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
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:了解外阴平滑肌瘤的临床特点、鉴别诊断和治疗方法。方法:回顾性分析我院2021年1月住院手术并经病理证实的1例外阴平滑肌瘤病例。结果:患者以“发现外阴肿物1年”之主诉入院。于门诊行前庭大腺囊肿造口术,未见囊液流出,行包块活检...目的:了解外阴平滑肌瘤的临床特点、鉴别诊断和治疗方法。方法:回顾性分析我院2021年1月住院手术并经病理证实的1例外阴平滑肌瘤病例。结果:患者以“发现外阴肿物1年”之主诉入院。于门诊行前庭大腺囊肿造口术,未见囊液流出,行包块活检术,病理诊断:考虑平滑肌瘤(病理号20-20256)。B超示:多发性子宫肌瘤(3.2 cm × 3.0 cm),右侧大阴唇皮下所见(5.8 cm × 4.8 cm)。行双侧外阴囊肿切除术后送病理检查,病理结果:(双侧外阴肿瘤)多发性平滑肌瘤,肿瘤直径5 cm建议随诊(病理号21-00581)。术后切口愈合好。结论:外阴平滑肌瘤是一类罕见的妇科良性肿瘤,大多数为单发,极少合并伴有子宫平滑肌瘤,易被误诊为前庭大腺囊肿,一旦发现应尽早进行手术治疗,避免其继续发展恶化。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:了解外阴平滑肌瘤的临床特点、鉴别诊断和治疗方法。方法:回顾性分析我院2021年1月住院手术并经病理证实的1例外阴平滑肌瘤病例。结果:患者以“发现外阴肿物1年”之主诉入院。于门诊行前庭大腺囊肿造口术,未见囊液流出,行包块活检术,病理诊断:考虑平滑肌瘤(病理号20-20256)。B超示:多发性子宫肌瘤(3.2 cm × 3.0 cm),右侧大阴唇皮下所见(5.8 cm × 4.8 cm)。行双侧外阴囊肿切除术后送病理检查,病理结果:(双侧外阴肿瘤)多发性平滑肌瘤,肿瘤直径5 cm建议随诊(病理号21-00581)。术后切口愈合好。结论:外阴平滑肌瘤是一类罕见的妇科良性肿瘤,大多数为单发,极少合并伴有子宫平滑肌瘤,易被误诊为前庭大腺囊肿,一旦发现应尽早进行手术治疗,避免其继续发展恶化。
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。
