Endocrine effects of three common gas signaling molecules in humans: A literature review.

Gases such as hydrogen sulfide, nitric oxide and sulfur dioxide have important regulatory effects on the endocrine and physiological processes of the body and are collectively referred to as "gas signaling molecules". These gas signaling molecules are also closely related to Alzheimer's disease, the inflammatory response and depression. In this paper, we introduce the production and metabolic pathways of NO, H2S and SO2 in living organisms and review the regulatory functions of gas signaling molecules in the endocrine system and their mechanisms in relation to their clinical applications. This work will provide a basis for finding targets for intervention and establishing novel prevention and treatment strategies for related diseases.

Level of IGF1 in follicular fluid associated with IVF pregnancy outcome in the application of growth hormone.

OBJECTIVES: The combination of growth hormone (GH) with gonadotropin was a prevalent method to improve clinical reproduction in adjuvant for assisted reproduction treatment (ART). However, the contradictory results from previous studies failed to confirm the benefits. The present study is focused on the mechanism analysis of GH-IGF1-gonadal axis in ART and the changes of IGF1 in follicular fluid among different types of patients. MATERIAL AND METHODS: We recruited 136 patients and divided them into eight groups according to their ages and ovarian reserves. The baseline characteristics of the study population were summarized. The therapeutic outcomes in the study population were observed. In the meantime, concentrations of IGF1 in follicular fluids from different types of patients who underwent GH strategy were measured by Western blot. The functional mechanism of GH-IGF1-gonadal axis in ART was also analyzed. RESULTS: We analyzed the baseline characteristics of the study population, the therapeutic outcome of GH-IGF-1-gonadal axis, as well as the relative protein level of IGF1 and IGFBP1 in follicular fluid from different groups. The chemical pregnancy rate was significantly increased in different degrees for groups with GH co-treatment compared to groups without GH co-treatment. The IGF1 in follicular fluid of patients under 35 years' old showed an upward trend compared with groups of poor, normal and high ovarian reserves. After GH induction, IGF1 in follicular fluid was significantly increased in patients over 35 years old. CONCLUSIONS: The study suggested that the application of GH might be beneficial to the pregnancy outcome in patients. GH application in patients older than 35 years might have a beneficial effect on pregnancy outcome via promoting the expression of IGF1. Our study indicates a different mechanism from GH application among younger and older patient in ART and provides a new clue for individual clinical treatment in infernity patients.

[Colpocleisis in elderly patients with severe pelvic organ prolapse].

OBJECTIVE: To study the objective and subjective therapeutic effect of total and partial (LeFort) colpocleisis in treatment of severe pelvic organ prolapsed (POP) in selected elderly patients. METHODS: From Oct. 2005 to Feb. 2010, 63 severe POP patients [59-87 years, median age (75+/-6) years] with stage III and IV by POP-Q system underwent total and partial colpocleisis. The mean age was (75+/-6) years (59-87 years). Fifty-eight patients (58/63, 92%) present more than one kind of medical disease. There were 53 cases with uterus prolapse, 1 case with cervix prolapse and 9 cases with vaginal vault prolapse. Seven patients were recurrent POP from previous surgery. Twenty-three patients (36%) presented voiding difficulty. Seven patients (17%) presented obstructive bowel symptom. Three patients (5%) presented fecal incontinence, and 28 patients (44%) presented either had urinary incontinence or history of that. Among 63 patients, 48 patients (76%) underwent total colpoclesis, and 15 (24%) patients partial colpoclesis. Meanwhile, 58 (92%) patients underwent levator myorrhaphy plus perineorrhaphy and 20 (32%) patients underwent anti-urinary incontinence procedure (TVT-O), respectively. Patients were followed up to evaluate therapeutic effect at 2 months and 1 year after surgery. Objective evaluation included the POP-Q and the length of vagina, genital hiatus, perineal body. A nonvalidated Body Image and Satisfaction Questionnaire was completed for subjective evaluation. RESULTS: The mean operating time of 63 patients was (105+/-48) minutes, which was (128+/-58) in total and (82+/-26) minutes partial procedures, which exhibited significant difference (P<0.05). The mean blood loss was (187+/-128) ml (50-600 ml), total and partial procedures caused (232+/-159) and (101+/-54) ml, respectively, which also showed significant difference (P<0.05). No intraoperative injury or death occurred. The rate of postoperative complications was 5% (3/63). Mean follow-up time of 63 patients was 22.5 months (1-51 months). All patients had POP-Q staging score

[High vaginal uterosacral ligament suspension for treatment of uterine prolapse].

OBJECTIVE: To evaluate the physiological and anatomic basis,indications,surgical skills, prevention of ureter injury and clinic outcomes of using high uterosacral ligament suspension (HUS) for correction of advanced uterine prolapse by the vaginal route. METHODS: Fifty women with advanced uterine prolapse underwent transvaginal HUS after vaginal hysterectomy with reconstruction of pubocervical and rectovaginal fascia to correct their uterine prolapse between June 2003 and September 2007. The average age of the women was 60.1 years. The mean follow-up period was 24 months (range 4-51 months). The degree of pelvic organ prolapse preoperatively and anatomic outcomes postoperatively were assessed with pelvic organ prolapse quantification system (POP-Q). RESULTS: The remnants of the uterosacral ligaments were clearly identified and palpated posterior and medial to the ischial spines by traction with a 24 cm long Allis clamp and used for successful vaginal vault suspension and reconstruction in all 50 consecutive advanced uterine prolapse patients. The ureter injury was avoided by complete knowledge of the ureter's course from the cervix/apex toward its insertion in the sacral region and how far outside of the uterosacral ligament, by uteri palpation and by suturing purposefully placed "deep" dorsally and posteriorly toward the sacrum, as well as by cystoscopy examination of the spillage of urine from both ureters. Mean POP-Q point C improved from 1.5 to -7.5 cm with a median follow-up of 24 months. If the successful HUS was defined as point C < or = stage I prolapse, both the objective and subjective cure rates were as high as 100% with a maximum follow-up of 51 months. None of the 50 patients had repeat operation for recurrence of prolapse. There was no major intra-or postoperative complications, such as ureter and other pelvic organ injury. CONCLUSION: HUS with fascial reconstruction seems to be a safe, minimal traumatic, tolerable and highly successful procedure for vaginal repair of advanced uterine prolapse. Because of the use of native tissue as suspension site HUS is more physiologic and cost effective.

[Vaginal paravaginal repair in treatment of severe anterior vaginal prolapse and cystocele].

OBJECTIVE: To explore the rationality, efficacy and safety of vaginal paravaginal repair (VPVR) in treating anterior vaginal prolapse and cystocele. METHODS: Twenty-five consecutive women with stage II to IV and grade II-III anterior vaginal prolapse and cystocele evaluated by pelvic organ prolapse quantification (POP-Q) and Baden-Walker half way system were treated by VPVR. One hundred and one concomitant procedures for reconstructive pelvic surgery were also performed. The VPVR consisted of a thorough entry from the vesicovaginal space under the inferior pubic ramus into the retropubic space, exposing the area of the arcus tendineus fascia pelvis (ATFP), placing nonabsorbable sutures around ATFP on either side and fixed to appropriate locations on the bladder fascia and anterior vaginal walls. Tying of these sutures resulted in dramatic elevation of the lateral superior sulci, as well as prolapsed vesica. Patients were followed up after operation. The cure rate was estimated subjectively and objectively, according to POP-Q and Baden-Walker half way system. RESULTS: All patients had their surgery completed by VPVR. The average operative time was 40 min and estimated blood loss was 70 ml. Two minor intraoperative hemorrhage occurred during dissection of retropubic space and there were no other complications. No morbidity after operation was observed either. Postoperatively, two patients developed obstructive voiding and urinary retention. One recovered completely in a few days, the other has improved slowly for 2 months. Patients were followed up for 2 - 14 months. Two patients with asymptomatic stage I or grade I cystocele were found by examination between 2 and 6 months after operation. Our objective cure rate was 92% and subjective cure rate was 100% respectively at a mean of 6 months after operation. CONCLUSIONS: Since VPVR can restore the normal lateral attachment of the pubocervical fascia to pelvic side wall at ATFP, it is a reasonable, safe and effective procedure to correct severe anterior vaginal prolapse and cystocele.