Pub Date : 2025-02-25DOI: 10.3760/cma.j.cn112141-20240823-00467
S Zhu, X Yan, J C Song, X H Huang
Objective: To investigate the effectiveness, safety and feasibility of transumbilical laparoendoscopic single-site surgery (TU-LESS) for abdominal wall endometriosis (AWE) lesion resection. Methods: A total of 11 patients who underwent AWE lesion resection via TU-LESS at The First Affiliated Hospital of Nanjing Medical University from January 2022 to May 2024 were enrolled. The size, invasion depth of the lesion, horizontal distance from the lesion center to the original surgical scar, vertical distance from the lesion to the skin, body mass index (BMI), the thickness of abdominal wall fat, operative time, intraoperative blood loss, perioperative complications, postoperative pathology, postoperative incision healing and recurrence were recorded and analyzed. Results: All 11 patients in this study had a history of cesarean section, 10 of whom had transverse incision and 1 had longitudinal incision. The age was (35.0±6.2) years old. BMI was (25.0±4.0) kg/m2, with the highest being 33.9 kg/m2. The lesion size was (24.7±12.1) mm, with an average horizontal distance from the lesion center to the original surgical scar of (11.6±6.0) mm. The abdominal wall fat thickness was (21.4±5.8) mm, and the vertical distance from the lesion to the skin was (14.5±7.9) mm. There were a total of 12 lesions in the 11 patients. Among them, 1 lesion extended to the peritoneum inferiorly, 5 lesions extended to the rectus abdominis inferiorly, 5 lesions reached the anterior sheath of the rectus abdominis inferiorly, and 1 lesion was completely located within the abdominal wall fat. The operative time was (84.2±35.4) minutes, and the intraoperative blood loss was (9.0±4.2) ml. The postoperative incision healing of all patients was grade A. The anatomical structure of their umbilical region remained normal, free from any scarring, which contributed to the high satisfaction levels expressed by the patients. Postoperative pathological examination confirmed endometriosis with negative surgical margins, and no recurrence had been observed during follow-up. Conclusion: TU-LESS for AWE lesion resection is safe and feasible, particularly suitable for patients with lesions located far from the original surgical scar, deep lesion location, thick abdominal wall fat, and multiple focal leisons.
{"title":"[Preliminary discussion on transumbilical laparoendoscopic single-site surgery for abdominal wall endometriosis lesion resection].","authors":"S Zhu, X Yan, J C Song, X H Huang","doi":"10.3760/cma.j.cn112141-20240823-00467","DOIUrl":"10.3760/cma.j.cn112141-20240823-00467","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effectiveness, safety and feasibility of transumbilical laparoendoscopic single-site surgery (TU-LESS) for abdominal wall endometriosis (AWE) lesion resection. <b>Methods:</b> A total of 11 patients who underwent AWE lesion resection via TU-LESS at The First Affiliated Hospital of Nanjing Medical University from January 2022 to May 2024 were enrolled. The size, invasion depth of the lesion, horizontal distance from the lesion center to the original surgical scar, vertical distance from the lesion to the skin, body mass index (BMI), the thickness of abdominal wall fat, operative time, intraoperative blood loss, perioperative complications, postoperative pathology, postoperative incision healing and recurrence were recorded and analyzed. <b>Results:</b> All 11 patients in this study had a history of cesarean section, 10 of whom had transverse incision and 1 had longitudinal incision. The age was (35.0±6.2) years old. BMI was (25.0±4.0) kg/m<sup>2</sup>, with the highest being 33.9 kg/m<sup>2</sup>. The lesion size was (24.7±12.1) mm, with an average horizontal distance from the lesion center to the original surgical scar of (11.6±6.0) mm. The abdominal wall fat thickness was (21.4±5.8) mm, and the vertical distance from the lesion to the skin was (14.5±7.9) mm. There were a total of 12 lesions in the 11 patients. Among them, 1 lesion extended to the peritoneum inferiorly, 5 lesions extended to the rectus abdominis inferiorly, 5 lesions reached the anterior sheath of the rectus abdominis inferiorly, and 1 lesion was completely located within the abdominal wall fat. The operative time was (84.2±35.4) minutes, and the intraoperative blood loss was (9.0±4.2) ml. The postoperative incision healing of all patients was grade A. The anatomical structure of their umbilical region remained normal, free from any scarring, which contributed to the high satisfaction levels expressed by the patients. Postoperative pathological examination confirmed endometriosis with negative surgical margins, and no recurrence had been observed during follow-up. <b>Conclusion:</b> TU-LESS for AWE lesion resection is safe and feasible, particularly suitable for patients with lesions located far from the original surgical scar, deep lesion location, thick abdominal wall fat, and multiple focal leisons.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"128-135"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-25DOI: 10.3760/cma.j.cn112141-20240726-00416
Y F Chen, P Bai, Y Q Zhao, L N Cong, N Li, J Zuo, G Y Zhang, Y C Sun, S M Li, Q Li
Objective: To investigate the application of pedicled or perforator flaps transfer in the stage Ⅰ tissue defect repair after vulvar cancer surgery. Methods: From January 2005 to December 2023, 20 patients with vulvar cancer who underwent extensive episiectomy or extended episiectomy±inguinal lymph node resection+vulvar defect flap transfer were collected in Huanxing Cancer Hospital of Chaoyang District and Cancer Hospital and Peking Union Medical College, Chinese Academy of Medical Sciences. The survival status, appearance structure, sexual function satisfaction, tumor recurrence, and survival were analyzed. Results: (1) The median age of the 20 patients was 59 years (ranged: 29-73 years). There were 14 patients with recurrence and 6 patients with initial treatment. Pathological types: 14 cases of squamous cell carcinoma, 4 cases of Paget's disease, 1 case of malignant melanoma, 1 case of adenoid cystic carcinoma (salivary gland type carcinoma). (2) Among the 20 patients, 6 cases underwent extensive episiotomy and 14 underwent extended episiotomy (1 of them underwent extensive excision of inguinal masses). Simultaneous inguinal lymphadenectomy (or dissection) were performed in 11 cases, including 7 cases of bilateral inguinal lymph node resection (or dissection) and 4 cases of unilateral inguinal lymph node resection (or dissection). Flap source: pedicled flap in 12 cases, perforator flap in 8 cases. All the 20 patients were removed at 10-14 days after operation, and all of them survived with rosy skin color and good elasticity. Seventeen cases of transferred flaps healed at stage Ⅰ, 2 cases healed at about 6 weeks due to incision leakage, and 1 case healed at 6 weeks after incision infection debridement. Six months after the operation, 2 cases felt that the pubic mound was thick and swollen. The other 18 cases showed vulva fullness and elasticity, no displacement of urethral opening, no deviation of urethra during urination, no stenosis of vaginal opening, no vulvar scar pain. In addition to 1 unmarried 29-year-old patient and 6 patients over 65 years old who had no sexual life before and after surgery, the other 13 patients had normal sexual life after surgery. (3) The follow-up period were 6 to 100 months, and 9 cases (45%, 9/20) relapsed during the follow-up period. There were 5 deaths (25%, 5/20), who were due to recurrence of vulvar cancer. The 5-year survival rate of 20 patients was 75%, including 83% in 6 patients with initial treatment and 71% in 14 patients with recurrence and reoperation. Conclusions: The combination of flap transfer for episioplasty with vulvar cancer surgery does not affect the wound healing. Because the external structure of the vulva is repaired, it could effectively improve the local wound healing ability and improve the organ function, and has good clinical application value.
{"title":"[Application of pedicle or perforator flaps transfer in the stage Ⅰ tissue defect repair after vulvar cancer surgery].","authors":"Y F Chen, P Bai, Y Q Zhao, L N Cong, N Li, J Zuo, G Y Zhang, Y C Sun, S M Li, Q Li","doi":"10.3760/cma.j.cn112141-20240726-00416","DOIUrl":"10.3760/cma.j.cn112141-20240726-00416","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the application of pedicled or perforator flaps transfer in the stage Ⅰ tissue defect repair after vulvar cancer surgery. <b>Methods:</b> From January 2005 to December 2023, 20 patients with vulvar cancer who underwent extensive episiectomy or extended episiectomy±inguinal lymph node resection+vulvar defect flap transfer were collected in Huanxing Cancer Hospital of Chaoyang District and Cancer Hospital and Peking Union Medical College, Chinese Academy of Medical Sciences. The survival status, appearance structure, sexual function satisfaction, tumor recurrence, and survival were analyzed. <b>Results:</b> (1) The median age of the 20 patients was 59 years (ranged: 29-73 years). There were 14 patients with recurrence and 6 patients with initial treatment. Pathological types: 14 cases of squamous cell carcinoma, 4 cases of Paget's disease, 1 case of malignant melanoma, 1 case of adenoid cystic carcinoma (salivary gland type carcinoma). (2) Among the 20 patients, 6 cases underwent extensive episiotomy and 14 underwent extended episiotomy (1 of them underwent extensive excision of inguinal masses). Simultaneous inguinal lymphadenectomy (or dissection) were performed in 11 cases, including 7 cases of bilateral inguinal lymph node resection (or dissection) and 4 cases of unilateral inguinal lymph node resection (or dissection). Flap source: pedicled flap in 12 cases, perforator flap in 8 cases. All the 20 patients were removed at 10-14 days after operation, and all of them survived with rosy skin color and good elasticity. Seventeen cases of transferred flaps healed at stage Ⅰ, 2 cases healed at about 6 weeks due to incision leakage, and 1 case healed at 6 weeks after incision infection debridement. Six months after the operation, 2 cases felt that the pubic mound was thick and swollen. The other 18 cases showed vulva fullness and elasticity, no displacement of urethral opening, no deviation of urethra during urination, no stenosis of vaginal opening, no vulvar scar pain. In addition to 1 unmarried 29-year-old patient and 6 patients over 65 years old who had no sexual life before and after surgery, the other 13 patients had normal sexual life after surgery. (3) The follow-up period were 6 to 100 months, and 9 cases (45%, 9/20) relapsed during the follow-up period. There were 5 deaths (25%, 5/20), who were due to recurrence of vulvar cancer. The 5-year survival rate of 20 patients was 75%, including 83% in 6 patients with initial treatment and 71% in 14 patients with recurrence and reoperation. <b>Conclusions:</b> The combination of flap transfer for episioplasty with vulvar cancer surgery does not affect the wound healing. Because the external structure of the vulva is repaired, it could effectively improve the local wound healing ability and improve the organ function, and has good clinical application value.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"136-143"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-25DOI: 10.3760/cma.j.cn112141-20241105-00586
Y W Fan, G C Zhao, S Y Yang, W H Chen, N N Zhao, H Y Liu
<p><p><b>Objective:</b> To explore the clinical efficacy of three different surgical timings of modified cervical cerclage in twin pregnant women with cervical insufficiency. <b>Methods:</b> The clinical data of 73 twin pregnant women who underwent modified cervical cerclage and had pregnancy outcomes in Qilu Hospital of Shandong University (Qingdao) from April 2014 to July 2023 were retrospectively analyzed. According to the different timings of surgery, they were divided into prophylactic cerclage group, ultrasound-indicated cerclage group (further divided into cervical length (CL)≤15 mm and 15 mm<CL<25 mm subgroups) and emergency cerclage group. The differences in pregnancy and neonatal outcomes among the three groups were compared. The clinical data and pregnancy outcomes of pregnant women delivered at <34 weeks and ≥34 weeks were compared, and multivariate logistic regression was used to analyze the influencing factors of preterm birth before 34 weeks. <b>Results:</b> (1) The prolonged gestational age and postoperative CL in the prophylactic cerclage group were longer than those in the ultrasound-indicated cerclage group; the gestational age at delivery, prolonged gestational age, postoperative CL, live birth rate and neonatal birth weight in the prophylactic cerclage group were higher than those in the ultrasound-indicated cerclage group, and the preterm birth rate before 34, 32 and 28 weeks of gestation and premature rupture of membranes were lower than those in the emergency cerclage group; the gestational age of delivery, prolonged gestational age, postoperative CL, live birth rate and the rate of neonatal birth weight of the pregnant women in the ultrasound-indicated cerclage group were higher than those in the emergency cerclage group, and the rate of premature birth before 34, 32 and 28 weeks of gestation and late neonatal birth weight <1 500 g were lower than those in the emergency cerclage group; the differences were statistically significant (all <i>P</i><0.05). (2) The gestational age and postoperative CL in the 15 mm<CL<25 mm group were longer than those in the CL≤15 mm group, and the gestational age at delivery and neonatal birth weight in the CL≤15 mm group were higher than those in the emergency cerclage group. The incidence of preterm birth before 32 weeks of gestation and birth weight <1 500 g in the cervical dilatation group were significantly lower than those in the emergency cerclage group (all <i>P</i><0.05). (3) The incidence of abnormal cervicovaginal discharge and postoperative C-reactive protein (CRP) level of pregnant women with delivery gestational age <34 weeks were significantly higher than those of pregnant women with delivery gestational age ≥34 weeks, while preoperative CL and postoperative CL were significantly shorter than those of pregnant women with delivery gestational age ≥34 weeks (all <i>P</i><0.05). Multivariate logistic regression analysis showed that postoperative CRP>10 mg/L was a risk factor for p
{"title":"[Clinical study of modified cervical cerclage at different surgical timings in twin pregnant women with cervical insufficiency].","authors":"Y W Fan, G C Zhao, S Y Yang, W H Chen, N N Zhao, H Y Liu","doi":"10.3760/cma.j.cn112141-20241105-00586","DOIUrl":"10.3760/cma.j.cn112141-20241105-00586","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical efficacy of three different surgical timings of modified cervical cerclage in twin pregnant women with cervical insufficiency. <b>Methods:</b> The clinical data of 73 twin pregnant women who underwent modified cervical cerclage and had pregnancy outcomes in Qilu Hospital of Shandong University (Qingdao) from April 2014 to July 2023 were retrospectively analyzed. According to the different timings of surgery, they were divided into prophylactic cerclage group, ultrasound-indicated cerclage group (further divided into cervical length (CL)≤15 mm and 15 mm<CL<25 mm subgroups) and emergency cerclage group. The differences in pregnancy and neonatal outcomes among the three groups were compared. The clinical data and pregnancy outcomes of pregnant women delivered at <34 weeks and ≥34 weeks were compared, and multivariate logistic regression was used to analyze the influencing factors of preterm birth before 34 weeks. <b>Results:</b> (1) The prolonged gestational age and postoperative CL in the prophylactic cerclage group were longer than those in the ultrasound-indicated cerclage group; the gestational age at delivery, prolonged gestational age, postoperative CL, live birth rate and neonatal birth weight in the prophylactic cerclage group were higher than those in the ultrasound-indicated cerclage group, and the preterm birth rate before 34, 32 and 28 weeks of gestation and premature rupture of membranes were lower than those in the emergency cerclage group; the gestational age of delivery, prolonged gestational age, postoperative CL, live birth rate and the rate of neonatal birth weight of the pregnant women in the ultrasound-indicated cerclage group were higher than those in the emergency cerclage group, and the rate of premature birth before 34, 32 and 28 weeks of gestation and late neonatal birth weight <1 500 g were lower than those in the emergency cerclage group; the differences were statistically significant (all <i>P</i><0.05). (2) The gestational age and postoperative CL in the 15 mm<CL<25 mm group were longer than those in the CL≤15 mm group, and the gestational age at delivery and neonatal birth weight in the CL≤15 mm group were higher than those in the emergency cerclage group. The incidence of preterm birth before 32 weeks of gestation and birth weight <1 500 g in the cervical dilatation group were significantly lower than those in the emergency cerclage group (all <i>P</i><0.05). (3) The incidence of abnormal cervicovaginal discharge and postoperative C-reactive protein (CRP) level of pregnant women with delivery gestational age <34 weeks were significantly higher than those of pregnant women with delivery gestational age ≥34 weeks, while preoperative CL and postoperative CL were significantly shorter than those of pregnant women with delivery gestational age ≥34 weeks (all <i>P</i><0.05). Multivariate logistic regression analysis showed that postoperative CRP>10 mg/L was a risk factor for p","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-25DOI: 10.3760/cma.j.cn112141-20240829-00481
J H Lang
{"title":"[Do not injury, please！].","authors":"J H Lang","doi":"10.3760/cma.j.cn112141-20240829-00481","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240829-00481","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"81-82"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-25DOI: 10.3760/cma.j.cn112141-20241119-00612
C Y Shi, H X Yang
{"title":"[Challenges and considerations in diagnosis and treatment of cervical insufficiency].","authors":"C Y Shi, H X Yang","doi":"10.3760/cma.j.cn112141-20241119-00612","DOIUrl":"10.3760/cma.j.cn112141-20241119-00612","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"94-98"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-25DOI: 10.3760/cma.j.cn112141-20250106-00012
{"title":"[Chinese expert consensus on the role of hysteroscopic morphological characteristics in the fertility preservation treatment for endometrial cancer].","authors":"","doi":"10.3760/cma.j.cn112141-20250106-00012","DOIUrl":"10.3760/cma.j.cn112141-20250106-00012","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"83-93"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.3760/cma.j.cn112141-20240511-00272
L Li, H Y Wang, J Qiao, R Li, P Liu
Objective: To explore biomarkers for the efficacy of lymphocyte immunotherapy (LIT) treating women with unexplained recurrent spontaneous abortion (URSA). Methods: Serum samples from 24 URSA potients who received LIT were collected at Peking University Third Hospital from December 2014 to June 2015. Semiquantitative sandwich-based antibody arrays containing 40 cytokines were used to screen target immune cytokines in the peripheral blood of URSA patients before and after LIT. Multifactor quantitative microsphere flow cytometry detection validated the levels of target cytokines. Based on the final pregnancy outcome after LIT, 24 URSA patients were divided into the full-term delivery group (15 cases) and the abortion group (9 cases). Furthermore, linear regression analysis were applied to evaluate the relationship between target cytokines and pregnancy outcomes. Results: Semiquantitative sandwich-based antibody arrays suggested that, among all 24 URSA patients included in this study, the intensities of the fluorescence signal were significantly lower post-LIT versus pre-LIT for the following cytokines: interleukin-15 (IL-15), monokine induced by γ-interferon (MIG), C-C motif chemokine ligand (CCL) 1 (all P<0.05). In the full-term delivery group, the intensities of the fluorescence signal post-LIT were significantly lower than pre-LIT for the following cytokines: IL-15, CCL1, macrophage inflammatory protein (MIP) 1α (all P<0.05). In the abortion group, the intensities of the fluorescence signal post-LIT were significantly lower than pre-LIT for the following cytokines: MIG, MIP-1δ (all P<0.05). Linear regression analysis showed that the intensity of the fluorescence signal of CCL11 was increased and the intensity of the fluorescence signal of soluble tumor necrosis factor receptor 2 (sTNFR2) was decreased in the full-term delivery group after LIT, the differences were statistically significant (P=0.012, 0.029). Validation results of multifactor quantitative microsphere flow cytometry detection showed that the level of CCL11 was significantly increased (P=0.001) and the level of sTNFR2 was significantly decreased (P=0.001) in the full-term delivery group after LIT. Conclusion: CCL11 and sTNFR2 maybe serve as potential biomarkers that could predict pregnancy outcomes after LIT in women with URSA.
{"title":"[Exploration of CCL11 and sTNFR2 as potential biomarkers for the efficacy of lymphocyte immunotherapy in women with unexplained recurrent spontaneous abortion].","authors":"L Li, H Y Wang, J Qiao, R Li, P Liu","doi":"10.3760/cma.j.cn112141-20240511-00272","DOIUrl":"10.3760/cma.j.cn112141-20240511-00272","url":null,"abstract":"<p><p><b>Objective:</b> To explore biomarkers for the efficacy of lymphocyte immunotherapy (LIT) treating women with unexplained recurrent spontaneous abortion (URSA). <b>Methods:</b> Serum samples from 24 URSA potients who received LIT were collected at Peking University Third Hospital from December 2014 to June 2015. Semiquantitative sandwich-based antibody arrays containing 40 cytokines were used to screen target immune cytokines in the peripheral blood of URSA patients before and after LIT. Multifactor quantitative microsphere flow cytometry detection validated the levels of target cytokines. Based on the final pregnancy outcome after LIT, 24 URSA patients were divided into the full-term delivery group (15 cases) and the abortion group (9 cases). Furthermore, linear regression analysis were applied to evaluate the relationship between target cytokines and pregnancy outcomes. <b>Results:</b> Semiquantitative sandwich-based antibody arrays suggested that, among all 24 URSA patients included in this study, the intensities of the fluorescence signal were significantly lower post-LIT versus pre-LIT for the following cytokines: interleukin-15 (IL-15), monokine induced by γ-interferon (MIG), C-C motif chemokine ligand (CCL) 1 (all <i>P</i><0.05). In the full-term delivery group, the intensities of the fluorescence signal post-LIT were significantly lower than pre-LIT for the following cytokines: IL-15, CCL1, macrophage inflammatory protein (MIP) 1α (all <i>P</i><0.05). In the abortion group, the intensities of the fluorescence signal post-LIT were significantly lower than pre-LIT for the following cytokines: MIG, MIP-1δ (all <i>P</i><0.05). Linear regression analysis showed that the intensity of the fluorescence signal of CCL11 was increased and the intensity of the fluorescence signal of soluble tumor necrosis factor receptor 2 (sTNFR2) was decreased in the full-term delivery group after LIT, the differences were statistically significant (<i>P</i>=0.012, 0.029). Validation results of multifactor quantitative microsphere flow cytometry detection showed that the level of CCL11 was significantly increased (<i>P</i>=0.001) and the level of sTNFR2 was significantly decreased (<i>P</i>=0.001) in the full-term delivery group after LIT. <b>Conclusion:</b> CCL11 and sTNFR2 maybe serve as potential biomarkers that could predict pregnancy outcomes after LIT in women with URSA.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 1","pages":"24-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.3760/cma.j.cn112141-20240807-00439
S W Wu, N Zhang
<p><p><b>Objective:</b> To investigate the impact of preconception body mass index (BMI) on neonatal birth weight and the risk of macrosomia in pregnant women across various age groups. <b>Methods:</b> A cohort study was conducted, selecting pregnant women who underwent their initial prenatal assessment at Beijing Obstetrics and Gynecology Hospital from September 1st, 2018 to March 31st, 2020. Relevant data were collected from the hospital's electronic medical record system. Logistic regression nested cubic spline was used to analyze the nonlinear association between preconception BMI and neonatal birth weight. Binary logistic regression was also employed to assess the association between preconception BMI and macrosomia risk. <b>Results:</b> (1) A total of 13 015 pregnant women were examined, revealing an incidence of macrosomia of 6.33% (824/13 015). The preconception BMI of pregnant women in the macrosomia group was significantly higher than that in the non-macrosomia group [(23.1±3.4) vs (21.6±3.1) kg/m<sup>2</sup>], and the age was significantly higher than that in the non-macrosomia group [(32.1±3.6) vs (31.7±3.7) years], the differences were statistically significant (all <i>P</i><0.05). (2) Preconception BMI was positively correlated with neonatal birth weight. Pregnant women with preconception BMI of 15.0 kg/m<sup>2</sup>, 20.0 kg/m<sup>2</sup>, and 25.0 kg/m<sup>2</sup> had decreased birth weight of 121 g (95%<i>CI</i>: 35-183 g) and increased birth weights of 78 g (95%<i>CI</i>: 54-102 g) and 182 g (95%<i>CI</i>: 151-213 g), respectively, compared to those with a preconception BMI of 18.0 kg/m<sup>2</sup>. (3) For each 1.0 kg/m<sup>2</sup> increase in preconception BMI, the risk of macrosomia increased by 14% (<i>OR</i>=1.14, 95%<i>CI</i>: 1.11-1.16; <i>P</i><0.001). When stratified by age, it was observed that elevated preconception BMI significantly increased the incidence of macrosomia in women aged 27-38 years. Among them, the risk of delivering macrosomia among 37 years old pregnant women was most affected by preconception BMI (<i>OR</i>=1.33, 95%<i>CI</i>: 1.17-1.51; <i>P</i><0.001). (4) The stability and sensitivity analysis results showed that the preconception BMI of pregnant women with a preconception BMI of 18.0-<25.0 kg/m<sup>2</sup> had a significant impact on the risk of macrosomia (<i>OR</i>=1.23, 95%<i>CI</i>: 1.17-1.29; <i>P</i><0.001), while the preconception BMI of other preconception BMI stratification pregnant women had no significant impact on the risk of macrosomia (all <i>P</i>>0.05). Hypertension disorders in pregnancy, gestational diabetes mellitus and abnormal blood lipid during pregnancy were not the mediators associated with preconception BMI and macrosomia. After excluding three factors respectively, the impact of preconception BMI on the risk of macrosomia was the same as before (<i>OR</i>=1.14, 95%<i>CI</i>: 1.11-1.16; <i>P</i><0.001). <b>Conclusions:</b> Preconception BMI is linked to neonatal birth wei
{"title":"[Age-stratified association between preconception body mass index and risk of macrosomia at delivery].","authors":"S W Wu, N Zhang","doi":"10.3760/cma.j.cn112141-20240807-00439","DOIUrl":"10.3760/cma.j.cn112141-20240807-00439","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of preconception body mass index (BMI) on neonatal birth weight and the risk of macrosomia in pregnant women across various age groups. <b>Methods:</b> A cohort study was conducted, selecting pregnant women who underwent their initial prenatal assessment at Beijing Obstetrics and Gynecology Hospital from September 1st, 2018 to March 31st, 2020. Relevant data were collected from the hospital's electronic medical record system. Logistic regression nested cubic spline was used to analyze the nonlinear association between preconception BMI and neonatal birth weight. Binary logistic regression was also employed to assess the association between preconception BMI and macrosomia risk. <b>Results:</b> (1) A total of 13 015 pregnant women were examined, revealing an incidence of macrosomia of 6.33% (824/13 015). The preconception BMI of pregnant women in the macrosomia group was significantly higher than that in the non-macrosomia group [(23.1±3.4) vs (21.6±3.1) kg/m<sup>2</sup>], and the age was significantly higher than that in the non-macrosomia group [(32.1±3.6) vs (31.7±3.7) years], the differences were statistically significant (all <i>P</i><0.05). (2) Preconception BMI was positively correlated with neonatal birth weight. Pregnant women with preconception BMI of 15.0 kg/m<sup>2</sup>, 20.0 kg/m<sup>2</sup>, and 25.0 kg/m<sup>2</sup> had decreased birth weight of 121 g (95%<i>CI</i>: 35-183 g) and increased birth weights of 78 g (95%<i>CI</i>: 54-102 g) and 182 g (95%<i>CI</i>: 151-213 g), respectively, compared to those with a preconception BMI of 18.0 kg/m<sup>2</sup>. (3) For each 1.0 kg/m<sup>2</sup> increase in preconception BMI, the risk of macrosomia increased by 14% (<i>OR</i>=1.14, 95%<i>CI</i>: 1.11-1.16; <i>P</i><0.001). When stratified by age, it was observed that elevated preconception BMI significantly increased the incidence of macrosomia in women aged 27-38 years. Among them, the risk of delivering macrosomia among 37 years old pregnant women was most affected by preconception BMI (<i>OR</i>=1.33, 95%<i>CI</i>: 1.17-1.51; <i>P</i><0.001). (4) The stability and sensitivity analysis results showed that the preconception BMI of pregnant women with a preconception BMI of 18.0-<25.0 kg/m<sup>2</sup> had a significant impact on the risk of macrosomia (<i>OR</i>=1.23, 95%<i>CI</i>: 1.17-1.29; <i>P</i><0.001), while the preconception BMI of other preconception BMI stratification pregnant women had no significant impact on the risk of macrosomia (all <i>P</i>>0.05). Hypertension disorders in pregnancy, gestational diabetes mellitus and abnormal blood lipid during pregnancy were not the mediators associated with preconception BMI and macrosomia. After excluding three factors respectively, the impact of preconception BMI on the risk of macrosomia was the same as before (<i>OR</i>=1.14, 95%<i>CI</i>: 1.11-1.16; <i>P</i><0.001). <b>Conclusions:</b> Preconception BMI is linked to neonatal birth wei","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 1","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.3760/cma.j.cn112141-20240805-00436
E N Liu, F Miao, Y F Zhou
{"title":"[Research advances of diagnosis and treatment of rectovaginal septum endometriosis].","authors":"E N Liu, F Miao, Y F Zhou","doi":"10.3760/cma.j.cn112141-20240805-00436","DOIUrl":"10.3760/cma.j.cn112141-20240805-00436","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.3760/cma.j.cn112141-20240930-00532
H Y Dong, L Li
{"title":"[Research progress in neoadjuvant therapy for epithelial ovarian cancer].","authors":"H Y Dong, L Li","doi":"10.3760/cma.j.cn112141-20240930-00532","DOIUrl":"10.3760/cma.j.cn112141-20240930-00532","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 1","pages":"71-78"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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