【摘要】 目的 了解青年早期宫颈癌患者在卵巢移位术后的卵巢功能。 方法 2001年1月-2009年12月收治53例年龄26~40岁宫颈癌Ⅰb~Ⅱa期患者，其中27例在宫颈癌根治术中行卵巢移位术为观察组，26例行宫颈癌根治术切除双侧卵巢的为对照组。术后应用血清卵泡刺激素（FSH）、黄体生成激素（LH）、雌二醇（E2），B超及Kuppermann评分进行卵巢功能测定，随访1~4年。 结果 观察组术后4年内卵巢功能基本正常，对照组术后1个月卵巢功能丧失。观察组术后4年内血FSH、LH、E2及Kuppermann评分与对照组比较有显著性意义（Plt;0.05）；两组复发率比较无显著性意义（P gt;0.05）。 结论 青年早期宫颈癌患者在宫颈癌根治术中行卵巢移位术对其卵巢功能无明显影响。【Abstract】 Objective To investigate the function of ovary after ovarian transposition among young patients with early-stage cervical cancer. Methods A total of 53 young females (26-40 years old) with early stage cervical cancer (FIGO ⅠB or ⅡA) from January 2001 to December 2009. Ovarian transposition was performed at the same time of radical hysterectomy and pelvic lymphadenectomy on 27 patients who were the experimental group. Radical hysterectomy and pelvic lymphadenectomy was done without ovarian transposition on other 26 patients who were the control group. The function of ovarian was evaluated by serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), the ultrasound examination and Kuppermann score system in all patients during 1- 4 years’ follow-up. Results The patients in the control group became climacteric in one month after the operation. However, among the patients in the experimental group, their normal ovarian function was preserved within 1- 4 years’ follow-up. There was statistically significant difference between the experimental group and the control group regarding to serum E2, FSH, LH level and Kuppermann score of the patients (Plt;0.05). However, there was no statistically significant difference between the two groups regarding to the recurrence rate (Pgt;0.05). Conclusion Ovarian transposition has statistical significant effect on protection of ovarian function in young patients with early stage cervical cancer, who undergoes radical hysterectomy and pelvic lymphadenectomy.
ObjectiveTo analyze the status quo of outcome indicators in the randomized controlled trials (RCTs) of premature ovarian failure (POF)/primary ovarian insufficiency (POI) published at home and abroad, and provide a sufficient basis for the selection of outcome indicators in related studies in the future.MethodsChina National Knowledge Infrastructure, Chongqing VIP Data, Wanfang Data, SinoMed, PubMed, the Cochrane Library, and Embase were searched for RCT articles of POF/POI published between the establishment of the databases and June 2021. Two researchers independently screened and extracted the literature, and finally summarized the outcome indicators of the included studies.ResultsA total of 186 articles meeting the inclusion criteria were selected, including 180 articles in Chinese and 6 articles in English. The choice of outcome indicators was diverse. Of the 186 articles, 2 Chinese articles and 1 English article used primary and secondary outcome indicators; 19 Chinese articles and 4 English articles used independent indicators, 4 Chinese articles used composite indicators, and 157 Chinese articles and 2 English articles used both independent indicators and composite indicators.ConclusionsThe selection and use of outcome indicators in clinical RCTs of POF/POI are not standardized, and there are problems such as neglect of primary and secondary outcome indicators, and lack of standards for the selection of clinical research outcome indicators. As a result, the credibility of the curative effect is reduced, and the results of similar studies cannot be combined and compared.
目的 通过观察卵巢早衰 POF 患者外周血CD4+CD25+调节性T细胞 Treg 及干扰素-γ（IFN-γ）、转化生长因子-β(TGF-β)的变化，探讨POF的免疫学发病机制。 方法 收集2011年12月－2012年9月就诊的POF患者17例，卵巢储备功能减退 DOR 患者11例，以及生殖中心健康育龄女性16例，流式细胞仪定量检测外周血Treg数量，Elisa方法检测血清IFN-γ、TGF-β的水平，并以FSH/LH评价卵巢储备功能，进行相关性分析。 结果 与对照组相比，POF组和DOR组IFN-γ水平增高 P＜0.01 、TGF-β水平降低 P＜0.01 ，POF患者及DOR患者Treg比例降低 P＜0.01 ，IFN-γ的增高与卵巢储备功能的下降呈显著正相关 r=0.70，P＜0.01 。 结论 Treg 和IFN-γ、TGF-β水平与卵巢早衰密切相关，IFN-γ对评估卵巢储备功能、预测卵巢早衰具有参考价值。
ObjectiveTo systematically review the influence on ovarian reserve function by different hemostatic methods during laparoscopic cystectomy in treatment of ovarian endometrioma (OE). MethodsDatabases including The Cochrane Library, PubMed, EMbase, CNKI, CBM and WanFang Data were electronically searched, to collect relevant randomized controlled trials (RCTs) about laparoscopic electro coagulation vs. microscopically suture for OE from 1990 to Mar, 2014. Meanwhile, references of included studies were also retrieved manually. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then RevMan 5.2 software was used for meta-analysis. ResultsA total of 16 RCTs involving 1 236 patients were finally included. The results of meta-analysis showed that the luteinizing hormone (LH) levels after 1 month, 2 months, 6 months and 12 months and estradiol (E2) levels after 2 months, 6 months had no significant differences between the two groups and the E2 level after 12 month of the suture group was significantly lower than that of the electro coagulation group. The levels of follicle stimulating hormone (FSH), LH, E2, antral follicle count (AFC), mean ovarian stromal peak systolic blood flow velocity (PSV) and anti-Mullerian hormone (AMH) in the suture group were significantly superior to those in the electro coagulation group at other follow-up time. ConclusionCurrent evidence suggests that in treatment of ovarian endometriotic cyst by laparoscopic cystectomy, compared with electro coagulation hemostasis, suture hemostasis has less influence on ovarian reserve function. Due to limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.
ObjectivesTo systematically review the efficacy and safety of traditional Chinese herbal medicine Kuntai in the treatment of premature ovarian insufficiency (POI).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on Kuntai for treating premature ovarian insufficiency from inception to August, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsTwenty-one RCTs involving 1 777 patients were included, which were categorized as Kuntai vs. western medicine and Kuntai combined with western medicine vs. western medicine. The results of meta-analysis showed that: the efficacy of Kuntai was equivalent to western medicine; effective rate (RR=2.78, 95%CI 1.73 to 4.45, P<0.000 01), the change of Kupperman’s score (MD=−3.25, 95%CI −3.75 to −2.76, P<0.000 01), the change of serum FSH (MD=−6.99, 95%CI −8.07 to −5.90, P<0.000 01), E2 (MD=7.01, 95%CI 3.01 to 11.01, P=0.000 6) and LH (MD=−4.66, 95%CI −6.45 to −2.86, P<0.000 01) in Kuntai combined with hormone replacement therapy (HRT) group were higher than that in the HRT group.ConclusionsKuntai combined with HRT is superior to HRT alone in the effective rate, the change of Kupperman’s score, the change of serum FSH, E2 and LH for patients with premature ovarian insufficiency. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
Objective To summarize the progress of effect of gonadotropin-releasing hormone agonist on protecting ovarian function of young breast cancer patients who received chemotherapy, and to provide reference for clinical work. Methods Through searching of PubMed, CNKI, WanFang database, and other databases, we mainly collected relevant literatures in nearly five years, which concerning the effect of gonadotropin-releasing hormone agonist on protecting the ovarian function of young breast cancer patients who received chemotherapy. Results Young breast cancer patients faced with problems about long-term survival, quality of life, social psychological pressure, and other related problems. Chemotherapy caused irreversible damage to the ovarian function. Chemotherapy combind with gonadotropin-releasing hormone agonist could prevent premature ovarian failure and improve patients’ quality of life. Conclusions Gonadotropin-releasing hormone agonist combines with chemotherapy can protect the ovarian function of young breast cancer patients, and reduce premature ovarian failure and retain reproductive function with no serious adverse effect. In addition, it shall not affect the curative effect of chemotherapy itself, but this conclusion still needs further randomized controlled clinical trial to confirm.