Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the as...Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.展开更多
Objective:Pelvic organ prolapse(POP)is a common condition in postmenopausal women,with an increasing prevalence due to aging.Some women experience POP recurrence after surgical treatment,significantly affecting their ...Objective:Pelvic organ prolapse(POP)is a common condition in postmenopausal women,with an increasing prevalence due to aging.Some women experience POP recurrence after surgical treatment,significantly affecting their physical and mental health.The uterosacral ligament is a critical pelvic support structure.This study aims to investigate the molecular pathological changes in the uterosacral ligament of postmenopausal women with recurrent POP using transcriptomic analysis.Methods:Transcriptomic data of uterosacral ligament tissues were obtained from the public dataset GSE28660,which includes samples from 4 postmenopausal women with recurrent POP,4 with primary POP,and 4 without POP.Differentially expressed genes(DEGs)were identified between recurrent POP and both primary and non-POP groups.Further analysis included intersection analysis of DEGs,gene ontology enrichment,protein protein interaction(PPI)network construction,gene set enrichment analysis(GSEA),single-sample GSEA,and xCell immune cell infiltration analysis to explore molecular pathological changes in recurrent POP.Additionally,histological and molecular differences in the uterosacral ligament were compared between simulated vaginal delivery(SVD)rat models with and without ovariectomy.Results:Compared with primary POP and non-POP groups,recurrent POP exhibited activation of adipogenesis and inflammation-related pathways,while pathways related to muscle proliferation and contraction were downregulated in the uterosacral ligament.Nine key DEGs(ADIPOQ,FABP4,IL-6,LIPE,LPL,PCK1,PLIN1,PPARG,and CD36)were identified,with most enriched in the peroxisome proliferator-activated receptor(PPAR)signaling pathway.These genes were significantly correlated with lipid accumulation,monocyte infiltration,and neutrophil infiltration in the uterosacral ligament.Urodynamic testing revealed that the bladder leak point pressure was significantly higher in ovariectomized SVD rats,both of which had higher values than the sham group.Masson staining showed pronounced adipogenesis in the uterosacral ligament of ovariectomized SVD rats,along with reduced collagen and muscle fibers compared to the sham and non ovariectomized SVD groups.Furthermore,real-time RT-PCR confirmed significantly elevated expression of key DEGs,including ADIPOQ,IL-6,PCK1,and PLIN1,in the uterosacral ligaments of ovariectomized SVD rats.Conclusion:Adipogenesis and inflammation in the uterosacral ligament may contribute to its reduced supportive function,potentially leading to recurrence POP in postmenopausal women.展开更多
目的:探讨选择性血管阻断技术在妊娠晚期穿透性胎盘治疗中应用的价值。方法:回顾性分析2003年1月至2010年12月中南大学湘雅医院明确诊断的孕龄≥34周的15例穿透性胎盘患者的临床资料。根据患者是否使用血管阻断技术,分为血管阻断组(n=8...目的:探讨选择性血管阻断技术在妊娠晚期穿透性胎盘治疗中应用的价值。方法:回顾性分析2003年1月至2010年12月中南大学湘雅医院明确诊断的孕龄≥34周的15例穿透性胎盘患者的临床资料。根据患者是否使用血管阻断技术,分为血管阻断组(n=8)与血管未阻断组(n=7);血管阻断组按血管阻断技术应用的时机,又分为预防性应用组(n=4)和治疗性应用组(n=4,其中1例为髂总动脉球囊取出后)。比较血管阻断组与血管未阻断组出血量、子宫切除率及并发症发生情况。结果:15例穿透性胎盘患者术中平均出血量为3813 mL,子宫切除率为73.3%(11/15),近期并发症发生率为20.0%(3/15,包括2例凝血功能障碍和1例下肢血栓形成),远期并发症的发生率为0;其中血管阻断组平均出血量为2512 mL,子宫切除率为62.5%(5/8);血管未阻断组平均出血量5549 mL,子宫切除率85.7%(6/7);两组平均出血量及子宫切除率相比差异均有统计学意义(P<0.05)。且预防性应用组的平均出血量和子宫切除率亦显著低于治疗性应用组(1350 mL vs 3600 mL,60.0%vs 66.7%,P<0.05)。结论:穿透性胎盘患者术中出血量大,子宫切除率高;选择性血管阻断技术可减少其出血量,降低子宫切除率,但仍有严重出血以及切除子宫的风险。展开更多
目的：建立中、晚期妊娠胎儿后颅窝池宽度（width of posterior cranial fossa，WPCF）的超声检测参考值，探讨WPCF与胎儿畸形及染色体异常的关系。方法：常规经腹超声检测妊娠14～41周2848例胎儿WPCF，并随访至胎儿出生后。结果：接受...目的：建立中、晚期妊娠胎儿后颅窝池宽度（width of posterior cranial fossa，WPCF）的超声检测参考值，探讨WPCF与胎儿畸形及染色体异常的关系。方法：常规经腹超声检测妊娠14～41周2848例胎儿WPCF，并随访至胎儿出生后。结果：接受检测的2848例胎儿中，正常2772例，出生缺陷儿76例。发现正常胎儿WPCF在32周之前随孕周增加而增宽，33周之后随孕周的增加而缩窄。最大宽度为13．4mm；正常胎儿WPCF≥8mm发生率占8．84％，畸形儿占17．46％，畸形儿发生率明显高于正常儿。大部分染色体异常胎儿在中期妊娠时WPCF正常，至晚期妊娠时部分明显增宽。部分畸形胎儿如脑积水、典型Dandy—Walker综合症等WPCF明显增宽。结论：WPCF随孕周而变化，32周之前随孕周的增加而增宽，但33周之后随孕周的增加而变窄，29～32周最易检测。部分染色体异常和／或某些先天畸形胎儿妊晚期WPCF明显增宽。中晚期妊娠时WPCF≥10mm时应密切随访，WPCF≥14mm者应建议做产前诊断。展开更多
基金supported by the Science and Technology Innovation Program of Hunan Province,China(2020SK2073).
文摘Objective:Previous studies have demonstrated that the metals cadmium and arsenic exhibit estrogen-like effects and may influence the occurrence and development of gynecological tumors.This study aims to explore the association between urinary cadmium and arsenic levels and the prevalence of gynecologic cancers using data from the National Health and Nutrition Examination Survey(NHANES).Methods:Data from female participants in NHANES 2003—2018 were analyzed.Using R software,datasets(DEMO,BMX,etc.)were merged,and complete cases were retained by intersecting row names,yielding a total of 2999 participants.After applying strict exclusion criteria,2802 participants were included:83 with gynecologic cancer(cancer group)and 2719 without(control group).Demographic,reproductive health,and urinary cadmium and arsenic data were collected.Binary Logistic regression models were employed to assess associations between urinary cadmium and arsenic levels and gynecologic cancer risk.Results:High urinary cadmium and arsenic levels were risk factors for gynecologic cancers,with odds ratios(ORs)of 1.623(95%CI 1.217 to 2.166)and 1.003(95%CI 1.001 to 1.005),respectively.After propensity score matching(PSM),the trend remained;cadmium was still a statistically significant risk factor with an OR of 2.182(95%CI 1.343 to 3.545),while arsenic’s association,though not statistically significant,still trended toward risk(OR=1.004,95%CI 0.999 to 1.009).Subgroup analyses showed that both cadmium and arsenic were risk factors for ovarian cancer(OR=1.745,95%CI 1.178 to 2.586 and OR=1.005,95%CI 1.002 to 1.008,respectively);these associations persisted after PSM.Additionally,cadmium increased the risk of endometrial cancer(OR=1.617,95%CI 1.109 to 2.356).Conclusion:Exposure to cadmium and arsenic is associated with an increased risk of ovarian and endometrial cancers.These findings suggest that reducing environmental exposure to heavy metals such as cadmium and arsenic may help prevent certain gynecologic cancers.
基金supported by the Key Research and Development Program of Hunan Province(2023SK2038)the Natural Science Foundation of Hunan Province(2024JJ8121),China。
文摘Objective:Pelvic organ prolapse(POP)is a common condition in postmenopausal women,with an increasing prevalence due to aging.Some women experience POP recurrence after surgical treatment,significantly affecting their physical and mental health.The uterosacral ligament is a critical pelvic support structure.This study aims to investigate the molecular pathological changes in the uterosacral ligament of postmenopausal women with recurrent POP using transcriptomic analysis.Methods:Transcriptomic data of uterosacral ligament tissues were obtained from the public dataset GSE28660,which includes samples from 4 postmenopausal women with recurrent POP,4 with primary POP,and 4 without POP.Differentially expressed genes(DEGs)were identified between recurrent POP and both primary and non-POP groups.Further analysis included intersection analysis of DEGs,gene ontology enrichment,protein protein interaction(PPI)network construction,gene set enrichment analysis(GSEA),single-sample GSEA,and xCell immune cell infiltration analysis to explore molecular pathological changes in recurrent POP.Additionally,histological and molecular differences in the uterosacral ligament were compared between simulated vaginal delivery(SVD)rat models with and without ovariectomy.Results:Compared with primary POP and non-POP groups,recurrent POP exhibited activation of adipogenesis and inflammation-related pathways,while pathways related to muscle proliferation and contraction were downregulated in the uterosacral ligament.Nine key DEGs(ADIPOQ,FABP4,IL-6,LIPE,LPL,PCK1,PLIN1,PPARG,and CD36)were identified,with most enriched in the peroxisome proliferator-activated receptor(PPAR)signaling pathway.These genes were significantly correlated with lipid accumulation,monocyte infiltration,and neutrophil infiltration in the uterosacral ligament.Urodynamic testing revealed that the bladder leak point pressure was significantly higher in ovariectomized SVD rats,both of which had higher values than the sham group.Masson staining showed pronounced adipogenesis in the uterosacral ligament of ovariectomized SVD rats,along with reduced collagen and muscle fibers compared to the sham and non ovariectomized SVD groups.Furthermore,real-time RT-PCR confirmed significantly elevated expression of key DEGs,including ADIPOQ,IL-6,PCK1,and PLIN1,in the uterosacral ligaments of ovariectomized SVD rats.Conclusion:Adipogenesis and inflammation in the uterosacral ligament may contribute to its reduced supportive function,potentially leading to recurrence POP in postmenopausal women.
文摘目的:探讨选择性血管阻断技术在妊娠晚期穿透性胎盘治疗中应用的价值。方法:回顾性分析2003年1月至2010年12月中南大学湘雅医院明确诊断的孕龄≥34周的15例穿透性胎盘患者的临床资料。根据患者是否使用血管阻断技术,分为血管阻断组(n=8)与血管未阻断组(n=7);血管阻断组按血管阻断技术应用的时机,又分为预防性应用组(n=4)和治疗性应用组(n=4,其中1例为髂总动脉球囊取出后)。比较血管阻断组与血管未阻断组出血量、子宫切除率及并发症发生情况。结果:15例穿透性胎盘患者术中平均出血量为3813 mL,子宫切除率为73.3%(11/15),近期并发症发生率为20.0%(3/15,包括2例凝血功能障碍和1例下肢血栓形成),远期并发症的发生率为0;其中血管阻断组平均出血量为2512 mL,子宫切除率为62.5%(5/8);血管未阻断组平均出血量5549 mL,子宫切除率85.7%(6/7);两组平均出血量及子宫切除率相比差异均有统计学意义(P<0.05)。且预防性应用组的平均出血量和子宫切除率亦显著低于治疗性应用组(1350 mL vs 3600 mL,60.0%vs 66.7%,P<0.05)。结论:穿透性胎盘患者术中出血量大,子宫切除率高;选择性血管阻断技术可减少其出血量,降低子宫切除率,但仍有严重出血以及切除子宫的风险。
文摘目的：建立中、晚期妊娠胎儿后颅窝池宽度（width of posterior cranial fossa，WPCF）的超声检测参考值，探讨WPCF与胎儿畸形及染色体异常的关系。方法：常规经腹超声检测妊娠14～41周2848例胎儿WPCF，并随访至胎儿出生后。结果：接受检测的2848例胎儿中，正常2772例，出生缺陷儿76例。发现正常胎儿WPCF在32周之前随孕周增加而增宽，33周之后随孕周的增加而缩窄。最大宽度为13．4mm；正常胎儿WPCF≥8mm发生率占8．84％，畸形儿占17．46％，畸形儿发生率明显高于正常儿。大部分染色体异常胎儿在中期妊娠时WPCF正常，至晚期妊娠时部分明显增宽。部分畸形胎儿如脑积水、典型Dandy—Walker综合症等WPCF明显增宽。结论：WPCF随孕周而变化，32周之前随孕周的增加而增宽，但33周之后随孕周的增加而变窄，29～32周最易检测。部分染色体异常和／或某些先天畸形胎儿妊晚期WPCF明显增宽。中晚期妊娠时WPCF≥10mm时应密切随访，WPCF≥14mm者应建议做产前诊断。
