The exploration of infertility′s pathogenesis through gene editing technology / 中国医师杂志

Recently, the incidence rate of infertility has been increasing year by year. Lesions of the female reproductive system are the most important causes of infertility, such as premature ovarian failure, polycystic ovary syndrome, pelvic inflammatory disease, endometriosis, recurrent abortion, etc. However, the specific pathogenesis of infertility needs to be further studied. Gene editing is a technical method to change the sequence of deoxyribonucleic acid (DNA) in biological cells, which is an indispensable tool for studying gene function and disease pathogenesis. In this research, we review the recent progress in studying the pathogenesis of female infertility related diseases through gene editing technology, so as to explore a new direction for the clinical diagnosis and treatment of infertility.

Chronic mucocutaneous anogenital herpes: series of ten cases and literature review

Abstract Anogenital herpes is one of the most prevalent sexually transmitted infections worldwide. It has several clinical manifestations, from cases of primary herpes infection to recurrent forms, among them chronic mucocutaneous herpes. This presentation is rare, characterized by a duration of more than four weeks, usually associated with immunosuppression and resistance to classic anti-herpetic treatment. The present study presents a series of ten cases of chronic mucocutaneous herpes with a discussion about its clinical, laboratory, and therapeutic aspects.

Diagnosis and treatment of Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma infections in female genital tract / 中华检验医学杂志

Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma are common in female genital tract infections,which are associated with urethritis,cervicitis,pelvic inflammatory disease,ectopic pregnancy,infertility,chronic pelvic pain and perinatal infections.They can cause the infectious diseases asymptomatically,which would be easily neglected.Nucleic acid amplification test(NAAT)can provide an accurate diagnosis for these diseases,and qualified laboratories should be suggested to develop the project. Appropriate sensitive antibiotics and sex partners participation are essential for treatment.Noticeably, asymptomatic carrier should be differentiated during the treatment of Mycoplasma infections.It should increase awareness of these infectious diseases,in order to reduce the harm caused by misdiagnosis.(Chin J Lab Med,2018,41:263-266)

Prevalence of breast and gynecological diseases in female workers in the administrative office and workshop of an automobile part factory / 中华劳动卫生职业病杂志

Objective@#To investigate the prevalence of breast and gynecological diseases in female workers in the administrative office and workshop of an automobile part factory, and to provide a basis for promoting the health of female workers.@*Methods@#In March 2015, color ultrasound examination of the breast, uterus, and bilateral adnexa was performed for all female workers, and routine gynecological examination, routine leucorrhea examination, and thinprep liquid-based cytology test were performed for married female workers. The detection rates of breast and gynecological diseases in female workers in the administrative office and workshop were analyzed.@*Results@#In the 314 female workers, the overall detection rate of breast and gynecological diseases was 86.31%; the detection rate of abnormal breast ultrasound results was 72.93%, mainly breast hyperplasia; the detection rate of abnormal gynecological ultrasound results was 12.14%, mainly hysteromyoma, pelvic effusion, and uterus-rectum fossa effusion. The overall detection rate of cervicitis or vaginitis in married female workers was 66.86%. The univariate analysis showed that compared with those in the administrative office, the female workers in the workshop had significantly higher detection rates of breast hyperplasia and grade 2 breast lesions on the Breast Imaging-Reporting and Data System (BI-RADS) and significantly lower detection rates of hysteromyoma and grade 3 breast lesions on the BI-RADS (all P <0.05) . The multivariate analysis showed that age was a risk factor for hysteromyoma (OR=1.261) , age and working in the workshop were risk factors for breast hyperplasia (OR=1.065 and 1.834) , married status was a protective factor against breast hyperplasia and grade 2 breast lesions on the BI-RADS (OR=0.334 and 0.450) , and working in workshop was a risk factor for grade 2 breast lesions on the BI-RADS (OR=1.890) and a protective factor against grade 3 breast lesions on the BI-RADS (OR=0.355) .@*Conclusion@#Female workers in an automobile part factory have high prevalence rates of breast and gynecological diseases. Night shifts for female workers in the workshop should be reduced as much as possible, and female workers, especially those in the administrative office, should be guided to release pressure and take a balanced diet.

The multivariate analysis of CA125 and inflammation indicators in gynecological diseases / 国际检验医学杂志

Objective To investigate whether there is a correlation between carbohydrate antigen125(CA125) and inflammation indicators in gynecological diseases ,analyze the possible mechanism of the disease .Methods Retrospectively analyze the regression and correlation between CA125 and routine blood classification indicators in 4 291 patients from department of reproductive health and gynaecology .Stepwise multiple regression model was used to analyze the common disease from department of gynaecology in‐cluding pelvic infection ,endometriosis ,uterine fibroids .Results The analysis of 4 291 cases showed that there was a correlation be‐tween CA125 and leukocyte count ,neutrophil‐to‐lymphocyte ratio (NLR) .The correlation coefficient was 0 .170 .For diseases of different types ,in patients with pelvic inflammation and endometrial ectopic there were correlations between CA125 and NLR .The correlation coefficient were 0 .290 and 0 .342 respectively .Conclusion There might be a correlation between CA125 and the inflam‐mation indicators .It should be carefully to diagnose cancer related diseases ,especially when inflammatory factors and CA125 in‐creased at the same time .

Value of ultrasound in obstetrics and gynecology emergency in diagnosis and differential diagnosis / 中国医师杂志

Objective To explore the value of ultrasonography in the diagnosis and identification of Obstetrics and Gynecology in accident and emergency.Methods A retrospective method was taken to 80 cases of obstetrics and gynecology emergency patients with ultrasound diagnosis data analysis in the hospital from June 2014 to June 2015,and compared to surgical and pathological diagnosis,to observe the ultrasonic diagnosis value.Results The correct rate of the ultrasound diagnosis of ectopic pregnancy,ovarian cyst torsion,inevitable abortion,threatened abortion,corpus luteum rupture,trophoblastic disease,and acute pelvic inflammatory disease was 90.9％,94.1％,100.0％,100.0％,85.7％,75.0％,and 100.0％,and the overall diagnostic accuracy was 93.8％.Conclusions The Emergency Department of obstetrics and gynecology patients used ultrasound has a better diagnosis effect,and high diagnostic accuracy.At the same time,the ultrasound examination is gynecology and obstetrics emergency check the preferred way,strong repeatability,and better observed lesions,high application value.

Application of Point Zigong to Gynecological Diseases and Its Modern Theoretical Basis / 上海针灸杂志

Point Zigong is an empirical point for acupuncture treatment of gynecological diseases. Now it is widely applied to clinical treatment and has a marked therapeutic effect. The therapeutic effect of point Zigong stimulation on gynecological diseases is closely related to the anatomical position, morphostructure specificity and action effect of the acupoint. In the present study on this acupoint, the single acupoint is seldom applied and the mechanism is not completely clear. It is needed to conduct a thoroughstudy in the future.

Resultados citopatológicos de mulheres que realizaram exame do colo do útero em um laboratório escola da Universidade Federal de Goiás, Goiânia-GO: estudo de prevalência / Cytopathological results from women that realized the examination of cervix in a laboratory-school from Federal University of Goiás, Goiânia-GO: prevalence study

Objetivo - Avaliar a prevalência de câncer de colo do útero e infecções genitais em mulheres atendidas no serviço de saúde pública de Goiânia-GO. O exame de Papanicolaou é o método utilizado para detecção das lesões intraepiteliais e neoplásicas da cérvice uterina, tendo importante papel na prevenção do câncer do colo do útero e no diagnóstico das infecções genitais. Métodos - Estudo retrospectivo dos laudos dos exames citopatológicos das mulheres atendidas nas Unidades de Atenção Básica em Saúde (UABS) de Goiânia-GO, entre 03/2006 a 05/2008. Os esfregaços citológicos foram analisados no Centro de Análises Clínicas Rômulo Rocha da Faculdade de Farmácia da Universidade Federal de Goiás (CACRR/FF/UFG). Resultados - Um total de 15.615 mulheres foi incluído no estudo. A mediana de idade foi de 33 anos (14-93 anos), a maioria (57,6%) tinha entre 20 e 39 anos e 6,6% (n=1.034) eram < 20 anos de idade. Mais de 50% dos casos de infecção entre adultas e adolescentes eram causados por Gardnerella vaginalis e 13,6% por Trichomonas vaginalis. Entre mulheres mais jovens (20-39 anos),16,9% das infecções foi causada por Candida sp. Aproximadamente 7,6% dos esfregaços avaliados apresentaram alterações celulares, sendo 4,9% células escamosas atípicas de significado indeterminado/lesão intraepitelial escamosa de baixo grau (ASC-US/LSIL) para as mulheres entre 20-29 anos e 2,6% células escamosas atípicas com possível lesão de alto grau/lesão intraepitelial escamosa de alto grau e células glandulares atípicas (ASC-H/+) para mulheres entre 20 e 49 anos. Conclusão - Lesões graves em mulheres jovens chamam atenção para a necessidade de políticas de saúde pública que reforcem a importância do Papanicolaou para a prevenção do colo de útero.

Objective - To correlate the prevalence of cervical cancer and genital infections with the age of women treated at public health service of Goiânia-GO. Papanicolaou test is the method used for detection of intraepithelial and neoplastic lesions in the uterine cervix, playing an important role in cervical cancer prevention and helping in female genital infections'diagnosis. Methods - Women's cytopathological tests were analyzed at Health Care Units from Goiânia-GO, between 03/2006 and 05/2008. Smears were analyzed at Clinical Analysis Laboratory Rômulo Rocha, at Pharmacy Faculty of the Federal University of Goiás. Results - The total of 15.615 women were included in this study. The median age was 33 years (14-93 years), 57.6% were between 20 and 39 years of age and 6.6% were adolescents <20 years of age. More than 50% of cases of infection among adults and adolescents were caused by Gardnerella vaginalis, followed by 13.6% by Trichomonas vaginalis and to 16.9% by Candida sp. Approximately, 7.6% of smears evaluated showed cellular alterations, and 4.9% atypical squamous cells of undetermined significance/squamous intraepithelial lesion of low grade (ASC-US/LSIL) for women aged 20-29 years and 2.6% atypical squamous cells can damage high-grade/squamous intraepithelial lesion high-grade and atypical glandular cells (ASC-H/+) for women aged 20-49 years. Conclusion - Serious injuries in young women draw attention to the need for public health policies that reinforce the importance of the Papanicolaou test for cervical cancer prevention.

Lipschütz ulcer (ulcus vulvae acutum): a rare cause of genital lesion / Úlcera de Lipschütz (ulcus vulvae acutum): uma causa rara de lesão genital

Lipschütz Ulcer, or ulcus vulvae acutum, is a rare and probably underdiagnosed entity that usually presents as an acute painful vulvar ulcer in young women. The etiology is unknown, although recent reports have associated it with the Epstein-Barr virus. The diagnosis is made by exclusion after ruling out sexually transmitted diseases, autoimmune causes, trauma, and other etiologies of genital ulcerations. We report a case of a young woman who developed flu-like symptoms and painful vulvar ulcers. Complementary examinations ruled out sexually transmitted diseases and the other usual causes of genital ulcers; lesions healed with no sequelae or recurrences. This case represents a rare important differential diagnosis of genital ulceration.

A Úlcera de Lipschütz, ou ulcus vulvae acutum, é uma entidade rara mas provavelmente subdiagnosticada, que se apresenta como úlcera vulvar aguda dolorosa numa mulher jovem. A etiologia é desconhecida embora relatos recentes a tenham associado à primo-infecção pelo vírus Epstein-Barr. O diagnóstico é estabelecido após exclusão de doenças sexualmente transmissíveis, causas autoimunes, traumáticas e outras etiologias de úlceras genitais. Relatamos o caso de uma jovem que desenvolveu quadro gripal e dolorosas úlceras genitais. Os exames complementares excluiram doenças sexualmente transmissíveis e as outras causas habituais de ulceração genital. As lesões cicatrizaram sem sequelas e sem recorrências. Este caso representa um diagnóstico diferencial importante e raro de ulceração genital.

Effect of Black Cohosh on Genital Atrophy and Its Adverse Effect in Postmenopausal Women / 대한폐경학회지

OBJECTIVES: It is to evaluate the effect of black cohosh on genital atrophy and its adverse effect in postmenopausal women. METHODS: A total of 100 postmenopausal women having moderate to severe degree of climacteric symptoms were randomly allocated to receive black cohosh combined proparation (n = 50) or placebo (n = 50) daily for 12 weeks. A total of seventy eight subjects completed the study. The effect of black cohosh on vaginal atrophy was evaluated by measuring Maturation value (MV). MV was determined from vaginal smear at 0 and 12 weeks of treatment. Safety assessment included vital signs, physical examinations, adverse events, and routine laboratory parameters. Assessments were carried out at the beginning, and after 4, 8, and 12 weeks of treatment. RESULTS: The mean (+/- standard deviation) MV decreased 0.18 (0.48 +/- 0.33 to 0.30 +/- 0.24) in the black cohosh group and 0.13 (0.44 +/- 0.31 to 0.31 +/- 0.22) in the placebo group. There was no statistical difference between the groups. But adverse events were observed in 7 (14%) patients in the black cohosh group and 6 (12%) patients in the placebo group, without statistical significance. No significant effects were observed on blood pressure, heart rate, body temperature, physical findings, and laboratory values. Black cohosh was well tolerated. CONCLUSION: Black cohosh did not exert estrogenic effects with regards to vaginal atrophy. Further studies on the long-term safety and the appropriate doses of cohosh are needed.

Aspectos ginecológicos e obstétricos de pacientes atendidas nos serviços público e privado de saúde: há diferenças? / Gynecological and obstetrics aspects of patients treated in public and private health services: are there any differences?

OBJETIVO: Avaliar os aspectos epidemiológicos e clínicos de pacientes ginecológicas atendidas nas redes privada e pública de saúde. MÉTODOS: Estudo de corte transversal, no qual foram estudados prontuários de 243 pacientes (122 pacientes no serviço público e 121 no privado), de janeiro de 2007 a janeiro de 2008. Excluíram-se os prontuários de pacientes grávidas, com sangramento genital, histórico de uso de cremes ou géis vaginais em intervalos inferiores há 15 dias e pacientes que tiveram relação sexual em prazo inferior a cinco dias da consulta avaliada. A análise dos dados foi realizada com recursos de processamento estatístico do software Stata, versão 9.2, considerando-se o nível de significância de 5 por cento. RESULTADOS: A média de idade das pacientes foi de 27±12 anos entre pacientes da rede pública, e de 25,9±10,4 anos na rede particular, não havendo diferença estatística entre estas médias (F=0,5 e p=0,4). As pacientes da rede pública apresentaram escolaridade mais baixa (p<0,001), eram preferencialmente do lar (p<0,001), iniciaram vida sexual mais precocemente, tiveram maior número de parceiros (p<0,001), de gestações (p<0,001) e de partos (p=0,004) e utilizavam principalmente a camisinha como método contraceptivo (p=0,013). Não houve diferença estatística em relação aos antecedentes de doenças sexualmente transmissíveis, ao diagnóstico de candidíase, vaginose bacteriana, tricomoníase ou neoplasia. CONCLUSÕES: As pacientes da rede pública de saúde apresentam maior número de gestações e partos. São, em geral, donas de casa, com baixa escolaridade, iniciam vida sexual mais precocemente e com maior número de parceiros. Entretanto, não houve diferença entre os grupos quando se avaliaram doenças mamárias, infecções ginecológicas ou neoplasias de colo uterino, o que sugere que o nível socioeconômico não é o único elemento no determinismo da doença e, por isso, outras variáveis devem ser avaliadas.

PURPOSE: To evaluate the epidemiological and clinical aspects of gynecological patients seeking care in the private and public health networks. METHODS: In this cross-sectional study we analyzed the records of 243 patients (122 public service patients and 121 private service ones), from January 2007 to January 2008. We excluded records of pregnant patients with vaginal bleeding, history of using vaginal creams or gels at intervals of less than 15 days and patients who had sexual intercourse within less than five days before their visit and with incomplete clinical data. Data were analyzed statistically using the Stata software, version 9.2, with a 5 percent level of significance. RESULTS: The mean age of the patients attending the public health service was 27±12 years-old and 25.9±10.4 years-old for patients attending the private health service, with no statistical difference between means (F=0.5 and p=0.4). Patients attending the public health service had lower education (p<0.001), they were preferentially housewives (p<0.001), began sexual life early, had a greater number of partners (p<0.001), of pregnancies (p<0.001) and of deliveries (p=0.004), and mainly used the condom as a contraceptive method (p=0.013). There was no statistical difference between groups regarding the history of sexual transmitted diseases, diagnosis of candidiasis, bacterial vaginosis, trichomoniasis, or neoplasia. CONCLUSIONS: Patients attending the public health service have a higher number of pregnancies and births. They are usually housewives with low educational level, their sex life begins early, and they have more partners. However, there was no difference between groups when evaluating breast diseases, gynecological infections, or cancer of the cervix, which suggests that socioeconomic status is not the only element in the determination of the disease and, therefore, other variables should be evaluated.

Donovanose / Granuloma inguinale (Donovanosis)

Os autores apresentam imagens de duas formas clínicas mais frequentes da Donovanose, em ambos sexos. A donovanose é considerada uma doença sexualmente transmissível, endêmica nas regiões tropicais e semitropicais do globo. Apresentam também imagens de duas lâminas: uma da pesquisa direta (corpúsculos de Donovan, dentro de grandes células mononucleadas coradas de vermelho pelo Giemsa) e outra de achados histológicos típicos (formato de alfinete dentro do histiócito).

The authors present images of two of the most common clinical forms of granuloma inguinale (donovanosis) in males and females. Donovanosis is considered a sexually transmitted disease that is endemic in tropical and subtropical regions of the world. Two microscopic images are also shown, one of a direct smear (the presence of Donovan bodies within large mononuclear cells identified using Giemsa stain) and the other of typical histological findings (rod-shaped Donovan bodies within a mononuclear histiocyte).

Lesiones en los genitales externos: Enfoque diagnóstico y conducta que debe seguir el médico de la familia

Se expone la causa de las lesiones en los genitales externos según 3 grandes grupos clasificatorios y se indican en cada caso las manifestaciones clínicas más importantes y los medios de diagnóstico específicos. Se muestra una guía práctica para el correcto enfoque diagnóstico y la conducta que debe seguir el médico de la familia.

The cause of the geniatalia lesions is exposed according to three large classificatory groups. The most important clinical manifestations as well as the specific diagnostic tools are indicated for each case. A practical guide for the proper diagnostic approach and for the behavior the family physician should follow is shown.

Algunas afecciones y problemas de interés de la ginecología infantojuvenil en la atención primaria

Se realiza una revisión de las principales afecciones y problemas de interés para la atención primaria en la ginecología infantojuvenil, con énfasis en los aspectos preventivos y diagnósticos de éstas.

A review of the main affectations and problems of interest for primary health care in pediatric and adolescent gynecology is made, emphasizing the preventive and diagnostic aspects of them.

HIV infections in obstetrics and gynaecology

@#Thirteen women were discovered to be positive for human immunodeficiency virus (HIV) infection during pregnancy at the Port Moresby General Hospital from 1988 to 1995; of these, eight were diagnosed in the first half of 1995. Risk testing for HIV status is unlikely to discover more than 20% of HIV-positive antenatal patients because risk factors target intravenous drug users and the sexual behaviour of men. Pregnancy does not seem to have a major impact on the progress of HIV disease, but could be detrimental particularly in the later stages of the disease. Especially in developing countries, where HIV-positive patients are more likely to be of poor nutritional status and burdened with a number of other infections, there is a higher risk of preterm labour, small-for-dates babies and chorioamnionitis in pregnancy. The risk of vertical transmission is increased when viral loads are high, the general maternal condition is poor and delivery is preterm. Rates in Papua New Guinea appear to be following the higher rates which have been reported from Africa. Gynaecological conditions found in association with HIV infection, including pelvic inflammatory disease, vulvovaginal candidiasis and cervical neoplasia, may be resistant to treatment and tend to recur. Contraception for HIV-positive women may be more important to them than prevention of viral transmission; Depo-Provera and tubal ligation have special benefits in this regard. HIV infection in association with psychiatric disturbance might be an indication for termination of pregnancy. PIP: Risk testing for HIV serostatus is unlikely to detect more than 20% of HIV-positive pregnant women. Of the 11 pregnant women discovered to be HIV-infected at Port Moresby General Hospital in Papua New Guinea in 1994-95, only four had more than two sexual partners since 1992 and none was an intravenous drug user. The deleterious effect of pregnancy on HIV disease progression appears to be small but variable, with more serious effects in the later stages of disease. The risk of vertical transmission increases when viral loads are high, the general maternal condition is poor, and delivery is preterm. In developing countries, where HIV-infected pregnant women are likely to be malnourished and to have concomitant infections such as malaria and tuberculosis, the risks of preterm labor, small-for-gestational age infants, and chorioamnionitis are increased. HIV-related gynecologic conditions such as pelvic inflammatory disease, vulvovaginal candidiasis, and cervical neoplasia may be resistant to treatment and tend to recur. Pregnancy prevention through effective contraceptive methods such as Depo-Provera and tubal ligation may be more important to HIV-infected women than prevention of viral transmission, especially when both partners are seropositive.