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Objective:To investigate the efficacy of transumbilical laparoendoscopic single-site supracervical hysterectomy in the treatment of benign uterine diseases.Methods:The clinical data of 39 patients with benign uterine diseases with the volume of uterus less than that at the 14 weeks of pregnancy who underwent supracervical hysterectomy in People's Hospital of Hechuan District of Chongqing, China between January 2018 and December 2019 were retrospectively analyzed. These patients were divided into transumbilical laparoendoscopic single-site supracervical hysterectomy group (single-site group, n = 21) and transumbilical laparoendoscopic multiple-site supracervical hysterectomy group (multiple-site group, n = 18) according to different surgical approaches. Operation time, specimen removal time, intraoperative blood loss, incision suture time, tissue debris shedding rate, postoperative off-bed time, length of hospital stay, pain score on postoperative day 1, time to anal exhaust, and the incidence of complications within 30 days after surgery were compared between the two groups. Results:Tissue debris shedding rate in the single-site group was significantly lower than that in the multiple-site group [0.00% (0/21) vs. 100.00% (18/18), χ2 = 39.00, P < 0.001]. Operation time in the single-site group was significantly longer than that in the multiple-site group [(74.20 ± 9.15) minutes vs. (62.90 ± 6.20) minutes, t = 3.323, P < 0.05). Specimen removal time and incision suture time in the single-site group were (11.10 ± 2.33) minutes and (3.90 ± 0.88) minutes, respectively, which were significantly longer than those in the multiple-site group [(4.90 ± 0.88) minutes, (2.90 ± 0.74) minutes, t = 7.97, 0.386, both P < 0.05]. There were no significant differences in intraoperative blood loss, postoperative off-bed time, pain score on postoperative day 1, length of hospital stay, time to anal exhaust, and the incidence of complications within 30 days after surgery between the two groups (all P > 0.05). Conclusion:Transumbilical laparoendoscopic single-site and multiple-site supracervical hysterectomy can acquire similar short-term surgical outcomes in the treatment of benign uterine diseases at the time of less than 14 weeks of pregnancy and transumbilical laparoendoscopic single-site supracervical hysterectomy can eliminate the long-term complications caused by tissue dissemination.
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Objective:To study the risk factors affecting the prognosis of patients with type Ⅰ endometrial cancer.Methods:A total of 279 patients with type Ⅰ endometrial cancer admitted to the First Affiliated Hospital of Southwest Medical University were enrolled from January 2010 to January 2015. The clinical data of all patients were retrospectively analyzed. The Kaplan-Meier method was used to estimate patients′ survival rate. Cox regression risk model was used to analyze the risk factors that might affect the prognosis of patients with endometrial cancer.Results:Of 279 patients with endometrial cancer, postoperative recurrence was observed in 36 patients. The 5-year disease free survival rate was 87.10%(243/279). The 2, 3 and 5-year survival rates were 95.9% (95% CI: 93.6%-98.3%), 94.3% (95% CI: 91.6%-97.2%), and 90.4% (95% CI: 86.6%-94.3%). Univariate analysis showed that obesity ( HR=2.194, 95% CI: 1.031-4.671, P=0.041), myometrial invasion ( HR=2.957, 95% CI: 1.382-6.329, P=0.005), tissue grading (G2: HR=3.271, 95% CI: 1.336-8.010, P=0.010; G3: HR=9.933, 95% CI: 3.565-27.672, P<0.001), tumor size ( HR=8.067, 95% CI: 2.426-26.821, P=0.001), abdominal cytology ( HR=3.293, 95% CI: 1.523-7.121, P=0.002), surgery-pathological staging (Ⅲ stage: HR=28.357, 95% CI: 11.516-69.828, P<0.001), nature of lymph node ( HR=14.629, 95% CI: 5.023-42.606, P<0.001), cervical interstitial infiltration ( HR=3.806, 95% CI: 1.653-8.764, P=0.002), accessory metastasis ( HR=9.101, 95% CI: 3.831-21.622, P<0.001) and lymphovascular space invasion ( HR=5.011, 95% CI: 2.233-11.249, P<0.001) were all correlated with the prognosis of the patients. Multivariate analysis showed that the independent risk factors for the prognosis of endometrial cancer patients were depth of myometrial invasion ( HR=2.503, 95% CI: 1.115-5.616, P=0.026), histological grading (G2: HR=3.143, 95% CI: 1.205-8.198, P=0.019; G3: HR=3.655, 95% CI: 1.151-11.610, P=0.028), surgery-pathological staging (Ⅲ stage: HR=27.701, 95% CI: 9.608-79.869, P<0.001) and lymphovascular space invasion ( HR=3.297, 95% CI: 1.370-7.936, P=0.008). Conclusion:Obesity, myometrial invasion, tissue grading, tumor size, abdominal cytology, surgery-pathological staging, nature of lymph node, cervical interstitial infiltration, adnexal metastasis and lymphovascular space invasion all affect the prognosis of patients. Depth of myometrial invasion, histological grading, surgical-pathological staging and lymphovascular space invasion are independent risk factors for the prognosis of patients with Ⅰ endometrial cancer.
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Objective To invOstigatO thO clinical OffOct of thO ultrasound monitoring curOttagO and balloon placOmOnt hOmostas in thO trOatmOnt of cOsarOan scar prOgnancy.Methods From May 2014 to May 2016, thO clinical data of 13 casOs with cOsarOan scar prOgnancy in thO POoplO＇s Hospital of HOchuan District wOrO rOtrospOctivOly analyzOd. All 13 casOs rOcOivOd mOthotrOxatO, ultrasonic monitoring curOttagO and balloon placOmOnt hOmostas thOrapy wOrO obsOrvOd.Results Of 13 casOs,11 casOs wOrO curOd, including 9 casOs of gOstational sac OndogOnous typO and mass typO 2 casOs. ThO intraopOrativO blOOding was (167 ± 101)mL, thO opOration timO was (12.3 ± 6.3)min, thO blood HCG droppOd to normal timO was (37.2 ± 13.8)d. ThOrO wOrO 2 casOs of failurO, all of which wOrO OxogOnous gOstational sac .Conclusion Utrasound monitoring curOttagO combinOd with balloon comprOssion is a simplO, safO and Oconomical mOthod for thO trOatmOnt of OndogOnous typO of caOsarOan scar prOgnancy, which is worthy of clinical promotion.
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Objective To investigate the changes of hemoglobin levels in patients with ovarian cancer after chemotherapy and the influence of anemia on the prognosis of patients.Methods A total of 73 patients with ovarian cancer were selected.SPSS 25.0 statistical software was used to analyze the changes of hemoglobin levels after chemotherapy.According to the hemoglobin content before chemotherapy,the patients were divided into anemia group (Hb ＞ 110 g/L) and non-anemia group (Hb ＜ 110 g/L).Log Rand was used to compare the difference of survival time between the two groups.COX model was used to analyze the related factors affecting the prognosis of ovarian malignant tumors.Results The hemoglobin content before and after six chemotherapy cycles were (108.24 ± 18.09) g/L and (100.17 ±21.06) g/L respectively,with significant difference (P =0.021).The incidence of anemia and the degree of anemia gradually increased.The rate of anemia after six cycles of chemotherapy was higher than before chemotherapy,with significant difference (P =0.027).Survival analysis showed that progression free survival (PFS) was significantly lower in the anemic group than in the non-anemic group (P =0.01).COX regression analysis showed that anemia,postoperative residual lesion size,and surgical clinical staging were independent factors affecting the prognosis of patients with ovarian malignant tumors.Conclusions Chemotherapy reduces the hemoglobin content in patients with ovarian malignant tumors and aggravates anemia.Anemia affects the survival rate of patients with ovarian malignant tumors and is an independent factor affecting the prognosis of patients.
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Objective To study the effect of human homologue of polycomb 2 (HPC2) on the growth of cervical cancer cells siha and the regulation of E7 gene.Methods HPC2 and E7 genes of siha cells were silenced by siRNAs respectively.Detected the expression of HPC2 gene and protein in siha cell lines after E7 gene silencing,cell proliferation activity and the rate of cell apoptosis.Results The expressions of HPC2 mRNA and protein were decreased in siha cells with E7 gene silencing,cell proliferation was inhibited,and apoptosis was increased,which was similar to HPC2 gene silencing.Conclusion HPC2 may be involved in the regulation of cell proliferation and apoptosis,and its expression may be closely related to E7 gene in SiHa cells.
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Objective To systematically evaluate the clinical effect and safety of repaglinide and metformin for treating diabetes mellitus (MD) of secondary failure of sulfonylurea (SFS).Methods The randomized controlled trials (RCT) at home and abroad on the comparison of effect and safety of repaglinide and metformin in treating MD with SFS were retrieved.The modified Jadad scale was employed to evaluate the literature quality.The RevMan5.3.1 software was used for conducting the meta analysis.Results A total of 10 RCT were included.The meta-analysis results showed that compared with metformin for treating MA with SFS,repaglinide decreased the fasting blood glucose effectively (MD=-2.30,95 ％ CI:-2.53--2.06,P＜0.01),increased the fasting C-peptide (MD=0.06,95％CI:0.02-0.11,P=0.01),reduced the postprandial 2 h blood glucose (MD=-2.17,95 ％CI:-2.44-1.89,P＜0.01) and decreased glycosylated hemoglobin (MD=-2.60,95％CI:-3.21--2.00,P＜0.01) as well as the adverse reactions (RR=0.05,95％CI:0.02-0.09,P＜0.01).However,there was no statistical difference in fasting insulin between the repaglinide and metformin groups (MD=0.18,95％CI:-0.18-0.54,P=0.32).Conclusion Currently evidences suggest that repaglinide is superior to metformin for treating MD with SFS.
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Objective To investigate the expression of USP22 in cervical cancer cells,and the effects of USP22 on cell proliferation and chemosensitivity to cisplatin in cervical cancer cells. Methods Quantitative real-time polymerase chain reaction(qRT-PCR)was conducted to detect the expression of USP22 mRNA in cervical cancer cells.Cell count kit-8,flow cytometry,and tumorigenesis were performed to detect the effects of USP22 on the proliferation,apoptosis,cycle cycle,and chemosensitivity of cervical cancer cells to cisplatin in vitro and in vivo. Results USP22 was upregulated in cervical cancer cells compared to human immortalized epidermal cells. Cell proliferation was inhibited,cell apoptosis was promoted,cell cycle was arrested in G1 stage and chemosensi-tivity to cisplatin was enhanced in cervical cancer cells transfected with USP22-siRNAs.Furthermore,tumorigene-sis assays proved tumor growth was inhibited and chemosensitivity to cisplatin was enhanced when USP22 was silenced in HeLa cells. Conclusion USP22 expression is upregulated in cervical cancer cells,and USP22 could promote cell proliferation and inhibit chemosensitivity to cisplatin in cervical cancer cells.
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Objective To investigate the correlation between three sperm indexes and the outcome of in vitro fertilization and embryo transfer(IVT-ET) before and after semen treatment.Methods The semen derived from 298 male patients treated with IVT-ET from the Affiliated Hospital of Southwest Medical University was retrospectively analyzed.Routine analysis of semen before treatment was performed according to the WHO standard.Vitrolife density gradient centrifugation combined with upstream method was used to analyze sperm parameters after sperm analysis,and the observation and statistics were performed after fertilization and sequential culture to day 3.Results The total viability of spermatozoa before and after semen treatment,the percentage of normal spermatozoa,sperm density,and other differences were statistically significant (P＜0.05);The normal sperm morphology rate was positively correlated with fertilization rate(r=0.487,P＜0.01) and cleavage rate(r=0.250,P＜0.05);The sperm vitality of post-processed semen was positively related to the fertilization rate (r =0.249,P＜0.05,);and significantly cleavage rate (r =0.272,P＜0.05);After treatment,sperm density was positively correlated with 2 PN(r=0.609,P＜0.01) and multiple PN fertilization rates(r=0.243,P＜0.05).Conclusion Our experimental results indicate that the parameters of post-processed sperm treated at the day when the oocytes were collected may be more helpful in predicting the fertilization rate and cleavage rate of IVF-ET.Therefore,the IVF-ET treatment protocols should be chose based on the normal sperm morphology rate and sperm vitality after semen treatment.
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Objective To evaluate the impact of warmed and humidified CO2 on the gynecological laparoscopic operation. Methods We searched keywords related to gynecological laparoscopic and CO2 pneumoperitoneum temperature and humidity on Pubmed and Wanfang database, then analyze the postoperative pain, analgesic consumption, core temperature, operation time, length of hospital stay. Results 17 publications included into the meta analysis after screening. Compared with the standard laparoscopy, warmed and humidified CO2 can reduce postoperative pain and prevent intraoperative hypothermia. No significant difference in postoperative analgesic consumption, postoperative core temperature, duration of recovery and hospital stay, endoscope lens fog and operation time. Conclusions Only few beneficial effects on postoperative pain and core temperature have been identified in this meta-analysis, though more studies are probably needed to study the real impact of warmed and humidified CO2 for laparoscopic procedures.
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Objective To analyze the impact of uterine septum on pregnancy and influencing factors on postopera-tive pregnancy. Methods 125 patients with septate uterus and bearing requirement who underwent TCRS were fol-lowed up to assess fertility outcome. The clinical data was retrospectively analyzed. Results Spontaneous abortion rate was 70.40%and 19.39%, live birth rates was 10.40%and 72.45 %in preoperation and postoperation respec-tively. The difference was statistically significant ( < 0.05). Spontaneous abortion rate in older than 35 years old group was significantly higher than that in younger than 35 years old group, but live birth rate was lower. There was no significant difference in different times of operation in uterine cavity, number of abortion and septum length and so on. Conclusions TCRS can significantly improve pregnancy outcome. The age has influence on postoperative pregnancy outcome. Abortion numbers, septum length, septal base width, intrauterine device (IUD) and hormone re-placement therapy (HRT) may have no effects.
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<p><b>OBJECTIVE</b>To investigate the location and characteristics of microdeletions of Y chromosome azoospermia factor (AZF) genes in infertile males with azoospermia and severe oligozoospermia in southern Sichuan.</p><p><b>METHODS</b>Multiplex PCR was used to detect 18 sequence tagged sites (STS) involved in Y chromosome AZF microdeletions among 224 infertile males (including 134 azoospermia cases and 90 severe oligozoospermia cases) and 70 healthy males.</p><p><b>RESULTS</b>Among the 224 infertile males, the overall frequency of microdeletions was 12.1% (27/224), and were 13.4% (18/134) in those with azoospermia and 10.0% (9/90) in those with severe oligozoospermia. The most frequent microdeletions have occurred in the AZFc region (51.9%). Compared with the 6 STS loci recommended by European Academy of Andrology and European Molecular Genetics Quality Network, 22.7% more deletions were detected based on the 18 STS loci selected from the AZF region.</p><p><b>CONCLUSION</b>Identification of Y chromosome microdeletions has a significant implication on the diagnosis of male infertility. The most frequent microdeletions have occurred in the AZFc region in southern Sichuan. To use more sequence tagged sites for the screening can improve the reliability and detection rate of Y chromosome microdeletions.</p>
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Adult , Female , Humans , Male , Middle Aged , Azoospermia , Genetics , Chromosome Deletion , Chromosomes, Human, Y , Infertility, Male , GeneticsABSTRACT
Objective To investigate the influence of processed total motile sperm (PTMS) count of husband on clinical pregnan-cy rate of intrauterine insemination(IUI) .Methods We retrospectively analyzed a total of 229 cycles of IUI among 131 patients in our hospital during the past three years .The cycles were divided into 5 groups according to the PTMS count :group A(0 .05) among five groups .Conclusion Ideal clinical pregnancy can be achieved when the PTMS count is between 3 × 106 and 5 × 106 .