Susceptibility-Weighted MRI in the Evaluation of Gynecologic Diseases

Introduction: Owing to the advanced development of MRI science, it causes obvious great changes of many diseases that affect the female genital system and affect their fertility. Hemorrhagic gynecological diseases especially endometriosis affect young females and cause cyclic pain, in addition to infertility. So early detection is essential for proper treatment. Susceptibility-weighted (SWI) as one of the most recent newly created MRI sequences is highly sensitive to detect products of hemorrhage within different gynecologic disorders with 94.7% sensitivity being more meticulous than conventional MRI sequences as T1 and T2. Aim of the Work: A comparison between T1 and T2 as conventional MRI sequences with susceptibility-weighted images (SWI) in many gynecologic disorders by the detection of the presence of internal products of hemorrhage at any stage. Subjects and Methods: 48 consecutive patients from Benha University clinics (age range, 17 - 60 years;mean age, 35.67 years). The patients included in the study were presenting with pelvic pain, irregular menses, Dyspareunia, and swelling. All with suspicious diagnosis of ovarian and extra-ovarian lesions. 38 patients out of the 48 patients were known to contain hemorrhagic disorder;all the patients underwent MRI routine pelvis protocol adding SWI sequence. Results: There was a greatly significant difference between SWI and conventional MRI sequences T1and T2 with sensitivity 94.7%, 57.9% and 33.3% respectively. Conclusion: SWI is a promising tool in the evaluation of hemorrhagic foci within different gynecological disorders. The great ability of detecting hemosiderin foci increases the value of SWI over conventional MRI or US.

Differentiating and Treating Gynecological Diseases based on the Theory of Collateral Diseases

The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.

Application of Guizhi Fuling Pill in Gynecology

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology,such as the treatment of uterine leiomyoma,ovarian cyst,infertility and dysmenorrhea,in order to provide further research ideas for clinical researchers.

Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies： a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China

Background： To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy （LH） compared with abdominal hysterectomy （AH） in case of benign gynecological disease. Methods： A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies （3,539 LH vs.1,356 AH） between 2007 and 2013 was involved. Operative time （OT）, estimated blood loss （EBL）, intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed. Results： The EBL （174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively）, passing flatus （38.7±14.1 vs. 48.1±13.2 hours）, days with indwelling catheter （1.5±0.6 vs. 2.2±0.8 days）, use of analgesics （6.5% vs. 73.1%）, intra-operative complication rate （2.4% vs. 4.1%）, post-operative complication rate （2.3 % vs. 5.7%）, post-operative constipation （12.1% vs. 24.6%）, mild and serious stress urinary incontinence （SUI） post-operative （P〈0.001; P=0.014）, and proportion of Female Sexual Functioning Index （FSFI） total score 〈26.55 post-operative （P〈0.001） of the LH group were significantly less than those of AH group. There were no significant differences in OT （106.5±34.5 vs. 106.2±40.3 min） between the two groups. Conclusions： LH is a safe and efficient operation for improving patients＇ long-term quality of life （QoL）, and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.

上海市妇科疾病及乳腺疾病筛查服务成本核算

目的调查上海市2家筛查机构提供妇科疾病及乳腺疾病(以下简称“两病”)筛查服务的方式、流程和内容,构建两病筛查服务成本核算体系,分别对2家样本机构的两病筛查旧包(筛查项目包括妇科三合诊检查、阴道分泌物常规检查、阴道超声检查、宫颈脱落细胞学检查、乳腺红外线检查和乳房手诊检查)和上海市60家筛查机构的两病筛查新包(筛查项目包括妇科三合诊检查、阴道分泌物常规检查、阴道超声检查、乳房手诊检查、宫颈液基薄层细胞学检查、乳腺彩色多普勒超声检查)进行成本核算。方法采用文献研究、关键知情人访谈等方法构建两病筛查服务成本核算体系,设计成本数据调查表,组织承担两病筛查的医疗机构根据实际情况逐一填报调查表。结果上海市妇女两病筛查旧包和新包的实际成本均比上海市现行收费高。剔除各筛查机构收到的财政补偿后,两病筛查旧包和新包的剩余成本均比上海市现行收费低。结论政府可结合现有补偿渠道综合考虑筛查的间接成本,合理确定筛查经费的投入标准,并通过改进筛查技术和项目来提高退休妇女和生活困难妇女的获得感。

Impact of Fibromyalgia on Female Infertility

Fibromyalgia is a chronic, widespread musculoskeletal pain and polyalgic syndrome, evolving for more than three months. Research on its consequences on fertility is therefore relevant to explore. The aim of this study is to highlight the relationship between fibromyalgia and some women’s diseases that induced infertility. The results showed that fibromyalgia is more common in 92.9% of patients wishing to procreate and 64.8% of patients with gynecological disorders. 70.7% of patients with menstrual disorder have fibromyalgia and 76.5% of fibromyalgia patients have myomas. Among ovarian pathologies, 76.5% of women with ovarian dystrophy have fibromyalgia. Fibromyalgia is also very prevalent in women with miscarriage (55.9%) and stillbirth history (90.1%). For all studied situations, a highly significant difference was observed (p < 0.000). All these data suggest that fibromyalgia is related to different situations that can induce infertility in women.

Modern Clinical Application of Ding 1541

For hundreds of years, Ding 1541 is used in traditional Chinese medicine(TCM) for the treatment of numerous ailments, including qi and blood stasis-related disorders. It showed good efficacy in relieving irregular menstruation, dysmenorrhea, metrorrhagia, and metrostaxis.Now, Ding 1541 has been widely used in various conditions, including primary dysmenorrhea, menstrual disorder, endometriosis, infertility,premenopausal syndrome, polycystic ovary syndrome, and premature ovarian failure. Compared with western medicine treatment, Ding 1541 has showed some advantages. In this review, we tried to summarize the underlying mechanisms for Ding 1541’s effects. We collected clinical data and briefly analyzed these diseases based on the theories of TCM and the pathology. These data suggested that the underlying mechanisms of Ding 1541 involved increasing uterine blood supply, decreasing menstrual blood prostaglandin F2 a level, improving the immune, and enhancing the function of the hypothalamus-pituitary-ovary, etc.

Chinese Expert Consensus on Clinical Application of Female Contraceptive Methods

Unintended pregnancy is a global issue, with approximately 85,000,000 women around the world having unintended pregnancy annually. The contents of clinical application of women’s contraceptive methods are very wide, involving multiple areas. This consensus deeply discusses the specific contraceptive needs at different statuses, combined with gynecological diseases, postabortion contraception, and postpartum family planning, ensuring the correct use of contraceptive methods under the corresponding status. The top priority of the consensus is the specific contraception consensus section for women combined with gynecological diseases because medical treatment effect as well as side effects should be weighed carefully. The consensus is to make high-efficiency and individual contraceptive strategy for different groups based on multidisciplinary(gynecology, obstetrics, and family planning) and multidimensional aspects, which can provide uniform guidance for medical and health organizations under the condition as relevant global guidance or consensus is still lacking.