[Modified tubo-uterine implantations for proximal tubal occlusive infertility after femal sterilization with mucilago phenol].

OBJECTIVE: To explore the effects of modified tubo-uterine implantations performed on women with proximal tubal occlusive infertility after femal sterilization with mucilago phenol. METHODS: Two hundred and eight infertile women who were admitted to the Second Affiliated Hospital of Sun Yat-sen University between 1986 and 2004 were included. They all accepted modified tubo-uterine implantation after occlusion of fallopian tubes with mucilago phenol. RESULTS: It was found that the occlusions were all located in the interstitial portion or isthmic portion of the fallopian tubes. Different degrees of pelvic adhesions were found in 65 cases. Fifty-seven cases were slightly adhesive, seven cases were of moderate degree and one case was severe. One hundred and ninety-nine cases were followed up after operations (95.7%). One hundred and ninety-three women accepted hydrotubation in the following month just after the operation and 185 women were found to be unobstructed (95.8%). One hundred and forty-three women became pregnant, the pregnant rate being 71.9% (143/199). One hundred and twenty-five women had term deliveries (87.4%), three women were in early pregnancy and two in midtrimester pregnancy. Eleven women had spontaneous abortion (7.7%). Two women had tubal pregnancy (1.0%). None of the 199 cases had any signs of endometriosis. CONCLUSIONS: Modified tubo-uterine implantations are quite effective for proximal tubal occlusive infertility. It may be a favorable method for such kind of tubal occlusions.

[Study on causes and treatment of repeated vulvovaginitis in girlhood].

OBJECTIVE: To explore the causes and treatment of repeated vulvovaginitis in girlhood in order to improve its prevention and treatment. METHODS: Fifty-one girls with repeated vulvovaginitis (age < or = 10 years) admitted to The Second Affiliated Hospital of Sun Yat-sen University from Jan. 1990 to Nov. 2004 were reviewed retrospectively. RESULTS: We found 28 girls (55%) suffering from non-specific vulvovaginitis and 14 ones (27%) suffering from posterior recto-vaginal fistula with in 51 patients. Five girls (10%) were smitten with vulval ulcer and 3 ones (6%) had been were found with vaginal foreign bodies. One girl (2%) was smitten with adhesion of labia minora. The vaginal discharges taken from 21 girls were cultured. Seventeen cases found bacteria. The positive rate of bacteria culture in the 21 cases reached 81%, in which, E.coli accounted for 5 cases (24%), staphylococcus and streptococcus accounted for 3 cases (14%) respectively. Patients suffering from non-specific vulvovaginitis and vulval ulcer accepted external lotion, antibiotic ointment or combining with antibiotics. Patients suffering from posterior recto-vaginal fistula accepted fistulectomy. Three girls who found vaginal foreign bodies took out of foreign bodies by hysteroscope. Fifty-one girls all were cured after appropriate therapy. CONCLUSIONS: Vulvovaginitis is the most common gynecologic diagnosis in girlhood. The principal cause of repeated invasion is non-specific vulvovaginitis and the secondly one is posterior recto-vaginal fistula. It need overhaul during the diagnosis. It is very availability to use hysteroscopy and do bacteria culture + antibiotic sensitivity test for repeated pediatric vulvovaginitis.

[Expression of insulin receptor substrate 1 and phosphorylation of tyrosine in adipose tissue of polycystic ovary syndrome].

OBJECTIVE: To study expression of insulin receptor substrate 1 (IRS-1) and phosphorylation of tyrosine in adipose tissue of polycystic ovary syndrome (PCOS) to approach the mechanism of insulin resistance (IR) in PCOS at tissue and cellular level. METHODS: IRS-1 expression and tyrosine phosphorylation of adipose tissue were studied with immunoprecipitation, Western-blot and ECL immunoblotting. RESULTS: The differences of IRS-1 expression in adipose tissue among the obese PCOS group (82 +/- 15)%, the non-obese PCOS group (79 +/- 18)%, the obese control group (75 +/- 19)% and the non obese control group (70 +/- 19)% were not significant (P > 0.05). IRS-1 tyrosine phosphorylation in adipose tissue in the obese PCOS group [(52 +/- 23)%, P < 0.001], the obese control group [(45 +/- 22)%, P < 0.01] and non-obese PCOS group [(70 +/- 25)%, P < 0.05] were markedly lower than that in the non-obese control group (88 +/- 12)%. The obese control group had more reduction than non-obese control group (P < 0.05). The differences between the obese PCOS group and the obese control group or the two PCOS groups were not significant (P > 0.05). CONCLUSION: IRS-1 tyrosine phosphorylation in adipose tissue in the two PCOS groups decreased markedly than in the non-obese control group. It might be involved in the disorder of insulin-signaling transduction downstream of insulin receptor and the occurrence of IR.

[Correlation between local hormones and CD36 transcription level in women with polycystic ovary].

OBJECTIVE: To detect CD(36) expressions in polycystic ovary (PCO), and to explore its correlation with local androgen and insulin at transcription level. METHODS: From August 2002 to February 2003, 12 patients with asymmetric PCO, 15 primary or secondary infertile patients without endocrine disorders and 8 polycystic ovary syndrome (PCOS) with bilateral PCO were recruited. Extraction of follicular fluid and detection of testosterone (T), dehydroepiandrosterone sulfate (DHEAS), insulin (INS) and androstenedione (A(2)) were performed. Relative CD(36) mRNA expression level of human ovarian inner thecal cells was analyzed by auto image analysis system (IAS) after RT-PCR. RESULTS: The level of CD(36) mRNA expression in thecal cells was 0.24 +/- 0.07 in polycystic ovary of PCO group and 0.21 +/- 0.05 in bilateral ovaries of PCOS group, respectively, which were significantly lower than 0.83 +/- 0.13 in normal ovaries (P < 0.01). T and INS levels of follicle fluid in PCO were significantly higher than that in normal ovaries (P < 0.01). T and INS levels of follicle fluid were negatively related to CD(36) mRNA expression of follicular theca interna (r = -0.6810, r = -0.6708, P < 0.01). CONCLUSION: Decrease of scavenger receptor gene CD(36) mRNA may play a role in the pathogenesis of PCO by increasing the level of T and INS in follicular fluid.

Characterization of unilateral polycystic ovary compared with polycystic ovary syndrome.

Twelve patients with unilateral polycystic ovarian morphology demonstrated milder degrees of ovarian and other endocrine dysfunction than polycystic ovary syndrome patients and had fewer incidences of hyperprolactinemia and hyperandrogenism.