ABSTRACT
Objective To explore the effectiveness and safety of vaginal paravaginal repair(VPVR) plus vaginal bridge repair in the treatment of female pelvic organ prolapse (POP). Methods Sixty-five patients with different defects of pelvic floor underwent VPVR or plus vaginal bridge repair for posterior vaginal wall. Patients were followed up after operation. The cure rate was estimated subjectively and objectively. The patients' quality of life was evaluated by the pelvic floor distress inventory short form 20 (PFDI-20). Results All 65 cases were treated by vaginal hysterectomy and anterior vaginal repair, in which there were 33 cases underwent VPVR while 32 cases underwent VPVR plus middle area repair. Forty concomitant procedures for vaginal bridge repair were also performed. The average operative time was (110.00±20.12) min and blood loss was (119.52±45.33) ml. The symptom of stress urinary incontinence of 25 cases significantly released after operation. Four incision recovery delayed and there were no other complicatious occurred. Patients were followed up for 6-29 months,the objective cure rate was 100.00% (65/65) and subjective cure rate was 92.31%(60/65), and 58 cases (89.23%)improved significantly with the quality of life comparing with that of pre-operation by completing PFDI-20 (P<0.01). Conclusions It is an effective and safe procedure for VPVR plus vaginal bridge repair to correct median to severe anterior vaginal prolapse and posterior vaginal wall prolapse. More clinical trials are needed to evaluate their long-term outcome.
ABSTRACT
Objective To investigate the effect of chemotherapy on ovarian function in young patients with malignant germ cell tumors of the ovary after conservative surgery.Methods 15 patients (11～29 years old) with ovarian malignant germ cell tumors were treated by ovarectomy and the following chemotherapy.Their menstruation and serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2) levels and basal antral follicle(F0) numbers were observed from the duration of chemotherapy to one year after chemotherapy.The serum levels of FSH,LH,E2 and basal antral follicle numbers between the chemotherapy-related amenorrhea(CRA) patients and the patients with benign tumors of ovary who underwent unilateral adnexa removed at the same period(control group,n=10) were compared.Results Oligomenstruation occurred in 13 of 15 cases undergoing chemotherapy after conservative surgery(86.7%),in whom CRA occurred in 10 cases(66.7%) at the duration of 4-6 cycle chemotherapy appearing significantly rising serum level of FSH,LH and declining serum E2 level and F0 numbers.There was a significantly positive correlation between the frequency of amenorrhea and the duration of chemotherapy(r=1.000,P=0.01).Generally menstruation resumed around 2～3 months after chemotherapy.Ahhough the serum levels of sexual hormone seemed to be normal at half a year after chemotherapy in CRA patients,the serum FSH(8.30±1.46 mU/ml) and E2(80.50±7.86 ng/L) level were significantly increased as compared with that of the control group and the reverse was found in Fo numbers(3.80±1.04) (t Fo,FsH,E2=7.660,5.277,7.225;P F0,FSH,E2<0.001,<0.001,<0.001).One year after chemotherapy,serum hormone level and the ovary reserve function of the CRA patient came to be normal[FSH=(5.59±0.52)mU/ml,LH=(5.25±0.84)mU/ml,E2=(56.50±5.13)ng/L,Fo=(6.50±1.08)] and that of control group [FSH=(5.43±0.35)mU/ml,LH=(5.17±0.48)mU/ml,E2=(58.10±3.73)ng/L,F0=(6.60±0.97)](t=1.177,0.694,0.505,0.740;P>0.05,>0.05,>0.05,P>0.05).Conclusions Ovarian function impairment may occur in young patients in adolescence and sexual maturity period with ovarian malignant germ cell tumors who were treated by conservative surgery followed by chemotherapy.Although the CRA is reversible,the recovery of menstruation does not meail the recovery of ovarian funetion.because the ovarian impairment may continue to a duration of half a year after chemotherapy.The drug which can safeguard ovariall function should be considered during chemotherapy.
ABSTRACT
OBJECTIVE To assure the medical safety,enhance the medical care,prevent medical infection by(endoscope) examination and do effectively the standardized management for rinse and disinfection of endoscope.METHODS Strengthening the organization,to establish and consummate the system,increase the devotion of(facilities,) organize personal training and standardize the work procedures.RESULTS The work for rinse and(disinfection) of endoscope in hospital came to be standardized management gradually.CONCLUSIONS The(standardized) management for rinse and disinfection of endoscope is the assurance for the validity and security of(endoscope) sterilization.