Academy of Medicine-Ministry of Health Clinical Practice Guidelines: assessment and management of infertility at primary healthcare level

The Academy of Medicine (AMS) and Ministry of Health (MOH) have developed the clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level to provide doctors and patients in Singapore with evidence-based treatment for infertility. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the AMS-MOH clinical practice guidelines on Assessment and Management of Infertility at Primary Healthcare Level, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2013/cpgmed_infertility.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

Influence of hepatic artery thermotherapy on the vascular permeability of hepatic tumor tissue and normal fiver tissue in VX2 tumor-bearing rabbits / 介入放射学杂志

Objective To evaluate the effects of interventional thermotherapy(60℃)via hepatic artery on the vascular permeability of hepatic tumor tissue and normal liver tissue in VX2 tumor-bearing rabbits.Methods Thirty white rabbits were used in this experiment,Thirty VX2 tumor-bearing rabbits models were established by direct injection of VX2 tissue particle into the liver parenchyma and were randomly and equally divided into three groups:(1)non-perfusion group(n=10),used as control group; (2)normal thermal perfusion group(n=10),a perfusion of 30ml saline at 37 4±0.5℃ via hepatic artery in 15 minutes was used;(3)hyper-thermai perfusion group(n=10),a perfusion of 30ml saline at 60±0.5℃via hepatic artery in 15 minutes was used.The vascular permeability of the tumor tissue and the normal liver tissue was estimated with Evan's blue method.Results In all three groups the vascular permeability was significantly incleased in tumor tissue than that in normal liver tissue(P＜0.05).Normal thermal perfusion resulted in a significant increase in the permeability of vasculature(JP＞0.05).Hyper-thermal peffusion resulted in a significant increase in vascular permeability of tumor tissue (P＜0.05),and vascular permeability was increased in tumor tissue mole markedly than that in normal tissue(P＜0.05).Conclusion Hyperthermia hepatic arterial perfusion can increase vascular permeability for both tumor tissue and normal tissue in VX2 tumor-bearing rabbits.