Intrauterine exposures and risk of endometriosis

BACKGROUND: Intrauterine environmental exposures have been adversely associated with male reproductive health in contrast to limited investigation of such exposures and female reproductive health. METHODS: To address this research gap, a cohort comprising 84 women aged 18-40 years undergoing laparoscopy was recruited prior to surgery and followed through the post-operative period for endometriosis diagnosis. Women were interviewed about environmental exposures and those of their mothers while pregnant with them (use of alcohol, caffeinated beverages and cigarettes). Endometriosis was diagnosed in 32 women from the laparoscopy cohort; 52 women had no endometriosis visualized. Using unconditional logistic regression, odds ratios (OR) and 95% confidence intervals (CIs) were estimated for the intrauterine exposures adjusting for potential confounders. RESULTS: No significant associations were seen between intrauterine exposure to alcohol or caffeine and a diagnosis of endometriosis. Adjusting for age, significant reductions in odds of an endometriosis diagnosis were observed for intrauterine cigarette exposure both in the absence (OR 0.22, 95% CI 0.06-0.82) or presence (OR 0.05, 95% CI 0.01-0.42) of women's current smoking. CONCLUSIONS: While speculative, in utero cigarette exposure may be associated with a lower risk of surgically diagnosed adult-onset endometriosis, possibly as a result of alterations in hormonal milieu or pathologic angiogensis.     

精液参数对宫腔内人工授精妊娠结局的影响

目的探讨精液参数对宫腔内人工授精妊娠结局的影响,为需要IUI患者提供参考。方法回顾性分析2010年7月-2016年10月在吉林大学第一医院接受IUI治疗的511对不孕症夫妇,共完成1090个周期。比较分析男女双方年龄、不孕年限、原发性或继发性不孕、处理前精子的活力、浓度、总数、前向精子运动总数(TMS)及处理后前向运动精子活动总数(PTMS)与IUI临床妊娠率间的关系。结果1090个IUI周期共获得130个妊娠周期,周期妊娠率为11.93%,女方年龄、不孕年限在妊娠组与非妊娠组中比较差异有统计学意义(P<0.05)。处理前精子的活力、浓度、总数、TMS、PTMS等参数比较差异无统计学意义(P>0.05),多因素Logistic回归分析结果显示精液常规各项参数与临床妊娠率均无明显相关性(P>0.05)。结论在IUI中女方年龄、不孕年限可影响IUI临床妊娠率;各项精液参数与IUI临床妊娠率无明显相关性,不能有效预测此类型患者IUI的临床妊娠结局。     

丙酮酸乙酯对宫内感染致脑损伤新生仔鼠AQP4表达和脑组织超微结构的影响

目的 研究丙酮酸乙酯(EP)对宫内感染致新生仔鼠脑损伤水通道蛋白4(AQP4)表达和脑组织超微结构的影响。方法 选取36只孕鼠随机分为 LPS组(n=12)、EP组(n=12)、NS组(n=12)。LPS组:孕17 d、18 d连续两天腹腔注射 LPS 380 μg/kg;EP组:同法制备孕鼠宫内感染模型,并在注射LPS后立即给予孕鼠腹腔注射 EP 40 mg/kg;NS组:腹腔注射同等量生理盐水。对孕鼠分娩后的胎盘和新生仔鼠脑组织进行HE染色观察宫内感染和脑损伤情况。剔除早产鼠,各组随机选取新生仔鼠36只,于生后12、24、48 h对脑组织进行免疫组织化学染色,观察AQP4的表达;电镜观察脑组织超微结构的变化。结果 与NS组比较,LPS组孕鼠胎盘组织可见大量的炎性细胞浸润,有宫内感染,LPS组仔鼠HE染色提示有脑损伤;与LPS组相比较,EP组仔鼠出生后24 h、48 h脑组织AQP4的表达量均低于LPS组(P<0.05);电镜下LPS组神经细胞超微结构显示损伤严重。结论 丙酮酸乙酯对宫内感染致脑损伤新生仔鼠的脑组织具有一定的神经保护作用,可能与AQP4表达水平有关。     

(GγAγδβ)0$({}^{\rm G}{\gamma}{}^{\rm A}{\gamma}\delta\beta)^0$-Thalassemia: Report of two cases in a family

Case 1 presented with severe anemia and received an intrauterine blood cell transfusion at 33 weeks of gestation. The anemia spontaneously improved in early infancy. Case 2, the father of Case 1, had an uneventful birth with no evidence of anemia, though microcytic anemia was observed during childhood. The genetic analysis of the β-globin gene cluster identified a novel heterozygous deletion of DNA extending from the Gγ-globin gene downstream to the β-globin gene, confirming a diagnosis of (^Gγ^Aγδβ)⁰-thalassemia. In cases where thalassemia is suspected based on blood tests, a genetic diagnosis should be performed for the sake of the offspring.     

Imaging of intrauterine contraceptive devices.

OBJECTIVE: Intrauterine contraceptive devices (IUDs) are reemerging as common methods of birth control in the United States. Imaging, especially sonography, has an important role in their evaluation. This review illustrates the normal and abnormal imaging appearances of IUDs. METHODS: We describe and illustrate the appearance of different types of IUDs on different imaging modalities as well as radiologically relevant complications associated with IUDs. RESULTS: On sonography, the IUD should be visualized as centrally located within the endometrial cavity, with the crossbar (if present) in the fundal portion of the endometrial cavity. Some older patients have IUDs in place that are no longer commonly used, such as the Lippes Loop (Ortho Pharmaceutical, Raritan, NJ) and Saf-T-Coil (Julius Schmid Laboratories, Little Falls, NJ), which have a pathognomonic appearance. Newer IUDs, such as the early version of the Mirena IUD (Leiras Oy, Turku, Finland), may be difficult to visualize on sonography. Patients from China frequently have a ring-shaped IUD. Sonography is important in assessing the complications of IUDs, including a low position, associated infection, myometrial migration, uterine perforation, intrauterine or extrauterine pregnancy associated with the IUD, and retention and fragmentation of the IUD. If an IUD is known to be present but not visualized sonographically, plain radiography is helpful in assessing the location. Computed tomography and magnetic resonance imaging are not typically used to assess IUDs, but the appearances of IUDs should be recognized with these modalities. CONCLUSIONS: Imaging, specifically sonography, has a crucial role in the evaluation and management of IUDs and associated complications.     

宫腔镜在宫腔粘连诊治中的应用

目的探讨宫腔镜诊断和治疗宫腔粘连的临床效果。方法对31例宫腔粘连患者进行宫腔镜检查，并在镜下电切分离子宫内粘连，术后予以抗生素、人工周期、IUD留置治疗。结果31例宫腔粘连完全分离，无并发症发生，术后28例月经恢复正常，3例经量仍较少。20例痛经者术后缓解18例。结论宫腔镜是目前诊断和治疗宫腔粘连最准确、最理想的方法，值得推广应用。     

间苯三酚与利多卡因联用对绝经期妇女取环术效果的评价

目的：评价间苯三酚与利多卡因联用对绝经后妇女宫内节育器取出术的使用效果。方法：将绝经后行取环术的87例妇女分为观察组和对照组,观察组予术前间苯三酚联合术中局部用利多卡因阻滞麻醉,对照组患者予术中常规使用利多卡因局部阻滞麻醉,比较2组患者术中宫颈口松弛情况和镇痛及取环效果。结果：观察组患者的镇痛和取环效果显著优于对照组（P〈0.05）;前者宫颈口松弛情况与后者比较,其差异无统计学意义（P〉0.05）。结论：间苯三酚与利多卡因用于绝经妇女取环术,可显著减轻患者疼痛,改善取环效果。     

Impact of using a fast‐freezing technique and different thawing protocols on viability and fertility of frozen equine spermatozoa

The effects of freezing technique and thawing protocol on thawed semen viability and fertility were studied. Ejaculates from 5 stallions (n = 25) were frozen by conventional or a fast‐freezing technique. Frozen semen was thawed by two thawing protocols (37 °C 30 s^?1 or 75 °C 7 s^?1). Thawed semen was evaluated by progressive motility, vigour, morphology and plasma membrane integrity. Mares (n = 25) were inseminated with 300 (n = 11) or 150 (n = 14) million spermatozoa. A greater (P < 0.05) vigour and progressively motile spermatozoa were detected, respectively, at thawing and after 20 min post‐thawing in the fast‐freezing technique than in the conventional one. Plasma membrane integrity was also greater (P < 0.05) in semen frozen with the fast‐freezing technique. Semen viability was not affected by thawing protocol. Pregnancy rate using the fast‐freezing technique was 76% (19/25), and did not differ (P > 0.05) between insemination doses. We concluded that the 150 million progressively motile spermatozoa per dose using a deep‐horn insemination maximises the use of equine semen. The fast‐freezing technique, as compared to the conventional one, efficiently preserves the viability and fertilising capacity of spermatozoa, indicating a new method to improve the fertility of frozen equine semen.