Objective:To evaluate the value of diagnosis and therapy of cold knife conization with electro-cautery hemostasis by hysteroscope in the treatment of ceNical intraepithelial neoplasia (CIN).Methods :A retrospective analysis of the clinical data was carried out in 193 cases with CIN underwent cold knife coniza-tion with electrocautery hemostasis by hysteroscope from January 2005 to November 2008, and all patients had pathological diagnosis under colposcopic biopsy.Results:The operative time was from 15 to 40 mi-nutes, and the blood loss dunng operation was from 5 to 25 milliliters.The coincidence rate of histopathology before and after conization was 67.88% in 131 cases.9 CIN Ⅲ patients had positive margins after opera-tion, owing to scab break off bleeding of cervical wound was encountered in 18 cases.No infection and cervi-cal adhesion or stenosis occurred.Conclusions :Cold knife conization with electrocautery hemostasis by hyst-eroscope is an effective diagnosis and treatment for CIN.

Objectlve:To assess the influential factors of decision-to-delivery inteval (DDI) in caesarean section, and its influence on neonatal outcomes.Methods:472 caesarean sections were divided into two groups according to Lucas's classification :the emergency caesarean sections as group 1 (291) ; and the e-lective caesarean sections as group 2 (181).It was divided into DDI ≤30 min group and DDI > 30 mir group in group 1.A retrospective study was performed in DDI, influential factors of DDI, neonatal Apgar score and umbilical arterial blood gas.Results: ①The mean DDI was 35.5±11.6 min in group 1,in wgich DDI≤30 min was 210 cases (72.2%) and 49.3 ±22.8 min in group 2, in which DDI≤30 min was 86 cases (47.5%).②IN group 1,umbilical artery pH and Apgar core at 1 min after birth could be improved sigbificantly in the cases of DDI ≤ 30 min (P<0.05) , but no correlation was found between the DDI and Apgar scrore at 5 min ,as compared with DDI ＞30MIN CASES(p＞0.05).③It was mainly influenced by time taken to get the patient into operation room in DDI >30 min (56 cases, 69.1 %).Concluslons :The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as pos-sible might improve the neonatal outcome.

Objective:To analysis the clinical characteristics of pulmonary hypertension (PH) complicating pregnancy, then to explore the delivery time and the monitodng as well as the treatment during perinatal peri-od.Methods:The data of 10 cases with PH treated in our hospital from June 2005 to January 2009 were retro-spectively analyzed.Reaults:1 case was primary pulmonary hypertension(PPH) ; 9 cases were secondary PH (SPH), in which 4 cases were rheumatic heart disease and 5 cases were congenital heart diseases.3 cases were slight PH,6 cases were moderate PH, and 1 were severe group.4 cases NYHA class were Ⅰ～Ⅱ and 6 cases NYHA class were Ⅲ～Ⅳ.4 cases were term delivery,5 cases were premature delivery, and 1 got artifi-cial abortion.8 cases were cesarean section, and 1 was vaginal delivery.2 cases were very low birth weight infants, 1 infant was death and 1 mother was death.Conclusions:The patient of PPH should avoid concei-ving.For SPH patients whether to conceive depends on cardiac function, the level of pulmonary arterial pres-sure and should better get pregnancy after surgery or medication.It should terminate pregnancy in the first tri-mester for moderate or severe patients.Cesarean section is more suitable for those in the second or third tri-mester.The prognosis of the mother and neonate depends on several factors.

Objective:To investigate the change of petvic floor function in the third trimester of pregnancy and early postpartum.Methods :46 pregnant women in the third trimester in our hosprtal from July to October 2007 were randomly selected.In late pregnancy, 6 ～8 weeks and 12 ～14 weeks after delivery, the incidenca of stress urinary incontinence (SUI) and bladder neck mobility in different stage of puerperium was carried out.They were respectively given score, protectrve pad experiment, ultrasonic testing residual urine and peri-neum ultrasound examination.An anarysis on their.Results :The incidence of SUI that diagnosis by POP-Q or POP-Q combined with pat test was 47.83% ,39.13% respectively in late pregnancy group;21.74% ,15.22% in 6 ～8 weeks after delivery;17.24%.13.7g% in 12 ～14 weeks after delivery.The difference between late pregnancy group and 6～8 waeks after delivery group was statistical significance (P<0.05).There was no significantly difference between 6 ～8 weeks and 12 ～14 weeks after delivery groups(P>0.05).There was significant difference between 6 ～ 8 weeks and 12～14 weeks after delivery group while compared the bladder neck angle[(88.11± 13.36)° vs(82.17 ±10.28)°]with the bladder neck rotation angle[(21.67 ±10.64) ° vs (16.79±8.57) °].Conclusions :Pregnancy and delivery can damage the function of pelvic floor, which has certain rehabilitation after delivery.

Objective:Surgery intervention and its effect on pregnancy heart disease were explored. Meth-ods:Retrospective review of 34 cases of pregnancy heart disease who needed surgery intervention from Jan, 2000 to Dec,2007 was done. Results:17 patients had percutaneous balloon mitral valve (PBMV) dilatation, the area of mitral valve enlarged markedly postoperatively ( P <0.01 ). 9 patients had open chest surgery un-der extracorpory circulation,7 of them had re-replacement mechanical valve due to mechanical valve throm-bosis. One patient had left atrium mucomamectomy. One patient had Wad's sinus breakout and repairmen. 5 patients had Radiofrequency catheter ablation (RFCA) for supraventricular tachycardia. 3 patients had int-racardiac device (ICD) for Ⅲ grade atrioventicular block. 22 patients had cardiac function as grade Ⅲ～Ⅳ and postoperatively recovered to grade Ⅰ～Ⅱ . All 34 patients were alive after treatment, 23 fetus were alive (67.6%), and no adverse results were found during the follow-up. Conclusions:When patients who had pregnancy heart disease need surgery intervention, individualized treatment plan should be made by multidis-cipline experienced doctors according to different heart disease and cardiac function.

Objective:The causes, management, and prevention of complications in laparoscopic gyneco-logic surgery were investigated. Methods:A retrospective analysis was done based on clinical data of 8279 cases of laparoscopic gynecologic surgery from January 1996 to December 2008 in this hospital. Results:The complication rate was 0.88% (73/8279). These included five cases intraperitoneal bleeding, five cases injury of ureter, 20 cases abdominal vessel damage, 10 cases vulva emphysema, 25 cases wound healing delay and each one case respectively for stomach injury, bladder injury, secondary abdominal cavity preg-nancy,infection and incision hernia. The occurrence rates of complications between hysteroscopy combined with laparoscopic surgery and pure adnexal surgery were no difference( P >0.05). Compared to adnexal op-erations, there was a significantly higher complication rate in myomectomy and laparoscopic assistant vaginal hysterectomy (P < 0.01 ). Conclusions:Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operators. In order to reduce complications, careful oper-ation and avoiding over self -confidence are essential.

Objective:To evaluate the efficacy of loop electrosurgical excision procedure(LEEP) in the treatment of different grade of cervical intraepithelial neoplasia(CIN). Methods:898 cases with CIN treated by LEEP were retrospectively analyzed. Operation time, blood loss during the operation, changes of histopathologic results and high-rick HPV before and after the operation were studied. The diagnosis and treatment results by LEEP were evaluated. Results: The average operation time was 5.1 minutes. The average blood loss during the operation was 5.6 ml. The concordance rate of pathologic results under colposcope before operation and after LEEP was 77.73% (698/898) .96 cases had increased CIN grade after LEEP(10.69%). The HPV-DNA loading dose after operation declined significantly (P< 0.01). Conclusions: The detection rate of invasive cervical cancer by LEEP is higher than multiple punch biopsy under electronic colposcope. LEEP is an effective method for the diagnosis and treatment of CIN, and it can eliminate high-rick HPV at the same time of ablating the cervical lesion.

Objective:To explore the effect and mechanism of Xinfuning( recombinant human α-2b interferon capsule for vaginal foams) on the clearance of human papilloma virus (HPV). Methods: The patients with HPV infection were divided into experimental group (Xinfuning group) and control group (Shurunshuan group, a common recombinant human interferon α-2b in suppository form) .The HPV negative conversion rate was compared between the two groups after action on vaginal posterior fomix. The content of cytokines IL-4, IL-10, IFN-γ, TNF-a in the cervical region before or after the application was detected by ELISA. Results:The negative conversion rate in the experimental group was higher than that in the control group ( P<0.05). The content of IL-4, IL-10 was decreased and the cont ent of IFN-γ,TNF-α was increased apparently( P < 0.05). Conclusions: Interferon has the effect on clearance of HPV infection by regulating Th1/Th2 balanced state to boost immunization and the unique preparation of Xinfuning can strengthen such function.

Objective:To investigate the pathogen flora of recurrent vulvovaginal candidiasis(RWC),and to discuss its treatment. Methods: Fungal culture and susceptibility tests of vaginal discharge from 108 RWC patients were performed. Sensitive drugs were selected for effective consolidating treatment for half year. Fungal smears were examined at the 3rd and 6th months after the treatment respectively. Results:①Among RWC patients,there were 81 cas es of Candida albicans(75.0%), 19 cases of C. Glabrata(17.6%), 4 cases of C. Parapsilosis(3.7%) ,2 cases of C.tropicalis (1.9%) and 2 cases of M. Krusei (1.9%). The drug susceptibility test showed that 80.6% of these 108 patients were sensitive to nystatin; 66.7% were sensitive to clotrimazole; 65.7% were sensitive to miconazole; 57.4% were sensitive to fluconazole;8.3% were sensitive to ketoconazole;6.5% were sensitive to itraconazole; 7.4% were resistant to all of the above drugs.②The score of symptom and sign was significantly improved compared with the first visit at the 3rd and 6th month after the treatment( P<0.0001). The negative rate was 76.2%(80/105) at the 3rd month after the treatment and 64.8%(68/105)at the 6th month after the treatment. Conclusions:①The rate of non Candida albicans is increased to 25% in RWC patients, and 17.60% is Candida glabrata.②During the treatment of RWC, the drugs should be selected according to fungal culture, results of susceptibility test, medication experience of patients,and attack character. The research of immune abnormality of the local vagina will be helpful to improve the cure rate of RWC.

Objective:To investigate the clinical effects of levonorgestrel-releasing intrauterine device(LNG-IUD) in the treatment of adenomyosis in perimenopausal period. Methods: A total of 92 patients with adenomyosis in perim enopausal period were treated with LNG-IUD and followed up at the 3rd,6th, 12th,24th month. Change of menses, uterine volume,visual analogue scale (VAS) of dysmenorrhea,the serum CA_(125) level and degree of satisfaction with the treatment were observed. Results:The dysmenorrhea was alleviated along with the follow-up time in all of the pa tients after insertion of the LNG-IUD ( P<0.05). The menstrual volume, uterine volume and serum CA_(125) level were decreased significantly(P<0.05) .Conclusions:LNG-IUD is a safe, effective and simple treatment of adenomyosis in perimenopausal period.