经尿道电切术加2.5％5-氟尿嘧啶局部灌注治疗男性尿道内尖锐湿疣

目的：探讨经尿道电切术及2．5％5-氟尿嘧啶治疗尿道内尖锐湿疣的疗效及安全性。方法：对尿道内尖锐湿疣进行经尿道电切术加5-氟尿嘧啶局部灌注治疗。结果：治疗15例,治愈13例,尿道内复发2例。结论：经尿道电切术加2．5％氟尿嘧啶局部灌注治疗尿道内尖锐湿疣是一种安全有效的治疗方法。     

Application of tumor markers in ovarian malignancies

Ovarian cancer is the fifth leading cause of death in women. The incidence of this malignancy increases in women over the age of 40. The overall five years survival is less than 30%, as most women present with advanced stage disease. Until recently, detection of early stage ovarian cancer has been difficult since it is usually nonpalpable and asymptomatic. The definitive diagnosis of an ovarian mass is a common problem in gynecologic patients with adnexal mass. The routine standard evaluation for adnexal masses includes patient's history, physical examination, ultrasound and histopathological examination. These parameters individually or in combination have little predictive value. The accuracy of diagnostic tools are of immense value and great concern to practicsing Gynecologists and Oncologists. The clinical application of serum concentration of CA 125, AFP and hCG is of great help not only as diagnostic aid but also in monitoring efficacy of any treatment modality like chemotherapy, radiotherapy or surgical resection. Additionally, evaluation of tumor marker concentration helps in predicting early biochemical recurrence and in prognostication in different types of ovarian malignancies. The ability to differentiate a malignant mass from a benign pelvic mass pretherapeutically could be enhanced optimally by additional use of tumor markers such as cancer antigen CA-125, alphafetoprotein and human chorionic gonadotrophin in pre-and postmenopausal women.     

乳腺癌患者保留肋间臂神经的临床意义

目的：探讨乳腺癌腋窝淋巴结清扫术保留肋间臂神经的价值。方法：对天津医科大学附属肿瘤医院2000．1-2001．12月间69例保留肋间臂神经和34例切除肋间臂神经的乳腺癌患者进行随访。结果：肋间臂神经保留组术后48例无感觉方面上的变化，11例发生感觉麻木，1例上肢出现烧灼感，9例上肢出现感觉减退；而肋间臂神经切除组术后3例出现腋窝无汗．18例发生感觉麻木，4例上肢出现烧灼感，9例上肢出现感觉减退。两组之间在统计学上有显著性差异（x^2=48．1570；P〈0．05）；肋间臂神经保留组58例术后未发生患肢疼痛，11例发生患肢疼痛；而肋问臂神经切除组5例术后未发生患肢疼痛，29例术后发生患肢疼痛。两组患者之间在统计学上有显著性差异（x^2=46．1194；P〈0．05）。结论：乳腺癌患者保留肋间臂神经可以明显减少术后患侧上肢感觉障碍和疼痛的发生，从而提高患者的生活质量。     

草鱼鳃上台湾棘带吸虫囊蚴内种群空间格局参数的月变化

报道草鱼鳃上台湾称带吸虫囊蚴内种群的空间格局参数。从1993年8月至1994年4月为期9个月的研究发现：囊蚴内种群每月的方差均较大,且方差／均值都大于1,扩散性指标也大于1,表明囊蚴在草鱼鳃上呈聚集分布;囊蚴内种群每月的平均密度、平均拥挤度、聚块性指标起不相同,表明囊蚴分布的聚集强度各不相同,由负二项参数K值反映出聚集的强度变化,K值越大聚集强度越小,K值越小,聚集强度越大。     

Dynamic measurements of serum inhibin B and estradiol: apredictive evaluation of ovarian response to gonadotrophin stimulation in the early stage of IVF treatment

Objective: We dynamically measured serum inhibin B and estradiol in the early stage of hormonal stimulation to predict the ovarian response in in vitro fertilization (IVF) treatment. Methods: A total of 57 patients (<40 years of age) who un-derwent the first cycle of long protocol IVF or introcytoplasmic sperm injection (ICSI) treatment were included. Serum inhibin B, estradioi, follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were measured four times: (i) on Day 3 of the menstrual cycle (basal); (2) on the day before the first administration of gonadotrophin (Gn) (Day 0); (3) on Day 1 of Gn therapy; and (4) on Day 5 of Gn therapy. Comparisons of these measurements with ovarian responses and pregnancy outcomes were made and analyzed statistically. Results: (1) On Day 1 and Day 5 of recombinant FSH (rFSH) stimulation, ovarian response, i.e., numbers of follicles, oocytes, fertilized oocytes, and embryos, had a positive correlation (rS=0.46～0.61, P=0.000) with raised inhibin B and estradiol concentrations, but a negative correlation (rS=-0.67～-0.38, P=0.000 or P<0.01) with total rFSH dose and total days ofrFSH stimulation. (2) No significant variation (P>0.05) between the pregnant and non-pregnant groups on the basis of mean age or on all hormone concentrations at four times of the IVF cycle was observed. However, all the seven patients aged >35 years did not reach pregnancy. Conclusions: (1) Serum inhibin B and estradiol concentrations obtained shortly after Gn therapy may offer an accurate and early prediction of ovarian response; (2) Low levels of serum inhibin B and estradiol obtained shortly after Gn stimulation indicate the need for a longer period of Gn treatment and a higher daily dosage; (3) No obvious pregnancy difference among patients of age <35 years was found; however, IVF pregnancy outcome is significantly lower in women of age >35 years.     

Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system

Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO_2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and in-traoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Con-clusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients' and the government's burden significantly.     

实验室中变形虫的培养初探

根据变形虫的结构特点及其生活习性，在室温条件下自制培养液培养大变形虫。野外采集种源，室内恒温培养蛞蝓变形虫。     

The value of endoscopic ultrasonography on diagnosis and treatment of esophageal hamartoma

Objective:To examine the values of endoscopic ultrasonography(EUS) on diagnosis and treatment of esophageal hamartoma.Methods:We compared and analyzed various kinds of imaging examinations such as barium esophagram,contrast-enhanced computed temography(CT)and conventional gastroscopy in retrospectively reviewing the clinical data of an esophageal hamartoma patient seen in our clinic in the First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China.Having received various imaging examinations,this patient was finally diagnosed with esophageal hamartoma and underwent gastroscopic resection of hamartoma with the diagnostic information obtained from EUS.The patient had been regularly followed up for 13 months after treatment.Results:Barium esophagram,CT and conventional gastroscopy detected the lesion,but were unable to distinguish it from conlmon esophagopolypus and other submucosal lesions,and unable to determine etiopathogenisis.EUS detected the hamartoma and identified its intemal structure,echo,exact size,depth of invasion,origin and the relationship between adjacent tissues and organs,differentiating the lesion from other submucosal tumors and clearly defining the diagnosis.EUS-guided fine needle aspiration(FNA) also helped to identify the etiological diagnosis.Conclusion:EUS was superior to other imaging means in diagnosis and treatment of hamartoma.     

青光眼滤过术后浅前房的临床分析

目的分析青光眼滤过术后浅前房的原因及处理。方法对行青光眼滤过手术的256例青光眼住院患者术后发生浅前房的原因及处理方法进行回顾性分析．结果256眼发生浅前房41眼,发生率为16．02％,浅前房发生时间在术后1到6d,其中房水滤过过强29眼,结膜瓣渗漏6眼,脉络膜脱离4只眼,恶性青光眼2眼,手术治疗4眼,其余37眼保守治疗。结论青光眼小梁切除术后浅前房的常见原因为房水滤过过强、结膜瓣渗漏、脉络膜脱离,大多患者都可以通过保守治疗治愈,必要时采取手术治疗．     

Hyperinsulinemia and Hypoadiponectinemia are Associated with Increased Risk for Occurrence of Ovarian Cancer in Non-diabetic Women of North Indian Population

Ovarian cancer has been emerged as a most common and lethal gynecological malignancy in India. High serum insulin and low adiponectin have been associated with increased risk of ovarian cancer. But their role in development of ovarian cancer is conflicting and little evidence is available. We aimed to evaluate blood levels of insulin and adiponectin in epithelial ovarian cancer (EOC) patients and their association with the risk to develop EOC. The study included following three groups; Group 1: fifty cases of cytohistopathologically confirmed cases of EOC, Group 2: fifty age matched cases of benign ovarian conditions and Group 3: fifty ages matched healthy controls with no evidence of any benign or malignant ovarian pathology as ruled out by clinical examination and relevant investigations. Cytohistopathologically confirmed and newly diagnosed cases of EOC and benign ovarian cancer were included in this study. The median value of fasting serum insulin was significantly high (15.0 µlU/ml, P = 0.02) and adiponectin were significantly low (5.1 µg/ml, P < 0.001) in ovarian cancer patients compared to benign ovarian tumors and healthy controls group. A significant increase risk of ovarian cancer was found in high tertile (≥ 18.7 µlU/ml) of serum insulin level (OR = 2.7; 95% CI = 1.00–6.67, P = 0.04) and lower tertile (≤ 5.45 µg/ml) of adiponectin level (OR = 3.2; 95% CI = 1.10–9.71, P = 0.03). High serum insulin level and low adiponectin levels were significantly associated with increased risk for development of ovarian cancer.