Laparoscopic umbilical trocar port site endometriosis: A case report.

BACKGROUND: Abdominal wall endometriosis can occur secondary to gynecological and obstetric pelvic laparotomy; however, this is a rare clinical event. There are few cases of endometriosis involving the incision site of a laparoscopic surgery, especially for those of the endometrial nodule at the umbilical trocar port site where the camera is placed. CASE SUMMARY: We describe the case of a 37-year-old woman who presented with a 2-year history of a tough swelling below the umbilicus, which presented periodical pain during menstruation. The patient had undergone laparoscopic ovarian cystectomy 4 years prior, and we theorized that the umbilical nodule was a complication of that laparoscopic surgery. Histological analysis confirmed the diagnosis of abdominal umbilical scar endometriosis secondary to previous laparoscopic surgery. Surgical removal of the nodule followed by three cycles of leuprorelin was curative. CONCLUSION: Abdominal mass and pain in women of childbearing age with a previous history of pelvic surgery should support consideration of endometriosis at the surgical site.

[Correlation Between MTHFR Mutation and Idiopathic Premature Ovarian Failure in Chinese Han Women].

OBJECTIVE: To investigate whether the methylene tetrahydrofolate reductase (MTHFR) 677C/T polymorphisms were related to the prevalence of 46,XX premature ovarian failure (POF) in Chinese Han women. METHODS: Infertile Chinese Han women were divided into 2 groups: POF group (n=147) and control group (n=166).The expression of MTHFR gene in peripheral blood was determined by RT-PCR. The 677C/T genotype of MTHFR gene was identified by restriction fragment length polymorphism (RFLP). Genotype frequencies and allele frequencies were counted. PCR product were randomly examined for gene sequencing to verify whether the amplified fragment. Relationship between MTHFR gene polymorphism and clinical characteristics of idiopathic POF was analyzed. RESULTS: The results of gene sequencing showed that the PCR amplification fragment was the target gene fragment, and the sequencing showed that the genotype was 100% consistent with the enzymatic display genotype. The MTHFR 677C/T genotype distribution in both the POF group and the control group was consistent with the Hardy-Weinbreg balance law (P>0.05). The frequencies of CC, CT and TT genotypes of MTHFR 677C/T were 48.3%, 40.8% and 10.9% in the POF group, and 37.3%, 47.6% and 15.1% in the control group, respectively. There was no statistically significant difference in the frequency of genotypes between the two groups (χ2=4.04, P>0.05). The T, C allele frequencies were 31.3% and 68.7% in POF, 38.9% and 61.1% in control group, there were no significant differences in the frequencies of T, C alleles between the two groups (χ2=3.90, P=0.05). Subgroup analyzes in POF group, no significant difference were detected between CC and CT+TT genotypes in menopause age, FSH, E2, endometrial thickness and antral follicle number. CONCLUSIONS: The distribution of the MTHFR 677C/T polymorphisms in Chinese Han POF population was not significantly different from controls, implying that MTHFR gene polymorphisms may not be the risk factor of idiopathic POF occurred in Chinese.

[Effects of Fukang oral liquid on the prevention of intrauterine adhesion and expressions of TGF-beta1, PAI-1 and MMP-9 in endometrium of rats].

OBJECTIVE: To investigate the preventing effect of Fukang oral liquid (fuk) in intrauterine adhesions and its effects on the expression of TGFbeta-1, PAI-1 and MMP-9 in endometrium of rats with intrauterine adhesions. METHODS: 50 female wistar rats were divided into high, medium, low dose of Fukang oral liquid group (Hfuk, Mfuk, Lfuk), blank control group (Bcon), and model control group (Mcon) (n = 10 in each group). The rats in Hfuk, Mfuk and Lfuk groups were treated with intragastric administration of 4 mL, 2 mL and 1 mL Fukang Oral Liquid per day, while the rats in Mcon group and Bcon group received 2 mL physiological saline intragastric administration per day. All of rats were executed on 10th day and the sample of endometrium was harvested for the study of histology and morphology and the expression of TGFbeta-1, PAI-1 and MMP-9. RESULTS: Under the light microscope, the organizational structure of the uterine cavity and uterine wall was clear in Bcon group, the uterine cavity disappeared in Mcon group, and the layers structure remained normal arrangement in three fuk treated groups. TGFbeta-1 and PAI-1 protein expressions in Hfuk, Mfuk, Lfuk groups were less than those in Mcon group (P < 0.001), but MMP-9 protein expressions were higher. (P < 0.001). CONCLUSION: Fukang oral liquid show preventing effect on IUA, the mechanism may be related to its effects on the expressions of TGF-beta1, PAI-1, and MMP-9 in the endometrium.

CYP1B1 C4326G polymorphism and susceptibility to cervical cancer in Chinese Han women.

Cytochrome P450 1B1 (CYP1B1) is a key P450 enzyme, which could catalyze the formation of 4-hydroxy estrogen metabolites and play a role in estrogen-dependent cancers. We hypothesized that genetic variant in CYP1B1 may modify individual susceptibility to cervical cancer. The aim of this study was to evaluate the association between CYP1B1 C4326G polymorphism and cervical cancer risk in Chinese women. We extracted the peripheral blood samples in 250 patients with cervical cancer and 250 female controls. The matrix-assisted laser desorption ionization time-of-flight mass spectrometry method and direct DNA sequencing were performed to detect the polymorphism. The frequencies of CC, CG, and GG genotypes of CYP1B1 C4326G in cases and controls were 66.0, 26.8, 7.2% and 75.2, 21.6, and 3.2%, respectively, and there was a significant difference between the two groups (P = 0.034). Compared with the wild-type CC genotype, the variant GG genotype was associated with a significantly increased risk of cervical cancer (adjusted OR = 2.30; 95% CI = 1.02, 5.50). Moreover, stratification analysis by age, smoking, drinking, human papillomaviruses (HPV) 16 or 18 carrier status, and family history of cervical cancer, we found that the variant genotypes containing the G allele were associated with a significantly increased risk of cervical cancer among HPV 16 or 18-positive individuals (adjusted OR = 2.85; 95% CI = 1.45, 5.62) and among women younger than 45 years old (adjusted OR = 1.87; 95% CI = 1.03, 3.37). These results suggest that CYP1B1 C4326G polymorphism may increase risk of cervical cancer in Chinese women, especially among young individuals with high-risk HPV infection.

X-ray repair cross-complementing group 1 (XRCC1) genetic polymorphisms and cervical cancer risk: a huge systematic review and meta-analysis.

BACKGROUND: Previous studies investigating the association between X-ray repair cross-complementation group 1(XRCC1) polymorphisms and cervical cancer (CC) risk has provided inconsistent results. The aim of our study was to assess the association between the XRCC1 gene Arg399Gln, Arg194Trp, Arg280His polymorphisms and risk of CC. METHODS: Two investigators independently searched the Medline, Embase, CNKI, and Chinese Biomedicine Databases for studies published before March 2011.Summary odds ratios (ORs) and 95% confidence intervals (CIs) for XRCC1 polymorphisms and CC were calculated in a fixed-effects model or a random-effects model when appropriate. RESULTS: Ultimately, 9, 5 and 2 studies were found to be eligible for meta-analyses of Arg399Gln, Arg194Trp and Arg280His, respectively. Our analysis suggested that the variant genotypes of Arg194Trp were associated with a significantly increased CC risk (Trp/Trp vs Arg/Arg, OR = 2.21, 95% CI = 1.60-3.06; Arg/Trp vs Arg/Arg, OR = 1.23, 95% CI = 1.02-1.49; dominant model, OR = 1.36, 95% CI = 1.14-1.63; recessive model, OR = 2.06, 95% CI = 1.51-2.82). For Arg280His polymorphism, no obvious associations were found for all genetic models. For Arg399Gln polymorphism, also no obvious associations were found for all genetic models. In the subgroup analyses by ethnicity/country, a significantly increased risk was observed among Asian, especially among Chinese. To get more precise evidences, adjusted ORs (95%CI) by potential confounders (such as age, ethnicity or smoking, etc) were also calculated for XRCC1 Arg399Gln and Arg194Trp, however, the estimated pooled adjusted OR still did not change at all. CONCLUSION: This meta-analysis suggests that Arg194Trp polymorphism may be associated with CC risk, Arg399Gln polymorphism might be a low-penetrent risk factor for CC only in Asians, and there may be no association between Arg280His polymorphism and CC risk.

Estrogen receptor-alpha gene PvuII (T/C) and XbaI (A/G) polymorphisms and endometriosis risk: a meta-analysis.

Estrogen receptor-alpha (ER-α) polymorphisms have been hypothesized to be associated with the risk of endometriosis (EMT) development by many epidemiological studies, however, the available results were conflicting. To derive a more precise estimation of association between the ER-α PvuII (T/C) and XbaI (A/G) polymorphisms and risk of EMT, we performed a meta-analysis. Summary odds ratios (ORs) and 95% confidence intervals (95% CIs) for ER-α polymorphisms and EMT were calculated in a fixed-effects model and a random-effects model when appropriate. This meta-analysis included 20 case-control studies with 1752 cases and 1742 controls for PvuII polymorphism and 15 case-control studies with 1349 cases and 1411 controls for XbaI polymorphism. For PvuII T/C polymorphism, no obvious associations were found for all genetic models when all studies were pooled into the meta-analysis. In the subgroup analyses by ethnicity, country, HWE in controls and study sample size, a significantly increased risk was observed among Caucasians (recessive model, OR=2.56, 95% CI=1.06-6.16) and among studies without the HWE (recessive model, OR=1.85, 95% CI=1.20-2.84). For XbaI A/G polymorphism, also no obvious associations were found for all genetic models. In the subgroup analyses by ethnicity, country, HWE in controls and study sample size, still no obvious associations were found. No publication bias was found in the present study. This meta-analysis suggests that ER-α gene PvuII (T/C) and XbaI (A/G) polymorphisms may not be associated with EMT risk, while the observed increase in risk of EMT may be due to small-study bias.

[Morphology and celluar proliferation of follicles from cryopreserved human ovarian tissues].

OBJECTIVE: To compare the morphology and proliferation of primordial and primary follicles in fresh and vitrificated human ovarian tissues. METHODS: Human ovarian tissues were cryopreserved by direct cover vitrification (DCV) for 2 weeks. The morphology of the primordial and primary follicles from the frozen-thawed tissues was compared with those from the fresh tissues. Both fresh and cryopreservation tissues were cultured for 48 hours before the tissues were embedded in paraffin block for immunohistochemical staining for PCNA. RESULTS: The distribution of primordial and primary follicles in the fresh ovarian tissues was not different from that in the frozen tissues. The cryopreserved tissues had less abnormal morphology in primordial follicles than in primary follicles, but no difference was found between the cryopreserved tissues and fresh tissues. Positive staining on PCNA expression in granulsa cells and oocyte of transitional follicles and primary follicles as well as stromal cells were found in fresh, fresh cultured and cryopreserved cultured ovarian tissues. The fresh tissues had less positive staining on PCNA in the follicle than in the fresh cultured and cryopresered cultured tissues. CONCLUSION: Cryopreserved human ovarian tissues by DCV can maintain partial primordial and primary follicles. Follicles in cryopreserved ovarian tissues can initiate development in vitro culture.

[Impact of progesterone in peritoneal fluid on sperm motility in infertile patients with endometriosis].

OBJECTIVE: To evaluate the impact of progesterone in the peritoneal fluid on human sperm motility in the infertile patients with endometriosis. METHODS: Peritoneal fluids were collected from 41 patients by laparoscopy, of which 17 were infertile patients with endometriosis, 11 were fertile patients with endometriosis and 13 were fertile controls. The concentrations of progesterone in the peritoneal fluids were measured by the immulyze-enzyme amplified luminescence system. After 4 h of incubation in vitro with the collected peritoneal fluids, sperm motility was assessed by the computer-assisted analyzer (CASA). RESULTS: The concentrations of progesterone in the peritoneal fluids in the patients (infertile patients with endometriosis, fertile patients with endometriosis and the fertile controls) did not differ significantly (P > 0.05) in the proliferate phase. The sperms incubated with the peritoneal fluids from the patients with endometriosis had significant lower sperm motion parameters (A, VCL, VSL, VAP, ALH) than those of the fertile controls (P < 0.05). Although the sperm motility incubated with the peritoneal fluids from the patients with endometriosis was enhanced by the exogenous progesterone, no significant correlation was established between the concentrations of progesterone in the peritoneal fluids and the sperm motility (P > 0.05). CONCLUSION: The peritoneal fluids of infertile patients with endometriosis inhibit the sperm motility. The inhibition is not associated with the concentrations of progesterone in the peritoneal fluids. However, the sperm motility can be enhanced by adding exogenous progesterone to the peritoneal fluids.

[Impact of NO in peritoneal fluid on sperm motility in patients with endometriosis].

OBJECTIVE: To determine the level of NO in the peritoneal fluids in patients with endometriosis and to evaluate the impact of NO on human sperm motility. METHODS: Peritoneal fluids were taken from 19 patients with Endometriosis, 16 infertile patients with Endometriosis, and 21 patients without Endometriosis (control group). The macrophages in the peritoneal fluids were segregated and cultivated. The concentrations of NO metabolin (nitrate and nitrite) were measured. Human sperms were incubated with the culture fluids to detect the motility of the sperms. RESULTS: The patients with Endometriosis had significant higher levels of NO in the peritoneal fluids than the controls (P < 0.05). The motility of sperms declined significantly in the culture fluids of infertile patients with Endometriosis compared with the fertile patients with Endometriosis and the controls (P < 0.05). CONCLUSION: Elevated NO in the peritoneal fluids in patients with endometriosis may play a role in the pathogeneses of Endometriosis-associated infertility.

[Effect of rosiglitazone on integrin beta1 expression and apoptosis of proximal tubular cell exposed to high glucose].

OBJECTIVE: To evaluate the effect of rosiglitazone (ROS) on integrin beta1 expression and apoptosis of proximal tubular cell exposed to high glucose. METHODS: The proximal tubular cells of rats were cultured in vitro and divided into 6 groups: control group, normal glucose (5 mmol/L) group, high glucose (30 mmol/L) group, only ROS (10 micromol/L) group, glucose (30 mmol/L)+ROS (5 micromol/L) group, and glucose (30 mmol/L) +ROS (10 micromol/L) group. The cells were cultured for 48 hrs and the integrin beta1 expressions were detected by Western blot and RT-PCR; The apoptosis was evaluated by flow cytometry after the cells were cultured for 24, 48, 72 hrs. RESULTS: The expressions of integrin beta1 protein and mRNA of high glucose (30 mmol/L) group were significantly increased as compared with control group and normal glucose (5 mmol/L) group. The integrin beta1 of glucose (30 mmol/L)+ROS (5 or 10 micromol/L) group was decreased as compared with high glucose group (P < 0.05). Flow cytometry demonstrated the decreased apoptosis to be with time-dependence. CONCLUSION: ROS can strikingly inhibit the expression of integrin beta1 in proximal tubular cells exposed to high glucose, with a marked dose-dependent manner. The effect of ROS on cell apoptosis may be relevant to integrin beta1.