Ovarian tissue grafting: Lessons learnt from our experience with 55 grafts

Purpose

Uncertainties remain regarding the clinical efficacy of ovarian tissue cryopreservation and grafting. We report a retrospective analysis of reproductive outcomes and lessons learnt following 55 ovarian tissue transplant procedures at our center from 2006 to 2019.

Methods

We analyzed variables related to graft success such as tissue volume, follicular density, total follicular volume, and age on the duration of graft function.

Results

Follicular density and total follicular volume correlate positively with duration of graft function. All clinical pregnancies in our cohort occurred in women who were aged 35 or less at the time of ovarian tissue cryopreservation.

Conclusion

Graft success, as determined by eventual pregnancy and the longevity of graft function, may be impacted by factors including age at cryopreservation, follicular density, and total follicular volume.

     

258例不孕症患者腹腔镜诊断分析

对２５８例不孕症患者利用腹腔镜检查诊断不孕原因,明确病因后进行针对性治疗,并追踪随访术后妊娠率,妊娠结局。结果２５８例中９５例为输卵管炎,术后妊娠４２例,妊娠率４４２１％,８４例子宫内膜异位症,术后妊娠６２例,妊娠率７３８１％,６１例多囊卵巢综合征,术后妊娠２７例,妊娠率４４３６％。结果表明：腹腔镜检查能迅速,正确地诊断不孕原因,术后针对病因治疗,提高了不孕症患者的妊娠率。     

去势对不同月龄雌性大鼠骨丢失的影响

为了探讨去势对不同月龄雌性大鼠体质量、骨密度、组织病理学的影响,以便选用恰当月龄的大鼠复制绝经后骨质疏松的动物模型。本研究选用3、6、12月龄的SD雌性大鼠共48只,每月龄组16只,均分成A、B两组,A组为对照组,B组为去势组。分别于术后6、12周测量体质量、腰椎和股骨的骨密度及组织病理学观察。结果发现3月龄的去势级大鼠的体质量增加尤为明显,3、6月龄大鼠的去势组较对照组在去势后6、12周骨密度均有显著性差异（P＜0．001）,组织病理学观察去势组骨小梁稀疏,皮质骨变薄,骨髓腔扩大;而12月龄的大鼠骨密度改变不显著。结论：绝经后骨质疏松模型复制大鼠的年龄是6月龄为佳,3～6月龄亦可选用,12月龄以后不适宜选择。     

Transitional cell carcinoma of the renal pelvis and ureter: Outcome and patterns of relapse in patients treated with postoperative radiation

We assessed the records of 101 patients with locally advanced transitional cell carcinoma (TCC) of the renal pelvis and ureter treated with postoperative radiation therapy to determine outcome and patterns of failure. Locally advanced disease (i.e., T3–4N0 or N+ disease) was identified in 65 patients. Postoperative radiation was used to treat 86 patients, with a median dose of 35 Gy in 20 fractions over 4 weeks to the tumor bed and regional lymph nodes. There were 15 patients with no residual disease who were offered no further therapy. No patient received postoperative chemotherapy. Prognostic factors were examined using univariate and multivariate analysis, and the patterns of failure were identified after postoperative irradiation. Median follow-up was 9.3 years, during which 76 deaths occurred. The 5-year overall survival was 43% and 10-year survival was 23%. A multivariate analysis identified T3 category, lymph node involvement, and age at diagnosis as significant prognostic factors for survival. Tumor grade was a significant prognostic factor on univariate analysis but not on multivariate analysis. Failure analysis showed that only 36% of patients with locally advanced disease remained relapse free. For this group of patients, distant metastases developed in 53%, and locoregional failured occurred in 35% despite postoperative irradiation. Locoregional failure occurred in 95% of patients with nodal involvement who received postoperative radiation, and 77% of those developed distant relapse. This leads us to conclude that patients with resected locally advanced (T3, T4N0, N+) TCC of the upper urinary tracts have a high risk of relapse and death from disease despite postoperative radiotherapy. Because the main feature of the disease is early distant failure, post-operative chemotherapy is required to improve the outcome for this group of patients.     

A psychophysiological evaluation of female urethral syndrome: Evidence for a muscular abnormality

This is a preliminary investigation into a recently defined urological disorder occurring in a subgroup of women with urethral syndrome suggestive of pelvic floor muscular (PFM) dysfunction. Symptoms include straining to void, urgency, frequency, hesitation, incontinence and/or retention, and subpubic pain. Finding neither bladder nor urological abnormalities, urologists may consider these women emotionally unstable without organic cause for their symptoms. However, their distress may be a consequence rather than a cause of their voiding problems. Sixteen female urological patients were matched with 16 asymptomatic controls to investigate PFM functioning, psychological status, and symptomatology. Results showed heterogeneity of symptomatology and little elevation of depression or anxiety when comparing patients with controls. Hypotheses of muscular abnormality were confirmed. Patients evidenced poor control over tensing and relaxing PFM, elevations of PFM activity under various conditions, and chronic pain as a prominent symptom. Treatment approaches specifically designed to address PFM dysfunction are discussed.     

辨证分期治疗慢性盆腔炎合并免疫性不孕症18例疗效观察

目的：探讨辨证分期治疗慢性盆腔炎合并免疫性不孕症的临床疗效。方法：选择慢性盆腔炎合并免疫性不孕症(血清抗精子抗体阳性)患者18例，采用辨证分期治疗。月经干净后，治以活血化瘀、理气祛湿为主；在(或相当于)排卵期或排卵后，治以补肾养血，活血化瘀为主；在经前期，治以理气活血调经为主；在月经干净后至经前期，加用小剂量阿司匹林。结果：盆腔炎临床症状及体征痊愈7例，显效6例，有效5例；全部患者获得妊娠，宫内妊娠者17例(观察至妊娠3月，均正常)，输卵管妊娠1例；结论：中医辨病辨证结合的周期疗法加小剂量阿司匹林治疗慢性盆腔灸合并免疫性不孕症有一定的疗效。     

CO_2激光联合卡介菌多糖核酸肌肉注射治疗女性尖锐湿疣

目的 :评价卡介菌多糖核酸联合CO2 激光治疗女性尖锐湿疣 (CA)的疗效。方法 :治疗组 :CO2 激光治疗后采用卡介菌多糖核酸肌肉注射 ,与对照组单用CO2 激光治疗相比较。结果 :两组经二次CO2 激光治疗后复发率分别为8.3%、31.0 % ,治疗组复发率显著低于对照组 (P <0 .0 1) ,未见明显不良反应。结论 :卡介菌多糖核酸联合CO2 激光治疗女性尖锐湿疣 ,可提高治愈率 ,有效降低复发率 ,安全可靠。     

对贵阳市100例女性吸毒者的艾滋病知识、态度调查

目的:了解女性吸毒者对艾滋病的态度和相关知识掌握情况。方法:对2000年在贵阳市公安局戒毒中心强制戒毒的100名女性海洛因依赖者进行匿名问卷调查。结果:该吸毒群体中以烫吸方式滥用毒品者占81.0％,静脉注射方式占7.0％,烫吸、静脉注射混用方式占12.0％;与他人合用过注射器的占静脉注射者的47.4％;知道艾滋病是传染病的占93.0％;知道共用注射器可以传播艾滋病的占83.0％;知道孕妇可将艾滋病病毒传染给胎儿的占50.0％;知道艾滋病病毒主要侵害免疫系统的占31.0％;知道艾滋病是可预防的占63.0％;知道艾滋病是不可治愈的占49.0％;知道安全套可预防艾滋病感染的占34.0％,对预防艾滋病所采取的保护措施的应答中,肯定应答率最高的一项为35.0％。结论:本调查显示,贵阳地区女性吸毒者对艾滋病的传播方式仍缺乏全面了解,对预防知识的了解仍很贫乏,提示在该群体中进行艾滋病知识的宣传、教育和行为干预,对遏制艾滋病的传播、减少危害有极其重要的意义。     

HOXA-11基因与不孕及妊娠失败关系的研究

目的 :研究HOXA 11基因与不孕及妊娠失败的关系。方法 :选择 4 1例不明原因不孕症患者及 30例难免流产患者 ,同时选择 2 8例正常未孕者及 18例正常早期妊娠者分别作为对照组 ,留取子宫内膜或蜕膜组织。子宫内膜标本通过组织学检查分为增生期或分泌期。难免流产及正常妊娠组均妊娠 6～ 9周。采用原位杂交方法检测所有子宫内膜或蜕膜组织中的HOXA 11基因mRNA的表达。结果 :整个月经周期子宫内膜腺上皮细胞及间质细胞中均有HOXA 11基因mRNA表达 ,并因月经周期不同而有所波动。HOXA 11基因mRNA在分泌中晚期子宫内膜间质细胞中阳性表达率为 10 0 % ,在增生期子宫内膜间质细胞中的阳性表达率为 6 3.6 % ,差异有显著性 (P <0 .0 5 ) ;在不明原因不孕症患者中HOXA 11基因失去了它在正常子宫内膜表达的周期性变化 ,而且基因表达缺失明显。HOX A 11基因在正常增生期及分泌期子宫内膜腺上皮细胞或间质细胞中的阳性表达率分别为90 .9%、82 .4 %和 6 3.6 %、10 0 % ,在不孕症增生期及分泌期子宫内膜两种细胞的阳性表达率分别为 38.9%、4 7.8%和 2 2 .2 %、39.1% ,两组分别比较 ,差异均有显著性 (P <0 .0 5 ) ;HOXA 11基因在正常早期妊娠蜕膜细胞中持续表达 ,其阳性表达率均为 10 0 % ,在难免流产蜕膜细胞中的阳性表达