Clinical analysis of modified laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse / 中国实用妇科与产科杂志

OBJECTIVE: To explore clinical effectiveness of modified laparoscopic sacrocolpopexy by using double-mesh in the treatment of pelvic organ prolapse.METHODS: A retrospective analysis was conducted in 61 patients with pelvic organ prolapse who received LSC from September 1,2012 to September 30,2017.Among 61 patients,32 cases received modified LSC(modified group)and 29 cases received traditional Y-mesh LSC(traditional group).The intraoperative and postoperative parameters were compared between the two groups and the improvement in subjective symptoms was evaluated by using the simple questionnaire(PFIQ-7)and subjective cure rate was assessed.RESULTS: The difference was of statistical significance in operation time[(127.34+7.88)min vs.(143.28+15.38)min]between the modified group and the traditional group(P0.05).The median follow-up time of 61 patients was 28 months.In the modified group and traditional group,the objective cure rates were 96.86% and 89.65%,respectively.After operation each indicator point was recovered anatomically according to POP-Q,and there was statistical difference compared with before operation.The score of postoperative PFIQ-7 was obviously reduced compared to the preoperative parameter.The subjective cure rates of the modified group and traditional group were 100% and 94.74%,respectively.There was no new complications occurring in the modified group.There were 3 cases of postoperative mesh exposure in the traditional group.The symptoms of urinary incontinence disappeared after TVT-O in both groups.Two new cases of urinary incontinence occured in both groups after surgery.CONCLUSION: Both of the two operations for pelvic organ prolapse are safe and effective.The modified LSC is an alternative surgical option for ptatients with pelvic organ prolapse because of its advantages,such as simpler operation,shorter operation time,and fewer longterm complications.

Longitudinal analysis of vaginal microbiota in women with recurrent vulvovaginal candidiasis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the vaginal flora in patients with recurrent vulvovaginal candidiasis (RVVC).</p><p><b>METHODS</b>Vaginal swabs were collected at different time points from 6 RVVC patients and 5 healthy women of child-bearing age. The dynamic changes, microbiota composition, alpha diversity and beta diversity in the two groups were assessed by analyzing the 16S rRNA V4 hypervariable region amplified from the total genomic DNA from the swabs.</p><p><b>RESULTS</b>Lactobacillus was the predominant species in healthy women with similar proportions of L.iners and L.crispatus; small proportions of Gardnerella, Prevotella and other genus were also detected. In some healthy women, the vaginal flora showed a high relative abundance of anaerobic bacteria such as Gardnerella, Prevotella, Atopobium, Sneathia. Compared with the healthy women, patients with RVVC showed a significantly reduced diversity of vaginal flora, where L.iners was the predominant species and the content of L.crispatus decreased significantly. In healthy women, the vaginal flora fluctuated with the menstrual cycle, and the fluctuation was the most prominent during menstruation; the dominant species either alternated regularly or maintain an absolute superiority in the menstrual cycle. The vaginal flora showed attenuated fluctuation in women with RVVC, were highly conserved within the menstrual cycle, and maintained a similar composition in the episodes and intermittent periods.</p><p><b>CONCLUSION</b>The vaginal flora of RVVC patients do not undergo regular variations with the menstrual cycle and shows a similar composition between the episodes and intermittent periods. Promoting the production of L.iners or inhibiting the colonization of L.crispatus to restore the composition of the vaginal flora may help in the treatment of RVVC.</p>

Laparoendoscopic single-site surgery for gynecologic malignancy: the first report in China / 南方医科大学学报

<p><b>OBJECTIVE</b>To report the first case of laparoendoscopic single-site surgery (LESS) for gynecologic malignancy in China and discuss the application of LESS in minimally invasive gynecologic surgery.</p><p><b>METHODS</b>A 57-year-old postmenopausal woman presented with vaginal bleeding for 5 years and diagnostic curettage revealed endometrial cancer. Staged LESS for endometrial cancer was performed using a single multiple-channel port (Tri-port) inserted through a solitary 2.5 cm upper umbilicus incision.</p><p><b>RESULTS</b>The operation was completed successfully. The total operative time was 4.5 h, the duration of the LESS procedure was 4.0 h, and the establishment of the operative access took 1.0 h. No other port incision or transfer to open procedure was needed. The intraoperative blood loss was 100 ml. Bowel peristalsis and micturition recovered 2 days after the operation, and the peritoneal drainage tube was removed 4 days after the operation without vaginal bleeding. No obvious scar was left on the surface of umbilicus.</p><p><b>CONCLUSION</b>LESS can be a promising minimally invasive approach to effective management of benign and malignant gynecological diseases.</p>

Transumbilical laparoendoscopic single-site surgery-assisted vaginal hysterectomy: initial report in South China / 南方医科大学学报

<p><b>OBJECTIVE</b>To report the first case of transumbilical laparoendoscopic single-site surgery-assisted vaginal hysterectomy in South China, and discuss its feasibility and safety.</p><p><b>METHODS</b>A 42-year-old woman with multiple myoma of the uterus underwent laparoendoscopic single-site surgery-assisted vaginal hysterectomy performed using a single multiple-channel port inserted through a solitary 2 cm upper umbilicus incision.</p><p><b>RESULTS</b>The total operative time was 3 h, and duration of the laparoendoscopic procedure was 2 h. The surgery was completed uneventfully without an additional port incision or transfer to open surgery. The intraoperative blood loss was 100 ml. Bowel peristalsis was recovered 3 days after the operation. The vaginal stump and abdominal incision healed smoothly without occurrence of vaginal bleeding.</p><p><b>CONCLUSION</b>With the development of surgical instruments and improvement of the surgeons' skills, laparoendoscopic single-site surgery, due to its invasiveness, can be a promising approach to the management of gynecological disease including gynecological malignant tumors.</p>

Small interference RNA targeting nuclear factor-kappaB inhibits endometriotic angiogenesis in chick embryo chorioallantocic membrane / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of small interference RNA (siRNA) targeting nuclear factor-kappaB (NF-kappaB) on endometriosis.</p><p><b>METHOD</b>The eutopic endometrium of women with endometriosis were transplanted into the nonvascular region of 8-day-old chicken embryo chorioallantocic membrane (CAM), and the effects of NF-kappaB p65 siRNA on the vascularization and endometriotic lesion formation were tested with proper controls.</p><p><b>RESULTS</b>Transplantation of the endometrium onto the CAM resulted in a strong angiogenic response in the chicken tissue. The angiogenesis was significantly reduced and endometriotic lesion formation significantly suppressed with siRNA targeting NF-kappaB in comparison with the control group.</p><p><b>CONCLUSIONS</b>The NF-kappaB pathway is involved in the development of endometriotic lesions in vitro, and NF-kappaB gene silencing reduces endometriotic angiogenesis and promotes cell apoptosis in the endometriotic lesions, suggesting that NF-kappaB might be a good target for endometriosis treatment.</p>

Construction of a recombinant adenoviral vector expressing human endostatin / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct the recombinant adenovirus vector expressing human endostatin.</p><p><b>METHODS</b>Human endostatin gene extracted from pGEM-T Easy vector containing the target gene fragment was successfully amplified using PCR and cloned into pShuttle2 vector. The target gene was subcloned into an adenovirus vector and the resulted recombinant adenovirus (Ad-hEndo) was linearized before transfected into HEK 293 packaging cells. The Ad-hEndo recombinant adenovirus was efficiently amplified in 293T cells and purified by CsCl density centrifugation, and the titer of the virus was determined.</p><p><b>RESULTS</b>The amplified hEndostatin cDNA was verified by PCR and sequencing, and the resulted virus titer reached 5.2 x 10(9) pfu/ml.</p><p><b>CONCLUSION</b>The recombinant adenovirus containing human endostatin gene has been successfully constructed, which may provide important basis for gene therapy research for angiogenesis-dependent diseases.</p>

Evaluation of tumor necrosis factor-alpha and tumor necrosis factor-beta in serum of patients with endometriosis / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the levels of tumor necrosis factor-alpha (TNF-alpha) and tumor necrosis factor-beta (TNF-beta) before and after conservative laparoscopic surgery in patients with endometriosis.@*METHODS@#The levels of TNF-alpha and TNF-beta in the serum of both 82 patients with EMS and 68 controls were determined by ELISA.@*RESULTS@#The levels of TNF-alpha and TNF-beta in the serum of patients with EMS were significantly higher than those of the controls (P < 0.01), and they increased with the clinical terms ( P < 0.05). After clearance of endometrosis foci with laparoscopic conservative surgery, the TNF-alpha levels decreased significantly in EMS III - IV, and TNF-beta levels decreased significantly in EMS I - IV.@*CONCLUSION@#Measuring TNF-alpha and TNF-beta levels in the serum of patients with EMS may have important value in postoperative follow-up, surveillance and evaluation of the effectiveness of the surgery.