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Objective To evaluate the efficacy,bleeding profile and safety of low-dose levonorgestrel-releasing intrauterine system (LNG-IUS 8) in Chinese healthy women of childbearing age.Methods A multi-center,open-label,single-arm clinical trial conducted at 16 centres in China enrolled 773 healthy women of childbearing age (mean age 31.6 years old,range 18 to 40 years old),who demanded contraception,from April 2006 to June 2013.All women placed LNG-IUS 8 for 3 years and then been followed up at 3,6,9,12,18,24,30,36 months.The efficacy variables including pregnancy rate and expulsion rate were analyzed using life table,while observing adverse events (AE) to evaluate the safety.The bleeding profile happened during the study was assessed using 90-day reference intervals (World Health Organization criteria).Results Eight pregnancies occurred among 773 women,resulting in a overall Pearl index of 0.42 per 100 women years.The 3-year cumulative pregnancy rate was 0.37 per 100 women years and the 3-year cumulative expulsion rate was 1.99 per 100 women years.The number of women with bleeding/spotting reduced and the bleeding/spotting days declined over time.Totally 219 AE were reported related to LNG-IUS 8 placements.The most common AE were vaginal bleeding (8.2％,63/773)and the ovarian cyst (6.2％,52/773).LNG-IUS 8 had an improving effect on dysmenorrhea that the percentage of women with dysmenorrhea as well as the days of dysmenorrhea decreased over time.The percentage of women satisfied or very satisfied with LNG-IUS 8 was 87.2％ (622/713).Conclusion LNG-IUS 8 is highly effective and safe for Chinese healthy women of childbearing age.
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Objective To establish the premature ovarian insufficiency (POI) rat model with cyclophosphamide (CTX),and investigate the effects and mechanism of CTX on the ovarian structure and function.Methods Fifty female Sprague-Dawley (SD) rats were randomly divided into model group and control group.Rats in model group received intraperitoneal injection of loading dose CTX (50mg/kg),and maintenance dose of 8mg/(kg.d) for 14 days.Rats in the control group were given the same amount of saline during the same period.The modeling effects were judged by observation and comparison of estrous cycle,levels of sex hormone and morphological changes of organs between the two groups;the apoptosis of follicular granulose cell were detected by TUNEL,the contents of inflammatory cytokines in tissue homogenates were detected by ELISA,and the expressions of apoptosis related proteins were measured by Western blotting.Results Compared with control group,the estrous cycle in model group was disordered;the levels of serum anti-mullerian hormone (AMH) and estrogen (E2) decreased significantly (P＜0.01) and those of follicle stimulating hormone (FSH) increased markedly (P＜0.01);the quantity of follicles decreased obviously (P＜0.05);the endometrium atrophied,the uterine wall thinned and the glands decreased in number.Compared with the control group,the apoptosis of follicular granulose cells increased in model group;the contents of TNF-α,IL-1β and IL-6 in the tissue homogenate increased significantly (P＜0.01),the contents of vascular endothelial growth factor-α (VEGF-α) decreased markedly (P＜0.01);the expression of apoptosis related protein Bax was up-regulated remarkably (P＜0.01),while of Bcl-2 was down-regulated obviously (P＜0.01).Conclusion CTX may induce the changes of ovary structure and endocrine function,and the mechanism may be related to the local microenvironment changes and the imbalance of Bax/Bcl-2 expression in regulating the apoptosis of granulose cells.
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Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China.Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China.200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed.Results A total of 2 093 specimens were collected in this study.The detection rate of Trichomonas was 5.5%(115/2 093). The detection rate of Candida mycelia was 15.9%(333/2 093), with germinal spores was 4.1%(86/2093).The detection rate of bacterial vaginosis was 18.8%(394/2 093).The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3%(571/2 093).The normal flora with the insufficiency of H2O2 accounted for 23%(480/2 093).The bacteria inhibiting flora accounted for 3.8%(79/2 093).The abnormal microflora(non BV type)accounted for 14.9%(312/2 093).The abnormal microflora(BV intermediate type)accounted for 13.4%(280/2 093).The abnormal microflora(BV type)accounted for 17.6%(369/2 093).The average pH of vaginal discharge was 4.58 ±0.495.There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river, while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north.The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors.The patients′age from bacteria inhibition group was 49.64 +16.68 which was significantly higher than that of the other microecology groups.The proportion of abnormal microflora of patients from the oral contraceptive group was 40%(20/50).The proportion of abnormal microflora of patients from IUD group was 36.6%(63/172).Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327)which was significantly lower.The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups.Conclusion This study showed the vaginal microecology status of the Chinese outpatient ′s clinic and found that the vagina microecology was related to age, region and contraceptive methods.The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med,2018, 41:287-291)
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Physical ablation is a new kind of tumor treatment which directly acts on local solid tumors to eradicate or destroy tumor tissues by use of various advanced physical techniques. Physical ablation can be classified by physical characteristics as thermal ablate therapy (TAT), cryoablation and electrical ablation. Recent studies and technical trend of these three physical ablation treatments are reviewed in this paper.
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Animals , Humans , Catheter Ablation , Methods , Cryosurgery , Hyperthermia, Induced , Neoplasms , General Surgery , Therapeutics , Salvage TherapyABSTRACT
In recent years, many experts have done some researches on experiment and mechanism of intracellular electromanipulation (IEM) under nanosecond pulsed electric field (nsPEF). The experiment results have shown that nsPEF could not induce electroporation of cell membrane, but could induce intracellular effects such as apoptosis, calcium release, enhancement of gene expression, and fragmentation of DNA and chromosome. In order to account for the phenomenon, researchers believe that when the pulse width of the pulsed electric field is larger than the charging time of plasma membrane, the pulsed electric field mainly targets on the outer membrane of cell; and that the effect of the pulsed electric field on nucleus and nuclear membrane increases with the decrease of the pulse width. It is also believed that the effect of electroporation changes from the outer membrane to intracellular electromanipulation when the pulse width decreases to a value being smaller than the charging time of plasma membrane.
Subject(s)
Apoptosis , Calcium , Metabolism , Cell Membrane , Metabolism , Cell Nucleus , Metabolism , Cell Physiological Phenomena , Electromagnetic Fields , Electroporation , Gene ExpressionABSTRACT
Objective To investigate ultrasound as a therapy for white lesions of the vulva.Methods Immunohistochemistry and hybridization in situ were used to study changes in VEGF protein and mRNA in the vulva skin of rabbits after ultrasound irradiation.Results After irradiation,VEGF protein and mRNA had increased markedly after 4 and 7 days,but their levels recovered by day 14.Conclusion Ultrasound irradiation causes local edema and hypoxia which enhance production of VEGF.VEGF promotes growth of local microvessels and increases the permeability of the endothelial cells of blood vessels.These changes improve nutrition of the mierovessels and nerve endings and ameliorate the microenvironment for tissue growth.One could speculate that ultrasound irradiation helps rehabilitation and regeneration of pathologic vulva skin.
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Objective To explore the antitumor effect of interleukin 21(IL-21) after transfected into in HeLa cells in severe combined immunodeficiency(SCID) mice or human peripheral blood lymphocytes-SCID(hu-PBL-SCID) mice.Methods pcDNA4/HisMax-IL-21 was transfected into human cervical cancer cell line HeLa to produce HeLa-IL-21 cells.Totally 48 SCID mice were randomly and equally divided into SCID group(0.2 ml PBS,i.p.) and hu-PBL-SCID group(0.2 ml 2?107/ml hu-PBL,i.p.).Then every group was further divided into 3 subgroups(n=6) to receive a subcutemeous implantation of HeLa,HeLa-vector or HeLa-IL-21 cells,and the rest 6 mice were intraperitoneally injected with anti-asialo GM1 50 mg/animal 1 d before and 4 d after HeLa-IL-21 cells transplantation for NK cell depletion.The growth of the tumor mass was observed.Flow cytometry was used to detect CD8-and DX5-positive cells in hu-PBL from hu-PBL-SCID mice,and spleen NK cells from SCID mice or hu-PBL-SCID mice.The secretion of IFN-? and cytotoxicity of splenic cells from HeLa/HeLa-IL-21-bearing SCID mice or hu-PBL-SCID mice were detected with double sandwich ELISA assay and LDH assay respectively.Results Growth of HeLa-IL-21 tumors was significantly suppressed compared with that of HeLa cells,with a slow development and smaller volume.But this growth suppression was not observed in NK cell depletion groups,with SCID group more severe than hu-PBL-SCID group.hu-PBL-SCID mice bearing HeLa-IL-21 cells(16.55?4.53)had a higher toxicity in spleen cells than those SCID mice bearing HeLa-IL-21 cells(8.32?2.12) or HeLa cells(3.42?1.56)(P
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The article summarizes the questions of clinical practicing in obstetrics and gynecology through clinical teaching in person,and find out some measures to improve teaching quality of clinical practicing.
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Objective To explore the clinical efficacy of focused ultrasound for patients with white lesions of the vulva,as well as its safety and feasibility.Methods Clinical data of 941 patients with white lesions of the vulva treated with focused ultrasound from June 2003 to December 2005 were retrospectively reviewed.The mean age of the patients was 40.8 years(18-70 years)and the median course of the disease was 6.2 years(3 months-45 years).Meanwhile,pathological diagnosis was performed in all the patients before treatment,in which 498 cases were squamous hyperplasia,342 cases were lichen sclerosus and 101 cases were lichen sclerosus with squamous hyperplasia.Patients were followed up and therapeutic effects of focused ultrasound was evaluated at 6 and 12 months after the treatment,respectively.The symptoms of pruritus in the vulva and the changes in the color and elasticity of the vulvar lesions were observed.Results Of all the patients,900 were followed up after the treatment,and the ratio of effectiveness was 94.9%.Only 46 patients(5.1%)had no response to the therapy.Of the effective patients,434 cases were completely cured(48.2%),and 420 cases were improved(46.7%).Pruritus of vulva recurred in 101 patients (11.2%)one year after treatment;however,these patients still had a response to the second or third treatment.Conclusions Focused ultrasound therapy is a highly effective instrument in treatment of white lesions of the vulva.It can not only relieve the symptoms of itching,but is also helpful in recovering the color and elasticity of the vulva.