Residual ovarian activity during oral steroid contraception

Steroid drugs with contraceptive properties have been available in the clinical setting for over four decades and are still subject to improvement. Estrogens, progestins and anti-progestins have been used alone or in various combinations, regimens and routes of administration to favour the balance between efficacy and undesirable effects. One of the most important changes in this respect is the gradual lowering of steroid dosage in commercially available contraceptives. Current steroid contraceptive pills still achieve the goal of suppression of pituitary-ovarian activity, but the margins for error are minimal. In this review the available data on modes of action and the effects on suppressing pituitary-ovarian activity by different forms of oral contraception are reassessed. Although pregnancy rates provide a crude measure of contraceptive efficacy, no benchmark for pituitary-ovarian inhibition is available to test the suppressive potential of contraceptive drugs. Consequently, many studies provide incomplete and/or incomparable results. For the further study of those forms of steroid contraception that rely predominantly on suppression of ovarian activity, prevention of dominant follicles selection should be the objective.     

灵芝孢子对大鼠脊神经腹根切断后脊髓运动神经元存活及其NT-3、NOS表达的影响

目的探讨灵芝孢子（萌动激活赤灵芝孢子）对大鼠脊髓受损伤运动神经元存活和表达神经营养素-3（NT-3）及一氧化氮合酶（NOS）的影响.方法对单侧腹根切断后的大鼠胃饲不同剂量的灵芝孢子,计算受损伤运动神经元存活率;用免疫组织化学及原位杂交方法检测NT-3的表达;用酶组织化学方法检测NOS的活性.结果腹根切断后35 d,对照组运动神经元存活率为47.32%,灵芝孢子低、中、高剂量组的运动神经元存活率分别为67.11%、72.67%和81.67%;腹根切断后高剂量组存活的运动神经元NT-3和NOS的表达都高于对照组. 结论灵芝孢子促进大鼠脊髓前角受损伤的运动神经元存活,其存活率与用药剂量有关;灵芝孢子促进大鼠脊髓存活的运动神经元表达NT-3和NOS.     

围绝经期子宫肌瘤的处理

子宫肌瘤是妇女生殖器官最常见的良性肿瘤,围绝经期为其好发年龄。因妇女围绝经期具有独特的生理特征,该年龄段子宫肌瘤的治疗同样具有特殊性。文章通过概括分析子宫肌瘤的临床病理特征以及围绝经期妇女的生理特点,进一步阐述围绝经期子宫肌瘤的处理方法及选择策略。     

Determinants of the competing outcomes of intrauterine infection,abruption, or spontaneous preterm birth after preterm premature rupture of membranes*

Objective: Patients with PPROM are at risk for a variety of outcomes, including chorioamnionitis (CA), placental abruption (PA), or preterm labor (PTL). Competing risk regression can analyze a cohort’s risk of individual outcomes while accounting for ongoing deliveries secondary to competing events.

Methods: A secondary analysis of the subjects from MFMU BEAM study of neuroprotection after preterm birth (BEAM) with conservative PPROM management. Deliveries were categorized as: PA, CA, PTL, “elective” or “indicated”. The association between outcomes of PA, CA or PTL and clinical predictors of twins, ethnicity, parity, gestational age at rupture, bleeding, contractions, cervical dilation, preterm birth history, weight, and genitourinary infections were evaluated via competing risk regression.

Result: 1970 subjects were included. The significance and directionality of predictors varied according to specific outcomes. Patients with twins had an increased PTL hazard (1.85) though reductions in CA- (0.66) or PA-specific (0.56) hazards. Decreased latency in African-Americans was almost entirely due to an increased CA hazard (1.44) without a significant association with PTL. Increasing gestational age at membrane rupture was associated with a decreasing hazard of CA although increasing hazard of PTL.

Conclusions: For patients with PPROM, the hazards associated with different clinical predictors vary according to exact outcomes.     

Nature and nurture in the development of childhood obesity: early infant feeding practices of overweight/obese mothers differ compared to mothers of normal body mass index

Objective: The purpose of this study was to describe early infant feeding practices among overweight/obese mothers using the Infant Feeding Practices Study II (IFPS II).

Methods: In this study, we used data pertaining to the first 2 months postpartum of IFPS II. The data set includes 2387 mothers who provided information about infant feeding habits at the 2-month postpartum period.

Results: Overweight/obese mothers were less likely to breastfeed exclusively at 2 months infant age and more likely to breastfeed at low intensity the first 2 months compared to mothers of normal body mass index (BMI). Logistic regression analysis revealed, that after controlling for potential confounders, obese mothers were 1.38 (95% CI: 1.11, 1.72) times more likely to introduce solids to their infants before 4 months of age, and 1.37 (95% CI: 1.10, 1.89) times more likely to add cereal to the infant formula than their normal BMI counterparts.

Conclusions: In conclusion, overweight/obese mothers not only fall short of clinical practice guidelines in regards to breastfeeding, but also are more likely to initiate early introduction (<4 months infant age) to solid foods compared to their normal BMI counterparts. Interventions should be targeted to this group.     

术前NLR和PLR对上皮性卵巢癌患者预后的评估价值

目的:探讨术前中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)对上皮性卵巢癌患者预后的评估价值。方法:收集2005年11月至2012年12月在天津市中心妇产科医院初治且经手术治疗的153例卵巢良性肿瘤和206例上皮性卵巢癌患者的临床病理资料,比较术前NLR和PLR在卵巢良恶性肿瘤的区别,根据统计学方法选取NLR和PLR临界值,分析NLR和PLR与上皮性卵巢癌临床病理因素的关系。通过单因素及多因素分析评估术前NLR和PLR对患者术后生存的影响。结果:术前NLR和PLR水平在上皮性卵巢癌中明显高于卵巢良性肿瘤。选取NLR=2.62和PLR=173分别作为临界值。单因素分析结果显示,FIGO分期晚、中-低分化、腹水、脉管癌栓、CA125≥35、NLR≥2.62、PLR≥173是影响患者术后无病生存期(DFS)的危险因素(P0.05);FIGO分期晚、腹水、脉管癌栓、CA125≥35、PLR≥173是影响患者术后总生存期(OS)的危险因素(P0.05)。多因素分析显示,FIGO分期晚、NLR≥2.62、脉管癌栓是上皮性卵巢癌患者DFS的独立危险因素(P0.05)。结论:NLR和PLR方便测得且价格便宜,对卵巢癌的预后有一定的评估价值。     

Factors associated with latency period in preterm prelabor rupture of membranes

Objective: To determine the factors associated with prolonged latency periods in preterm prelabor rupture of membrane (PPROM).

Methods: This retrospective study analyzed data from singleton pregnant women with gestational age between 28 and 34 weeks suffering from PROM. Multivariate regression analysis was used to evaluate the association between the factors and latency period?≥?2 and?≥?7 days.

Results: A total of 231 cases of PPROM were included. Prolong latency period?≥2 and 7 days were achieved in 141 (61%) and 54 (23.4%) cases. Higher gestational age at PPROM and cervical dilatation?>2?cm were associated with a shorter latency period <2 days. Multiparity and presence of uterine contraction at admission were associated with a shorter latency period <7 days. Prophylactic antibiotics [odds ratio (ORs) 6.69, 95% confidence interval (CI) 3.0–14.89], and tocolysis (ORs 2.74, 95%CI 1.25–6.02) were factors associated with latency period?≥?2 days. Only prophylactic antibiotics (ORs 7.7, 95%CI 2.54–23.34) was a factor associated with latency period?≥7 days.

Conclusions: Prophylactic antibiotics and tocolysis are two major factors associated with latency period?≥2 days in PPROM, where prophylactic antibiotics is the main factor associated with latency period?≥7 days in PPROM.     

PLPP2: Potential therapeutic target of breast cancer in PLPP family

PLPPs (Phospholipid phosphatases) are widely expressed in different human tissues, regulate cell signal transduction, and are overexpressed in cancers such as gliomas, pancreatic adenocarcinoma, lung adenocarcinoma, and so on. As a member of the PLPP family, PLPP2 (phospholipid phosphatase 2) plays a vital role in the occurrence and development of breast cancer, but its mechanism is still unclear. Our research found that PLPP2 was overexpressed in breast cancer, and the higher expression level of PLPP2 showed a worse prognosis for breast cancer patients. Further analysis showed that overexpression of PLPP2 affected the expression of CDC34 (cell-division cycle 34), LSM7 (Like-Smith 7), and SGTA (small glutamine-rich tetratricopeptide repeat-containing protein alpha) through EMT (epigenetic-mesenchymal transition) related pathways to promote the occurrence and development of breast cancer. In vitro, silencing PLPP2 significantly reduced the proliferation, invasion, and migration abilities of human breast cancer cells MDA-MB-231. ER+ is a common subtype of breast cancer. Furthermore, we found that the overexpression of PLPP2 was significantly related to the poor prognosis of ER+ breast cancer. These results indicate that PLPP2 has value as a potential therapeutic target for breast cancer, especially for ER+ breast cancer.     

基于3D-ResNet深度影像特征的胆囊癌生存预测模型

建立一个精准的个体化胆囊癌患者生存预测模型,分析、寻找新的胆囊癌预后因素,对于患者预后评估、治疗模式选择、手术患者筛选、术后辅助治疗方案确定及医疗资源合理使用均具有重要意义。本文提出一种基于3D-ResNet提取深度影像特征建立胆囊癌患者生存预后模型的方法,通过迁移学习以及训练3D-ResNet自动提取患者CT的深度特征,并利用提取的深度影像特征,通过Cox比例风险回归模型建立胆囊癌患者的生存预测模型。实验结果表明,基于深度影像特征建立的胆囊癌患者预后因子在预测患者生存时的C指数达到0.734,利用深度影像特征预后因子预测患者的1、3、5年存活率AUC分别达到0.833、0.791、0.813。本方法对胆囊癌预后预测有着良好的指示作用。