Introduction: Cutaneous endometriosis is an uncommon but well-known skin disorder that represents about 0.5% to 1% of all endometriosis. The objective of this case series is to report clinical presentation, diagnosis,...Introduction: Cutaneous endometriosis is an uncommon but well-known skin disorder that represents about 0.5% to 1% of all endometriosis. The objective of this case series is to report clinical presentation, diagnosis, and management of various forms of cutaneous endometriosis. Material and Methods: It was an observational, retrospective and descriptive review of cases presenting with cutaneous endometriosis among Cameroonian women managed at the gynaecological outpatient department of Yaounde Gynaeco-Obstetric and Pediatric Hospital. All the following parameters were analysed: age, parity, previous pelvic surgery, presenting symptoms and duration, associated symptoms, localizations, imaging, size of the lesion, other localization of endometriosis, management and histopathological results. Results: we reported 4 cases of cutaneous endometriosis, with 3 umbilical endometriosis and 1 abdominal scar endometriosis. Patient age ranged from 28 to 39 years with an average of 33 years. All patients described infertility (two primary and two secondary) and two had a history of abdominal surgery. All patients presented local cyclical signs such as pain, swelling, color change and bleeding. The duration of symptoms varied from 2 to 3 years and the size of lesions ranged from 2 to 3.5 cm for umbilical lesions and was 9 cm for abdominal scar endometriosis. In all cases, no imaging was required for the diagnosis, which was suspected on the basis of patient’s history and the cyclical nature of local signs, followed by wide surgical excision and confirmation on histopathology. Conclusion: Cutaneaous endometriosis is a rare benign condition. Umbilical endometriosis seems to be the main cutaneous localization and can be described as primary or secondary. Even if its diagnosis must be confirmed by histopathology, it should be considered in patient with cutaneous cyclic signs such as pain, swelling or bleeding with or without history of abdominal surgery.展开更多
Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting aroun...Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.展开更多
Endometriosis is a common chronic gynecological disease with endometrial cell implantation outside the uterus.Angiogenesis is a major pathophysiology in endometriosis.Our previous studies have demonstrated that the pr...Endometriosis is a common chronic gynecological disease with endometrial cell implantation outside the uterus.Angiogenesis is a major pathophysiology in endometriosis.Our previous studies have demonstrated that the prodrug of epigallocatechin gallate(ProEGCG)exhibits superior anti-endometriotic and anti-angiogenic effects compared to epigallocatechin gallate(EGCG).However,their direct binding targets and underlying mechanisms for the differential effects remain unknown.In this study,we demonstrated that oral ProEGCG can be effective in preventing and treating endometriosis.Additionally,1D and 2D Proteome Integral Solubility Alteration assay-based chemical proteomics identified metadherin(MTDH)and PX domain containing serine/threonine kinase-like(PXK)as novel binding targets of EGCG and ProEGCG,respectively.Computational simulation and BioLayer interferometry were used to confirm their binding affinity.Our results showed that MTDH-EGCG inhibited protein kinase B(Akt)-mediated angiogenesis,while PXK-ProEGCG inhibited epidermal growth factor(EGF)-mediated angiogenesis via the EGF/hypoxia-inducible factor(HIF-1a)/vascular endothelial growth factor(VEGF)pathway.In vitro and in vivo knockdown assays and microvascular network imaging further confirmed the involvement of these signaling pathways.Moreover,our study demonstrated that ProEGCG has superior therapeutic effects than EGCG by targeting distinct signal transduction pathways and may act as a novel antiangiogenic therapy for endometriosis.展开更多
Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-...Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.展开更多
Endometriosis is defined as the presence of endometrial tissue that is located outside the uterine cavity, associated with fibrosis and inflammatory reaction. The most common atypical locations are the gastrointestina...Endometriosis is defined as the presence of endometrial tissue that is located outside the uterine cavity, associated with fibrosis and inflammatory reaction. The most common atypical locations are the gastrointestinal tract, urinary tract, lung, as well as abdominal surgical scars. Its diagnosis is still very difficult, especially when it manifests itself as an acute large bowel obstruction. We report the rare case of a 41-year-old patient diagnosed with acute colonic obstruction following a rectal tumor. She had undergone colonostomy even though colonoscopy biopsies were nonspecific, and a computed tomography (CT) scan was requested. It showed an adnexal heterogenous mass, therefore the patient had a laparotomy and a subtotal hysterectomy with bilateral salpingo-oophorectomy and a biopsy of the recto-colonic hinge. Histologic examination revealed a diagnosis of rectal endometriosis. The purpose of this work is to report a rare case of colonic endometriosis responsible for an acute large bowel obstruction.展开更多
Objective:To explore the effect of Hupo powder(HP)on autophagy in menstrual blood-derived stem cells(MenSCs)with endometriosis(EMT).Methods:EMT MenSCs(E-MenSCs)and healthy MenSCs(H-MenSCs)were isolated from the menstr...Objective:To explore the effect of Hupo powder(HP)on autophagy in menstrual blood-derived stem cells(MenSCs)with endometriosis(EMT).Methods:EMT MenSCs(E-MenSCs)and healthy MenSCs(H-MenSCs)were isolated from the menstrual blood of patients with EMT and healthy female participants,respectively.We identified their stem cells’characteristics via adipogenic and osteogenic differentiation.Twelve male SpragueeDawley rats received 0.9% NaCl and HP-dispensing granules by gastric irrigation to prepare blank serum and medicated serum,respectively.We used serum concentrations of 5%,10%,and 20%,each at administered times of 12,24,and 48 h to select the best condition.These cells were divided into three groups:blank serum of the control group,blank serum of the model group,and medicated serum of the HP group.H-MenSCs were used in the control group,while E-MenSCs were used in the model and HP groups.We analyzed cell viability using a cell counting kit-8 assay,observed cell morphology,evaluated the amounts of auto-phagosomes and autolysosomes by transmission electron microscopy,and detected the protein expression of autophagy markers(LC3-II and Beclin1)by Western blot.Results:E-MenSCs and H-MenSCs became long fusiform with a diffuse radial pattern,forming lipid droplets and calcium nodules after adipogenic and osteogenic differentiation.We then used the best conditiond 20% serum and 48 hdfor the subsequent experiments.In contrast to the model group,the HP group exhibited lower cell viability(=0.007),larger amounts of autophagosomes and autolysosomes(P<0.001 and P=0.001,respectively),and higher expression of LC3-II and Beclin1(P=0.021 and P=0.019,respectively).Conclusion:Hupo powder can promote autophagy in E-MenSCs,which might be one of the mechanisms underlying its therapeutic effects.展开更多
Endometriosis is defined as a condition with endometrium-like tissues migrating outside of the pelvic cavity.However,the mechanism of endometriosis is still unclear.Lactate can be covalently modified to lysine residue...Endometriosis is defined as a condition with endometrium-like tissues migrating outside of the pelvic cavity.However,the mechanism of endometriosis is still unclear.Lactate can be covalently modified to lysine residues of histones and other proteins,which is called lactylation.The results showed that the higher level of lactate and lactate dehydrogenase A enhanced the histone H3 lysine 18 lactylation(H3K18lac)in ectopic endometrial tissues and ectopic endometrial stromal cells than that in normal endometrial tissues and normal endometrial stromal cells.Lactate promoted cell proliferation,migration,and invasion in endometriosis.Mechanistically,lactate induced H3K18lac to promote the expression of high-mobility group box 1(HMGB1)in endometriosis,and HMGB1 knockdown significantly reduced the cell proliferation,migration,and invasion of the lactate-treated cells through the phosphorylation of AKT.In conclusion,lactate could induce histone lactylation to promote endometriosis progression by upregulating the expression of HMGB1,which may provide a novel target for the prevention and treatment of endometriosis.展开更多
Objective:Key genes were screened to analyze molecular mechanisms and their drug targets of endometriosis by applying a bioinformatics approach.Methods:Gene expression profiles of endometriosis and healthy controls we...Objective:Key genes were screened to analyze molecular mechanisms and their drug targets of endometriosis by applying a bioinformatics approach.Methods:Gene expression profiles of endometriosis and healthy controls were obtained from the Gene Expression Omnibus database.Significant differentially expressed genes were screened using the limma package.Correlation pathways were screened by Spearman correlation analysis on the echinoderm microtubule-associated protein-like 4(EML4)and enrichment in endometriosis pathways and estimated by the GSVA package.Immune characteristics were assessed by the“ESTIMATE”R package.Potential regulatory pathways were determined by enrichment analysis.The SWISS-MODE website was used in homology modeling with EML4 and EML4 protein activity was predicted.VarElect was employed in molecular docking for screening potential compound inhibitors targeting endometriosis.Results:Ten endometriosis and 10 normal samples were included.EML4 was significantly upregulated in endometriosis(p<0.05).Thirty significantly correlated pathways involving 18 positive and 12 negative correlations,including GLYCOSAMINOGLYCAN_BIOSYNTHESIS_HEPARAN_SULFATE and GLYCOSPHINGOLIPID_BIOSYNTHESIS_GANGLIO_SERIES were screened between EML4 and endometriosis.Immunocorrelation analysis showed a significant difference in immune-related pathways in endometriosis and normal samples(p<0.05).In endometriosis,EML4 was associated with T-cell CD4 resting memory,activated mast cells,plasma cells,activated NK cells,M2 macrophages,and follicular helper T cells(p<0.05).Molecular docking identified five potential inhibitors of EML4,and compound DB05104(asimadoline)bound well to EML4 protein to exert its physiological effects.Conclusion:Differential gene expression and immune correlation analyses revealed that EML4 may affect endometriosis through multiple targets and pathways,the mechanism of which involved immune cell activation and infiltration.Molecular docking and dynamics simulation verified DB05104 as a potential inhibitor of EML4 and a powerful target for endometriosis treatment.展开更多
BACKGROUND Endometriosis is a common benign gynecological disease that causes dysmenorrhea in women of childbearing age.Malignant tumors derived from endometriosis are rarely reported and are found in only 1%of all pa...BACKGROUND Endometriosis is a common benign gynecological disease that causes dysmenorrhea in women of childbearing age.Malignant tumors derived from endometriosis are rarely reported and are found in only 1%of all patients with endometriosis.Here,we report a well-differentiated squamous cell carcinoma(SCC)caused by squamous metaplasia of endometriosis that co-occurred in the uterus and ovaries.CASE SUMMARY A 57-year-old postmenopausal woman had a 6-month history of irregular uterine bleeding.The uterus and adnexa were examined by computed tomography,and there were two solid cystic masses in the pelvis and right adnexa.Histological findings of surgical specimens showed well-differentiated SCC arising from squamous metaplasia of ectopic endometrial glands in the uterus and ovaries.The patient received chemotherapy after surgery and was followed up for 3 mo without metastasis.CONCLUSION The continuity between ectopic endometrial glands and SCC supports that SCC originates from ectopic endometrial glands with metaplasia towards squamous epithelium.展开更多
BACKGROUND Lung endometriosis is an extremely rare gynecological disease.Current literature reports suggest that the majority of patients will present with only generic symptoms,such as hemoptysis,pneumothorax,and hem...BACKGROUND Lung endometriosis is an extremely rare gynecological disease.Current literature reports suggest that the majority of patients will present with only generic symptoms,such as hemoptysis,pneumothorax,and hemopneumothorax,which often leads to misdiagnosis.To date,there are 18 case reports of lung endometriosis that describe the clinical manifestation,imaging changes,treatment,and prognosis of the disease.To provide further insights into this rare disease,we present a new case report and a brief review of pulmonary endometriosis.CASE SUMMARY We report here about a 19-year-old woman who was admitted to the hospital for repeated catamenial hemoptysis over a 3-mo period.computed tomography(CT)imaging during menstruation revealed patchy high-density shadows,approximately 0.5 cm3 in size,in the right middle lobe of the lung.The patient’s hemoptysis and changes in the CT scans resolved after menstruation.Thoracoscopic right middle lobectomy,right lower lung repair,and closed thoracic drainage were performed.Postoperative histopathology confirmed lung endometriosis.There was no recurrence of symptoms at the 6 mo follow-up.CONCLUSION We propose diagnosing lung endometriosis by thoroughly taking reproductive history,clinical details,imaging,and histopathology followed by treatment with surgical resection.展开更多
BACKGROUND Polypoid endometriosis(PEM)is a rare and unique type of endometriosis.To date,no article has provided a systematic report of this disease.The current article provides a complete report on rare PEM based on ...BACKGROUND Polypoid endometriosis(PEM)is a rare and unique type of endometriosis.To date,no article has provided a systematic report of this disease.The current article provides a complete report on rare PEM based on ultrasound,magnetic resonance imaging,intraoperative findings and postoperative pathology data.CASE SUMMARY A 38-year-old female patient was admitted to our hospital after complaining of“vague pain in the right lower quadrant with an aggravated menstrual period for 8 mo”.The patient underwent laparoscopic exploratory surgery on January 7,2022.The postoperative pathology revealed extensive PEM.CONCLUSION PEM is a type of endometriosis that is a benign disease but has biological properties similar to malignant tumours.展开更多
Objective:The expression of pyroptosis related factors GSDMD,Caspase-1,NLRP3,IL-1β,IL-18 and PI3K/AKT signaling pathways in ovarian endometriosis was investigated and their correlations analyzed.Methods:A total of 50...Objective:The expression of pyroptosis related factors GSDMD,Caspase-1,NLRP3,IL-1β,IL-18 and PI3K/AKT signaling pathways in ovarian endometriosis was investigated and their correlations analyzed.Methods:A total of 50 patients with endometriosis who underwent ovarian cystectomy in the Department of Gynecology,the First Affiliated Hospital of Bengbu Medical College from January 2022 to January 2023 were enrolled as endometriosis group.In addition,55 patients with normal endometrial tissue who underwent hysteroscopic surgery in the hospital during the same period were selected as the control group,and patients with endometriosis were excluded during the operation.RT-qPCR,Western Blot was used to detect the expression of pyroptosis-related factor and PI3K/AKT signaling pathway mRAN,protein in the above tissues,and the correlation between the expression of the two was analyzed by Pearson correlation test.Results:The expression of pyroptosis-related factors and mRAN of PI3K/AKT signaling pathway in ectopic ovarian cyst tissues was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that pyroptosis-related factors in ectopic ovarian cysts were positively correlated with the mRNA expression levels of PI3K/AKT signaling pathway(P<0.05).Conclusion:The pyroptosis correlation factors GSDMD,Caspase-1,NLRP3,IL-1β,IL-18 and PI3K/AKT signaling pathways are highly expressed in ovarian endometriosis,and the pyroptosis-related factors are positively correlated with the expression of PI3K/AKT signaling pathway,suggesting that the regulation of endometriosis by activating the PI3K/AKT signaling pathway is likely to be achieved by activating the PI3K/AKT signaling pathway.展开更多
Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age...Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.展开更多
Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors relate...Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors related to the organization of the health care system greatly delay its diagnosis. The objectives of the present study were to determine the diagnosis delay and to assess the quality of life before surgery of women with endometriosis using the specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We carried out a descriptive, observational, retrospective study in 8 medical centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80 women with endometriosis confirmed by laparoscopy (16 diagnostic and 64 operative laparoscopies) and histopathology were interviewed. We used the revised American Society for Reproductive Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI) score was calculated for infertile women and the EHP-5 questionnaire to assess quality of life. Our data was entered and analyzed using Statistical Analysis Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients showed a severe deterioration in quality of life (604 ± 235). A negative relationship was observed between the age of the patient, the diagnostic delay, and the alteration of the quality of life in patients over 36 years old and those with about 11 years of diagnostic delay presenting the slight alteration. Patients with a high social level had very severe quality impairment. Women on hormonal treatment, those with a history of pregnancy, childbirth, miscarriage and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations, our preliminary study highlights that in sub-Saharan Africa, the diagnosis of endometriosis is delayed and associated with a severe alteration in quality of life. Moreover, diagnosis of endometriosis seems to be restricted to women with high social levels. Therefore, further efforts are required to develop a health policy to decrease delay for diagnosis with potential benefits on symptoms, quality of life, fertility while limiting stigma and psychological effects of this debilitating pathology.展开更多
Introduction: Endometriosis is a chronic disease affecting approximately 10% of women. Our aim was to describe the epidemiological profile, clinical presentation and location of lesions in patients operated on for end...Introduction: Endometriosis is a chronic disease affecting approximately 10% of women. Our aim was to describe the epidemiological profile, clinical presentation and location of lesions in patients operated on for endometriosis. Methodology: We conducted an analytical cross-sectional study with retrospective data collection over a period of 05 years from 1 January 2017 to 31 March 2022. Our study population consisted of women who had undergone laparoscopy for endometriosis. Data analysis was performed using SPSS software version 23.0. Results: In total we included 159 patients who had undergone laparoscopy for endometriosis. The mean age was 32.9 ± 5.9 years, most of whom were nuligravida 61.6% (n = 99). Infertility was the most frequent reason for consultation, accounting for 72.3% (n = 115), followed by dysmenorrhoea in 60.8% (n = 96) of cases and chronic pelvic pain in 37.7% (n = 60). In addition, 46 (28.9%) patients complained of deep dyspareunia, 17 (10.7%) of dyschezia and nine (5.7%) of dysuria. Magnetic Resonance Imaging (MRI) was used in one patient. Diagnostic laparoscopy was performed directly in 77 (48.4%) patients. The lesions were multifocal, according to the #ENZIAN classification nomenclature. Tubal lesions were most frequently found 107 (67.3%) on the left, followed by compartment B (uterosacral ligaments, cardinal ligaments and lateral pelvic wall) 49.7% (n = 79), and endometriomas 40.9% (n = 65). Conclusion: Women operated on for endometriosis were of a more advanced age, and predominantly nulliparous. Infertility was the most frequent reason for consultation and tubal location most frequently encountered for superficial lesions and compartiment B for deep lesions according to #ENZIA.展开更多
Background:Chinese herbal medicines have been proven to be effective in clinical treatment and disease prevention.Jinlingzi San is a herbal medicine used for the treatment of endometriosis.However,a comprehensive netw...Background:Chinese herbal medicines have been proven to be effective in clinical treatment and disease prevention.Jinlingzi San is a herbal medicine used for the treatment of endometriosis.However,a comprehensive network pharmacology approach has not been used to understand the active ingredients and therapeutic mechanisms behind Jinlingzi San in the treatment of endometriosis.Methods:A network pharmacology approach and a molecular docking approach were used to predict the active ingredients and potential targets of Jinlingzi San in the treatment of endometriosis.Results:The integrated network pharmacology approach successfully identified 60 active ingredients and 540 key targets of action in Jinlingzi San dispersion.Among them,STAT3,TP53,MAPK3,RELA,MAPK1,JUN and other key genes were mainly regulated through pathways in cancer,lipid and atherosclerosis,AGE-RAGE signaling pathway in diabetic complications,pancreatic cancer,prostate cancer,PI3K-Akt signaling pathway,Th17 cell differentiation,and other signaling pathways in the cell body,receptor complexes,cytoplasm,nucleoplasm,and plasma membrane.Conclusion:Based on a systems network pharmacology approach,our work successfully predicts the active components and potential targets of Jinlingzi San for the treatment of endometriosis and helps to illustrate the mechanism of action at an integrative level.This demonstrates that Jinlingzi San for the treatment of endometriosis is regulated through a multi-component,multi-target,multi-system co-regulation.This study identifies key genes and pathways associated with endometriosis and pathogenesis from new insights,and also provides a viable approach to the chemical basis and pharmacological studies of Jinlingzi San.展开更多
Background:Breast cancer and endometriosis are two significant diseases that threaten the health of female worldwide.The relationship between them is still in a state of controversy.In present study,we identified the ...Background:Breast cancer and endometriosis are two significant diseases that threaten the health of female worldwide.The relationship between them is still in a state of controversy.In present study,we identified the risk of breast cancer in patients with endometriosis through a meta-analysis.Methods:A systematic search of the PubMed,Embase and Cochrane Library,with the terms for endometriosis,breast and cancer,tumor,neoplasm,or carcinoma combined.Studies on related risk estimates of endometriosis and breast cancer were included in the meta-analysis.Furthermore,a series of analytical methods such as sensitivity analysis,the Cochran Q test,Begg’s and Egger’s test were used to analyze the information of collected studies.Results:Finally,a total of 8 studies were included.After statistical analysis based on STATA software,the combined odds ratio of the results was 1.13(95%CI:1.09–1.17).And the results of subgroup analysis showed that the odds ratio values of different outcome indexes were 1.06(95%CI:1.02–1.09,P<0.05),the effective effect estimates were presented in SIR(P=0.006,I^(2)=80.3%).Conclusion:In present study,we identified that patients with endometriosis have an increased risk of breast cancer.It is worth considering that our research was a summary analysis of epidemiological data.More in-depth studies are needed to determine the pathophysiology of this relationship.展开更多
The study aims to reveal the mechanism of traditional Chinese medicine in the treatment of endometriosis and provide support for further research on traditional Chinese medicine and its active ingredients.The literatu...The study aims to reveal the mechanism of traditional Chinese medicine in the treatment of endometriosis and provide support for further research on traditional Chinese medicine and its active ingredients.The literature survey was conducted using PubMed,Web of Science,CNKI and other databases with“endometriosis”,“Chinese medicine”,“Chinese herbal medicine”and“natural plants”as the main keywords.Traditional Chinese medicine can exert their therapeutic effects on endometriosis by inhibiting inflammation through multiple pathways and multiple targets,regulating cell proliferation and apoptosis,angiogenesis,cell adhesion and oxidative stress.Traditional Chinese medicine can intervene in endometriosis in multiple ways and with multiple targets.In-depth study of Chinese medicine for endometriosis can provide new ideas for exploring the pathogenesis of endometriosis and developing new drugs.展开更多
BACKGROUND To describe the characteristics,diagnosis and surgical treatment of inguinal endometriosis(IEM).CASE SUMMARY We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 201...BACKGROUND To describe the characteristics,diagnosis and surgical treatment of inguinal endometriosis(IEM).CASE SUMMARY We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 2011 to 2019.Relevant features,symptoms,images,surgical treatment,hormonal therapy and follow-up were collected and discussed.A total of 10 cases of IEM diagnosed by surgery and pathology were characterized by a lesion on the right side(9/11);five patients had symptoms related to the menstrual cycle,and only 3 patients were clearly diagnosed before surgery.Ultrasonography was of little assistance in confirming the diagnosis,but magnetic resonance imaging showed specific,high-intensity patterns.Anatomically,most of the IEM lesions were located in the extraperitoneal ligament(10/11);nine patients had inguinal hernias(IH),five had concurrent or prior pelvic endometriosis,and four had infertility.The clinical results from extensive resection were satisfactory.CONCLUSION IEM is an extremely rare condition that can easily be misdiagnosed prior to surgery.A right IH may contribute to the formation of right-sided IEM,and extensive resection involving the round ligament and hernia sac is essential to prevent recurrence.展开更多
Endometriosis is a chronic and progressive gynecologic disorder that affects 10% - 50% of women of reproductive age worldwide. Chronic pain and infertility are the most debilitating problems associated with it requiri...Endometriosis is a chronic and progressive gynecologic disorder that affects 10% - 50% of women of reproductive age worldwide. Chronic pain and infertility are the most debilitating problems associated with it requiring both medical and surgical treatment. Laparoscopy is considered the gold standard for diagnosis and treatment. However, a 10% rate of conversion to laparotomy has been reported when performed by skilled laparoscopic surgeons and much higher in low volume less skilled surgeons. To improve surgical outcomes, robotic assistance is the logical next step in performing minimally invasive gynecological surgeries, especially in complex endometriosis cases. Enhanced 3D visualization and 10× magnification along with Endowrist instruments with seven degrees of freedom facilitates precise and careful dissection. Firefly technology using ICG green dye can improve detection of small and invisible lesions. Robotics is useful in deep infiltrating disease manifesting as lesions deeper than the superficial tissues of rectovaginal septum, vaginal fornix, pelvic sidewalls, parametrium, bowel or ureter and bladder. Trials show no increase in surgical time, blood loss, or intra- or postoperative complications and similar clinical outcome when robotics is compared with laparoscopy. At present, it is more appropriate to compare it with laparotomy rather than laparoscopy. Robotics can be used to manage recurrence of endometriosis after hysterectomy. Surgeons experienced in conventional laparoscopy can utilize robotic platform for deep infiltrating endometriosis for performing complex surgical dissection and achieving the surgical goals in mind and reduce conversions to open surgery. Robotic assistance can bridge the gap in performance of laparoscopic surgery in advanced endometriosis.展开更多
文摘Introduction: Cutaneous endometriosis is an uncommon but well-known skin disorder that represents about 0.5% to 1% of all endometriosis. The objective of this case series is to report clinical presentation, diagnosis, and management of various forms of cutaneous endometriosis. Material and Methods: It was an observational, retrospective and descriptive review of cases presenting with cutaneous endometriosis among Cameroonian women managed at the gynaecological outpatient department of Yaounde Gynaeco-Obstetric and Pediatric Hospital. All the following parameters were analysed: age, parity, previous pelvic surgery, presenting symptoms and duration, associated symptoms, localizations, imaging, size of the lesion, other localization of endometriosis, management and histopathological results. Results: we reported 4 cases of cutaneous endometriosis, with 3 umbilical endometriosis and 1 abdominal scar endometriosis. Patient age ranged from 28 to 39 years with an average of 33 years. All patients described infertility (two primary and two secondary) and two had a history of abdominal surgery. All patients presented local cyclical signs such as pain, swelling, color change and bleeding. The duration of symptoms varied from 2 to 3 years and the size of lesions ranged from 2 to 3.5 cm for umbilical lesions and was 9 cm for abdominal scar endometriosis. In all cases, no imaging was required for the diagnosis, which was suspected on the basis of patient’s history and the cyclical nature of local signs, followed by wide surgical excision and confirmation on histopathology. Conclusion: Cutaneaous endometriosis is a rare benign condition. Umbilical endometriosis seems to be the main cutaneous localization and can be described as primary or secondary. Even if its diagnosis must be confirmed by histopathology, it should be considered in patient with cutaneous cyclic signs such as pain, swelling or bleeding with or without history of abdominal surgery.
文摘Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.
基金supported by the GRF RGC&CRF,Hong Kong(Grant Nos.:475012 and C5045-20 EF)HMRF,Hong Kong(Grant No.:03141386)+3 种基金ITF,Hong Kong(Grant No.:ITS/209/12)UGC Direct Grant 2011,2012,2021.032HKOG Trust Fund 2011,2014,2019the National Natural Science Foundation of China(Grant Nos.:81974225 and 82201823)。
文摘Endometriosis is a common chronic gynecological disease with endometrial cell implantation outside the uterus.Angiogenesis is a major pathophysiology in endometriosis.Our previous studies have demonstrated that the prodrug of epigallocatechin gallate(ProEGCG)exhibits superior anti-endometriotic and anti-angiogenic effects compared to epigallocatechin gallate(EGCG).However,their direct binding targets and underlying mechanisms for the differential effects remain unknown.In this study,we demonstrated that oral ProEGCG can be effective in preventing and treating endometriosis.Additionally,1D and 2D Proteome Integral Solubility Alteration assay-based chemical proteomics identified metadherin(MTDH)and PX domain containing serine/threonine kinase-like(PXK)as novel binding targets of EGCG and ProEGCG,respectively.Computational simulation and BioLayer interferometry were used to confirm their binding affinity.Our results showed that MTDH-EGCG inhibited protein kinase B(Akt)-mediated angiogenesis,while PXK-ProEGCG inhibited epidermal growth factor(EGF)-mediated angiogenesis via the EGF/hypoxia-inducible factor(HIF-1a)/vascular endothelial growth factor(VEGF)pathway.In vitro and in vivo knockdown assays and microvascular network imaging further confirmed the involvement of these signaling pathways.Moreover,our study demonstrated that ProEGCG has superior therapeutic effects than EGCG by targeting distinct signal transduction pathways and may act as a novel antiangiogenic therapy for endometriosis.
基金supported by the National Natural Science Foundation of China(81830115).
文摘Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.
文摘Endometriosis is defined as the presence of endometrial tissue that is located outside the uterine cavity, associated with fibrosis and inflammatory reaction. The most common atypical locations are the gastrointestinal tract, urinary tract, lung, as well as abdominal surgical scars. Its diagnosis is still very difficult, especially when it manifests itself as an acute large bowel obstruction. We report the rare case of a 41-year-old patient diagnosed with acute colonic obstruction following a rectal tumor. She had undergone colonostomy even though colonoscopy biopsies were nonspecific, and a computed tomography (CT) scan was requested. It showed an adnexal heterogenous mass, therefore the patient had a laparotomy and a subtotal hysterectomy with bilateral salpingo-oophorectomy and a biopsy of the recto-colonic hinge. Histologic examination revealed a diagnosis of rectal endometriosis. The purpose of this work is to report a rare case of colonic endometriosis responsible for an acute large bowel obstruction.
基金This study was supported by the National Natural Science Foundation of China(81973895)the Key Research Projects of Beijing University of Chinese Medicine(2020-JYB-ZDGG-143-3).
文摘Objective:To explore the effect of Hupo powder(HP)on autophagy in menstrual blood-derived stem cells(MenSCs)with endometriosis(EMT).Methods:EMT MenSCs(E-MenSCs)and healthy MenSCs(H-MenSCs)were isolated from the menstrual blood of patients with EMT and healthy female participants,respectively.We identified their stem cells’characteristics via adipogenic and osteogenic differentiation.Twelve male SpragueeDawley rats received 0.9% NaCl and HP-dispensing granules by gastric irrigation to prepare blank serum and medicated serum,respectively.We used serum concentrations of 5%,10%,and 20%,each at administered times of 12,24,and 48 h to select the best condition.These cells were divided into three groups:blank serum of the control group,blank serum of the model group,and medicated serum of the HP group.H-MenSCs were used in the control group,while E-MenSCs were used in the model and HP groups.We analyzed cell viability using a cell counting kit-8 assay,observed cell morphology,evaluated the amounts of auto-phagosomes and autolysosomes by transmission electron microscopy,and detected the protein expression of autophagy markers(LC3-II and Beclin1)by Western blot.Results:E-MenSCs and H-MenSCs became long fusiform with a diffuse radial pattern,forming lipid droplets and calcium nodules after adipogenic and osteogenic differentiation.We then used the best conditiond 20% serum and 48 hdfor the subsequent experiments.In contrast to the model group,the HP group exhibited lower cell viability(=0.007),larger amounts of autophagosomes and autolysosomes(P<0.001 and P=0.001,respectively),and higher expression of LC3-II and Beclin1(P=0.021 and P=0.019,respectively).Conclusion:Hupo powder can promote autophagy in E-MenSCs,which might be one of the mechanisms underlying its therapeutic effects.
文摘Endometriosis is defined as a condition with endometrium-like tissues migrating outside of the pelvic cavity.However,the mechanism of endometriosis is still unclear.Lactate can be covalently modified to lysine residues of histones and other proteins,which is called lactylation.The results showed that the higher level of lactate and lactate dehydrogenase A enhanced the histone H3 lysine 18 lactylation(H3K18lac)in ectopic endometrial tissues and ectopic endometrial stromal cells than that in normal endometrial tissues and normal endometrial stromal cells.Lactate promoted cell proliferation,migration,and invasion in endometriosis.Mechanistically,lactate induced H3K18lac to promote the expression of high-mobility group box 1(HMGB1)in endometriosis,and HMGB1 knockdown significantly reduced the cell proliferation,migration,and invasion of the lactate-treated cells through the phosphorylation of AKT.In conclusion,lactate could induce histone lactylation to promote endometriosis progression by upregulating the expression of HMGB1,which may provide a novel target for the prevention and treatment of endometriosis.
基金funded by the Role and Mechanism of EML4 in Regulating Oocyte Meiosis and Leading to the Infertility Project(SDFEYJGL2103).
文摘Objective:Key genes were screened to analyze molecular mechanisms and their drug targets of endometriosis by applying a bioinformatics approach.Methods:Gene expression profiles of endometriosis and healthy controls were obtained from the Gene Expression Omnibus database.Significant differentially expressed genes were screened using the limma package.Correlation pathways were screened by Spearman correlation analysis on the echinoderm microtubule-associated protein-like 4(EML4)and enrichment in endometriosis pathways and estimated by the GSVA package.Immune characteristics were assessed by the“ESTIMATE”R package.Potential regulatory pathways were determined by enrichment analysis.The SWISS-MODE website was used in homology modeling with EML4 and EML4 protein activity was predicted.VarElect was employed in molecular docking for screening potential compound inhibitors targeting endometriosis.Results:Ten endometriosis and 10 normal samples were included.EML4 was significantly upregulated in endometriosis(p<0.05).Thirty significantly correlated pathways involving 18 positive and 12 negative correlations,including GLYCOSAMINOGLYCAN_BIOSYNTHESIS_HEPARAN_SULFATE and GLYCOSPHINGOLIPID_BIOSYNTHESIS_GANGLIO_SERIES were screened between EML4 and endometriosis.Immunocorrelation analysis showed a significant difference in immune-related pathways in endometriosis and normal samples(p<0.05).In endometriosis,EML4 was associated with T-cell CD4 resting memory,activated mast cells,plasma cells,activated NK cells,M2 macrophages,and follicular helper T cells(p<0.05).Molecular docking identified five potential inhibitors of EML4,and compound DB05104(asimadoline)bound well to EML4 protein to exert its physiological effects.Conclusion:Differential gene expression and immune correlation analyses revealed that EML4 may affect endometriosis through multiple targets and pathways,the mechanism of which involved immune cell activation and infiltration.Molecular docking and dynamics simulation verified DB05104 as a potential inhibitor of EML4 and a powerful target for endometriosis treatment.
文摘BACKGROUND Endometriosis is a common benign gynecological disease that causes dysmenorrhea in women of childbearing age.Malignant tumors derived from endometriosis are rarely reported and are found in only 1%of all patients with endometriosis.Here,we report a well-differentiated squamous cell carcinoma(SCC)caused by squamous metaplasia of endometriosis that co-occurred in the uterus and ovaries.CASE SUMMARY A 57-year-old postmenopausal woman had a 6-month history of irregular uterine bleeding.The uterus and adnexa were examined by computed tomography,and there were two solid cystic masses in the pelvis and right adnexa.Histological findings of surgical specimens showed well-differentiated SCC arising from squamous metaplasia of ectopic endometrial glands in the uterus and ovaries.The patient received chemotherapy after surgery and was followed up for 3 mo without metastasis.CONCLUSION The continuity between ectopic endometrial glands and SCC supports that SCC originates from ectopic endometrial glands with metaplasia towards squamous epithelium.
文摘BACKGROUND Lung endometriosis is an extremely rare gynecological disease.Current literature reports suggest that the majority of patients will present with only generic symptoms,such as hemoptysis,pneumothorax,and hemopneumothorax,which often leads to misdiagnosis.To date,there are 18 case reports of lung endometriosis that describe the clinical manifestation,imaging changes,treatment,and prognosis of the disease.To provide further insights into this rare disease,we present a new case report and a brief review of pulmonary endometriosis.CASE SUMMARY We report here about a 19-year-old woman who was admitted to the hospital for repeated catamenial hemoptysis over a 3-mo period.computed tomography(CT)imaging during menstruation revealed patchy high-density shadows,approximately 0.5 cm3 in size,in the right middle lobe of the lung.The patient’s hemoptysis and changes in the CT scans resolved after menstruation.Thoracoscopic right middle lobectomy,right lower lung repair,and closed thoracic drainage were performed.Postoperative histopathology confirmed lung endometriosis.There was no recurrence of symptoms at the 6 mo follow-up.CONCLUSION We propose diagnosing lung endometriosis by thoroughly taking reproductive history,clinical details,imaging,and histopathology followed by treatment with surgical resection.
文摘BACKGROUND Polypoid endometriosis(PEM)is a rare and unique type of endometriosis.To date,no article has provided a systematic report of this disease.The current article provides a complete report on rare PEM based on ultrasound,magnetic resonance imaging,intraoperative findings and postoperative pathology data.CASE SUMMARY A 38-year-old female patient was admitted to our hospital after complaining of“vague pain in the right lower quadrant with an aggravated menstrual period for 8 mo”.The patient underwent laparoscopic exploratory surgery on January 7,2022.The postoperative pathology revealed extensive PEM.CONCLUSION PEM is a type of endometriosis that is a benign disease but has biological properties similar to malignant tumours.
基金Anhui Provincial Department of Education Natural Science Key Project (No.2022AH051428)Graduate Innovation Program of Bengbu Medical College (No.Byycx22099)。
文摘Objective:The expression of pyroptosis related factors GSDMD,Caspase-1,NLRP3,IL-1β,IL-18 and PI3K/AKT signaling pathways in ovarian endometriosis was investigated and their correlations analyzed.Methods:A total of 50 patients with endometriosis who underwent ovarian cystectomy in the Department of Gynecology,the First Affiliated Hospital of Bengbu Medical College from January 2022 to January 2023 were enrolled as endometriosis group.In addition,55 patients with normal endometrial tissue who underwent hysteroscopic surgery in the hospital during the same period were selected as the control group,and patients with endometriosis were excluded during the operation.RT-qPCR,Western Blot was used to detect the expression of pyroptosis-related factor and PI3K/AKT signaling pathway mRAN,protein in the above tissues,and the correlation between the expression of the two was analyzed by Pearson correlation test.Results:The expression of pyroptosis-related factors and mRAN of PI3K/AKT signaling pathway in ectopic ovarian cyst tissues was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that pyroptosis-related factors in ectopic ovarian cysts were positively correlated with the mRNA expression levels of PI3K/AKT signaling pathway(P<0.05).Conclusion:The pyroptosis correlation factors GSDMD,Caspase-1,NLRP3,IL-1β,IL-18 and PI3K/AKT signaling pathways are highly expressed in ovarian endometriosis,and the pyroptosis-related factors are positively correlated with the expression of PI3K/AKT signaling pathway,suggesting that the regulation of endometriosis by activating the PI3K/AKT signaling pathway is likely to be achieved by activating the PI3K/AKT signaling pathway.
文摘Endometriosis is a clinical and recurrent condition characterized by the presence of functional endometrial tissue outside the uterine cavity and myometrium. It is estimated that 6% to 10% of women of reproductive age, 50% to 60% of adolescents and adults with pelvic pain, and up to 50% of women with infertility are pregnant from the condition. However, this proportion tends to be even greater due to the difficulty in diagnosing it: because it presents different symptoms, lack of information from health professionals, and a high-cost diagnostic test. Another aggravating factor is the average time from the onset of symptoms to the medical diagnosis, which even today ranges from five to ten years;this delay has consequences for disease progression, as it prevents early treatment, which is important for improving pain levels and physical and psychological well-being. Aware of these mishaps, it is therefore important to assess the difficulties faced by doctors in the diagnosis of endometriosis in the public health system, in Brazil, the Unified Health System (SUS). With this purpose, a cross sectional was carried out, developed in the virtual environment using traffic in Google forms, with the difficulties quantified in the Likert scale. Participating physicians pointed out a medium difficulty for patients with endometriosis to access the consultation (58%) and moderate difficulty (52%) to perform an ultrasound examination;also signaled great difficulty in performing magnetic resonance imaging (77%) and laparotomy (61%) in these patients. It is hoped that knowledge about the difficulties faced by physicians in the diagnosis of endometriosis in the SUS will give these physicians a voice and corroborate, even if minimally, so that there is more research that provokes the search for these difficulties, in order to improving the quality of life of these women.
文摘Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors related to the organization of the health care system greatly delay its diagnosis. The objectives of the present study were to determine the diagnosis delay and to assess the quality of life before surgery of women with endometriosis using the specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We carried out a descriptive, observational, retrospective study in 8 medical centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80 women with endometriosis confirmed by laparoscopy (16 diagnostic and 64 operative laparoscopies) and histopathology were interviewed. We used the revised American Society for Reproductive Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI) score was calculated for infertile women and the EHP-5 questionnaire to assess quality of life. Our data was entered and analyzed using Statistical Analysis Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients showed a severe deterioration in quality of life (604 ± 235). A negative relationship was observed between the age of the patient, the diagnostic delay, and the alteration of the quality of life in patients over 36 years old and those with about 11 years of diagnostic delay presenting the slight alteration. Patients with a high social level had very severe quality impairment. Women on hormonal treatment, those with a history of pregnancy, childbirth, miscarriage and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations, our preliminary study highlights that in sub-Saharan Africa, the diagnosis of endometriosis is delayed and associated with a severe alteration in quality of life. Moreover, diagnosis of endometriosis seems to be restricted to women with high social levels. Therefore, further efforts are required to develop a health policy to decrease delay for diagnosis with potential benefits on symptoms, quality of life, fertility while limiting stigma and psychological effects of this debilitating pathology.
文摘Introduction: Endometriosis is a chronic disease affecting approximately 10% of women. Our aim was to describe the epidemiological profile, clinical presentation and location of lesions in patients operated on for endometriosis. Methodology: We conducted an analytical cross-sectional study with retrospective data collection over a period of 05 years from 1 January 2017 to 31 March 2022. Our study population consisted of women who had undergone laparoscopy for endometriosis. Data analysis was performed using SPSS software version 23.0. Results: In total we included 159 patients who had undergone laparoscopy for endometriosis. The mean age was 32.9 ± 5.9 years, most of whom were nuligravida 61.6% (n = 99). Infertility was the most frequent reason for consultation, accounting for 72.3% (n = 115), followed by dysmenorrhoea in 60.8% (n = 96) of cases and chronic pelvic pain in 37.7% (n = 60). In addition, 46 (28.9%) patients complained of deep dyspareunia, 17 (10.7%) of dyschezia and nine (5.7%) of dysuria. Magnetic Resonance Imaging (MRI) was used in one patient. Diagnostic laparoscopy was performed directly in 77 (48.4%) patients. The lesions were multifocal, according to the #ENZIAN classification nomenclature. Tubal lesions were most frequently found 107 (67.3%) on the left, followed by compartment B (uterosacral ligaments, cardinal ligaments and lateral pelvic wall) 49.7% (n = 79), and endometriomas 40.9% (n = 65). Conclusion: Women operated on for endometriosis were of a more advanced age, and predominantly nulliparous. Infertility was the most frequent reason for consultation and tubal location most frequently encountered for superficial lesions and compartiment B for deep lesions according to #ENZIA.
基金supported by grants from the Heilongjiang Provincial Traditional Chinese Medicine Research Project:Mechanism study of Zhuyu Ning in treating endometriosis based on the Wnt/β-catenin signaling pathway (ZHY2022-130)the National Traditional Chinese Medicine Clinical Research Base Business Construction Scientific Research Special Project (JDZX2015057)of the State Administration of Traditional Chinese Medicine:Clinical observation of the therapeutic effect of acupuncture on dysmenorrhea in endometriosis based on the VEGF/VEGFR pathway.
文摘Background:Chinese herbal medicines have been proven to be effective in clinical treatment and disease prevention.Jinlingzi San is a herbal medicine used for the treatment of endometriosis.However,a comprehensive network pharmacology approach has not been used to understand the active ingredients and therapeutic mechanisms behind Jinlingzi San in the treatment of endometriosis.Methods:A network pharmacology approach and a molecular docking approach were used to predict the active ingredients and potential targets of Jinlingzi San in the treatment of endometriosis.Results:The integrated network pharmacology approach successfully identified 60 active ingredients and 540 key targets of action in Jinlingzi San dispersion.Among them,STAT3,TP53,MAPK3,RELA,MAPK1,JUN and other key genes were mainly regulated through pathways in cancer,lipid and atherosclerosis,AGE-RAGE signaling pathway in diabetic complications,pancreatic cancer,prostate cancer,PI3K-Akt signaling pathway,Th17 cell differentiation,and other signaling pathways in the cell body,receptor complexes,cytoplasm,nucleoplasm,and plasma membrane.Conclusion:Based on a systems network pharmacology approach,our work successfully predicts the active components and potential targets of Jinlingzi San for the treatment of endometriosis and helps to illustrate the mechanism of action at an integrative level.This demonstrates that Jinlingzi San for the treatment of endometriosis is regulated through a multi-component,multi-target,multi-system co-regulation.This study identifies key genes and pathways associated with endometriosis and pathogenesis from new insights,and also provides a viable approach to the chemical basis and pharmacological studies of Jinlingzi San.
文摘Background:Breast cancer and endometriosis are two significant diseases that threaten the health of female worldwide.The relationship between them is still in a state of controversy.In present study,we identified the risk of breast cancer in patients with endometriosis through a meta-analysis.Methods:A systematic search of the PubMed,Embase and Cochrane Library,with the terms for endometriosis,breast and cancer,tumor,neoplasm,or carcinoma combined.Studies on related risk estimates of endometriosis and breast cancer were included in the meta-analysis.Furthermore,a series of analytical methods such as sensitivity analysis,the Cochran Q test,Begg’s and Egger’s test were used to analyze the information of collected studies.Results:Finally,a total of 8 studies were included.After statistical analysis based on STATA software,the combined odds ratio of the results was 1.13(95%CI:1.09–1.17).And the results of subgroup analysis showed that the odds ratio values of different outcome indexes were 1.06(95%CI:1.02–1.09,P<0.05),the effective effect estimates were presented in SIR(P=0.006,I^(2)=80.3%).Conclusion:In present study,we identified that patients with endometriosis have an increased risk of breast cancer.It is worth considering that our research was a summary analysis of epidemiological data.More in-depth studies are needed to determine the pathophysiology of this relationship.
文摘The study aims to reveal the mechanism of traditional Chinese medicine in the treatment of endometriosis and provide support for further research on traditional Chinese medicine and its active ingredients.The literature survey was conducted using PubMed,Web of Science,CNKI and other databases with“endometriosis”,“Chinese medicine”,“Chinese herbal medicine”and“natural plants”as the main keywords.Traditional Chinese medicine can exert their therapeutic effects on endometriosis by inhibiting inflammation through multiple pathways and multiple targets,regulating cell proliferation and apoptosis,angiogenesis,cell adhesion and oxidative stress.Traditional Chinese medicine can intervene in endometriosis in multiple ways and with multiple targets.In-depth study of Chinese medicine for endometriosis can provide new ideas for exploring the pathogenesis of endometriosis and developing new drugs.
文摘BACKGROUND To describe the characteristics,diagnosis and surgical treatment of inguinal endometriosis(IEM).CASE SUMMARY We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 2011 to 2019.Relevant features,symptoms,images,surgical treatment,hormonal therapy and follow-up were collected and discussed.A total of 10 cases of IEM diagnosed by surgery and pathology were characterized by a lesion on the right side(9/11);five patients had symptoms related to the menstrual cycle,and only 3 patients were clearly diagnosed before surgery.Ultrasonography was of little assistance in confirming the diagnosis,but magnetic resonance imaging showed specific,high-intensity patterns.Anatomically,most of the IEM lesions were located in the extraperitoneal ligament(10/11);nine patients had inguinal hernias(IH),five had concurrent or prior pelvic endometriosis,and four had infertility.The clinical results from extensive resection were satisfactory.CONCLUSION IEM is an extremely rare condition that can easily be misdiagnosed prior to surgery.A right IH may contribute to the formation of right-sided IEM,and extensive resection involving the round ligament and hernia sac is essential to prevent recurrence.
文摘Endometriosis is a chronic and progressive gynecologic disorder that affects 10% - 50% of women of reproductive age worldwide. Chronic pain and infertility are the most debilitating problems associated with it requiring both medical and surgical treatment. Laparoscopy is considered the gold standard for diagnosis and treatment. However, a 10% rate of conversion to laparotomy has been reported when performed by skilled laparoscopic surgeons and much higher in low volume less skilled surgeons. To improve surgical outcomes, robotic assistance is the logical next step in performing minimally invasive gynecological surgeries, especially in complex endometriosis cases. Enhanced 3D visualization and 10× magnification along with Endowrist instruments with seven degrees of freedom facilitates precise and careful dissection. Firefly technology using ICG green dye can improve detection of small and invisible lesions. Robotics is useful in deep infiltrating disease manifesting as lesions deeper than the superficial tissues of rectovaginal septum, vaginal fornix, pelvic sidewalls, parametrium, bowel or ureter and bladder. Trials show no increase in surgical time, blood loss, or intra- or postoperative complications and similar clinical outcome when robotics is compared with laparoscopy. At present, it is more appropriate to compare it with laparotomy rather than laparoscopy. Robotics can be used to manage recurrence of endometriosis after hysterectomy. Surgeons experienced in conventional laparoscopy can utilize robotic platform for deep infiltrating endometriosis for performing complex surgical dissection and achieving the surgical goals in mind and reduce conversions to open surgery. Robotic assistance can bridge the gap in performance of laparoscopic surgery in advanced endometriosis.
