摘要：目的体外实验已证实S-SOX5蛋白转录调节运动纤毛基因Spag6，为进一步探索其在体内的作用，拟构建S-Sox5基因的敲除载体。方法利用新型DNDF-7和携带LoxP位点的LPL4载体，选择S-Sox5基因第1外显子作为条件性敲除目的片段，SV129系Es细胞DNA为模板分步扩增包括S-Sox5第1外显子的中间段（middle piece），上游同源左臂4．8kb（upper arm）及下游同源右臂2．5kb（down arm）的基因片段；构建upper-arm-DNDF7、down-arm-DNDF7和middle-piece-LPL4质粒，将middle-piece-LPL4的酶切产物LoxP—middle—***和down-arm-DNDF7酶切产物相连，形成携带LoxP位点的middle-down-arms-DNDF7重组质粒，该质粒与upper-arm-DNDF7酶切产物相连，获得S-Sox5基因打靶载体。结果经酶切鉴定及测序证实，构建的upper-arm-DNDF7、middle-piece-LPL4、down-arm-DNDF7重组质粒和S-Sox5基因打靶载体结构正确，与设计相符。结论成功构建小鼠S-Sox5条件基因打靶载体，为进一步建立S-Sox5条件敲除小鼠，在体内研究其功能打下基础。

摘要：Objective:This study was undertaken to determine the frequency of postsurgical ovarian failure in patients undergoing laparoscopic excision of bilateral endometriomas. Study design:Patients who had been operated on for bilateral ovarian endometriosis between January 1995 and December 2003 and who were younger than 40 years at the time of surgery were contacted by telephone and interviewed. Results:Atotal of 126 patients were recruited. Mean ±SD age of patients at the time of surgery was 30.4 ±4.3 years. Postsurgical ovarian failure was documented in 3 cases,corresponding to a rate of 2.4%(95%CI 0.5%-6.8%). In all cases,this complication occurred immediately after surgery. Conclusion:Patients who had been operated on for bilateral endometriomas have a low but definite risk of premature ovarian failure occurring immediately after surgery.

摘要：Objective: The purpose of this study was to investigate the effect of raloxifene on leptin and insulin-like growth factor- I levels and their relation with the biochemical markers of bone metabolism in postmenopausal women. Study design: Sixty-four women were given 60 mg/d raloxifene for 6 months. Serum leptin, insulin-like growth factor- I, alkaline phosphatase, calcium, osteocalcin, and collagen type I cross-link C-telopeptide levels were measured before and after the treatment. The patients were grouped as obese (body mass index, ≥ 25 kg/m2) or non-obese (body mass index, < 25 kg/m2). Results: The mean basal leptin level was significantly higher (P < .001), and the mean crosslink C-telopeptide level was significantly lower (P = .001) in obese patients. Raloxifene therapy increased leptin levels (P < .001) and decreased insulin-like growth factor- I, alkaline phosphatase, and cross-link C-telopeptide levels significantly (P < .001). There was a strong negative correlation between leptin and cross-link C-telopeptide (r = - 0.703; P < .001). Insulin-like growth factor- I was not correlated with any parameter. Conclusion: Raloxifene increases serum leptin levels while decreasing bone resorption in postmenopausal women.

摘要：Objectives The purpose of this study was to compare the efficacy of cervical ripening with 2 Foley catheter balloon volumes. Study design Pregnant women admitted for induction of labor with a term singleton gestation were randomly assigned for cervical ripening by a balloon inflated with 30 mL or 80 mL of sterile saline. Results Two hundred and three women were included in the analysis. Ripening of the cervix with the larger balloon volume was associated with a significantly higher rate of postripening dilatation of 3 cm or more (76.0%vs 52.4%, P <.001). In primiparous women, the larger balloon volume resulted in a significantly higher rate of deliveries by 24 hours (71.4%vs 49%, P <.05), and a significantly less requirement of augmentation with oxytocin (69.3%vs 90.4%, P <.05). Conclusion Ripening of the unfavorable cervix in primiparous women with a Foley catheter balloon inflated with 80 mL provided effective more dilatation, faster labor, and decreased need for oxytocin than with a balloon inflated with 30 mL of sterile saline.

摘要：Objective: This study was undertaken to determine how consistently indigent, predominantly Hispanic women who had previously selected male condoms as their contraceptive method had used condoms and emergency contraception (EC) during the 2 weeks before their family planning clinic visit and reasons for any nonuse. Study design: Cross-sectional survey with no personal identifiers collected. Results: Two hundred forty-eight women were surveyed. Overall, 43.8% of sexually active women reported inconsistent condom use during the prior 14 days. Only 39% of women who had not used condoms consistently used EC at least once. The most common reason for nonuse of both condoms (44% ) and EC (41% ) was that the woman did not perceive that she was at risk. Conclusion: Inconsistent use of condoms and low use of EC are very frequent, even in a short-time frame. Patients may be reluctant to volunteer to clinicians their real contraceptive choices. Risk taking occurs at high rates, even among couples provided ready and free access to male condoms and EC.

摘要：Objective: Assess whether women note a change in aspects of arousal because of removal of the uterus and cervix. Study design: Between 1990 and 1992, 105 women were asked to report on their sexual function before and at 3, 8, and 18 months after undergoing a total hysterectomy. Results were analyzed by χ 2. Results: Hysterectomies were abdominal or vaginal, and 42% of subjects had ovaries removed and initiated estrogen replacement. Ease of arousal diminished in 24% and improved in 11% . Intensity of orgasms decreased in 15% and increased in 14% . Effects of nipple stimulation were usually preserved. Sexual satisfaction increased significantly. Seven women noted distinctly worse sexual function. Conclusion: An indicated total hysterectomy will likely increase sexual satisfaction and not change the effect of breast stimulation. The few women with disturbingly reduced sexual sensation deserve assessment and treatment.

摘要：Objective:We longitudinally examined the changes of brachial to ankle distensibility using pulse wave velocity (PWV)-throughout pregnancy and its difference between normal pregnancy and pregnancy-induced hypertension (PIH) groups. Study design:One hundred and eighty-three pregnant women were included in this study. The PWV examinations were performed in a longitudinal way during the first,second,and third trimesters of pregnancy,and immediately and 1 month after delivery. Results:In normal pregnancies,the PWV significantly decreased at the second trimester,increased from the third trimester through immediately after delivery,and decreased again at 1 month after delivery. In PIH patients,it increased in proportion to the progression of gestation. Conclusion:We monitored the longitudinal changes in PWV and constructed a PWV normogram during pregnancy. The predictive value of PWV and blood pressure for PIH was higher than that of blood pressure alone,suggesting the usefulness of measuring PWV to predict PIH.

摘要：Objective:This study examines the operative details and complications of colorectal resection in patients with ovarian and primary peritoneal carcinoma. Study design:Patients who underwent colorectal resection for ovarian and primary peritoneal cancer were identified in our surgical database for the period 1988 through 2002. Results:Of the 125 patients who were identified,73%were undergoing primary cytoreduction; 18%were undergoing secondary cytoreduction,and 7%were undergoing interval cytoreduction. The mean length of colon that was removed was 15.7 cm. The method of anastomosis was stapler in 63%and hand sewn in 22%; 15%patients had no anastomosis performed. A protective ostomy was used in 13%of patients. Optimal cytoreduction ( < 1 cm) was achieved in 74%. Operative complications occurred in 37%of patients,with the most common being hemorrhage (25%). Anastomotic leaks occurred in 2.5%of the patients,and the most common postoperative complication was ileus (28%). Postoperative bowel function returned to normal in 71%of patients. Conclusion:To obtain optimal cytoreduction in patients with ovarian cancer,colorectal resection often is necessary. Colorectal resection can be performed with a low risk of anastomotic complications,and patients frequently have the return of normal bowel function.

摘要：Objective: The purpose of this study was to evaluate the experience with endometrial carcinoma in women ≤45 years of age at Ochsner Clinic Foundation, New Orleans, La. Study design: We evaluated the clinical history, treatment, and follow-up of 38 women ≤45 years of age diagnosed with endometrial cancer. Results: Thirty-eight patients received primary treatment for endometrial cancer: stage I, 32 (84.2%); stage II, 1 (2.6%); stage III, 4 (10.5%); stage IV, 1 (2.6%). Tumors were well differentiated in 20 (52.6%), moderately differentiated in 10 (26.3%), and poorly differentiated in 8 (21.1%). At end of study period 32 women (84.2%) were alive with no evidence of disease, 5 had died of recurrent disease, and 1 died of metastatic breast cancer. Conclusion: Patients ≤45 years of age had lower incidence of advanced stage disease, higher degree of tumor differentiation, and better prognosis compared to patients older than 45 years.

摘要：Objective: The aim of the study was to propose a set of tests to clarify the diagnosis of repeated implantation failure in patients undergoing in vitro fertilization (IVF). Study design: Fifty-nine patients with at least two unsuccessful IVF attempts were included in the study. Blood samples were evaluated for the presence of underlying thyroid abnormalities, antiphospholipid antibodies (aPL), increased levels of natural killer cells (NK), inherited thrombophilia and mouse embryo assay factor (MEAf). The same tests were performed on 20 normal fertile control patients. Results: Seventy-six percent of IVF patients showed at least one abnormal result. This incidence was higher with respect to that found among control patients (45% ). The prevalence of thyroid abnormalities, aPL and increased NK level was higher in IVF patients whereas no differences were observed in terms of prevalence of inherited thrombophilias and MEAf. Conclusions: A better understanding of reproductive failure mechanisms should allow an effective diagnostic flow chart and a focused therapeutic option for patients experiencing repeated IVF failure. With this objective in mind, our data provide two important results: thyroid abnormalities, aPL and increased NK levels are more prevalent in women experiencing IVF failure. No evidence was found for an association between inherited thrombophilia and MEAf and failure to achieve pregnancy after IVF.