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Significance of circadian gene Period2 expression in epithelial ovarian cancer and the effect of gene overexpression on growth of ovarian cancer xenografts in nude mice

Zhaoxia WANG ; Li LI

Chinese Journal of Obstetrics and Gynecology.2015;(6):446-451. doi:10.3760/cma.j.issn.0529-567x.2015.06.009

Objective To study the significance of circadian gene Period2 expression in epithelial ovarian cancer tissues and the effect of gene overexpression on the growth of ovarian cancer xenografts in nude mice. Methods Twenty-two cases of ovarian cancer paraffin specimens in the First Hospital of Shanxi Medical University (ovarian cancer group) were chosed during Jau. 2010 to Dec. 2013, including 8 cases of stageⅠ, 8 cases of stageⅡ, and 6 cases of stageⅢ, while 6 cases of benign ovarian epithelial tumor paraffin specimens were selected as control (benign tumor group). Period2 gene were detected by real-time quantitative PCR and western blot methods in different stages of ovarian cancer tumor tissues. Established theovarian cancer xenografts in nude mice with ovarian cancer cell line SKOV3, and they weredivided into 3 groups (n=8), including the recombinant plasmid group, empty plasmid group and control group. Using gene transfection technique to transfer Period2 gene into tumor tissues, tested the expression of Period2 mRNA in tumor tissues by real-time quantitative PCR after transfection into all nude mice, monitoredthetransplant tumor growth and calculating the tumor inhibition rate,detected the antiapoptotic gene BRE, apoptosis related tumor necrosis factor receptor (TNFR1) andtumor suppressor gene NIX in tumor tissues by real-time PCR and western blot in different groups. Results (1)The expression level of Period2 mRNA in tumor tissues amongovarian cancer group stageⅠ,ⅡandⅢwere respectively 2.59±0.50, 0.47± 0.08 and 0.42 ± 0.08, but benign tumor group was 6.59 ± 1.05. The expression level of Period2 protein in ovarian cancer group stage Ⅰ,Ⅱ and Ⅲ were respectively 0.835 ± 0.087, 0.412 ± 0.035 and 0.199 ± 0.031, while benign tumor group was 0.874 ± 0.094. The expression level of Period2 mRNA and protein in benign tumor group was higher than those in ovarian cancer group stageⅠ,ⅡorⅢ(P<0.01). With ovarian cancer stage increased, the expression of Period2 mRNA and protein were decreased or absent (P<0.05).(2)Two weeks after transfection, the expression level of Period2 mRNA in recombinant plasmid group tumor tissue was significantly higher than those in the empty plasmid group or the control group (6.11±0.56 vs 0.50±0.09 vs 0.44 ± 0.08, respectively;P<0.01), the transplanted tumor volume of recombinant plasmid group was significantly less than those in empty plasmid group or the control group[ (486±70) mm3 vs (835±106) mm3 vs (846 ± 110) mm3, respectively;P<0.01], the tumor inhibition rate of the recombinantin plasmid group was as high as 42.9%, that was significantly higher than those in the empty plasmid group and the control group (3.8% and 0, respectively;P<0.05).(3)The expression level of BRE mRNA and protein in transplanted tumor tissues in the recombinant plasmid group were significantly lower than those in empty plasmid group and the control group;the expression level of TNFR1 and NIX were significantly higher than those in the empty plasmid group and the control group (all P<0.05). Conclusions Period2 mRNA and protein expression are absent in ovarian cancer of advanced stage. Transfection and stable expression of Period2 gene could slow down the growth of ovarian cancer, and the tumor inhibition rate could be significantly increased. Period2 gene may promote ovarian cancer cells apoptosis through inhibition of BRE gene expression and promoting TNFR1, NIX gene expressionto exert anti-tumor effect.

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Comparison of the effect of three β-thalassemia prenatal screening strategies using in Guangdong province

Bing LI ; Aihua YIN ; Mingyong LUO ; Li WU ; Yuanzhu MA ; Xionghu WANG ; Xiaozhuang ZHANG ; Qingguo ZHAO

Chinese Journal of Obstetrics and Gynecology.2015;(6):434-440. doi:10.3760/cma.j.issn.0529-567x.2015.06.007

Objective To compare the effect of three β-thalassemia prenatal screening strategies in Guangdong province. Methods A total of 13 284 hospital-delivered couples and 13 369 newborns were recruited from 91 hospitals in 21 counties or districts of Guangdong province from June to December 2012. Mean cell volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A2 (Hb A2) were tested for all the couples, and all the couples and newborns were detected by 17 types ofβ-globin gene mutations. The effect of three β-thalassemia prenatal screening strategies were compared as following:(1) MCV/MCH with Hb A2 serial screening(SS):Hb A2 was tested if the woman′s MCV<82 fl and(or)MCH<27 pg. If the woman′s Hb A2>3.5, it meant positive. And if the woman wasβ-thalassemia carrier and her husband′s Hb A2>3.5, it meant couple positive. (2) MCV/MCH with Hb A2 parallel screening(PS):if the woman′s MCV<82 fl and (or) MCH<27 pg and(or) Hb A2>3.5 pg, it meant couple positive. And the husband would be tested forβ-globin gene mutations if the woman was β-thalassemia carrier. (3) MCV/MCH with Hb A2 serial screening for couples(SSC):if one of the couple or both of them had MCV<82 fl and(or) MCH<27 pg, the couple would be tested for Hb A2, and if one of the couple got Hb A2>3.5, it meant couple positive. Results (1) For the SS strategy, the sensitivity was 92.69%(583/629);the specificity was 99.87%(12 638/12 655); the positive predictive value was 97.17%(583/600);and the negative predictive value was 99.64%(12 638/12 684). The results ofβ-globin gene mutations tested showed that the rate ofβ-thalassemia carriers was 4.74%(629/13 284) in the 13 284 pregnant women, and it was 4.29%(570/13 284) in their husbands. (2) The SS strategy detected 27 (0.20%,27/13 284) β-thalassemia carrier couples. For the SS strategy detecting β-thalassemia carrier couples, the missed diagnosis rate was 11.11%(3/27);the sensitivity was 88.89%(24/27);the specificity was 100.00%(27/27); the positive predictive value was 100.00%(24/24); and the negative predictive value was 99.98%(13 257/13 260). (3) When using the SS strategy for 13 369 offsprings, there were 582β-thalassemia carriers (4.35%,582/13 369), including 578 (99.31%,578/582) minorβ-thalassemia, 3 (0.52%,3/582) intermediaβ-thalassemia and 1 (0.17%,1/582) major β-thalassemia. The SS strategy detected 25 fetuses who neededβ-thalassemia prenatal diagnosis. (4) For the PS strategy, the sensitivity was 98.09%(617/629); the specificity was 88.73%(11 229/12 655); the positive predictive value was 30.20%(617/2 043); and the negative predictive value was 99.89%(11 229/11 241). (5) When using the PS strategy for theβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 95.55%(12 667/13 257);the positive predictive value was 4.38%(27/617);and the negative predictive value was 100.0%(12 667/12 667). (6) The PS strategy detected 28 fetuses who needed β-thalassemia prenatal diagnosis in 13 369 offsprings. (7) For the SSC strategy, the sensitivity was 93.80%(590/629); the specificity was 95.75%(12 117/12 655); the positive predictive value was 52.30%(590/1 128); and the negative predictive value was 99.68%(12 117/12 156). When the SSC strategy was used for the husbands, the sensitivity was 92.28%(526/570); the specificity was 95.27%(12 112/12 714);the positive predictive value was 46.63%(526/1 128); and the negative predictive value was 99.64%(12 112/12 156). (8) When the SSC strategy was used inβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 91.69%(12 156/13 257);the positive predictive value was 2.39%(27/1 128);and the negative predictive value was 100.00%(12 156/12 156). (9) The SSC strategy detected 28 fetuses who neededβ-thalassemia prenatal diagnosis. Conclusions All the three β-thalassemia prenatal screening strategies had good effect in clinical practice and public health. While in the high-prone area of β-thalassemia, MCV/MCH with Hb A2 parallel screening and MCV/MCH with Hb A2 serial screening for couples stratigies were better.

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Comparison of levator ani muscles in three-dimensional MRI-based models in women with and without pelvic organ prolapse at rest

Ping LIU ; Ruolan CHEN ; Chunlin CHEN ; Lan CHEN ; Cheng PENG ; Lu HUANG ; Jianping WANG ; Huanqing TAN ; Kedan LIAO ; Lian TANG ; Yuezhi WANG ; Lei TANG ; Shizhen ZHONG

Chinese Journal of Obstetrics and Gynecology.2015;(6):428-433. doi:10.3760/cma.j.issn.0529-567x.2015.06.006

Objective Comparison of the levator ani muscles in three-dimensional (3D) MRI-based models in women with and without pelvic organ prolapse at rest to analyze the morphological characteristics of levator ani muscles in women with POP. Methods Twenty-five women with POP and 22 women with normal pelvic support were selected from Nanfang Hospital of Southern Medical University. Axial, sagittal, and coronal T2-weighted pelvic magnetic resonance scans were obtained with the women in the supine position.The 3D models were reconstructed from the source images. Morphological changes was compared within the two groups of levator ani muscles, and the 3D models were measured to determine the levator ani muscle volume (LVOL), levator plate angle (LPA), levator hiatus width (LH-W) and length (LH-L), distance between symphysis and levator sling muscle (LSG). Results There were no puborectalis avulsions in control, in POP, 3 cases of avulsions just in left, 3 cases of avulsions just in right, 7 cases in bilateral. The shape of iliococcygeus were all dome-shaped in control, 11 cases were U-shaped and 14 cases were dome-shaped in POP. The shape of levator hiatus were 7 cases of U-shape, 12 cases of V-shape, 3 cases of irregular in control; 5 cases of U-shape, 4 cases of V-shape, 16 cases of irregular in POP. POP versus control: LH-L: (68.0 ± 8.9) versus (61.6 ± 7.2) mm (P<0.05); LH-W: (41.4 ± 3.9) versus (38.0 ± 3.2) mm (P<0.05); LSG-L: (29.6 ± 7.4) versus (24.6 ± 3.7) mm (P<0.05); LSG-R: (28.4 ± 6.8) versus (23.9 ± 3.2) mm (P<0.05); LPA: (51.0 ± 11.3)° versus (40.6 ± 6.3)° (P<0.05); LVOL: (23.7 ± 5.8) versus (24.6 ± 5.0) cm3 (P>0.05). Conclusions It is possible to assess the morphologic changes of levator ani by using 3D MRI models objectively, our 3D data demonstrate larger in LVOL, LPA, LH-W, LH-L, LSG, and the changes in shape. It is helpful to diagnose and assess the specific situation of patients POP in clinic.

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Efficiency of single incision adjustable mini sling, Ajust, for the treatment of stress urinary incontinence combined with advanced pelvic organ prolapse in eldly women

Haizheng JIN ; Yongxian LU ; Wenjie SHEN ; Xin LIU ; Jingxia LIU ; Jing GE ; Yinghui ZHANG ; Lin QIN ; Rui LI ; Yuhui YANG

Chinese Journal of Obstetrics and Gynecology.2015;(6):409-414. doi:10.3760/cma.j.issn.0529-567x.2015.06.003

Objective To estimate the efficiency of the single incision adjustable mini sling, Ajust, in the treatment of stress urinary incontinence (SUI) concomitant with advanced pelvic organ prolapse (POP) in eldly women. Methods From Dec. 2013 to Jul. 2014, 58 patients who had been diagnosed as SUI combined with advanced POP underwent both single incision adjustable mini sling and reductive surgery for advanced POP in the First Affiliated Hospital, General Hospital of People′s Liberation Army. Fifty-eight patients were assessed to evaluate the safety and efficiency at 2, 6, 12 months postoperatively. The primary outcomes include objective and subjective cure rate, Ajust sling related complications, ralues of urinary distress inventory (UDI-6), incontinence impact questionnaire short form (IIQ-7) and patient global impression of change (PGI-C). Results There was no case of leakage tested by cough test, so the objective cure rate for anti-incontinence had been achived to 100% (58/58) at a mean 12 months follow-up. There were 91% (53/58) of the patients′ PGI-C score reached 5, and 9% (5/58) of the patients′ PGI-C score reached 4. No case underwent the reoperation. There was no case of hematoma, bladder perforation, urethral injury, groin pain, as well as pain in the puncture point during the perioperative period of time. The values of UDI-6 and IIQ-7 declined significantly postoperatively (P<0.01). Conclusions The single incision mini sling, Ajust, presents satisfactory objective and subjective cure rate in the treatment of mild and moderate SUI combined with severe POP in the eldly womem. The advantages of this mini sling includes mini-invasiveness, simple to use, rare complications and less urinary retention rate. It is a procedure worth recommending in the clinical treatment of mild to moderate SUI.

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Identification and characterization of stem cells in an ovarian cancer cell line and examination their drug resistance

Zhentong WEI ; Yishu WANG ; Xiaowei YU ; Songling ZHANG

Chinese Journal of Obstetrics and Gynecology.2015;(6):452-457. doi:10.3760/cma.j.issn.0529-567x.2015.06.010

Objective To isolate side population (SP) cells from an established ovarian cancer (OC)cell line,characterize these cells,and examine their drug resistance. Methods SP and non-SP (NSP) cells were isolated by fluorescence-activated cell sorting (FACS),and cultured in differential conditions,then detected their SP ratio to compare their capability of differentiation and self-renewal. Moreover,SP and NSP cell tumorigenesis was examined by subcutaneous and intraperitoneal injection of these cells to nonobes ediabetic(NOD)-severe combined immundeficient(SCID)mice. Drug resistance to cisplatin was examined by cell counting kit-8 (CCK-8).Results SP cells could be isolated stablly and insistently. There was(4.81 ± 0.43)%of SP cells in the established OC cell line and(4.89 ± 0.33)%of SP cells after cultured the isolated SP cells in differentiation condition,and there was no significant different between these two quantities (P>0.05). However,after cultured the NSP cells,there was only (0.10 ± 0.03)%of SP cells which was significantly lower than that contained in the OC cell line(P<0.01). In the tumorigenesis assay 1.0 × 103 SP cells were injected subcutaneously and formed the xenografted tumors in 6 weeks(3/3),and 1.0×104 NSP cells were injected subcutaneously and did not form xenografted tumors in 12 weeks(0). The tumorigenic capability of SP cells was higher than that of NSP cells(P<0.01). Both the original and the xenografted tumors were low differentiated serous cystadenocarcinomas and expressed the ovarian serous cystadenocarcinomas CA125 marker after stained by HE and immunohistochemistry. Simultaneously,the SP cells were also capable to form tumors as shown by intraperitoneal injection. In the drug resistance assay shown that the 50% inhibitory concentration (IC50) of the SP and NSP cells were respectively(2.33 ± 0.14)μg/ml and(1.60 ± 0.04)μg/ml(P<0.05). After treated the unsorted OC cells with cisplatin,the quantity of SP cells increased to(40.10 ± 4.22)%and there was significant difference,when compared to the untreated cells which was(4.81±0.43)%(P<0.01). The SP cells survival rate was(58.7± 3.3)%when treated with cisplatin at its IC50 dose,and the rate decreased to(7.2±1.3)%(P<0.01)when verapamil was present. Conclusions The SP cells could be isolated from the established OC cell line. They had the capacities of self-renewal,differentiation,and tumorigenesis,and the new tumor demonstrated the original tumor′s phenotype. The SP cells also had stem cells′ biological characteristics and is resistant to cisplatin.

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Expression of Gas6 in placenta and decidua tissues and its relationship with the pathogenesis of preeclampsia

Hongai SANG ; Yuyan MA ; Xiaodan ZHU ; Linlin WANG ; Mengya HE

Chinese Journal of Obstetrics and Gynecology.2015;(6):441-445. doi:10.3760/cma.j.issn.0529-567x.2015.06.008

Objective To investigate the expression of growth arrest-specific protein 6 (Gas6) in the placenta and decidua tissues and its relationship with the pathogenesis of preeclampsia. Methods All the patients were recruited in Qilu Hospital of Shangdong University from October 2013 to June 2014. Among them, thirty-two women with early-onset severe preeclampsia who received cesarean section were assigned to the preeclampsia group, and thirty healthy pregnant women who received cesarean section were defined as the control group. Blood glucose, blood lipids, platelet count, D-dimer levels and other clinical indicators of the two groups were detected. Immunohistochemistry of SP was conducted to identify the localization of Gas6 protein in the placenta and decidua tissues. And reverse transcription (RT)-PCR was performed for quantitative analysis of Gas6 RNA expression in placentas. The correlations between placental Gas6 mRNA levels with clinical indicators were analyzed. Results (1) The gestational age at delivery, blood pressure, serum albumin, platelet count and birth weight of fetuses showed statistically significant differences between the two groups(P<0.05). (2) The Gas6 protein expressed in the cytoplasm and nucleus of the syncytiotrophoblasts and decidual cells in the placenta and decidual tissues of the two groups. (3) The Gas6 mRNA expression elevated significantly in the placenta of preeclampsia group (0.60 ± 0.38) when compared to that of the control group (0.34±0.22;P<0.05). (4) The expression of Gas6 mRNA was positively related with body mass index, diastolic blood pressure, systolic blood pressure, free fatty acids and creatinine (P<0.05), while it was negatively associated with serum albumin(P<0.05). Conclusion The high expression of Gas6 in the placenta and decidua tissues may be related to the pathogenesis of severe preeclampsia.

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Postpartum pelvic floor rehabilitation on prevention of female pelvic floor dysfunction:a multicenter prospective randomized controlled study

Zhijing SUN ; Lan ZHU ; Jinghe LANG ; Yewu ZHANG ; Guizhi LIU ; Xiaochun CHEN ; Songzhi FENG ; Juxin ZHANG ; Yuhong YAO ; Jie ZHANG ; Yuanyuan SU ; Guiying FANG ; Mei YANG ; Juan LIU ; Zhimin MA

Chinese Journal of Obstetrics and Gynecology.2015;(6):420-427. doi:10.3760/cma.j.issn.0529-567x.2015.06.005

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P<0.01). According to Point Aa, treatment group and control group in the postpartum 6 weeks was (-2.2 ± 0.7) versus (-2.4 ± 0.6) cm, in postpartum 12 months (-2.5 ± 1.1) versus (-2.7 ± 0.6) cm, the improvement in treatment group was statistically significant (P<0.01). And the other points were not significantly different (P>0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.

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POP-Q indication points, Aa and Ba, involve in diagnosis and prognosis of occult stress urinary incontinence complicated with pelvic organ prolapse

Cheng LIU ; Wenying WU ; Qing YANG ; Ming HU ; Yang ZHAO ; Li HONG

Chinese Journal of Obstetrics and Gynecology.2015;(6):415-419. doi:10.3760/cma.j.issn.0529-567x.2015.06.004

Objective To investigate the correlation between pelvic organ prolapse quantitation (POP-Q) indication points and the incidence of occult stress urinary incontinence (OSUI) and its impact on prognosis. Methods Retrospective study medical records of 93 patients with pelvic organ prolapse (POP) staged atⅢ-Ⅳ, of which underwent pelvic reconstruction operations with Prolift system from Jan. 2007 to Sept. 2012. None of these patients had clinical manifestations of stress urinary incontinence (SUI) before surgery, and in which 44 patients were included in study group (POP complicated with OSUI) because they were identified with OSUI, another 49 patients as control group (simple POP). Follow-up and collecting datas including POP-Q, stress test, urodynamic recordings, incidence of de novo SUI, statistic analyzing by logistic regression and receiver operating characteristic curve (ROC). Results (1) The study group had a much higher incidence of 30%(13/44) on de novo SUI than that of control group (4%, 2/49;P<0.01). (2) Vaginal delivery (OR=5.327, 95%CI:1.120-25.347), constipation (OR=5.789, 95%CI:1.492-22.459), preoperative OSUI (OR=13.695, 95%CI:2.980-62.944), anterior vaginal wall prolapse (OR=6.115, 95%CI:1.231-30.379) were identified as dependent risk factors for de novo SUI by logistic regression analysis. (3) For POP patients that complicated with OSUI, we chose a cutoff value of +1.5 cm for Aa point as the threshold to predicting incidence of de novo SUI according to ROC curve, area under the curve (AUC) was 0.889 (P<0.05), the sensitivity reached 88.9%and specificity was 73.9%. According to ROC curve of Ba point, a cutoff value of+2.5 cm was chosen as the threshold to predicting incidence of de novo SUI post-operation, it had a sensitivity of 66.7% and specificity of 82.6%, AUC was 0.766 (P<0.05). Conclusions Pre-operative OSUI is a dependent risk factor of de novo SUI for advanced POP patients. Aa and Ba points are correlated with preoperative OSUI, and it is worthy to be considered as a risk predictor on forecasting the incidence of de novo SUI post pelvic reconstruction surgery.

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Predictive value of abnormal second-trimester maternal serum triple screening markers for adverse pregnancy outcomes

Zhuming HU ; Xiangyin LIU ; Linlin LI ; Chunshu JIA ; Dejun LI ; Ruizhi LIU

Chinese Journal of Obstetrics and Gynecology.2014;49(10):749-753. doi:10.3760/cma.j.issn.0529-567x.2014.10.007

Objective To investigate the predictive value of abnormal multiples of the median (MoM) of second trimester maternal serum triple screening (STMSTS) markers for adverse pregnancy outcomes.Methods 16 000 singleton pregnancies at 15+0 to 20+6 weeks' gestation who underwent STMSTS between July 2010 and January 2013 in the First Hospital of Jilin University were recruited.Maternal serum AFP,free β-hCG (F-β-hCG) and unconjugated estriol (uE3) levels were measured using time-resolved fluoroimmunoassay,and then convened to MoM.LifeCycle 3.2 software was used to calculate risk,and a risk value greater than 1 in 270 or 1 in 350 was considered as high risk for trisomy 21 syndrome (Down syndrome,DS) and trisomy 18 syndrome (Edwards syndrome,ES),respectively.MoM of AFP more than 2.5was considered high risk for open neural tube defect (ONTD).Amniocentesis and karyotyping,ultrasound screening were advised for high risk women.AFP,F-β-hCG higher than 2.0 MoM or uE3 lower than 0.5MoM was considered as abnormal,respectively.The MoM of STMSTS marker between women with adverse pregnancy outcome and with normal outcome was compared.Results (1) The median MoM of AFP,F-β-hCG and uE3 was 0.91 MoM,0.94 MoM and 1.05 MoM,respectively.Of the 16 000 pregnant women,there was no statistical difference in the median MoM of triple screening marker at different weeks of gestation (P＞0.05).The positive rate of DS,ES and ONTD in women ≤35 years old (n=14 972) was 4.03％ (603/14 972),0.36％(54/14 972) and 0.29％(44/14 972) respectively.And in women＞35 years old(n=1 028),the positive rate was 24.51％ (252/1 028),1.95％ (20/1 028) and 0.78％ (8/1 028),respectively.There was a statistically significant difference of positive rate between the two groups(P＜0.05).(2) 9 cases of DS,1 case of ES and 1 ease of ONTD were found in the high risk group,and 2 cases of DS in the low risk group.The detection rate of DS,ES and ONTD was 9/11,1/1 and 1/1 respectively; and the positive predictive value was 1.05％(9/855),1.35％(1/74) and 1.92％(1/52),respectively.(3)The incidence of adverse outcome (group 1) was 1.49 ％(239/16 000).7 760 pregnant women in this study were healthy during pregnancy,so were their fetuses (group 2).There were significant differences in the age at delivery,body weight and markers' MoM of STMSTS between the two groups(P＜0.01).(4) In group 1,the rate of abnormal MoM of AFP or F-β-hCG was 7.95％(19/239) and 23.85％ (57/239),and the abnormal rate of MoM of uE3 was 4.18％(10/239).The rate of two abnormal MoM of markers was 5.02％(12/239); the rate that all three MoM were abnormal was 0.84％(2/ 239).However,in group 2,the rate of two abnormal MoM of markers was 0.14 ％(11/7 760); and the rate that all three MoM were abnormal was 0.There was a significant difference of abnormal MoM of maternal serum marker between the two groups (P＜0.01).Conclusions There is a relationship between abnormal marker of STMSTS and adverse outcomes.STMSTS show a high value in the detection of DS,ES and ONTD.

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Effect of pelvic floor muscle training with biofeedback on stress urinary incontinence in postpartum and post-menopausal women

Juan LIU ; Jie ZENG ; Hailan WANG ; Yan ZHOU ; Chunyan ZENG

Chinese Journal of Obstetrics and Gynecology.2014;49(10):754-757. doi:10.3760/cma.j.issn.0529-567x.2014.10.008

Objective To investigate the short-term effect of pelvic floor muscle training (PFM) with biofeedback on stress urinary incontinence (SUI) in postpartum and post-menopausal women.Methods According to the different period that the SUI occurs,107 women with SUI were divided into two groups:the group of SUI in postpartum with 60 women,and the group of SUI in post-menopausal with 47 women.PFM with biofeedback was performed on all patients for 8 weeks.One hour pad-weighing test,voiding diary,transperineal three-dimensional ultrasound and female pelvic floor muscle assessment were recorded before and after treatment.Results There was statistically significant difference in 1 hour padweighing test between pre-treatment and post-treatment for the group of SUI in postpartum (the negative,mild,moderate,and severe cases of post-treatment:21,24,14,1,of pre-treatment:0,30,28,2; P＜0.05),and the group of SUI in post-menopausal (the negative,mild,moderate,and severe cases of post-treatment:7,22,11,7,of pre-treatment:0,14,25,8; P＜0.05).The strength of the pelvic floor muscles of type Ⅰ and type Ⅱin two groups after treatment were significantly different from those in pre-treatment (P＜0.01).The efficient rate of improvement in symptoms after treatment in the group of SUI in postpartum was 88％ (53/60) and the cure rate was 38％ (23/60).While the efficient rate in the group of SUI in post-menopausal women was 64％(30/47) and the cure rate was 15％ (7/47).There was statistically significant difference in the development of symptoms in two groups after treatment (P=0.003).Conclusion PFM with biofeedback is an effective treatment for SUI in postpartum and post-menopausal women,especially for postpartum ones.

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