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Expression of PR and Bcl-2,Bax in Ectopic and Eutopic Endometrium in Patients with Endometriosis

Journal of Practical Obstetrics and Gynecology.2010;26(1):45-48,后插1.

Objective:The pathogenesis of endometriosis(EMT)was explored by detecting the relationship of progesterone receptors(PR)and apoptosis-associated factors with EMT.Methods:Immunohistochemical imaging analysis was used to quantify the expression of PR,Bcl-2 and Bax in ectopic and eutopic endometrium in patients with EMT.Results:Expressions of PR and Bcl-2 in eutopic endometrium are higher than those in ectopic endometrium(P<0.05).Expression of Bax in ectopic endometrium is higher than that in eutopic endometrium(P<0.05).There is no statistical difference of PR,Bcl-2 and Bax expression between proliferative and secretary endometrium.Conclusions:Either in proliferative or secretary phase,expressions of PR in eutopic endometrium are higher than those in ectopic endometrium,thus eutopic endometrium is more liable to proliferate in low level continuously,migrate and implant.Expressions of Bcl-2 and Bax in eutopic and ectopic endometrium have no relationship with endometrium cycling.The apoptosis of ectopic endometrium is weakened and its proliferative power is continuously enhanced.

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Detection of Telomerase RNA Component Gene Amplification in Cervical In- traepithelial Neoplasia and Cervical Cancer with Fluorescence in Situ Hybridization and Its Clinical Significance

Wei LIU ; Lijun SUN

Journal of Practical Obstetrics and Gynecology.2010;26(2):124-127,插1.

Objective:To investigate the amplification of the telomerase RNA component (TERC) gene in cervical cancer and cervical intraepithelial neoplasia (CIN) using dual-color interphase fluorescence in situ hybridization (FISH) and its significance in screening of cervical lesion. Methods:Cervical cast-off cell specimens were screened from 120 outpatients with cervical lesion, including normal cell from liquid based cytology (20 cases), CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer cell from liquid based cytology (each of 25 cases). The amplification of TERC gene in cervical cast-off cells was detected by dual-color interphase FISH. The results of normal samples were used to set up the threshold. Results:①The percentages of abnormal cells in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer were significantly higher than threshold value ( P<0.05), and the percentage of abnormal cells was increased with the serious degree of pathological grade (P<0.01) ; ②The percentagesof 2:3,2:4,2:5 and great than or equal to 4:4 types in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer were significantdifferences (all P<0.01). The percentages of 2:4,2:5 and great than or equal to 4:4 types in cervical cancer were significant higher than that in CIN Ⅰ (P<0.001) while the percentage of 2:3 type was significant lower than that in it (P<0.001);③The percentage of abnormal cells was increased with the serious degree of cytological grade (P<0.01) in different cytological grades. The percentages of 2:3,2:5 and great than or equal to 4:4 types in atypical squamous cell of undetermined significance (ASCUS), low-grade squamous intraepithe-lial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) were significant differences (all P <0.01), and the percentages of 2:5 and great than or equal to 4:4 types in HSIL were significant higher than that in ASCUS( P <0.01) while the percentage of 2:3 type was significant lower than that in it ( P <0.01);④The detection rates of LSIL and HSIL with cytological examination in low grade and high grade CIN were 40% (10/25) and 62% (31/50) respectively, which were significant lower than the detection rates of FISH which was 100%(P<0.05).Conclusions:There is an abnormal amplification of TERC gene in CIN Ⅰ , Ⅱ , Ⅲ and cervical cancer, and its copy numbers are increased with the serious degree of pathological and cytological grades. Detection of amplification of TERC gene in cervical cast-off cells with FISH has a certain value for screening cervival lesion and prediction of lesion progression.

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Cervical Loop Electrosurgical Excision Procedure in the Treatment of Cervical Intraepithelial Neoplasia

Jiahao WU ; Dan WU ; Zhunan LI

Journal of Practical Obstetrics and Gynecology.2009;25(12):743-745.

Objective:To evaluate the efficacy of loop electrosurgical excision procedure(LEEP) in the treatment of different grade of cervical intraepithelial neoplasia(CIN). Methods:898 cases with CIN treated by LEEP were retrospectively analyzed. Operation time, blood loss during the operation, changes of histopathologic results and high-rick HPV before and after the operation were studied. The diagnosis and treatment results by LEEP were evaluated. Results: The average operation time was 5.1 minutes. The average blood loss during the operation was 5.6 ml. The concordance rate of pathologic results under colposcope before operation and after LEEP was 77.73% (698/898) .96 cases had increased CIN grade after LEEP(10.69%). The HPV-DNA loading dose after operation declined significantly (P< 0.01). Conclusions: The detection rate of invasive cervical cancer by LEEP is higher than multiple punch biopsy under electronic colposcope. LEEP is an effective method for the diagnosis and treatment of CIN, and it can eliminate high-rick HPV at the same time of ablating the cervical lesion.

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The Influence of Recombinant Human α-2b Interferon Capsule for Vaginal Foams on the Negative Conversion Rate of HPV

Yanxiang CHENG ; Jinghong JIANG ; Xuexian XU

Journal of Practical Obstetrics and Gynecology.2009;25(12):733-735.

Objective:To explore the effect and mechanism of Xinfuning( recombinant human α-2b interferon capsule for vaginal foams) on the clearance of human papilloma virus (HPV). Methods: The patients with HPV infection were divided into experimental group (Xinfuning group) and control group (Shurunshuan group, a common recombinant human interferon α-2b in suppository form) .The HPV negative conversion rate was compared between the two groups after action on vaginal posterior fomix. The content of cytokines IL-4, IL-10, IFN-γ, TNF-a in the cervical region before or after the application was detected by ELISA. Results:The negative conversion rate in the experimental group was higher than that in the control group ( P<0.05). The content of IL-4, IL-10 was decreased and the cont ent of IFN-γ,TNF-α was increased apparently( P < 0.05). Conclusions: Interferon has the effect on clearance of HPV infection by regulating Th1/Th2 balanced state to boost immunization and the unique preparation of Xinfuning can strengthen such function.

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Investigate the Pathogen Flora and the Treatment of Recurrent Vulvovaginal Candidiasis

Zhaohui LIU ; Xiaoli WANG ; Qinping LIAO

Journal of Practical Obstetrics and Gynecology.2009;25(12):730-732.

Objective:To investigate the pathogen flora of recurrent vulvovaginal candidiasis(RWC),and to discuss its treatment. Methods: Fungal culture and susceptibility tests of vaginal discharge from 108 RWC patients were performed. Sensitive drugs were selected for effective consolidating treatment for half year. Fungal smears were examined at the 3rd and 6th months after the treatment respectively. Results:①Among RWC patients,there were 81 cas es of Candida albicans(75.0%), 19 cases of C. Glabrata(17.6%), 4 cases of C. Parapsilosis(3.7%) ,2 cases of C.tropicalis (1.9%) and 2 cases of M. Krusei (1.9%). The drug susceptibility test showed that 80.6% of these 108 patients were sensitive to nystatin; 66.7% were sensitive to clotrimazole; 65.7% were sensitive to miconazole; 57.4% were sensitive to fluconazole;8.3% were sensitive to ketoconazole;6.5% were sensitive to itraconazole; 7.4% were resistant to all of the above drugs.②The score of symptom and sign was significantly improved compared with the first visit at the 3rd and 6th month after the treatment( P<0.0001). The negative rate was 76.2%(80/105) at the 3rd month after the treatment and 64.8%(68/105)at the 6th month after the treatment. Conclusions:①The rate of non Candida albicans is increased to 25% in RWC patients, and 17.60% is Candida glabrata.②During the treatment of RWC, the drugs should be selected according to fungal culture, results of susceptibility test, medication experience of patients,and attack character. The research of immune abnormality of the local vagina will be helpful to improve the cure rate of RWC.

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Treatment of 92 Cases of Adenomyosis in Perimenopausal Period with Levonorgestrel-releasing Intrauterine Device

Chunrong LEI ; Fengqin GUO ; Liqiong HUANG

Journal of Practical Obstetrics and Gynecology.2009;25(12):746-747.

Objective:To investigate the clinical effects of levonorgestrel-releasing intrauterine device(LNG-IUD) in the treatment of adenomyosis in perimenopausal period. Methods: A total of 92 patients with adenomyosis in perim enopausal period were treated with LNG-IUD and followed up at the 3rd,6th, 12th,24th month. Change of menses, uterine volume,visual analogue scale (VAS) of dysmenorrhea,the serum CA_(125) level and degree of satisfaction with the treatment were observed. Results:The dysmenorrhea was alleviated along with the follow-up time in all of the pa tients after insertion of the LNG-IUD ( P<0.05). The menstrual volume, uterine volume and serum CA_(125) level were decreased significantly(P<0.05) .Conclusions:LNG-IUD is a safe, effective and simple treatment of adenomyosis in perimenopausal period.

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Study of Fetal Brain Hypoxic Injury in Intrahepatic Cholestasis of Pregnancy

Lijuan ZHANG ; Ting CHEN ; Yiling DING

Journal of Practical Obstetrics and Gynecology.2009;25(11):672-674.

Objective: To study the relation of bile acid levels and fetal hypoxia and brain injury in Intrahepatic Cholestasis of Pregnancy (ICP). Methods: From May. 2006 to Sep. 2006, we selected 30 cases of ICP as the study group, and randomly selected 30 cases of normal pregnant women for delivery during the same period as the control group in our hospital. Color Doppler ultrasound was used to measure the peak systolic velocity to end-diastolic velocity (S/D) and the resistive index (RI) of fetal middle cerebral artery, and the automatic biochemical analyzer be used to detect the total bile acid (BA) in maternal blood, and BA, pH as well as lactate in umbilical arterial serum; neuron-specific enolase (NSE) in umbilical artery serum was detected by ELISA. The results were analyzed and compared. Results:①The BA concentration in maternal blood and newborn umbilical artery blood of the study group was significantly higher than that of the control group ( P<0.01). In the study group, the BA in maternal and newborn blood were positively correlated ( r=0.937, P< 0.01) ;②Lactate and the NSE Concentration in newborn umbilical artery of the study group was significantly higher than that of the control group ( P< 0.01). The pH value innewbom umbilical artery and The S/D, RI value of fetal middle cerebral artery in the study group was significantly lower than those of control group ( P< 0.01); ③ In the study group, the NSE concentration was positively correlated with BA and lactate concentration in newborn umbilical artery, while negatively correlated with the S/D and RI values of fetal middle cerebral artery and the pH value in newborn umbilical artery ( P<0.01). Conclusions: There is the existence of hypoxia and brain injury in fetus of ICP. By measuring the blood flow changes of fetal cerebral artery with Color Doppler and detecting pH, lactate as well as NSE levels in umbilical arterial blood, we could early predict the fetal hypoxia and diagnose the fetal brain injury in ICP.

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Comparatively Analysis on Clinicopathological Characteristics and Prognosis of Small Cell Carcinoma of the Cervix(SCCC) and Non-SCCC-A Single Center of Clinical Research

Xin YUAN ; Yangmei SHEN ; Xia ZHAO

Journal of Practical Obstetrics and Gynecology.2017;33(4):281-285.

Objective:To investigate the differences between patients with small cell carcinoma of the cervix and other type of cervical cancer on clinicopathological characteristics,treatment,prognosis through the retrospective analysis,also study the prognostic factors in patients with SCCC.Methods:The patients with SCCC(63 cases,research group) and patients with Non-SCCC(60 cases,control group) such as squamous cell carcinoma and adenocarcinoma of cervix were chosen during May 2003 and June 2015 in department of obstetrics and gynecology,west China second university hospital.The clinical pathological and survival data were collected,sort out,checked and analyzed.Chi-square test or Fisher's exact probability method was used to compare the differences of clinical features between the two groups.The 5-year disease-free survival(DFS) rate and 5-year overall survival(OS) rate were generated using the Kaplan-Meier method.Univariate and multivariate analysis were applied to research the prognostic factors.Results:①The median age of the patients in research group was 40 years old,younger than control group whose median age was 44 years old (P =0.001).The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in research group were significantly higher than those of control group (P ＜ 0.05).There were no significantly differences between two groups in clinical symptoms,FIGO stage,therapeutic schedule.②In the survival analysis,the research group estimated 5-year overall survival (OS) rate (29.2％) and estimated 5-year disease-free survival rate (DFS)(26.6％) was significantly lower than those of the control group(82.6％,and 76.7％,respectively) P ＜ 0.05.③In the COX multivariate regression analysis,the results showed that the lymph node metastasis was the independent factor influencing overall survival rate and disease-free survival rate(HR =4.784、3.067,P ＜ 0.05).In addition,the tumor size was the independent factor influencing overall survival rate (HR =3.610,P ＜ 0.05),and advanced FIGO staging was the independent factor influencing disease-free survival rate (HR =2.793,P ＜ 0.05).Conclusions:The patients with SCCC were younger than other cervical cancer,and the clinical symptoms,cervical appearance,treatment between the two types are almost the same.However,The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in patients with SCCC were significantly higher than other cervical cancer,and the prognosis of the patients with SCCC was very poor.The main prognostic factors were lymph node metastasis,advanced FIGO stage and tumor size.

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Emergency Cervical Cerclage Combined Mesh Patch Suture in the Treatment Caused by Cervical Incompetence Clinical Analysis of 32 Cases

Yurong JIANG ; Yiping YOU ; Yabing TANG

Journal of Practical Obstetrics and Gynecology.2017;33(4):307-310.

Objective:To investigate the clinical value of emergency cervical cerclage combined mesh patch suture in the treatment of cervical incompetence.Methods:From January 2011 to August 2016 in our hospital 65 cases of pregnant women with inevitable abortion,32 cases of they had carried out emergency cervical cerclage combined mesh patch suture(group A),33 cases of they had carried out cervical cerclage only(group B),The prolongation of gestation time,delivery gestational age,neonatal outcome,delivery mode and postoperative complications were compared between the two groups.Results:The operation time of A group was higher than that of group B,surgical complications of cervical laceration in group A was less than B group,the difference was statistically significant(P ＜ 0.05);there was no significant difference in the incidence of chorioamnionitis between the two groups(P＞0.05);the gestational age of group A was extended to 84.45 ±35.77 days,and the gestational age of B group was extended to 51.86 ±29.93 days,there was statistically significant difference between the two groups(P＜0.05);there was more than 28 weeks delivery in 23 cases(71.88％) in group A,and 17 cases (51.52％) in group B,the difference was statistically significant(P ＜ 0.05);there were no statistically significant differences in the delivery mode between the two groups(P ＞ 0.05);neonatal birth weight,birth Apgar 1 minutes score of group B were significantly lower than those of group A,the difference was statistically significant (P ＜0.05).Conclusions:Emergency cervical cerclage combined mesh patch suture can effectively prolong the gestational age,improve neonatal outcome,no obvious complication and has certain clinical applicative value.

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Influence Factor Analysis of Postoperative Pregnancy in Patients of Endometriosis Associated Infertility after Laparoscopy Combined with Hysteroscopy Treatment

Hongxue LIU ; Jian LI ; Ping LUO

Journal of Practical Obstetrics and Gynecology.2017;33(2):144-147.

Objective:To analyze the influence factors of postoperative pregnancy in patients of endometriosis associated infertility after laparoscopy combined with hysteroscopy treatment.Methods:340 patients with endometriosis associated infertility who underwent laparoscopy combined with hysteroscopy treatment in Maternal and Child Health Care Hospital of Xiamen from April in 2012 to April in 2014 were followed up for 18 ～ 42 months to assess fertility outcomes.The relative factors of postoperative pregnancy rate were analyzed.Results:85.88％ (292/340) of patients were followed up,and the overall postoperative pregnancy rate was 56.51％.Among which the postoperative pregnancy caseswere 115 cases (39.38％),40 cases (13.70％),8 cases (2.74％),2 cases (0.68％) in the 1 ～ 6 months,7 ～ 12 months,13 ～ 24 months,25 ～ 42 months,respectively.There were significant differences among the four groups(x 2 =11.76,P ＜ 0.05).The multy-factors analysis showed that age ≥35,infertility time ≥3,r-AFS stage relatively high were risk factors of postoperative pregnancy(OR =10.45,3.03,3.74,P ＜0.05),and secondary infertility,applying ovarian stimulation treatment were the protective factors of postoperative pregnancy(OR =0.23,0.33,P ＜ 0.05).Conclusions:Laparoscopy combined with hysteroscopy treatment can increase postoperative pregnancy rate,and the best time to pregnancy is the first one year after treatment.The age ≥35,infertility time≥3,r-AFS stage relatively high are the important causes for the postoperative infertility,while applying ovarian stimulation treatment can promote pregnancy rate.

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