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    02 July 2014, Volume 30 Issue 7 Previous Issue    Next Issue

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    Pathogeny and types of genitourinary fistula.
    YIN Yi-tong,XIA Zhi-jun.
    2014, 30(7): 500-502.  DOI: 10.7504/fk2014060102
    Abstract ( )   PDF (795KB) ( )  

    Abstract: Fistula refers to the abnormal canal between urinary system and reproductive system. Delivery,operation,inflammation,dysplasia and tumor are common reason for the genitourinary fistula. Vesicovaginal fistula,ureteral fistula,urethral fistula,vesicouterine fistula are common types of the genitourinary fistula. Etiology,risk factors,diagnosis is discussed in this essay.

    The prevention and new treatment techniques of iatrogenic urinary fistula.
    MIAO Ya-li, WANG Jian-liu.
    2014, 30(7): 502-505.  DOI: 10.7504/fk2014060103
    Abstract ( )   PDF (812KB) ( )  

    Abstract: Obstetric trauma and gynecological surgical injury is a major cause of iatrogenic injury fistula. Prevention is the key to decrease the fistula. With the advance in modern medicine and science technology, the treatment of urinary fistula would be improved, for example, using Robot-assisted endoscopic technique.

    How to deal with ureteral fistula and ureteral-vagina fistula.
    FAN Jin,LUO Xin .
    2014, 30(7): 505-507.  DOI: 10.7504/fk2014060104
    Abstract ( )   PDF (833KB) ( )  

    Abstract: Ureteral fistula,referring to that there is an abnormal passage between the ureter and the vagina,and urine will outflow from leak uncontrolled.Women ureter trip is closely to the female reproductive organs,which is one of the reasons damaging the ureter.The principles of ureteral fistula is to restore the continuity of the ureter as soon as possible,in order to protect the function of renal. Ureteral fistula is a serious complication of gynecologic surgery,so we should prevent ureteral injury.

    The surgery indications and keys of transvaginal vesicovaginal fistula repair.
    LI Han-song, ZHANG Yi.
    2014, 30(7): 507-510.  DOI: 10.7504/fk2014060105
    Abstract ( )   PDF (1335KB) ( )  

    Abstract: Transvaginal vesicovaginal fistula(VVF) repair itself is likely the most minimally invasive surgical procedures since the vagina in its native state serve as a natural orifice . Majority of VVF can be approached vaginally high success rate . In this paper , through the literature review combined with our own experiences,we summarize the surgery indications and keys of the transvaginal approach.

    The indications and art technique of laparo scopic repair for vesicovaginal fistula.
    LIANG Zhi-qing.
    2014, 30(7): 510-512.  DOI: 10.7504/fk2014060106
    Abstract ( )   PDF (615KB) ( )  

    Abstract: Bladder injury can be seen in surgical treatment of gynecologic malignant tumor. The article focuses on the reason, characteristics and prevention of bladder injury, also the indications and key point of laparoscopic surgery treatment.

    linical experience of transvaginal repair of complex vesicovaginal fistula.
    XU Xue-xian*, ZHOU Li-mei.
    2014, 30(7): 512-513.  DOI: 10.7504/fk2014060107
    Abstract ( )   PDF (784KB) ( )  

    Abstract: High failure rate of complicated vesicovaginal fistula becomes a common gynecological and urological problems, how to improve the success rate of surgery is a matter of concern to the medical staff, so we summarized the experience of transvaginal Repair from timing of surgery/surgical strategies/ operation points/prognostic factors to provide reference for clinicians.

    Prevention of urinary injury in gynecological operation.
    ZHANG Xiao-wei,XIAO Shu-yao.
    2014, 30(7): 514-517.  DOI: 10.7504/fk2014060108
    Abstract ( )   PDF (815KB) ( )  

    Abstract: Urinary tract injury is a rare complication of abdominal surgery, but the extreme seriousness of its consequences is possible. 50% of iatrogenic urinary tract injuries are caused by gynecological surgical procedures. In this paper , the causes and characteristics of three surgery methods including laparotomy, laparoscopy surgery, and trans-vaginal surgery are varied. Therefore, mastering the different characteristics of the surgical paths in pelvic surgery , selecting the appropriate surgical approach, having a good preoperative evaluation, being familiar with surgical anatomy of the region, using properly of a variety of electrical equipments, mastering skilled operative techniques, and keeping intraoperative vigilance in case of a urinary tract injury are all required in order to effectively prevent urinary tract injuries during gynecological surgery.

    Management of radiation-induced urinary fistula in patients with gynecological tumor.
    GAO Kun,HUANG Lei, LI Li.
    2014, 30(7): 517-521.  DOI: 10.7504/fk2014060109
    Abstract ( )   PDF (830KB) ( )  

    Abstract: The incidence of urinary fistula rate is very low in patients with gynecological tumor after radiation therapy,but it influences the quality of life seriously. Aspects as radiation injury, dose, postoperative radiotherapy, brachytherapy and radiation techniques impact the incidence of fistula. The operation treatment is the main treatment method at present. The abdominal approach repair by using pedicle flap and urinary diversion are applicable for radiation-induced urinary fistulas. Methods as strictly control surgical indications, improved radiotherapy techniques, reasonable application of brachytherapy may reduce radiation-induced urinary fistulas.

    Bulbocavernosus muscle flap and vulvar flap in the repair of complicated urinary fistula.
    SONG Yan-feng.
    2014, 30(7): 521-524.  DOI: 10.7504/fk2014060110
    Abstract ( )   PDF (900KB) ( )  

    Abstract: Urinary fistula can be divided into two types: simple and complex.Complicated urinary fistula that is difficult to be treated,has a high surgical failure rate.It is a troublesome in the repair of complicated fistulas.Clinical practice demonstrates that cure rate can be improved by taking advantage of tissue flaps,which usually consists of gracilis muscle,bulbocavernosus muscle flaps and vulvar flaps.This article will focus on the repair of complicated fistula used bulbocavernosus muscle and vulvar flaps.

    Congenital genitourinary fistula with female genital tract malformation.
    LIU Ling, JIN Hang-mei.
    2014, 30(7): 524-526.  DOI: 10.7504/fk2014060111
    Abstract ( )   PDF (798KB) ( )  

    Abstract: Congenital genitourinary fistula is a rare, complex female malformation , which often involves both urinary tract and genital tract malformation. If it is misdiagnosed, it can result in incorrect treatment and a poor outcome. A complete genitourinary tract investigation should be performed in patients with genitourinary fistulas to determine the appropriate treatment and to assess other congenital anomalies.

    The high risk factors and the prevention of obstetric urinary fistula.
    HUANG Pu, GOU Wen-li.
    2014, 30(7): 526-528.  DOI: 10.7504/fk2014060112
    Abstract ( )   PDF (932KB) ( )  

    Abstract: Obstetric urinary fistula is a complication of childbirth that often follows obstructed labor. This results in total urine incontinence. The psychosocial consequences are severe. The risk factors of obstetric urinary fistula include obstructed dystocia, birth trauma and surgical injury. Principal measures to prevent fistula formation include emphasis on antenatal examination, improve the obstetric professional technical skills, and to ensure that women have a skilled professional present during childbirth and have access to comprehensive obstetric care.

    Effect of medroxyprogesterone acetate on the radiosensitivity of cisplatin-resistant SKOV3/DDP cell lines of human ovarian cancer.
    YANG Yang,HAN Ping.
    2014, 30(7): 529-533.  DOI: 10.7504/fk2014060113
    Abstract ( )   PDF (1021KB) ( )  

    Abstract: Objective To Study effects of the cisplatin-resistance human ovarian cancer SKOV3/DDP cell line on the radiation therapy, and to observe the effect on radiosensitivity and its possible mechanisms by applying MPA on SKOV3/DDP cell line. Methods   MTT assay and the clonogenic assay were used to analyse relative survival rate of cells and radioresistance, with human ovarian cancer cell line SKOV3 and its cisplatin-resistance SKOV3/DDP cell line as research subject exposed to radioactive rays. By the same method to compare relative survival rate and radiosensitivity of SKOV3/DDP cell line treated with non-cytotoxic dose MPA or not. The software Sigma Plot version 10.0 and the multi-target click model S = 1-( 1-eD0/D) n were used to fit cell survival curve,and determining radiation-related parameters to evaluate the sensitizing effect.Flow cytometry was used to detect cell cycle and apoptosis. Results  With the increase of radiation dose, relative survival of SKOV3 and SKOV3/DDP cells was decreased, especially SKOV3 cells. The mean lethal dose (D0) of them were 3.186 and 7.794, and SKOV3/DDP cell line showed stronger radiation resistance with the increase of D0, which indicated that the radiation resistance of SKOV3/DDP cells is stronger than SKOV3 cells. The same methods showed that survival rate of SKOV3/DDP cell treated with the combination of MPA and radiation was lower than that with radiation alone.The average lethal dose (D0) were 4.040 and 7.794,and the sensitivity enhancement ratio (SER) was 1.929. The SKOV3/DDP cells cycle was arrested at phase G0/G1 after treated with MPA combined with radiation,with the proportion of cells at phase S decreased. And the apoptosis rate increased. Conclusion  Human ovarian carcinoma SKOV3/DDP cells have crossed resistance to chemotherapy and radiotherapy;MPA could reverse the resistance of SKOV3/DDP cells to radiation, and its possible mechanism was promoting cell apoptosis and arresting cell cycle process.

    Pregnancy outcomes of young patients with polycystic ovary syndrome after in vitro fertilization and embryo transfer.
    ZHANG Dan.
    2014, 30(7): 534-537.  DOI: 10.7504/fk2014060114
    Abstract ( )  

    Abstract: Objective To investigate the pregnancy outcome women with age <35 years polycystic ovary syndrome (PCOS) compared with control groups after in vitro fertilization and embryo transfer (IVF-ET). Methods Women with PCOS who underwent the first time of IVF between October 2007 and August 2010 were considered. A total of 68 PCOS patients and 1164 patients with tubal infertility were included, and reviewed focusing on the basal characteristics, IVF-ET outcomes, and pregnancy outcomes. Results The clinical pregnancy rate(30.9% vs. 44.1%), miscarriage rate (14.3% vs. 12.9%), multiple pregnancy rate (42.9% vs. 38.4%), preterm delivery rate (22.2% vs. 14.7%), small for gestational age (SGA) (9.5 %vs. 11.1%) infant and large for gestational age (LGA) infant (9.5% vs. 3.1%) rate were not different between two groups (P>0.05). On the other hand, the morbidity of gestational diabetes mellitus (GDM) (14.3% vs. 4.1%) and hypertensive disorder complicating pregnancy (HDCP) (4.0% vs. 1.0%) was significantly higher than those in control group (P<0.05). Conclusion Age <35 years PCOS patients after IVF-ET did not present various higher pregnancy complications, but they presented some worse pregnancy outcomes, especially in GDM and HDCP.

    Expression and significance of LXRα and SREBP-1c in placenta of pre-eclampsia.
    LI Jian-hua*,MIAO Xue-qin,HU Ji-fen*, CHEN Li-hong*.
    2014, 30(7): 538-542.  DOI: 10.7504/fk2014060115
    Abstract ( )  

    Abstract: Objective To evaluate the expression and correlations of liver X receptor alpha(LXRα) and its target gene sterol regulatory element-binding protein-1c (SREBP-1c) in placenta of pre-eclampsia(PE) and their significance in PE.Methods Between October 2011 and August 2012 in the First Affiliated Hospital of Fujian Medical University observed PE group 30 cases(mild 14cases and severe 16cases) and normal pregnancy group 30 cases. The level of mRNA and protein of LXRα and SREBP-1c were analyzed by reverse transcription-polymerase chain reaction(RT- PCR)and immunohistochemistry (IHC) in the placenta.Results RT-PCR and IHC all show that the expressions of mRNA and protein of LXRα and SREBP-1c increased gradually with significantly different levels among normal pregnancy,mild pre-eclampsia and severe pre-eclampsia groups(P<0.01 or P<0.05).There were positive correlations between the expression of LXRα mRNA and LXRα protein(r=0.417,P<0.01).There were positive correlations between the expression of SREBP-1c mRNA and SREBP-1c protein(r=0.611,P<0.01).There were positive correlations between the expression of LXRα protein and SREBP-1c protein(r=0.602,P<0.01).Conclusion The transcription and translation of LXRα and SREBP-1c in placenta of PE are significantly higher than that of normal pregnancy,which are highest in severe PE.

    The detection of HMGB1 in peripheral blood in gestational diabetes mellitus patients.
    SHI Yan, WU Li, ZHENG Wei-ling, YANG Chen.
    2014, 30(7): 543-545.  DOI: 10.7504/fk2014060116
    Abstract ( )  

    Abstract: Objective To detect the expression levels of high mobility group box chromosomal protein 1 (HMGB1) in peripheral blood in gestational diabetes mellitus (GDM) patients. To identify the relationship between HMGB1 and insulin resistance index ( HOMA-IR ) in GDM patient. Methods Select pregnant women who prenatal care in Suzhou Hospital Affiliated to Nanjing Medical University between January 2011 and December 2011. The recruitment of pregnant diagnosed with GDM between 24~28 weeks gestational age, A total of 100 cases. Recruitment of another 50 cases of normal pregnant women as the study control. The levels of fasting blood glucose, insulin, HMGB1, IL-6 levels were detected in peripheral blood. Results The insulin resistance index ( HOMA-IR ) in GDM pregnants 5.89±2.04 were higher than that in normal pregnant women2.08±1.08 (P<0.01 ); The concentration of HMGB1 and IL-6 in GDM patients were higher than that in health control group (P<0.01); and positive correlations r are 0.7713,0.7055 and 0.7147 respectively, between insulin resistance index ( HOMA-IR ) and the expression levels of HMGB1, IL-6 in GDM group.

    Meta-analysis on relevant factors of cervical intraepithelial neoplasia residual or recurrence after cervical conization.
    ZHOU Ping*,WANG Yi-feng.
    2014, 30(7): 546-552.  DOI: 10.7504/fk2014060117
    Abstract ( )  

    Abstract: Objective To investigate the relevant factors of cervical intraepithelial neoplasia residual or recurrence after cervical conization. Methods Searched Pubmed, CNKI and Wanfang database for relevant articles published from January 2006 to June 2013 with the keywords of “cervical intraepithelial neoplasia” , “cervical conization” , “esidual“, “recurrent” and “factor”, both in English and Chinese, and then fetched information and applied RevMan5 to do the Meta analysis. The type of research design is case-control study or cohort study. Results 15 articles met the inclusion criteria with 2721 follow-up cases. The result of Meta analysis showed that those people who are over 50 years old(OR=3.67,95%CI 2.44 ~5.52),with positive margin(OR=4.43,95%CI 3.42 ~5.75),gland involvement(OR=4.54,95%CI 2.22 ~9.30), pre-conization high load of human papillomavirus (HPV) (OR=6.51,95%CI 4.32 ~9.81), post-conization persistent positive high-risk HPV test (OR=33.39,95%CI 16.86 ~66.14),Human immunodeficiency virus(HIV) infection(OR=5.60,95%CI 3.10 ~10.11)and menopause(OR=2.32,95%CI 1.35~3.99) are with higher risk of residual or recurrence after cervical conization while smoking is a related factor of residual or recurrence after conization without statistical significance.Conclusion The relevant risk factors of cervical intraepithelial neoplasia residual or recurrence after cervical conization are over-50, positive margin, gland involvement, pre-conization high load of HPV, post-conization persistent positive high-risk HPV test, HIV infection and menopause while smoking is not the risk factor of cervical intraepithelial neoplasia residual or recurrence after cervical conization.

    Monitoring fetal ductus venosus flow spectrum in predicting the prognosis of fetuses in women with hypertensive disorder complicating pregnancy.
    SUN Yi, GUAN Yun-ping, XIANG Yu-shi.
    2014, 30(7): 553-556.  DOI: 10.7504/fk2014060118
    Abstract ( )  

    Abstract: Objective To assess parameters of ductus venosus (DV) flow spectrum in the prediction of the prognosis of fetuses in women with hypertensive disorder complicating pregnancy. Methods A total of 60 cases of normal single fetus and 38 cases of single fetus in women with hypertensive disorder complicating pregnancy were examined by color Doppler ultrasound between January 2012 and October 2013 in Shenyang Women’s and Children’s Hospital. The blood flow velocity parameters and resistance parameters of DV were measured. Results The resistance parameters in mild preeclampsia group were higher significantly than those in normal group(P<0.05). There was no significant difference in velocity parameters(P>0.05). The velocity parameters in severe preeclampsia group were lower than those in normal group and mild preeclampsia group(P<0.05), especially Va. Two cases with “a” vale reversed dead in uterus. All resistance parameters were higher than those in normal group and mild preeclampsia group significantly(P<0.05). The value of Vs/Va had high sensitivity (80.0%) and specificity (66.7%) in identifying fetal intrauterine growth restriction in women with severe preeclampsia. Conclusion There is no significant difference in velocity parameters between mild preeclampsia group and normal group. The velocity parameters in severe preeclampsia group are lower than those in normal group and mild preeclampsia group. The resistance parameters are in the increasing order of normal group, mild preeclampsia group and severe preeclampsia group. The value of Vs/Va can play a certain role in predicting fetal intrauterine growth restriction in women with severe preeclampsia. The reversal of “a” vale has certain significance in identifying poor outcome of fetus.

    Correlation between expression of ER,PR,C-erbB-2 and Ki-67 and its clinical pathology in endometrial carcinoma.
    LOU Xue-ling*,ZHOU Mei-ling,ZHANG Zhan-xin*,ZHANG Xi-hong*,YAO Li*.
    2014, 30(7): 557-560.  DOI: 10.7504/fk2014060119
    Abstract ( )  

    Abstract: Objective To investigate the expression of ER、PR、C-erbB-2 and Ki-67 in endometrial carcinoma and the correlation between their expression and clinical pathology. Methods Expression of ER,PR,C-erbB-2 and Ki-67 were detected in 30 normal endometrium,30 atypical hyperplasia and 80 endometrial carcinoma, using immunohistochemical S-P assay.Results The expression of ER,PR are gradually reduced in normal endometrium, atypical hyperplasia and endometrial carcinoma(P<0.05),The expression were difference in different differentiation endometrial carcinoma tissue types(P<0.05);C-erbB-2 was rarely expressed in normal endometrium while its expression rate in atypical hyperplasia was 53.33%,and endometrial carcinoma was 80.00%, which had statistical significance(P<0.05);The expression of Ki-67 in atypical hyperplasia was 33.33%,and endometrial carcinoma was 63.75%, showing significant difference(P<0.05). The expression of C-erbB-2 and Ki-67 was related to differentiated degree, clinical stage, muscle invasion and lymphatic metastasis(P<0.05). Conclusion The expression of ER,PR,C-erbB-2 and Ki-67 were related to clinical pathology of endometrial carcinoma,which can be used as indicators to judge the endometrial cancer prognosis and clinical treatment.

    Report of 41 cases of the conventional equipment laparo-endoscopic single-site salpingectomy.
    SHI Xiao-jun*, JIN Xiu-feng*,LU Song-chun.
    2014, 30(7): 561-564.  DOI: 10.7504/fk2014060120
    Abstract ( )  

    Abstract: Objective To investigate the effect,safety and excellence of laparo-endoscopic single-site salpingectomy(LESS) with conventional equipment.Methods Compare between two groups who were hospitalized in the gynecology department of the Jiaxing First Hospital between August 2011 and August 2012 one group (n=41) underwent conventional equipment laparo-endoscopic single-site salpingectomy,and another group(n=45) underwent conventional lapro-endoscopic salpingectomy(CLES). Results The cosmetic outcomes of LESS were better than that of CLES.The operating time of LESS was (30.43±5.83) min,and the intraoperative blood loss was (8.63±3.79) mL , the recovery time of gastrointestinal function was (5.03±0.72 )d , the length of stay was (5.03±0.72) d. The operating time of CLES was (21.09±3.82) min,and the intraoperative blood loss was (8.23±3.31) mL, the recovery time of gastrointestinal function was (5.24±0.63) d, the length of stay was (5.24±0.63 )d.So the operating time of LESS was longer(P<0.05),but there was no significant difference in intraoperative blood loss,recovery time of gastrointestinal function and length of stay between two groups (P>0.05). Conclusion With better cosmetic outcomes,LESS is safe and feasible with conventional equipment and easier accepted by patients.