Background Endometriosis is a controversial and enigmatic disease.Deep infiltrating endometriosis （DIE） is responsible for painful symptoms and is the least understood type of endometriosis.Little work has been devo...Background Endometriosis is a controversial and enigmatic disease.Deep infiltrating endometriosis （DIE） is responsible for painful symptoms and is the least understood type of endometriosis.Little work has been devoted to define the location of DIE lesions and its relationships with pain.The aim of the study was to investigate the relationship between the anatomical distribution of DIE lesions and pain symptoms.Methods Clinical data from 354 patients between May 2003 and December 2007 with laparoscopically diagnosed endometriosis were collected including 177 DIE patients and 177 non-DIE patients.The pain symptoms,including dysmenorrhea （DM）,chronic pelvic pain （CPP,defined as intermittent or permanent pelvic pain,not related to the menstruation and longer than 6 months）,deep dyspareunia （pelvic pain at intercourse） and dyschezia （pelvic pain with defecation）,were recorded for every patient before operation.Endometriotic lesions were recorded by their anatomical distributions,the depth of infiltration and lesion colors.And the relationship between the anatomical distribution of DIE lesions and pain symptoms was analyzed.Pearson＇s chi-square test or Fisher＇s exact test,one-way analysis of variance （ANOVA） and linear regression and binary Logistic regression were used for statistical analysis.Results The duration （（13.79±3.94） years） of pain suffering in DIE patients was much longer than that of non-DIE patients （P 〈0.01）.In DIE patients,60.7% of the uterosacral ligament （USL） nodules were bilateral （P 〈0.01）; 44.6% of the cul-de-sacs were completely blocked.Rectum invasion was observed in 19.9% of DIE patients （P=0.03）; pelvic adhesion was also more common.Up to 98.41% of the deep infiltrative lesions were located in the posterior pelvic compartment.DIE lesions were also found in bladder （1.58%）,USL （67.08%）,cul-de-sac （12.02%）,recto-vaginal septum （12.66%）,rectum and rectosigmoid junction （2.85%） and ureter （3.80%）.The odds ratio of USL-DIE for CPP,deep dyspareunia,dyschezia were 2.52,1.29 and 2.24 respectively.And the depth of infiltration correlated with the severity of dysmenorrhea.Conclusions DIE lesions were associated with severe pain symptoms.The main distribution of DIE lesions was in the posterior pelvic compartment,and was more widespread and severe in DIE patients.Moreover,resection of these DIE lesions are very important to treat the pain symptoms.展开更多
Background Human papillomavirus （HPV） is believed to be the most common sexually transmitted infection. However,little is known about the prevalence and distribution of HPV types in China. We aimed to assess the pre...Background Human papillomavirus （HPV） is believed to be the most common sexually transmitted infection. However,little is known about the prevalence and distribution of HPV types in China. We aimed to assess the prevalence and the distribution of HPV types as well as risks for abnormal cervical cytology in women who reside in the Tibetan Autonomous Region of China.Methods A cross-sectional study was performed involving a sample of 3036 women. An epidemiological questionnaire was applied and cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included chi-square and Logistic regression model.Results In this population, 3.66% （111/3036） had atypical squamous cells of undetermined significance （ASCUS）,1.45% （44/3036） low-grade squamous intraepithelial lesions （LSIL） and 1.09% （33/3036） had high-grade squamous intraepithelial lesions （HSIL）. Tibetan women （5.74%, 137/2387） exhibited lower abnormal cytology rates than non-Tibetan women （8.01%, 52/649, P=0.03）. The overall prevalence of HPV infection was 9.19% （279/3036）. We failed to identify any differences in HPV prevalence by age. In the groups with normal, ASCUS, LSIL and HSIL, the overall HPV prevalences were 7.41% （211/2847）, 24.32% （27/111）, 56.82% （25/44） and 45.45% （15/33）, respectively. HPV 16 （1.52%,46/3036） was the most common type, and was also the most prevalent in women with ASCUS （8.11%, 9/111） and HSIL （15.15%, 5/33）. The most common HPV type for Tibetan women was HPV 16 （1.42%, 34/2387）, whereas for non-Tibetan individuals it was HPV 33 （2.31%, 15/649）. Of the 279 HPV-infected women, 40 individuals （14.34%） presented with multiple HPV positivity. Women who had two pregnancies were more likely to have abnormal cytology smear （OR=1.67;95% CI： 1.07-2.61）.Conclusions A low prevalence of HPV positivity was observed in women who reside in the Tibetan Autonomous Region of China. The prevalence of abnormal cervical cytology and HPV type distributions were different between Tibetan and non-Tibetan women.展开更多
Background Endometriosis （EM） is a benign gynecologic disease predominantly found in women of reproductive age. However, its pathogenesis is still poorly understood. Our experiment was designed to establish a stable...Background Endometriosis （EM） is a benign gynecologic disease predominantly found in women of reproductive age. However, its pathogenesis is still poorly understood. Our experiment was designed to establish a stable and reliable cultural environment for coculture of endometrium and peritoneum, so as to observe the adhesion/invasion ability of endometrium from patients with or without EM. Methods Endometria of secretory phase and peritoneum were sampled from 6 women with endometriois during laparoscopy. Six with ovarian teratoma or simple ovarian cyst were taken as control. We cocultured endometrium and peritoneum into four groups （endometrium from EM cultured with peritoneum from EM, endometrium from control cultured with peritoneum from control, endometrium from EM cultured with peritoneum from non-EM and the endometrium from control cultured with peritoneum from EM） to observe the adhesion/invasion process in gas-liquid surface culture and in-medium culture. Specimens were collected at 1 hour, 6 hours, 12 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days and 7 days for histology, immunofluorescence and immunohistochemical analysis on cytokeratin 8 （CK8） and CD10. Results The gas-liquid surface culture was superior to in-medium culture for the maintenance of tissue morphology and survival of endometrium. CK8 immunoflurescence demonstrated no remarkable difference in adhesion process between patients with and without EM. CD10 immunochemistry manifested frequent invasion of endometrial stromal cells from EM patients into peritoneum of up to 3 days culture, while the endometriotic cells from non-EM patients did not invade into peritoneum. Conclusions Gas-liquid surface culture is a suitable model for observing the early events in EM lesion formation. Endometrium from patients with EM showed increased invasion capacity during coculture, which might help to explain the etiology of endometriosis.展开更多
Objective:To assess the efficacy and safety of Sanjie Analgesic Capsule(SAC)in Chinese patients with endometriosis-associated pain.Methods:This was a multicenter,randomized,double-blind,placebo-controlled trial conduc...Objective:To assess the efficacy and safety of Sanjie Analgesic Capsule(SAC)in Chinese patients with endometriosis-associated pain.Methods:This was a multicenter,randomized,double-blind,placebo-controlled trial conducted at 15 centers between November 2013 and July 2017 in China.Eligible 323 patients with endometriosis were randomized at a 3:1 ratio to the SAC group(241 cases)and placebo group(82 cases)by stratified block randomization.Patients in the SAC or placebo groups were given SAC or placebo 1.6 g 3 times per day,orally,respectively since the first day of menstruation for 3 consecutive menstrual cycles.The primary endpoint was clinical response to dysmenorrhea evaluated using a 10-point Visual Analogue Scale at 3 and 6 months.The secondary endpoint was the pain score evaluated by VAS(chronic pelvic pain,defecation pain,and dyspareunia)at 3 and 6 months,and the pain recurrence rate at 6 months.Adverse events(AEs)were recorded during the study.Results:A total of 241 women were included in the SAC group,and 82 were in the placebo group.Among these women,217(90.0%)and 71(86.6%)completed the intervention,respectively.At 3 months,overall response rate(ORR)was significantly higher in women administered SAC(80.1%)compared with those who received a placebo(30.5%,P<0.01).Six months after treatment,the ORR for dysmenorrhea was 62.7%in the SAC group and 31.7%in the placebo group(P<0.01).Chronic pelvic pain and defecation pain were significantly improved by SAC compared with placebo(both P<0.05).The incidence rates of total AEs events in the SAC and placebo groups were 6.6%and 9.8%,respectively,and no significant difference was shown between the two groups(P=0.339).Conclusion:SAC is well-tolerated and may improve dysmenorrhea in women with endometriosis-associated pain.展开更多
文摘Background Endometriosis is a controversial and enigmatic disease.Deep infiltrating endometriosis （DIE） is responsible for painful symptoms and is the least understood type of endometriosis.Little work has been devoted to define the location of DIE lesions and its relationships with pain.The aim of the study was to investigate the relationship between the anatomical distribution of DIE lesions and pain symptoms.Methods Clinical data from 354 patients between May 2003 and December 2007 with laparoscopically diagnosed endometriosis were collected including 177 DIE patients and 177 non-DIE patients.The pain symptoms,including dysmenorrhea （DM）,chronic pelvic pain （CPP,defined as intermittent or permanent pelvic pain,not related to the menstruation and longer than 6 months）,deep dyspareunia （pelvic pain at intercourse） and dyschezia （pelvic pain with defecation）,were recorded for every patient before operation.Endometriotic lesions were recorded by their anatomical distributions,the depth of infiltration and lesion colors.And the relationship between the anatomical distribution of DIE lesions and pain symptoms was analyzed.Pearson＇s chi-square test or Fisher＇s exact test,one-way analysis of variance （ANOVA） and linear regression and binary Logistic regression were used for statistical analysis.Results The duration （（13.79±3.94） years） of pain suffering in DIE patients was much longer than that of non-DIE patients （P 〈0.01）.In DIE patients,60.7% of the uterosacral ligament （USL） nodules were bilateral （P 〈0.01）; 44.6% of the cul-de-sacs were completely blocked.Rectum invasion was observed in 19.9% of DIE patients （P=0.03）; pelvic adhesion was also more common.Up to 98.41% of the deep infiltrative lesions were located in the posterior pelvic compartment.DIE lesions were also found in bladder （1.58%）,USL （67.08%）,cul-de-sac （12.02%）,recto-vaginal septum （12.66%）,rectum and rectosigmoid junction （2.85%） and ureter （3.80%）.The odds ratio of USL-DIE for CPP,deep dyspareunia,dyschezia were 2.52,1.29 and 2.24 respectively.And the depth of infiltration correlated with the severity of dysmenorrhea.Conclusions DIE lesions were associated with severe pain symptoms.The main distribution of DIE lesions was in the posterior pelvic compartment,and was more widespread and severe in DIE patients.Moreover,resection of these DIE lesions are very important to treat the pain symptoms.
文摘Background Human papillomavirus （HPV） is believed to be the most common sexually transmitted infection. However,little is known about the prevalence and distribution of HPV types in China. We aimed to assess the prevalence and the distribution of HPV types as well as risks for abnormal cervical cytology in women who reside in the Tibetan Autonomous Region of China.Methods A cross-sectional study was performed involving a sample of 3036 women. An epidemiological questionnaire was applied and cervical specimens were obtained for liquid-based cytology and HPV DNA detection. Statistical analysis included chi-square and Logistic regression model.Results In this population, 3.66% （111/3036） had atypical squamous cells of undetermined significance （ASCUS）,1.45% （44/3036） low-grade squamous intraepithelial lesions （LSIL） and 1.09% （33/3036） had high-grade squamous intraepithelial lesions （HSIL）. Tibetan women （5.74%, 137/2387） exhibited lower abnormal cytology rates than non-Tibetan women （8.01%, 52/649, P=0.03）. The overall prevalence of HPV infection was 9.19% （279/3036）. We failed to identify any differences in HPV prevalence by age. In the groups with normal, ASCUS, LSIL and HSIL, the overall HPV prevalences were 7.41% （211/2847）, 24.32% （27/111）, 56.82% （25/44） and 45.45% （15/33）, respectively. HPV 16 （1.52%,46/3036） was the most common type, and was also the most prevalent in women with ASCUS （8.11%, 9/111） and HSIL （15.15%, 5/33）. The most common HPV type for Tibetan women was HPV 16 （1.42%, 34/2387）, whereas for non-Tibetan individuals it was HPV 33 （2.31%, 15/649）. Of the 279 HPV-infected women, 40 individuals （14.34%） presented with multiple HPV positivity. Women who had two pregnancies were more likely to have abnormal cytology smear （OR=1.67;95% CI： 1.07-2.61）.Conclusions A low prevalence of HPV positivity was observed in women who reside in the Tibetan Autonomous Region of China. The prevalence of abnormal cervical cytology and HPV type distributions were different between Tibetan and non-Tibetan women.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 30571943）.
文摘Background Endometriosis （EM） is a benign gynecologic disease predominantly found in women of reproductive age. However, its pathogenesis is still poorly understood. Our experiment was designed to establish a stable and reliable cultural environment for coculture of endometrium and peritoneum, so as to observe the adhesion/invasion ability of endometrium from patients with or without EM. Methods Endometria of secretory phase and peritoneum were sampled from 6 women with endometriois during laparoscopy. Six with ovarian teratoma or simple ovarian cyst were taken as control. We cocultured endometrium and peritoneum into four groups （endometrium from EM cultured with peritoneum from EM, endometrium from control cultured with peritoneum from control, endometrium from EM cultured with peritoneum from non-EM and the endometrium from control cultured with peritoneum from EM） to observe the adhesion/invasion process in gas-liquid surface culture and in-medium culture. Specimens were collected at 1 hour, 6 hours, 12 hours, 24 hours, 2 days, 3 days, 4 days, 5 days, 6 days and 7 days for histology, immunofluorescence and immunohistochemical analysis on cytokeratin 8 （CK8） and CD10. Results The gas-liquid surface culture was superior to in-medium culture for the maintenance of tissue morphology and survival of endometrium. CK8 immunoflurescence demonstrated no remarkable difference in adhesion process between patients with and without EM. CD10 immunochemistry manifested frequent invasion of endometrial stromal cells from EM patients into peritoneum of up to 3 days culture, while the endometriotic cells from non-EM patients did not invade into peritoneum. Conclusions Gas-liquid surface culture is a suitable model for observing the early events in EM lesion formation. Endometrium from patients with EM showed increased invasion capacity during coculture, which might help to explain the etiology of endometriosis.
文摘Objective:To assess the efficacy and safety of Sanjie Analgesic Capsule(SAC)in Chinese patients with endometriosis-associated pain.Methods:This was a multicenter,randomized,double-blind,placebo-controlled trial conducted at 15 centers between November 2013 and July 2017 in China.Eligible 323 patients with endometriosis were randomized at a 3:1 ratio to the SAC group(241 cases)and placebo group(82 cases)by stratified block randomization.Patients in the SAC or placebo groups were given SAC or placebo 1.6 g 3 times per day,orally,respectively since the first day of menstruation for 3 consecutive menstrual cycles.The primary endpoint was clinical response to dysmenorrhea evaluated using a 10-point Visual Analogue Scale at 3 and 6 months.The secondary endpoint was the pain score evaluated by VAS(chronic pelvic pain,defecation pain,and dyspareunia)at 3 and 6 months,and the pain recurrence rate at 6 months.Adverse events(AEs)were recorded during the study.Results:A total of 241 women were included in the SAC group,and 82 were in the placebo group.Among these women,217(90.0%)and 71(86.6%)completed the intervention,respectively.At 3 months,overall response rate(ORR)was significantly higher in women administered SAC(80.1%)compared with those who received a placebo(30.5%,P<0.01).Six months after treatment,the ORR for dysmenorrhea was 62.7%in the SAC group and 31.7%in the placebo group(P<0.01).Chronic pelvic pain and defecation pain were significantly improved by SAC compared with placebo(both P<0.05).The incidence rates of total AEs events in the SAC and placebo groups were 6.6%and 9.8%,respectively,and no significant difference was shown between the two groups(P=0.339).Conclusion:SAC is well-tolerated and may improve dysmenorrhea in women with endometriosis-associated pain.
