Data Analysis of the Risks of Abnormal Female Reproductive System Haemorrhages Induced by Novel Oral An- ticoagulants Based on FAERS / 中国药房

OBJECTIVE：To eva luate the risk of abno rmal female reproductive system haemorrhage induced by novel oral anticoagulants （NOACs）. METHODS ：The abnormal female reproductive system haemorrhage reports induced by 4 kinds of NOACs as “dabigatran etexilate ”，“rivaroxaban”，“apixaban”and“edoxaban”were used as the first suspected dugs to collected from FDA adverse event reporting system （FAERS）database during Jan. 1st，2004-May 31st，2019. The report odd ratio （ROR） method was used to detect the signal of abnormal female reproductive system haemorrhage induced by NOACs. RESULTS ：A total of 2 658 adverse events related to abnormal female reproductive system haemorrhage were collected from FAERS database ， involving 330 reports of dabigatran etexilate ，2 049 reports of rivaroxaban ，267 reports of apixaban ，and 12 reports of edoxaban. The abnormal female reproductive system haemorrhage caused by dabigatran etexilate ，apixaban and edoxaban mainly occurred in patients aged 75 and older ，accounting for 37.27％，36.70％ and 58.33％ respectively；that of rivaroxaban mainly occurred in patients with 45-64 years old ，accounting for 33.04％. The incidence of severe adverse events （SAE）induced by dabigatran etexilate，rivaroxaban，apixaban and edoxaban were 96.36％，84.53％，47.19％ and 58.33％，respectively. All of patients in the included reports were mainly hospitalized and hospitalization stay wa s prolonged ，accounting for 64.78％，90.01％，86.51％ and 71.43％ ，respectively. A total of 12 suspected signals were detected，involving cervix uteri ，fallopian tube ，ovary，pelvis cavity，uterus，vagina，urinary tract ，etc. Among them ，there were 11 positive signals of rivaroxaban ，and the bleeding events were concentrated in vaginal hematoma [ROR ＝12.07， 药。95％CI（8.51，17.12）]，postmenopausal hemorrhage [ROR ＝ 9.89，95％CI（8.31，11.77）]，pelvic hematoma [ROR ＝7.68，95％CI（5.66，10.43）]. There were 4，4 and 2 suspicious signals for dabigatran etexilate ，apixaban and edoxaban. The main bleeding events of both apixaban [ ROR＝5.18，95％CI（1.81，5.85）] and edoxaban [ROR ＝48.19，95％CI（6.76，343.77）] were vaginal hematoma ；dabigatran etexilate-induced pelvic hematoma [ROR ＝ 12.56，95％CI（8.92，17.70）] had the strongest signal ，followed by urinary tract bleeding [ROR ＝5.41，95％CI（3.34，8.76）] and pelvic hemorrhage [ ROR＝2.53，95％CI（1.88，3.40）]. CONCLUSIONS ：Totally 4 kinds of NOACs can cause abnormal female reproductive system haemorrhage ，and the incidence of SAE is high ，of requiring hospitalization or prolonging hospitalization time. The risk of haemorrhage in rivaroxaban is the highest ，usually manifesting as vaginal hematoma ，postmenopausal hemorrhage and pelvic hematoma. Dabigatran etexilate mainly induce pelvic hematoma ，while apixaban and edoxaban are mainly cause vaginal hematoma.

Descripción histológica del aparato reproductor de avestruz hembra (Strutio camelus var. domesticus) / Histological description of the ostrich female reproductive system (Strutio camelus var. domesticus)

El auge de la producción intensiva del avestruz, comenzó en la década de los noventa impulsada por la calidad de su carne y potencialidad de sus subproductos. La raza empleada para producción por la calidad nutricional y sabor de su carne es el híbrido llamado African black (Struthio camelus var. domesticus). En cuanto a la reproducción, el avestruz hembra alcanza su madurez sexual a partir de los 2,5 años. Es importante considerar el aparato genital en aves de producción, ya que una alteración en él, puede generar deficiencias en la fertilidad que se traducen en un menor número de crías. El estudio histológico del aparato reproductor de la hembra será una herramienta más que permitirá resolver problemas reproductivos. Para este análisis se obtuvo muestras de los diferentes segmentos del aparato reproductor de 6 avestruces hembras en edad reproductiva y se procesaron de acuerdo a las técnicas histológicas de rutina. Los cortes fueron observados, fotografiados y analizados bajo microscopio de luz. Obtenidas las fotografías, se analizó comparativamente su morfología con la descrita en la gallina (Gallus gallus). El aparato reproductor de la hembra tiene la particularidad de tener desarrollado solo el ovario y oviducto izquierdo. El ovario es de gran tamaño y en forma de racimo, el cual varía según la estacionalidad. Presenta folículos primordiales, previtelogénicos, vitelogénicos y atrésicos. Los folículos vitelogénicos presentan células de la granulosa y de la teca interna y externa. El oviducto presenta de cefálico a caudal los siguientes segmentos: infundíbulo, magnum, istmo, útero y vagina, que desemboca en la cloaca a nivel del urodeo. En ellos hay pliegues de variada longitud, grosor y número que comprometen la mucosa y submucosa, con glándulas de secreción mucosa y serosa a excepción de la vagina. El análisis histológico comparativo, permitió establecer que la morfología del aparato reproductor de la hembra es semejante a la observada en la gallina con ciertas diferencias microscópicas (Gallus gallus).

In the 1990's, ostrich production reached a peak in our country, boosted by the special characteristics of its meat and the potential of the derivatives. The breed raised is a hybrid called African Black (Struthio camelus var. domesticus) which has a high quality meat in terms of nutritional factors and flavor. With regard to reproduction, the female ostrich reaches maturity at the age of 2.5 years. Genital organs are very important in fowl's production, because they can generate fertility deficiencies that, in turn can diminish brood number. Histological analysis allows a better understanding of the basic structure of the female's genital organs and is a helpful tool to resolve breeding problems. For this analysis samples were obtained from the different segments of the reproductive system of 6 female ostrich in reproductive age. These samples were processed using standard histological technique. Sections were observed, photographed and analyzed under the light-microscope. Photographs were compared with hen's samples. The ostrich female's reproductive system has the particularity of having just the left ovary and oviduct developed. The ovary has a big size and a cluster shape which varies from season to season. It presents paramount, previtellogenic, vitellogenic and atresic follicles. The vitellogenic follicles have granulosa cells and inner and external theca. The oviduct presents cephalocaudally: infundibulum, magnum, isthmus, uterus and vagina, flowing into the urodeum. It shows long pleats of different length and number, with drusen of mucose and serose secretion, except in the vagina. The comparative histological analysis allowed us to establish that the basic structure of the female reproductive system is similar to that of the hen (Gallus gallus).

Dermatoglyphic Pattern Differences in Females with Reproductive System Cancers and It’s Scope in Preventive Care

Introduction: Female reproductive system cancers shorten lifespan in women because of high mortality and morbidity. The detection of pre-invasive and micro-invasive stages makes near 100% survival of cancer patients. Dermatoglyphics is the scientific study of fingerprints. Many genes which take part in the control of finger and palm dermatoglyphic development distinguished cancer patients from the general population. It is possible that these genes also predispose to the development of malignancy. Since many investigations are needed to confirm the diagnosis of cancers, dermatoglyphics can be used as a screening procedure for planning preventive care if a specific pattern is known for a cancer. Aims and Objectives: To analyze the prints of different cancers, to analyze the results, compare with controls and observe the differences in main parameters of dermatoglyphic patterns and to determine a specific pattern for specific cancers. Subjects and Methods: This is a prospective, observational and an analytical study started after the approval by Institutional Ethical Committee of S.V. Medical College, Tirupati. The material for the study consisted of finger and palm prints of outpatients and inpatients of the Department of OBG, Tirupati, Cancer Hospital in and around Tirupati, Nellore and Kadapa. The ink prints of each finger and palm were collected and analyzed. Results: Ridge counts, digital patterns and main line formulae observed in different cancers in the present study were analyzed and presented. Mean TFRC was higher in normal group. Greater AFRC was observed in cancer cervix patients when compared to controls. In the present study, there is no difference (p> 0.05) in a-b ridge count among carcinoma of cervix and control group in both hands. Differences of mean atd, tad and tda angles among the groups are not statistically significant (P>0.05).The most common C-main line termination pattern of cancers are U followed by R and then Ab. IV interdigital area of both hands presented less incidence of loop pattern in cancer cases when compared to normal group. Special findings in respective cancers are discussed separately and they are not found in any other literature. Conclusion: There are very limited studies in literature on dermatoglyphic pattern in female reproductive cancers. Though the cost of prints is less, more time and skilled human resources are required for their analysis. Study sample size of controls and cases to be increased. Public should be enlightened about dermatoglyphics. If large number of studies are done and a specific pattern is established for specific cancers, then it becomes cost-effective to people so that a risk is predicted beforehand in any disease and preventive methods can be employed at an early age as the dermatoglyphic patterns do not change in a life time.

Study on Grouping Method of Diagnosis Related Groups for Surgical Groups in Female Reproductive System / 中国卫生经济

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

Ultra-estrutura dos ovaríolos de Tropidacris collaris (Stoll) (Orthoptera: Romaleidae) submetido a três fotoperíodos / Ultrastructure of the ovarioles of Tropidacris collaris (Stoll) (Orthoptera: Romaleidae) submitted to three photoperiods

A pesquisa teve o objetivo de avaliar a ultra-estrutura dos ovaríolos de Tropidacris collaris (Stoll), submetido aos fotoperíodos de 10L:14E, 12L:12E e 14L:10E. Foram utilizadas 60 ninfas (30 machos e 30 fêmeas) no último estágio de desenvolvimento, sendo colocados 10 casais em cada tratamento. Trinta dias após atingirem o estágio adulto, as fêmeas foram sedadas com éter etílico e dissecadas sob estereomicroscópio. Os ovaríolos foram fixados em Karnovsky (glutaraldeido 2,5 por cento, paraformaldeído 4 por cento e tampão cacodilato de sódio 0,1 M) e analisados em microscopia eletrônica de transmissão e varredura. Os resultados mostraram não haver influência dos fotoperíodos sobre a ultra-estrutura dos ovaríolos, onde estes apresentaram-se revestidos por uma bainha espessa constituída por um material homogêneo e filamentoso. Na região do filamento terminal observaram-se células com núcleos volumosos, algumas com citoplasma escasso, além de estruturas filamentosas assumindo característica de tecido conjuntivo. No germário, as células germinativas são maiores, com núcleos volumosos, escassos citoplasma e membrana celular com interdigitações. As células foliculares são menores com núcleo pequeno, apresentando ainda projeções citoplasmáticas. No vitelário as células foliculares sofrem modificações na sua morfologia, variando de cúbica a achatada.

The research evaluated the ultrastructure of the ovarioles of Tropidacris collaris (Stoll), submitted to photoperiods 10L:14D, 12L:12D and 14L:10D. Sixty nymphs (30 males and 30 females) in the last stage of development were paired in ten couples in each treatment. Thirty days after adult emergence, the females were immobilized with ethylic ether and dissected under stereomicroscope. The ovarioles were transferred to Karnovsky fixative (2.5 percent glutaraldehyde, 4 percent paraformaldehyde and 0.1 M sodium cacodylate buffer) and analyzed in transmission and scanning electron microscopes. The different photoperiods had no effect on the ovarioles' ultrastructure. Each ovariole is covered by a thick sheath constituted by a homogeneous and filamentous material. In the terminal filament, there are cells with large nuclei, some with scarce cytoplasm and projections cytoplasmatic, besides filamentous structures assuming characteristic of conjunctive tissue. In the germarium, the germ cells are big with large nuclei, scarce cytoplasm and plasma membrane containing interdigitations. The follicular cells are small with a small nucleus, yet presenting cytoplasmatic projections. In the vitellarium the follicular cells suffer modifications in their morphology varying from cubic to flat.