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Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China.Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China.200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed.Results A total of 2 093 specimens were collected in this study.The detection rate of Trichomonas was 5.5%(115/2 093). The detection rate of Candida mycelia was 15.9%(333/2 093), with germinal spores was 4.1%(86/2093).The detection rate of bacterial vaginosis was 18.8%(394/2 093).The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3%(571/2 093).The normal flora with the insufficiency of H2O2 accounted for 23%(480/2 093).The bacteria inhibiting flora accounted for 3.8%(79/2 093).The abnormal microflora(non BV type)accounted for 14.9%(312/2 093).The abnormal microflora(BV intermediate type)accounted for 13.4%(280/2 093).The abnormal microflora(BV type)accounted for 17.6%(369/2 093).The average pH of vaginal discharge was 4.58 ±0.495.There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river, while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north.The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors.The patients′age from bacteria inhibition group was 49.64 +16.68 which was significantly higher than that of the other microecology groups.The proportion of abnormal microflora of patients from the oral contraceptive group was 40%(20/50).The proportion of abnormal microflora of patients from IUD group was 36.6%(63/172).Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327)which was significantly lower.The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups.Conclusion This study showed the vaginal microecology status of the Chinese outpatient ′s clinic and found that the vagina microecology was related to age, region and contraceptive methods.The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med,2018, 41:287-291)
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Objective To explore the relationship of human papilloma virus (HPV) genotype and loading dose with development of cervical intraepithelial neoplasia (CIN) or squamous cell carcinoma of the cervix ( SCC),and explore the relationship of HPV genotype and CIN or SCC.Methods One hundred and twenty four patients in Sun Yat-sen Memoral Hospital of Sun Yat-sen University with CIN or SCC from September 2005 to December 2010 were selected in this study.HPV DNA was detected by Hybrid capture Ⅱand flow-through hybridization and gene chip.The relationship between the infection of HPV and CIN or SCC was analyzed.The influencing factors of CIN or SCC were analyzed by logistic regression.Results The total detection rate of HPV was 75.8％,and it was 44.4％,70.0％,95.7％ and 76.2％ in CIN Ⅰ,CIN Ⅱ,CIN Ⅲ and SCC group,respectively.The detection rate of HPV in high-grade lesion group ( 84.5％ ) was higher than low-grade lesion group(44.4％ ).The median of HPV load decreased in order as CIN Ⅲ,SCC,CIN Ⅱ and CIN Ⅰgroup.Infection of multi-genotypes or single genotype of high-risk HPV accounted for 97.9％.In logistic regression,HPV loading dose had significant influence on degree of cervical lesion.Conclusions Infection of HPV is a main etiological factor for SCC.There is some kind of correlation between HPV loading dose and development of SCC.
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Objective To find out the requirement and to evaluate the effect of post-abortion counseling and education (PACE) among unmarried abortion adolescents.Methods The subjects of the study were unmarried adolescents from 10 to 24 years of age who wanted induced abortion in the Second Affiliated Hospital of Sun Yat-sen University from December 2007 to April 2008.Totally 122 subjects received the intervention of PACE were considered as intervention group.Meanwhile,67 subjects refused the intervention of PACE were considered as no intervention group.Two groups were both investigated the requirements of PACE before abortion and were followed-up at one year after abortion.Results 97.4% (184/189) of 189 unmarried abortion adolescents were willing to receive PACE,48.1% (91/189) of them hoped to receive PACE when saw the doctor,72.0% (136/189) of them required face-to-face counseling during PACE.During the year after abortion,74% (57/77) cases in intervention group and 24% (10/41) cases in no intervention group took effective contraception (P< 0.01 ),while 1% (1/77) of intervention group and 10% (4/41) of no intervention group had unwanted pregnancy.There were significant different for the rate of unwanted pregnancy between two groups (P=0.034).Conclusion For unmarried abortion adolescents,the intervention of PACE may markedly increase the rate of effective contraception used and decrease the rate of another unwanted pregnancy.
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One hundred and twenty four patients with cervical intra-epithelial neoplasia(CIN group)and 300 women in routine health check(control group)were recruited in the study.Ureaplasma urealyticum(UU)DNA in cervical secretions was detected by fluorescent quantitative PCR(FQ-PCR),and detectopm pf HPV was also performed in 103 CIN cases.The positive rate of UU was 64.5%in CIN group and 38.7%in control group(P＜0.05).The results demonstrated that UU infection may be associated with cervical intra-epithelial neoplasia,especially for high-grade lesions;and there may be interaction between UU and HPV infection in development of CIN.
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Objective To discuss the clinical feature, diagnosis and treatment options of adolescent endometriosis Methods The records of adolescent patients with endometriosis (11 20 years old) who were admitted to First, Second and Third Affiliated Hospital of Zhongshan University and Guangdong Provincial People's Hospital between 1990 and 2003 were retrospectively reviewed Results Forty three patients were diagnosed as endometriosis either by laparotomy or laparoscopy The chief symptoms leading to the diagnosis were palpable pelvic mass (18/43), dysmenorrhea (15/43), chronic pelvic mass (10/43) and acute pelvic pain (4/43) The majority of patients (53%) presented with the revised AFS r classification stage Ⅲ, 8 cases (19%) presented with stage Ⅰ, 3 cases (7%) with stage Ⅱand 9 cases (21%) with stage Ⅳ. Nine cases (21%) had complicated genital tract abnormalities Conservative operations, including salpingo oophorectomy ins cases, ovarian cystectomy in 31 cases and laparoscopic vaporization in 8 cases, were performed Surgeries were followed by hormonal suppression using oral contraceptives in a continuous or cyclic manner Conclusions Adolescent endometriosis may occur around 4 6 years after menarche The chief symptoms are palpable pelvic mass and dysmenorrhea The treatment of endometriosis in adolescence does not differ principally from that in adult women In the treatment of endometriosis and for the prevention of recurrence, it is recommended to give 3 6 months of oral contraceptives