子宫动脉栓塞治疗子宫肌瘤后临床受孕的观察

目的 探讨子宫动脉栓塞治疗子宫肌瘤后的临床受孕率。方法 3 3例子宫壁间肌瘤患者需行生育要求 ,采用Seldinger技术 ,行双侧子宫动脉栓塞术 ,追踪 3～ 16个月的临床受孕率。 结果 栓塞术后月经恢复多在 1～ 2个月 ,治疗后临床受孕率 48.48%。结论 子宫动脉栓塞术治疗子宫壁间肌瘤对需行生育要求的患者 ,是一种简单、有效可行微创方法 ,值得进一步探讨研究。

工效学因素对妇女临床受孕时间影响的研究

目的 探讨纺织厂工效学因素对临床受孕时间的影响。方法 对某纺织厂的新婚妇女进行前瞻性队列研究 ,对这些妇女工作岗位的工效学因素进行单因素和多因素 COX比例风险回归分析及 L IFETEST(生存时间分析 )。结果 每个月经周期的临床受孕率为 2 7.2 %,平均临床受孕时间为 (3.6± 0 .13)个月经周期 ,受孕率随受孕时间的延长而逐渐降低。对单个工效学因素和多个工效学因素的作用进行单因素和多因素 COX比例风险回归分析。单因素 COX分析结果显示工作强度和工作紧张均与受孕率有明显的剂量反应关系 ;多因素分析显示只有工作强度与受孕力有关 ,且中度工作强度组受孕力为轻度组的 0 .72倍 ,重度工作强度组受孕力为轻度组的 0 .6 1倍。结论 工作强度可能是影响妇女临床受孕时间的一个重要的工效学因素。

高剂趋黄体生成素在卵泡期不同时段对体外受精-胚胎移植的影响

目的探讨在控制超排卵(controlled ovarian hyperstimulation,COH)用药中,高剂量黄体生成素(luteinising hormone,LH)在卵泡的不同时期对体外受精-胚胎移植(inn vitro fertilization and embryo transfer,IVF-ET) 的影响。方法采用回顾性研究方法。常规方案实施IVF-ET的患者359例,按COH中卵泡刺激素(follicle- stimulating hormone,FSH)和LH的不同用量,以及它们的用药时间分为3组:A组(n=252),FSH≥225 IU/d,且LH ≤225 IU/d(对照组)。B组(n=43)为卵泡晚期高LH接触组,ESH>225 IU/d,且取卵前3 d内LH>225 IU/d(高LH 近期组)。C组(n=64)卵泡早、中期高LH接触组,FSH>225 IU/d,且取卵前4 d或以前LH>225 IU/d,取卵前3 d 内LH<225 IU/d(高LH远期组)。对各组在受精率,胚胎植入率,临床受孕率,继续妊娠率进行比较分析。结果A组的胚胎植入率,临床受孕率,继续妊娠率均高于B组(10.4% vs 7.0%,26.7 vs 18.4%,20.2% vs 9.5%,P均< 0.05);而与C组比较则差异无显著性(10.4% vs 9.5%,26.7 vs 23.6%,20.2% vs 18.6%,P均>0.05),但受精率差异有显著性(60.2% vs 50.4%,P<0.05)。C组的胚胎植入率,临床受孕率与B组差异无显著性(9.5% vs 7.0%, 23 6 vs 18 4%,P>0,05),但C组的继续妊娠率明显高于B组(18.6% vs 9.5%,P<0.05)。结论降调节下COH 应用LH>225 IU/d时,使IVF-ET的受精率下降。在卵泡晚期(取卵前3 d内)高LH的不良影响较大,其植入率、临床受孕率、继续妊娠率均明显下降。

补肾活血法对子宫内膜容受性影响的研究进展

随着社会、自然环境以及人们生活方式的变化，不孕不育症的患病率也显著上升。辅助生育技术（ART）经过几十年的发展，虽然体外授精的成功率在90%左右，但临床妊娠率依然不高，与人们的要求有很大差距。其重要原因之一就是子宫内膜容受性差。故此，临床迫切需要找到改善子宫内膜容受性的药物和方法。中医补肾活血法通过临床应用及试验研究证实能有效改善子宫内膜容受性，提高临床受孕率，现综述如下。 1子宫内膜容受性的评判标准〈br〉 1.1子宫内膜厚度、类型和容积子宫内膜厚度和类型在月经周期中呈规律性改变，反映内膜的功能状态。很多研究发现，子宫内膜厚度和类型在妊娠组与非妊娠组有显著性差异。在辅助生殖治疗中，内膜厚度至少要达到某一最小值（内膜厚度范围在5 mm--8 mm之间）才能保证正常的胚胎植入。

Ki-67 as a prognostic marker according to breast cancer molecular subtype

Objective: Ki-67 plays an important function in cell division, but its exact role is still unknown. Moreover, few works regarding its overall function were published. The present study evaluated the clinical significance of Ki-67 index as a prognostic marker and predictor of recurrence in different molecular subtypes of breast cancer. The relationship of Ki-67 index with different clinicopathological factors was also analyzed.Methods: Ki-67 index was measured in 107 cases of primary breast cancer from 2010-2012. These patients were evaluated for estrogen receptor, progesterone receptor, and HER2. Ki-67 was divided according to percentage levels: < 15% and > 15%. Followup ranged from 32 months up to 6 years.Results: Approximately 44, 23, 15, and 25 cases were grouped as luminal A, luminal B, HER2 subtype, and triple-negative(TN),respectively. No luminal A patients showed Ki-67 level higher than 15%, and their recurrence was 20%. In luminal B group, Ki-67 level higher than 15% was observed in 69% of patients, and recurrence was 39%. In HER2 subtype, Ki-67 was higher than 15% in34% of cases, and recurrence was 40%. In triple-negative cases, Ki-67 was higher than 15% in 60% of cases, and recurrence was detected in 32% of patients. Patients with Ki-67 less than 15% displayed better overall survival than those with Ki-67 higher than15%(P = 0.01). Patients with Ki-67 higher than 15% exhibited higher incidence of metastasis and recurrence than those with Ki-67 less than 15%(P = 0.000).Conclusions: Ki-67 may be considered as a valuable biomarker in breast cancer patients.