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Objective:To investigate the clinical effects of high-intensity focused ultrasound (HIFU), gonadotropin-releasing hormone agonist (GnRH-a), and levonorgestrel intrauterine extended-release system (LNG-IUS) on adenomyosis (AM) alone or in combination.Methods:The clinical and follow-up data of 338 AM patients who received conservative treatment in the First Affiliated Hospital of Xinjiang Medical University from July 2018 to March 2019 were analyzed retrospectively. The treatment related parameters, dysmenorrhea (VAS) score, menstrual volume (PBAC) score, uterine volume, recurrence rate of dysmenorrhea, hemoglobin (Hb) and carbohydrate antigen 125 (CA125) levels at 3, 6, and 12 months after treatment were compared among HIFU treatment (H group), GnRH-a treatment (G group), LNG-IUS treatment (L group), HIFU combined with GnRH-a treatment (H+ G group), HIFU combined with LNG-IUS treatment (H+ L group), HIFU combined with GnRH-a and LNG-IUS treatment (H+ G+ L group).Results:There was no significant difference in sound power, treatment time and ablation rate among the four HIFU groups ( P>0.05). The dysmenorrhea score, menstrual volume score, and CA125 levels in the 6 groups were significantly lower than before treatment ( P<0.05). The hemoglobin level of H group, H+ G group, H+ L group, H+ G+ L group continued to increase after treatment ( P<0.05). The VAS scores of the H+ G, H+ L, and H+ G+ L groups were significantly lower than those of the H and L groups at 3 and 6 months after treatment ( P<0.05). G group and H+ G group alleviated 100% of dysmenorrhea after 3 months of treatment, and the curative effect decreased afterwards. The recurrence rate of dysmenorrhea was 19.44%, 30.16%, 26.67%, 7.30%, 8.10%, 3.77% in H group, G group, L group, H+ G group, H+ L group, and H+ G+ L group, respectively ( P<0.05). The PBAC scores in the H+ G, H+ L, and H+ G+ L groups were significantly lower than those in the H, L, and G groups at 6 and 12 months after treatment ( P<0.05). The uterus volum in group L before treatment was smaller than that of the other groups ( P<0.05), and the uterus volume increased slightly in 3 months, 6 months, and 12 months after treatment than before treatment, but with no statistically significant difference ( P>0.05). The uterine volume of G, H+ G, and H+ G+ L groups were smaller than that of H and G groups at 3 months after treatment, and the uterine volume of group G at 12 months after treatment was larger than that at 3 and 6 months after treatment, but still smaller than before treatment ( P<0.05). The uterine volume, dysmenorrhea score, and menstrual volume score of the H+ G+ L group at 12 months after treatment were [(157.33±35.96)cm 3, (1.07±0.82)point, (69.57±17.24)point], which were all smaller than those of the other groups ( P<0.05). Conclusions:HIFU, GnRH-a, LNG-IUS alone or combined treatment of AM are safe and effective, but comprehensive treatment can improve clinical efficacy, delay and reduce recurrence and reduce the incidence of total hysterectomy.
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Objective To investigate the application of hysterosalpingography (HSG)with iopromide in diagnosing female infer-tility.Methods 549 infertile women had performed HSG with iopromide,and X-ray images were analyzed retrospectively.Results Prevalence of uterine hypoplasia in primary infertility was higher in the minority than in the ethnic Han.Tubal obstruction was more common than hydrosalpinx and severe fimbria adhension.92.3% of the infertile women had pelvic inflammation disease.The dose of iopromide could be increased in need.Conclusion Prevalence of uterine hypoplasia is different as ethnic difference.Obstruction is the most common factor in tubal infertility.It is safe to use iopromide in HSG.
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ObjectiveTo evaluate the relationship and significant between low molecular-weight protein (LMP) methylation and expression,and Uyghur women cervical lesions with human papillomavirus (HPV) infection.MethodsGenetic information was obtained from the GenBank database,specialized software was used to scan gene promoter regions,and CpG island fragment specific primers was designed,gene methylation and CpG site sequences related information were gained by the PCR amplification,vector cloning and sequencing of the bisulfate-modified cervical cancer cell DNA.Methylation status of LMP was quantitative evaluated by Sequenom MassARRAY DNA in 78 subjects with different cervical lesions; mRNA and protein of LMP2 and LMP7 were evaluated by RT-PCR and immunohistochemistry.HPV infection status determined use HPV gene chips.ResultsGene promoter region CpG fragments methylation sequencing it was detected that selected CpG sites of cervical cancer cell genome LMP7 had methylation.However no methylation site was found in gene promoter region of LMP2.The percent of LMP7 methyiation was increased steadily with the severity of cervical lesions.showing 0.0652±0.0488,0.0728+0.0548 and 0.1864+0.0893 of which with normal control,CIN and CSCC (P＜0.01).LMP7 was significantly reduced in CSCC and CIN compared with normal cervical epithelium,and its mRNA expression consistent with the results of proteins,while no significant difference in LMP2 expression.Moreover,the methylated proportion of LMP7 was negatively associated with the protein expression in cervical lesions ( F =8.69,P =0.035 ).Stratified analysis indicated that the percents of LMP7 methylation in subjects with HPV16 positive still increased( t=1.996,P=0.049).ConclusionOur findings indicated that LMP7 methylation was significantly associated with cervical lesions and HPV infection.
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Objective To investigate the curative effects of different types of hysteroscopic surgery for endometrial polyps. Methods A total of 327 cases by different ways of hysteroscopic surgery for endometrial polyps from Nov 1999 to Nov 2004 were followed up. The mean age was (40?6) yea rs. The mean follow-up was( 3.0?0.6) years. Among 228 polyps patients in s exual maturity without desire of maintaining fertility, 53 (group A) underwent p olypectomy with electrosurgical vaporization, and 175 cases (group B) did polype ctomy with endometrial resection. Fifty-four (group C) cases (19 cases of infe rtility), who desired future childbearing, did polypectomy with endometrial rese ction of superficial layer near the polyps. Forty-five postmenopausal patients(group D) did polypectomy with endometrial coagulation. Results The time of operation: group A (15.1?0.8) second,group B (19.7?0.7) s econd,group C (20.9?0.7) second,and group D (22.1?0.8) second. None of polyps recurred for the patients of groups A and D after operation, and the recu rrent rate of groups B and C was 1.7% and 7.4%. There were no cases with amen orrhea in group C, who hoped to keep the function of fertility, but the recurren t rate of polyps was higher than other three groups. Of 19 cases of infertility , 14 cases became pregnant after the surgery. Conclusion It is feasible to select different hysteroscop ic surgery for endometrial polyps,according to different ages and the desire of childbearing of the patients.