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Objective:To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis.Methods:From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis.Results:(1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent ( κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95% CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher ( RR=4.16, 95% CI: 2.38-7.14; RR=2.38, 95% CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups ( P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions:Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.
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Objective To investigate the incidence, influencing factors and intervention of gestrinone-related abnormal uterine bleeding at different dosage of gestrinone in the clinical treatment. Methods This was a multicenter, randomized, control study of 195 Chinese women with endometriosis or adenomyosis from June 2011 to November 2013. The subjects were randomized into three groups with oral administration of gestrinone, 2.5 mg dose at one time;twice a week group:67 cases with oral administration twice a week last three months;double dose first month group:67 cases with oral administration triple times a week at first month, then twice a week for two months; three times a week group: 61 cases with oral administration three times a week last three months. The improvement of the abnormal uterine bleeding, the changes in estrogen, liver function and blood coagulation were evaluated. At the same time, B-ultrasound examination evaluation were performed. Results (1) Three months later, the incidence of abnormal uterine bleeding in twice a week group was 30%(20/67), in double dose first month group and three times a week group were 7%(5/67) and 16%(10/61) respectively, there were significant difference between three groups (P0.05). The body mass index significantly increased in three group (P0.05). As for blood coagulation, there were also no significant differences between the groups (P>0.05). Conclusions Double dose of gestrinone in the first month could significantly decrease the incidence of gestrinone-related abnormal uterine bleeding. It is a more optimied dosage of gestrinone and without severe side effects. Clinical trial registration Chinese Clinical Trial Registry, registration number: ChiCTR- TRC-12002327.
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Objective To study the antitumor effects of photodynamic therapy (PDT)treated by ovarian cancer cell lysates in rat epithelial ovarian cancer in vivo. Methods Female Fischer344 rats of 6 -8 weeks were allocated to four groups ( n = 8 each) : PDT group ( inoculated intraperitoneal with PDT tumor cell lysates), freeze/thaw group ( inoculated intraperitonealy with freeze-thaw tumor cell lysates), normal saline group (inoculated intraperitoneal with normal saline) and control group. Rat epithelial ovarian cancer NuTu19 cells were injected into all rats by intraperitoneal at day 7,while injected with normal saline in control group. The number of tumor specific interferon-γ (IFN-γ) secreting splenocytes was quantified by enzyme linked immunospot(ELISPOT) assay, the cytotoxic T lymphocyte(CTL) activity of splenocytes was measured by lactate dehydrogenase(LDH) analysis and tumor growth and the survival time of rats were also observe& Results Stimulated by PDT tumor cell lysates, the number of tumor specific IFN-γ secreting splenocytes in PDT group, freeze/thaw group, normal saline group and control group were 448. 8±34. 2, 211.2±47.9,43.3 ± 11.1,16.1 ± 2.4 respectively, which were significant differences among of them ( P < 0.05). Stimulated by freeze/thaw tumor cell lysates, the number of tumor specific IFN-γ, secreting splenocytes in four groups were 151.7 ± 22.6,188.7 ± 53.0, 18.2 ± 12.2,8.8 ± 7.7 respectively, which were not significant differences among of them ( P>0.05 ). Cytotoxicity of splenocytes of PDT group increased significantly than that in other three groups(P <0.05). Except rats in control group were all alive until the experiment ended, the mean survival time of other rats were 234 d in PDT group, 171 d in freeze/ thaw group and 168 d in normal saline group, which in PDT group was significantly higher than those in freeze/thaw group and normal saline group ( P<0.05 ). Conclusions Rats treated by PDT tumor cell lysates could produce antitumor effects in vivo, which shown that induce tumor-specific immune response and prolong the life span.