Gynecology and Obstetrics Clinical Medicine最新文献

{"title":"Anal cancer screening in women with a history of human papillomavirus-related lower genital tract cancers: a pilot study","authors":"I. M. Poynten, Fengyi Jin, Rhonda Farrell, Trevor Tejada-Berges, C. Law, Richard Hillman, J. Roberts, Andrew Grulich","doi":"10.1136/gocm-2024-000001","DOIUrl":"https://doi.org/10.1136/gocm-2024-000001","url":null,"abstract":"Women diagnosed with a history of lower genital tract cancer (LGTC) and precancer are at increased risk of anal cancer. Screening for anal cancer in a manner analogous to cervical cancer may detect precursor anal high-grade squamous intraepithelial lesions (HSILs) and prevent progression to cancer.In a pilot study of anal cancer screening, women with previous LGTC and aged ≥18 years in Sydney, Australia underwent a digital anorectal examination, anal swab for human papillomavirus (HPV) and p16/Ki67 testing and completed a questionnaire. Participants with positive HPV and/or p16/Ki67 results were referred for a high-resolution anoscopy (HRA) and evaluation of their HSILs.Of 52 participants, 46 agreed to screening and 6 provided demographic information only. Median age was 46.5 years (IQR: 36.0–59.0). Anal high-risk HPV (HRHPV) was detected in only seven (15.2%) participants (three HPV16). Eight (17.4%) had positive p16/Ki67 dual staining, with invalid results for 25 (54.4%). Of 10 women referred for HRA, 9 attended and 3 had HSILs, representing 6.5% of the screened population. Questionnaires were completed by 41 participants (89.1%). The majority reported that being screened was reassuring (97.5%) and was positive for their health (95.1%).This pilot study demonstrated a lower-than-expected prevalence of anal HRHPV. Screening with HRHPV and p16/Ki67 staining identified anal HSILs in 6.5% of screened women. Despite some discomfort, screening was viewed as beneficial by almost all participants. The utility of p16/Ki67 dual staining was low, suggesting it may not be a suitable anal cancer screening methodology.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical steps in the conceptualisation of the urethral ligament plication (ULP), a tape-free operation for stress urinary incontinence (SUI) cure","authors":"P. Petros","doi":"10.1136/gocm-2024-000017","DOIUrl":"https://doi.org/10.1136/gocm-2024-000017","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese expert consensus on diagnosis and treatment of anal intraepithelial neoplasia","authors":"Yanyun Li, Hongwei Zhang, Qing Cong, Mingzhu Li, Hui Bi, Yun Zhao, Zhixue You, Qi Zhou, Li Geng, Mingrong Qie, Fanghui Zhao, Linhong Wang, Beihua Kong, Ding Ma, Long Sui, Lihui Wei","doi":"10.1136/gocm-2024-000013","DOIUrl":"https://doi.org/10.1136/gocm-2024-000013","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic management of perivascular a retroperitoneal perivascular ectopic pregnancy","authors":"Guo Zhang, Junxiang Ren, Jianliu Wang","doi":"10.1136/gocm-2024-000024","DOIUrl":"https://doi.org/10.1136/gocm-2024-000024","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of oestrogen and oestrogen-calcium axis in endometrial carcinoma","authors":"Xuerun Liu, Jianliu Wang, Jingyi Zhou","doi":"10.1136/gocm-2024-000012","DOIUrl":"https://doi.org/10.1136/gocm-2024-000012","url":null,"abstract":"Unopposed oestrogen is recognised as an inducer of endometrial cancer. Over the past 50 years, the effects of oestrogen on the endometrium and endometrial cancer have been a hot topic in the field of gynaecological oncology. In recent years, a series of studies by our team revealed that the non-genomic transcriptional effects of oestrogen can influence the progression of endometrial carcinoma by regulating calcium ions, suggesting that inhibiting calcium ion channel proteins could serve as an adjuvant therapy for endometrial cancer. In this review, we retrospectively summarise the sources of oestrogen in vivo, the effects of oestrogens on the uterus and endometrium, oestrogen signalling and the clinical application of oestrogen-related compounds, emphasising the significant role of oestrogen–calcium axis inhibition in adjuvant therapy for endometrial cancer.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rationality of the FIGO2023 staging for early-stage endometrial cancer, compared with the FIGO2009 staging","authors":"Aoxuan Zhu, Yangyang Dong, Xingchen Li, Yiqin Wang, Jianliu Wang","doi":"10.1136/gocm-2024-000016","DOIUrl":"https://doi.org/10.1136/gocm-2024-000016","url":null,"abstract":"The International Federation of Gynecology and Obstetrics (FIGO) released a new staging for endometrial cancer (EC), which revised the FIGO2009 staging to include histopathological and molecular features. The purpose of this study was to validate the prognostic accuracy of the new staging and discuss its clinical applicability.In this single-centre retrospective study, 540 patients with primary surgically treated early-stage EC were enrolled and staged according to FIGO2009/2023. Kaplan-Meier survival analysis was used to compare for prognostic differentiation. Cox regression was used to identify potential prognostic indicators.A total of 81 patients underwent staging shifts, all stage elevation. The prognosis difference between new stages I and II was more significant. The new staging was more predictive of death postoperatively. Lesion maximum diameter (LMD) was one of the independent risk factors associated with prognosis. Taking LMD=5.70 cm as the cut-off value could further differentiate patients with divergent prognoses within FIGO2023 stage IIC.FIGO2023 staging demonstrated greater prognostic accuracy. In addition, LMD may be another critical factor affecting prognosis.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Externally validated nomogram for predicting short-term pregnancy outcome of singleton pregnancies with fetal growth restriction (FGR)","authors":"Fufen Yin, Mingrui Jin, Yujing Li, Yang Li, Xiuju Yin, Junshu Xie, Xiaohong Zhang","doi":"10.1136/gocm-2024-000009","DOIUrl":"https://doi.org/10.1136/gocm-2024-000009","url":null,"abstract":"This study aimed at developing an available predictive model of singleton pregnancies with fetal growth restriction (FGR) for accurate and individualised prognosis assessment.The prediction nomogram was developed by using multivariable Cox regression with data for 301 singleton FGR pregnancies at Peking University People’s Hospital. External validation was performed in 321 eligible singleton FGR pregnancies at the Affiliated Hospital of Qingdao University.Absent umbilical arterial flow, fetal anomaly, history of abnormal pregnancy, non-cephalic presentation and history of caesarean section were independent prognostic factors for adverse perinatal outcomes in singleton FGR pregnancies in the training set. In the training cohort of the internal validation set, the nomogram estimated pregnancy prognosis of FGR singleton pregnancies based on these five variables, with a concordance index (C-index) of 0.859 (95% CI: 0.81 to 0.90) for predicting termination of pregnancy (TOP), which included intrauterine fetal death and therapeutic lethal induction, with a C-index of 0.92 (95% CI: 0.86 to 0.98) for predicting stillbirth, and a C-index of 0.87 (95% CI: 0.83 to 0.92) for predicting therapeutic lethal induction with indications. Encouragingly, consistent results were observed in the external validation set, with a C-index of 0.776 (95% CI: 0.71 to 0.84) for predicting TOP, which included intrauterine fetal death and therapeutic lethal induction, with a C-index of 0.773 (95% CI: 0.70 to 0.84) for predicting stillbirth, and a C-index of 0.776 (95% CI: 0.70 to 0.85) for predicting therapeutic lethal induction with indications. Furthermore, the calibrations of the nomograms predicting the 28th and 34th TOP-free gestation week strongly corresponded to the actual survival outcome.This prediction model may help clinicians in decision-making for singleton pregnancies with FGR, especially for patients with a single abnormal umbilical arterial flow or fetal anomaly, without induced labour indications for these abnormalities.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytokine landscapes of pregnancy: mapping gestational immune phases","authors":"S. Dutta, P. Sengupta, Fong Fong Liew","doi":"10.1136/gocm-2024-000011","DOIUrl":"https://doi.org/10.1136/gocm-2024-000011","url":null,"abstract":"Synchronised physiological adaptations occur during pregnancy to achieve systemic, immune and neuroendocrine equilibrium in the mother’s body, allowing semiallogenic fetal growth.Depending on the cytokine profile alterations occurring through pregnancy, the latter can be divided into three distinct phases. In the first immunological phase of pregnancy, proinflammatory cytokines promote inflammatory reactions needed for implantation. In the second phase, a possible change from proinflammatory to anti-inflammatory cytokines creates a symbiosis between maternal and fetal components, ensuring fetal development. In the third phase, inflammatory and cytolytic cytokines operate again to reinforce an inflammatory environment for parturition. The article offers a detailed account of immune adaptations during pregnancy and highlights the distinctive cytokine profiles that mark each phase.By providing a simplified depiction of pregnancy phases based on cytokine profiles, the article aims to inspire more research in reproductive immunology and improve the management of pregnancy-related inflammation and infection.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in research on transcutaneous electrical acupoint stimulation for alleviating pelvic pain in women","authors":"Yi Ling Wang, Xin Lei Lu, Shang Wang, Xiao Hong Chang, Rong Zhang, Hong-Lan Zhu","doi":"10.1136/gocm-2024-000006","DOIUrl":"https://doi.org/10.1136/gocm-2024-000006","url":null,"abstract":"Pelvic pain is a common complaint of discomfort in women, with an increasing incidence and seriously affecting patients’ quality of life. Its etiology involves multiple systems and disciplines, and therefore treatment modalities are diverse. Transcutaneous electrical acupoint stimulation (TEAS) therapy is a classic analgesic means, and electrical stimulation of local acupoints can achieve obvious analgesic effects. This review aims to discuss the application of TEAS for the treatment of various types of pelvic pain, the selection of optimal parameters and the renewal of equipment.TEAS for treatment of pelvic pain in women has been reported mainly for endometriosis, pelvic inflammatory disease (PID), intrauterine adhesion (IUA), pelvic stasis syndrome, interstitial cystitis, primary dysmenorrhoea and other diseases. And for parameter selection, the most used of frequency is dilatational wave, the most used stimulation intensity is 10–20 mA, and the acupoint selection should be based on the specific conditions of the patient.The analgesic mechanism of TEAS has not been fully elucidated, but the efficacy of the treatment is remarkable and there are no significant adverse effects. The selection of the parameters for TEAS and the combination of acupoints for different pains are still the main directions of future research.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state and influencing factors of social alienation in patients with stress urinary incontinence","authors":"Lili Xing, Lianhua Bai, Sen Li, Jingjing Gong, Xiaoting Wei, Lei Liu, Ting Chen, Xiaodan Li","doi":"10.1136/gocm-2024-000018","DOIUrl":"https://doi.org/10.1136/gocm-2024-000018","url":null,"abstract":"To understand the current level of social alienation among patients with stress urinary incontinence (SUI) and analyse the influencing factors to provide a foundation for better clinical support for patients’ reintegration into society.We conducted a comprehensive survey and analysis involving 230 patients with SUI using a general information questionnaire, a general sense of alienation scale and a social impact scale.The general sense of alienation scale score of patients with SUI was 25.43±13.994, while the social impact score was 39.25±12.167. Multiple linear regression analysis revealed that marital status, primary caregiver, presence of concurrent illnesses and severity of urinary incontinence were the key influencing factors contributing to SUI-related social alienation (p<0.05).Patients who suffered from SUI experienced a moderate level of social alienation. Tailored interventions are recommended, especially for individuals who are divorced, rely on friends or relatives as primary caregivers, have concurrent illnesses or experience severe SUI, to enhance their social integration.","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}