ABSTRACT
Objective:To investigate the clinical characteristics and pregnancy outcomes in pregnant women with left ventricular non-compaction (LVNC).Methods:The clinical data of seven pregnant women with LVNC from January 2011 to December 2021 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed, including age, gestational age of symptom first occured, LVNC history, clinical symptoms, New York Heart Association (NYHA) cardiac function class, echocardiography, blood brain natriuretic peptide (BNP), treatment and the maternal and fetal outcomes.Results:Five cases were diagnosed before pregnancy, of which there were three women with medication; one case diagnosed in the month of pregnancy; one case diagnosed at 36 weeks of gestation. NYHA cardiac function was grade Ⅰ in four cases and grade Ⅱ in three cases before or during the first trimester of pregnancy. Of the five pregnant women who underwent echocardiography, there were one case of left ventricular insufficiency, three cases of mild left ventricular dysfunction and one case of normal left ventricular function before or during the first trimester of pregnancy. Of the five pregnant women to the second and third trimester of pregnancy, there were one case of grade Ⅳ, one case of grade Ⅲ, two cases of grade Ⅱ-Ⅲ and one case of grade Ⅱ in NYHA class ; three cases of left ventricular insufficiency, two cases of normal left ventricular function by echocardiography four cases had cardiac symptoms at 15-24 weeks of gestation and were treated with medication. In four cases, blood BNP increased to 214-1 197 ng/L during pregnancy, and were 89-106 ng/L after termination of pregnancy. There were 4 cases with arrhythmia. Indications for termination of pregnancy: LVNC complicated with heart failure in two cases, LVNC complicated with decreased cardiac function and threatened preterm birth in one case, complicated with pregnancy at full term in two cases, LVNC complicated with severe pulmonary hypertension in one case, and left ventricular dysfunction in one case. Cesarean section in four cases in the third-trimester, in one case in the second-trimester, and forceps curettage in two cases were taken. Two full-term infants,two preterm infants were born without LVNC.Conclusions:Women diagnosed with LVNC and low left ventricular ejection fraction before pregnancy are more prone to decreased cardiac function during pregnancy. Carrying out pregnancy risk assessment and strengthening the multi-disciplinary team management of high risk factors in pregnancy are conducive to achieve good pregnancy outcomes.
ABSTRACT
Objective To evaluate the value of i-Scan in the diagnosis of Barrett′s esophagus.Methods 52 patients diagnosed with Barrett′s esophagus by gastroscopies and pathological examinations were observed under the ordinary edoscopy and i-Scan respectively.Besides,the Barrett's esophageal mucosa were classified by Endo with i-scan mode, the target lesions was taken to be biopsied and pathologically examined.Results ( 1 ) In the 52 patients,mucosal lesions were found in 46 cases (88.5%) under i-Scan and 35 cases (67.3%) under ordinary edoscopy respectively,mucosal lesion detection rate in i-Scan was significantly higher than normal white mode( P<0.01).In the 33 patients which found mucosal lesions in the two modes,the definition of lesion margins,morphology of lesion cryptaeand mucosa capillaries revealed by i-Scan were superior to that by white lighted endoscopy ( P<0.05);(2) Under i-scan mode,the detection of specific intestinal metaplasia ( SIM) of typeⅣ,type V in sensitivi-ty,accuracy,specificity were respectively 90.0%,93.5%,94.4%.Conclusion i-Scan is very easy to operate and has a clear lesion of Barrett′s esophagus,which helps to target the lesion at pathological biopsy.
ABSTRACT
Objective To study the clinical effect of laparoscopic vaginoplasty using pedicled ileal and sigmoid colon segment.Methods From January 2004 to December 2009,105 cases undergoing laparoscope-assisted vaginoplasty using a vascularized pedicled intestinal flap were studied retrospectively.Operation time,blood loss in operating,bowel movement after operation,postoperation hospital duration,side effect,and artificial vagina were compared between two surgical management.Results The vaginoplasty were preformed successfully in all 105 cases.There were 48 patients treated by aparoscopeassisted ileal vaginoplasty and 57 patients treated by laparoscope-assisted sigmoid colon vaginoplasty.The values of the operation time [(141 ±22) minutes versus (159 ± 18) minutes,P =0.000],blood loss in operating [(42 ±6) ml versus (83 ± 14) ml,P =0.000],bowel movement after operation (36 ±9) hours versus (68 ±8)hours(P =0.000),and postoperation hospital duration [(9.8 ±2.0) days versus (11.1 ± 1.3) days,P =0.004] in the sigmoid colon vaginoplasty group were longer or higher than those in ileal vaginoplasty group (P ＜ 0.05).No intraoprative complication occurred.There were four postoperative complications:2 cases with intestinal obstruction in sigmoid colon vaginoplasty group,1 case with urethral orifice stenosis and 1 case with vaginal-rectal fistula in ileal vaginoplasty group.At follow-up of 6-62 months,all artificial vaginas had a capacity of over two fingers in wideness and 12-15 cm in length.Vaginal discharges resembled a milky white water or mucus without odour.Fifty-five patients with sexual intercourse reported satisfactory results.Six patients complained vaginal stenosis:5 patients in ileal vaginoplasty group and 1 patient in sigmoid colon vaginoplasty group.Conclusions Laparoscope-assisted vaginoplasty using pedicled ileum or sigmoid colon segment are both the effective ways in forming vagina.The latter management takes more time and blood loss while operating,yet the incidence of vaginal opening contracture appeared to be decreasing trend.
ABSTRACT
Objective To study the clinical effect of gasless-laparoscopic vaginoplasty using sigmoid colon segment.Methods Clinical data of 119 cases undergoing laparoscopic or gasless-laparoscopic vaginoplasty using a vascularized pedicled sigmoid colon segment in Beijing Anzhen Hospital from January 2007 to December 2010 were reviewed retrospectively.Those patients were classified into 57 cases with laparoscopic sigmoid colon vaginoplasty and 62 cases with gasless-laparoscopic sigmoid colon vaginoplasty.The operation time,blood loss in operating,bowel movement after operation,postoperation hospital duration,side effect,and artificial vagina were compared between laparoscopic and gasless-laparoscopic group.Results The vaginoplasty were preformed successfully in 119 cases.The mean operation time of were (159 ± 18) min in laparoscopic group and (146 ± 17) min in gasless-laparoscopic group,respectively,which reached statistical difference (P ＜0.01).The blood loss in operating were (83 ± 14) ml and (86 ± 13)ml,bowel movement after operation were (68 ± 8) hours and (68 ± 11) hours,and postoperation hospital duration were (11.1 ± 1.3) days and (11.4 ± 1.9) days respectively in laparoscopic group and gasless-laparoscopic group.No significant difference were found in the blood loss in operating,bowel movement after operation,and postoperation hospital duration between two groups (P ＞ 0.05).No intraoperative complication occurred.There were two cases with incomplete adhesive intestinal obstruction at 15-20 days postoperatively,which one was in laparoscopic group and one was in gas-less laparoscopic group.At 6-50 months of following up (median time 12 months),all artificial vaginas had a capacity of over two fingers in wideness and 12-15 cm in length.Vaginal discharges resembled a milky white water or mucus without odour.Eighty-five patients with sexual intercourse reported satisfactory feeling.One patients complained vaginal stenosis in laparoscopic group.Conclusion Gasless-laparoscopic vaginoplasty using sigmoid colon segment is an alternative feasible and practical treatment.
ABSTRACT
BACKGROUND: The postnatal sexual health of women is crucial in reproductive health, due to lack of sexual knowledge and sexual heath care service as well as conventional idea, the medical staff and postnatal women themselves pay little attention and discussion on the sexual health after childbirth.OBJECTIVE; To investigate the prevalence and types of women's sexual problems after childbirth, identify the factors associated with dyspareunia and investigate the status quo of postnatal sexual health care service. DESIGN: Cross-sectional study and follow-up survey within six months after delivery.SETTING: Department of Reproductive Medicine, Chongqing University of Medical Sciences. PARTICIPANTS: A total of 798 primiparous women delivering a live birth in Department of Obstetrics at the First Affiliated Hospital of Chongqing University of Medical Sciences between November 2000 and July 2001, and 79 husbands who accompanied their wives during the follow-ups were adopted in this study.METHODS: The primiparous women after 6 months of childbirth and husbands conducted routine postnatal follow-ups and were informed of the follow-up content. The interview was used in this cross-sectional study and the questionnaires were finished under the help of health professional. And some advice, consultations and treatments can be given in time. MAIN OUTCOME MEASURES; ①main change of postnatal sexual life;②postnatal sexual problems and related factors. RESULTS: Totally 460 out of 798 primiparous women in accordance with the inclusive and exclusive criterions received follow-up surveys after telephone or letter notification. ①Main change of postnatal sexual life: Of the 460 respondents, 94.74% had resumed sexual activity within six months after delivery. Compared with one year pre-pregnancy, the number of sexual activity decreased obviously within 3-6 months after delivery, and 66.0％ of postnatal women decreased the sexual desire.②Postnatal sexual problems and related factors: Sexual morbidity increased significantly after the childbirth: In the first three months after delivery, 70.6％ of women experienced sexual problem(s), declining to 55.6％ during the 4th-6th months, and reduced to 34.2％ at the 6th month, but not reaching pre-pregnancy levels of 7.17％. The sexual problems of women after delivery included dyspareunia, vaginal dryness, orgasm disorder and vaginal relaxation, etc.4. And dyspareunia was the most common type. Between the 4th and 6th month after delivery, dyspareunia was significantly associated with the effect of traditional sexual ideas, experience of dyspareunia before pregnancy and current breastfeeding (P ＜ 0.05), while the association of dyspareunia with delivery mode was not significant.③Sexual care service and sexual counseling after delivery: Only 20.8％ of women received information about sexual health from health care personnel within 42 days after delivery, and consultation rate of sexual intercourse problems was 8.0％.④Husbands' comprehension of postnatal problems in women: Only 59.2％ of partners whose wives had postnatal sexual problem(s) knew that their wives had ever experienced sexual problem(s) and 8.1％ of partners had sought medical help. CONCLUSION; Sexual health problems are very common in women after childbirth, taking up for 70.6％. And the quality of postnatal sexual health is unrelated with delivery mode, but postnatal health care service are often overlooked, additionally lack of professional counseling and treatment. The current practices of encouraging the husband's supports after the childbirth may well influence the prevention and treatment of postnatal sexual problems in women.
ABSTRACT
Objective To study the operative methods and clinical outcome of laparoscopic ileal colpopoiesis with long vascular pedicle.Methods We reviewed 31 cases which had received ileal colpopoiesis,including 25 cases of congenital absence of vagina and 6 cases of male-to-female transsex.All cases were operated on by laparoscopic(8 cases) and laparoscopy assisted(23 cases) ileal colpopoiesis.The postoperative results were analyzed through physical examination and interview regarding the patient′s functional status and satisfaction during sexual intercourse.Results Ileal colpopoiesis were preformed successfully on all 31 cases.Follow-ups of 3-13 months were done for all of them.Patients used vaginal mould for at least 8 months.All artificial vaginas had excellent cosmetic results,including adequate vaginal length,good lubrication,and appearance and physical functions similar to female natural vagina,and sexual function was reportedly satisfactory.One of the patients had an operative complication of an intestinal obstruction,which was cured by a second operation and other treatments.Conclusions The laparoscopic and laparoscopy assisted ileal vaginoplasty is a feasible,safe and ideal method of current vaginoplasty due to its minor damage,excellent cosmetic results and similarity to normal vaginal features.However,vaginal mould should be used for a long period of time(at least 8 months) after an operation,to prevent vaginal orifice shrinkage.
ABSTRACT
Objective:This study was conducted to investigate the effects of mouse blastocysts on invasive,adhesive and mobile capacity of human endometrial carcinoma cells RL95-2 in vitro.Methods:RL95-2 cells were co-cultured with mouse blastocysts.Changes of invasive,mobile and adhesive capacity of RL95-2 cells were measured by the number of cells to penetrate polycarbonates coated with or without Matrigel,and adhesive rate by MTT after co-culture,respectively.Results:After co-culture with mouse blastocysts,number of RL95-2 cells to penetrate polycarbonates coated with or without Matrigel was significantly lower (14?5.66 vs 38.08?13.43 and 24.69?1.57 vs 59.19?2.39,respectively, P