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Epidemiological and Prognostic Aspects of Obesity and Pregnancy in the gynecology-obstetrics Department at the Sylvanus Olympio University Hospital center (CHU SO) in Lomé

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Open Journal of obstetrics and gynecology 2023年第1期13卷 88-96页

作者： Komlan Alessi Andele Ameyo Ayoko Ketevi Baguilane Douaguibe Akila Bassowa Dédé Régine Diane Ajavon Kodjo Fiagnon Abdoul Samadou Aboubakari Koffi Akpadza Department of gynecology and obstetrics Sylvanus Olympio University Hospital Center Lome Togo Department of gynecology and obstetrics Campus University Hospital Center Lome Togo Department of gynecology and obstetrics Regional Hospital Center Kara Togo Department of gynecology and obstetrics Kara University Hospital Center Kara Togo

Introduction: Obesity and pregnancy is a major public health problem worldwide, both maternal and fetal. Objective: This is to describe the epidemiological and prognostic aspects of obesity and pregnancy in the gynecology-obstetrics department at the Sylvanus Olympio University Hospital center (CHU SO) in Lomé. Methodology: This was a descriptive cross-sectional study concerning obesed pregnant women. The survey was conducted from the 1st to the 30th of June 2022 at the CHU SO. Results: We enrolled 55 obese pregnant women. The frequency of obesity and pregnancy was 5.14%. Resellers were represented at 41.8%. The average age was 31 years old. As risk factors, 85.5% claimed to have a fatty diet and 76% did not practice sports. The gestational pathologies found during pregnancy were hypertension in 47.4% of cases, preeclampsia in 24.6% and gestational diabetes in 7%. Caesarean section was the way of delivery in 63.6% of cases and those who gave birth vaginally presented a tear of the soft tissues in 85% of cases. Birth weight was abnormal (low weight and excess weight) in 61.8% of cases. Conclusion: The association between obesity and pregnancy constitutes an important risk factor for the mother and the fetus.

关键词： Obesity Pregnancy CHU SO Togo

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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

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Identifying Comprehensive Genomic Alterations and Potential Neoantigens for Cervical Cancer Immunotherapy in a Cohort of Chinese Squamous Cell Carcinoma of the Cervix

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Biomedical and Environmental Sciences 2024年第6期37卷 565-580页

作者： Meng Wu Jialu Zhou Zhe Zhang Yuanguang Meng School of Medicine Nankai UniversityTianjin 300071China Department of obstetrics and gynecology The First Medical Center of Chinese PLA General HospitalBeijing 100853China Department of obstetrics and gynecology Chinese PLA Medical SchoolBeijing 100853China Department of obstetrics and gynecology The Seventh Medical Center of Chinese PLA General HospitalBeijing 100700China

Objective Genomic alterations and potential neoantigens for cervical cancer immunotherapy were identified in a cohort of Chinese patients with cervical squamous cell carcinoma(CSCC).Methods Whole-exome sequencing was used to identify genomic alterations and potential neoantigens for CSCC immunotherapy.RNA Sequencing was performed to analyze neoantigen expression.Results Systematic bioinformatics analysis showed that C>T/G>A transitions/transversions were dominant in CSCCs.Missense mutations were the most frequent types of somatic mutation in the coding sequence regions.Mutational signature analysis detected signature 2,signature 6,and signature 7 in CSCC samples.PIK3CA,FBXW7,and BICRA were identified as potential driver genes,with BICRA as a newly reported gene.Genomic variation profiling identified 4,960 potential neoantigens,of which 114 were listed in two neoantigen-related databases.Conclusion The present findings contribute to our understanding of the genomic characteristics of CSCC and provide a foundation for the development of new biotechnology methods for individualized immunotherapy in CSCC.

关键词： Cervical squamous cell carcinoma Genome alteration Neoantigens Immunotherapy

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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

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Inpatient disease spectrum and clinical characteristics of surgical disorders in pediatric and adolescent gynecology: A single-institute study of 12 years data from China

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中华医学杂志(英文版) 2024年第10期137卷 1240-1242页

作者： Huang He Wang Siyun Zhan Ruixi Yin Ling Hu Yongchun Yang Donglai Shi Yangyang Department of obstetrics and gynecology Peking University First Hospital Xicheng District Beijing China Department of obstetrics and gynecology Inner Mongolia Ulanqab Second Hospital Ulanqab Inner Mongolia China Department of obstetrics and gynecology Jiujiang University Affiliated Hospital Jiujiang Jiangxi China

Pediatric and adolescent gynecology (PAG) is a specialized branch of gynecology that focuses on reproductive health issues of women from infancy to adolescence.[1] In 1939, the Hungarian Dobszay first established the new branch. Since then, the PAG subject has begun to develop and gradually matured in the past 80 years. While PAG has witnessed significant development in western countries, a substantial unmet need persists in addressing specific health concerns among children and adolescents with gynecological disorders. In China, where the PAG discipline is still in its infancy, this situation becomes even more critical. The diseases young females experience in the gynecological field have own particularities.[ 1] Also, PAG shares connections with various medical disciplines, notably surgery. Investigating the inpatient disease spectrum, prevalence rates, and clinical characteristics of PAG surgical disorders is of significant clinical importance, yet no previous research has addressed this in China or other countries. Therefore, the study retrospectively analyzed the clinical data of 512 PAG inpatients aged 0-18 years who received surgical treatment at Peking University First Hospital (PKUFH) from January 2010 to May 2022, so as to comprehensively outline the inpatient disease spectrum and clinical characteristics of surgical disorders in PAG, with the aim of offering management recommendations and evidential support for future clinical work. The study was approved by the Institutional Review Board of PKUFH (No. 2022[593]) and informed consent was waived due to the retrospective nature of the study. Non-normally distributed quantitative variables are shown as median (Q1, Q3), and categorical variables as count and percentage. Comparison tests were performed using chi-squared test and Fisher's exact test.

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Perinatal outcomes of re-recurrent gestational diabetes mellitus and their prognostic factors:A retrospective cohort study in China

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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

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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

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The impact of broad glutamine metabolism inhibition on the tumor microenvironment

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Genes & Diseases 2024年第3期11卷 2-4页

作者： Tianhe Li Yun-Ta Chuang Tian-Li Wang Departments of Pathology Oncologyand Gynecology and ObstetricsThe Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University School of MedicineBaltimoreMD 21231USA

Glutamine is an importantα-amino acid that provides carbon and nitrogen sources for the biosynthesis of nucleotides,proteins,and lipids.It also generates metabolites that fuel the tricarboxylic acid cycle and maintain intracellular redox balances.Malignant cells have a heightened metabolic dependence on glutamine to support incessant tumor growth and mitigate tumor microenvironmental stresses including hypoxia,nutrient depletion.

关键词： metabolism tumor microenvironment

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Maternal Deaths after Obstetrical Referral and/or Evacuation to the obstetrics gynecology Clinic of the Sylvanus Olympio University Hospital center, Togo

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Advances in Reproductive Sciences 2023年第2期11卷 37-45页

作者： Ameyo Ayoko Ketevi Bidilukinu Katende Akila Bassowa Komlan Alessi Andele Baguilane Douaguibe Dédé Régine Diane Ajavon Abdoul Samadou Aboubakari Koffi Akpadza Department of gynecology-obstetrics Faculty of Health Sciences University of Lome Lomé Togo Department of gynecology-obstetrics Faculty of Health Sciences University of Kara Kara Togo

Introduction: Maternal death or maternal mortality is “the death of a woman occurring during pregnancy or within 42 days of termination, regardless of duration or location, for any specific cause or aggravated by pregnancy or its management, but neither accidental nor fortuitous. Methods: This was a descriptive and analytical cross-sectional study carried out from January 1st, 2021 to April 30th, 2022 at the obstetrics gynecology Clinic of the Sylvanus Olympio University Hospital center (SOUHC). Results: we noted 86 cases of maternal deaths after referral/evacuation i.e. a maternal mortality rate hospital of 555 maternal deaths per 100,000 LB. The average age of the patients was 31.1 ± 6.3 years with extremes of 15 and 45 years. In 33.7% of cases our patients were resellers. Multiparas represented 33.7% of the sample, they had performed less than three antenatal consultations. Postpartum hemorrhage was the reference reason in 33.7%. In 74.4% of cases, the patients referred had arrived by taxi. In 87.9% of cases, the patients had died of direct obstetric causes. Immediate postpartum hemorrhage accounted for 44.6% of cases and anemia, 36.4%. There is a statistically significant association between the availability of blood product and the avoidability of maternal death after obstetrical referral and/or evacuation (p value = 0.0188 0.05). Conclusion: Determining responsibility for maternal death is not always easy. There is an urgent need to strengthen the policy of reducing maternal mortality in Togo. This remains possible by developing communication strategies and a solid referral/counter-referral system.

关键词： Maternal Death Reference Counter Reference Togo

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Timing theory integrated nursing combined behavior change integrated theory of nursing on primiparous influence

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World Journal of Clinical Cases 2024年第2期12卷 293-301页

作者： Yan-Xia He Yang Lv Ting-Ting Lan Fang Deng Yuan-Yuan Zhang Department of obstetrics and gynecology Wuhan Children’s HospitalWuhan 430015Hubei ProvinceChina center for Reproductive Medicine Department of Obstetrics and GynecologySichuan Provincial People's HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610072Sichuan ProvinceChina

BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be a

关键词： Timing theory Behavior change Primipara Bad mood Quality of life

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