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Diagnosis and treatment of endometrial carcinoma

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The Chinese-German Journal of Clinical Oncology 2008年第3期7卷 170-175页

作者： rumana jafarey Department of Gynecology and Obstetrics Renmin Hospital of Wuhan University

Approximately 6000 endometrial cancer death occurs annually worldwide, predominantly noticed in postmenopausal women. The current diagnostic and therapeutic research tnals for endometrial carcinoma are giving new clues to select best postoperative adjuvant treatment especially in high risk disease. Transvaginal ultrasound and hysteroscepy endometrial biopsies are tending to replace the dilation and curettage in establishing a diagnosis. The standard primary treatment of endometrial carcinoma is surgery but to select best adjuvant therapy, the risk of disease recurrence is determined by certain pathological factors and also by surgical stage. The most commonly used adjuvant therapy is radiation therapy but satisfactory results have not been noticed in high-risk endometrial carcinoma. On the basis of review of current research guidelines it is indicated that hormonal or chemotherapeutic agents must be added with radiation therapy to improve prognosis and efficacy in endometrial carcinoma after surgery.

关键词： endometrial carcinoma adjuvant therapy radiation therapy

Morphological and ultrastructural changes in rat ovarian tissues after cryopreservation

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The Chinese-German Journal of Clinical Oncology 2012年第9期11卷 527-532页

作者： rumana jafarey Reproductive Medical Centre Renmin Hospital of Wuhan University

Objective: The aim of the study was to observe and compare the effects of cryopreservation and thawing meth- ods on rat ovarian tissues. Methods: Twenty 5-6 weeks old SPF-SD female rats were randomly divided into two groups, with ten rats in each group. Freshly isolated ovaries saved as a control (group 1: fresh ovaries) in formalin-fixed or vitrified immediately after dissection (group 2: vitrified ovaries). Ovaries in vitrified group were processed into thin slices then cryo- preserved, stored in liquid nitrogen for 21 days, rapidly thawed and grossly examined. All of the collected ovaries underwent hematoxylin and eosin-stained paraffin serial sections and observed the microscopic evaluation in vitrified ovaries. Results: Grossly the vitrified ovaries turned pale color and the size was same as before freeze. The vitrified ovarian tissue had normal anatomical structures of cortex and medulla under the microscope and had no difference with the fresh control ovarian tis- sue. The number and distribution of the follicles were similar with the fresh ovarian tissue, but had smaller size and the gap between oocyte and the surrounding granulosa cells was increased. Few ooctyes were in irregular appearance however the morphology of follicular cells did not give a different appearance as compared to the fresh control ovarian tissue. Conclusion: Cryopreservation of ovarian tissues by vitrification method has some detrimental effect on the morphology of follicles but does not induce negative impact on the number, density and survival of the primordial ovarian follicles. However the whole follicle anatomical structures also had no significant changes.

关键词： cryopreservation thawing ovarian tissue morphology

Fertility preservation in female cancer patients

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The Chinese-German Journal of Clinical Oncology 2011年第1期10卷 1-8页

作者： rumana jafarey Reproductive Medical Centre Renmin Hospital of Wuhan University

Cancer is not rare in younger women of reproductive age therefore the preservation of fertility among them has become a significant concern due to aggressive cancer therapy they must *** different strategies for fertility preservation are available in patients at ***,many of these available techniques are still experimental and have limited clinical *** ethical principle,better interdisciplinary cooperation between clinicians and patients,appropriate counseling and further research on cryopreservation and transplantation techniques may enhance their success to preserve fertility of young cancer *** this article,the existing and emerging fertility preserving strategies in young cancer female as well as their safety and ethical issues are discussed.

关键词： cancer transplantation cryopreservation fertility preservation

Study on the Estrous Cycle Regularity of Cryopreserved Rat Ovarian Tissues after Heterotopic Transplantation

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Open Journal of Obstetrics and Gynecology 2016年第5期6卷 293-298页

作者： rumana jafarey Syed Ali Rehan Shah Jaffri Reproductive Medical Centre Renmin Hospital of Wuhan University Wuhan China Federal Board of Revenue Islamabad Pakistan

Objective: To evaluate the re-initiation of ovarian function in cryopreserved ovarian grafts by means of vaginal smear of transplant rats. Methods: A total of 40 SPF-SD female rats (5 - 6 week-old) were randomly divided into three groups (blank control, castration control and transplant group). Ovaries were removed by surgical procedure then after cryopreservation and thawing procedures the ovarian tissues pushed inside the back muscles gap in transplant group. On the first PO day, vaginal smear collection was daily initiated. After 30 days, the PO day when the estrous cycle was re-initiated was considered for analysis as well as the estrous days and the number of estrous cycles. Results: Normal control group had a regular estrous cycle, while the transplant group had an estrous cycle disorder within first 2 weeks and later 2 weeks after the transplantation while the duration of diestrus cycle lasted longer. At the same time, the castration group had lost the normal estrous cycle, keeping continue in the stage of diestrus. Conclusion: In transplanted animals the re-initiated ovarian function can be predicted with alteration between estrous and diestrus phases with predominant estrous irregularity. Moreover, short autotransplanted graft duration needs time to perfuse by new blood vessels and hormone secretions, so could not directly affect its target organs to function properly.

关键词： Transplantation Cryopreservation Thawing Vaginal Smear Ovarian Tissue Rats

Combined effects of MPA and EBRT in stage Ic endometrial cancer patients

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The Chinese-German Journal of Clinical Oncology 2008年第11期7卷 650-657页

作者： rumana jafarey Wei Zhang Sun Jing Department of Gynecology and Obstetrics Renmin Hospital of Wuhan University Wuhan 430060 China Department of Health Statistics School of Public Health Wuhan University Wuhan 430072 China

Objective： To report the comparative effect of combined medroxyprogesterone acetate （MPA） and external beam pelvic radiotherapy （EBRT） with EBRT alone on local or distant recurrences, overall survival and treatment related toxicities in patients with stage Ic grade 3 endometrial cancer. Methods： A retrospective review of 80 International Federation of Gyne- cology and Obstetrics （FIGO） stage Ic grade 3 endometrial carcinoma patients treated between October 1994 and October 2004 at Renmin Hospital, Wuhan University, China was performed. All patients underwent surgery, of which 40 patients in arm I received combined MPA and EBRT while in arm II 40 patients received only adjuvant EBRT after surgery. The median dose of EBRT in arm I was 50 Gy （range 36-54 Gy） and in arm Ⅱ was 45.2 Gy （range 43.2-50.4 Gy）. Multivariate analysis was performed for the prognostic factors and Kaplan-Meier method was used for overall survival. Results： Of the 80 eligible patients, 40 in each group could be evaluated. The follow-up times ranged from 4-98 months with a median of 45 months. The overall survival rates at five years were 73% among patients treated with combined MPA and EBRT and 28.2% among patients treated with EBRT alone （P 〈 0.001）. The rate of distant metastasis was significantly higher among patients treated with EBRT alone group than combined MPA and EBRT （55% vs 25%, P = 0.006） while no difference in Ioco regional recurrence rates was observed in both treatment groups. Most of the side effects observed in the combined MPA and EBRT group. Age （P 〈 0.001） and the presence of progesterone receptors （P = 0.003） were independent significant prognostic factors for overall surviva} in multiple regression analysis. Conclusion： We has been concluded that the addition of progestagen to external beam pelvic radiotherapy significantly improved survival and reduced distant metastasis among women with stage Ic grade 3 endometrial cancer.

关键词： endometrial carcinoma FIGO stage Ic grade 3 medroxyprogesterone acetate (MPA) external beam pelvicradiotherapy (EBRT)

睾丸穿刺取精行卵胞浆内单精子注射的临床结局

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武汉大学学报（医学版） 2011年第1期32卷 101-104页

作者：闫文杰杨菁尹太郎张博 rumana jafarey 龙文武汉大学人民医院生殖医学中心湖北武汉430060

目的:观察卵胞浆内单精子注射(ICSI)使用经皮睾丸穿刺取精(PTSA)、PTSA后冷冻精子及体外射出精子的临床结局。方法:对2009年2-12月接受ICSI治疗的168个周期进行回顾性分析。168个周期分为3组,体外射精组95个周期,PTSA组41个周期,PTSA后... 详细信息

目的:观察卵胞浆内单精子注射(ICSI)使用经皮睾丸穿刺取精(PTSA)、PTSA后冷冻精子及体外射出精子的临床结局。方法:对2009年2-12月接受ICSI治疗的168个周期进行回顾性分析。168个周期分为3组,体外射精组95个周期,PTSA组41个周期,PTSA后冷冻精子组32个周期。对这3组的受精、胚胎、妊娠情况进行比较。结果:PTSA组、PTSA后冷冻精子组与体外射精组比较,每个周期受精卵数、卵裂数、移植胚胎数、优质胚胎数、临床妊娠率、自然流产率、分娩率等无统计学差异。结论:对于无精症患者,PTSA结合ICSI是一种有效的治疗手段,PTSA后冷冻精子对临床结局没有影响。

关键词：睾丸精子卵细胞浆内单精子注射无精症精子冷冻

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血清叶酸水平与早泄相关性的初步研究

武汉大学学报（医学版） 2012年第1期33卷 74-77页

作者： rumana jafarey 杨菁闫文杰尹太郎邹宇洁郭悦武汉大学人民医院生殖医学中心湖北武汉430060

目的:研究早泄患者血清叶酸水平的变化,并分析其影响早泄的可能机制。方法:随机收集原发性早泄患者60例为研究组,正常男性40例为对照组。记录两组研究对象的一般资料和平均阴道内射精潜伏期(IELT),检测血清的叶酸和性激素水平。所有参... 详细信息

目的:研究早泄患者血清叶酸水平的变化,并分析其影响早泄的可能机制。方法:随机收集原发性早泄患者60例为研究组,正常男性40例为对照组。记录两组研究对象的一般资料和平均阴道内射精潜伏期(IELT),检测血清的叶酸和性激素水平。所有参与试验者均填写中国早泄患者性功能评价表(CIPE),并计算分数。比较IELT、性激素、CIPE分数及叶酸水平在两组间的差异,应用Pearson直线相关分析叶酸与年龄、体重指数(BMI)、性激素、IELT及CIPE分数之间的相关性。结果:研究组血清叶酸水平、IELT和CIPE分数明显低于对照组(P<0.01)。血清叶酸水平与IELT、CIPE分数呈明显正相关(r=0.227,P<0.05;r=0.319,P<0.01)。结论:叶酸水平下降与早泄存在密切关系,可能通过影响5羟色胺和一氧化氮(NO)的代谢而引起早泄。

关键词：早泄叶酸一氧化氮 5羟色胺

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受精第3天胚胎的融合程度与植入潜能

中国组织工程研究与临床康复 2010年第53期14卷 9937-9940页

作者：张博杨菁尹太郎闫文杰 rumana jafarey 武汉大学人民医院生殖医学中心湖北省武汉市430060

背景:虽然辅助生殖技术发展迅速,但是胚胎植入率仍不理想,关于胚胎融合程度与植入潜能的关系尚无定论。目的:探讨受精第3天胚胎早期融合与植入率的相关性。方法:回顾性分析420例(共移植胚胎1016个)患者在超促排卵、体外受精及胚胎移植后... 详细信息

背景:虽然辅助生殖技术发展迅速,但是胚胎植入率仍不理想,关于胚胎融合程度与植入潜能的关系尚无定论。目的:探讨受精第3天胚胎早期融合与植入率的相关性。方法:回顾性分析420例(共移植胚胎1016个)患者在超促排卵、体外受精及胚胎移植后,植入成功胚胎早期融合情况与未植入成功胚胎早期融合情况的差别。结果及结论:受精第3天移植早期融合胚胎共200个,其中植入成功48个;受精第3天移植未早期融合胚胎共816个,其中植入成功133个,两组比较差异显著(P<0.05)。植入胚胎中有3个早期融合胚胎妊娠率达71.43%,有2个为31.91%有1个为51.06%,0个为39.81%。可见,在目前的胚胎选择标准下,胚胎早期融合可以显著提高胚胎的植入率,但是其具体机制,还有待进一步研究。

关键词：胚胎早期融合植入率妊娠率胚胎移植受精

Morphology and survival of cryopreserved-thawed ovarian tissues after heterotopic autotransplantation

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The Chinese-German Journal of Clinical Oncology 2014年第3期13卷 110-114页

作者： rumana jafarey Jing Yang Reproductive Medical Centre Renmin Hospital of Wuhan University

Objective： The aim of our study was to observe the survival and morphological changes of thawed ovarian tis- sues after heterotopic transplantation. Methods： Twenty SPF-SD female rats （5-6 weeks old） were equally randomized into the control group and experimental group. In control group, the freshly isolated ovaries were fixed in formalin. In experimental group, the freshly isolated ovaries were vitrified immediately and cut into thin slices. After stored in liquid nitrogen for 21 days, the tissues of experimental group were rapidly thawed and transplanted into back muscles of rats for 2 or 4 weeks, respectively. After that, all rats in experimental group were sacrificed and the ovarian tissues were collected and fixed in 4% formaldehyde solution. Then the ovarian tissues were stained with HE and observed under the light confocal microscope. Re- suits： With the naked eyes, there was no specific alteration except the size reduction with color changing. Under microscopy, we found normal cortex and medulla in the ovary, and the primordial follicles and follicles in various stages were observed in the cortex. The normal oocytes in ovarian tissues of experimental group were significant decreased than in the control group. Conclusion： The ovarian tissues survive well in experimental group and there is no significant difference in the proportion of follicles between different times （2 and 4 weeks） after grafting. Our results suggest that thawed ovarian tissues could survive after heterotopic transplantation into back muscles of rat models and maintain their morphology and function.

关键词： ovarian tissue morphology heterotopic transplantation thawing