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Chinese Medical Journal 2024年第4期137卷 499-501页

作者： Xia Xu Yanni Guo Tingting Liao Huale Zhang Rumeng Jiang Shuyao Huang Jianying Yan Department of obstetrics and gynecology Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics&Gynecology and PediatricsFujian Medical UniversityFuzhouFujian 350001China

To the Editor:Gestational diabetes mellitus(GDM)is a pathologic condition in which glucose intolerance and insulin resistance develop to different degrees during pregnancy.Women with GDM have higher odds of adverse maternal and fetal outcomes.Patients with a history of GDM were at a significantly increased risk for recurrence of GDM in subsequent pregnancies.Our previous and some other studies found an increased incidence of adverse perinatal outcomes in pregnant with recurrent GDM.^([1])So far,women with a prior history of GDM are not recommended to refrain from subsequent pregnancy in light of the limited available data.What about those women with a history of recurrent GDM?Should women with recurrent GDM be recommended to avoid further pregnancy?Currently,studies on perinatal outcomes of women with re-recurrent GDM and their prognostic factors are very rare.Therefore,this retrospective cohort study was performed to explore perinatal outcomes of pregnant woman with re-recurrent GDM and their prognostic factors.

关键词： mellitus pregnancy diabetes

Intrauterine Treatment of Monochorionic Triamniotic Triplet Pregnancy with Twin Reverse Arterial Perfusion Sequence

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Maternal-Fetal Medicine 2024年第2期6卷 120-123页

作者： Xiaomin Zhao Yongmei Shen Lying Yao Lei Zhang Shanshan Li Wen Li Hong Yu Ling Chen Ying Chang Tianjin Key Laboratory of Human Development and Reproductive Regulation Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity HospitalTianjin 300100China Prenatal Diagnosis Center Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity HospitalTianjin 300100China Radiology Department Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity HospitalTianjin 300100China Pathology Department Tianjin Central Hospital of Obstetrics and Gynecology/Nankai University Affiliated Maternity HospitalTianjin 300100China.

To editor:This study reports a pregnant woman who was naturally conceived with monochorionic triamniotic(MCTA)combined with twin reversed arterial perfusion(TRAP).An ultrasound revealed that one of the fetuses had a cardiac malformation,and a connection between the umbilical arteries was suspected.To reduce the acardiac fetus,radiofrequency ablation was performed at 17+3 weeks of pregnancy.At 36+4 weeks,two healthy infants were delivered via elective cesarean section.Postoperative examination revealed a direct connection between the umbilical arteries,with the placental perfusion acting as a direct pump.It is essential to identify the intrauterine status of the blood-supplying infant and vascular connections in order to achieve successful outcomes in pregnancies with complications,such as edema and heart failure.The studies involving human participants were reviewed and approved by Human Research Ethics Committee of Tianjin central hospital of obstetrics and gynecology.The patient provided her written informed consent to participate in this study.

关键词： Twinning Embryonic Monochorionic triamniotic Twin reversed arterial perfusion sequence Fetus reduction Placental perfusion

Clinical observation on 90 cases of primary dysmenorrhea treated by buccal acupuncture therapy:a randomized controlled study

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Journal of Traditional Chinese Medicine 2024年第1期44卷 172-181页

作者： YANG Yi YE Huijun ZHENG Huiling JIN Lihua Department of obstetrics and gynecology the Second Affiliated Hospital of Zhejiang Chinese Medical UniversityXinhua Hospital of Zhejiang ProvinceHangzhou 310005China

OBJECTIVE:To explore the short-term and long-term efficacy of buccal acupuncture therapy in the treatment of patients with primary dysmenorrhea(PD).METHODS:A total of 90 patients with PD who were admitted to the Second Affiliated hospital of Zhejiang University of Traditional Chinese Medicine from January 2020 to December 2021 were included in this study and randomly divided into three groups,including the observation group,the control group,and the placebo group,with 30 patients in each group.Patients in the observation group were treated according to the syndrome types of Traditional Chinese Medicine,those in the control group were treated with Saridon,and those in the placebo group received a placebo.The visual analog scale(VAS)scores of these patients were evaluated at different time points(before treatment,5 min after needle retention,30 min after needle retention,1 h after treatment,2 h after treatment,1 d after treatment,and 2 d after treatment).The Cox Menstrual Symptom Scale(CMSS)scores were assessed before the treatment and after three courses of treatment.Besides,these two scales were also evaluated during follow-up.Moreover,the pain score and adverse reactions of these patients were assessed during treatment.RESULTS:After treatment,the VAS and CMSS scores in the observation group decreased significantly(P<0.05)5 and 30 min after needle retention and after treatment.CONCLUSION:Buccal acupuncture therapy is verified to have short-term efficacy in the treatment of PD.In addition,this therapy has an immediate analgesic effect and long-term efficacy in reducing the severity and frequency of PD.

关键词： buccal acupuncture therapy primary dysmenorrhea pain score randomized controlled trial

Curcumin modulates oxidative stress to inhibit pyroptosis and improve the inflammatory microenvironment to treat endometriosis

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Genes & Diseases 2024年第3期11卷 102-105页

作者： Jie Ding Shanshan Mei Kaili Wang Wen Cheng Shuai Sun Zhexin Ni Xiaoqiu Wang Chaoqin Yu Department of gynecology of Traditional Chinese Medicine Changhai Hospital Affiliated to Naval Medical UniversityShanghai 200433China obstetrics and gynecology Department The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhouZhejiang 310006China Department of Pharmaceutical Sciences Beijing Institute of Radiation MedicineBeijing 100850China obstetrics and gynecology hospital of Fudan University Shanghai 200433China

Endometriosis(EM)is a common disease that affects approximately 10%-15%of women of childbearing age.The pathogenesis of EM is unclear,but studies have shown a strong association between EM and inflammation,as well as oxidative stress.^(1) Pyroptosis is also called inflammatory cell death.When pyroptosis occurs,it activates a strong inflammatory response.Pyroptosis is associated with oxidative stress,and Ros act as intermediate triggers to activate pyroptosi.

关键词： inflammatory death oxidative

The Support Systems and Coping Strategies of Infertile Women Attending the Out-Patient Consultation unit of CHRACERH yaoundé, Cameroon: A Cross-Sectional Study

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Open Journal of obstetrics and gynecology 2024年第6期14卷 869-887页

作者： Emenguele Pascale Mpono Fidelia Mbi Kobenge Gabrielle Laure Mengne Etienne Belinga Jean Marie Kasia Thomas Obinchemti Egbe Department of obstetrics and gynecology CHRACERH Yaound Yaound Cameroon Department of obstetrics and gynecology Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon Department of obstetrics and gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of obstetrics and gynecology Douala General Hospital Douala Cameroon Department of obstetrics and gynecology Faculty of Health Sciences University of Buea Buea Cameroon

Background: Infertility is a complex disorder with significant psycho-social and economic consequences. It globally affects 10% - 15% of couples. In Cameroon, little is known about what women do to overcome the psychosocial aspects of the disease. Objectives: This study aimed to identify the support systems and coping strategies of infertile women attending the outpatient consultation unit of the Gynaecological Endoscopic Surgery and Reproductive Teaching hospital (CHRACERH), yaoundé, Cameroon. Methods: A hospital-based cross-sectional study was conducted from the 14th of March to the 6th of April 2023 at CHRACERH yaoundé. A total of 190 participants were recruited using a convenience sampling method. Data regarding socio-demographic characteristics, support systems and coping strategies were collected using a pretested questionnaire. Descriptive and analytic statistics were conducted using SPSS version 25. Results: The mean age of participants was 39.52 ± 7.64 years. The majority 78.9% of participants were workers (public, private sector, or traders) and were Christians 95.8%. The most common source of psychological support was from family 76.8 and husbands 72.63%. Most of the participants 89.5% resorted to prayer and getting busy 48.4% as a coping strategy. There was no statistically significant relationship between coping strategies and psychological disorders p > 0.05. Conclusion: The main support system of participants was family, husband, and friends. Prayer, getting busy and adoption were the most common coping strategies. There is a need for the Ministry of Public Health and other stakeholders to put in place other support systems and coping strategies (FELICIA) used elsewhere and provide adequate health education and infection control to prevent infertility in Cameroon.

关键词： Infertility Coping Strategies Support Systems Mental Health Women

Histological Features of Uterine Myometrial Dysfunction:Possible Involvement of Localized Inflammation

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Current Medical Science 2024年第3期44卷 633-641页

作者： Sheng-lan ZHU Hui-ting ZHANG Yuan-yuan DU Yi JIANG Shao-shuai WANG Wen-cheng DING Ling FENG National Clinical Research Center for obstetrics and gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of obstetrics and gynecology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective The latest perspective suggests that elevated levels of inflammation and cytokines are implicated in atonic postpartum hemorrhage.Lipopolysaccharide(LPS)has been widely used to induce inflammation in animal models.Therefore,this study aimed to induce uterine inflammation using LPS to investigate whether local inflammation triggers dysfunction and atrophy in the myometrium,as well as the potential underlying molecular mechanisms involved.Methods In vivo,an animal model was established by intraperitoneal injection of 300μg/kg LPS in rats on gestational day 21.Hematoxylin-eosin(H&E)staining and Masson staining were employed to determine morphological changes in the rat uterine smooth muscle.Enzyme-linked immunosorbent assay(ELISA)was used to detect inflammatory cytokines.Immunohistochemistry,tissue fluorescence,and Western blotting were conducted to assess the expression levels of the uterine contraction-related proteins Toll-like receptor 4(TLR4)and the nuclear factor kappa-B(NF-κB)signaling pathway.In vitro,human uterine smooth muscle cells(HUtSMCs)were exposed to 2μg/mL LPS to further elucidate the involvement of the TLR4/NF-κB signaling pathway in LPS-mediated inflammation.Results In this study,LPS induced uterine myometrial dysfunction in rats,leading to a disorganized arrangement,a significant increase in collagen fiber deposition,and widespread infiltration of inflammatory cells.In both in vivo animal models and in vitro HUtSMCs,LPS elevated IL-6,IL-1β,and TNF-αlevels while concurrently suppressing the expression of connexin 43(Cx43)and oxytocin receptor(OXTR).Mechanistically,the LPS-treated group exhibited TLR4 activation,and the phosphorylation levels of p65 and IκBαwere notably increased.Conclusion LPS triggered the TLR4/NF-κB signaling pathway,inducing an inflammatory response in the myometrium and leading to uterine myometrial dysfunction and uterine atony.

关键词： lipopolysaccharide inflammatory response TLR4 NF-κB myometrium

Chinese Population Reference Curves for Ultrasound-Measured Amniotic Fluid Deepest Vertical Pocket in Dichorionic Twin Pregnancies,and Their Associations With Pregnancy Outcomes

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Maternal-Fetal Medicine 2024年第1期6卷 29-36页

作者： Zhengxin Lyu Tianchen Wu Shan Lu Pengbo Yuan Yangyu Zhao Yuan Wei Department of obstetrics and gynecology Peking University Third HospitalBeijing 100191China

Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:This retrospective cohort study,conducted at Peking University Third hospital from August 2011 to December 2020,used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound.After exclusions,reference curves were developed using 318 women with 3,299 DVP scans,and the data analyzed included maternal demographics,pregnancy outcomes,ultrasound measurements,and neonatal information.DVPs were assessed via ultrasound at regular intervals and grouped by gestational age(GA)for analyses.Linear mixed models were used to create amniotic fluid reference curves.Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests.Logistic regression provided both crude and adjusted odds ratios,adjusting for pre-pregnancy weight,age,ethnicity,parity,and conception mode.Significance was set at P<0.05 with 95%confidence intervals(CI),and the analyses were conducted using SPSS ver.26.0(IBM Corp.,Armonk,NY)and SAS ver.9.4(SAS Institute Inc.,Cary,NC,USA)software.Results:DVP increased from the first trimester to a maximum at 26 weeks(95%confidence interval(CI),2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2)and then decreased gradually toward term.Differences between twins 1 and 2 were significant after 26 weeks(95%CI for twin 1:5.3,5.5;95%CI for twin 2:4.4,4.5;P<0.010).Polyhydramnios of twin 1 increased the risk of large for GA.Oligohydramnios of twin 1 increased the risk of small for GA.Polyhydramnios of twin 2 increased the risk of small for GA,premature birth,and neonatal complications.Oligohydramnios of twin 2 increased the risk of preeclampsia,hypertensive disorder complicating pregnancy,and premature rupture of membranes.Conclusion:Reference curves for twin amniotic fluid volumes vary by GA and

关键词： Amniotic fluid Amniotic fluid deepest vertical pocket Reference curve Dichorionic twin Pregnancy outcome Ultrasound examination

Association between body mass index and in vitro fertilization/intra-cytoplasmic sperm injection outcomes: An analysis of 15,124 normal ovarian responders in China

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中华医学杂志(英文版) 2024年第7期137卷 837-845页

作者： Zheng Danlei Wang Yuanyuan Chen Lixue Zeng Lin Li Rong Department of obstetrics and gynecology Center for Reproductive Medicine Peking University Third hospital Beijing 100191 China Research Center of Clinical Epidemiology

Background: High body mass index (BMI) results in decreased fecundity, and women with high BMI have reduced rates of clinical pregnancy and live birth inin vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Meanwhile, ovarian responses show great heterogeneity in patients with a high BMI. This study aimed to analyze the effects of a high BMI on IVF/ICSI outcomes in the Chinese female with normal ovarian response.Methods: We performed a retrospective cohort study comprising 15,124 patients from the medical record system of the Reproductive Center of Peking University Third hospital, with 3530 (23.3%) in the overweight group and 1380 (9.1%) in the obese group, who had a normal ovarian response (5-15 oocytes retrieved) and underwent fresh embryo transfer (ET) cycles from January 2017 to December 2018, followed by linked frozen-thawed embryo transfer (FET) cycles from January 2017 to December 2020. Cumulative live birth rate (CLBR) was used as the primary outcome. Furthermore, a generalized additive model was applied to visually illustrate the curvilinear relationship between BMI and the outcomes. We used a decision tree to identify the specific population where high BMI had the greatest effect on IVF/ICSI outcomes.Results: High BMI was associated with poor IVF/ICSI outcomes, both in cumulative cycles and in separate fresh ET or FET cycles. In cumulative cycles, compared with the normal weight group, obesity was correlated with a lower positive pregnancy test rate (adjusted odds ratio [aOR]: 0.809, 95% confidence interval [CI]: 0.682-0.960), lower clinical pregnancy rate (aOR: 0.766, 95% CI: 0.646-0.907), lower live birth rate (aOR: 0.706, 95% CI: 0.595-0.838), higher cesarean section rate (aOR: 2.066, 95% CI: 1.533-2.785), and higher rate of large for gestational age (aOR: 2.273, 95% CI: 1.547-3.341). In the generalized additive model, we found that CLBR declined with increasing BMI, with 24 kg/m2 as an inflection point. In the decision tree, BMI only made a difference in the population aged ≤34.5 yea

关键词： Obesity Body mass index In vitro fertilization Live birth Decision trees Normal ovarian response

Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon

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Open Journal of obstetrics and gynecology 2024年第6期14卷 967-978页

作者： Jeffrey-Lewis Nzang Cliford Ebontane Ebong Simon Manga Florence Manjuh Félix Essiben Isidore Tompeen Judith Seungue Serge Robert Nyada Jeanne Hortence Fouedjio Ymele Fouelifack Julius Sama Dohbit Kloukanmey Zonal hospital Mdecins Sans Frontires Kloukanmey Benin Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon gynecology and obstetrics unit Central Hospital of Yaound Yaound Cameroon Womens Health Program Cameroon Baptist Convention Health Services Yaound Cameroon Department of obstetrics and Gynaecology Gyneco-Obstetric and Pediatric Hospital of Yaound Yaound Cameroon Expanded Program of Immunization Ministry of Health Yaound Cameroon Department of obstetrics and Gynaecology Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaounde Cameroon Department of obstetrics and Gynaecology University of Dschang Dschang Cameroon Higher Institute of Medical Technology Nkolondom Yaound Cameroon

Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist hospitals in yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity.

关键词： High-Risk Human Papillomavirus Precancerous Digital Cervicography VIA/VILI Serotype

Emerging mechanisms and implications of c GAS-STING signaling in cancer immunotherapy strategies

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Cancer Biology & Medicine 2024年第1期21卷 45-64页

作者： Jiawen Zhang Sihui Yu Qiao Peng Ping Wang Lan Fang Tongji University Cancer Center Shanghai Tenth People’s HospitalSchool of MedicineTongji UniversityShanghai 200072China Reproductive Medicine Center Department of Obstetrics and GynecologyShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 201620China Department of obstetrics and gynecology Zhongshan HospitalFudan UniversityShanghai 200032China

The intricate interplay between the human immune system and cancer development underscores the central role of immunotherapy in cancer treatment.Within this landscape,the innate immune system,a critical sentinel protecting against tumor incursion,is a key player.The cyclic GMP-AMP synthase(c GAS)and stimulator of interferon genes(STING)pathway has been found to be a linchpin of innate immunity:activation of this signaling pathway orchestrates the production of type I interferon(IFN-α/β),thus fostering the maturation,differentiation,and mobilization of immune effectors in the tumor microenvironment.Furthermore,STING activation facilitates the release and presentation of tumor antigens,and therefore is an attractive target for cancer immunotherapy.Current strategies to activate the STING pathway,including use of pharmacological agonists,have made substantial advancements,particularly when combined with immune checkpoint inhibitors.These approaches have shown promise in preclinical and clinical settings,by enhancing patient survival rates.This review describes the evolving understanding of the c GAS-STING pathway's involvement in tumor biology and therapy.Moreover,this review explores classical and non-classical STING agonists,providing insights into their mechanisms of action and potential for optimizing immunotherapy strategies.Despite challenges and complexities,the c GAS-STING pathway,a promising avenue for enhancing cancer treatment efficacy,has the potential to revolutionize patient outcomes.

关键词： cGAS-STING pathway type I interferon cyclic dinucleotide STING agonist cancer immunotherapy