Jinsong Han

A review of the pelvic organ prolapse quantification system in China

Introduction and hypothesisUnified staging systems for pelvic organ prolapse (POP) have been established. We examined the application of the POP quantification (POP-Q) system in China by examining its use in scientific journal articles.MethodsRelevant articles were identified by searching the Sinomed database using the terms: uterus prolapse, cystocele, proctocele, prolapse, and pelvic floor; limited to Chinese core journals in obstetrics and gynecology, from January 2004 to December 2014. We analyzed systems for grading POP severity and the adoption of POP-Q in different article categories and hospitals of different levels. For the last decade, with two 5-year groups (2005–2009; 2010–2014), the χ2 test was used to evaluate inter-group differences.ResultsIn a total of 429 articles, 331 included a staging system, 70.7% of which used POP-Q. The POP-Q system first appeared in 2004 in China, was reported in 50% of articles in 2007, and its highest use occurred in 2012 (89.5%). In 234 POP-Q system-utilizing reports, operative treatment and basic research accounted for 73.1% and 14.0% respectively. POP-Q usage increased from 2005–2009 to 2010–2014 in surgery-related articles (54.2% vs 85.2%; P = 0.000). The proportion of reports using POP-Q in level I, II, and III hospitals was 20.0%, 35.4%, and 77.8% respectively.ConclusionsThe POP-Q system, first used in 2004 in China, is now the most commonly used grading system, with surgery reports and level III hospitals accounting for the largest proportion of POP-Q applications.

Transcriptome Landscape of Human Oocytes and Granulosa Cells Throughout Folliculogenesis

Folliculogenesis is a highly regulated process that involves bidirectional interactions of the oocytes and surrounding granulosa cells (GCs). Little is unknown, however, about the transcriptomic profiles of human oocytes and GCs throughout folliculogenesis. Here we performed a high resolution RNA-Seq of human oocytes and GCs at each follicular stage, which revealed unique transcriptional profiles, stage-specific signature genes, oocyte- and GC-derived genes that reflect ovarian reserve. We identified reciprocal cell-to-cell interactions between oocytes and GCs, including NOTCH, TGF-β signaling and gap junctions and determined the expression patterns of maternal-effect genes involved in folliculogenesis and early embryogenesis. Finally, we demonstrated robust differences between human and mice oocyte transcriptomes. This is the first comprehensive overview of the transcriptomic signatures governing the stepwise human folliculogenesis in-vivo that provides a valuable resource for basic and translational research in human reproductive biology.

Feasibility and outcome of primary laparoscopic cytoreductive surgery for advanced epithelial ovarian cancer: a comparison to laparotomic surgery in retrospective cohorts

Objectives To assess the feasibility and outcome of primary laparoscopic cytoreductive surgery on advanced epithelial ovarian cancer in comparison with conventional open surgery. Materials and Methods Patients undergoing primary laparoscopic cytoreductive surgery (LCS) from March 2007 to December 2016 were matched to controls treated with laparotomic cytoreduction during the same period. Procedural data and outcomes were analyzed. Results The LCS group (n = 64) and laparotomic group (n = 68) had similar age, BMI, stages, histologic type and grading. The LCS group exhibited significantly less operating time (P < 0.001), less intraoperative blood loss (P < 0.001), and shorter time to recover postoperatively (P = 0.002). No statistical difference was observed for the number of pelvic and para-aortic lymph nodes dissected (P = 0.326 and P = 0.151). Significant difference was observed in satisfaction of the cytoreduction (95.3% vs. 76.5%, P = 0.008). No significant difference were observed either in intra-operative or in post-operative complications between the two groups (P = 0.250). Three patients in the LCS group experienced intra-operative complications (4.7%) and were all treated laparoscopically. The conversion rate was 3.1%. No significant differences were observed in the progression-free survival and overall survival between the two groups during the medium follow-up of 18 months (P = 0.236 and P = 0.216). The 2-year and 3-year progression-free survival was 67.9%, 55.5% in LCS group and 53.8%, 33.3% respectively in the control group. The 2-year and 3-year overall survival was 95.8%, 88.7% respectively in the LCS group and 89.0%, 83.7% in the control group. Conclusions Primary laparoscopic cytoreductive surgery in some strictly selected advanced stages of EOC patients was feasible and safe, resulting in oncologic outcomes not inferior to those in open surgery.

Tissue Reactions to Heterogenic and Allogeneic Acellular Dermal Matrix Mesh Placed in the Vesicovaginal Space in a Rabbit Model

Background and Aim: This study is aimed at investigating the tissue reactions of heterogenic and allogeneic acellular dermal matrix (ADM) mesh implanted in the vesicovaginal space in a rabbit model. Methods: Twenty eight rabbits were implanted with heterogenic or allogeneic mesh, respectively, in the vesicovaginal space, and 4 served as the no-implantation control group. Rabbits were sacrificed at 7, 30, and 90 days after implantation. Histopathological study and immunohistochemical examination for collagen were performed. Results: Heterogenic but not allogeneic mesh was identifiable at 90 days. In the allogeneic group, neovascularization was observed from day 7 after implantation. A chronic inflammatory reaction was noted in the heterogenic group at 30 days that decreased at 90 days. Inflammation was less in the allogeneic group, but giant cells and fibroblasts were present. With respect to collagen, the heterogenic mesh remained structurally unchanged at 90 days, while new collagen fibers were observed in the allogeneic group from day 7. Conclusion: The immunological outcomes of heterogenic and allogeneic ADM mesh are different. Heterogenic mesh induces a chronic inflammatory reaction at day 30 after implantation, and maintains its original form longer. Allogeneic mesh is associated with new collagen generation, but degrades earlier.

Dysgerminoma and Gonadoblastoma with Para-aortic Lymph Node Metastasis in a Patient with Swyer Syndrome.

To the Editor: In June 2013, a 17‐year‐old patient was admitted to our hospital for a pelvic mass and primary amenorrhea. The patient’s cousin had a similar clinical presentation without a definite diagnosis. Physical examination revealed a phenotypic female with a slender body, poor mammary gland development, an infantile vulva, no pubic hair, and a normal-appearing vaginal orifice and vestibule. A hard and solid abdominal mass, approximately 12 cm in diameter, was found. The vagina was approximately 3.0 cm in length with a blind end measured by cotton swabs. The human chorionic gonadotropin (HCG) (40.64 mU/ml) and lactate dehydrogenase (LDH) (431 U/ml) levels were elevated. The follicle-stimulating hormone (111 mU/ml) and leutinizing hormone (27.8 mU/ml) levels were also elevated, while the E2, T, and A levels were below the reference values. The diurnal cortisol and adrenocorticotropic hormone (ACTH) levels were normal. Chromosome karyotype analysis was then done and revealed a result of 46XY. Pelvic computed tomography scan revealed multiple masses posterior to the uterus and involving the retroperitoneal abdominal aorta to the level of the left renal veins.