In the presence of antischistosomular serum(Ab), the adherence of macrophages(M?). eosinophils(Eos) and neutrophils(Neu) to and the killing effect on schistosomula of Schistosoma japonicum were studied with a mouse model. In vitro experiment showed that all the three kinds of effectcr cells could adhere to the surface of the schistosomula when opsonized with specific Ab resulting in the significant increase in the percentage of dead schistosomula. When SPA was added to the system, the percentage of schistosomula with adherent cells decreased markedly. It was revealed that the adherence of cells was at least partially through the binding of Fc fragment of IgG to Fc receptor on the cell surfaces. After having been incubated with Ab and/or cells for 18 h in vitro, the schistosomula were inoculated into the peritoneal cavity of mice. The adult recovery rate 6 weeks after inoculation in groups Eos+Ab and M? + Ab were significantly lower than that of the control group (P

Objective To investigate the pathogenesis of endometriosis by studying endometriosis coexisting with variable genital tract anomalies and analysis the association between obstructive or nonobstructive anomalies with endometriosis.Methods From January 2000 to April 2010,a total of 67 cases of endometriosis coexisting with genital tract anomalies undergoing treatment in Peking Union Medical College Hospital were studied retrospectively.Results According to subtypes of concurrent genital tract anomalies,67 cases were divided into 19 cases in obstructive group and 48 cases in non-obstructive group.(1) Age and symptoms:the mean age were (22 ± 8) years in obstructive group and (32 ± 7) years in non-obstructive group,which reached statistical difference (P ＜ 0.05).The major symptoms were dysmenorrheal or chronic pelvic pain (14/19) and amenorrhea (8/19) in obstructive group.However,in non-obstructive group,the major symptoms were dysmenorrheal or chronic pelvic pain (31％,15/48) and infertility (35％,17/48) and abortion (21％,10/48).(2) Degree and incidence of endometriosis:the moderate or severe endometriosis was 11/19 in obstructive group and 40％ (19/48) in non-obstructive group,which did not show statistical difference (P ＞ 0.05).The incidence of peritoneal endometriosis,ovarian endometriosis,adenomyosis did not show significant difference between two groups (all P ＞ 0.05).The rate of moderate or severe endometriosis coexisting with duplex uterus,uterus bicornis and uterus septus did not show significant difference in non-obstructive group (P ＞ 0.05).Conclusions The severity of endometriosis showed no association with obstructive anomalies.The results implied that there might be other factors involved in pathogenesis of endometriosis.

The effects of various soluble extracts of Ascaris suum on human blood coagulation were studied. The extract of whole worm could prolong recalcification time (RT) and kaolin-activated, partial thromboplastin time (KPTT), but did not alter prothrombin time (PT), indicating that the intrinsic pathway of blood coagulation was inhibited by this extract, but the extrinsic pathway was not affected. Whole worm extract inhibited platelet aggregation induced by ADP, but did not influence the one induced by adrenaline. Neither whole worm extract nor body fluid caused fibrinolysis. In KPTT assays with three dif-ferent extracts, cuticle extract exhibited the strongest anticoagulant activity, while whole worm extract and body fluid much less so. These data suggested that anticoagulants of ascaris mainly exist in the cuticle,

Objective To investigate the route of minimal invasive sling procedures and evaluate their safety. Methods Tension-free vaginal tape (TVT),TVT-obturator (TVT-O) and posterior intravaginal sling (P-IVS) procedure were performed on five fresh pelvis.4% formaldehyde was used to preserve the cadavers and colored latex was injected into the vessels.An anatomic study and measurements between the trocars and related vessels or organs were carried out.Results There was no complication during all injections.The distance between TVT trocar and pubic vessels,the bladder,external lilac vessels and obturator vessels were 0.6,0.6,4.2 and 4.3 cm,respectively.Out of control of TVT trocar,the axial rotation or lateral diversion of TVT handle could injure these structures.We found during TVT-O operation,the retropubic space was not violated.The right placement of introducer was very important. When the beginning point was too deep into the anterior vaginal wall,2.2 cm proximal to urethral meatus or on a horizontal plane with a 35° angle relative to the urethral sagittal plane,the introducer would enter the retropubic space or perforate the upper posterior zone of the obturator membrane,where the obturator vessels and nerves exit the obturator canal.Based on our study,the diversion of P-IVS trocar would damage the rectum,and the pudendal vessels and nerves were relatively safe.Conclusions The TVT trocar passes the retropubic space and may injure the important vessels or organs.The route of TVT-O inside-out operation is stable and the retropubic space is not violated.The blunt design in the P-IVS trocar tips is helpful to reduce injury.

Objective To investigate clinical features and management of complicated or rare vulvovaginal anomalies derived from urogenital sinus malformation.Methods Medical documents of 6 cases with vulvovaginal anomalies treated in Department of Obstetrics and Gynecology in Peking Union Medical College Hospital in the past 10 years were reviewed retrospectively.According to embryological and anatomical characteristics,the classification system were established.Results This kind of vulvovngihal anomalies was very rare and not enrolled into current diagnosis and treatment system. All patients had a common clinical features:menstruation bleeding and urine from the same outflow tract;and two orifices on perineum were found by bimannal examination,one orifice located under clitoris,the other orifice Was anus.No vagihal vestibule and vulvar were observed between those two orifices.According to clinical features,those 6 cases were divided into 3 types:type Ⅰ Was persistence of distant urogenital sinus with clinical manifestation of simple labial fusion;type Ⅱ was low communication between vagina and urogenital sinus (infrasphincterie),presenting with distal vaginai atresia and urethrovagihal fistula;type Ⅲ was high communication (suprasphincteric) with distal vagihal atresia and more proximal urethrovavihal fistula.Type Ⅲ was frequently associated with severe rectum and anus anomaly,and other malformation as well.All patients were treated by surgical correction.Basically.the principle of operation wag to reconstruct perineal appearance,release the obstruction,and rear the defect and ultimately recovering the normal function.The alternative surgical methods should be considered individually.Conclusions The vulvovnginal anomalies derived from urogenital sinus malformation were complicated clinically.To establish classification system will be benefit for clinicians to make diagnosis and choose appropriate treatment. The individualized surgery should be performed on those patients to restore the structure and function,in the mean time,the factors associated with esthetics.sex and psychics should be considered.

Objective To investigate the effect of vagina reconstruction using tissue-engineering biological material (acellular dermal matrix) in an animal model.Methods Vagina excision and vagina reconstruction with tissue-engineering biological material were performed in 12 Chinese experimental miniature pigs.The control group was matched with two of normal vagina specimens resected.At week 1,2,4,6,8,12 after surgery,the animals were sacrificed,respectively,and the neovaginas were prepared for immunohistochemical and Van Gieson (VG) staining to evaluate the status of various layer growth of vagina.Epithelial broad spectrum of monoclonal antibodies of AE1/AE3 and α-actin were used to test the existence of epithelial and smooth muscle tissue by immunohistochemical staining.The ultrastructure of neovagina was studied by transmission electron microscope at week 1 and 12 after surgery.Contractile function of isolated smooth muscle of neovagina was evaluated by chemical and electronic stimulation after 12 weeks' reconstruction.Results (1) Epithelization of 2/3 neovaginal mucosa was observed within 1 week.Only 1-2 layer epitheliums were observed under the light microscopy and epithelial cells with characteristics of loose and disarrangement were shown with the electron microscopy.Within 4-6 weeks,epithelization in mucosa of neovaginal canal was intensified to 4-5 layers.After 12 weeks,the differences between the neovagina and the native vagina were harldy noted either in the gross or microscopically.(2) After 4 weeks,a few smooth muscle cells were observed with VG and immunohistochemical staining,and homogeneous muscle bundle was formed.(3) After 12 weeks,similar contractile responses between neovagina and native vagina were observed when KCI and electrical stimulation with different frequency and voltage were given [(2.96±0.29)g vs.(3.14±0.30)g,(3.43±0.34)g vs.(4.65±0.73)g,(4.92±0.38)g vs.(4.89±0.44)g].Conclusion The tissue-engineering biological material might be an ideal graft used in the reconstruction of vagina.

Objective To study the pathologic characteristics of eutopic endometrium in patients with endometriosis.Methods Pathologic characteristics of eutopic endometrium were studied in 176 patients with endometriosis in Peking Union Medical College Hospital from January 2007 to December 2008 retrospectively.Results About 72.2％(127/176)of eutopic endometrium were in proliferative phase,19.9％(35/176)of were observed as endometrial polyp,including 32 cases with simple endometrial polyp and 3 cases with abnormal hyperplasia combined with endometrial polyp.And 4.0％(7/176)showed abnormal hyperplasia.The incidence of pathologic changes in eutopic endometrium was 22.2％(39/176).Among 53 endometriosis patients combined with infertility,the incidence of pathologic changes of eutopic endometrium was 35.9％(19/53),which was significantly higher than 16.3％ in non-infertile patients (x2 =8.24,P =0.004).Among 65 cases with irregular menstruation,the incidence of endometrial polypus and endometrial hyperplasia were 20.0％(13/65)and 10.8％(7/65),which were significantly higher than 17.1％(19/111)and 0 in normal menstruation patients(x2 =13.839,P =0.003).Conclusions The eutopic endometrium of endometriosis were in proliferative phase state.The pathologic changes of eutopic endometrium were more in patients combined with infertility and irregular menstruation.

To explore the effect of Kaixin Capsule (KC, composed of Radix Panacis Quinquefolii, Radix Astragali, Radix Ophiopogonis, Rhizoma Chuanxiong,Rhizoma Cyperi, etc.) in reconstructing the collagen of non infarct region of left ventricle in rats after myocardial infarction (MI) and to study its mechanism.Seventy rats were allocated to mimic operation group (Group Ⅰ), model group (Group Ⅱ), high dosage KC group (Group Ⅲ), low dosage KC group (Group Ⅳ) and positive control group (Group Ⅴ). Rat models of left ventricle reconstruction were established by the ligation of the main stem of left coronary artery. Three days after modeling, the rats were treated with KC for eight weeks. And then the total collagen content in the myocardium of non infarct region and angiotensin Ⅱ (AngⅡ) and aldosterone (ALD) levels in blood and myocardium were measured by oxyproline hydroxyproline method and radioimmunoassay. The total collagen content was higher in Group Ⅱ than that in Group Ⅰ (P0 05) . [Conclusion]KC can inhibit the production of collagen and increase myocardial compliance and its mechanism may be involved in the regulation of rennin angiotensin aldosterone system.

Objective To investigate prevalence and risk factors of pelvic organ prolapse in women underwent routine gynecologic health care in Peking Union Medical College Hospital (PUMCH).Methods From Jan.2008 to Aug.2009,972 women underwent gynecological health care in PUMCH Were enrolled in this study.Questionnaires and pelfic examinations were given.The pelvic organ prolapse quantitive examination(POP-Q)system was used as the assessment tool.Results (1)Among all participants,the mean ages were(42±10)years(range 22 to 78 years),the mean height were(162±5)cm(range 142 to 180 cm),and the mean weight were(59±8)kg(range 42 to 91 kg).83.8%(815/972)of women were multipara.The mean total vagihal length(TVL)of 972 women was 8.20 cm.No women met the standard of pelvic organ prolapse, while 35.5% (345/972) of women presented mild posterior vaginal descent and 96. 7% (940/972) presented mild anterior vaginal descent, all of them were asymptomatic. (2) The length of genital hiatus (gh), TVL and C, D proximal to the hymen in nullipara were (2.26 ±0. 32), (8.08 ±0. 30), ( - 7.08 ± 0. 24) and ( - 8. 08 ± 0. 30) cm, which were significantly less than ( 2. 33 ± 0. 39 ),( 8. 22 ± 0. 35 ), ( - 7. 14 ± 0. 28 ) and ( - 8. 22 ± 0. 35 ) cm in multipara ( P < 0. 05 ). Ap and Pb proximal to the hymen of ( - 2. 87 ± 0. 22) and ( - 2. 87 ± 0. 22 ) cm in nullipara were significantly larger than ( -2.81 ±0.25) and ( -2.81 ±0.25) cm in multipara (P<0.05). When compared with nullipara, the incidence of posterior and anterior vaginal wall protrusion were increased ( OR = 1. 819). (3) The index of POP-P were compared among women at groups of 22 -34 years, 35 -49 years and more than 50 years (P <0. 05 ). Those index did not show statistical difference between women at group of 22 - 34 years and group of 35 -49 years (P >0. 05). However, those in women at group of 22 -34 years and 35 -49 years showed statistical difference when compared with women at group of more than 50 years ( P < 0. 05 ). When compared with women at group of 22 - 34 years, the incidence of posterior and anterior vaginal wall protrusion were increased ( OR = 1. 713, 3. 765). (4) Menopause status was associated with severities of all kinds of descent ( P < 0. 05 ) and presence of posterior vaginal protrusion ( OR = 3. 354 ). Conclusions Mild anterior and posterior vaginal descent by POP-Q were common among women in China. The risk of anterior vaginal descent is relatively higher than posterior vaginal descent. However, most of the women with descent are asymptomatic and need no treatment. The most important factors associated with the severity and detectable ratio of descent is parity and age.

Objective To study the clinical presentation and pathological features of rare nonepithelial vulvar tumors. Methods The clinical data of 42 patients with nonepithelial vulvar tumors who were operated on during 1986 to 2007 in Peking Union Medical College Hospital were analyzed. Results The average age of 42 patients was 44. 1 years. There were 32 eases (76%) with a vulvar mass. Twenty one of these 42 patients (50%) complained of associated symptoms of itch and pain Surgical treatment was the chief treatment of nonepithelial vulvar tumors, which included local excision (40, 95%), simple vulvectomy ( 1,2% ) and radical vulveetomy ( 1,2% ). Among the pathological diagnoses after operation,the most common benign histological subtypes were hidradenoma and haemangioma, while the must common malignant histological subtypes were leiomyosarcoma and aggressive angiomyxoma. Conclusions Most of the nonepithelial vulvar tumors are mesenehymal tumors. The clinical presentation has no special characteristics. Diagnosis of nonepithelial vulvar tumors can be made based on histological inspection.Surgical treatment is the treatment of choice.