Pregnancy outcomes in women with uterine anomalies / 安徽医科大学学报

Objective To investigate pregnancy complications,cesarean delivery and abnormal fetal presentation in women with uterine anomalies.Methods Fifty women diagnosed with uterine malformation and sixty women with normal uterus were retrospectively analyzed .Results The group comprised women with uterine malformation had significantly higher stillbirth or fetal death (P <0.05) and lower rates of the full-term delivery(P <0.05) than that of the control group.The subgroup comprised women with uterine anomalies had significantly higher rates of cesare -an section(P <0.05) and abnormal fetal position(P <0.05) than the control group.The birth weight and length of infant in observation group were significantly lower than those in control group (P <0.05).The rate of placenta abnormalities in uterine anomalies was significantly higher than that in control group (P <0.05).The incidences of premature rupture of membrane,cord entanglement,oligohydramnios,postpartum hemorrhage and neonatal asphyxia in observation group were no significant difference than those in control group .The rate of premature rupture of membrane(PROM) in uterus unicornis was significantly higher than that in other types (P <0.05).Conclusion Compared with women with normal uterus ,the incidences of abnormal fetal position ,the placenta abnormalities,pre-mature delivery,and stillbirth or fetal death in women with congenital uterine anomalies are high .Uterine anomalies are associated with a decrease in the birth weight and length .We should pay more attention to finding the uterine malformation and treatment before pregnancy .Antenatal care should be reinforced in pregnancy women with uterine anomalies.

expression of the autophagy gene beclin-1 mRNA and protein in ectopic and eutopic endometrium of patients with endometriosis

To investigate the expression of Beclin-1 mRNA and protein in eutopic and ectopic endometrium of women with and without endometriosis, and evaluate the association of Beclin-1 protein expression and serum CA125 levels in the endometriosis group due to CA125 being a well-known biomarker of endometriosis. The expression levels [mean +/- SD] of the mRNA and protein of Beclin-1 were examined in uterine endometria from 26 women without endometriosis and in eutopic and ectopic endometria from 26 endometriosis patients through experimental study, as reverse transcription PCR and Western-blotting assays. Serum CA125 levels in the endometriosis and control groups were compared and the correlation between Beclin-1 protein expression and serum CA125 was evaluated in the endometriosis group. Both eutopic [0.12 +/- 0.04, 1.25 +/- 0.42] and ectopic [0.12 +/- 0.05, 1.09 +/- 0.50] endometriotic tissue from 26 women with endometriosis expressed significantly lower levels of Beclin-1 mRNA and protein than endometrium from 26 normal women [0.15 +/- 0.02, 1.67 +/- 0.44] [p<0.05]. Serum CA125 levels were found to be significantly higher in the endometriosis group [p<0.05]. In addition, Beclin-1 protein expression of eutopic endometria in patients with endometriosis was negatively correlated with serum CA125 [r= -0.57, p<0.01]. The present study strongly suggests that Beclin-1 may play a role in the formation and progression of endometriosis

Perioperative nursing of 21 patients undergoing radical cystectomy with ileal neobladder / 现代临床护理

Objective To summarize the perioperative nursing of undergoing radical cystectomy with ileal neobladder for the treatment of bladder cancer? Method The nursing measures included preoperative psychological care,bowel and body preparation as well as postoperative nursing of drainage tube,ileal bladder irrigation,bladder functional exercise and basic nursing care? Results No patients suffered from postoperative complications such as infections,urinary fistula and anastomotic leakage? Twenty patients recovered autonomous urination within 3-6 months after the operation? One patient got minor urinal incontinence? Conclusions Cystectomy with orthotopic ileal neobladder trauma contributes to more complications due to large surgical trauma? Therefore,good perioperative care is important for the successful operations?

Clinical application of in vitro maturation of human immature oocytes for infertile women with polycystic ovary syndrome / 中华妇产科杂志

Objective To investigate clinical effect and safety of in vitro maturation(IVM)of human immature oocytes in infertile women with polycystic ovary syndrome by comparing with conventional in vitro fertilization(IVF)and intracytoplasmic sperm injection(ICSI).Methods From Jan.2003 to Dec.2009,157 infertile women with PCOS underwent 162 cycles IVM in Center for Reproductive Medicine,the First Affiliated Hospital of Anhui Medical University.In the mean time,109 patients with PCOS underwent 114 IVF/ICSI cycles as control group 1 and 106 patients with other factors underwent 106 IVF/ICSI cycles as control group 2.Treatment and outcome of pregnancy and infant were compared among those 3 groups.Results No statistically significant difference were found in terms of the positive rate of hCG in urine[35.7％(56/157),42.2％(46/109),44.3％(47/106)],the rate of clinical pregnancy[29.3％ (46/157),37.6％(41/109),41.5％(44/106)],the rate of entopic pregnancy[1.9％(3/157),1.8％ (2/109),0.9％(1/106)],the rate of miscarriage[18.6％(8/43),12.8％(5/39),20.9％(9/43)]and the rate of live-birth[22.3％(35/157),31.2％(34/109),32.1％(34/106)]among three grbups(IVM group,control group 1,control group 2,P ＞ 0.05).The rate of preterm labor,low weight newborn,mean birth weight,ratio of male to female did not show significantly difference among 3 groups(P ＞ 0.05).The average control ovarian stimulation was 6 days,the median dose of gonadotropin(Gn)was 675 IU,and the total hospital cost was(8392 ± 1328)RMB in IVM group,which were statistically lower than those in the other two control groups(P ＜ 0.01).The rate of multiple pregnancy was 4.7％(2/43)and ovarian hyperstimulation syndrome(OHSS)0 in IVM group,which were significantly lower than those in the other control group(P ＜0.01).Conclusion In vitro maturation is an effective treatment in infertile women with PCOS,it could obtain the similar pregnancy outcome and reduce total cost,the dosage of gonadotropinreleasing hormone and rate of OHSS compared with conventional IVF/ICSI.

Association between recurrent miscarriages and insulin resistance:a Meta analysis / 中华妇产科杂志

Objective To evaluate the association between recurrent miscarriages and insulin resistance.Methods The case-control studies on the association between recurrent spontaneous abortion and insulin resistance from June 1996 to April 2012 were collected from Medline,Elsevier,Chinese Journal Fulltext Database,Chinese Biological Medicine Database,data base of Wanfang,Springer link and EMBASE.RevMan 5.1 software was used for Meta analysis.Results According to the included criteria,7 clinical trials were finally selected.Total 467 cases with recurrent pregnancy loss were enrolled in study group,while 413 women with no history of abnormal pregnancies were enrolled in control group.No significant difference was found in average age and body mass index between the two groups (P ＞ 0.05).Meta analysis results showed that the level of fasting glucose was no statistical difference between study group and control group (WMD =2.27,95％ CI:-1.11 to 5.65,P ＞0.05); fasting insulin level was higher 2.05 mU/L in study group than that of in control group,the difference was statistically significant (WMD =2.05,95％ CI:1.03 to 3.08,P ＜ 0.01).Case number of study group on Homa-insulin resistance ＞ 4.5 was more than that of control group (OR =3.36,95％ CI:1.72 to 6.57,P ＜ 0.01).Case number of study group on glucose/insulin ratio ＜ 4.5 was more than that of the control group,statistical difference was found (OR =3.37,95％ CI:1.90 to 5.99,P ＜ 0.01).Conclusion Insulin resistance is associated with the susceptibility to recurrent miscarriages,and it may contribute to the occurrence of recurrent miscarriages.

Polymorphism of CYP11A1 gene in Chinese patients with polycystic ovarian syndrome / 中华妇产科杂志

Objective To investigate the association between polymorphism of cytochrome P450 subfamily Ⅺ A polypeptide 1 (CYP11A1) gene and polycystic ovarian syndrome (PCOS) in Chinese population. Methods From May 2005 to Dec.2008,290 PCOS cases treated in the First affiliated hospital of Anhui Medical University matched with 344 reproductive women as controls were enrolled in this study. Genotypes of 7 tagging single nucleotide polymorphisms(tSNP,rs12438594,rs4077582,rs9806234,rsl6968477,rs4887139,rs1843090,rsl 1632698)covering CYP11A1 gene (r~2≥0.8) and 3 microsatellite markers (D15S1547,D16S520,D15S1546) were chosed from the phase II database of Han population in HapMap data.Genotype and frequency of allele were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and haplotype of gene polymorphism were analyzed in 290 PCOS cases and 344 controls.Results Among 7 tSNPs and 3 microsatellite markers,the frequency of rs4077582,D15S1547,D15S1546 and rsl 1632698 between two groups reached statistical difference (P =0.010,0.044,0.018 and 0.026).The allele frequency of rs4O77582,rs4887139,rsl843090,D15S1547 and Dl 6S520 showed significant difference between two groups(P=0.002,0.048,0.030,0.001 and 0.024).Among 5 haplotype of CYP11A1(ACGCA13/6/9AG,ACGTA16/6/11AA,GCACG12/8/8AA,GTACA14/4/7GG,GTGCA13/6/7AG),the frequency of GTACA14/4/7GG and ACGCA13/6/9AG were 7.8% (45/580) and 25.3% (147/580) in PCOS group and 11.9% and 19.6% in control group,which showed statistical difference (P< 0.05 ).There was no significant difference in the level of serum androgen at difference genotype from rs4077582 between two groups (P>0.05).Conclusion The polymorphism of CYP11A1 gene was associated with PCOS,however,the relationship between gene sequence covered by tSNP/microsatellite markers and hyperandrogenism of PCOS should be further investigated.

Effect of double activation on the development of frozen-thawed oocytes after intracytoplasmic sperm injection / 中华妇产科杂志

Objective To investigate the influence on developmental potential of frozen-thawed rabbit oocytes with double assisted activation followed by intracytoplasmic sperm injection (ICSI). Methods A total of rabbit oocytes were collected and thawed after vitrification cryopreservation. Among all oocytes were cultured for 1 hour followed by ICSI. 156 Survived oocytes were divided into 5 groups randomly. I0634 single activation: 30 oocytes were added with calcium ionomycin ( I0634 ) at 5 μmol/L for 5 minutes;SrCl2single activation: 26 oocytes were added with strontium chloride at 10 mmol/L for 10 minutes;10634 double activation: 33 oocytes were activated by I0634 twice;SrCl2 double activation: 28 oocytes were activated by strontium chloride twice. Control group: 39 oocytes were not added with any activators. The rate of fertilization, cleavage and blastocysts formation were observed and compared between various groups. Result The rates of fertilization, cleavage and blastocysts formation were in group of SrCl2 single activation were higher than those of I0634 single activation group without statistical difference (54% vs. 33%, 27% vs. 17%, 8% vs. 3%, P <0.05 ). However, those above rates in double activation by I0634 were higher significantly than those of single I0634 activation (82% vs. 33%, 55% vs. 17%, 15% vs. 3%, P < 0.05). The rates of fertilization (61%) was higher and the rate of cleavage (21%) and blastocysts formation (7%) were lower in group of SrCl2 double activation in comparison with group of SrCl2 single activation without reaching statistical difference (P<0.05 ). Notably, the rates of fertilization, cleavage and blastocysts formation in I0634 double activation group were higher than those in group of SrCl2 double activation with statistical difference (82% vs. 61%, 55% vs. 21%, 15% vs. 7%, P<0.05). Conclusion It might enhance the potential of fertilization of oocytes and early embryo development treated by double activation following ICSI, however, those activated oocytes demonstrate rapid cleavage.

Effect of culture time on the spindle and chromosome configurations of human thawed oocytes with slow-cooHng and raid-thawing protocol / 中华妇产科杂志

0bjectlve To examine the metaphase II spindle and chromosome configurations of human oocytes cultured for different times after thawing.MethodsUsing slow.cooling and raid—thawing protocol combined with 0.3 mol/L sucrose and 1.5 mol/L 1,2-propanedio 1(1,2-PROH)to cryoprotect human mature oocytes(n=102),the 64 survival oocytes without abnormal zona pellucida and cytoskeletal were randomly assigned to three groups after thawing:group A:culture 1 hour(n=20),group B:culture 3 hour(n=22),group C:culture 5 hours(n=22),the flesh oocytes served as control group(n=18).Immunocytochefifical staining and fluorescence microscopy were used to assess the morphology of the metaphase II spindle and chromosome.Results(1)The normal spindle rates of groups A,B and C were 10％(2/20),46％(10/22)and 41％(9/22)respectively,significantly decreased compared with control group(83％,15/18;P<0.05).The rates of absent spindle in group A(45％,9/20)was significantly higher than control group(6％,1/18;P<0.01).Also,the rates of absent spindle in group A was higher than groups B(14％,3/20)and C(14％,3/20;P<0.05).However,no significant differences were observed in groups B and C(P>0.05).(2)A significant increase in abnormal chromosome rate was observed in group A(30％,6/20)compared to groups B(68％,15/22),C(64％,14/22)and control group(78％,14/18;尸<0.05).No differences in chromosome morphology were observed in groups B,C and control group(P>0.05).Conclusions The cryoproteetant protocol leads to a deleterious effect on the organization of the meiotic spindle and chromosome at MI stage.The 3—5 hours post—thawing incubation could permit restoration of the meiotic spindles and chromosome.

Study on the correlation of transforming growth factor ?1 and its receptors with spontaneous abortion after in vitro fertilization and embryo transfer / 中华妇产科杂志

Objective To understand the expressions of transforming growth factor ?1(TGF-?1) and its receptors(T?R) in villi and decidua during early pregnancy and their effects on early embryo development, and explore the mechanism of spontaneous abortion. Methods By immunohistochemical technique, expressions of TGF-?1 and its receptors were determined in villi and decidua from 10 cases of spontaneous abortion women after in vitro fertilization and embryo transfer (IVF-ET group), 20 cases of spontaneous abortion women (spontaneous abortion group), and 20 cases of normal early pregnancy women (control group). Results TGF-?1 and its receptors had high expressions in decidua cells, villus glands and interstitial cytoplasm in all three groups. The average light density of the expressions of TGF-?1 in the villi and decidua of IVF-ET, spontaneous abortion and control groups were 0.167 and 0.199, 0.198 and 0.201, 0.277 and 0.274, respectively. The intensity of T?R-Ⅰ in the villi and decidua of IVF-ET, spontaneous abortion and control groups were 0.144 and 0.150, 0.202 and 0.201, 0.238 and 0.281, respectively. And the expressions of T?R-Ⅱ in the villi and decidua of IVF-ET, spontaneous abortion and control groups were 0.199 and 0.145, 0.153 and 0.156, 0.300 and 0.301, respectively. The differences between the control group and both abortion groups were all significant (P

Diagnosis of cord entanglement by B ultrasonic combined doppler examination / 中华疾病控制杂志

Objective To evaluate diagnosis of cord entanglem ent and fetus safety by B ultra-sonic and nemodromometer. Methods 86 pregnant women were diagnosed as cord entanglement in late pregnancy by B ultrasonic examination and Doppler blood flow analysis of the S/D ratio from ma r to May, 1999. The pregnancy outcomes were followed up. Cord entanglement,es -pecially the high blood circulating resistance, suggested that there was h igh risk of fetal distress. The obstetrician would manage the delivery stage pro perly according to the results of Doppler examination.Results 7 2 women were proved cord entanglement after delivery wity coincident rate of 83. 7%. Five women were delivered by cesarean section and forceps among 11 cases of abno rmal S/D ratio, and the rate of operative delivery in group with abnormalS/D rat io was significantly higher than that of the group with normal S/D ratio (P ＜0.05). Conclusions The combined examination can improve the rate of diagnosis of cord entanglement and abnormal S/D ratio, forecast the feta l distress, reduce birth rate of infant with lower Apgar score and reduce the ces arean section rate due to social factor.