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Objective:To explore the application and teaching effect of TSPV (short for theoretical teaching, simulated surgical skills training, practical surgery training, and video-based review) 4-step teaching in skill training of gynecologic laparoscopic surgery.Methods:A total of 30 trainees who participated in gynecologic laparoscopic surgery training were randomly divided into two groups, with 15 in each group. The experimental group received TSPV 4-step teaching, while the control group adopted traditional teaching and completed training and assessment in stages. The general data, training assessment results, teaching feedback and satisfaction survey of the two groups were compared and analyzed. SPSS 20.0 was used for t-test and Chi-square test. Results:There was no statistical difference in age, gender distribution, education background, clinical working experiences and other general data between the two groups. There was no significant difference in the theoretical examination scores between the two groups [(85.3±4.6) vs. (83.4±4.3), P=0.252]. The scores of simulated operation assessment [(91.7±5.2) vs. [(72.4±5.9), P<0.001] and clinical practice assessment [(88.5±4.8) vs. (82.7±6.7), P=0.011] in the experimental group were better that those in the control group. In addition, the experimental group had a better overall evaluation of teaching satisfaction. Conclusion:TSPV 4-step teaching is a more optimized and popular gynecologic laparoscopic training mode, which is recommended to further promote the validation in teaching.
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Objective:To analyze the clinical data of corona virus disease 2019 (COVID-19) in pregnant women, and to study the characteristics of disease onset, diagnosis and treatment in pregnant women complicated with COVID-19.Methods:The clinical data of 29 pregnant women with COVID-19 hospitalized in Renmin Hospital of Wuhan University from January 30 to February 23, 2020 were retrospectively analyzed. The disease characteristics and experiences of diagnosis and treatment were concluded. The first day of onset was defined as the day when respiratory symptoms such as fever, cough, fatigue, and chest tightness occurred. Group one was admitted to the hospital within the first week of onset, and group two was hospitalized during the second week of onset. Statistical analysis was conducted by t test and Mann-Whitney U test. Results:The age of 29 patients ranged from 24 to 40 years old, with fever, cough and fatigue as the initial symptoms. There were five cases in the first trimester of pregnancy, five cases in the second trimester and 19 cases in the third trimester of pregnancy. There were 28 ordinary patients and one severe patient. Among the 29 patients, 14 were hospitalized in the first week of onset (group one), nine in the second week of onset (group two), and the remaining six were asymptomatic. On the day of admission, 22 patients showed lymphocytopenia in complete blood count and all the indicators of cellular immunity (CD3 + , CD4 + , CD8 + , CD19 + , CD16 + CD56 + T lymphocytes) were reduced in two patients. There were no significant differences between patients in group one and group two (all P>0.05). The levels of IgE and complement 3 were 28.45(18.30, 51.70) IU/mL and (1.219±0.320) g/L in group one, and 20.30(18.30, 75.80) IU/mL and (1.170±0.147) g/L in group two. The differences were statistical significance ( U=67 222.000, t=0.442, P=0.024、0.028). Primary chest computed tomography revealed ground-glass opacity in all 29 cases, which was considered as the diagnostic marker of viral pneumonia. Conventional therapy such as oxygen inhalation, antiviral, anti-infection was the main regimen for COVID-19 in pregnant women. Methylprednisolone and gamma globulin could be used for severe patients or ordinary patients with disease progression and slow recovery. No abortion or premature delivery occurred in patients in the first and second trimester of pregnancy. But in the third trimester of pregnancy patients, three cases of preterm labor and 13 cases of full-term pregnancy were all given emergency cesarean section after admission. One patient admitted to the hospital at gestation of 35 weeks underwent expectant management and then was given cesarean section at 37 weeks + 6 gestation. 2019 novel coronavirus nucleic acid detection in 17 neonatal nasal and pharyngeal swabs were all negative. Nineteen patients were cured and discharged, and the course of the patients was (19.60±5.38) days. The remaining 10 patients in hospital were mild. Conclusions:The COVID-19 patients with pregnancy generally exhibit mild symptoms and a favorable recovery. Concurrent damages to heart, liver and kidney and vertical transmission rarely occur. Most of the patients could be cured under routine treatment.
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Objective To investigate the application of "medical Salon" teaching in standardized training of residents in gynecology and obstetrics department. Methods A total of 30 residents of obstetrics and gynaecology receiving standardized training in the People's Hospital of Wuhan University from August 2015 to March 2018 were enrolled. They were randomly divided into experimental group and control group, with 15 persons in each group. In addition to daily training, the experimental group held a "theoretical salon" once a week and a "surgical salon" every quarter. Both groups of physicians took examinations of basic theories and clinical practice level and received evaluation of training satisfaction;SPSS 17.0 was used to perform t-test or paired t-test on intra-and inter-group data. Results Before the standardization training began, there was no significant difference in the scores of the basic theory and clinical practice between the two groups (P>0.05). After the training, the basic theory and clinical practice scores of the two groups were improved compared with those before training, and the difference was statistically significant (P<0.05). After the training, the scores of the basic theoretical examination of the experimental group were higher than those of the control group [(95.20±3.67) vs. (82.10±5.62)], and the scores of clinical practice of the experimental group was higher than the control group [(96.80±3.26) vs. (79.50±5.28)]; the teaching satisfaction scores of the experimental group were higher as well [(95.50±3.54) vs. (86.70±4.95)]. The differences were statistically significant (P<0.05). Conclusion The"Medical Salon"teaching helps to improve the quality of standardized training for obstetrics and gynecology residents and is worth promoting.
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Objective To explore the effect of lipid raft on cervical cancer cell growth and its mechanisms Methods HeLa cells in logarithmic phase were divided into three groups including control group, lipid raft interference agent group,and NADPH oxidase inhibitors group.Cells were treated with fre sh medium,3 μmol/L Apocynin and 1 mmol/L M-beta CD, respectively, for 24 h.Cell survival rate was detected using the MTT method, and the HIF-1α level was examined by Western-blot. Results Cell growths of the lipid raft interference agent group and NADPH oxidase inhibitors group were significantly slower than control group,(0.612±0.051 vs 0.984±0.034,0.591 ±0.074 vs 0.984±0.034,t=4.062,P＜0.05).HIF-1α expression in the lipid raft interference agent group and NADPH oxidase inhibitors group was also significantly reduced compared with control group (1.79±0.14 vs 2.56±0.22 and 1.54±0.12 vs 2.56±0.22) and the difference was significant (t=2.423,P＜0.05). Conclusion Lipid raft-NADPH oxidase pathway may activate HIF-1α and downstream protocarcinogenic gene expression to promote the growth of cervical cancer cells. The inhibitors of lipid raft and NADPH oxidase may become a new research direction for cervical cancer chemotherapy.
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Objective To search the literature of randomized controlled trials on the treatment of anterior vaginal wall prolapse with adjuvant materials and compare the efficacy and safety of anterior vaginal wall prolapse repair with and without adjuvant materials.Methods Searches were made in the databases of Pubmed,Embase and Ovid for randomized controlled trials from 1980 to 2012 on the treatment of anterior vaginal wall prolapse with adjuvant materials.Comprehensive meta-analyses were conducted with Revman 5.1 analysis software to compare vaginal wall anatomy failure rate,operative duration,intraoperative bleeding volume,postoperative visceral injury,pelvic pain,urinary infection,material exposure,material erosion,de novo urinary incontinence and de novo dyspareunia in the adjuvant materials repair and repair without adjuvant materials groups.Results A total of 20 randomized controlled trials including 2313 participants were retrieved.The shortest average follow-up period was 3 months and the longest 36 months.Compared with repair without adjuvant materials,the application of adjuvant materials in anterior vaginal wall repair reduced vaginal front wall prolapse anatomy failure rate lower anatomy failure rate,had a longer operating duration,more peri-operative bleeding and lower urinary tract infection rate.The comprehensive effects were as follows:P＜0.01,RR =0.51,95％CI:0.41-0.64;P ＜0.01,weighted mean differenece (WMD) =16.25,95％ CI:8.07-24.43;P =0.01,WMD =35.00,95％ CI:6.90-63.11 ;P =0.03,RR =0.51,95％ CI:0.28-0.93,respectively,but the comparison of two groups around in visceral injury,postoperative pain,de novo stress urinary incontinence and de novo dyspareunia had no significant differences (P =0.07,0.58,0.54 and 0.67) and the average materiale exposure and rosion rate were 4.37％ (27/618) and 7.69％ (24/312) respectively.Conclusions The application of adjuvant materials in anterior vaginal wall repair can improve the postoperative recurrence.But no obvious differences exist in the incidence of complications in anterior repair with adjuvant materials and repair without adjuvant materials.
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Objective To investigate the effect on the menstrual patterns and sexual quality of life of patients with adenomyosis after treated with Mirena IUD.Methods56 patients with adenomyosis who were treated with Mirena IUD were recruited from August 2009 to December 2009.We used Menstrual blood loss chart method,Dysmenorrhea score method and Brief Index of Sexual Function for Women (BISF-W) to evaluate the menstrual pattern,the volume of uterus and sexual quality after1,3,6,9,12 months.{Results53 patients were followed up,the rate was 94.6%.The condition of 56 patients became better after treated with Mirena for 3,6,9,12 months,dysmenorrhea[Placed before:(3.15±0.91)points;After placing:(1.41±0.51)points,(0.22±0.09)points,(0.07±0.01)points,0 points]and menstrual quantity[Placed before:(12.0±57.5)points;After placing:(71±23.1)points,(29±19.4)points,(18±10.5)points,(10±4.7)points]were both reduced(P＜0.05),the symptoms were not significantly improved after 1 month(P＞0.05).D2 indicators was significantly improved after 3 months of treatment (P＜0.05),sexual function was also improved after 6 months(P＜0.05～0.01).ConclusionsMirena IUD has a good effect on the menstrual pattern and sexual function for patients with adenomyosis.
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This study investigated the anti-HSV-2 effect of alumen through in vitro and in vivo experiments. Viable cell counting was employed to assess the toxicity of alumen on Vero cells. The inhibition rate of HSV-2 was defined as the cytopathic effect (CPE) of the cells infected with the virus. Alumen suppositories of different concentrations were vaginally applied to the guinea pigs which were then infected with HSV-2 via a vaginal route. The clinical symptoms were observed and the local virus titer calculated. The results showed that alumen had an in vitro anti-HSV-2 effect by means of antiviral duplication, direct killing of the virus, and antiviral adsorption. Alumen suppositories of different concentrations could reduce or completely inhibit HSV-2 infection in guinea pigs. It was concluded that alumen had an in vitro anti-HSV-2 effect through multiple approaches and it could suppress in vivo vaginal HSV-2 infection of guinea pig to some extent.
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Forty nine patients with vesicovaginal fistula underwent transvaginal repair by the use of Foley catheter in our hospital.The clinical data were retrospectively analyzed.The success rate of primary operation was 98% (2/49), the mean operation time was (85±8)min, the mean postoperative hospital stay was( 13±2) d, the rate of postoperative urine leakage was 2%(1/49), the mean bladder capacity was (378±53)ml.Transvaginal repair of vesicovaginal fistula by the use of Foley catheter is an effective surgical modality with satisfactory results.