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Objective:To evaluate the efficacy of gonadotropin-releasing hormone agonist (GnRH-a) pretreatment before total hysterectomy for adenomyosis patients with uterine volume ≥12 gestational weeks and moderate or severe anemia.Methods:From January 2018 to March 2023, 689 patients who underwent total hysterectomy for adenomyosis in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. According to the preoperative medication, they were divided into study group (127 cases) and control group (562 cases). Patients in the study group underwent GnRH-a pretreatment for 3 cycles before surgery, and the control group received operation directly. SPSS 26.0 software was used to perform 1∶1 matching for the two groups of patients through the propensity score matching method. Matching variables included age, body mass index, gravidity, parity, history of pelvic and abdominal surgery, menstrual cycle, menstrual period, dysmenorrhea score, initial diagnosis of cancer antigen 125 (CA 125), uterine volume and hemoglobin value. The dysmenorrhea score, uterine volume, hemoglobin value and CA 125 level before and after GnRH-a pretreatment in the study group were compared. And the duration of operation, intraoperative blood loss, postoperative white blood cell count, perioperative blood transfusion cases, postoperative disease rate, duration of hospitalization, total hospitalization cost between the two groups were compared. Results:With propensity score matching, 119 patients in the study group and 119 patients in the control group were finally enrolled in this study. In the study group, before and after the treatment with GnRH-a, the dysmenorrhea score (7.4±1.7 vs 5.6±1.8), uterine volume [(362±160) vs (233±126) cm 3], hemoglobin value [(74.1±10.7) vs (102.5±13.5) g/L], and CA 125 level [(104±76) vs (64±51) kU/L] were statistically different (all P<0.05). There were statistical differences of operation time [(86±18) vs (116±31) minutes], intraoperative blood loss [(24±9) vs (43±22) ml], white blood cell count after 1 day of operation [(9.80±0.10)×10 9/L vs (9.90±0.10)×10 9/L], number of perioperative blood transfusion case [5.9% (7/119) vs 61.3% (73/119)], postoperative disease rate [5.0% (6/119) vs 16.0% (19/119)], hospitalization duration [(7.1±1.6) vs (7.9±1.6) days], and total hospitalization cost [(35 323±5 275) vs (37 159±5 640) yuan] between the study group and the control group (all P<0.05). Conclusion:The pretreatment of using GnRH-a before total hysterectomy for adenomyosis patients with uterine volume ≥12 gestational weeks and moderate or severe anemia is not only conducive to improving dysmenorrhea, signs of anemia, reducing uterine volume, but also conducive to the implementation of surgery, reducing intraoperative and postoperative complications, and reducing hospital costs.
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The causes for male sexual orientation are complicated, which have not yet been clarified. Recent years have witnessed fruitful progress in the field of biology, while the impact of environment has received little attention. Adverse childhood experiences (ACEs), identified as a special environment in the early stage of development, can affect the individual phenotype by DNA methylation. Given the relationships among male sexual orientation, ACEs, and DNA methylation, as well as based on the existing theory, this article proposes the model "ACEs-DNA methylation-male sexual orientation"from the perspective of environment and epigenetics, aiming to provide a theoretical basis for future research.
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Child , Female , Humans , Male , Adverse Childhood Experiences , DNA Methylation , Sexual BehaviorABSTRACT
Objective:To estimate the status of pregnancy complications among women with polycystic ovary syndrome (PCOS) through a systematic review of published literatures.Methods:Systematic literature searches were conducted in PubMed,Web of Science,Medline,Embase,Cochrane Library,China National Knowledge Infrastructure (CNKI),Wanfang,Weipu and China Biology Medicine disc (CBMdisc),as well as the relevant articles published from inception to April 1st 2017,which reported the prevalence of pregnancy complications among women with PCOS.Random effective models were used to calculate pooled prevalence and 95％ confidence intervals.The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of those included studies.Subgroup analyses were used to evaluate the influence of overweight/obesity and insulin resistance before pregnancy on the estimates of pregnancy complications among women with PCOS.Results:Fifty-nine studies involving 13 378 PCOS women and 49 395 non-PCOS women were included.Among women with PCOS,pooled estimates were 20.26％ for gestational diabetes mellitus,13.94％ for hypertensive disorder ofpregnancy,64.16％ for caesarean section,13.35％ for preterm birth,9.84％ for macrosomia,5.88％ for low birth weight,5.25％ for early gestational age,8.45％ for late gestational age,1.93％ for neonatal malformations,0.88％ for perinatal mortality and 3.71％ for neonatal asphyxia.And the estimates of gestational diabetes mellitus,hypertensive disorder of pregnancy,caesarean section,preterm birth,macrosomia and neonatal asphyxia among women with PCOS were significantly higher than those in women without PCOS (all P＜0.05).Subgroup analysis showed the estimates of gestational diabetes mellitus,macrosomia and late gestational age among PCOS women who were overweight/obesity before pregnancy were significant higher than those among PCOS women with normal BMI (all P＜0.05);and compared to PCOS women without insulin resistance prior to pregnancy,PCOS women with pre-pregnancy insulin resistance were at an increased risk for gestational diabetes mellitus,preterm birth and macrosomia (all P＜0.05).Conclusion:PCOS in pregnancy is associated with high rates of pregnancy complications.It is an important risk factor for pregnancy complications.
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OBJECTIVE@#To investigate the risk factors for type 2 diabetes complicated with hypertension in adult residents in Liuyang, Hunan Province, P. R. China. @*METHODS@#The residents aged at or over 18 were selected through a method of multi-stage cluster random sampling from 10 towns in Liuyang. Questionnaires, physical measurements and laboratory tests were conducted. Type 2 diabetes complicated with hypertension were served as an experimental group, while simple diabetes, non-diabetes and non-hypertension (healthy control), or non-complication and healthy group (simple hypertension, simple diabetes, and healthy group) were served as control group, respectively. Three kinds of logistic regression model were used to analyze the risk factors for type 2 diabetes complicated with hypertension. @*RESULTS@#A total of 5 669 residents were included in the analysis, and the response rate was 97.74%. The results showed that the prevalence of type 2 diabetes complicated with hypertension of residents at or over 18 years old in Liuyang was 2.6% (95%CI: 2.2%, 3.1%). Logistic regression analyses demonstrated that for people at or over 60 years old, obesity and abnormal triglyceride were the independent risk factors for type 2 diabetes complicated with hypertension. @*CONCLUSION@#Aging, obesity and abnormal triglyceride can increase the risk of type 2 diabetes complicated with hypertension in adult residents in Liuyang.