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LAMC1, LAMA2 and LAMA3 gene polymorphisms and the risk for severe pelvic organ prolapse

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Science Bulletin 2019年第7期64卷 466-468页

作者： Lei Li Jia Kang Ye Zhang Meng Mao Yuxiang Yang jinghe lang Zhijing Sun Juan Chen Lan Zhu Department of Obstetrics and Gynecology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College

Pelvic organ prolapse (POP) is the descent of the pelvic organs,including bladder, uterus, vagina and rectum, resulting in pelvic discomfort, urinary and fecal incontinence and sexual dysfunction(1)The prevalence of symptomatic POP in China is 9.56%according to a cross-sectional study involving 54,000 adult women in six provinces in the mainland of China (unpublished data). The etiology of this disorder is multifactorial, including race, age, body mass index(BMI), parity and menopause (1)The loss of the integrity of vaginal connective tissue has been demonstrated to weaken the pelvic floor support and promote the development of POP.

关键词： POP LAMA2 and LAMA3 gene polymorphisms and the risk for severe pelvic organ prolapse LAMC1

A study on service capacity of primary medical and health institutions for cervical cancer screening in urban and rural areas in China

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Chinese Journal of Cancer Research 2019年第5期31卷 838-848页

作者： Yang Li Li Ma Chunxia Yang Zhangya Chen Yuqian Zhao Le Dang jinghe lang Youlin Qiao Department of Epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Division of Health Information Dissemination Institute of Medical InformationChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100005China Department of Epidemiology Dalian Medical UniversityDalian 116027China Department of Epidemiology and Biostatistics West China School of Public Health and West fourth HospitalSichuan UniversityChengdu 610041China Executive office Taiyuan Health SupervisionTaiyuan 030001China Office of Cancer Prevention and Treatment Sichuan Cancer Hospital&InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science&Technology of ChinaChengdu 610041China Department of Obstetrics and Gynecology Peking Union Medical College HospitalChinese Academy of Medical Sciences/Peking Union Medical College(CAMS/PUMC)Beijing 100730China

Objective: To provide a decision-making basis for sustainable and effective development of cervical cancer ***: This cross-sectional study assesses the service capacity to conduct cervical cancer screening with a sample of 310 medical staff, medical institutions and affiliated township health centers from 20 countylevel/district-level areas in 14 Chinese provinces in ***: The county-level/district-level institutions were the main prescreening institutions for cervical cancer screening. More medical staff have become engaged in screening, with a significantly higher amounts in urban than in rural areas(P<0.05). The number of human papillomavirus(HPV) testers grew the fastest(by 225% in urban and 125% in rural areas) over the course of the project. HPV testing took less time than cytology to complete the same number of screening tasks in both urban and rural areas. The proportion of mid-level professionals was the highest among the medical staff, 40.0% in urban and 44.7% in rural areas(P=0.406), and most medical staff had a Bachelor’s degree, accounting for 76.3% in urban and 52.0% in rural areas(P<0.001). In urban areas, 75.0% were qualified medical staff, compared with 68.0% in rural areas, among which the lowest proportion was observed for rural cytology inspectors(22.7%). The medical equipment for cervical pathology diagnosis in urban areas was better(P<0.001). HPV testing equipment was relatively adequate(typing test equipment was 70% in urban areas, and non-typing testing equipment was 70% in rural areas).Conclusions: The service capacity of cervical cancer screening is insufficient for the health needs of the Chinese population. HPV testing might be an optimal choice to fill the needs of cervical cancer screening given current Chinese medical health service capacity.

关键词： China cervical cancer screening health service capacity appropriate technology cytology testing HPV testing

Comparison of screening strategies for Lynch syndrome in patients with newly diagnosed endometrial cancer:a prospective cohort study in China

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Cancer Communications 2019年第1期39卷 390-401页

作者： Xiaopei Chao Lei Li Ming Wu Shuiqing Ma Xianjie Tan Sen Zhong Yalan Bi jinghe lang Department of Obstetrics and Gynecology Peking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical ScienceShuaifuyuan No.1Dongcheng DistrictBeijing 100730P.R.China Department of Pathology Peking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical ScienceBeijing 100730P.R.China

Background: The prevalence of Lynch syndrome and screening strategies for this disorder in Chinese patients with endometrial cancer have seldom been investigated. Such data would be essential for the screening, prevention, genetic counseling, and treatment of Lynch syndrome. The purpose of this prospective study was to determine the accuracy of the mismatch repair (MMR) protein immunohistochemistry (IHC), microsatellite instability (MSI) test, and clinical diagnostic criteria in screening for Lynch syndrome-associated endometrial cancer (LS-EC) in a prospective Chinese cohort. Methods: All patients with newly diagnosed endometrial cancer (EC) were evaluated using clinical diagnostic criteria (Amsterdam II criteria and the revised Bethesda guidelines), MSI test, and IHC of MMR proteins in tumor tissues. For all patients, the screening results were compared with results of germline sequencing for pathogenic variants of MMR genes. Results: Between December 2017 and August 2018, a total of 111 unselected patients with newly diagnosed EC were enrolled. Six patients (5.4%) harbored a pathogenic germline mutation of MMR genes: 1 had a mutation in MutL homolog 1 (MLH1), 2 in MutS homolog 2 (MSH2), and 3 in MutS homolog 6 (MSH6). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying LS-EC were 33.3%, 88.6%, 14.3%, and 95.9%, for the clinical criteria, 66.7%, 75.0%, 14.3%, and 97.3% for IHC of MMR proteins, 100%, 89.9%, 33.3%, and 100% for MSI test, and 100%, 72.4%, 20.0% and 100% for combined IHC and MSI test, respectively. The combination of IHC and MSI test had higher sensitivity and PPV than the clinical criteria (p = 0.030). MSI test and IHC were highly concordant for LS-EC screening (73/77, 94.8%). Conclusion: The accuracy of the combination of IHC of MMR proteins and MSI test for screening LS among Chinese patients with EC was superior to that of the clinical criteria.

关键词： Endometrial carcinoma Lynch syndrome Immunohistochemistry Microsatellite instability Germline mutations DNA mismatch repair genes

Vascular stent as a treatment for refractory cervical stenosis

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Chinese Medical Journal 2014年第5期127卷 986-987页

作者： Yang Jie Zhu Lan lang jinghe Department of Obstetrics and Gynecology Peking Union Medical College Hospital Chinese Academy of Medical Science Beijing 100730 China

Cervical stenosis is a clinical condition involving partial or complete obstruction of the endocervical *** 1996,Bauldauf proposed that the definition of cervical stenosis is a cervical canal into which a 2.5# Hegar dilator cannot be inserted.1 Acquired cervical stenosis can be a complication of surgical procedures such as conization,trachelectomy,and *** is a serious complication because of the clinical repercussions,which can include amenorrhea,hematometra,dysmenorrhea,infertility,infection,and *** surgical techniques are used in dilation and cervix ***,in some cases,unsuccessful dilation with refractory recurrent stenosis may lead to hysterectomy.A successful case in which a self-expanding nitinol vascular stent was used to treat cervical stenosis was described by Grund et al.2 Here we report two additional cases in which vascular stents were used to treat patients with recurrent cervical stenosis after cervical surgeries.

关键词： cervical stenosis vascular stent dilatation cervical leiomyoma conization

Tumor necrosis factor gene polymorphisms and endometriosis in Asians： a systematic review and meta-analysis

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Chinese Medical Journal 2014年第9期127卷 1761-1767页

作者： Lyu Jiangtao Yang Hua lang jinghe Tan Xianjie Department of Obstetrics & Gynecology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China

Background Numerous studies have described the association between polymorphisms in the tumor necrosis factor （TNF） gene and risk of ***,the results remain *** we reviewed studies reporting the association between TNF gene polymorphisms and endometriosis risk in *** PubMed and Embase were *** case-control studies assessing the role of multiple TNF gene polymorphisms in endometriosis were *** no less than two articles evaluated one variant,meta-analysis was conducted; otherwise,narrative analysis was chosen.A fixed-or random-effects model was employed according to the heterogeneity among *** strength of the association between TNF gene polymorphisms and endometriosis risk was assessed by odds ratios and 95％ confidence *** For TNF-α-238G＞A,-308G＞A,-857C＞T,and-863C＞A,no significant associations were identified from all genetic *** TNF-α-850T＞C,results from one study showed that patients harboring the heterozygote TC were less susceptible to endometriosis than patients harboring the homozygote *** TNF-α-1031T＞C,a mild increase in endometriosis risk was found in the Asian ***-analysis from two studies found that the TNF-β ＋252＞G polymorphism had a protective effect in Chinese *** to the limitations of the included studies,it is necessitated to perform more studies to elucidate the possible roles of TNF gene polymorphisms in the pathogenesis of *** TNF-α-1031T＞C and TNF-β ＋252A＞G were significantly associated with the risk of endometriosis in Asian and Chinese populations,*** further evaluate these associations,more large-scale,rigorously designed studies are needed.

关键词： tumor necrosis factor genetic polymorphism endometriosis meta-analysis

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开展微无创技术推行诊治“四化”

中华妇产科杂志 2022年第4期57卷 241-243页

作者：郎景和中国医学科学院北京协和医院妇产科北京100730

微无创技术的定义还未明晰, 但微无创是一种观念、一种原则, 是通过微无创技术达到微无创目的, 达到微无创效果。任何技术都要以临床诊治的"四化"为准则——规范化、个体化、人性化和微创化;微无创技术更是以"四化"为准则, 甚至于其已... 详细信息

微无创技术的定义还未明晰, 但微无创是一种观念、一种原则, 是通过微无创技术达到微无创目的, 达到微无创效果。任何技术都要以临床诊治的"四化"为准则——规范化、个体化、人性化和微创化;微无创技术更是以"四化"为准则, 甚至于其已内化于"四化"之中。应该以规范化做引领, 完成个体化、人性化和微创化;而又以人性化为宗旨。我们要掌握适应证、非适应证和禁忌证这三个不同的概念, 要强调四个因素——病人及其罹患的疾病, 与医生和医生所给予的治病方法。我们要学习和应用好真实世界研究, 更好地发展微无创技术, 造福于妇女和人类。

关键词：治病方法无创技术真实世界研究禁忌证微创化规范化个体化四化

Telomerase-mediated immortalization of human vaginal wall fibroblasts derived from patients with pelvic organ prolapse

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Chinese Medical Journal 2023年第5期136卷 578-587页

作者： Tao Guo Ting Xie jinghe lang Zhijing Sun Department of Obstetrics and Gynecology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesNational Clinical Research Center for Obstetric&Gynecologic DiseasesBeijing 100730China Department of Medical Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China.

Background: Extracellular matrix (ECM) remodeling is the most important pathomechanism of pelvic organ prolapse (POP). Fibroblasts are the key to ECM regulation. The passaging capacity of human vaginal wall fibroblasts (hVWFs) is limited in vitro . Here, we aimed to immortalize hVWFs through the introduction of human telomerase reverse transcriptase (hTERT). Methods: Primary cells were derived from the vaginal wall tissue of patients with POP. Cellular senescence was detected via senescence-associated β-galactosidase staining. We employed a lentiviral transfection vector to stably express hTERT in hVWFs at passage 3, generating immortalized hVWFs (i-hVWFs). We then assessed cellular proliferation via the CCK-8 and EdU assays as well as cellular migration via wound healing assays. G-banded chromosome karyotypic analysis was performed to evaluate chromosomal karyotype stability. Finally, cellular tumorigenesis capacity was assessed in nude mice. A two-tailed Student’s t test was used to compare differences between the two groups. Results: Our results showed that senescence of primary hVWFs significantly increased from passage seven. From passage 11, hVWFs showed a significantly higher senescence percentage than i-hVWFs. During the continuous passage, i-hVWFs presented stability in proliferation, migration capacity, expression of ECM regulation-related genes, and chromosome karyotype. In vivo tumorigenesis was absent in i-hVWFs. Conclusions: The senescence of hVWFs significantly increased from the seventh passage, and we successfully used hTERT to immortalize hVWFs derived from patients with POP. Studies on POP that require a long-lived hVWF line will benefit from our technique.

关键词： Pelvic organ prolapse Fibroblasts Telomere shortening Cellular senescence

An anatomical comparison of two minimally invasive pelvic reconstructive surgeries using fresh female cadavers

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Chinese Medical Journal 2014年第8期127卷 1510-1516页

作者： Wang Wenyan Zhu Lan Wei Bing lang jinghe Department of Obstetrics and Gynecology Second Affiliated Hospital of Anhui Medical University Hefei Anhui 230601 China Department of Obstetrics and Gynecology First Affiliated Hospital of Bengbu Medical College Bengbu Anhui 233004 China Department of Obstetrics and Gynecology Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Science Beijing 100730 China

Background During the past decade, graft materials have been widespread used in the vagina in order to correct pelvic organ prolapse. The aim of this study was to describe and compare the exact anatomical position of the puncture devices and their relations to the relevant anatomical structures in the ProliftTM and a modified pelvic reconstructive surgery with mesh. Methods Twelve fresh cadavers were allocated randomly to either the ProliftTM or the modified pelvic reconstructive surgery group. Each group had six fresh cadavers. Relevant distances between the puncture devices and anatomical structures were recorded in both minimally invasive puncture surgeries. Results The mean distances from the posterior puncture points of the obturator membrane to the posterior branch of obturator arteries were shorter （（0.60＋0.36） cm and （0.78＋0.10） cm） when compared with the distances to the anterior branch of obturator arteries （（1.53＋0.46） cm and （1.86＋0.51） cm） for the reconstruction of the anterior compartment in both surgeries （all P 〈0.05）. The distance from the puncture points of the pelvic floor through the ischiorectal fossa to the coccygeal and inferior gluteal arteries in the ProliftTM technique （（0.88＋0.10） cm） and （（1.59＋0.36） cm））were much shorter than that in the modified pelvic reconstructive surgery （（2.95＋0.09） cm） and （（3.40＋0,36） cm）） for the reconstruction of the middle and posterior compartments （all P 〈0.05）. Conclusions Compared with the ProliftTM technique, the modified pelvic reconstructive surgery with mesh would be safer not to cause great damage to the inferior gluteal arteries and the coccygeal arteries, The posterior branch of obturator arteries would be easier to be injured than the anterior branch of obturator arteries during anterior compartment reconstruction in both surgeries.

关键词： minimally invasive surgeries pelvic organ prolapse cadaveric study anatomy vaginal mesh

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妇科学之外科论

中华妇产科杂志 2023年第7期58卷 481-484页

作者：郎景和中国医学科学院北京协和医院妇产科北京100730

外科或外科手术是妇科诊断和治疗的重要手段,妇产科在某种意义上可以划归为外科范畴。外科解剖刀就是剑,作为妇产科医生我喜欢这句话,把它当成座右铭。剑有何用?如何使用?如何用好?这就是本文要讨论的问题。

关键词：妇产科医生外科解剖妇科学外科手术诊断和治疗座右铭