Risk Factors for Recurrence of Ovarian Endometriosis in Chinese Patients Aged 45 and Over

Background： When considering the issue of recurrence, perimenopausal women may have more dilemma during management comparing with young women, for example, whether to retain the uterus and ovary during surgery, whether it is necessary to add adjuvant medicine treatment after operation, and there is no evidence for reference about using ofgonadotropin-releasing hormone agonist. This study aimed to study the risk factors for the recurrence of ovarian endometriosis （EM） in patients aged 45 and over. Methods： This is a retrospective nested case-control study. We reviewed the medical records of patients aged over 45 years who underwent surgical treatments for ovarian EM from 1994 to 2014, in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences. By following up to January 2016, 45 patients were found to have relapses and regarded as the recurrence group. The patients with no recurrence during the same follow-up period were randomly selected by the ratio of 1：4 as the nonrecurrence group （ 180 patients in total）. Stratified Cox regression was used to analyze the risk factors of the recurrence. Results： Univariate analysis showed that there was a significant difference in the postoperative treatment （the percentage of patients who received postoperative treatment in non-recurrence group and recurrence group, 23.9% vs. 40.0%, x2=4.729, P = 0.030） and ovarian preservation （the percentage of patients who received surgery of ovarian preservation in non-recurrence group and recurrence group. 25.0 % vs. 44.4%, x2 = 19.462, P 〈 0.001 ） between the nonrecurrence group and the recurrence group. There was no correlation between recurrence and the following factors including patient＇s age, menarche age, gravidity, parity, CA125 level, ovarian lesions, menopausal status, combined benign gynecological conditions （such as myoma and adenomyoma） and endometrial abnormalities, and surgical approach or surgical staging （all P 〉 0.05）. Multivariate analysis indicated that whether to retain the ovary was the only independent risk factor of recurrence for patients aged 45 years and over with ovarian EM （odds ratio： 5.594, 95% confidence interval： 1.919-16.310, P= 0.002）. Conclusion： Ovarian preservation might be the only independent risk factor of recurrence for patients aged 45 years and over with ovarian EM.

Pathogenetic gene changes of eutopic endometrium in patients with ovarian endometriosis

To the Editor:Endometriosis refers to the endometrial tissue (interstitial substance and gland) with growth function occurring in the uterine lining of uterine cavity and the places outside myometrium.It often leads to pain,infertility,nodules or masses and other symptoms and signs,and thus,brings a heavy burden on individuals and society.Traditional blood reflux theory,immune theory,inflammatory theory,hormone theory,etc.,cannot fully elucidate the pathogenesis of endometriosis.

Simultaneous Enhancement of Toughness and Strength of Stretched iPP Film via Tiny Amount of β-Nucleating Agent under “Shear-free” Melt-extrusion

Herein,isotactic polypropylene films with smallβ-nucleating agent content were fabricated via a melt-extrusion-stretched technology with intended"shear-free"in barrel and die.Compared with neat films,the tensile strength,elongation at break and strain energy density at break of i PP film with 0.05 wt%β-nucleating agent are significantly improved by 13.8%,39.6%and 90.6%,respectively,indicating the simultaneously enhanced toughness and strength.Additionally,theβ-crystal content gradually increases with increasingβ-NA content,while the relative total daughter content ofα-andβ-crystal exhibits opposite tendency.Moreover,nucleation and crystal growth induced by variousβ-NA contents are different.This work proves an efficient strategy to enhance mechanical properties of isotactic polypropylene film via controlling elongation flow and addition of appropriateβ-NA content.

Clinical Manifestations of Adenomyosis Patients with or without Coexisting Endometriosis

To the Editor： Uterine adenomyosis （AM） is caused by the ectopic growth of endometrial glands and stroma in the myometrium of the uterus, accompanied by hyperplasia and hypertrophy of the surrounding smooth muscle cells, leading to a diffuse enlargement of the uterus.