并可在医务人员及公众中普及。To establish the core information of amniocentesis, and to make it more standardized and complete, and to inform the public the correct information about amniocentesis. Methods: We used Delphi questionnaires to consult relevant experts for twice. The response rate achieved 100 %. Results: All the core information in the questionnaires had got great attention and recognition. 18 and 9 core information were identified for the medical staff and the public separately. Conclusion: Experts showed great authority, enthusiasm and representative. The identified core information could be considered as the core information of amniocentesis, and could be widely applied by the medical staff and the public in future.

探讨宫颈促成熟球囊用于足月妊娠促宫颈成熟的安全性及有效性。方法 选择西安交通大学医学院第一附属医院2011年2~10月有计划分娩指征的足月妊娠初产妇90例，随机分为两组，45例用宫颈促成熟球囊计划分娩为研究组，45例应用普贝生计划分娩促宫颈成熟为对照组。对两组促宫颈成熟情况及计划分娩效果、应用后至临产时间、分娩方式、分娩结局以及不良反应进行比较分析。结果 研究组放置球囊12小时后自然临产率为57.78％，明显高于对照组34.07％(χ2=6.02，p<0.05);研究组宫颈成熟率为100.00％，显著高于对照组79.02％(χ2=32.72，p <0.05);阴道分娩成功率明显高于对照组(χ2=6.11，p <0.05);研究组无母儿不良结局，对照组6例发生强制宫缩，4例发生胎儿窘迫，两组母儿不良结局有显著性差异，剖宫产率明显低于对照组(χ2=6.04，p <0.05)。结论 宫颈促成熟球囊计划分娩效果明显优于普贝生，无不良副作用，值得临床推广。To investigate safety and effectiveness of double-balloon device of promoting cervical ripening in planned delivery.Methods 90 primiparae who had indications of planned delivery in the First Affiliated Hospital of Medical College,Xi’an Jiaotong University from February to October,2011 were randomly divided into two group:study group(n=45,who were placed adouble-balloon device of cervical ripening) and control group(n=45,who were given PropessTM through vaginal).Cervical ripening situation,effect of planned delivery,time ftrom placement of the double-balloon device to onset of labor,pattern of delivery,delivery outcome and adverse reactions in the two groups were compared.Results 26 parturient women in the study group delivered naturally within 12 hours after using the double-balloon device with effective rate of 57.78% and 12 parturient women in the control group did so with effective rate of 34.07%.The effeetive rate in the study group was significantly higher than that in the control group(χ2=6.02,p<0.05). rhe cervical ripening rate in the study group was 100%,which was significantly higher than 79.02% in the control group (χ2=32.72,p<0.05).The successful rate of vaginal delivery in the study group was significantly higher than that in the control group (χ2=6.11,p<0.05).There were no maternal and neonatal adverse outcomes in study group, 6 cases with forced contractions and 4 cases with fetal distress were in control group. There were significantly differences between the two groups in maternal and neonatal outcomes, cesarean section rate in the study group was significantly lower than the control group(χ2=6.04,p<0.05).Conclusion In promoting ripening of the cervix,double-balloon device is significantly better than PropessTM through vaginal.So the application of double-balloon device of cervical ripening should be popularized in clinic.

目的:探讨妊娠期甲状腺功能筛查的必要性及妊娠期亚临床甲状腺功能减退症(SCH)左旋甲状腺素(L-T4)替代治疗的安全性及有效性。方法:对2009年4月至2010年4月在我院产科做产前保健检查的孕20周以前的孕妇964例，进行甲状腺功能的筛查，将确诊SCH的孕妇分为治疗组和对照组，治疗组根据TSH水平，孕期予50~75ug LT4治疗，对照组不予干预，每隔4周复查两组孕妇TSH及TT4直至分娩，观察治疗组与对照组的围生期结局，进行统计学分析。结果:964例孕妇初次筛查TSH值范围在0.011~14.047mU/L之间，均数为1.568 mU/ L，P2.5为0.078 mU/ L，P5为0.190 mU/ L ，P95为3.568 mU/ L，P97.5为4.571 mU/ L;诊断临床甲减2例(发病率0.2%)，亚临床甲亢2例(发病率0.2%)，SCH68例(发病率7.05%);在接受L-T4治疗的23例SCH孕妇中，无1例治疗导致不良妊娠结局发生，SCH孕妇LT4治疗组与对照组围生期结局差异无统计学意义。结论:深圳市孕妇甲状腺功能异常的发病率偏高，故妊娠期甲状腺功能的筛查是非常必要的，孕期适量的L-T4替代治疗对母儿是安全的。Objective: To investigate the necessity for screening of thyroid function during pregnancy, and the safety and efficacy of gestational subclinical hypothyroidism levothyroxine replacement therapy. Methods: 964 pregnant women less than 20 weeks for obstetric examination from April 2009 to April 2010 were selected and accepted thyroid function screening. Subclinical hypothyroidism women were divided into the treatment group and control group. The treatment group received 50-75ug LT4 according to TSH level while the control group received no intervention. The levels of TSH and TT4 were reviewed every four weeks until delivery and perinatal outcomes were observed and analyzed statistically for the two groups. Results: TSH value for 964 cases of pregnant women first screening range from 0.011 to 14.047 mU/L, mean 1.568 mU/L, P2.5 0.078 mU/L, P5 0.190 mU/L, P95 3.568mU/L, P97.5 4.571mU/L.2 cases were diagnosed as clinical hypothyroidism(0.2% incidence),2 subclinical hyperthyroidism(0.2% incidence) and 68 subclinical hypothyroidism(7.05% incidence). No LT4 treatment adverse pregnancy outcome occurred for 23 SCH pregnant women. The difference of perinatal outcome between the treatment group and the control group was not statistically significant. Conclusions: The incidience of thyroid malfunction was high in pregnant women of Shenzhen City.It is necessary to screen the thyroid function during pregnancy and it is safe for mother and child to receive appropriate dose of levorotatory thyroid hormone replacement therapy during pregnancy period.

【目的】分析年轻子宫内膜癌患者临床病例特点、预后及影响因素。【方法】选取中山大学附属第一医院1996年1月~2007年1月间 290例子宫内膜癌患者，回顾性分析≤45岁组和＞45岁组病例的年龄、手术病理分期及病理特征,对所有病例进行随访。 【结果】1.我院该阶段≤45岁的子宫内膜癌患者占同期全部内膜癌患者的比例有增加趋势，平均发病年龄有向前推移。2. 两组各期别所占比例均无显著性差异。两组中Ia-Ib的比例占多数，分别为68.5%和65.4%，差异无统计学意义(P>0.05)。3.与＞45岁组相比，≤45岁组高分化子宫内膜样腺癌，Ia+Ib期所占比例较高(P<0.05)。生存时间及无进展生存时间均较长(P<0.05)。【结论】45岁以下妇女子宫内膜癌的发病呈上升趋势;大多数为高分化子宫内膜样腺癌，手术-病理分期早, 预后较好;影响预后的主要因素是病理类型及卵巢转移.[Objective]Analyse clinical presentation and prognosis and the influence factors of endometrial carcinoma patients aged 45 years and younger.[Method] 290 cases of endometrial carcinoma from the First Affiliated Hospital of Sun Yat-Sen University from Jan 1996 to Jan 2006 were divided into tow groups of younger below age 45 years old  and elder above 45 years old. Analyze age,operation-pathology stage and pathology features retrospectively, follow up all cases.[Results]1. The percentage of endometrial carcinoma in young women below 45 years old in our hospital increased, average age went ahead.2.there was no significant difference in operation-pathology stage between the two groups(P>0.05),Ia-Ib cases were most in both groups,percentages were 68.5 and 65.4% respectively.3.Compared with elder above 45 years old,more cases took good differention,early stage and long survival time in younger below 45 years old ,and the difference is significant(P<0.05). [Conclusion] The percentage of young patients below 45 years old with endometrial carcinoma has been increased in our hospital.Most cases  manifested well differentiated endometrioid adenocarcinoma, early operation-pathology stage,and better prognosis.Influence factor of prognosis were pathologic types and ovarian metastasis.

目的 探讨宫内外同时妊娠(HP)的病因、诊断及治疗方法。方法 回顾2007年7月至2009年7月广州医学院第三附属医院妇产科住院部6例明确诊断为宫内外同时妊娠的患者资料，并分析HP的病因、诊断方法、鉴别诊断、治疗方法及妊娠结局。结果 6例患者诊断孕周为6至10周，其中有5例为体外授精-胚胎移植(IVF-ET)术后，1例为人工授精(AIH)后受孕;5例入院前B超发现宫内外同时妊娠，有1例先兆流产入院治疗复查B超发现;均住院接受手术治疗，5例术后即予抗炎及保胎治疗，治愈出院，随访足月分娩;1例术后即予抗炎，3天后予保胎治疗，但术后第6天宫内妊娠流产。结论 有盆腔炎性疾病后遗症及人工助孕病史等高危因素者在B超检查诊断HP后，应及早行手术联合术后保胎治疗，以提高宫内胎儿预后。【Abstract】 objective To investigate the pathogenesis、diagnosis and treatment of heterotopic pregnancy(HP).Methods This retrospective study was conducted in six cases of HP diagnosed from all ectopic pregnancy from July 2007 to July 2009 at inpatient department of the Third Affiliated Hospital of Guangzhou Medical College. The clinical data of the patients were reviewed and the pathogenesis, diagnosis and treatment of HP were analyzed.Results Among the of all 6 cases whose gestational week were 6 weeks to 10 weeks, , 5 cases were pregnant by IVF-ET, one case was pregnant by AIH. All of them were diagnosed by ultrasonography detection and treated laparoscopic surgery. Five patients received anti-inflammatory and miscarriage treatment postoperatively were cured and had successful full-term delivery. One patient received anti-inflammatory treatment and miscarriage treatment the first day and the 3rd day postoperatively,suffered abortion 6 days after surgery. Conclusion someone has the risk factors such as pelvic inflammatory disease and artificial help pregnant history if been diagnosed by ultrasonography detection, should be arranged laparoscopic surgery as early as possible to improve prognosis.