Objective To evaluate the efficacy of hysteroscopic adhesiolysis for intrauterine adhesion. Methods Thirty-two patients with intrauterine adhesions underwent hysteroscopic adhesiolysis between January 2001 and December 2003. Results In the 14 patients with stage Ⅰ or Ⅱ adhesions, the uterine cavity regained normal status after surgery. Among the 9 patients with stage Ⅲ adhesions, the oviductal orifice of the diseased side could be exposed in 6 patients. Of the 9 patients with stage Ⅳ or Ⅴ adhesions, the uterine cavity was dissected to normal configuration but the oviductal orifice was not exposed in 5 patients, and perforation of uterus occurred in 1 patient, who later received a laparoscopic repair and recovered uneventfully. No complications such as overhydration or postoperative infection took place. Out of 27 patients with abnormal menstruation, a regular menses was obtained in 25 patients (92.6%) postoperatively, and amenorrhea remained in 2 (7.4%). The periodic abdominal pain of 12 patients was relieved after operation. The postoperative pregnancy rate was 42.9% (6/14). Conclusions Hysteroscopic adhesiolysis is a safe and effective option for women with intrauterine adhesion.

Objective To summarize the funding of scientific research projects on obstetrics and gynecology by National Natural Science Foundation of China (NSFC) from 2007 to 2016 and to display the hotspots of scientific research on obstetrics and gynecology. Methods A systemic search was performed for the information of projects supported by NSFC from 2007 to 2016. The indicators for analysis included the number of projects, total investment, project categories, research units and research field. The research direction of each project was decided based on title, summary and key words provided by the profile of each project. Results The total investment on obstetrics and gynecology by NSFC was 23.214 million with a total of 82 projects in 2007. It increased year by year and reached the peak in 2014 (359 projects 208.990 million). The investment and number of projects remained stable after 2014. General projects (1109 projects 608.000 million) formed the majority of projects. Youth science fund projects (1035 projects 214.976 million) increased steadily and the number was nearly equal to general projects. There were only a small amount of key projects (20 projects 54.720 million) and major projects (7 projects 38.400 million). The investment varied in different research units. The greatest 10 units (less than 6% of total), including 7 comprehensive universities, 2 medical universities and 1 institute of medicine, got 1113 projects invested (43.84% of total,1113/2539). The hot areas like gynecological tumor (920 projects 350.615 million),hypertensive disorders complicating pregnancy (91 projects 37.470 million) and polycystic ovarian syndrome (77 projects 29.540 million) were more likely to receive investment, while some interdisciplinary science like maternal and child health (28 projects 12.050 million), imaging and biomedicine (37 projects 14.770 million) began to achieve attention in recent years. Conclusions The number of researches invested will be increased for the scientific research in obstetrics and gynecology especially the areas of research focus, although the amount allocated for each will be decreased relatively. Besides, multidisciplinary work will be performed so as to develop obstetrics and gynecology of China to a high level.

Objective To assess the efficacy of laparoscopic salpingostomy in infertile women with distal tube obstruction. Methods 109 women with infertility underwent laparoscopic salpingostomy and the results were retrospectively analyzed. Results The total cumulative pregnancy rate was 32.9%.The cumulative pregnancy rate was 44.4% in the unilateral distal tube obstruction group after laparoscopic salpingostomy,while it was 20% in the bilateral distal tube obstruction patients(p

Objective To investigate the clinical value of the YSZ-1 uterine manipulator in total laparoscopic hysterectomy.Methods Total laparoscopic hysterectomy was employed in a total of 78 women by using the LigaSure,ultrasonic scalpel,and the YSZ-1 uterine manipulator.The anterior fornix was opened and the manipulator was placed on the lip of the cervix.Then the uterus was completely removed.Results The operation was completed smoothly in all the 78 patients.The operating time was 45~90 min(mean,63 min),and the intraoperative blood loss was 40~100 ml(mean,65 ml).No urinary tract injuries,vaginal bleeding,or other postoperative complications occurred.The length of postoperative hospital stay was 4~7 d(mean,5.3 d).Follow-up examinations in the 78 patients for 3~6 months(mean,4 months) showed that the vaginal wound normally healed up. Conclusions Use of the YSZ-1 uterine manipulator in total laparoscopic hysterectomy makes the procedure easier and safer.The YSZ-1 uterine manipulator is a useful laparoscopic instrument.

Objective To investigate the effect of cervical knife conization (CKC) or loop electrical excision procedure (LEEP)on the outcome of subsequent pregnancies and mode of deliveries. Methods A retrospective case-control study including 228 women after treatment with LEEP or CKC for cervical intraepithelial neoplasia (CIN) Ⅱ -Ⅲ who gave birth in the First Affiliated Hospital of Sun Yat-sen University and He-xian Memorial Hospital of Pangyu from January 2004 to January 2010 was performed.Patients (n = 228) without cervical surgical history were randomly extracted from the respective hospitals birth registries as controls and were matched by age, gestation,parity and income.The information including gestational age, premature rupture of membranes (PROM), type of deliveries and birth weight of the two groups were collected.Results The gestational age of women treated with conization was (268.3±26.2) d, longer than that of the women without surgery (279.4±25.3) d (t=4.60, P＜0.01). The incidence of preterm birth was 18.0％(41/228) and 4.4％ (10/228) (x2 = 21.22, P＜ 0. 05). The incidence of PROM was higher in conizationgroup (10.1％, 23/228) than that (1.3％, 3/228) in control group (x2=16.32, P＜0. 05). Risk for PROM was almost eight fold (OR=8. 42, 95％CI: 2.49-28.44) higher in conization group. Cesarean section rate was higher in conization group (69.3 ％ ) than in control group (39.0 ％ )(x2=42.06, P＜0. 01). The gestational age of women treated with LEEP was longer than those treated with CKC[(269.8±24.6) d vs (260.2± 26.5) d, t= 4. 01, P＜0.01]. The incidence of preterm birth was 13. 1％ (22/168) and 31.6％ (19/60) (x2 = 10. 34, P＜0. 05). The mean birth weight of women with LEEP was heavier than that with CKC[(3358.5 ±812.2) g vs (3295.9 ±832.6) g, t=3.08, P＜0. 01]. The incidence of PROM (7.1％, 12/168) of woman with CKC was higher than that (1.3％, 11/60) of women with LEEP (x2 =6.10, P＜0.05). Conclusions Conization might increase the incidence of preterm delivery and preterm PROM. LEEP showed less adverse effect onthe outcome of subsequentpregnanciesthan CKC,and waspreferredfor primigravida, and the risk of treatment should be informed in advance.

Objective To evaluate the safety and the feasibility of hypophysin injection for hemostasis during laparoscopic stripping of ovarian endometrioma.Methods Retrospective analysis of 86 cases with ovarian endometrionm.Forty-two patients with prophylactic dilute hypophysin injection into cornua uterus and mesosalpinx(study group),and 44 patients without vasopressin(control group).The operative time,intraoperative blood loss,the highest postoperative temperature,postoperative stay and the rate of recurrence were compared.Results The operative time in the study group and the control group were(51.24±22.58)min and(67.02±25.14)min,the intraoperative blood loss were(42.16±26.10)ml and (68.23±28.21)ml,respectively.There was significantly different between two groups(P＜0.01).The rates of recurrence in the study group and the control group were 4.76% and 11.36%,respectively.But it was no significantly different between two groups(P＞0.05).Both the highest postoperative temperature and postoperative stay was no difference between two groups(P＞0.05).Conclusions Hypophysin can reduce the operative time and intraoperative blood loss during laparoscopic stripping of ovarian endometrioma,and it is possible to reduce the rate of recurrence.It is a safe,feasible,cheapand convenient method,and worth using in clinic.

[Objective]To investigate the inhibitory effect and mechanism of the microRNA-320d(miR-320d)on epithelial mesenchymal transition in endometrial carcinoma JEC cells.[Methods]JEC endometrial carcinoma cell lines were transfected with miR-320d mimics or negative control mimic,respectively,as M320d or NCM group. Control group was established with untreated JEC endometrial carcinoma cells. miR-320d content in each group was detected by RT-PCR method. Transwell assay was used to detect the migration and invasion ability of the 3 groups. Western-blot assay was used to detect the expressions ofα-Catenin,E-cad-herin,Vimentin and PBX3 protein in 3 groups. Antagonistic effect of PBX3 overexpression on miR-320d inhibition of EMT was detect-ed by western blot assay. The relationship between miR-320d and PBX3 was detected by dual luciferase assay.[Results]The expres-sion level of miR-320d in M320d group was significantly up-regulated,and the expression level of miR-320d was 808.25 ± 15.58 times higher than that of control group(P<0.05). The number of migrating cells in M320d group was 29.56 ± 0.59,which was signif-icantly lower than that of control group at 94.48 ± 1.02(P < 0.05). The number of invasive cells in M320d group was 7.33 ± 0.84, which was significantly lower than that of group control 86.28 ± 3.51(P < 0.05). Compared with control group ,the expression of α-Catenin and E-cadherin protein was significantly increased ,the expression of Vimentin protein was significantly decreased ,and the expression of PBX3 protein was significantly decreased. After PBX3 overexpression,the expression ofα-Catenin and E-cadherin protein were significantly decreased,the expression of Vimentin protein were significantly increased. Dual luciferase assay showed that PBX3 is a downstream target gene of miR-320d(P<0.05).[Conclusion]miR-320d may inhibit the expression of EMT related protein through the downstream target gene PBX3 and inhibit the epithelial mesenchymal transition function of endometrial carcinoma JEC cells.

AIM:To demonstrate the relationship between hormones in follicular fluid and the expression of LH receptor in granulosa cells(GC) in anovulatory women with polycystic ovary syndrome(PCOS).METHODS: Follicles were obtained from 12 women with PCOS and 15 women with normal menstrual period through surgery at time between day 7 and day 10 of menstrual cycle.The accumulations of estrogen(E2),progesterone(P),luteinizing hormone(LH),follicle stimulating hormone(FSH) and insulin in follicular fluid were determined by a automatism chemiluminescent microparticle immunoassay(CMIA) for the quantitative determination.The accumulation of androstenediol(A) was determined by ELISA.The amounts of the mRNA expressions of LH receptors from GC and theca cells(TC) respectively were measured by RT-PCR using ?-actin as intra-control simultaneously.RESULTS: The levels of LH [(3.8?2.1 vs 1.7?0.8)IU/L,P

Objective To investigate the long-term oncological outcomes of laparoscopic radical hysterectomy (LRH) plus lymph node dissection (LND) and abdominal radical hysterectomy (ARH) plus LND for patients with stage Ⅰ a2-Ⅱ a2 cervical cancer.Methods A retrospective review of stage Ⅰ a2-Ⅱ a2 cervical cancer patients who underwent LRH + LND (n=372) and ARH + LND (n=434) at the First Affiliated Hospital of Sun Yat-sen University from Jan.2005 to Aug.2013 was performed.Individual patient matching was performed by the risk factors for recurrence [tumor size,lymph vascular space invasion (LVSI),depth of cervical stromal invasion,lymph node metastasis,parametrialinvolvement,and resection margin involvement] between two groups.After matched,a total of 203 patient pairs (LRH-ARH) were enrolled.The survival data,surgery data,intraoperative and postoperative complications were compared between the two groups.To assess the prognosis factors,the univariate and multivariate Cox's proportional hazards modelanalysis were conducted.Stratified analysis was performed based on the independent prognosis factors to investigate the survival data between the two surgery groups.Results (1) Surgery data:The operating time [(239±44) vs (270±42) minutes],estimated blood loss [(210± 129) vs (428±320) ml],the duration of bowel motility return [(2.0±0.8) vs (3.0± 1.6) days] and hospital stay [(11 ±6) vs (13±6) days] in the LRH group were significantly shorter than those in ARH group (all P＜0.01).(2) Intraoperative and postoperative complications:The intraoperative complications rate was similar betweentwo groups [6.4％(13/203) vs 6.9％(14/203),P=1.000].The rate of postoperative complications (excluded bladder dysfunction) in the LRH group were significantly lower than those in the ARH group [9.4％ (19/203) vs 20.2％ (41/203),P=0.002].While there was no significant difference in the rates of bladder dysfunction between two groups [36.5％ (74/203) vs 37.4％ (76/203),P=0.910].(3) Recurrence and survival data:There was no significant difference in the recurrence rates between the LRH group and ARH groups [7.9％ (16/203) vs 9.4％ (19/203),P=0.850].There were similar 5-year recurrence-free survival (RFS;92.1％ vs 91.1％,P=0.790) and 5-year overall survival (OS;93.7％ vs 96.1％,P=0.900).(4) Prognosis factor:In univariate analysis,the results showed that tumor size,International Federation of Gynecology and Obstetrics (FIGO) stage,adjuvant therapy,LVSI,stromal invasion,parametrium invasion,pelvic lymph node metastasis,and para-aortic lymph node metastasis were significantly associated with poor prognosis (all P＜0.01).However,age,body mass index (BMI),surgery type,histological type,grade were not significantly associated with poor prognosis (all P＞0.05).The multivariate analysis results,showed that tumor size,pelvic lymph node metastasis,and para-aortic lymph node metastasis were significantly associated with poor prognosis (all P＜0.01).Stratified analysis showed that,even in patients with tumor size ＞4 cm,pelvic lymph node metastasis positive,and para-aortic lymph node metastasis positive in all subgroups,there were not significant difference for the estimated 5-year RFS and 5-year OS between LRH and ARH group (all P＞0.05).Conclusion For patients with stage Ⅰ a2-Ⅱ a2 cervical cancer,LRH plus lymph node dissection is an oncologically safe and surgical feasible alternative to ARH.

Objective To evaluate the efficacy and quality of life of segmental bowel resection for bowel endometriosis. Methods Totally 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection were recruited. A visual analogue scale (VAS) and the 36-item short form health survey (SF-36) questionnaire were administered before and at least 1 year after surgery, respectively. Pregnancy rates were also recorded. Results Sixty-two patients in total underwent follow-up ranging from 12 to 74 months. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, pain on defecation and chronic pelvic pain. The relief of dysmenorrhea (2.9 ± 2.2 versus 7.5 ± 2.9), dyspareunia (0.7 ± 0.5 versus 4.3 ± 2.2) and pain on defecation (1.6 ± 0.7 versus 7.3 ± 1.9) after surgery was statistically significant (all P<0.01). The scores for all 8 domains of the SF-36 questionnaire were significant improved after segmental bowel resection (all P<0.01). The complication rate was 45% (28/62), including 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, pelvic abscess and general peritonitis. All of the patients with complications recovered well throughout follow-up. The postoperative pregnancy rate of the previous infertile patients was 6/10. Among the 6 gestational cases, 2 had labour, 2 underwent caesarean sections, one had a spontaneous natural abortion, and one underwent uterine curettage. Conclusion Segmental bowel resection could significantly relieve pain and improve quality of life for patients with bowel endometriosis.