ABSTRACT
Objective:To observe the efficacy and safety of single-port laparoscopy for giant ovariotubal cysts.Methods:38 patients with giant ovarian and fallopian tube cysts in Ruijin Hospital Affiliated to Shanghai Jiaotong University Hospital from January 2018 to June 2019 were retrospectively analyzed. They were divided into transumbilical single-port laparoscopy group (18 cases) and traditional laparoscopy group (20 cases). The perioperative related indexes such as operation time, intraoperative bleeding and the number of analgesic cases were compared between the two groups.Results:All 38 patients successfully completed the operation without conversion to laparotomy, and no auxiliary hole was added in the single-port laparoscopy group; There were no postoperative complications and no cystic fluid leakage. In the single-port laparoscopy group, 18 patients were satisfied with the concealment of umbilical scar. There was no statistically significant difference in operation time [(51.67±13.72)min vs (55.50±14.59)min], intraoperative blood loss [(52.22±24.38)ml vs (61.50±28.88)ml] and first postoperative anal exhaust time [(25.77±8.59)h vs (27.60±6.67)h] between single-port laparoscopy group and traditional laparoscopy group (all P>0.05); The number of cases requiring postoperative analgesia in the single-port laparoscopy group (2 cases vs 12 cases) was less than that in the traditional laparoscopy group ( P<0.05); The out of bed activity time [(20.95±3.65)h vs (26.95±5.43)h] and postoperative discharge time [(3.11±0.68)h vs (4.30±1.21)h] were shorter than those in the traditional laparoscopy group (all P<0.05). All 38 patients were followed up in the gynecological clinic for 6-24 months. The incision healed well without recurrence. Conclusions:Transumbilical single-port laparoscopic surgery for giant ovarian and fallopian tube cysts is reliable and safe when the possibility of malignant ovarian and fallopian tube tumors was excluded before operation.
ABSTRACT
The ability of tumor cells to sustain continuous proliferation is one of the major characteristics of cancer. The activation of oncogenes and the mutation or inactivation of tumor suppressor genes ensure the rapid proliferation of tumor cells. The PI3K-Akt-mTOR axis is one of the most frequently modified signaling pathways whose activation sustains cancer growth. Unsurprisingly, it is also one of the most commonly attempted targets for cancer therapy. FK506 binding protein 8 (FKBP8) is an intrinsic inhibitor of mTOR kinase that also exerts an anti-apoptotic function. We aimed to explain these contradictory aspects of FKBP8 in cancer by identifying a "switch" type regulator. We identified through immunoprecipitation-mass spectrometry-based proteomic analysis that the mitochondrial protein prohibitin 1 (PHB1) specifically interacts with FKBP8. Furthermore, the downregulation of PHB1 inhibited the proliferation of ovarian cancer cells and the mTOR signaling pathway, whereas the FKBP8 level in the mitochondria was substantially reduced. Moreover, concomitant with these changes, the interaction between FKBP8 and mTOR substantially increased in the absence of PHB1. Collectively, our finding highlights PHB1 as a potential regulator of FKBP8 because of its subcellular localization and mTOR regulating role.
Subject(s)
Female , Humans , Apoptosis , Cell Line, Tumor , Cell Proliferation , Ovarian Neoplasms , Phosphatidylinositol 3-Kinases , Proteomics , Repressor Proteins , TOR Serine-Threonine Kinases , Tacrolimus Binding ProteinsABSTRACT
Objective:To compare the oncology effect and risk between hepatopplenectomy and conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, so as to provide guidance for clinical application.Methods:One hundred and eighteen patients with hepatic carcinoma with hypersplenism in the Private hospitals of Zhejiang Province Yiwu were studied retrospectively. Patients were divided into 2 groups according to different operation methods: combined hepatosplenectomy group and conventional hepatectomy group with 59 cases in each group. Blood routine, liver function, complication and tumor effect (local recurrence, distant metastasis and 1, 3, 5 years survival rate) was compared between two group.Results:There was no significant difference in operation time, intraoperative blood loss and hospitalization time between the two groups ( P>0.05). Compared with that of the control group, the clinical total effective rate of the combined group was significantly increased: 94.92% (56/59) vs. 79.66% (47/59), P<0.05; there was no significant difference in the incidence of complications between the two groups ( P>0.05); the two groups were followed up to August 1, 2019. The median survival time of the two groups was significantly higher than that of the open group (29 months vs 22 months) ( P<0.05); the local recurrence rate, distant metastasis rate, 1, 3 and 5-year survival rate between the two groups were statistically significant ( P<0.05). The platelet and white blood cells in the combined group were significantly higher than those in the control group after 7 days′ treatment: (264.48 ± 75.37) × 10 9/L vs. (153.53 ± 42.11) × 10 9/L, (7.86 ± 1.43) × 10 9/L vs. (3.48 ± 1.32) × 10 9/L, P<0.05. Compared with that of the control group, alanine aminotransferase and aspartate aminotransferase were significantly decreased: (49.42 ± 31.88) U/L vs. (84.22 ± 43.95) U/L, (36.50 ± 21.50) U/L vs. (49.98 ± 35.63) U/L, P<0.05. Conclusions:Compared with conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, combined hepatosplenectomy can effectively promote the increase of peripheral blood PLT and WBC and the recovery of liver function without increasing the risk of surgery, and the long-term follow-up results are more satisfactory, which has high clinical application value.
ABSTRACT
Objective:To explore the effect of minimally invasive percutaneous pedicle screw internal fixation on the anterior height and Cobb angle of injured vertebra in patients with single vertebra magerl type A thoracolumbar fracture.Methods:71 cases of single vertebra magerl type A thoracolumbar fracture admitted in our hospital from January 2015 to January 2017 were reviewed. Among them, 31 patients who received minimally invasive percutaneous pedicle screw internal fixation were as the observation group, and 40 patients receiving open pedicle internal fixation were as control group. All the patients were followed up for one year, and the preoperative and postoperative indexes, the height of the anterior edge of the injured vertebra and Cobb angle, as well as the score of Oswestry dysfunction were compared between the two groups.Results:The length of incision and the time of descending were shorter in the observation group than in the control group, and the amount of bleeding during operation was less than in the control group ( P<0.05); there was no significant difference in operation time between the two groups ( P>0.05). There was no significant difference in serum creatine kinase (CK) and C-reaction protein (CRP) levels between the two groups ( P>0.05); the levels of serum CK and CRP in the two groups increased significantly after operation, and those in the control group were significantly higher than those in the observation group ( P<0.01). There was no significant difference in the height of anterior edge and Cobb angle between the two groups ( P>0.05); 7 days and 1 year after operation, the height of the anterior edge of the two groups was significantly higher than that before operation ( P<0.01), and the Cobb angle was significantly lower than that before operation ( P<0.01), but there was no significant difference between the two groups ( P>0.05). There was no significant difference in Oswestry dysfunction score between the two groups ( P>0.05); the scores of Oswestry dysfunction were significantly reduced in both groups 7 days and 1 year ater operation, and the observation group was significantly lower than the control group ( P<0.01). Conclusions:Minimally invasive percutaneous pedicle screw fixation can effectively improve the anterior height and Cobb angle of the injured vertebra in patients with single vertebra magerl A thoracolumbar fracture, and the perioperative indexes, serum inflammatory factors and Oswestry dysfunction scores are better than those of open pedicle internal fixation, which is worthy of clinical application.
ABSTRACT
Objective@#To characterize the relations between the practice of parenting and associated factors on children (0-5 years old) in urban areas of China, in order to provide evidence for promoting the early development of children and to provide positive guidance and service programs on parenting.@*Methods@#A total of 4 515 parents from 15 cities (14 provinces) were surveyed with a self-administered questionnaire. Parenting and Family Adjustment Scales (PAFAS) was used, including parameters as: consistency and coercive parenting, positive encouragement, parent-child relationship and parental emotion adjustment, family relationship and parental teamwork aspects, etc. Both single factor analysis and multiple linear regression were used to examine the associations between parenting practice, individual, parental and family factors.@*Results@#The mean score of PAFAS was 21.00 (15.00-28.00), associated with factors as children’s age, only-child family, premature delivery, father’s education level, confidence on parenting, problems regarding the parental mood, annual family income, family structure and behavior on seeking professional help, etc. Results showed that there were big differences on the practice of parenting in China and influenced by variety of factors.@*Conclusions@#The general situation of parenting was well, in the urban areas of China. The practice of parenting was associated with a series of individual, parental and family factors. Programs on improving the parenting skills and promoting the early development of children, should be highlighted.
ABSTRACT
From August 1st to 7th, 2017, the breastfeeding knowledge of medical staff were collected from 52 medical health institutions in 29 provinces through a network system. A total of 35 243 questionnaires were included in the study to analyze the current status of breastfeeding knowledge and related factors. The qualified rate of breastfeeding knowledge questionnaires for medical staff in this study was 75.3% (26 546/35 243). Compared with those in the eastern region and those who were mothers, the qualified rate of breastfeeding knowledge of medical staff in the central region or the western region and medical staff who were fathers or expectant parents was lower, with OR (95%CI) values about 0.71 (0.67-0.75), 0.66 (0.61-0.72), 0.63 (0.55-0.72) and 0.87 (0.80-0.95), respectively. Compared with those attaining high school education or below and those with children aged<1 month, the qualified rate of breastfeeding knowledge was higher in medical staff with bachelor′s degree, graduate degree or above, and with children aged 1-5, 6-23 and ≥24 months, with OR (95%CI) values about 1.92 (1.80-2.05), 2.16 (1.94-2.42), 2.28 (1.93-2.70), 2.41 (2.06-2.83) and 1.99 (1.72-2.32), respectively.
ABSTRACT
Objective@#To investigate the association between maternal nocturnal sleep during pregnancy and their infants′ nocturnal sleep patterns in early infancy by establishing a birth cohort.@*Methods@#In this prospective study,healthy pregnant women and their infants were recruited in Chongqing Health Center for Women and Children from September 2013 to January 2014. A total of 40 healthy pregnant women and their infants were enrolled, and 34 pairs (85%) completed the whole survey. Actiwatch, wearing on the mother′s wrist or infant′s ankle,was used to monitor nighttime sleep at home for 7 times in total,with 7 consecutive days for each monitoring course. Pregnant women were monitored at 16, 24, 32 weeks gestational age, and were required to finish Pittsburgh Sleep Quality Index (PSQI) scale at the end of each monitoring. Their infants were initially monitored at 14 days after birth, followed by 1st, 2nd, and 3rd month after birth,with sleep diary recorded by parents. Pearson correlation analysis and multivariate linear regression were used to investigate the potential correlation between these two sleep patterns.@*Results@#The average nocturnal sleep time was (465±53) min throughout pregnancy, with increased trend in the latency of maternal nighttime sleep onset ((30±15), (34±29), (38±30) min) while decreasing of average sleep efficiency ((85±5)%, (84±8)%, (83±8)%). The longest night sleep duration decreased from (382±74) min in the first trimester to (330±83) min in the third trimester (F=4.932, P<0.05), while awakening time after sleep onset (WASO) correspondingly increased from (27±22) min to (53±25) min (F=12.605, P<0.05). In terms of infants, the latency of nighttime sleep onset decreased from (43±33) min on the 14th day to (20±29) min at 3-month of age (t=3.281, P=0.002), while the longest nighttime sleep duration increased from (20±62) min to (265±140) min (t=3.867, P<0.01); meanwhile, the total nocturnal sleep time and the sleep efficiency increased from (373±126) min and (63±28)% to (431±103) min and (75±16)%, respectively (t=2.362, P=0.024; t=2.418, P=0.039, respectively). After adjusting for maternal age and body mass index (BMI), parental educational level and family income, maternal mood, exposure to tobacco and alcohol during pregnancy, method of delivery, as well as infants′ gender, feeding patterns and gestational weeks, the regression analysis showed that the total nocturnal sleep time and the longest nighttime sleep duration during pregnancy were positively correlated with the corresponding parameters of their infants at the age of 3 months (B=0.541, 95%CI 0.168-0.914, t=2.882, P=0.005; B=0.310, 95%CI 0.035-0.586, t=2.240, P=0.027, respectively).@*Conclusions@#The total nocturnal sleep time and the longest nighttime sleep duration during pregnancy are positively correlated with the corresponding parameters of their infants in early infancy. Paying more attention to improve maternal sleep quality may facilitate their infants to establish sleep-wake patterns early.
ABSTRACT
We reported a case of infectious endocarditis in second trimester of a twin pregnancy. The patient was admitted for "recurrent fever for 5 weeks and left limb hemiplegia for 2 weeks" at 27+2 gestational weeks and underwent aortic biovalve replacement and periaortic valve abscess isolation. Warfarin was given to anticoagulant after operation. The pregnancy was terminated by cesarean section at 35+2 gestational weeks. She and her infants recovered after operation. Clinical manifestations of gestational infectious endocarditis are insidious. Diagnosis promptly and treatment by multidisciplinary collaboration is indispensable.
ABSTRACT
Objective To investigate the factors correlated to the pregnancy rate of the patients with endometriosis after laparoscopy.Methods A total of 80 patients with endometriosis related infertile who received laparoscopic surgery in our hospital from January 2010 to January 2017 were enrolled in this study.The postoperative pregnancy of the patients and related factors were analyzed by logistic regression.Results The postoperative pregnancy rate was 37.5％ (30/80).Among the pregnancies,22 cases were ≤ 12 months,8 cases ＞ 12 months.Logistic regression analysis revealed that postoperative combined medication [gonadotropin-releasing hormone-agonist (GnRH-a)] (OR =19.222,95％ CI:3.528-104.731,P ＜ 0.05) and artificial proconceptive (OR =13.581,95％ CI:1.913-96.397,P ＜0.05) are correlated with pregnancy rate after laparoscopic surgery.Conclusions Postoperative combined medication and artificial proconceptive are influencing factors of pregnancy rate after laparoscopy in endometriosis patients with infertile.
ABSTRACT
Objective@#To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People′s Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood.@*Method@#Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales.@*Result@#In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the Kappa value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6.@*Conclusion@#The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.
ABSTRACT
Objective To construct the growth percentile curves of weight-,length/height-,head circumference and BMI for 1 to 4 year-olds who had been breastfed in urban areas.Methods Data was from the longitudinal study on 1 025 breastfed children aged 1 to 4 years,in 8 urban areas during 2008-2012.MLwiN2.25 was selected to construct the multi-level models of weight-for-age,length for-age,head circumference-for-age and BMI-for-age.The models included many growth relevant factors including gender,age,family and social demographic characteristics,perinatal factors,parent biological characteristics,dietary patterns and diseases of childen.Based on these models,predicted values (P3,P15,P50,Ps5,P97) were estimated to fit the percentiles reference curves.Results The percentiles reference curves of weight-,length/height,head circumferenceand BMI-for-age for the 1-4 year-olds who had been breastfed in the urban areas were developed.Differences of all the indicators between boys and girls were statistically significant (P＜0.001).Weight,length/height,head circumference and BMI were higher in boys than those in girls,with an average differences as 0.56-0.76 kg,0.89-1.12 cm,0.64-0.91 cm and 0.31-0.52 kg/m2.Conclusion The percentiles reference curves on growth,constructed by the longitudinal observational data and scientific method,were important in reflecting the development ofbreastfed children in urban areas.
ABSTRACT
Objective To construct the growth percentile curves of weight-,length/height-,head circumference and BMI for 1 to 4 year-olds who had been breastfed in urban areas.Methods Data was from the longitudinal study on 1 025 breastfed children aged 1 to 4 years,in 8 urban areas during 2008-2012.MLwiN2.25 was selected to construct the multi-level models of weight-for-age,length for-age,head circumference-for-age and BMI-for-age.The models included many growth relevant factors including gender,age,family and social demographic characteristics,perinatal factors,parent biological characteristics,dietary patterns and diseases of childen.Based on these models,predicted values (P3,P15,P50,Ps5,P97) were estimated to fit the percentiles reference curves.Results The percentiles reference curves of weight-,length/height,head circumferenceand BMI-for-age for the 1-4 year-olds who had been breastfed in the urban areas were developed.Differences of all the indicators between boys and girls were statistically significant (P＜0.001).Weight,length/height,head circumference and BMI were higher in boys than those in girls,with an average differences as 0.56-0.76 kg,0.89-1.12 cm,0.64-0.91 cm and 0.31-0.52 kg/m2.Conclusion The percentiles reference curves on growth,constructed by the longitudinal observational data and scientific method,were important in reflecting the development ofbreastfed children in urban areas.
ABSTRACT
Objective To investigate the effects of different drugs and to explore the mechanism of pain in mice with adenomyosis ( ADM) .Methods The mouse model of adenomyosis was induced by oral administration of tamoxifen. The vaginal smear was examined by cytology, and serum levels of 5-HT, GnRH-R, NGF and NF were determined.Results Higher level of 5-HT was detected in the controls compared with the models.The expression of GnRH-R and NGF in nor-mal endometrium and eutopic endometrium were significantly lower than those in ectopic endometrium.The expression on NF in normal endometrium was significantly lower than that in the eutopic and ectopic endometria.Conclusions Similar with regular dose of GnRH-a, half dose of GnRH-a can slow down the progress of ADM as well as reducing pain.Combina-tion of regular dose of GnRH-a and Diane-35 could consolidate the therapeutic effect and even achieve pathological cure.5-HT may take an active part in the mechanism of pain in ADM.
ABSTRACT
<p><b>OBJECTIVE</b>To understand the infantile nocturnal sleep-wake pattern developmental trajectory with Actiwatch, which would benefit the clinical assessment of infantile sleep.</p><p><b>METHOD</b>This study was a longitudinal study conducted between 7 Oct, 2009-30 Oct, 2011 in 10 hospitals of 9 cities of China ( Beijing, Xi'an, Qingdao, Wuhan, Changsha, Chongqing, Huzhou, Xiamen and Liuzhou). Actiwatch was used to track the sleep-wake pattern development trajectory of healthy infants in the first year of life in the home setting. Participating infants were followed up at 10th day and 28th day during the first month, and then monthly from the second to the sixth month after birth, and then at ninth and twelve months of age respectively. Meanwhile, infantile sleep was observed continuously for about 60 hours at each visit. According to the characteristics of repeated measurement data of this study, two-level random effect model was adopted to analyze the trend of infantile nocturnal sleep-wake parameters changing with age, and the gender difference.</p><p><b>RESULT</b>A total of 473 healthy infants were included in this study, among whom 246 (52.0%) were boys, and 227 (48.0%) were girls; 355 (75.1%) infants completed the whole year follow-up survey. With infants' age increasing, the latency of infants' nighttime sleep onset decreased from 66.8 minutes on 10th day to 15.5-18.7 minutes at 6-12 months of age. The number of night wakes also decreased with age, while uninterrupted sleep periods lengthened with age. On the 10th day, there were 3.0 times of nightwaking on average, and the longest continuous sleeping interval lasted for 227.6 minutes on average. At 12-month of age, infants could sleep continuously for 350.9 minutes at most on average, while the number of nightwaking decreased to 1.6 times per night on average. Generally, nighttime sleep efficiency increased from 66.3% on the 10th day to 86.3% at 12-month of age. The differences of sleep-wake patterns between boys and girls presented as boys' nocturnal longest uninterrupted sleep period was 19 minutes shorter(266.6 vs. 285.6 min), and the average nighttime sleep efficiency was 2.2% lower (74.2% vs. 76.4%) compared with girls respectively. And the differences of sleep efficiency between boys and girls reduced gradually along with the growth.</p><p><b>CONCLUSION</b>During the first 6 months after birth, infantile sleep-wake pattern undergo obvious change. The capability of sleep-onset and uninterrupted sleep improved with age, and the sleep efficiency increased.</p>
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , China , Longitudinal Studies , Sleep , Physiology , Surveys and QuestionnairesABSTRACT
OBJECTIVE@#We used electrophysiological methods to study that whether GABA could elicit OHCs outward currents provide evidence for exsitence of GABA-A receptor and investige the relationship between the effect of GABA and the development of OHCs.@*METHOD@#We used whole-cell recording OHCs at current-clamp or voltage-clamp to verify the function of GABA receptor on OHCs. Then we counteds the responsive cells vs. total number cells, and according to results to study the relationships between the GABA receptor and development of OHCs.@*RESULT@#OHC was elicited outward current or hyperpolarized by GABA and the responsive cells were decreased with development.@*CONCLUSION@#The result of GABA receptor decreasing with development suggested that the receptor may draw efferents to OHCs or facilitate the MOC-OHC synapse formation.
Subject(s)
Animals , Rats , Electrophysiological Phenomena , Hair Cells, Auditory, Outer , Physiology , Patch-Clamp Techniques , Receptors, GABA-A , Physiology , gamma-Aminobutyric Acid , PhysiologyABSTRACT
Tumor dormancy is a state that tumor cells long-term exist in human body,without obvious growth. Dormant cell is one of the origins of tumor recurrence or metastasis. The exact mechanism of tumor dor-mancy is still unclear. Combined with cellular and molecular biological techniques,tumor cell transplantation and culture in vitro can establish experimental tumor dormancy-recurrence models. These in vivo and in vitro models can be used to investigate mechanisms of tumor dormancy and to explore novel treatments.
ABSTRACT
Compared to the conventional two-dimensional (2D) culture,in vitro three-dimensional cell culture (3DCC) can mimic the microenvironment more exactly.Compared to in vivo animal models,3DCC is less time-consuming and can be real-time recorded.Thus,3DCC fills the gap between 2D culture and animal models,which is used for oncologic research quickly.In 3DCC,the characteristics of cancer cells,such as morphology,the capability of invasion and migration and the resistance to chemo-radiotherapy,are quite different from those in 2D culture.The development of 3DCC technology provides a platform for oncology,organization engineering and gene or drug screening.
ABSTRACT
Numb,one of the important cell fate determinants,plays a key role in regulation of nerve system development,and it is closely related to the occurrence of tumors.It is proven that Numb is implicated in the processes of occurrence,invasion and metastasis of tumors through regulating the way of cell division,cell polarity,epithelial-mesenchymal transitions and several signal pathways,e.g.,Notch,Hh,p53.The expression levels of Numb in cells are related to the malignant degree and prognosis of tumors.It is vital to explore the role of Numb in tumors for treating tumors at the standpoint of Numb.
ABSTRACT
Objective To investigate clinical significance and application of modified pelvic floor reconstruction developed by Peking Union Medical College Hospital ( MPFR ) in treatment of severe pelvic organ prolapse (POP) by comparing the effectiveness, quality of postoperative sexual life, life satisfaction and risk factors for POP recurrence with the following two surgical procedures: traditional total vaginal hysterectomy with anterior-posterior colporrhaphy (TVH-APC) and total vaginal hysterectomy with lateral colporrhaphy and sacrospinous ligament fixation and vaginal bridge repair and episiotomy (TVH-LC-SSLFVBR-EP). Methods Totally 173 patients with severe POP and at least two compartments defects of pelvic floor underwent surgeries in the study, 86 patients (group A) were treated by MPFR with polypropylene mesh application, 58 (group B) were treated by TVH-APC, and 29 patients (group C) were treated by TVH-LC-SSLF-VBR-EP. Peri-operative data and outcomes of postoperative courses at 6, 12, 18 months were collected and analyzed, in the meantime, the risk factors of recurrence were studied. Results (1) No statistical difference was observed among the above 3 groups in terms of length of operation, amount of blood loss, length of hospital stay, and morbidity after surgery ( P ＞ 0.05). ( 2 ) Cost hospitalization was ( 11 448 ±3049) Yuan in group A, which was significantly higher than (7262 ± 1607) Yuan in group B and (7140 ± 1817 ) Yuan in group C (P ＜ 0.05 ). (3) The length of vaginal cuff of (7.5 ± 1.4) cm in group A and ( 5.6 ± 1.1 ) cm in group C were significantly longer than (7.1±0.6) cm in group B ( P＜0.05). The width of vaginal cuff of (4.3±0.3) cm in group A was larger than (3.4±0.3) cm in group B and (3.3±0.4) cm in group C (P＜0.05). (4) The recurrence rate at 12 months after surgery was 12.8% (11/86)in group A, which was similar with 17.2%(5/29) in group C (P＞0.05) and significantly less than 36.2% (21/58) in group B (P＜0.05). The rate of active sexual life of 16.3% (14/86) in group A was significantly higher than 1.7% (1/58) in group B and 0 in group C ( P ＜ 0. 05 ). The index of life quality improvement at 12 months after surgery was 48±12 in group A, which was no less than 53±16 in group C ( P＞0.05) and higher than 27 ± 9 in group B ( P＜0.05). (5 ) Mesh rejection was observed in 6 patients in group A within 3 months after surgery, while the posterior vaginal wall was exclusively involved. No difference was found in urinary retention or urinary incontinence among three groups (P ＞0. 05 ). (6) The severe degree of POP, type of surgical procedure ( TVT-APC), anterior compartment defect of pelvic floor,and early days of performing pelvic floor reconstruction surgeries were high risk factors for POP recurrence (P＜ 0.05). Conclusions MPFR has a better curative effect and lower recurrence rate on patients with POP. It can help patients regain integrity of anatomical structure and functions of pelvic floor. TVH-LCSSLF-VBR-EP is also effective.
ABSTRACT
Objective To investigate the influence of gonadotropin-releasing hormone (GnRH) analogues on ovarian cancer and ovarian function in vivo.Methods ES-2 cells were cultured and xenotransplanted into 36 nude mice,which were divided into 6 groups:normal saline (NS) group:NS 0.1 nd/day subcutaneous injection,and then NS 0.2 ml/week peritoneal injection; cisplatin (DDP) group:NS 0.1 ml/day subcutaneous injection,and then DDP 5 mg/kg ( diluted to 0.2 ml ) per week peritoneal injection; goserelin group:100 μg goserelin ( diluted to 0.1 ml) per day subcutaneous injection,and then NS 0.2 ml/week peritoneal injection; goserelin + DDP group:100 μg goserelin ( diluted to 0.1 ml) per day subcutaneous injection,and DDP 5 mg/kg (diluted to 0.2 ml) per week peritoneal injection; cetrorelix group:100 μg cetrorelix (diluted to 0.1 ml) per day subcutaneous injection and NS 0.2 ml/week peritoneal injection; cetrorelix + DDP group:100 μg cetrorelix (diluted to 0.1 ml) per day subcutaneous injection and DDP 5 mg/kg ( diluted to 0.2 ml) per week peritoneal injection.All the peritoneal injection started from subcutaneous injection one week later.To compare the weight of nude mice,the volumes of transplanted tumors,the expression of Ki-67 antigen in transplanted tumors,the estrus,the ratio of atretic follicles,the ratio of primary and preantral follicles,the levels of serum anti-Mullerian hormone ( AMH ),folliclestimulating hormone ( FSH),estradio ( E2 ) and progesterone (P) in each group.Results There were no significant difference in the weight of nude mice among 6 groups ( P ＞ 0.05 ),which on day 29 in NS group was ( 19.8 ±2.2) g,DDP group (20.5 ± 1.4) g,gosereline group ( 19.6 ±0.9) g,goserelin + DDP group ( 19.7 ± 1.6) g,cetrorelix group (20.7 ±2.2) g,and cetrorelix + DDP group ( 19.0 ± 1.7) g.The tumor volumes of different groups on the 12th day:NS group (241 ± 179) mm3,DDP group (78 ±20) mm3,gosereline group (78 t±55) mm3,goserelin + DDP group (64 ±48) mm3,cetrorelix group (78 ±64) mm3,or cetrorelix + DDP group (70 ± 19) mm3,in which there were significant difference between NS group and the other groups ( P ＜ 0.05 ) ; and the same result was obtained on day 15,19,22,26 and 29 ( P ＜ 0.05 ).The expression of Ki-67 in NS group was ( 33 ± 10 ) ％,in which it was higher than those in DDP group 3.5％,goserelin group 8.8％,goserelin + DDP group 1.5％,cetrorelix group (23 ± 11 ) ％,or cetrorelix + DDP group ( 8 ± 6 ) ％ ( P ＜ 0.05 ).The ratio of primary and preantral follicles in goserehn group was (71.5 ± 8.1 ) ％,in goserelin + DDP group was (62.4 ± 4.1 ) ％,in cetrorelix group was (71.2 ± 7.4) ％,and in cetrorelix + DDP group was (63.8 ±3.1 )％,in which they were much higher than that in DDP group ( 47.0 ± 4.8 ) ％ ( P ＜ 0.05 ).The level of AMH in goserelin group was ( 98 ± 27 ) ng/ml,which was much higher than that in NS group (66.2 ± 17.4) ng/ml (P ＜0.05),while there were no difference in the levelsof FSH,E2 or P among different groups ( P ＞ 0.05).Conclusion GnRH analogues could inhibit the growth of transplanted tumors in nude mice,meanwhile increase the secretion of AMH,decrease the frequencies and prolong the lasting time of estrus,decrease the ratio of atretic follicles,raise the ratio of primary and preantral follicles,which may be protect the ovarian function of nude mice.