The original online version of this article (Oraif, A. (2016) Routine Episiotomy Practice at a Tertiary Care Center in Saudi Arabia. Open Journal of Obstetrics and Gynecology, 6, 794-797. http://dx.doi.org/10.4236/ojo...The original online version of this article (Oraif, A. (2016) Routine Episiotomy Practice at a Tertiary Care Center in Saudi Arabia. Open Journal of Obstetrics and Gynecology, 6, 794-797. http://dx.doi.org/10.4236/ojog.2016.613097) was published without the coauthors mistakenly. To reflect the contribution and responsibility of the coauthors at the time of the study, we revised authorship and affiliation of the article.展开更多
Background: Clinical practice guidelines are important for standard of care. This study was undertaken to assess the quality of Obstetrics and Gynecology guidelines in India. Objective Systematic appraisal of clinical...Background: Clinical practice guidelines are important for standard of care. This study was undertaken to assess the quality of Obstetrics and Gynecology guidelines in India. Objective Systematic appraisal of clinical practice guidelines (CPG) in obstetrics and gynecology in India uses Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Methods: All reported Indian guidelines in obstetrics and gynecology from 1st Jan. 2000 to 1st April 2018 were identified and subjected to inclusion using 3-point assessment criteria (relevance, clarity of intervention/outcome, and appropriate use of healthcare resources) using WHO AGREE-II instrument. Separate scores for the mean item, domain, and standardized were calculated by averaging the scores across two appraisers. Results & Discussion: Of 47 Clinical Practice Guidelines in Obstetrics and Gynecology (CPG) from India, 8 met the inclusion criteria. These were assessed using AGREE II checklist. Overall scores ranged from 8% to 22% (median 5%). No guideline received “Yes” for clinical use by either of the appraisers. Scores for scope and purpose and clarity were high but were very low for all the other domains. Only 1 review had identified cost as one of the focus areas as part of the guideline. Conclusion: Though being clinically relevant the clinical practice guidelines related to obstetrics and gynecology in India score poorly. There is a need for sensitization and capacity building of clinicians and public health professionals on the development of CPG related to obstetrics and gynecology in India.展开更多
Introduction: Morocco has experienced, like the whole world, the COVID-19 pandemic. Until the writing of this article, a subjective observation of the increase in the number of anencephaly has been observed in our fac...Introduction: Morocco has experienced, like the whole world, the COVID-19 pandemic. Until the writing of this article, a subjective observation of the increase in the number of anencephaly has been observed in our facility. And since the teratogenic potential of the SARS Cov 2 virus is not sufficiently documented, we wondered if there would be a relationship between the relatively high number of anencephalic fetuses and COVID-19 infection. Aim: the objective of the study is to look for a possible correlation between the period of conception of these anencephalies and the pandemic. Material and methods: This is a retrospective study (from June 1, 2020 to May 31, 2022 in the Obstetrics Gynecology department, Faculty of Medicine and Pharmacy, CADI AYYAD UNIVERSITY Marrakech Morocco) consisting of the analysis of the number of patients in the target embryonic period (namely the closure of the neural tube: D18 to D30 of embryonic life) compared to the reference curves of the evolution of the SARS Cov2 pandemic. Results: The analysis of the number of patients at the target embryonic phase shows that many of our anencephalons (63%) were conceived during periods of high diffusion of the SARS Cov 2 virus in Morocco. Conclusion: Our study suggests a relationship between the COVID-19 pandemic and the occurrence of anencephaly, we cannot, however, highlight the type of direct or indirect relationship that binds them. Therefore, further studies should be considered to better investigate this relationship.展开更多
Background: Congenital anomalies are among the leading causes of fetal loss, despite it can be identified prior to birth through advanced technology in expert hands. Our research aimed at estimating the prevalence of ...Background: Congenital anomalies are among the leading causes of fetal loss, despite it can be identified prior to birth through advanced technology in expert hands. Our research aimed at estimating the prevalence of congenital anomalies in Sudan. Methods: A facility-based retrospective cross-sectional study combined with a community-based survey through a telephone interview was implemented on a purposive convenient sample of 138 participants. The data were computerized in Epi Info 7. Google Earth Pro enabled to collect the geographical coordinates for the residence of the participants. Descriptive statistics were performed through SPSS 23 and ArcGIS 10.3 was used to generate the geographical distribution map of congenital defects to visualize the catchment areas of Soba Ultrasonography Unit. Results: Of the 138 participants, the estimated prevalence of congenital defects was 2.2/10,000 live births. The ultrasonography screening revealed that neural tube defects were the most prevalent anomalies with 13.0% (18/138), which represented 47.4% (18/38) of all defects. Concerning children, a mortality rate of 23.2% (32/138) was reported. Conclusions: The child mortality rate post ultrasound screening of 23.2%, and the neural tube defects being the most common anomalies appealed to Sudan health authorities for focusing on more preventive antenatal practices to strengthen and promote maternal and child health.展开更多
The activation of the PI3K/AKT/m TOR pathway plays a key role in ovarian cancer tumorigenesis, progression and chemotherapy resistance. This study aimed to explore the possible mechanism that PI-103, a dual inhibitor ...The activation of the PI3K/AKT/m TOR pathway plays a key role in ovarian cancer tumorigenesis, progression and chemotherapy resistance. This study aimed to explore the possible mechanism that PI-103, a dual inhibitor of phosphatidylinositide 3-kinase and m TOR, enhances the sensitivity of SKOV3/DDP ovarian cancer cell line to cisplatin chemotherapy. The results showed that PI-103 could significantly increase the sensitivity of SKVO3/DDP cells to cisplatin through inhibiting the activation of PI3K/Akt/m TOR signaling pathway and inducing cell cycle arrest and apoptosis.展开更多
Parthenogenetic embryonic stem cells have pluripotent differentiation potentials,akin to fertilized embryo-derived embryonic stem cells.The aim of this study was to compare the neuronal differentiation potential of pa...Parthenogenetic embryonic stem cells have pluripotent differentiation potentials,akin to fertilized embryo-derived embryonic stem cells.The aim of this study was to compare the neuronal differentiation potential of parthenogenetic and fertilized embryo-derived embryonic stem cells.Before differentiation,karyotype analysis was performed,with normal karyotypes detected in both parthenogenetic and fertilized embryo-derived embryonic stem cells.Sex chromosomes were identified as XX.Immunocytochemistry and quantitative real-time PCR detected high expression of the pluripotent gene,Oct4,at both the mRNA and protein levels,indicating pluripotent differentiation potential of the two embryonic stem cell subtypes.Embryonic stem cells were induced with retinoic acid to form embryoid bodies,and then dispersed into single cells.Single cells were differentiated in N2 differentiation medium for 9 days.Immunocytochemistry showed parthenogenetic and fertilized embryo-derived embryonic stem cells both express the neuronal cell markers nestin,βIII-tubulin and myelin basic protein.Quantitative real-time PCR found expression of neurogenesis related genes(Sox-1,Nestin,GABA,Pax6,Zic5 and Pitx1) in both types of embryonic stem cells,and Oct4 expression was significantly decreased.Nestin and Pax6 expression in parthenogenetic embryonic stem cells was significantly higher than that in fertilized embryo-derived embryonic stem cells.Thus,our experimental findings indicate that parthenogenetic embryonic stem cells have stronger neuronal differentiation potential than fertilized embryo-derived embryonic stem cells.展开更多
The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine (TCM)-Jinyebaidu (JYBD) to guinea pig cytomegalovirus (GPCMV) intrauterine infection. The virus-free female and male ...The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine (TCM)-Jinyebaidu (JYBD) to guinea pig cytomegalovirus (GPCMV) intrauterine infection. The virus-free female and male guinea pigs were screened with nest-polymerase chain reaction (N-PCR). After inbred, pregnant guinea pigs were selected and divided into 3 groups randomly: 5 guniea pigs of the blank control group were not given either GPCMV or JYBD. 31 guniea pigs of the positive control group were inoculated 1 mL (10 7 TCID 50) suspension of GPCMV intraperitoneal. 10 guniea pigs of the experimental group were inoculated GPCMV firstly and then perfused stomach with JYBD for 14 days (Dosage in accordance with the modulus of the weight ratio of human to guniea pig). The effects of JYBD on the intrauterine infection of GPCMV were observed. The results showed that JYBD could decrease the maternal infection rate from 100 % (31/31) to 50 % (5/10) (P<0.001), the intrauterine infection rate from 100 % (72/72) to 75 % (21/28) (P<0.001), and the rate of abnormal outcome of pregnancy from 64.4 % (29/45) to 25.0 % (7/28) (P<0.001), the infective symptoms being relieved. It can be concluded that traditional Chinese medicine- JYBD can prevent and treat GPCMV intrauterine infection, and can be expected a prophylactic drug for HCMV intrauterine infection.展开更多
The fertilization process is the net result of a complex sequence of events that collectively result in the fusion of the opposite gametes. The male gamete undergoes continuous morphological and biochemical modificati...The fertilization process is the net result of a complex sequence of events that collectively result in the fusion of the opposite gametes. The male gamete undergoes continuous morphological and biochemical modifications during sperm development in the testis (spermatogenesis), maturation in the epididymis, and capacitation in the female reproductive tract. Only the capacitated spermatozoa are able to recognize and bind to the bioactive glycan residue(s) on the ovum's extracellular coat, the zona pellucida (ZP). Sperm-zona binding in the mouse and several other species is believed to take place in two stages. First, capacitated (acrosome-intact) spermatozoa loosely and reversibly adhere to the zona-intact ovum. In the second stage tight irreversible binding occurs. Both types of bindings are attributed to the presence of glycan- binding proteins (receptors) on the sperm plasma membrane and their complementary bioactive glycan units (ligands) on the surface of the ZP. The carbohydrate-mediated adhesion event initiates a signal transduction cascade resulting in the exocytosis of acrosomal contents. This step is believed to be prerequisite which allows the hypemctivated acrosome-reacted spermatozoa to penetrate the ZP and fertilize the ovum. This review focuses on the role of carbohydrate residues in sperm-ovum interaction, and triggering of the acrosome reaction. I have attempted to discuss extensive progress that has been made to enhance our understanding of the well programmed multiple molecular events necessary for successful fertilization. This review will identify these events, and discuss the functional significance of carbohydrates in these events.展开更多
Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical c...Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical characterist ics and basic research. Results: Ambiguous genitalia are closely related to the functio n of androgen. It could be classified into 3 groups: androgen excess, androgen d eficiency and failure of gonadal differentiation. Differential diagnosis depends on clinical manifestations, chromosome examination, serum hormone determination s, final gonadal pathology, receptor study etc.Conclusion: Ambiguous genitalia are related to abnormal androgen ic effect and early correct etiological diagnosis is the key to its management.展开更多
Objective: To summarize the clinical outcomes of 117 human vitrified blastocyst transfer cycles and to determine the impact factors.Methods: In IVF-ET cycles, supernumerary embryos were cultured to 5-Day(D5) or 6-Day(...Objective: To summarize the clinical outcomes of 117 human vitrified blastocyst transfer cycles and to determine the impact factors.Methods: In IVF-ET cycles, supernumerary embryos were cultured to 5-Day(D5) or 6-Day(D6), blastocysts of various stages were cryopreserved by vitrification using cryoloops. Survival rate and clinical pregnancy rate were observed.Results: A total of 312 blastocysts were thawed in 117 frozen embryo transfer cycles, the survival rate was 90.7% (283/312) after thawing. After the transfer of 230 blastocysts in 115 cycles, 69.6% (80/115) of the women got clinically pregnant, and 17.5% (14/80) of them suffered from miscarriage, 39 healthy babies were born in 28 deliveries, and the other 38 pregnancies are ongoing. The implantation rate was 47.4% (109/230). In 107 transfer cycles with 2 hatched blastocysts transferred in each cycle, 72.9% (78/107) got clinically pregnant, while in 8 cycles with 1 or no hatched blastocysts in the two transferred blastocysts, the clinical pregnancy rate is 25%(2/8). The clinical pregnancy rates were not statistically different between natural (77.4%, 24/31) or artificial endometrium preparation (66.7%, 56/84) cycles. Conclusions: These findings suggest that blastocyst vitrification is effective in terms of implantation rate and pregnancy outcome. Transferring of two hatched blastocyst can achieve a higher pregnancy rate.展开更多
Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the med...Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the medical records of 119 cervical cancer patients with intermediate-risk factors treated with radical hysterectomy and pelvic lymphadenectomy from December 1997 to September 2010. The intermediate-risk factors included bulky tumor (≥4 cm), lymphovascular space invasion, and deep stromal invasion. Sixteen patients did not receive adjuvant therapy (observation group);73 were treated with chemotherapy (CT group);30 were treated with adjuvant radiation therapy (RT group). The significance of the clinical parameters, 3- and 5-year overall survival (OS) rates of each group, was analyzed. Results: The 3- and 5-year OS rates between the observation group and adjuvant therapy group (CT plus RT groups) were not statistically different (3-year OS: 100% and 94.4%, respectively;5-year OS: 100% and 92.3%, respectively;p > 0.05). The 3- and 5-year OS rates between the CT group and RT group were also not statistically different (3-year OS: 93.6% and 96.4%, respectively;5-year OS: 80.7% and 96.4%, respectively;p < 0.05). Univariate and multivariate analysis of survival indicated that different adjuvant therapies were not independent prognostic indicators for IB-IIB cervical cancer patients with intermediate-risk factors. Conclusions: CT may have equivalent therapeutic effect as RT for stage IB-IIB cervical cancer patients with intermediate-risk factors after radical surgery, and prospective randomized trial is needed to study the effect of CT in these patients.展开更多
Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the go...Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.展开更多
Objective:To compare the outcomes of vitrification using cryoloop with slow-freezing meth-od for human blastocyst cryopreservation.Methods:In IVF-ET cycles,supernumerary embryos were cultured to Day 5 or Day 6,blas-to...Objective:To compare the outcomes of vitrification using cryoloop with slow-freezing meth-od for human blastocyst cryopreservation.Methods:In IVF-ET cycles,supernumerary embryos were cultured to Day 5 or Day 6,blas-tocysts were cryopreserved by vitrification using cryoloops or slow-freezing method,then blasto-cyst survival rate and pregnant rate were compared.Results:115 vitrified blastocysts from 39 cycles were warmed,104(90.4%)blastocysts sur-vived.After the transfer of 74 blastocysts in 38 cycles,28(73.7%)women got clinically preg-nant,2(7.1%)of them suffered from miscarriage,2 healthy babies were born in 2 deliveries,and the other 24 pregnancies are ongoing.As to slow-freezing method,87 blastocysts from 21 cy-cles were thawed,37(42.5%)of them survived,28 blastoeysts were transferred in 15 cycles,6(40%)women got clinically pregnant,1 of them miscarried,3 healthy babies were born in 2 de-liveries,and the other 3 pregnancies are ongoing.Conclusion:The survival rate and pregnant rate of vitrification using cryoloop are superior totraditional slow-freezing method,and the transfer cancel rate is lower than that of slow-freezingmethod.The miscarriage rate is similar in two methods.展开更多
To explore the reversal effect of mifepristone on multidrug resistance (MDR) in drug-resistant human breast cancer cell line MCF7/ADR and its mechanisms. Methods: Expression of MDR1 and MDR-associated protein(MRP) mRN...To explore the reversal effect of mifepristone on multidrug resistance (MDR) in drug-resistant human breast cancer cell line MCF7/ADR and its mechanisms. Methods: Expression of MDR1 and MDR-associated protein(MRP) mRNA in MCF7/ADR cells was detected using reverse transcription- polymerase chain reaction(RT-PCR). Western blotting was used to assay the protein levels of P-glycoprotein (P-gp) and MRP. Intracellular rhodamine 123 retention and [3H]vincristine (VCR) accumulation were measured by flow cytometry and liquid scintillation counter, respectively. MTT reduction assay was used to determine the sensitivity of cells to the anticancer agent, adriamycin (ADR). Additionally, a MCF7/ADR cell xenograft model was established to assess the reversal effect of mifeprisone on MDR in MCF7/ADR cells in vivo. Results: Miferpristone dose-dependently down- regulated the expression of MDR1 and MRP mRNA in MCF7/ADR cells, accompanied by a significant decrease in the protein levels of P-gp and MRP. After exposure to 5, 10, and 20 mmol/L mifepristone, MCF7/ADR cells showed a 3.87-, 5.81-, and 7.40-fold increase in the accumulation of intracellular VCR(a known substrate of MRP), and a 2.14-, 4.39-, and 5.53-fold increase in the retention of intracellular rhodamine 123(an indicator of P-gp function), respectively. MTT analysis showed that the sensitivity of MCF7/ADR cells to ADR was enhanced by 7.23-, 13.62-, and 20.96-fold after incubation with mifepristone as above-mentioned doses for 96 h. In vivo, mifepristone effectively restored the chemosensitivity of MCF7/ADR cells to ADR. After 8 weeks of administration with ADR(2 mg穔g-1穌-1) alone or in combination with mifepristone(50 mg穔g-1穌-1), the growth inhibitory rate of xenografted tumors in nude mice was 8.08% and 37.25%, respectively. Conclusion: Mifepristone exerts potent reversal effects on MDR in MCF7/ADR cells in vitro and in vivo through down- regulation of MDR1/P-gp and MRP expression and inhibition of P-gp- and MRP-dependent drug efflux, thus increasing the sensitivity to anticancer drug.展开更多
Objective:To study the change of TIZ expression in epithelial ovarian cancer cells.Methods:HO8910 cells were transinfected with siRNA to inhibit the expression of TIZ.pcDNA3.1-TIZ vectors were combined to increase the...Objective:To study the change of TIZ expression in epithelial ovarian cancer cells.Methods:HO8910 cells were transinfected with siRNA to inhibit the expression of TIZ.pcDNA3.1-TIZ vectors were combined to increase the TIZ expression level.The cell viabilily,colony forming efficiency and cycle distribution of HO8910,HO8910/NC,HO8910/pcDNA3.1-NC,HO8910/ TIZ-573 and HO8910/pcDNA3.l-TIZ were compared,and the invasion rate,migration rate and adhesion rate between 5 groups of cells were compared.Results:Compared with those of HO8910,HO8910/NC and HO8910/pcDNA3.1-NC,the cell viability,colony forming efficiency and cell cycle distribution of HO8910/ TIZ-573 were increased,while the indexes of HO8910/pcDNA3.1-NC were decreased with statistical significant difference(P<0.05).There was no statistical significant difference in the invasion rate,migration rate and adhesion rate between 5 groups of cells(P>0.05).Conclusions:The expression of TIZ can inhibit the proliferation of epithelial ovarian cancer cells.展开更多
The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concen...The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concentrated oxygen administration. This study investigated changes in cognitive ability, blood oxygen saturation (%), and heart rate (beats/min) in normal elderly subjects at three different levels of oxygen [21% (1 L/min), 93% (1 L/min), and 93% (5 L/min)] administered during a 1-back task. Eight elderly male (75.3 ± 4.3 years old) and 10 female (71.1 ± 3.9 years old) subjects, who were normal in cognitive ability as shown by a score of more than 24 points in the Mini-Mental State Examination-Korea, participated in the experiment. The experiment consisted of an adaptation phase after the start of oxygen administration (3 minutes), a control phase to obtain stable baseline measurements of heart rate and blood oxygen saturation before the task (2 minutes), and a task phase during which the 1-back task was performed (2 minutes). Three levels of oxygen were administered throughout the three phases (7 minutes). Blood oxygen saturation and heart rate were measured during each phase. Our results show that blood oxygen saturation increased, heart rate decreased, and response time in the 1-back task decreased as the concentration and amount of administered oxygen increased. This shows that administration of sufficient oxygen for optimal cognitive functioning increases blood oxygen saturation and decreases heart rate.展开更多
Background: Endometriosis is an important cause of infertility and chronic pelvic pain. Our study aims to understand the cause and effect relationship of endometriosis with these two clinical presentations. Objectives...Background: Endometriosis is an important cause of infertility and chronic pelvic pain. Our study aims to understand the cause and effect relationship of endometriosis with these two clinical presentations. Objectives: 1) To study the correlation between stage of endometriosis with pain and infertility;2) To evaluate role of transvaginal ultrasound for diagnosis of endometriosis using laparoscopic diagnosis as gold standard. Methodology: Total of 89 women presenting with infertility and or pain and with laparoscopic findings of endometriosis were included in the study. The results were analysed by logistic regression. Results: The mean age of women was 29.67 years. Seventy three percent of patients had moderate to severe disease while 31.46% of patients with endometriosis were infertile. Symptom of pain could be categorised as dysmenorrhea (71.47%), dyspareunia (41.5%) and dyschezia (15.7%). There was no association of endometriosis stage with the pain type, duration of symptoms. Transvaginal ultrasound seems a reliable test for diagnosis of ovarian endometriosis and advanced stage disease. 87.5% of patients with ovarian endometrioma had advanced disease (higher than Stage II rAFS). Conclusion: No correlation was found between the stage of endometriosis and severity of symptoms. Presence of endometrioma on USG was associated with advanced stage of endometriosis.展开更多
Objective: The aim of this study was to determine the influence of long-term low-dose hor mone replacement therapy (HRT) on the intima-media wall of the carotid artery in postmenopa usal women by ultrasound.Methods: 1...Objective: The aim of this study was to determine the influence of long-term low-dose hor mone replacement therapy (HRT) on the intima-media wall of the carotid artery in postmenopa usal women by ultrasound.Methods: 146 postmenopausal women were divided into the HRT group(n= 68, HRT over 5years after menopause) and the control group(n= 78, no HRT). The intima-media thickness (IMT) of the carotid arteries was measured bilaterally, the characteristics of the atherosclerotic plaques were described, the peak systolic velocity (PSV) and resistance index (RI) were measured by ultrasound examination.Results: The IMT of HRT group was significantly smaller than that of the control group,(0. 089±0. 22) cm vs (0. 093±0.29) cm, (P＜0. 01). The occurrence of plaques was reduced in HRT group than the control group (7.7% vs 12.7%, P＜0. 05). The plaques were most frequently found at the bifurcation of the arteries. The soft and mixed plaques in HRT group were found significantly less than that of the control group (soft 1.7% vs 4. 5%, mixed 3.1% vs 6. 7%, both P＜0.05), while the hard plaques in HRT group were more than those of the control group(2.6% vs 1.3%, P＜0. 05). The maximum plaque thickness of HRT group was less than that of control group (0. 191±0. 057) cm vs (0. 226±0. 073) cm, (P＜0.05). The internal carotid artery PSV and RI in the two groups were similar [PSV (65.61±26.55) cm/s vs (64.82±27. 22) cm/s, RI (0.67±0. 082) vs (0. 68±0. 075), both P＞0.05].Conclusion: Our study indicated that HRT may has an effect to reduce the carotid IMT thickness, inhibit the plaque formation, and make the plaques harder and more stable. The long-term low-dose HRT may protect the postmenopausal women against the artherosclerosis of the carotid artery.展开更多
Objective: To determine the association of apoptosis in the layers of human fetal membranes distal to rupture site with labor at term. Study Design: Fetal membranes were collected from elective cesarean sections (n = ...Objective: To determine the association of apoptosis in the layers of human fetal membranes distal to rupture site with labor at term. Study Design: Fetal membranes were collected from elective cesarean sections (n = 8) and spontaneous vaginal deliveries (n = 8) at term. The extent of apoptosis within fetal membrane layers was determined using terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling (TUNEL) assay and western blots for pro-apoptotic active caspase-3 and anti-apoptotic Bcl-2. Results: Apoptotic index in chorionic trophoblasts of membranes distal to rupture site obtained after vaginal delivery was 3-fold higher than those obtained from elective cesarean (11.57% ± 4.98% and 4.05% ± 2.4% respectively;p = 0.012). The choriodecidua layers after vaginal deliveries had higher expression of the pro-apoptotic active caspase-3 and less expression of the anti-apoptotic Bcl-2 than those obtained from elective cesarean sections. Conclusions: Labor at term is associated with increased apoptosis in chorionic trophoblast cells of human fetal membranes distal to rupture site.展开更多
Objective: To identify current treatment strategies for postpartum hemorrhage used by obstetricians (OB/GYNs) and hematologists (HEMs). Study Design: We conducted a survey of OB/GYNs (n = 220) and HEMs (n = 30) to des...Objective: To identify current treatment strategies for postpartum hemorrhage used by obstetricians (OB/GYNs) and hematologists (HEMs). Study Design: We conducted a survey of OB/GYNs (n = 220) and HEMs (n = 30) to describe the characteristics of current treatment strategies for postpartum hemorrhage. Surveys were administered via a structured questionnaire on a secure internet website from 5 - 12 October 2009. Results: The majority of OB/GYN and HEM respondents were practicing in a community hospital environment (77%). Of the OB/GYNs, the majority practiced at hospitals with over 2000 deliveries per year (77%). A majority (58%) of OB/GYNs were affiliated with hospitals that lacked a massive transfusion protocol to treat severe postpartum hemorrhage. Subsequent to uterine massage and additional oxytocin, the majority of OB/GYNs (73%), preferred the administration of Methergine? as the next level of intervention for postpartum hemorrhage. There was considerable variability in response to specific treatment strategies for several hypothetical case scenarios;however, the large majority of OB/GYNs favored obstetrical procedures over interventional radiology or administration of rFVIIa. A large majority (77%) of physicians who are familiar with rRVIIa as treatment for postpartum hemorrhage reported being very satisfied with the agent for this indication. Conclusions: An established, systematic treatment strategy among OB/GYNs emerged only in the case of mild postpartum hemorrhage.展开更多
文摘The original online version of this article (Oraif, A. (2016) Routine Episiotomy Practice at a Tertiary Care Center in Saudi Arabia. Open Journal of Obstetrics and Gynecology, 6, 794-797. http://dx.doi.org/10.4236/ojog.2016.613097) was published without the coauthors mistakenly. To reflect the contribution and responsibility of the coauthors at the time of the study, we revised authorship and affiliation of the article.
文摘Background: Clinical practice guidelines are important for standard of care. This study was undertaken to assess the quality of Obstetrics and Gynecology guidelines in India. Objective Systematic appraisal of clinical practice guidelines (CPG) in obstetrics and gynecology in India uses Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Methods: All reported Indian guidelines in obstetrics and gynecology from 1st Jan. 2000 to 1st April 2018 were identified and subjected to inclusion using 3-point assessment criteria (relevance, clarity of intervention/outcome, and appropriate use of healthcare resources) using WHO AGREE-II instrument. Separate scores for the mean item, domain, and standardized were calculated by averaging the scores across two appraisers. Results & Discussion: Of 47 Clinical Practice Guidelines in Obstetrics and Gynecology (CPG) from India, 8 met the inclusion criteria. These were assessed using AGREE II checklist. Overall scores ranged from 8% to 22% (median 5%). No guideline received “Yes” for clinical use by either of the appraisers. Scores for scope and purpose and clarity were high but were very low for all the other domains. Only 1 review had identified cost as one of the focus areas as part of the guideline. Conclusion: Though being clinically relevant the clinical practice guidelines related to obstetrics and gynecology in India score poorly. There is a need for sensitization and capacity building of clinicians and public health professionals on the development of CPG related to obstetrics and gynecology in India.
文摘Introduction: Morocco has experienced, like the whole world, the COVID-19 pandemic. Until the writing of this article, a subjective observation of the increase in the number of anencephaly has been observed in our facility. And since the teratogenic potential of the SARS Cov 2 virus is not sufficiently documented, we wondered if there would be a relationship between the relatively high number of anencephalic fetuses and COVID-19 infection. Aim: the objective of the study is to look for a possible correlation between the period of conception of these anencephalies and the pandemic. Material and methods: This is a retrospective study (from June 1, 2020 to May 31, 2022 in the Obstetrics Gynecology department, Faculty of Medicine and Pharmacy, CADI AYYAD UNIVERSITY Marrakech Morocco) consisting of the analysis of the number of patients in the target embryonic period (namely the closure of the neural tube: D18 to D30 of embryonic life) compared to the reference curves of the evolution of the SARS Cov2 pandemic. Results: The analysis of the number of patients at the target embryonic phase shows that many of our anencephalons (63%) were conceived during periods of high diffusion of the SARS Cov 2 virus in Morocco. Conclusion: Our study suggests a relationship between the COVID-19 pandemic and the occurrence of anencephaly, we cannot, however, highlight the type of direct or indirect relationship that binds them. Therefore, further studies should be considered to better investigate this relationship.
文摘Background: Congenital anomalies are among the leading causes of fetal loss, despite it can be identified prior to birth through advanced technology in expert hands. Our research aimed at estimating the prevalence of congenital anomalies in Sudan. Methods: A facility-based retrospective cross-sectional study combined with a community-based survey through a telephone interview was implemented on a purposive convenient sample of 138 participants. The data were computerized in Epi Info 7. Google Earth Pro enabled to collect the geographical coordinates for the residence of the participants. Descriptive statistics were performed through SPSS 23 and ArcGIS 10.3 was used to generate the geographical distribution map of congenital defects to visualize the catchment areas of Soba Ultrasonography Unit. Results: Of the 138 participants, the estimated prevalence of congenital defects was 2.2/10,000 live births. The ultrasonography screening revealed that neural tube defects were the most prevalent anomalies with 13.0% (18/138), which represented 47.4% (18/38) of all defects. Concerning children, a mortality rate of 23.2% (32/138) was reported. Conclusions: The child mortality rate post ultrasound screening of 23.2%, and the neural tube defects being the most common anomalies appealed to Sudan health authorities for focusing on more preventive antenatal practices to strengthen and promote maternal and child health.
基金supported by the National Natural Science Foundation of China (30973475)the Natural Science Foundation of Jiangsu Province (BK2012749)the Maternal and Child Health Research Project of Jiangsu Province (F201351)
文摘The activation of the PI3K/AKT/m TOR pathway plays a key role in ovarian cancer tumorigenesis, progression and chemotherapy resistance. This study aimed to explore the possible mechanism that PI-103, a dual inhibitor of phosphatidylinositide 3-kinase and m TOR, enhances the sensitivity of SKOV3/DDP ovarian cancer cell line to cisplatin chemotherapy. The results showed that PI-103 could significantly increase the sensitivity of SKVO3/DDP cells to cisplatin through inhibiting the activation of PI3K/Akt/m TOR signaling pathway and inducing cell cycle arrest and apoptosis.
基金supported by the National Natural Science Foundation of China,No. 30900155 and 81070496the Research Foundation of Education Bureau of Shaanxi Province,China,No. 09JK785+1 种基金Foundation of Interdisciplinary for Postgraduates from Northwest University,No. 08YJC22the Key Laboratory Funding of Northwestern University,Shaanxi Province in China
文摘Parthenogenetic embryonic stem cells have pluripotent differentiation potentials,akin to fertilized embryo-derived embryonic stem cells.The aim of this study was to compare the neuronal differentiation potential of parthenogenetic and fertilized embryo-derived embryonic stem cells.Before differentiation,karyotype analysis was performed,with normal karyotypes detected in both parthenogenetic and fertilized embryo-derived embryonic stem cells.Sex chromosomes were identified as XX.Immunocytochemistry and quantitative real-time PCR detected high expression of the pluripotent gene,Oct4,at both the mRNA and protein levels,indicating pluripotent differentiation potential of the two embryonic stem cell subtypes.Embryonic stem cells were induced with retinoic acid to form embryoid bodies,and then dispersed into single cells.Single cells were differentiated in N2 differentiation medium for 9 days.Immunocytochemistry showed parthenogenetic and fertilized embryo-derived embryonic stem cells both express the neuronal cell markers nestin,βIII-tubulin and myelin basic protein.Quantitative real-time PCR found expression of neurogenesis related genes(Sox-1,Nestin,GABA,Pax6,Zic5 and Pitx1) in both types of embryonic stem cells,and Oct4 expression was significantly decreased.Nestin and Pax6 expression in parthenogenetic embryonic stem cells was significantly higher than that in fertilized embryo-derived embryonic stem cells.Thus,our experimental findings indicate that parthenogenetic embryonic stem cells have stronger neuronal differentiation potential than fertilized embryo-derived embryonic stem cells.
文摘The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine (TCM)-Jinyebaidu (JYBD) to guinea pig cytomegalovirus (GPCMV) intrauterine infection. The virus-free female and male guinea pigs were screened with nest-polymerase chain reaction (N-PCR). After inbred, pregnant guinea pigs were selected and divided into 3 groups randomly: 5 guniea pigs of the blank control group were not given either GPCMV or JYBD. 31 guniea pigs of the positive control group were inoculated 1 mL (10 7 TCID 50) suspension of GPCMV intraperitoneal. 10 guniea pigs of the experimental group were inoculated GPCMV firstly and then perfused stomach with JYBD for 14 days (Dosage in accordance with the modulus of the weight ratio of human to guniea pig). The effects of JYBD on the intrauterine infection of GPCMV were observed. The results showed that JYBD could decrease the maternal infection rate from 100 % (31/31) to 50 % (5/10) (P<0.001), the intrauterine infection rate from 100 % (72/72) to 75 % (21/28) (P<0.001), and the rate of abnormal outcome of pregnancy from 64.4 % (29/45) to 25.0 % (7/28) (P<0.001), the infective symptoms being relieved. It can be concluded that traditional Chinese medicine- JYBD can prevent and treat GPCMV intrauterine infection, and can be expected a prophylactic drug for HCMV intrauterine infection.
基金The work was supported in part by grants HD25869 and HD34041 from the National Institute of Child & Human Development
文摘The fertilization process is the net result of a complex sequence of events that collectively result in the fusion of the opposite gametes. The male gamete undergoes continuous morphological and biochemical modifications during sperm development in the testis (spermatogenesis), maturation in the epididymis, and capacitation in the female reproductive tract. Only the capacitated spermatozoa are able to recognize and bind to the bioactive glycan residue(s) on the ovum's extracellular coat, the zona pellucida (ZP). Sperm-zona binding in the mouse and several other species is believed to take place in two stages. First, capacitated (acrosome-intact) spermatozoa loosely and reversibly adhere to the zona-intact ovum. In the second stage tight irreversible binding occurs. Both types of bindings are attributed to the presence of glycan- binding proteins (receptors) on the sperm plasma membrane and their complementary bioactive glycan units (ligands) on the surface of the ZP. The carbohydrate-mediated adhesion event initiates a signal transduction cascade resulting in the exocytosis of acrosomal contents. This step is believed to be prerequisite which allows the hypemctivated acrosome-reacted spermatozoa to penetrate the ZP and fertilize the ovum. This review focuses on the role of carbohydrate residues in sperm-ovum interaction, and triggering of the acrosome reaction. I have attempted to discuss extensive progress that has been made to enhance our understanding of the well programmed multiple molecular events necessary for successful fertilization. This review will identify these events, and discuss the functional significance of carbohydrates in these events.
文摘Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical characterist ics and basic research. Results: Ambiguous genitalia are closely related to the functio n of androgen. It could be classified into 3 groups: androgen excess, androgen d eficiency and failure of gonadal differentiation. Differential diagnosis depends on clinical manifestations, chromosome examination, serum hormone determination s, final gonadal pathology, receptor study etc.Conclusion: Ambiguous genitalia are related to abnormal androgen ic effect and early correct etiological diagnosis is the key to its management.
文摘Objective: To summarize the clinical outcomes of 117 human vitrified blastocyst transfer cycles and to determine the impact factors.Methods: In IVF-ET cycles, supernumerary embryos were cultured to 5-Day(D5) or 6-Day(D6), blastocysts of various stages were cryopreserved by vitrification using cryoloops. Survival rate and clinical pregnancy rate were observed.Results: A total of 312 blastocysts were thawed in 117 frozen embryo transfer cycles, the survival rate was 90.7% (283/312) after thawing. After the transfer of 230 blastocysts in 115 cycles, 69.6% (80/115) of the women got clinically pregnant, and 17.5% (14/80) of them suffered from miscarriage, 39 healthy babies were born in 28 deliveries, and the other 38 pregnancies are ongoing. The implantation rate was 47.4% (109/230). In 107 transfer cycles with 2 hatched blastocysts transferred in each cycle, 72.9% (78/107) got clinically pregnant, while in 8 cycles with 1 or no hatched blastocysts in the two transferred blastocysts, the clinical pregnancy rate is 25%(2/8). The clinical pregnancy rates were not statistically different between natural (77.4%, 24/31) or artificial endometrium preparation (66.7%, 56/84) cycles. Conclusions: These findings suggest that blastocyst vitrification is effective in terms of implantation rate and pregnancy outcome. Transferring of two hatched blastocyst can achieve a higher pregnancy rate.
文摘Objective: The objective is to evaluate the effectiveness of chemotherapy as postoperative adjuvant therapy for stage IB-IIB cervical cancer with intermediate-risk factors. Methods: We retrospectively reviewed the medical records of 119 cervical cancer patients with intermediate-risk factors treated with radical hysterectomy and pelvic lymphadenectomy from December 1997 to September 2010. The intermediate-risk factors included bulky tumor (≥4 cm), lymphovascular space invasion, and deep stromal invasion. Sixteen patients did not receive adjuvant therapy (observation group);73 were treated with chemotherapy (CT group);30 were treated with adjuvant radiation therapy (RT group). The significance of the clinical parameters, 3- and 5-year overall survival (OS) rates of each group, was analyzed. Results: The 3- and 5-year OS rates between the observation group and adjuvant therapy group (CT plus RT groups) were not statistically different (3-year OS: 100% and 94.4%, respectively;5-year OS: 100% and 92.3%, respectively;p > 0.05). The 3- and 5-year OS rates between the CT group and RT group were also not statistically different (3-year OS: 93.6% and 96.4%, respectively;5-year OS: 80.7% and 96.4%, respectively;p < 0.05). Univariate and multivariate analysis of survival indicated that different adjuvant therapies were not independent prognostic indicators for IB-IIB cervical cancer patients with intermediate-risk factors. Conclusions: CT may have equivalent therapeutic effect as RT for stage IB-IIB cervical cancer patients with intermediate-risk factors after radical surgery, and prospective randomized trial is needed to study the effect of CT in these patients.
文摘Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.
文摘Objective:To compare the outcomes of vitrification using cryoloop with slow-freezing meth-od for human blastocyst cryopreservation.Methods:In IVF-ET cycles,supernumerary embryos were cultured to Day 5 or Day 6,blas-tocysts were cryopreserved by vitrification using cryoloops or slow-freezing method,then blasto-cyst survival rate and pregnant rate were compared.Results:115 vitrified blastocysts from 39 cycles were warmed,104(90.4%)blastocysts sur-vived.After the transfer of 74 blastocysts in 38 cycles,28(73.7%)women got clinically preg-nant,2(7.1%)of them suffered from miscarriage,2 healthy babies were born in 2 deliveries,and the other 24 pregnancies are ongoing.As to slow-freezing method,87 blastocysts from 21 cy-cles were thawed,37(42.5%)of them survived,28 blastoeysts were transferred in 15 cycles,6(40%)women got clinically pregnant,1 of them miscarried,3 healthy babies were born in 2 de-liveries,and the other 3 pregnancies are ongoing.Conclusion:The survival rate and pregnant rate of vitrification using cryoloop are superior totraditional slow-freezing method,and the transfer cancel rate is lower than that of slow-freezingmethod.The miscarriage rate is similar in two methods.
文摘To explore the reversal effect of mifepristone on multidrug resistance (MDR) in drug-resistant human breast cancer cell line MCF7/ADR and its mechanisms. Methods: Expression of MDR1 and MDR-associated protein(MRP) mRNA in MCF7/ADR cells was detected using reverse transcription- polymerase chain reaction(RT-PCR). Western blotting was used to assay the protein levels of P-glycoprotein (P-gp) and MRP. Intracellular rhodamine 123 retention and [3H]vincristine (VCR) accumulation were measured by flow cytometry and liquid scintillation counter, respectively. MTT reduction assay was used to determine the sensitivity of cells to the anticancer agent, adriamycin (ADR). Additionally, a MCF7/ADR cell xenograft model was established to assess the reversal effect of mifeprisone on MDR in MCF7/ADR cells in vivo. Results: Miferpristone dose-dependently down- regulated the expression of MDR1 and MRP mRNA in MCF7/ADR cells, accompanied by a significant decrease in the protein levels of P-gp and MRP. After exposure to 5, 10, and 20 mmol/L mifepristone, MCF7/ADR cells showed a 3.87-, 5.81-, and 7.40-fold increase in the accumulation of intracellular VCR(a known substrate of MRP), and a 2.14-, 4.39-, and 5.53-fold increase in the retention of intracellular rhodamine 123(an indicator of P-gp function), respectively. MTT analysis showed that the sensitivity of MCF7/ADR cells to ADR was enhanced by 7.23-, 13.62-, and 20.96-fold after incubation with mifepristone as above-mentioned doses for 96 h. In vivo, mifepristone effectively restored the chemosensitivity of MCF7/ADR cells to ADR. After 8 weeks of administration with ADR(2 mg穔g-1穌-1) alone or in combination with mifepristone(50 mg穔g-1穌-1), the growth inhibitory rate of xenografted tumors in nude mice was 8.08% and 37.25%, respectively. Conclusion: Mifepristone exerts potent reversal effects on MDR in MCF7/ADR cells in vitro and in vivo through down- regulation of MDR1/P-gp and MRP expression and inhibition of P-gp- and MRP-dependent drug efflux, thus increasing the sensitivity to anticancer drug.
基金supported by Soft Science Research Project in Hebei Province(12457612)
文摘Objective:To study the change of TIZ expression in epithelial ovarian cancer cells.Methods:HO8910 cells were transinfected with siRNA to inhibit the expression of TIZ.pcDNA3.1-TIZ vectors were combined to increase the TIZ expression level.The cell viabilily,colony forming efficiency and cycle distribution of HO8910,HO8910/NC,HO8910/pcDNA3.1-NC,HO8910/ TIZ-573 and HO8910/pcDNA3.l-TIZ were compared,and the invasion rate,migration rate and adhesion rate between 5 groups of cells were compared.Results:Compared with those of HO8910,HO8910/NC and HO8910/pcDNA3.1-NC,the cell viability,colony forming efficiency and cell cycle distribution of HO8910/ TIZ-573 were increased,while the indexes of HO8910/pcDNA3.1-NC were decreased with statistical significant difference(P<0.05).There was no statistical significant difference in the invasion rate,migration rate and adhesion rate between 5 groups of cells(P>0.05).Conclusions:The expression of TIZ can inhibit the proliferation of epithelial ovarian cancer cells.
文摘The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concentrated oxygen administration. This study investigated changes in cognitive ability, blood oxygen saturation (%), and heart rate (beats/min) in normal elderly subjects at three different levels of oxygen [21% (1 L/min), 93% (1 L/min), and 93% (5 L/min)] administered during a 1-back task. Eight elderly male (75.3 ± 4.3 years old) and 10 female (71.1 ± 3.9 years old) subjects, who were normal in cognitive ability as shown by a score of more than 24 points in the Mini-Mental State Examination-Korea, participated in the experiment. The experiment consisted of an adaptation phase after the start of oxygen administration (3 minutes), a control phase to obtain stable baseline measurements of heart rate and blood oxygen saturation before the task (2 minutes), and a task phase during which the 1-back task was performed (2 minutes). Three levels of oxygen were administered throughout the three phases (7 minutes). Blood oxygen saturation and heart rate were measured during each phase. Our results show that blood oxygen saturation increased, heart rate decreased, and response time in the 1-back task decreased as the concentration and amount of administered oxygen increased. This shows that administration of sufficient oxygen for optimal cognitive functioning increases blood oxygen saturation and decreases heart rate.
文摘Background: Endometriosis is an important cause of infertility and chronic pelvic pain. Our study aims to understand the cause and effect relationship of endometriosis with these two clinical presentations. Objectives: 1) To study the correlation between stage of endometriosis with pain and infertility;2) To evaluate role of transvaginal ultrasound for diagnosis of endometriosis using laparoscopic diagnosis as gold standard. Methodology: Total of 89 women presenting with infertility and or pain and with laparoscopic findings of endometriosis were included in the study. The results were analysed by logistic regression. Results: The mean age of women was 29.67 years. Seventy three percent of patients had moderate to severe disease while 31.46% of patients with endometriosis were infertile. Symptom of pain could be categorised as dysmenorrhea (71.47%), dyspareunia (41.5%) and dyschezia (15.7%). There was no association of endometriosis stage with the pain type, duration of symptoms. Transvaginal ultrasound seems a reliable test for diagnosis of ovarian endometriosis and advanced stage disease. 87.5% of patients with ovarian endometrioma had advanced disease (higher than Stage II rAFS). Conclusion: No correlation was found between the stage of endometriosis and severity of symptoms. Presence of endometrioma on USG was associated with advanced stage of endometriosis.
文摘Objective: The aim of this study was to determine the influence of long-term low-dose hor mone replacement therapy (HRT) on the intima-media wall of the carotid artery in postmenopa usal women by ultrasound.Methods: 146 postmenopausal women were divided into the HRT group(n= 68, HRT over 5years after menopause) and the control group(n= 78, no HRT). The intima-media thickness (IMT) of the carotid arteries was measured bilaterally, the characteristics of the atherosclerotic plaques were described, the peak systolic velocity (PSV) and resistance index (RI) were measured by ultrasound examination.Results: The IMT of HRT group was significantly smaller than that of the control group,(0. 089±0. 22) cm vs (0. 093±0.29) cm, (P＜0. 01). The occurrence of plaques was reduced in HRT group than the control group (7.7% vs 12.7%, P＜0. 05). The plaques were most frequently found at the bifurcation of the arteries. The soft and mixed plaques in HRT group were found significantly less than that of the control group (soft 1.7% vs 4. 5%, mixed 3.1% vs 6. 7%, both P＜0.05), while the hard plaques in HRT group were more than those of the control group(2.6% vs 1.3%, P＜0. 05). The maximum plaque thickness of HRT group was less than that of control group (0. 191±0. 057) cm vs (0. 226±0. 073) cm, (P＜0.05). The internal carotid artery PSV and RI in the two groups were similar [PSV (65.61±26.55) cm/s vs (64.82±27. 22) cm/s, RI (0.67±0. 082) vs (0. 68±0. 075), both P＞0.05].Conclusion: Our study indicated that HRT may has an effect to reduce the carotid IMT thickness, inhibit the plaque formation, and make the plaques harder and more stable. The long-term low-dose HRT may protect the postmenopausal women against the artherosclerosis of the carotid artery.
文摘Objective: To determine the association of apoptosis in the layers of human fetal membranes distal to rupture site with labor at term. Study Design: Fetal membranes were collected from elective cesarean sections (n = 8) and spontaneous vaginal deliveries (n = 8) at term. The extent of apoptosis within fetal membrane layers was determined using terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling (TUNEL) assay and western blots for pro-apoptotic active caspase-3 and anti-apoptotic Bcl-2. Results: Apoptotic index in chorionic trophoblasts of membranes distal to rupture site obtained after vaginal delivery was 3-fold higher than those obtained from elective cesarean (11.57% ± 4.98% and 4.05% ± 2.4% respectively;p = 0.012). The choriodecidua layers after vaginal deliveries had higher expression of the pro-apoptotic active caspase-3 and less expression of the anti-apoptotic Bcl-2 than those obtained from elective cesarean sections. Conclusions: Labor at term is associated with increased apoptosis in chorionic trophoblast cells of human fetal membranes distal to rupture site.
文摘Objective: To identify current treatment strategies for postpartum hemorrhage used by obstetricians (OB/GYNs) and hematologists (HEMs). Study Design: We conducted a survey of OB/GYNs (n = 220) and HEMs (n = 30) to describe the characteristics of current treatment strategies for postpartum hemorrhage. Surveys were administered via a structured questionnaire on a secure internet website from 5 - 12 October 2009. Results: The majority of OB/GYN and HEM respondents were practicing in a community hospital environment (77%). Of the OB/GYNs, the majority practiced at hospitals with over 2000 deliveries per year (77%). A majority (58%) of OB/GYNs were affiliated with hospitals that lacked a massive transfusion protocol to treat severe postpartum hemorrhage. Subsequent to uterine massage and additional oxytocin, the majority of OB/GYNs (73%), preferred the administration of Methergine? as the next level of intervention for postpartum hemorrhage. There was considerable variability in response to specific treatment strategies for several hypothetical case scenarios;however, the large majority of OB/GYNs favored obstetrical procedures over interventional radiology or administration of rFVIIa. A large majority (77%) of physicians who are familiar with rRVIIa as treatment for postpartum hemorrhage reported being very satisfied with the agent for this indication. Conclusions: An established, systematic treatment strategy among OB/GYNs emerged only in the case of mild postpartum hemorrhage.
