Patients' poor communication with their doctors in the first visit of the gynecological endocrinology outpatient clinics.

OBJECTIVE: To investigate patients' communication with their gynecologists in the first visit of the gynecological endocrinology outpatient clinics. STUDY DESIGN: We developed a questionnaire to evaluate 379 women' expectations of their first visit, information-giving about illness, and understanding of the consultation they encountered from April to August 2010. Descriptive statistics and multiple linear regression analysis were used to analyze the data. RESULTS: Before the first visit, 55% (208/379) of participants hoped to get the doctors' special attention, and 60% (227/379) of patients expected a very satisfying consultation. During the consultation, only 34% (129/379) of patients provided their case history clearly according to physicians' inquiry, 21% (81/379) of patients understood the examination and 28% (105/379) of patients understood the therapeutic regime after doctors' explanation. Correlation analysis showed that sociodemographic characteristics such as young age (under 20 years old), low level of education (primary school or less), and lack of medical knowledge affected patients' information-giving about illness and understanding of their first visit (all ps < 0.05). CONCLUSIONS: Patients expected a patient-centered doctor-patient communication in gynecological endocrinology outpatient clinics. They could not communicate well with their doctors, which was affected by age, education, and medical background.

[A family-based transmission disequilibrium test of polymorphisms of endothelial nitric oxide synthase gene in children with orthostatic intolerance].

OBJECTIVE: Recent studies have found that the variation of G894T on the region of T786C and 7th exon promoted by endothelial nitric oxide synthase (eNOS) gene is associated with cardiovascular disease. This research explored possible correlations between eNOS gene polymorphisms and orthostatic intolerance (OI) in children through linkage disequilibrium analysis between eNOS genes T786C and G894T and OI. METHODS: PCR, Macrorestriction Map and other molecular biotechnology were used to determine the genotypes of eNOS/T786C and G894T in 60 OI probands and their parents. Correlation analysis and transmission disequilibrium test (TDT) between T786C, G894T and OI were performed. RESULTS: There was linkage disequilibrium of eNOS/T786C and G894T gene polymorphisms in the occurrence of childhood OI (P<0.05). CONCLUSIONS: eNOS genes T786C and G894T may be associated with the pathogenesis of OI.

[Efficacy and safety of drospirenone-ethinylestradiol on contraception in healthy Chinese women: a multicenter randomized controlled trial].

OBJECTIVE: To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. METHODS: This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 microg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 microg ethinylestradiol plus 150 microg desogestrel, 195 cases) with the ratio of 3:1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). RESULTS: The values of basal features were similar between two groups (P > 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group (-0.297, -0.057, 0.033, 0.150 respectively) was more obvious than that in the desogestrel group (-0.108, 0.023, 0.231, -0.023 respectively) with a significant difference (P < 0.05). Some other values which improved in both two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12.6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0.57 kg) while it decreased in Yasmin group (-0.28 kg) with a significant difference (P < 0.01). CONCLUSIONS: Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.

[The effects of progesterone and insulin-like growth factor (IGF- I and IGF-II) on proliferation in human decidual stromal cells of early pregnancy in vitro].

OBJECTIVE: To study the effect of progesterone and Insulin-like growth factor (IGF-I and IGF-II) on proliferation in human decidual stromal cells of early pregnancy in vitro. METHODS: [3H]Thymidine (3H-TdR) uptake was applied to assess cell proliferation in human decidual stromal cells of early pregnancy (gestation of 5 to 7 weeks) in vitro after cultured with progesterone, IGF-I or IGF-II. RESULTS: Progesterone, IGF-I and IGF-II stimulated cell proliferation by 1.6-3.4 folds inhuman decidual stromal cells of early pregnancy in vitro (P<0.01), and those effects were time-dependent (P<0.01). CONCLUSION: Progesterone, IGF-I and IGF-II may play an important role in the regulation of proliferation and decidualization of stromal cells in human decidua of early pregnancy, which is essential for embryo implantation and the maintenance of early pregnancy.

Th17/Treg cell level and clinical characteristics of peripheral blood of patients with Sjogren's syndrome complicated with primary biliary cirrhosis.

This study aims at analyzing the Th17/Treg cell level and clinical characteristics of the peripheral blood of patients with Sjogren's syndrome (SS) complicated with primary biliary cirrhosis (PBC) so as to deepen the understanding of this disease and seek for its possible onset mechanism.A retrospective analysis was conducted on the clinical data of 24 patients [8 (33%) males and 16 (67%) females] with SS complicated with primary biliary cirrhosis, 50 patients with primary SS and 93 healthy volunteers. These patients were divided into 3 groups: experimental group (SS+PBC), control group (SS) and healthy group. Then, peripheral blood was collected and flow cytometry was conducted to detect level of Th17 cells and Treg cells. A fully automatic biochemical detector was used to detect the corresponding liver function index. The correlation analysis was made based on the clinical manifestations and biochemical characteristics.Compared with the healthy group and control group, the experimental group had the highest Th17/Treg cell ratio, and Th17 cell frequency was significantly increased (P <.05). Furthermore, ALT, AST, ALP, γ-GT, TBIL, and other indexes were positively correlated to the Th17/Treg ratio (P <.05).Th17/Treg cell level and its ratio in peripheral blood of patients with SS complicated with primary biliary cirrhosis were significantly unbalanced, indicating that Th17 cells participate in the onset of this disease to a large extent. Furthermore, the Th17/Treg ratio has a certain correlation with some of the liver function indexes, on which a stratified analysis could be made furtherly according to the seriousness of the conditions.

[Xianling Gubao Capsule improves semen quality].

OBJECTIVE: To observe the effect of the compound Chinese traditional drug Xianling Gubao Capsule on the semen quality of infertile males. METHODS: We treated 66 infertile men with Xianling Gubao Capsule for 24 months, and analyzed the semen quality and sperm morphology before and after the treatment. RESULTS: Two months after the medication, sperm concentration was increased by a small margin, but no statistically significant changes were observed in sperm vitality and motility (P > 0.05), the rate of morphologically normal sperm was significantly raised from 25.8% before treatment to 57.6% (P < 0.05) in those with the normal rate > or = 15%, but decreased from 53.0% to 25.8% (P < 0.05) in those with the normal rate < 9%. Among the 7 cases of oligospermia, the rate of morphologically normal sperm was elevated to an average of 10.9% after the 4-month medication, significantly different from the baseline rate of 5.8% (P < 0.05). Five spontaneous pregnancies and 1 successful IVF-ICSI were achieved during the treatment. CONCLUSION: Xianling Gubao Capsule can improve semen quality and significantly increase the percentage of morphologically normal sperm.

[Impact of controlled ovarian hyperstimulation delayed, which occurs after functionally pituitary downregulation by depot GnRH agonist, on the outcome of in vitro fertilization and embryo transfer].

OBJECTIVE: This study observed the influence on hormone, embryos and clinical outcomes when the starting time of controlled ovarian hyperstimulation (COH) was delayed after applying a half-dose depot gonadotropin-releasing hormone agonist (GnRHa). METHODS: A total 207 cycles were divided into 3 groups: control group (98 cycles, which performed daily low dose GnRHa during the mid-luteal phase in patients' menstrual cycles and reduced the dosage to a half at the next day 3, and added gonadotropin (Gn), conventional group (63 cycles, in which pituitary desensitization was obtained with a half-dose depot GnRHa in the mid-luteal phase, and then Gn was added at day 3) and delayed group (46 cycles, having the same usage of GnRHa to conventional group, but not adding Gn until day 7). RESULTS: The cancellation rate of cycle in conventional group was the highest (P < 0.01). At the beginning of COH, serum E2 and LH levels in delayed and control group were significantly higher than those in conventional group (P < 0.01). On the day of HCG given, serum E2 level in control group was the highest (P < 0.05). LH level in delayed and control group was higher than that in conventional group (P < 0.01). Concerning the clinical efficacy and outcome, the numbers of Gn ampoules and periods for stimulation were less in delayed group than in conventional group; the numbers of retrieved and fertilized oocytes, numbers of good quality embryos, clinical pregnancy rate and embryo implantation rate in delayed and control groups were significantly more than those in conventional group (P < 0.01). In ICSI cycles, the numbers of retrieved oocytes and metaphase II oocytes in delayed and control group were more than those in conventional group. CONCLUSIONS: A half-dose depot GnRHa may produce over suppression to pituitary gland in fertilization in vitro, appropriate delay of COH starting time can decrease ovarian stimulation period and ampoules of Gn, and increase retrieved good quality oocytes, so we could achieve a larger number of good quality embryos with a good chance of implantation.