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OBJECTIVE@#To analyze relevant factors for recurrence of ovarian endometriosis after conservative surgery. @*METHODS@#A cohort study was performed on 310 patients who had performed conservative surgery for ovarian endometriosis. All patients underwent clinical interview. The relevant factors included: age at surgery, clinical symptom and signs, medical history, gynecologic examination, preoperative gravidity, complication, adenomyosis, American Society for Reproductive Medicine (ASRM) scores, post-operative drug therapy, post-operative gravidity and so on. The logistic regression analysis was performed to determine the predictive factors for recurrence of endometriosis. @*RESULTS@#The relevant factors by univariate analysis were determined. The history of endometriosis surgery, history of intrauterine operation, tenderness nodule at cal-de-sal, bilateral endometrioma, multilocular cyst, intraoperative ASRM scores, complication of adenomyosis and operation time were the risk factors; whereas pre- and post-operative gravidity, post-operative drug therapy, and age at surgery were the protective factors. Meanwhile, the relevant factors by multivariate analysis were also confirmed. The history of endometriosis surgery, history of intrauterine operation, tenderness nodule at cal-de-sal, bilateral endometrioma, multilocular cyst, and intraoperative ASRM scores were the risk factors; whereas post-operative gravidity, post-operative drug therapy, pre-operative gravidity, and age at surgery were the protective factors. @*CONCLUSION@#The risk factors for recurrence of ovarian endometriosis are history of endometriosis surgery, history of intrauterine operation, tenderness nodule at cal-de-sal, bilateral endometrioma, multilocular cyst, intraoperative ASRM scores, whereas the protective factors are pre- and post-operative gravidity, post-operative drug therapy and age at surgery.
Subject(s)
Female , Humans , Cohort Studies , Endometriosis , General Surgery , Laparoscopy , Organ Sparing Treatments , Ovary , Pathology , Postoperative Period , Recurrence , Risk Factors , Treatment OutcomeABSTRACT
Objective To investigate the effect of targeted interruption of cyclooxygenase-2 (COX-2) gene by small interference RNA (siRNA) on the expression of COX-2, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in eutopic and ectopic endometrial stromal cells (ESC) with endometriosis, and the effect on the content of 6-keto-prostaglandin-F1α (6-keto-PGF1α, metabolites of COX) and the apoptosis of eutopic and ectopic ESC with endometriosis. Methods Ectopic and eutopic ESC from 30 women with endometriosis were isolated and cultured respectively. Then, ESC were classified into three groups: interference group, negative control group and blank control group. ESC in interference group were injected into siRNA transfection complex while ESC in negative control group were injected into negative control transfection complex. ESC from 10 participants without endometriosis were the normal control group. The mRNA and protein expression of COX-2, VEGF, MMP-9 in pre-transfected and post-transfected eutopic and ectopic ESC were detected through real time reverse transcription PCR and western blot. The content of 6-keto-PGF1α was determined by ELISA, the apoptotic cells were detected by flow cytometry. Results After interruption of COX-2 gene, there were no significant difference in the mRNA and protein expression of COX-2, VEGF and MMP-9 between the negative control group and blank control group (P>0.05); the mRNA and protein expression of the three genes in interference group were significantly lower than those in negative control group and blank control group (P0.05);compared with those of negative control group and blank control group, the content of 6-keto-PGF1αin interference group decreased significantly (P0.05). The results from flow cytometry displayed that, there was no significant difference in apoptotic cells between the negative control group and blank control group (P>0.05);compared with those of negative control group and blank control group, more apoptotic cells were detected in interference group and the difference was significant (P<0.01);the apoptotic cells in ectopic ESC were significantly more than that in eutopic ESC (P<0.05); the apoptosis rate in interference group of eutopic and ectopic ESC were (33.76 ± 0.06)%, (47.18 ± 0.12)%. Conclusions Our results suggested the targeted interruption of COX-2 gene by siRNA effectively inhibited the mRNA and protein expression of COX-2, VEGF and MMP-9 in both eutopic ESC and ectopic ESC with endometriosis, greatly increased the apoptotic rate of cells and obviously reduced the content of 6-keto-PGF1αby inhibiting the activity of COX-2. And the changes in ectopic endometrium were more evident than those in eutopic endometrium.
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Objective To evaluate the effect of evidence-based nursing in preventing and controlling the pulmonary infection of patients with stroke.Methods The randomized controlled trials (RCT) on the evidence-based nursing in preventing and controlling the pulmonary infection of patients with stroke were collected using the domestic and foreign databases,which were analyzed by RevMan 5.2 software.Results Nine RCTs were included in the study.The results of Meta-analysis revealed that the effect of the amount of OR values and 95％ confidence interval of the incidence and the cure rate of pulmonary infection was 0.42 (0.33～0.54),14.10 (4.57-43.50).Conclusions The evidence-based nursing can reduce the incidence of the pulmonary infection and improve the cure rate.
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Objective To investigate the clinical effect of hysteroscope combined with B-ultrasound in the treatment of uterin cavity adhesion. Methods Hegar dilatior or electric knife of hysteroscope was used to cut adhesion, which was monitored by B-ultrasound. Antibotics, artificial hormonal cycle treatment and IUD in uterin cavity were used after operation. Results 55 cases of uterin cavity adhesion were separated completely and had no complication. Amenorrhvea or rare menstrual flow occurred in 48 cases,and menstrual flow recovered in 43 cases (89 6%) . 24 cases of dysmenorrhvea relieved. 21 of 36 patients who hoped for pregnancy became pregnant(58.3%).The pregnant rate of patients with light uterin cavity adhesion was highest, followed by moderate uterin cavity adhesion, and there was no pregnancy in the cases of serious uterin cavity adhesion(? 2=6 826, P =0 033). Conclusions Hysteroscope combined with B-ultrasound to treat uterin cavity adhesion is a preferable method. Pregnancy after operation was closely related to degree of uterin cavity adhesion.