Objective To investigate the clinical effectiveness of pelvic floor reconstruction surgery with Prolift system and rou‐tine transvaginal surgery in treating pelvic organ prolapse (POP) .Methods We analyzed an retrospective study of 64 patients with POP patients from June 2009 to March 2011 .All patients were divided into two groups ,32 cases of the reconstruction group were treated with pelvic floor reconstruction surgery with Prolift system ,as reconstruction group ,the other 32 cases in routine treatment group with routine transvaginal surgery ,which inclouded transvaginal hysterectomy ,repair of anterior and posterior vaginal wall ,as routine treatment group ,the pre operative ,peri operative data and follow up results were compared between the two groups and to evaluate the outcomes of the two groups after surgery .Results The age ,body mass index ,menopause age ,pregnant times and the degree of uterus prolapse were no significant difference between the two groups (P>0 .05) .The operation of all the patients were successful .No patient were infected after surgery ,no vascular injury ,or urinary system injury ,or rectal injury occurred .Reconstruc‐tion group showed more significant in the amounts of blood loss ,average operation time ,anal exsufflation time ,mean of highest postoperative body temperature ,the urinary canal indwelling time and the postoperative hospitalization time compared with routine treatment group(P<0 .05) .The follow up rate was 93 .8% (30/32)in reconstruction group ,1 patient (3 .1% )experienced recur‐rence ,1 patient(3 .1% )experienced mesh erosion ,1 patient(3 .1% ) experienced new urinary tract symptoms ,of 19 patients who were sexually active ,1 patient suffered from algopareunia and 2 from sexual intercourse discomfort respectively .The follow up rate was 90 .6% (29/32)in routine treatment group ,4 patients(12 .5% )experienced new urinary tract symptoms ,8 patients(25% )expe‐rienced recurrence ,of 16 patients who were sexually active ,3 patients suffered from algopareunia and 5 from sexual intercourse dis‐comfort .The objective cure rates at 3 and 6 months after operation was no significant difference between the two groups (P>0 .05) ,but the objective cure rate at 12 months after operation was significantly different between the two groups (P<0 .05) .The objective curative rate in reconstruction group was significantly higher than that in routine treatment group .Conclusion Pelvic floor reconstruction surgery with Prolift system is a safe and effective methods of minimally invasive surgery ,patients had better regain integrity of anatomical structure and functions of pelvic floor in short term for POP when compared with routine transvaginal sur‐gery ,but its long term study is still needed .

Early tumor shrinkage( ETS) is defined as the reduction rate of tumor volume evaluated in ear-ly treatment.In recent years,mutiple studies have demonstrated that ETS predicted tumor prognosis well,it can be used as an important predictor of prognosis.Finding a predictor in the early phase of treatment can optimize treat-ment regimens and ameliorate the prognosis of tumor.We summarize the research progress of the relationship be-tween ETS and prognosis.

Objective To explore the effectiveness of applying case leaded PBL in the teaching of obstetrics and gynecology.Methods Totally 80 (2006 grade) five-year clinical medicine students were divided into 2 groups (n =20) according to complete randomized designing principle.Case leaded PBL and traditional teaching methods were applied in the two groups respectively.Operation skill test,theoretic examination and questionnaires were used for evaluation and x2 was used to analyze the sample rate.Results Overall scores in final theoretic examination of PBL group were higher than those in traditional teaching group,but without significant difference (x2 =0.241,P ＞ 0.05).Scores of operation skill test were higher in PBL group than in traditional teaching group,with significant differences (x2 =6.229,P ＜ 0.05).Questionnaire results showed that satisfaction degree was higher in cases PBL group than in traditional teaching group,except that of ‘ systematical study’ item.Conclusions case leaded PBL teaching can not only enhance students' learning interests,intrigue their initiatives to improve practical ability,skills to communicate with patients and self-learning ability,but also enhance young teachers' coaching ability.

Objective To study the efficacy of problem-based learning (PBL) in clinical teaching of gynecology and obstetrics.Methods Totally 170 students in our department for probationary were divided into two groups randomly.Students in the two groups were taught by theoretical lecture and case study in the ward.PBL (After the lectures,teachers choose clinical cases,students inquire medical history and do physical examination,students discuss on the case and propose treatment scheme,students look up references and consult specialist to determine treatment scheme,students do team report and teachers give comments) was used in experimental group (n=87) while traditional teaching method (teachers guide students to inquire medical history,do physical examination,analyze the cases and make diagnosis,do differential diagnosis and give treatment as well as answer the questions posed by students) in control group (n=83).Ability of students to solve the practical problems was assessed by final examination (theoretical exam and case analysis) and the efficacy of PBL was investigated by questionnaire survey.SPSS 11.5 soft ware was employed to do statistic analysis.Measurement data were analyzed by t test and manifested asand enumeration data were analyzed by chi-square test.P≤ 0.05 stands for statistical differences.Results There was no difference in theoretical score between experimental group and control group.Score of case analysis was higher in experimental group than in control group (t=2.236,P=0.017).Students' satisfaction degree of PBL was much higher than that of traditional teaching method.Conclusions PBL is better than traditional teaching method in clinical teaching of gynecology and obstetrics.It can improve students' ability of problem-analyzing and problem-solving,therefore should be promoted in clinie education.

Diversified clinical teaching methods which include theoretical teaching by multimedia,specific chapter explains with PBL,contacting with clinical diseases and integrating theoretical knowledge by case discussion,solving learning problems and introducing new progress by seminars,can improve the quality of teaching in the department of obstetrics and gynecology.

Objective To observe the clinical curative effects of transvaginal surgery in treatment of uter -ine prolapse .Methods The clinical data of 301 cases of uterine prolapse in our hospital treated with transvagi-nal surgery were retrospectively analyzed .Results The surgeries of 301 cases were successful .Among the 114 cases with the first degree uterine prolapse,63 cases were cured(55.26%),25 cases were improved(21.93%), 23 cases were relapsed ( 20.18%) , and 3 cases were ineffectively ( 2.63%) .The clinical effective rate was 77.19%.Among the 178 cases with the second degree uterine prolapse ,101 cases were cured(56.74%),67 ca-ses improved(37.64%),and 10 cases were relapsed(5.62%).The clinical effective rate was 94.28%.Among the 9 cases with the third degree uterine prolapse , 1 case was cured ( 11.11%) , 5 cases were improved (55.56%),1 case was relapsed(11.11%),and 2 cases were ineffectively(22.22%).The clinical effective rate was 66.67%.Conclusion Transvaginal surgery is regarded as an good method for the first and second degree u -terine prolase because of its curative effects ,less pain ,low incidence of complications and quick recovery .Howev-er, it is ineffective and has a higher rate of recurrence for some cases of third degree uterine prolapse .

Objective To investigate the correlation between neural tube defects (NTDs) and DACT1 gene, and provide the basic data for disease diagnosis and genetic counseling. Methods Blood samples were obtained from 163 NTDs patients and 480 unrelated healthy individuals. Mutation detection of DACT1 gene and DNA direct sequencing was carried out by PCR amplification. Bioinformatics analysis of these mutated loci was performed. Results Six mutations were found in NTDs patients, including 4 missense mutations (p.R45W, p.D142G, p.N356K and p.V702G). But these mutations were not found in 480 healthy individuals. Three mutated amino acid residues (p.45R, p.142D and p.356N) were highly conservative in evolution, and the mutated carriers were female patients, and suffered from anencephaly. Conclusion DACT1 gene mutation may be a risk factor of NTDs in Han population of northern China.

OBJECTIVE: To explore the characteristics of differentially methylated genes and gene ontology associated with neural tube defects (NTDs). METHODS: Twelve subjects from 3 NTDs pedigrees were enrolled. Patients with NTDs have served as the case group, while their family members with normal phenotypes have served as the control group. Genomic DNA was extracted from peripheral venous blood samples of the families and used for DNA methylation analysis. Pairwise comparison was carried out primarily for patient-offspring pairs, and co-segregation of methylation pattern with NTDs was analyzed. Pathway related to differentially methylated genes was predicted with DAVID software. RESULTS: Pairwise comparison indicated that VTRNA2-1 was the only gene in which all CpG sites were methylated. Co-segregation of VTRNA2-1 gene methylation with NTDs was found in all pedigrees. Pathways of hypermethylated genes included plasma membrane component, regulation of cellular protein metabolic process, and regulation of actin cytoskeleton organization, while the pathways of hypomethylated genes have included transcription regulator activity, cell adhesion, and neuronal differentiation. CONCLUSION Methylation of the VTRNA2-1 gene has co-segregated with NTDs in the studied pedigrees. The pathways of differentially methylated genes has involved with mechanism of neural tube development.
CpG Islands ; DNA Methylation ; Gene Ontology ; Humans ; MicroRNAs ; genetics ; Neural Tube Defects ; genetics ; Pedigree

OBJECTIVE:To study the clinical effects of curettage under hysteroscopy combined with estrogen and progesterone in preventing intrauterine adhesion after missed abortion.METHODS:A total of 120 patients receiving missed abortion selected from gynecology department of our hospital during Jun.2014-Jun.2016 were randomly divided into observation group (60 cases) and control group (60 cases) according to seguential coding.Observation group was given estradiol valerate 3 mg,qd,for 5 d in total,received curettage under hysteroscope,and was given Estradiol valerate tablet/Estmdiol valerate cyproterone tablet one tablet,qd after surgery,for 21 d.Control group received routine curettage and didn't take estrogen and progesterone during the perioperative period.The time of vaginal bleeding,endometrial thickness 14 d after surgery,the amout of vaginal bleeding with in 3 months after surgery,intrauterine adhesion,the occurrence of ADR were observed in 2 groups.RESULTS:In observation group,57 cases completed the study except that 2 cases withdrew from the study due to the amount of vaginal bleeding as much as menstrual volume and 1 case withdrew from the study due to pregnancy tissue self-discharge.The duration of postoperative vaginal bleeding was (3.2 ±1.1) d in observation group and (5.4 ± 1.9) d in control group.The endometrial thickness of observation group was (8.04 ± 1.52)mm and that of control group was (5.27 ± 2.36) mm;the incidence of intrauterine adhesion was 3.5％ in observation group (2/57)and 15％ in control group (9/60).Above indexes of observation group were better than those of control group (P＜0.05).CONCLUSIONS:Curettage under hysteroscope combined with estrogen and progesterone helps to reduce post-curettage vaginal bleeding,promote endometrial repair and prevent intrauterine adhesion so as to protect women's reproductive ability.

Objective To investigate the safety and efficacy of ultrasound ablation in treatment of uterine fibroids. Methods Ninety-nine patients with 117 leiomyomas in total treated by Haifu JC focused ultrasound tumor therapeutic system were enrolled in prospective and non-randomized clinical trial in First Affiliated Hospital of Chongqing Medical University and Academy of Military Medical Sciences. Ultrasound ablation was performed guided by real-time ultrasonography under conscious sedation for single session. All patients were followed up at 6 months after treatment. On the day of treatment and after 1 month, patients were given by magnetic resonance imaging(MRI) exam to evaluate the effect of fibroids ablation. At 3 and 6months after treatment, the ratio of ablated area and volume reduction of fibroids more than 50% were evaluated by MRI exam again. The symptoms improvements were evaluated by uterine fibroid symptom (UFS) and complications were analyzed by guideline of society of international radiation (SIR). Results The average ablated area ratio of the target fibroid was (76 ± 24)%. The average reduction in fibroid volume determined by MRI at 3 and 6 months after treatment was (45 ± 21)% and (59 ± 26)%. Which were significantly decreased than those before treatment (P < 0. 05). At 6 months after treatment, 84. 6% (99/117) of patients showed more than 50% volume reduction, the rate of improved symptom score was 92%(66/72). All patients could resume normal daily activities at 2 hours after treatment. The adverse reactions of SIR C - D included delayed hospitalization, repeat treatment and increased level of nursing. E - F included permanent sequelae and death. In this study, no adverse reactions of C - F were recorded. Common complications (SIR A- B, only observation or simple management without sequelae) were 35% (35/99).Four cases with adverse reactions B of SIR were found, including 2 cases with skin burning of degree Ⅱ and 2 cases with febrile, they were administered by symptomatic therapy and changing dressing The other adverse reaction A of SIR included sorness of buttock, vaginal discharge, dysuria and painful urination, they were only suggested by follow-up. Conclusion It was efficacy and safe that ultrasound ablation as a single strategy were used in treatment of uterine fibroids.