Pre-eclampsia is a pregnancy complication with multiple organs and system injuries,seriously impairing maternal and fetal health.Nevertheless,the etiopathogenesis of pre-eclampsia has not been fully elucidated yet.In normal pregnancy,Toll-like receptor 4(TLR4)at the maternal-fetal interface regulates the homeostasis of the inflammatory-immune microenvironment.In pre-eclampsia,abnormal TLR4 signaling at the maternal-fetal interface not only mediates deviated inflammatory-immune reaction,but also interacts with other novel pathological phenomena,including ferroptosis,pyroptosis,metabolism reprogramming,and cellular senescence.Furthermore,TLR4 at the maternal-fetal interface may mediate the abnormal development of the nervous system in the offspring.In addition,targeting TLR4 at the maternal-fetal interface may be one of the potential pharmacological mechanisms for new therapeutic research in pre-eclampsia.Based on recent relevant literature,this article explores the multiple possible roles of TLR4 at the maternal-fetal interface in pre-eclampsia and provides reference for the study of the pathogenesis and therapies of pre-eclampsia.
Robert's uterus is a rare uterine malformation that often manifests as abdominal pain and dysmenorrhea,making it difficult to distinguish from residual horn uterus and bicorner uterus.This paper retrospectively analyzes the diagnosis and treatment process of a patient with renal deficiency and anal atresia.The patient underwent preoperative three-dimensional ultrasound imaging and magnetic resonance imaging to provide information on the internal and external morphology of the uterus,which helps to develop a reasonable surgical plan and actively communicate with doctors and patients.Laparoscopic examination combined with hysteroscopic oblique hysterectomy was used for precise diagnosis and treatment during the surgery,and transabdominal ultrasound monitoring was used.Postoperative prevention of recurrence was achieved through barrier method.Through comprehensive management mode,accurate diagnosis and satisfactory results of metroplastic surgery were achieved.
Pelvic organ prolapse(POP)is a disease caused by weakened pelvic support structures mediated by mutiple factors.The primary risk factors are multiple pregnancies and vaginal deliveries.However,the pathophysiological process of POP is not yet known.Surgery is one of the most important methods of treating moderate to severe POP.Surgical procedures associated with the uterosacral ligament(USL)play an important role in restoring apical support and have a high surgical success rate.However,the risk of postoperative recurrence and complications are still present,largely due to a lack of adequate knowledge of the USL anatomy histology and biomechanics.Accurate knowledge of the anatomical location and tissue composition of the USL not only allows finding the most suitable site for USL suspension,but also prevents intraoperative damage to adjacent organs and tissues,such as the ureter,rectum,nerves and blood vessels.In addition,a comprehensive understanding of the biomechanical properties of the various components of USL can also suggest new solutions for the study of POP pathogenesis,prevention strategies and customization of personalized surgery.
Objective:To understand the current situation of primary dysmenorrhea among female college students in a university in Shanxi,and analyze the influencing factors of dysmenorrhea.Methods:A self-administered questionnaire with two-dimensional code was distributed among 700 female college students in a university in Shanxi for investigation,and the status quo of primary dysmenorrhea of female college students was analyzed,and the influencing factors of dysmenorrhea were analyzed by multivariate Logistic regression.Results:642 valid questionnaires were collected,with the effective recovery rate was 91.7%.Among them,there were 295 cases with dysmenorrhea,and the incidence of dysmenorrhea was 46.0%.Logistic regression analysis showed that family history of dysmenorrhea and menstrual headache were risk factors for dysmenorrhea(all P＜0.05).Compared with female college students with strong and unbalanced mental activity,quiet female college students with strong and balanced mental activity had a lower risk of dysmenorrhea(P＜0.05).Compared with female college students with moderate menstrual flow,no study pressure,never sedentary during menstruation and better knowledge of menstrual health care,female college students with more menstrual flow,great study pressure,frequent sedentary during menstruation and less knowledge of menstrual health care increased the risk of dysmenorrhea(all P＜0.05).Conclusions:The incidence of primary dysmenorrhea among female college students is high.Family,school and society should strengthen reproductive health awareness education for female college students,strengthen their guidance on harmonious and healthy behavior,and recommend schools offer healthy psychology courses,so as to effectively prevent the occurrence of primary dysmenorrhea.
Objective:To summarize the influencing factors of maternal parenting sense of competence(PSOC)in China.Methods:The literatures of PubMed,EMbase,Web of Science,CINAHL,CNKI,VIP,and Wanfang Data from the establishment to November 2022 were searched by computer,and the research on the influencing factors of maternal PSOC in China was included.Two researchers independently completed literature screening,quality evaluation and information extraction,and used Stata15 software for statistical analysis.Results:Six cross-sectional studies and one cohort study were included,including 3 284 maternal women.The results of the Meta-analysis show that maternal women aged 26-30 have lower PSOC than those aged over 30(SMD=-0.39,95%CI:-0.64--0.14),mothers with a high school diploma or below have a lower PSOC than those with a college degree or higher(SMD=-0.38,95%CI:-0.52--0.23),primiparas have lower PSOC than multiparas(SMD=-0.47,95%CI:-0.81--0.12);the maternal PSOC with family income less than 5 000 yuan per month is lower than 5 000 yuan per month or more(SMD=-0.28,95%CI:-0.38--0.18);and the maternal PSOC with breast feeding is higher than that with formula feeding(SMD=0.28,95%CI:0.19-0.38),mothers attending maternity school have a higher PSOC than those not attending maternity school(SMD=0.14,95%CI:0.03-0.25).Conclusions:Age,educational background,parity,household income,feeding patterns and attending maternity school are the main influencing factors of maternal PSOC.Hospitals and communities can develop personalized intervention strategies based on different influnencing factors to improve maternal PSOC.
Objective:To investigate the effect of cervicitis status on human papilloma virus(HPV)infection.Methods:The E6-c-Myc-P2A-E7-c-3Flag gene lentivirus was used to infect the control group(untreated human normal cervical epithelial cells)and the experimental group[human normal cervical epithelial cells induced with lipopolysaccharide(1 μg/mL)for 24 h],respectively,and observe the effect of cervicitis status on the expression of Myc-E6 and Flag-E7 tagged proteins.Results:Compared with the control group,the expression of human interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,and IL-17A mRNA was significantly increased in the experimental group,and the differences were statistically significant(both P＜0.05).After 72 h of infection with the E6-c-Myc-P2A-E7-c-3Flag gene lentivirus,the transfection efficiency of the experimental group and the control group was(89.05±0.16)%and(79.30±1.97)%,respectively,with a statistically significant difference(P＜0.05).The expression of Myc-E6 and Flag-E7 tagged proteins in the experimental group was significantly increased compared to the control group,and the difference was statistically significant(both P＜0.05).Conclusions:Cervical epithelial cells are more susceptible to HPV infection when they are in an inflammatory state.
Sodium-taurocholate cotransporting polypeptide(NTCP)deficiency disease is a bile acid metabolic disease caused by biallelic mutations in solute carrier family 10 member 1(SLC10A1),with regional and racial differences in distribution,and SLC10A1 c.800C>T(p.Ser267Phe)is a high-frequency mutation in China.Children with NTCP deficiency disease are mainly manifested as pathological jaundice and a small proportion could have delayed growth,motor and neurological development.While in adults,clinical symptoms and signs are not obvious,biochemical tests indicate elevated serum total bile acid levels,and some are accompanied by decreased levels of transaminase and 25-hydroxyvitamin D3.The high concentration of serum bile acids of NTCP deficiency needs to be distinguished from hepatitis B and D virus infection,autoimmune hepatitis and intrahepatic cholestasis of pregnancy.There have been few reports about the effects of pregnancy combined with the high concentration of serum bile acids caused by NTCP deficiency on the mother and fetus.The molecular genetic mechanism,clinical manifestations,laboratory tests,diagnosis,treatments and its impact on the mother and fetus of NTCP deficiency disease were reviewed to provide a basis for the clear diagnosis and correct intervention of patients with this disease.
Subclinical hypothyroidism(SCH)is the most common thyroid diseases during pregnancy.The vascular endothelial function injury and autonomic nervous dysfunction in SCH patients may increase the risk of cardiovascular diseases.Hypertensive disorders of pregnancy(HDP)complicate pregnancy and lead to increased rates of adverse pregnancy outcomes and mortality for both mothers and fetuses.Studies have found that SCH is associated with the increased incidence of HDP,but there is no uniform conclusion at present,and the potential benefits of levothyroxine(L-T4)treatment for HDP in SCH pregnant women are still controversial.This article reviews the impact of SCH on HDP during pregnancy and the effectiveness of L-T4 treatment,so as to standardize the clinical pregnancy management program and reduce the occurrence of perinatal adverse pregnancy outcomes in pregnant women and fetus.
The incidence rate of cervical cancer is the highest among gynecological malignancies.At present,surgery is still an effective treatment for early-stage cervical cancer,but cervical cancer has a high recurrence rate and distant metastasis,poor prognosis in advanced stages,and limited treatment options.This article focuses on a case with recurrence of cervical cancer despite radical hysterectomy and combined chemotherapy and radiotherapy,who developed vesicovaginal fistula and rectovaginal fistula with severe infection,and achieved a survival benefit by treatment with cadonilimab monotherapy and combination chemotherapy.It aims to provide new ideas for the treatment of recurrent cervical cancer.
Corona virus disease 2019(COVID-19)is an acute infectious disease characterized by respiratory symptoms,and there is no specific treatment so far.In addition to general preventive measures,vaccination is a safe and effective measure.However,due to the group particularity of pregnant and lactating women,there are doubts about the safety and effectiveness of COVID-19 vaccine,resulting in a low coverage rate of COVID-19 vaccine and a relative lack of relevant data.However,with a series of physiological changes during pregnancy,pregnant women are more likely to be infected with the novel coronavirus,and the risk of adverse pregnancy outcomes increases.Therefore,it is necessary to summarize the evidence of the safety and effectiveness of COVID-19 vaccine in pregnant women,so as to provide references for subsequent relevant studies and safety evaluation of COVID-19 vaccine.
Objective:To analyze the characteristics of intrauterine microbiota in infertile women with poor endometrial receptivity(PER)and identify its biomarkers.Methods:A total of 63 infertile women who visited our gynecology department from July 2021 to May 2022 were selected.According to ultrasound evaluation of endometrial receptivity,40 cases were assigned to the PER group,while 23 cases with good endometrial receptivity were assigned to the control group.Endometrial tissue samples were collected from two groups of patients for 16S rRNA sequencing,to compare the characteristics and differences of intrauterine microbiota between the two groups.Results:There was no significant difference in the α diversity of intrauterine microbiota between the two groups(P＞0.05).However,the individual difference of intrauterine microbiota in PER group was significantly higher than that in control group(P＜0.05).The relative abundance of the dominant phylum Proteobacteria in the intrauterine of the PER group was significantly higher than that in the control group(50.52%vs.19.35%).The dominant genus in both groups was Lactobacillus,but the relative abundance of Lactobacillus in the intrauterine of the PER group was significantly lower than that of the control group(21.76%vs.45.96%),while the relative abundance of Ralstonia was significantly higher than that in the control group(18.01%vs.0.48%).The relative abundance of Ralstonia_unclassified in the intrauterine microbiota of the PER group was significantly higher than that in the control group(18.01%vs.0.48%),while the relative abundance of Lactobacillus_crispatus was significantly lower than that in the control group(3.82%vs.23.78%).The Biomakers at the phylum,family,and genus levels of the intrauterine microbiota in the PER group are Proteobacteria;Burkholderiaceae,Vibrionaceae,etc;Ralstonia,Vibrio,etc.Conclusions:Infertility women with PER may have dysbiosis of the intrauterine microbiota,with a decrease in the relative abundance of Lactobacillus and an increase in the relative abundance of characteristic pathogenic bacteria such as Burkholderia and Ralstonia possibly related to PER.
Intrauterine adhesions can cause a series of symptoms such as amenorrhea,secondary infertility and recurrent abortion in women.There is still a high recurrence rate after hysteroscopic transcervical resection of adhesions,which seriously affects women's fertility and mental health.Estrogen adjuvant therapy can effectively reduce the recurrence rate after transcervical resection of adhesions by promoting the repair of residual endometrial hyperplasia and reducing the expression of endometrial fibrosis factors,but a unified medication regimen has not yet been formed.The commonly used clinical regimen is estradiol valerate tablets 2-4 mg/d or equivalent hormone plus progesterone sequential oral administration for 2-3 menstrual cycles.The efficacy of high-dose estrogen therapy is still not very clear,or individualized estrogen therapy can be formulated by detecting the expression level of estrogen receptor in the endometrium to achieve the best efficacy.Oral estrogen is the most classic treatment for intrauterine adhesions.However,recent studies have shown that transdermal and transvaginal administration of estrogen have higher bioavailability,fewer adverse reactions,and comparable efficacy.At present,there are still significant variation in the usage and dosage of estrogen in a large number of clinical studies.Therefore,more large-scale and high-quality studies are still needed to explore the best medication regimen of estrogen.
Vesicouterine fistula is a very rare type of urogenital fistula.The main symptoms are varying degrees of urineincontinence(vaginal leakage),periodic hematuria and amenorrhea.Vesicouterine fistula can be divided into three types.Type Ⅰ,also known as Youssef's syndrome,is the most common type of vesicouterine fistula.Surgical repair is the main treatment.This paper reports a case of vesicouterine fistula presenting with Youssef's syndrome,which was successfully repaired through laparoscopic surgery.After 4 years of follow-up,there was no hematuria and the menstrual cycle remained regular.Ultrasound examination indicated that the incision of the lower uterine segment and the rupture of the posterior bladder wall healed well.
Gynecological diseases are one of the causes that threaten women's health.The incidence and mortality rate of gynecological malignant tumors are in the forefront among various systemic diseases in women,and the prognosis of the disease is poor due to tumor recurrence and drug resistance.Sphingolipids are important substances that make up plasma lipoproteins and are essential for various cellular functions and signaling.Sphingolipid metabolism is involved in regulating inflammatory responses and the proliferation,migration,invasion and metabolism of cancer cells.Studies have confirmed that there are differences in the levels of sphingolipids and their metabolites in benign and malignant gynecological diseases,including ceramides,sphingomyelin,sphingosine-1-phosphate and sphingosine.Abnormalities in sphingolipid levels can affect disease progression and sensitivity to chemoradiotherapy,analyzing sphingolipid metabolism may predict the outcome of disease.The review summarizes the research progress of sphingolipid metabolism in benign and malignant gynecological diseases to gain an in-depth understanding of the characteristics and functions of sphingolipids,which can provide new insights for exploring and discovering the pathogenesis,diagnosis,treatment and prognosis of benign and malignant gynecological diseases,in order to improve the treatment prospects and prolong the survival of patients.
Vimentin is an important type Ⅲ intermediate filament protein,mainly derived from mesenchymal cells.Vimentin is expressed in various types of tumors,and up-regulated expression of Vimentin is related to the migration and invasion ability of tumor cells,suggesting poor prognosis.Vimentin is a typical marker of epithelial-mesenchymal transition of tumor cells and a potential drug target.Studies have shown that Vimentin is abnormally expressed in cervical cancer,ovarian cancer and endometrial cancer,and is related to prognosis,tumormetastasis and recurrence,which has potential clinical application value.This article reviews the relationship between Vimentin as well as gynecological malignancy and its possible mechanism.
Ozone is a strong oxidizing gas,with bactericidal and anti-inflammatory effects,which has shown certain efficacy in the treatment of skin,joint and oral diseases.Vaginitis is a common gynecological disease with high clinical incidence and recurrence rate,and the clinical efficacy of drug treatment for vaginitis is unsatisfactory.The application of ozone therapy in the treatment process of vaginitis patients can kill vaginal pathogenic microorganisms by exerting the powerful oxidation effect of ozone and stimulating the generation of cytokines,accelerating the dissipation of inflammatory cells.It can also exert its nutritional properties of ozone,promoting the regeneration of vaginal mucosa cell and strengthen the local immunity of the vagina,restore the normal pH of the vagina,and rebuild the homeostasis of the vaginal environment.However,at present,there is no unified standard for the concentration,dosage,duration,follow-up period and selection of ozone properties in the treatment of vaginitis with ozone therapy.How to select the appropriate treatment plan according to the patient's condition and play the best effect of ozone therapy will become the key to the promotion and application of ozone therapy in the future.
Polycystic ovary syndrome(PCOS)is a common endocrine disease characterized by hyperandrogenic phenotype in women of reproductive age.The pathogenesis of PCOS remains unclear,and androgen is now thought to have an essential impact on the pathogenesis of PCOS.Bisphenol A(BPA),an environmental endocrine disruptor,can increase the relevant androgen synthetase and induce PCOS through excessive androgen exposure.Studies have shown that BPA exposure can inhibit the activity of aromatase,prevent the binding of androgen and receptor,thus inducing hyperandrogenemia.BPA can also regulate the ovarian function of PCOS through oxidative stress,estrogen-related pathways,hypothalamic-pituitary-ovarian axis,regulation of obesity and insulin resistance,and other routes.This article aims to review the neuroendocrine mechanism and related signal pathways of BPA-induced PCOS by regulating hyperandrogen,clarify the specific biological functions of BPA and provide a reference for follow-up research.
Objective:To explore the impact of different pregnancy methods on the perinatal outcomes of twin pregnancies.Methods:A retrospective analysis was conducted on the clinical data of 815 twin pregnant women who gave birth at the Changsha Maternal and Child Health Hospital affiliated to Hunan Normal University from January 2019 to January 2023.They were divided into a natural pregnancy group(398 cases)and an in vitro fertilization-embryo transfer(IVF-ET)group(417 cases)based on the pregnancy mode.The basic information,pregnancy complications,and perinatal outcomes of the two groups were compared.Results:In IVF-ET group,the age of pregnant women,the gestational week of delivery,the proportion of primiparas,the proportion of polycystic ovary syndrome,the proportion of the dichorionic diamniotic,the incidence of gestational diabetes mellitus,the rate of cesarean section,the amount of postpartum hemorrhage and the rate of postpartum hemorrhage were higher than those in natural pregnancy group,and the proportion of scar uterus was lower than that in the natural pregnancy group(both P＜0.05).The premature birth rate and transfer rate to neonatal department in the IVF-ET group were lower than those in the natural pregnancy group,while the birth weight of bigger infants was higher than that in the natural pregnancy group(both P＜0.05).Conclusions:The incidence of perinatal complications increases in twin pregnant women who conceive through IVF-ET.It is necessary to strictly grasp the guidelines for embryo transfer,strictly control the number of embryos transferred,strengthen perinatal management,reduce the occurrence of pregnancy complications,and maximize the safety of mother and infant.
Endometrial cancer is one of the three major gynecological cancers,and the proportion of endometrial cancer among women of childbearing age is increasing yearly.How to achieve effective,safe and economical prevention and control of endometrial cancer through early diagnosis and screening has become a major topic.At present,there are still huge challenges in the early diagnosis and screening of endometrial cancer,including inadequate methods and programs,uncertain screening objects,and lack of efficient and minimally or non-invasive methods.In recent years,the molecular and imaging protocols are gradually alleviating these difficulties,which are expected to become efficient and safe screening programs for endometrial cancer.This article is aimed to review the current status of endometrial cancer screening and the research progress of emerging molecular and imaging regimens of early screening and diagnosis of endometrial cancer,and explore the implementation of future screening strategies.
High-grade neuroendocrine carcinoma of the uterus is a rare malignant tumor of the uterus with high malignancy and poor prognosis.Due to its low incidence rate,there is no standard treatment at present.Therefore,this paper reports the diagnosis and treatment of a 56-year-old patient with stage Ⅳ uterine high-grade neuroendocrine carcinoma accompanied by endometrioid adenocarcinoma.The patient has undergone surgery,followed by 1 intraperitoneal chemotherapy and 6 courses of systemic chemotherapy(paclitaxel+platinum),then the patient's outcome was close to complete response.Subsequently,2 courses of consolidation chemotherapy were performed,and the patient's condition was evaluated as stable.Currently followed up for 2 years and 10 months,the patient recovered well and did not show obvious signs of recurrence on imaging examination.With retrospective analysis of the clinical characteristics,diagnosis,and treatment of this case as well as relevant literature analysis,this paper aim to improve clinician's understanding of this type of disease.
