Successful laparoscopic resection of fallopian tube abscess caused by Escherichia coli in a 12-year-old adolescent virgin:a case report and review of the literature.

BACKGROUND: Upstream infection with vaginal flora can develop into tubal endothelial damage and tubal edema, which can lead to tubal obstruction and fallopian tube abscess if left untreated. Fallopian tube abscess in adolescent virgins is very rare, it may lead to long-term or even lifelong complications once it occurred. CASE PRESENTATION: A 12-year-old adolescent virgin with no history of sexual intercourse and previous physical fitness who presented with lower abdominal pain with nausea and vomiting for 22 h, body temperature up to 39.2 °C. Laparoscopic surgery revealed an abscess in the left fallopian tube, the left fallopian tube was surgically removed, successfully treated, and the pus was cultured for escherichia coli. CONCLUSION: It is important to consider possibility of tubal infection in young.

Safe abortion: A retrospective study of negative pressure suction in abortion under the monitoring of ultrasound.

OBJECTIVE: To observe the effectiveness of ultrasound monitoring during negative pressure suction for abortion. METHODS: This retrospective study analyzed patients with abortion who underwent negative pressure suction, excluding 23 cases with incomplete information and missing interviews, leaving a total of 200 patients included in the study. They were divided into an ultrasound group (n = 100) and a non-ultrasound group (n = 100) based on whether ultrasound monitoring was used. The ultrasound group was applied negative pressure suction under ultrasound monitoring, and the non-ultrasound group was applied traditional negative pressure suction. The operative time and complications were assessed after the treatment. RESULTS: The operative time in the ultrasound group was 3.19 ± 0.62 min and in the non-ultrasound group was 6.35 ± 1.20 min, revealing a significantly shorter operative time in the ultrasound group than in the non-ultrasound group (P < 0.05). There was one case of uterine residual in the ultrasound group. There were eight cases with uterine residuals, four cases with intrauterine adhesions, one case with missed aspiration, and one case with perforation of the uterus in the non-ultrasound group. The complication rate in the ultrasound group was less than that in the non-ultrasound group (P < 0.05). CONCLUSION: Ultrasound-monitored negative pressure suction has obvious advantages over ordinary negative pressure suction in that it can shorten operation time, reduce operative complications, and ensure a safe and effective abortion.

[Fetal malnutrition assessment program].

OBJECTIVE: To study the application of ponderal index (PI), body mass index (BMI), mid-arm circumference/head circumference (MAC/HC), and Clinical Assessment of Nutritional Status (CANS) score in assessing the nutritional status of neonates at birth, and to find a simple and reliable scheme for the assessment of fetal nutritional status. METHODS: PI, BMI, MAC/HC, and CANS were used to assess the nutritional status of full-term infants and preterm infants shortly after birth. The assessment results of these methods were analyzed. RESULTS: Among the 678 full-term infants, 61, 102, 47, and 131 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. Among the 140 preterm infants, 30, 87, 9, and 112 were diagnosed with malnutrition by PI, BMI, MAC/HC, and CANS respectively. The combination of BMI and CANS had a detection rate of 99.3% in full-term infants and 100% in preterm infants. Compared with the single method, the combination significantly improved the detection rate of malnutrition (P < 0.05), while there was no significant difference between the combination of BMI+CANS and the combination of PI+BMI+CANS (P > 0.05). CONCLUSIONS: The combination of BMI+CANS can reduce the rate of missed diagnosis of fetal malnutrition. It is therefore a simple and reliable method for the assessment of fetal malnutrition.

Silent spontaneous posterior uterine rupture of a prior caesarean delivery at 36 weeks of gestation.

BACKGROUND: In caesarean section patients, the spontaneous rupture of the posterior wall of the uterus is extremely rare, with nonspecific signs and symptoms being present. Perinatal and maternal morbidity and mortality are high. CASE PRESENTATION: A 28-year-old woman at 36 + 6 weeks of gestation presented with mild uterine contractions and developed a sudden abdominal distension. An emergency laparotomy was performed, and the posterior wall of the uterus had ruptured. A baby boy was born. CONCLUSION: Silent uterine rupture is very rare and easy to ignore due to nonspecific clinical symptoms, unexplained haemoglobin reduction and haemoperitoneum, but these features caution us to more closely consider uterine rupture in patients.

Robot-assisted versus conventional laparoscopic surgery in the treatment of advanced stage endometriosis: a meta-analysis.

OBJECTIVE: To evaluate the safety and efficacy of robot-assisted laparoscopy (RAL) versus conventional laparoscopy (CL) in the treatment of advanced stage endometriosis. MATERIALS AND METHODS: Utilizing electronic databases (PubMed, Embase, and Elsevier), a systematic literature review was performed between 2008 and 2015 to compare the RAL surgery with CL surgery (CLS) in the treatment of advanced stage endometriosis. According to meta-analysis criteria, two comparative clinical trials were selected. Outcome measures including length of operation, blood loss, operative complications, and the length of hospitalization, were estimated by the RevMan 5.1 software. RESULTS: In the meta-analysis, there were no significant differences in blood loss, complication, and hospital stay between RAL and CL surgeries in the treatment of advanced stage endometriosis. However, RAL surgery required a higher mean operating time than CL surgery (WMD: 73.85, 95% CI: 56.77-90.94; p < 0 .00001). Comparative studies demonstrated that RAL displayed no outstanding advantages. CONCLUSIONS: As a new minimally invasive method, RAL technology is safe and efficient alternative to CL in the treatment of advanced stage endometriosis. The latent benefits of RAL technology for the treatment of advanced stage endometriosis remain uncertain.

Menopausal Symptoms and Sleep Quality During Menopausal Transition and Postmenopause.

BACKGROUND: Menopausal symptoms and sleep difficulty were physiological processes that were affected by genetic and other factors. This study was to investigate the prevalence of menopausal symptoms and sleep quality in menopausal transition (MT) and postmenopause (PM) women in Taiyuan, Shanxi. METHODS: A community-based survey of women's menopausal symptoms and sleep quality was conducted between July 2012 and May 2013 at six municipal districts of Taiyuan, Shanxi. A sample of 2429 women aged 40-59 years was divided into four groups: early MT, late MT, early PM, and late PM. Sleep quality in the past 2 weeks before the interview was recorded. The data were analyzed using SPSS 16.0. RESULTS: The prevalence of menopausal symptoms was 49.8%. Mild, moderate, and severe symptoms were observed in 28.9%, 18.5%, and 2.5% of participants, respectively. The highest prevalence of menopausal symptoms occurred in the early postmenopausal stage; the subsequences were the late postmenopausal stage and the early MT stage. Interestingly, among the 13 items of modified Kupperman index, the five most common symptoms were fatigue, arthralgia and myalgia, decreased libido, insomnia, and nervousness. Meanwhile, 55% perimenopausal women had poor sleep. CONCLUSIONS: Menopausal symptoms are common but mild among women in Taiyuan, Shanxi during MT and PM. In these stages, the prevalence of poor sleep is high.

Antiemetic role of thalidomide in a rat model of cisplatin-induced emesis.

The efficacy of thalidomide to attenuate cisplatin-induced emesis was evaluated in a rat model. Four groups were utilized: control group (peritoneal injection and gastric lavage with normal saline), cisplatin group (peritoneal injection of cisplatin at 10 mg/kg and gastric lavage with normal saline), thalidomide group (cisplatin as above and gastric lavage with thalidomide at 10 mg/kg), and granisetron group (positive control for antiemetic effects; cisplatin given as above and gastric lavage done with granisetron at 0.5 mg/kg). The cisplatin-induced kaolin consumption (pica behavior) was used as a model of emesis in patients. The animals' kaolin and food intakes were measured. Further, medulla and gastric tissues were obtained 5 and 33 h after peritoneal injections to quantify the levels of Substance P and Neurokinin-1 receptor (NK-1R). The cisplatin-induced kaolin consumption was significantly (p < 0.05 vs. cisplatin group) attenuated by thalidomide 72 h after the injection. The levels of Substance P in the medulla and gastric tissue were increased 5 h after the injection in both cisplatin and thalidomide groups, however, returned faster to normal levels in the thalidomide group (p < 0.05 vs. cisplatin group). Further, levels of NK-1R in the cisplatin, thalidomide, and granisetron group were significantly increased at both 5 and 33 h (p < 0.05 vs. control group), with no obvious difference among these three groups. In conclusion, thalidomide attenuates animal equivalent of cisplatin-induced emesis, and this beneficial effect is associated with decreased levels of Substance P levels in the medulla and gastric tissue.

Overcoming paclitaxel resistance in lung cancer cells via dual inhibition of stathmin and Bcl-2.

Lung cancer is the leading cause of death from malignancy in people and over 85% of these patients eventually die from disseminated disease. Paclitaxel (TAX) is widely used as an antimicrotubule agent for the treatment of lung cancer. Unfortunately, the resistance to this antimicrotubule agent occurs frequently. Stathmin (STMN1) is a ubiquitous microtubule destabilizing protein linked to cancer and cell health and its expression level often correlates with cancer stage progression and prognosis for survival. Overexpression of the antiapoptotic protein Bcl-2 has been shown to prolong drug-induced growth arrest, potentially inducing resistance. In this study, we used a short hairpin RNA (shRNA) approach to evaluate the effect of STMN1 and Bcl-2 downregulation in the sensitivity to TAX in lung cancer cells. We achieved significant downregulation of STMN1 and Bcl-2 mRNA and protein expression by a combination of double shRNA treatment strategy. Our experimental data showed that inhibition of STMN1 and Bcl-2 expression with RNA interference can sensitize lung cancer cells to TAX. These findings suggest a novel approach to improve the efficacy of certain antimicrotubule agents against lung cancer by regulating the function of STMN1 and Bcl-2.

Fasting plasma glucose at 24-28 weeks to screen for gestational diabetes mellitus: new evidence from China.

OBJECTIVE: To evaluate the usefulness of a fasting plasma glucose (FPG) at 24-28 weeks' gestation to screen for gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: The medical records and results of a 75-g 2-h oral glucose tolerance test (OGTT) of 24,854 pregnant women without known pre-GDM attending prenatal clinics in 15 hospitals in China were examined. RESULTS: FPG cutoff value of 5.1 mmol/L identified 3,149 (12.1%) pregnant women with GDM. FPG cutoff value of 4.4 mmol/L ruled out GDM in 15,369 (38.2%) women. With use of this cutoff point, 12.2% of patients with mild GDM will be missed. The positive predictive value is 0.322, and the negative predictive value is 0.928. CONCLUSIONS: FPG at 24-28 weeks' gestation could be used as a screening test to identify GDM patients in low-resource regions. Women with an FPG between ≥4.4 and ≤5.0 mmol/L would require a 75-g OGTT to diagnose GDM. This would help to avoid approximately one-half (50.3%) of the formal 75-g OGTTs in China.

[Pollution assessment in the intertidal zone of Beibu Gulf using multi-biomarker pollution index].

This paper assessed the coastal environmental quality along the Beibu Gulf using a statistical approach, multi-biomarker pollution index (MPI). Samples of clam (Paphia undulata) and sediment were collected at nine sites from the intertidal zone of Beibu Gulf in April 2011. Nine biomarkers of response were measured both in gill and digestive gland in Paphia undulata, and twelve kinds of contaminants were measured in different sediment samples. According to the Pearson' s correlation coefficients between biomarker responses in Paphia undulata and contaminant levels in sediments, five biomarkers either in gill for oxidized glutathione (GSSG), reduced glutathione (GSH), glutathione S-transferase (GST) or in digestive gland for thiobarbituric acid reactive substances (TBARS) and glutathione peroxidase (GPx) were selected for MPI calculation. For each biomarker at each site, a response index was allocated, and the MPI value of this site was calculated as the sum of the response index of the five biomarkers. The results of the calculation (MPI values from 18 to 39) showed significant differences among sampling sites. The environmental quality of all sites ranged from class 1 (clean) to class 3 (lightly contaminated), and no site fell into class 4 (contaminated) or class 5 (heavily contaminated), indicating a good environmental quality in the intertidal zone of Beibu Gulf. However, the environmental quality at some sites (S1, S3, 54 and S7) fell into class 3 (lightly contaminated), indicating mild interference from human activities has occurred.