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Objective@#To investigate the clinical value of transvaginal three-dimensional ultrasonography in the differential diagnosis of benign and malignant endometrial diseases after menopause.@*Methods@#From April 2015 to April 2017, the imaging data of transvaginal three-dimensional ultrasonography of 184 patients with benign and malignant breast tumors in the Second People's Hospital of Yuhang District were retrospectively analyzed.The peak systolic flow velocity, resistance index, peak systolic velocity, intimal arterial resistance index and blood flow display rate of uterine artery of benign and malignant endometrial diseases were compared.@*Results@#The accuracy, sensitivity and specificity of transvaginal three-dimensional ultrasonography in the diagnosis of endometrial diseases were 91.30%(168/184), 92.00%(46/50), 91.04%(122/134), respectively.There were no statistically significant differences in the peak systolic flow velocity, resistance index, peak systolic velocity of patients with benign and malignant endometrial diseases by transvaginal three-dimensional ultrasonography(t=1.17, 0.88, 0.51, all P>0.05). The intimal arterial resistance index of patients with malignant endometrial diseases by transvaginal three-dimensional ultrasonography was significantly lower than patients with benign endometrial diseases(t=2.59, P<0.05). The blood flow display rates of uterine artery of patients with malignant endometrial diseases by transvaginal three-dimensional ultrasonography were 19.40%(26/134), 92.00%(46/50). The blood flow display rate of uterine artery of patients with malignant endometrial diseases by transvaginal three-dimensional ultrasonography was significantly higher than patients with benign endometrial diseases(χ2=7.26, P<0.05).@*Conclusion@#Transvaginal three-dimensional ultrasonography in the differential diagnosis of benign and malignant endometrial diseases after menopause has higher accuracy, sensitivity and specificity.
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Objective]The paper summarizes the clinical experience of Professor Lu Su for treating menopausal syndrome.[Methods] By learning from Professor Lu Su, sum up the knowledge of etiology and pathogenesis, treatment characteristics and analyze cases. [Results]Professor Lu Su thought that the main etiological and pathogenesis of menopausal syndrome was that deficiency of the kidney-yin and hyperactivity of heart and liver fire. The kidney water cannot aid heart, the occurrence of heart(including liver) fire too strong, the heart is not calm, leading to hot flashes sweating, upset insomnia and other symptoms of menopausal syndrome. Therefore, she made a total therapeutic principle of invigoration of the kidney and nourishment of Yin, purging heart fire and soothing the nerves. Besides, the article introduces prescribing characteristics of other lesions relating to menopausal syndrome, such as blood stasis, phlegm, yang deficiency and disharmony between spleen and stomach. In treatment, Lu Su is good at syndrome differentiation and treatment, prescribing refinedly and simply, combining medication with psychotherapy. [Conclusion]Therapies of Professor Lu Su on treating menopausal syndrome have significant effect.
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Objective To investigate the clinical features of uterine empyema complicated with perforation of the uterus,the causes of misdiagnosis and measures of reducing misdiagnosis.Methods Twenty clinical cases from 2008 to 2013 in the First People's Hospiptal of Shangqiu were treated postmenopausal,uterine empyema and uterine perforation,and 16 cases of whose first diagnosed leak or misdiagnosed patients were retrospectively analyzed.Summarize the clinical characteristics,misdiagnosis and experiences in order to reduce the misdiagnosis of the disease.Results Among 20 cases of uterine perforation and Uterine empyema,16 cases first diagnosed misdiagnosed,and the incidence was 80％ (16/20).One case was diagnosed tumor torsion,1 case of diagnosis of pelvic abscess,14 cases first diagnosed of surgery (8 cases of acute peritonitis,gastrointestinal perforation in 4 cases and 2 cases of perforated appendicitis).It all occurred in postmenopausal women,and the main clinical features were that:high fever,lower abdominal pain,feel bloated in the rectal,mass pelvic cavity,weakened movement of intestine and cervical disturbance pain.results of emoyemic bacteria culture were mainly colon bacillus (E.coli).The main causes of misdiagnosis were atypical clinical manifestations,clinicians lack of comprehensive analysis and dynamic observation of the disease,over-reliance on laboratory examinations;their performance was often the first diagnosis of acute abdomen surgery,the surgeon only undergraduate examination,as well as undergraduate diagnosis of inertia thinking,neglect gynecological examination.All patients had a one-time cure after surgery.Conclusion Uterine empyema complicated with uterine perforation occurs mainly in postmenopausal women,which had a higher rate of misdiagnosis.Correctly diagnosis and timely treatments make benefits to the prognosis.
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Growth of uterine myoma to huge size after menopause is very unusual especially when postmenopausal pattern is not on hormone replacement therapy. Recently we experienced 6000g of myoma uteri grown after menopause in 59 year old patient who visited emergency room due to vaginal bleeding for 10 days. After diagnostic work-up to rule out malignancy, she underwent exploration and huge uterine myoma was removed by total hysterectomy and bilateral salpingoopphorectomy. This patient is presented here with brief review of related literatures.