目的 通过检测人睾丸生殖细胞肿瘤中的Skp2蛋白质异常表达,探讨相关意义。 方法 应用S-P免疫组织化学法检测睾丸生殖细胞肿瘤，正常睾丸组织和慢性睾丸炎组织中Skp2的表达。 结果 睾丸生殖细胞肿瘤中Skp2阳性表达率为74.5%，正常睾丸组织中Skp2阳性表达率为20.0%，在慢性睾丸炎组织中Skp2阳性表达率为40.0%，在3种不同睾丸组织中表达差异有统计学意义（P＜0.05）；Skp2表达与不同组织学类型的睾丸生殖细胞肿瘤无相关性（P＞0.05）；随着临床分期的增高，睾丸生殖细胞肿瘤中的Skp2表达增多，差异无统计学意义（P＞0.05）。 结论 在人睾丸生殖细胞肿瘤中的Skp2高表达，提示细胞周期的异常调控在睾丸生殖细胞肿瘤的发生、分化中起着重要的作用。
Microsurgical varicocelectomy (MVC) is the current gold standard for the treatment of varicocele. Studies have shown that MVC can bring certain clinical benefits to patients with varicocele and male infertility. In today’s era of assisted reproduction, MVC is clinical used usually to improve ART outcomes before treatment with assisted reproductive technology (ART). This article summarizes the efficacy evaluation and cost-effectiveness of MVC combined with ART. Although there is a lack of prospective evidence supporting MVC before ART, many large retrospective studies have shown that operating MVC before using ART may improve ART outcomes. However, large-scale and standardized clinical trials are still needed to further verify the effectiveness and feasibility of MVC before ART.
ObjectivesTo systematically review the epidemiology of high-risk human papillomavirus (HPV) infections in western Chinese females.MethodsPubMed, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect epidemiological studies on female genital high-risk HPV infection in western China from January 2000 to July 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using R software.ResultsA total of 35 studies involving 149 037 objects were included. The results of meta-analysis showed that: the total infection rate of high-risk HPV in the northwest was 12.21% (95%CI 10.0% to 16.72%), and that in the southwest was 17.48% (95%CI 13.55% to 21.4%). The infection rate of high-risk HPV among healthy females in the northwest was 10.03% (95%CI 10.0% to 11.67%), while that in the southwest was 14.94% (95%CI 11.51% to 18.38%). CINⅠ, CINⅡ-Ⅲ and cervical cancer patients in the northwest with high-risk HPV infection rate were 70.31% (95%CI 49.0% to 91.61%), 84.29% (95%CI 68.36% to 100.22%) and 89.35% (95%CI 74.15% to 104.55%), respectively. The infection rates of patients with corresponding lesions in the southwest were 59.06% (95%CI 45.87% to 72.25%), 83.79% (95%CI 76.62% to 90.96%), and 81.07% (95%CI 67.77% to 94.37%), respectively.ConclusionsCurrent evidence shows that the epidemiological pattern of female genital high-risk HPV infection in western China is basically consistent with overseas. The high-risk HPV subtypes are subtype 16, 18, 31, 52, 53 and 58. The HPV vaccine used in China has basically covered the prevalent high-risk HPV subtypes in Western China. The wide application of vaccine may reduce the incidence and mortality of cervical precancerous lesions and cervical cancer, which will ensure reproductive health females in Western China. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo systematically review the effects of assisted reproductive technology in single pregnancy on the incidence of gestational diabetes.MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect cohort studies on the correlation between assisted reproductive technology (ART) and gestational diabetes mellitus (GDM) incidence in single pregnancy from inception to June 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 16 cohort studies involving 2 017 573 cases of single pregnancy were included. The results of meta-analysis showed that compared with the natural pregnancy group, the incidence of GDM was higher in the ART group (RR=1.54, 95%CI 1.30 to 1.83, P<0.000 01). In East Asia and Non-East Asia, the incidence of GDM in the ART group was higher than that in the natural pregnancy group (East Asia: RR=1.55, 95%CI 1.26 to 1.92, P<0.000 01; Non-East Asia: RR=1.49, 95%CI 1.18 to 1.89. P<0.000 1).ConclusionsCurrent evidence shows that the incidence of GDM may increase in single pregnancy with ART compared with natural pregnancy. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.
Objective To observe the effect of assisted reproductive technology (ART) on retinopathy of prematurity (ROP) in preterm infants. MethodsA retrospective clinical study. From January 2016 to January 2020, 639 preterm infants who were hospitalized at Children's Hospital of Zhengzhou University and underwent fundus screening at a gestational age ≤32 weeks were included in the study. There were 366 males and 273 females. Gestational age at birth were (28.3±1.4) weeks; birth weight were (1 153.8±228.8) g. Severe ROP was detected in 60 cases (9.4%, 60/639); 120 were ART recipients, and 519 were naturally conceived, and were divided into the ART group and the control group accordingly. The incidence of gestational diabetes mellitus (χ2=21.675), pulmonary surfactant application (χ2=13.558), and twin births (yes) (χ2=145.568) in mothers of the children examined in both groups were significantly higher than that of the control group, and the difference were statistically significant in all cases (P＜0.001). Comparison of quantitative data between groups was performed by t-test, and comparison of count data was performed by χ2 test; logistic regression was used to analyze the effect of ART on the incidence of ROP. ResultsOf the 60 cases of severe ROP, 18 (15.0%, 18/120) and 42 (8.1%, 42/519) cases were in the ART group and control group, respectively. The incidence of severe ROP was significantly higher in the ART group than in the control group, and the difference was statistically significant (χ2=4.680, P=0.024). Compared with the control group, the incidence of severe ROP was significantly higher in the ART group for gestational age at birth ＜28 weeks and birth weight ＜1 000 g, and the differences were statistically significant (χ2=10.116, 3.785; P=0.002, 0.037). Logistic regression analysis showed that ART was a non-independent risk factor for the occurrence of ROP (P＞0.05). ConclusionAssisted reproductive technology may have a certain influence on the occurrence of ROP, which is not an independent factor.
【摘要】 目的 探讨颅内原发生殖细胞瘤的临床特征。方法 收集华西医院脑外科2000年1月—2009年3月119例颅内原发生殖细胞瘤的临床资料进行回顾性分析。结果 发病率约占同期颅内肿瘤的 1.1%。男〖DK〗∶女=1.64〖DK〗∶1,平均发病年龄15.4岁。临床表现主要为颅内高压症状及视力视野改变,分别为61、56例；肿瘤主要来源于松果体区及鞍区；64例患者行放疗或放疗加化疗,随访45例。55例患者行手术治疗(其中术后行单纯放疗19例,放疗加化疗5例),随访36例。随访时间3~94个月,平均29.7个月。行放疗和放化疗的患者3、5年生存率明显高于单纯行手术治疗的患者。结论 颅内原发生殖细胞瘤多见于儿童及青少年,男性多见,肿瘤大多位于松果体区及鞍区。临床表现位于松果体区者主要为颅内高压症状等,位于鞍区者主要为视力视野改变、尿崩等。放疗联合化疗是主要治疗手段。
Objective To investigate effectiveness of the modified edge resection technique for composite labia minora and clitoral hood reduction with preserved microstructures. Methods A retrospective analysis was conducted on 36 female patients, who were diagnosed with composite hypertrophy of the labia minora and clitoral hood and admitted between September 2022 and December 2024. The patients’ ages ranged from 18 to 45 years (mean, 27.4 years). The primary surgical motivations included poor appearance alone (8 cases), functional impairment alone (14 cases), both poor appearance and functional impairment (12 cases), and psychological factors (2 cases). All patients were treated with the modified edge resection technique for composite labiaminora and clitoral hood reduction with preserved microstructures. The surgical technique emphasized precise adjustments to the clitoral-labial junction and optimization of the anterior labial structure to ensure a natural postoperative appearance and functional integrity. Postoperative follow-up assessed improvements in appearance and function of clitoral hood and labia minora, complications, and overall patient satisfaction. Results One patient exhibited suboptimal wound healing, while the remaining patients experienced no complications such as postoperative bleeding, hematoma, wound dehiscence, suture cutting, or labial edema and enlargement. Thirty patients were followed up with a duration of 1-6 months (mean, 2.4 months). In the early postoperative period, 2 patients perceived asymmetry of the bilateral labia minora; 1 underwent labial revision surgery, while the other achieved near-symmetry without intervention. At last follow-up, 25 patients experienced varying degrees of relief from preoperative functional impairments, while the remaining patients showed no improvement; 27 patients reported varying degrees of improvement in appearance, 2 reported no change, and 1 reported a worse appearance compared to preoperatively. Sixteen patients were very satisfied with the surgical results, 8 were satisfied, 5 were moderate satisfied, and 1 was dissatisfied, with a satisfaction rate of 80% (24/30). Conclusion The modified edge resection technique for composite labia minora and clitoral hood reduction with preserved microstructures which preserves and optimizes fine anatomical structures through precise adjustments at the clitoral-labial junction, achieves high patient satisfaction with both aesthetic and functional outcomes while minimizing postoperative complications.
Objective To define an evidence-based conclusion concerning ultrasound screening for fetal genital system malformations during pregnancy. Methods In order to assess whether or not ultrasound screening for fetal genital system malformations is effective and feasible, we searched The Cochrane Library (Issue 3, 2009), MEDLINE (1981 to 2009), ACP Journal Club (1991 to 2008), and BMJ Clinical Evidence (1999 to 2008) for systematic reviews, randomized controlled trials (RCTs), cohort studies, and controlled clinical trials. Results Five cohort studies and three crosssectional studies were retrieved. The results showed ultrasound screening detected fetal sex determination by the contour of the rump and the angle of the genital tubercle to a horizontal line through the lumbosacral skin surface in the first trimester. Scrotal size and penile length increases with gestational age for male fetuses, and by 32 weeks, bilateral testicular descent was observed in most cases. Ultrasonographic scans, fetal genetic studies, and hormonal assays of amniotic fluid can diagnosis certain diseases, fetal sex differentiation disorders, fetal endocrinal disorders, and chromosome abnormality. Conclusion The findings of this study should reassure physicians and parents alike that ultrasound screening is an reliable option for the prenatal diagnosis of fetal genital system malformations, but more randomized controlled trials are needed to further supply relevant evidence.