ObjectiveTo explore the effect of chronic unpredictable mild stress (CUMS) on the reproductive function of mice and provide a suitable animal model for reproduction and stress. MethodsA total of 240 female Kunming mice were feed for 5 days, and then divided randomly into the control group (n=90) and experimental group (n=150). The mice in the experimental group were stressed by 9 chronic mild unpredictable stress factors for 4 weeks and validated by open field test and sucrose consumption test. We administrated pregnant mare serum gonadotropin (PMSG)/human chorionic gonadotropin (HCG) for induction of superovulation and observed the ovarian response and embryo development potential. ResultsAfter 4-week CUMS stimulation, the weight gain, 2% sugar consumption test and open field test were significantly different between the mice in two groups (P>0.05). After PMSG/HCG was administrated, the antra follicles and preovulatory follicles significantly reduced significantly in the experiment group than that in the control group (P<0.05); the number of oocytes, fertilization rate, 2-cell embryos, D4 embryos, blastocysts, high quality embryo rate and D5 bed points were all significantly decreased in the experiment group than those in the control group (P<0.05). ConclusionThe CUMS female Kunming mice model is a kind of emotional stress animal model with low reproductive function, which is effective, operable and repeatable; it could be used for further study on the mechanism of reproductive medicine.
ObjectiveTo explore the suitable division of male genitalia subunits and the effectiveness of large-area perineum defect repair under its guidance.MethodsAccording to the anatomical and functional characteristics of male genitalia, the subunit division scheme was proposed: area Ⅰ, glans penis; area Ⅱ, body of penis; area Ⅲ, scrotum; area Ⅳ, scrotum. Between April 2017 and July 2019, 12 patients with large genitalia defects were treated, with an average age of 60.9 years (range, 57-66 years) and an average disease duration of 2.7 years (range, 2-5 years). The defect area involved area Ⅰ in 1 case, area Ⅱ in 7 cases, area Ⅲ in 5 cases, and area Ⅳ in 8 cases; the size of area ranged from 6 cm×4 cm to 23 cm×16 cm. The causes of defect included 3 cases of trauma, 6 cases of Paget disease, 2 cases of squamous cell carcinoma, 1 case of spindle cell tumor. According to the design of the corresponding repair scheme, the main repair methods were to rotate and advance the skin flap and pedicled skin flap in the same area. When the defect was large, the free skin flap transplantation, free skin grafting, and free mucosa transplantation were used to repair the defect.ResultsAll the patients were followed up 6-13 months with an average of 8.6 months. Skin flap, skin graft, and mucosa survived in one stage in 10 patients; infection occurred in 1 case after the scrotal flap of area Ⅲ was transferred to repair the defect in area Ⅱ, 1 case had distal venous crisis at 2 days after repair area Ⅲ defect used free anterolateral thigh flap, and after active treatment, the condition improved. The appearance of the receiving area and the supplying area was good, and the local feeling was recovered satisfactorily. The range of motion of hip joint was good in 10 cases, and 2 cases were slightly stretched but did not affect normal life. All patients had normal urination and defecation function, and were satisfied with the treatment effectiveness.ConclusionThe subunits of male genitalia can be used to guide the repair of the defect, which can better restore the physiological appearance and function, and has positive clinical significance.
【摘要】 目的 探讨超声检查对阴道斜隔综合征的诊断价值，分析超声图像特点，提高诊断率，为临床选用最佳的手术方式提供依据。 方法 回顾性分析2008年1月-2010年6月经手术确诊为阴道斜隔综合征的15例患者的临床资料及超声检查结果，总结阴道斜隔综合征的声像图特点。 结果 15例经临床确诊为阴道斜隔综合征的患者，超声诊断14例，均表现为双子宫、双宫颈、阴道或宫颈积液/血，9例左肾缺如，5例右肾缺如。误诊1例，为单子宫伴一侧附件巨大囊肿。 结论 超声具有诊断准确、简便、无创、重复性好、价格实惠等优点，对于临床诊断生殖系统畸形具有十分重要的意义，应列为首选检查方式。【Abstract】 Objective To investigate the diagnostic value of ultrasonography in examining oblique vaginal septum syndrome, analyze the characteristics of ultrasound image to improve the ultrasound diagnosis rate, in order to provide guidance for clinical surgeries. Methods We retrospectively analyzed the clinical data and ultrasound examination results of 15 patients diagnosed to have oblique vaginal septum syndrome in our hospital, and summarized their ultrasonographic characteristics. Results Among the 15 patients, 14 were diagnosed to have the disease by ultrasound examination. The ultrasound image showed a double uterus, double cervix, and vaginal or cervical fluid or blood for all the patients among whom 9 had absent left kidney, and 5 had absent right kidney. One patient was misdiagnosed to have single uterus with giant cysts on one side. Conclusions Ultrasound diagnosis is simple, noninvasive, reproducible, affordable and accurate in diagnosing. It is very useful in clinical diagnosis of reproductive system abnormalities and should be listed as the preferred way of examinations.
目的 通过检测人睾丸生殖细胞肿瘤中的Skp2蛋白质异常表达,探讨相关意义。 方法 应用S-P免疫组织化学法检测睾丸生殖细胞肿瘤，正常睾丸组织和慢性睾丸炎组织中Skp2的表达。 结果 睾丸生殖细胞肿瘤中Skp2阳性表达率为74.5%，正常睾丸组织中Skp2阳性表达率为20.0%，在慢性睾丸炎组织中Skp2阳性表达率为40.0%，在3种不同睾丸组织中表达差异有统计学意义（P＜0.05）；Skp2表达与不同组织学类型的睾丸生殖细胞肿瘤无相关性（P＞0.05）；随着临床分期的增高，睾丸生殖细胞肿瘤中的Skp2表达增多，差异无统计学意义（P＞0.05）。 结论 在人睾丸生殖细胞肿瘤中的Skp2高表达，提示细胞周期的异常调控在睾丸生殖细胞肿瘤的发生、分化中起着重要的作用。
ObjectiveTo explore the indication and effectiveness of urogenital sinus surgery in feminizing genitoplasty of disorder of sex development (DSD).MethodsA retrospective analysis was made on clinical data from 22 patients with DSD who underwent one stage feminizing genitoplasty between October 2010 and December 2015. The patients’ age ranged from 1 year and 2 months to 21 years, with the median age of 2 years and 1 month. According to the Prader classification criteria, the appearance of vulvas were rated as grade Ⅰ in 7 cases, grade Ⅱ in 6 cases, grade Ⅲ in 8 cases, and grade Ⅳ in 1 case. Cystoscopy was applied before feminizing genitoplasty in all patients. Low confluence of vagina and urethra was found in 19 patients, while high confluence was found in 3 patients. The mean length of urogenital sinus was 1.6 cm (range, 0.5-3.0 cm). The mean length of water-filled vagina was 4.4 cm (range, 3.5-5.5 cm). Cervix was detected at the end of vagina in 16 patients, meanwhile absence of cervix was detected in 6 patients. The same procedures of clitoroplasty and labioplasty were used in all patients. Three procedures of urogenital sinus surgery were applied, as the " cut-back” vaginoplasty in 6 patients, the " flap” vaginoplasty in 11 patients, and the partial urogenital sinus mobilization (PUM) in 5 patients.ResultsAll procedures were completed successfully and the incisions healed by stage Ⅰ. All patients were followed up 12-74 months, with the average of 30.5 months. The outcome of appearance evaluation was excellent in 13 patients (59.1%), good in 6 patients (27.3%), and poor in 3 patients (13.6%). Urinary incontinence, post-void residual, urinary infection, and urethrovaginal fistula were not found in 17 toilet trained patients.ConclusionUrogenital sinus surgery is the most critical step in feminizing genitoplasty of DSD. It can be finished in one stage procedure with clitoroplasty and labioplasty before puberty. If thoroughly evaluation before surgery is completed and the principle of different procedures is handled, the outcome will be satisfactory.
ObjectiveTo investigate the effectiveness of clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate for genital virilization in girls with congenital adrenal hyperplasia (CAH). MethodsBetween June 2000 and October 2015, 27 girls with genital virilization were treated with clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate. The chromosomal karyotype was 46, XX in all patients, whose age ranged from 3 to 11 years (mean, 3.9 years). According to Parder's virilization scale, 5 cases were classified as stage Ⅱ, 18 cases as stage Ⅲ, and 4 cases as stage Ⅳ. The hormone tests showed decreased cortisol level and increased testosterone and 17-hydroxyprogesterone levels. They were diagnosed with non-salt-wasting CAH. ResultsAll of the patients underwent clitoroplasty successfully. The mean operation time was 74 minutes (range, 58-95 minutes). Incision healed primarily. The patients were followed up 6 months to 10 years (median, 19 months). The external genitalia had good appearance, without necrosis of flap and the glans clitoris, abnormal sensation of the glans clitoris, or clitorism recurrence. Five girls had breast development and normal menstrual cycle during adolescence, and 1 patient who was followed up for 10 years gave birth to a son. ConclusionClitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate is a relatively ideal method for treating genital virilization in girls. It has less complications, good aesthetic and functional results. There are satisfactory outcomes when combining with the endocrine treatment.
Objective To observe the effect of assisted reproductive technology (ART) on retinopathy of prematurity (ROP) in preterm infants. MethodsA retrospective clinical study. From January 2016 to January 2020, 639 preterm infants who were hospitalized at Children's Hospital of Zhengzhou University and underwent fundus screening at a gestational age ≤32 weeks were included in the study. There were 366 males and 273 females. Gestational age at birth were (28.3±1.4) weeks; birth weight were (1 153.8±228.8) g. Severe ROP was detected in 60 cases (9.4%, 60/639); 120 were ART recipients, and 519 were naturally conceived, and were divided into the ART group and the control group accordingly. The incidence of gestational diabetes mellitus (χ2=21.675), pulmonary surfactant application (χ2=13.558), and twin births (yes) (χ2=145.568) in mothers of the children examined in both groups were significantly higher than that of the control group, and the difference were statistically significant in all cases (P＜0.001). Comparison of quantitative data between groups was performed by t-test, and comparison of count data was performed by χ2 test; logistic regression was used to analyze the effect of ART on the incidence of ROP. ResultsOf the 60 cases of severe ROP, 18 (15.0%, 18/120) and 42 (8.1%, 42/519) cases were in the ART group and control group, respectively. The incidence of severe ROP was significantly higher in the ART group than in the control group, and the difference was statistically significant (χ2=4.680, P=0.024). Compared with the control group, the incidence of severe ROP was significantly higher in the ART group for gestational age at birth ＜28 weeks and birth weight ＜1 000 g, and the differences were statistically significant (χ2=10.116, 3.785; P=0.002, 0.037). Logistic regression analysis showed that ART was a non-independent risk factor for the occurrence of ROP (P＞0.05). ConclusionAssisted reproductive technology may have a certain influence on the occurrence of ROP, which is not an independent factor.