Twin-Twin Transfusion Syndrome After Radiofrequency Ablation in Dizygotic Monochorionic Triamniotic Triplet Pregnancy With Sex Discordance: A Case Report.

Background: We report a case of dizygotic monochorionic triamniotic triplet pregnancy. Twin-twin transfusion syndrome was subsequently diagnosed combined with sex discordance in the two surviving fetuses after one fetus was reduced, which is extremely rare and has not been previously reported. Case Presentation: After reducing one fetus by radiofrequency ablation of a monochorionic triamniotic triplet pregnancy, twin-twin transfusion syndrome was subsequently diagnosed combined with sex discordance in the two surviving fetuses. Amniotic fluid for chromosome analysis showed normal karyotype 46, XY/46, XX of the donor and recipient fetus, and short tandem repeat (STR) analysis revealed dizygotic twins. Conclusions: Through this is an unusual case, we aim to emphasize the importance of accurate diagnosis of chorionicity and zygosity in sex discordant triplet pregnancy, which is the key to appropriate clinical management.

High-intensity focused ultrasound in the management of adenomyosis: long-term results from a single center.

OBJECTIVE: To investigate the long-term clinical outcomes of patients with adenomyosis treated by high-intensity focused ultrasound (HIFU). MATERIALS AND METHODS: From June 2012 to January 2020, 2311 patients with adenomyosis were treated with HIFU at our center, 1982 patients who have complete clinical data were retrospectively reviewed. Among the patients who completed the follow-up, 485 were treated with HIFU alone, 289 were treated with HIFU followed by GnRH-a, 255 were treated with HIFU combined with Mirena and 594 were treated with HIFU combined with GnRH-a and Mirena. The dysmenorrhea severity pain score and average menorrhagia severity score before and at 3 months, 6 months, 1 year, 2 years, 3 years and 5 years after HIFU were compared. The adverse effects were recorded. In addition, the efficacy between patients treated with GnRH-a and/or Mirena were compared. RESULTS: After HIFU ablation, the dysmenorrhea severity pain score and the menorrhagia severity score were significantly decreased at each follow-up time point. However, it was observed that as the follow-up time increased, the effective rate of HIFU treatment in improving dysmenorrhea and menorrhagia decreased. The 6 months and 3 years follow-up results showed that the efficacy of HIFU combined with Mirena and HIFU combined with GnRH-a and Mirena were significantly higher than HIFU alone and HIFU combined with GnRH-a (p < 0.05). The major complications were rare. CONCLUSION: HIFU is a safe and effective treatment for patients with adenomyosis. HIFU combined with Mirena or HIFU combined with GnRH-a and Mirena can significantly enhance the long-term treatment results.

Therapeutic effect of robot-assisted laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse. / æœºå™¨äººè¾ åŠ©è ¹è ”é•œä¸‹é˜´é“éª¶éª¨å›ºå®šæœ¯æ²»ç–—ç›†è ”å™¨å®˜è„±åž‚çš„ç–—æ•ˆ.

OBJECTIVES: To assess short-term functional outcomes achieved by robot-assisted sacrocolpopexy for pelvic organ prolapse. METHODS: We retrospectively collected clinical and operative data for female patients who underwent either pure laparoscopic sacrocolpopexy (a control group, n=20) or robot-assisted laparoscopic sacrocolpopexy (a study group, n=20) between December 2017 and December 2018. The clinical indicators included age, gestational age, parity, the stage of pelvic organ prolapse. Perioperative data included operative time and total blood loss. Post-operative outcomes included hospital stay, the time of detaining urethral catheterization, and the restart of anal exhaust after surgery. At the same time, complications and quality of life were observed till 6 months after the surgery. RESULTS: There were no definitely differences in the perioperative data between the 2 groups. It is worth mentioning that robot-assisted laparoscopic sacrocolpopexy was superior in strict operative time. With a follow-up of 6 months, the study group's anatomic repair rate was 100% (20/20), while the control group was 95% (19/20). Pelvic Floor Distress Inventory-short Form 20 (PFDI-20) and Pelvic Floor Impact Questionnaire-short Form 7 (PFIQ-7) were used to evaluate patients' quality of life. There was no significant difference in the scores between the study group and the control group before and 6 months after surgery. Only the data of the PFDI-20 questionnaires at 1 month after operation were statistically significant, and in the control group was larger than that in the study group, showing that robotic surgery can recover faster than laparoscopy, and the quality of life can be improved quickly. CONCLUSIONS: Robot-assisted laparoscopic sacrocolpopexy is a safe and reliable technique, faster than laparoscopy in recovery and has a short-term effect.

TXNIP induced by MondoA, rather than ChREBP, suppresses cervical cancer cell proliferation, migration and invasion.

Evidence has indicated the associations between thioredoxin-interacting protein (TXNIP) and cancers. However, the role of TXNIP in cervical cancer remains unclear. Hence, this study aims to investigate the role of TXNIP in regulating cervical cancer cell proliferation, migration and invasion. TXNIP expression can be regulated by either MondoA or ChREBP in a cell- or tissue- dependent manner. Thus, we also explored whether TXNIP expression in cervical cancer can be regulated by MondoA or ChREBP. Our results showed that TXNIP expression was decreased in cervical cancer cells (HeLa, SiHa, CaSki, MS751, C-33A). Furthermore, TXNIP overexpression inhibited cell proliferation, migration and invasion in HeLa cells, whereas TXNIP silencing exerted the opposite effect in C-33A cells. Moreover, TXNIP expression could be induced by MondoA, rather than ChREBP in HeLa cells. Additionally, MondoA overexpression inhibited cell proliferation, migration and invasion through upregulating TXNIP in HeLa cells. In summary, TXNIP induced by MondoA, rather than ChREBP, suppresses cervical cancer cell proliferation, migration and invasion. Our findings provide new ideas for the prevention and treatment of cervical cancer.