Zhang X.,Fudan University |
Zhang X.,Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases |
Wu C.,Changzhou Maternal and Child Health Care Hospital |
Yang M.,Fudan University |
And 9 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2017
Objectives: We described laparoscopic repair of previous lower uterine segment caesarean scar defect (PCSD) in a series of 146 patients in our hospital. Methods: From April 2010 to July 2015, 146 patients with PCSD in the Obstetrics and Gynecology Hospital of Fudan University underwent laparoscopic repair of PCSD. The surgical and pregnancy outcome were followed, and the risk factors for successful healing of the repair were analyzed. Results: The patients in the incomplete and complete excision group both had an obviously shortened period after surgery. Single factor analysis showed that the thickness of the residual myometrium, suturing material, and estimated blood loss were correlated with the effects of surgery. Multivariate logistic regression analysis showed that the thickness of the residual myometrium and suturing material were independent risk factors for successful healing of the repair. Thirty-two patients desired for fertility in this study, and 12 of them got pregnant in 13-32 months after surgery, including 8 term cesarean delivery, 2 preterm cesarean delivery, 1 artificial abortion, 1 cesarean scar pregnancy, and 2 were pregnant when this study was summarized. Conclusions: Laparoscopic complete excision of CSD and repair with delayed absorbable material may be performed with fair symptom relief and acceptable postoperative anatomic and functional outcomes. © 2017, E-Century Publishing Corporation. All rights reserved.
Li L.,Nanjing Medical University |
Wu J.,Nanjing Medical University |
Pu D.,Nanjing Medical University |
Zhao Y.,Nanjing Medical University |
And 13 more authors.
Maturitas | Year: 2012
Objective: To investigate the factors associated with the age of natural menopause and menopausal symptoms in a large population of Chinese middle-aged women. Study design: In this cross-sectional study, a total of 20,275 women (40-65 years) attending health screening in Jiangsu Province of China were enrolled. A structured questionnaire was used to collect data of demographics, menopausal status, chronic diseases, reproductive history, etc. Also we evaluated the severity of menopausal symptoms by Kupperman menopause index (KMI). Main outcome measure: Menopausal age and scorings of Kupperman menopause index. Results: The overall median age at natural menopause was 50 years. Lower educational level, poor economic status, lower body mass index (BMI), age at menarche less than 14 years, nulliparity and smoking were associated with earlier onset of natural menopause (P < 0.05). The most frequently symptoms in postmenopausal women were sexual problems (57.05%), muscle/joint pain (53.29%) and insomnia (51.02%), while fatigue, insomnia and muscle/joint pain were predominant symptoms in pre- and peri-menopausal women. After adjusting for confounding factors, logistic regression analysis revealed that women with poor educational background, low income, divorce, higher BMI, higher parity, smoking and chronic diseases presented higher KMI scores (P < 0.05). Conclusion: The study provided an estimate of median age at natural menopause in Chinese women. The main factors contributing to earlier onset of menopause and severity of menopausal symptoms were lower educational level, poor economic status, and smoking. Thus, this study provides important insights for physicians to prevent and treat menopause related symptoms. © 2012 Elsevier Ireland Ltd.
Lu H.,Southern Medical University |
Jiang P.-C.,Changzhou No 2 Peoples Hospital |
Zhang X.-D.,Nanchang University |
Hou W.-J.,Southern Medical University |
And 10 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015
High risk human papillomavirus (HPV) infection is the major cause of cervical cancer. Bacterial vaginosis (BV) is considered as the most prevalent vaginal imbalance affecting women of reproductive age. However, the relationship between HPV and BV infection is unclear. This study aimed to assess the prevalence of human papillomavirus (HPV) infection combined with bacterial vaginosis (BV) infection in Shanghai suburbs and evaluate associations between bacterial vaginosis with HPV infection, cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods: From October 1, 2009 to October 31, 2013, a total number of 3502 women who visited Fengxian Hospital, Southern Medical University were enrolled in this study. All participants gave informed consent and agreed to HPV, BV, chlamydia, mycoplasma and thinprepcytologic test (TCT). In addition, all women took histopathologic examination under colposcopy. Statistical analyses were done using SPSS 17.0 for windows (IBM). In present study the overall BV-positive rate was 9.25%. The top three high risk HPV types were listed as follows (in descending order): HPV16, 52, 58. Moreover, our data showed BV infection tended to occur in the HPV positive women, HPV infection also tended to occur in the BV positive women. Most of the women who present HPV with BV infection were younger than 30 years old. We also found that CIN and cervical cancer occurred mainly in HPV/BV positive and HPV with BV positive group. BV infection and HPV infection may haveconsistency or synergies. HPV with BV infection may increase the incidence of CIN and cervical cancer. © 2015 E-Century Publishing Corporation. All rights reserved.
Yu Z.,Nanjing Medical University |
Han S.,Nanjing Medical University |
Wu J.,Inner Mongolia Maternal and Child Health Care Hospital |
Li M.,Xinjiang Medical University |
And 6 more authors.
Jornal de Pediatria | Year: 2014
Objective to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants. Methods this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia. Results in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40th percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95th percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75th percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875. Conclusions this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination. © 2014 Sociedade Brasileira de Pediatria.
Jiang S.,Changzhou Maternal and Child Health Care Hospital |
Yang Y.,Wuhan Center Hospital |
Fang M.,Zhejiang Cancer Hospital |
Li X.,Hunan Aerospace Hospital |
And 2 more authors.
Oncology Letters | Year: 2016
Considering the crucial significance of the tumor microenvironment in cancer development and progression, the present study aimed to investigate the changes in macrophages and angiogenesis during the cervical cancer (CC) progression process from chronic cervicitis to cervical intraepithelial neoplasia grades I-III (CIN I-III) to CC. This investigation included quantitative analysis and assessment of the spatial associations between tumor-associated macrophages (TAMs) and tumor neo-vessels. The conventional immunohistochemistry staining technique was used to detect cluster of differentiation (CD)68 and CD105 biomarker expression for TAMs and tumor neo-vessels, respectively. In addition, with the assistance of quantum dot (QD)-based two-component in situ imaging technology, the expression of the TAMs and tumor neo-vessels could be observed simultaneously. The quantitative analysis and co-evolution of the TAMs and tumor neo-vessels could then be processed. During the progression process from chronic cervicitis to cervical CIN I-III, and ultimately to invasive CC, the expression of the macrophages and neo-vessels in the tumor microenvironment increased synchronously. According to the quantitative analysis results, the median value of the TAM density was higher in the CC group (5,540.14) than in the CIN I-III group (2,502.17) and the chronic cervicitis group (1,403.31), with statistical significance in all three groups (P<0.001, for between-group comparisons). The number of neo-vessels was also much higher in the CC group (n=27) than in the CIN I-III group (n=17) or the chronic cervicitis group (n=6.5), with statistical significance in all three groups (P<0.001, for between-group comparisons). These findings demonstrated the great significance and close association of TAMs and tumor angiogenesis during CC development and progression. Thus, QDs-based in situ and simultaneous imag-ing of key cancer molecules may provide insights with regardto the biology of cancer invasion. © 2016, Spandidos Publications. All rights reserved.
Xing B.L.,Changzhou Maternal and Child Health Care Hospital |
Li T.,Changzhou Maternal and Child Health Care Hospital |
Tang Z.H.,Changzhou Maternal and Child Health Care Hospital |
Jiao L.,Changzhou Maternal and Child Health Care Hospital |
And 3 more authors.
Genetics and Molecular Research | Year: 2015
DNA methylation plays an important role in carcinogenesis and cancer development. In this study, we examined gene methylation in epithelial ovarian cancer (EOC) using cationic conjugated polymer (CCP)-based fluorescence resonance energy transfer (FRET) to evaluate the application of cumulative methylation alternations of genes associated with cancer antigen 125 for early cancer diagnosis. The methylation status of 3 genes (Ras association domain family 1 isoform A, RASSF1A; opioid-binding protein/cell adhesion molecule, OPCML; homeobox A9, HOXA9) were examined and compared in 35 EOC samples and 11 normal ovarian tissue samples using CCP-based FRET. Gene methylation levels were clustered into 3 sections and assigned a value; values for the 3 genes were summed. Although methylation of the OPCML gene was significantly associated with stage, histological types, grade, and ascites and that of RASSF1A and HOXA9 was not, the sum for the 3 genes was significantly associated with stage and ascites. The sum showed higher sensitivity (85.7%) and specificity (100%) for discriminating EOC from normal ovarian tissues than did the methylation status of RASSF1A, OPCML, and HOXA9 (48.6, 77.1, 77.1, and 100, 88.1, 100%, respectively). Combining cancer antigen 125 levels with the sum increased the sensitivity to 94.3%. The detection and analysis of a panel of genes’ methylation status with the CCP-based FRET technique may be useful for diagnosis and screening of EOC; the associated cancer antigen 125 can be used to increase diagnostic sensitivity. © FUNPEC-RP.
PubMed | Henan Provincial Peoples Hospital, Changzhou Maternal and Child Health Care Hospital and Huazhong University of Science and Technology
Type: | Journal: PeerJ | Year: 2016
Iron overload is recognized as a new pathogenfor osteoporosis. Various studies demonstrated that iron overload could induce apoptosis in osteoblasts and osteoporosis in vivo. However, the exact molecular mechanisms involved in the iron overload-mediated induction of apoptosis in osteoblasts has not been explored.In this study, we attempted to determine whether the mitochondrial apoptotic pathway is involved in iron-induced osteoblastic cell death and to investigate the beneficial effect of N-acetyl-cysteine (NAC) in iron-induced cytotoxicity.The MC3T3-E1 osteoblastic cell line was treated with various concentrations of ferric ion in the absence or presence of NAC, and intracellular iron, cell viability, reactive oxygen species, functionand morphology changes of mitochondria and mitochondrial apoptosis related key indicators were detected by commercial kits. In addition, to further explain potential mechanisms underlying iron overload-related osteoporosis, we also assessed cell viability, apoptosis, and osteogenic differentiation potential in bone marrow-derived mesenchymal stemcells(MSCs) by commercial kits.Ferric ion demonstrated concentration-dependent cytotoxic effects on osteoblasts. After incubation with iron, an elevation of intracelluar labile iron levels and a concomitant over-generation of reactive oxygen species (ROS) were detected by flow cytometry in osteoblasts. Nox4 (NADPH oxidase 4), an important ROS producer, was also evaluated by western blot. Apoptosis, which was evaluated by Annexin V/propidium iodide staining, Hoechst 33258 staining, and the activation of caspase-3, was detected after exposure to iron. Iron contributed to the permeabilizatio of mitochondria, leading to the release of cytochrome C (cyto C), which, in turn, induced mitochondrial apoptosis in osteoblasts via activation of Caspase-3, up-regulation of Bax, and down-regulation of Bcl-2. NAC could reverse iron-mediated mitochondrial dysfunction and blocked the apoptotic events through inhibit the generation of ROS. In addition, iron could significantly promote apoptosis and suppress osteogenic differentiation and mineralization in bone marrow-derived MSCs.These findings firstly demonstrate that the mitochondrial apoptotic pathway involved in iron-induced osteoblast apoptosis. NAC could relieved the oxidative stress and shielded osteoblasts from apoptosis casused by iron-overload. We also reveal that iron overload in bone marrow-derived MSCs results in increased apoptosis and the impairment of osteogenesis and mineralization.
PubMed | Guangzhou Medical College, Inner Mongolia Maternal and Child Health Care Hospital, Nanjing Medical University, The Fifth Peoples Hospital of Shenzhen and 4 more.
Type: Journal Article | Journal: Jornal de pediatria | Year: 2014
to prospectively validate a previously constructed transcutaneous bilirubin (TcB) nomogram for identifying severe hyperbilirubinemia in healthy Chinese term and late-preterm infants.this was a multicenter study that included 9,174 healthy term and late-preterm infants in eight hospitals of China. TcB measurements were performed using a JM-103 bilirubinometer. TcB values were plotted on a previously developed TcB nomogram, to identify the predictive ability for subsequent significant hyperbilirubinemia.in the present study, 972 neonates (10.6%) developed significant hyperbilirubinemia. The 40(th) percentile of the nomogram could identify all neonates who were at risk of significant hyperbilirubinemia, but with a low positive predictive value (PPV) (18.9%). Of the 453 neonates above the 95(th) percentile, 275 subsequently developed significant hyperbilirubinemia, with a high PPV (60.7%), but with low sensitivity (28.3%). The 75(th) percentile was highly specific (81.9%) and moderately sensitive (79.8%). The area under the curve (AUC) for the TcB nomogram was 0.875.this study validated the previously developed TcB nomogram, which could be used to predict subsequent significant hyperbilirubinemia in healthy Chinese term and late-preterm infants. However, combining TcB nomogram and clinical risk factors could improve the predictive accuracy for severe hyperbilirubinemia, which was not assessed in the study. Further studies are necessary to confirm this combination.