Abnormal Uterine Bleeding due to Retention of Fetal Bones after Abortion: A Case Report

Background: Retention of fetal bones is a rare cause of abnormal uterine bleeding. Others may present as subfertility, chronic pelvic pain, abnormal vaginal discharge, menometrorrhagia, dysmenorrhea and spontaneous expulsion of bony fragments. Incidence is 0.26% among patients undergoing hysteroscopy. Aim: To document a pattern of presentation of retained fetal bone and its management. Case Presentation: Our patient is an 18-year old who presented with vaginal bleeding of four weeks duration and managed for abnormal uterine bleeding due to retained fetal bone following second trimester abortion. Conclusion: The use of transvaginal ultrasound in making diagnosis of retained fetal bone is effective. Treatment by removal of bones through evacuation by dilatation and curettage or hysteroscopy brings about resolution of symptoms. Use of pelvic ultrasonography to confirm complete evacuation of the uterus after abortion especially second trimester abortion could aid in early diagnosis and management of incomplete abortion.

Research progress in the treatment of perimenopausal abnormal uterine bleeding with traditional Chinese and western medicine

In order to fully understand the research progress of Chinese and Western medicine in the treatment of perimenopausal abnormal uterine bleeding,this paper reviews all kinds of research by referring to related literature reports at home and abroad.The results showed that western medicine mainly used hormone drugs,supplemented by surgery,but the clinical adverse reactions were more and the recurrence rate was higher;traditional Chinese medicine often obtained satisfactory results through the treatment of traditional Chinese medicine,syndrome differentiation,stage treatment,acupuncture and other treatment methods,with fewer adverse reactions and low recurrence rate,but the effect of sudden collapse and hemostasis was slower;the combination of Chinese and Western medicine can learn from each other and become The research focus in recent years is worthy of further discussion.

Study on Relevance of Endothelin to Abnormal Uterine Bleeding Associated with Long-Term Subdermal Implants Use

ve To investigate the relationship between estradiol, progesterone and endothe-lin (ET) and abnormal uterine bleeding after using sub-dermal contraceptive implant

Study on mechanism of Radix Paeoniae Rubra-Cortex Moutan in treatment of abnormal uterine bleeding based on network pharmacology

Objective:To explore the mechanism of the treatment of abnormal uterine bleeding with Radix Paeoniae Rubra-Cortex Moutan.Methods:To search the effective elements and action targets of paeony peony skin drug pair by searching the pharmacology platform of traditional Chinese medicine system;to select the disease targets of abnormal uterine bleeding by searching the human gene information database;to select the common targets of drugs and diseases by R language,to construct the interaction network of drugs compounds action targets diseases by using the software of Cytoscape;to construct the protein-protein interaction network by using the string platform The interaction network(PPI)was used to visualize the results,and the bio information package of Bioconductor was used to analyze go function enrichment and KEGG pathway.Results:This study included 16 compounds and 67 key targets.After enrichment analysis,87 go functional items and 116 KEGG signaling pathways were obtained.Quercetin,scutellarin,kaempferol and stigmasterol in Radix Paeoniae Rubra-Cortex Moutan directly act on interleukin-6,epidermal growth factor receptor,cystatin 3,mitogen activated protein kinase 8,vascular endothelial growth factor and other related targets,and are mainly enriched in Kaposi sarcoma associated herpesvirus infection and hepatis B.Age-range,TNF and other signal pathways.Conclusion:Radix Paeoniae Rubra-Cortex Moutan may play the role of anti-cell proliferation and apoptosis,protection of vascular endothelium,anti-inflammatory response,regulation of hormone secretion,and improvement of antioxidant activity through multi-component and multi-target,and play the role of treatment of abnormal uterine bleeding.

The therapeutic efficacy and safety of Gongxuening capsule in dysfunctional uterine bleeding:a systematic review and meta-analysis

Background:Gongxuening capsule is a Chinese patent medicine for treating the dysfunctional uterine bleeding.We report a meta-analysis of the combination efficacy between conventional medicines with Chinese patent drug Gongxuening in the treatment of dysfunctional uterine bleeding.Materials and methods:Seven databases were used to retrieve the relevant research of Chinese patent drug Gongxuening treatment for dysfunctional uterine bleeding from the databases establishment to 2020.The data were extracted independently by 2 researchers according to the described selection research.The meta-analysis was performed using RevMan5.3 software.Results:This study included 23 randomized trials,with a total of 1,836 dysfunctional uterine bleeding patients.Chinese patent drug Gongxuening could significantly improve the effective rate,and reduce endometrial thickness,control bleeding time,complete hemostasis time and sex hormone level,and no serious adverse events.Based on sensitivity analysis and subgroup analysis,the heterogeneity sources of endometrial thickness,complete hemostasis time and sex hormone level were found.In follicle stimulating hormone and luteinizing hormone,there was no significant difference between the two groups when Chinese patent drug Gongxuening combined with desogestrel ethinylestradiol.Conclusion:Conventional medicines combined with Chinese patent drug Gongxuening can make patients with dysfunctional uterine bleeding achieve better effective rate,and no serious adverse events occurred.

Adolescence dysfunctional uterine bleeding:perspectives from the combination of traditional Chinese medicine and modern medicine

Because their endocrine system is not yet developmentally mature,adolescent girls are prone to dysfunctional uterine bleeding caused by insufficiency of the hypothalamic-pituitary-gonadal axis.The view of modern medicine is mainly aimed at the secretory function of sex hormones,such as estrogen and progesterone.However,it causes distress to patients because of the susceptibility of their treatment to endocrine system disorders.Traditional Chinese medicine considers the damage to the function of the Conception Vessel and Thoroughfare Vessel as the key to the disease.In this way,we guide the use of traditional Chinese medicine and acupuncture and achieve good results.The pathogenesis and management of functional uterine bleeding in adolescence are discussed from two medical perspectives in this article.

Research Progress on Treatment of Abnormal Uterine Bleeding during Puberty with Traditional Chinese and Western Medicine

In recent years,the frequency of clinical occurrence of abnormal uterine bleeding in adolescence has gradually increased.In order to fully understand the research progress in the treatment of abnormal uterine bleeding in adolescence,various studies and clinical experience have been reviewed by consulting related literature reports.The results found that currently Western medicine mainly uses hormone drugs in clinical treatment,but there are risks such as more clinical adverse reactions and higher recurrence rate;traditional Chinese medicine(TCM)treatment has achieved satisfactory results,but the advantages of sudden collapse and hemostasis are not obvious.Combined TCM and Western medicine treatment,it can learn from each other and has become a research hotspot in recent years,which is worthy of an in-depth discussion.

Identification and verification of effective components of Huanghuai for dysfunctional uterine bleeding based on network pharmacology and molecular docking

Objective:The Huanghuai(HH),which is made from the dried roots of Scutellaria baicalensis(Huangqin in Chinese) and the dried flowers and buds of Sophora japonica(Huaihua in Chinese),is a traditional Chinese formula used to treat dysfunctional uterine bleeding(DUB)(Benglou in Chinese) and proven to treat hemostasis effectively in our previous study.Network pharmacology and molecule docking were performed to study the underlying mechanism of Huanghuai(HH),and pharmacodynamic experiments were conducted to verify its curative effect.Methods:TCMSP,UniProt,GeneCards,STRING,DAVID databases,and Cytoscape 3.7.2 were utilized for the construction of a compound-target-pathway network.Docking the potential effective components with potential targets.The HPLC analysis of the potential effective components was performed.In vivo,the hot plate test model was used to study the analgesic activity,the egg white was used to study the swollen reaction in the sole in mice,and the hemostasis effect was studied by the capillary method,tail-breaking method and abortion uterus test.Results:The results showed that six compounds(acacetin,beta-sitosterol,wogonin,baicalein,kaempferol and quercetin) and four potential targets(PTGS2,AKT1,TP53 and TNF) in the compound-targetpathway network were the potential material basis for HH to treat DUB.It can be seen that the binding energy of the acacetin,wogonin,baicalein,beta-sitosterol,kaempferol and quercetin in HH docked with the receptor proteins PTGS2,AKT1,TP53,and TNF were far less than-5.0 kJ/mol,which means the molecules have low conformational energy,stable structure and high binding activity.And the result of HPLC analysis showed that acacetin,wogonin,baicalein,kaempferol and quercetin were the potential effective components of the hemostasis mechanism of HH,beta-sitosterol was removed due to low content.In vivo testing of the potential effective components,it revealed that the group of potential effective components identified by HPLC could increase the pain threshold,inhibit the swelling hind paws of mice induced by egg white,reduce the bleeding time and clotting time,reduce uterine bleeding,decrease the uterine weight,increase the content of Ca and ET-1,and reduce the content of NO in uterine homogenate tissue,and decrease of E_(2) and P content in uterine serum in aborted rats,whose efficacy was equal to HH.Conclusion:The results indicated that HH and potential active ingredient groups obtained from network pharmacology can treat DUB and play a hemostatic effect.The results obtained by network pharmacology have certain reliability.This study provides new indications for further mechanism research of HH on DUB and the development of HH or its components as an alternative therapy for patients with DUB.At the same time,the application of network pharmacology strategy may provide a powerful tool for exploring the mechanism of traditional Chinese medicine and discovering new biologically active ingredients.

Novasure treatment for one case of abnormal uterine bleeding with active systemic lupus erythematosus

Abnormal uterine bleeding（AUB）, especially in the menopausal transition period,is showing a tendency of rising in recent years, and after treatment, high recurrence rate for the treatment of hormone treatment, the endometrial resection and uterine resection. But for patients with severe systemic disease with AUB, it may get worse with the conventional treatment. Novasure provides us with an effective measure for the treatment of AUB with active systemic lupus erythematosus（SLE）.

Acute recurrent cerebral infarction caused by moyamoya disease complicated with adenomyosis:A case report

BACKGROUND Moyamoya disease is essentially an ischemic cerebrovascular disease.Here,we describe a case of acute recurrent cerebral infarction caused by moyamoya disease with concurrent adenomyosis which,to our knowledge,is the first in the literature.A literature review is also presented.CASE SUMMARY A 38-year-old female presented to the Research and Treatment Center of Moyamoya Disease in our hospital with"left limb weakness"as the main symptom.She was diagnosed with acute cerebral infarction and moyamoya disease through magnetic resonance imaging and digital subtraction angiography.Prior to this,she had experienced a prolonged menstrual period of one-month duration.This was investigated and adenomyosis was diagnosed.After passing the acute cerebral infarction phase,the patient underwent surgery for adenomyosis followed by combined cerebral revascularization.During the postoperative follow-up,improvements of the perfusion imaging stage and modified Rankin Scale were observed.A review of the literature showed only 16 reported cases of gynecological diseases complicated with stroke.The clinical characteristics,pathogenesis,therapeutic effects,and long-term prognosis of these cases have been studied and discussed.CONCLUSION In patients with moyamoya disease,early management of gynecological-related bleeding disorders is essential to prevent the complications of cerebral events.

Application of Comprehensive Health Education in Nursing of Patients with Metrorrhagia and Metrostaxis Treated by Hysteroscopic Electrotomy

Objective:To explore the application of health education in the nursing care of patients with metrorrhagia and metrostaxis after hysteroscopic electrotomy and the effect on the occurrence of disease complications.Methods:Totally 70 patients admitted from March 2018 to March 2019 were randomly divided into two groups.The control group was given routine nursing,while the observation group was given comprehensive health education combined with routine nursing.The unhealthy emotions(anxiety and depression)of patients were assessed using Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA).The incidence of complications,and surgical related matters were recorded and compared between two groups after nursing interventions.Results:A lower HAMD score,A lower HAMA score,a shorter hospitalization time,a shorter operation time and a less intraoperative bleeding volume,a lower incidence rate of complications(massive bleeding and uterine perforation),and a higher degree of patients’cooperation in surgery were shown in observation group compared with control group after nursing intervention(P all<0.05).Conclusion:The application of health education in the nursing of metrorrhagia and metrostaxis patients can relieve the patients’anxiety and depression,improve their understanding and mastery of relevant disease knowledge and their ability to cope with bleeding and their self-health care,as well as reduce the incidence of complications and the length of hospital stay and promote the rehabilitation of patients.Therefore,it is worthy of clinical application.

Atypical endometrial hyperplasia in a 35-year-old woman:A case report and literature review

BACKGROUND Atypical endometrial hyperplasia(AEH)is a common precancerous lesion of endometrial carcinoma(EC).The risk factors for AEH and EC directly or indirectly related to estrogen exposure include early menarche,nulliparity,polycystic ovarian syndrome,diabetes,and obesity.Both AEH and EC rarely occur in young patients(<40-years-old),who may desire to maintain their fertility.Evaluating the cancer risk of AEH patients is helpful for the determination of therapeutic plans.CASE SUMMARY We report a rare case of AEH in a 35-year-old woman who presented to the Hunan Provincial Maternal and Child Health Care Hospital with a large mass in the uterus.She married at 20-years-old,and had been married for more than 15 years to date.Several characteristics of this patient were observed,including nulliparity,limited sexual activity(intercourse 1-2 times a year)in recent years,and irregular vaginal bleeding for 2 years.Gynecological examination revealed an enlarged uterus,similar to the uterus size in the fourth month of pregnancy,and the uterine wall was relatively hard.Curettage was performed based on transvaginal sonography and magnetic resonance imaging results.Findings from the pathological examination were typical for AEH.The patient was cured after treatment with the standard therapy of high-dose progesterone.CONCLUSION In patients with intrauterine lumps that may be malignant,a pathological report should be obtained.

Possible Effect of COVID-19 Vaccines on Menstruation in Cape Coast, Ghana, West Africa: Case Series Report

Covid-19 was declared a global pandemic by the World Health Organization;it has caused more than 4,697,099 deaths worldwide. Since the discovery of Vaccines, the rate of infections and deaths are declining in countries that were able to conduct mass vaccination, making the vaccines the most effect tool in the fight against Covid-19. However, there is still vaccination skepticism. The side effects of vaccines could fuel more skepticism. There are emerging possible new side effects such as abnormal uterine bleeding post Covid-19 vaccination, for which health care providers and the population should be aware. In this paper, we are reporting three (3) cases of abnormal uterine bleeding which seems to be linked to Covid-19 vaccines. We reported two incidents of heavy menstrual bleeding and one incident of inter-menstrual bleeding which are likely associated with COVID 19 vaccination, even though the causality could not be confirmed. Also both types of vaccines, Messenger RNA and Adenovirus vector could possibly be associated with abnormal uterine bleeding. As research is still ongoing, more knowledge would be available, meanwhile, healthcare providers and the population should be made aware of the new possible side effects of Covid-19 vaccines.