Objective:To analyze the application value of a non-catheter tampon in abdominal hysterectomy,providing a reference for related research.Methods:A total of 100 patients were included in this study,with data collected ...Objective:To analyze the application value of a non-catheter tampon in abdominal hysterectomy,providing a reference for related research.Methods:A total of 100 patients were included in this study,with data collected between January 4,2022,and January 4,2024.The patients were divided into two groups:the new group and the traditional group,each comprising 50 patients.Results:Compared with the traditional group,the new group demonstrated significantly lower intraoperative blood loss(P<0.05).Additionally,the incidence of complications,operation time,hospital stay,time required to resume normal activities,and postoperative VAS scores were all significantly lower in the new group(P<0.05).Conclusion:The application of a non-catheter tampon during abdominal hysterectomy yields satisfactory results.This approach is worthy of further clinical promotion and application.展开更多
C-type lectins(CTLs)act as pattern recognition receptors(PRRs)to initiate the innate immune response in insects.A CTL with dual carbohydrate recognition domains(CRDs)(named immulectin-4[IML-4])was selected from the Os...C-type lectins(CTLs)act as pattern recognition receptors(PRRs)to initiate the innate immune response in insects.A CTL with dual carbohydrate recognition domains(CRDs)(named immulectin-4[IML-4])was selected from the Ostrinia furnacalis transcriptome dataset for functional studies.We cloned the full-length complementary DNA of O.furnacalis IML-4(OfIML-4).It encodes a 328-residue protein with a Glu-Pro-Asn(EPN)and Gln-Pro-Asp(QPD)motifs in 2 CRDs,respectively.OfIML-4 messenger RNA levels increased significantly upon the bacterial and fungal infection.Recombinant OfIML-4(rIML-4)and its individual CRDs(rCRD1 and rCRD2)exhibited the binding ability to various microorganisms including Escherichia coli,Micrococcus luteus,Pichia pastoris,and Beauveria bassiana,and the cell wall components including lipopolysaccharide from E.coli,peptidoglycan from M.luteus or Bacillus subtilis,and curdlan from Alcaligenes faecalis.The binding further induced the agglutination of E.coli,M.luteus,and B.bassiana in the presence of calcium,the phagocytosis of Staphylococcus aureus by the hemocytes,in vitro encapsulation and melanization of nickel-nitrilotriacetic acid beads,and a significant increase in phenoloxidase activity of plasma.In addition,rIML-4 significantly enhanced the phagocytosis,nodulation,and resistance of O.furnacalis to B.bassiana.Taken together,our results suggest that OfIML-4 potentially works as a PRR to recognize the invading microorganisms,and functions in the innate immune response in O.furnacalis.展开更多
Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognost...Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.展开更多
BACKGROUND Postpartum hemorrhage(PPH)is a leading cause of maternal mortality,and hysterectomy is an important intervention for managing intractable PPH.Accurately predicting the need for hysterectomy and taking proac...BACKGROUND Postpartum hemorrhage(PPH)is a leading cause of maternal mortality,and hysterectomy is an important intervention for managing intractable PPH.Accurately predicting the need for hysterectomy and taking proactive emergency measures is crucial for reducing mortality rates.AIM To develop a risk prediction model for PPH requiring hysterectomy in the ethnic minority regions of Qiandongnan,China,to help guide clinical decision-making.METHODS The study included 23490 patients,with 1050 having experienced PPH and 74 who underwent hysterectomies.The independent risk factors closely associated with the necessity for hysterectomy were analyzed to construct a risk prediction model,and its predictive efficacy was subsequently evaluated.RESULTS The proportion of hysterectomies among the included patients was 0.32%(74/23490),representing 7.05%(74/1050)of PPH cases.The number of deliveries,history of cesarean section,placenta previa,uterine atony,and placenta accreta were identified in this population as independent risk factors for requiring a hysterectomy.Receiver operating characteristic curve analysis of the prediction model showed an area under the curve of 0.953(95%confidence interval:0.928-0.978)with a sensitivity of 90.50%and a specificity of 90.70%.CONCLUSION The model demonstrates excellent predictive power and is effective in guiding clinical decisions regarding PPH in the ethnic minority regions of Qiandongnan,China.展开更多
Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment mo...Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.展开更多
Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the ...Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed by an obstetric gynaecologist (230 patients, 96.2%), an obstetric gynaecology resident (six patients, 2.5%), or a general practitioner with district surgical expertise (three patients, 1.3%). In the majority of cases (180 patients, 75.3%), total hysterectomy was performed. The incidence of maternal mortality (26 patients, 10.9%), and perinatal mortality (223 newborns, 93.4%) was notably elevated in our series. Conclusion: Our findings are in close alignment with those previously documented in the literature. The practice of emergency obstetric hysterectomy is a common occurrence in our region. It is considered a last resort when conservative procedures have failed or are not an option. Improved obstetric management would result in a reduction in the number of cases of haemostatic hysterectomy. The availability of blood products is expected to improve maternal prognosis.展开更多
Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided...Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.展开更多
目的比较不同复合全麻策略对腹腔镜子宫切除术患者的临床效果及对血清CRP、BNP、B细胞及NK细胞的影响。方法选取2021年7月至2023年11月池州市第二人民医院收治的122例行腹腔镜子宫切除术患者为观察对象,采用抽样便利法将其分为A组(硬膜...目的比较不同复合全麻策略对腹腔镜子宫切除术患者的临床效果及对血清CRP、BNP、B细胞及NK细胞的影响。方法选取2021年7月至2023年11月池州市第二人民医院收治的122例行腹腔镜子宫切除术患者为观察对象,采用抽样便利法将其分为A组(硬膜外阻滞复合全麻)、B组(静脉复合吸入全麻),各61例。比较两组麻醉相关指标(麻醉时长、恢复自主呼吸时长、术后完全清醒时间、拔管时长、术后住院时长)、疼痛情况、生命体征(MAP及心率)、血清CRP及BNP、B细胞及NK细胞及不良反应总发生率。结果A组麻醉时长长于B组,恢复自主呼吸时长、术后完全清醒时间、拔管时长、术后住院时长均短于B组,差异有统计学意义(P<0.05)。术后6 h、12 h、24 h、48 h,两组VAS评分均降低,且术后12 h、24 h、48 h A组VAS评分均显著低于B组,差异有统计学意义(P<0.05)。A组气腹后MAP高于B组,气腹后、术毕心率低于B组,差异有统计学意义(P<0.05)。较麻醉前,两组术后1 d、术后3 d血清CRP、BNP水平均出现上升,但A组术后1 d、术后3 d上述指标水平显著低于B组,差异有统计学意义(P<0.05)。较术前,两组术后30 min B细胞及NK细胞均升高,但A组术后30 min NK细胞低于B组,差异有统计学意义(P<0.05);两组术前、术后30 min B细胞比较,差异无统计学意义(P>0.05)。结论腹腔镜子宫切除术中,硬膜外阻滞复合全麻在镇痛、生命体征、抗炎护心、免疫及安全性等方面均优于静脉复合吸入全麻,可为麻醉策略选择提供有力依据。展开更多
文摘Objective:To analyze the application value of a non-catheter tampon in abdominal hysterectomy,providing a reference for related research.Methods:A total of 100 patients were included in this study,with data collected between January 4,2022,and January 4,2024.The patients were divided into two groups:the new group and the traditional group,each comprising 50 patients.Results:Compared with the traditional group,the new group demonstrated significantly lower intraoperative blood loss(P<0.05).Additionally,the incidence of complications,operation time,hospital stay,time required to resume normal activities,and postoperative VAS scores were all significantly lower in the new group(P<0.05).Conclusion:The application of a non-catheter tampon during abdominal hysterectomy yields satisfactory results.This approach is worthy of further clinical promotion and application.
基金supported by the National Key Research and Development Program of China(2019YFE0120400)National Natural Science Foundation of China(31672361).
文摘C-type lectins(CTLs)act as pattern recognition receptors(PRRs)to initiate the innate immune response in insects.A CTL with dual carbohydrate recognition domains(CRDs)(named immulectin-4[IML-4])was selected from the Ostrinia furnacalis transcriptome dataset for functional studies.We cloned the full-length complementary DNA of O.furnacalis IML-4(OfIML-4).It encodes a 328-residue protein with a Glu-Pro-Asn(EPN)and Gln-Pro-Asp(QPD)motifs in 2 CRDs,respectively.OfIML-4 messenger RNA levels increased significantly upon the bacterial and fungal infection.Recombinant OfIML-4(rIML-4)and its individual CRDs(rCRD1 and rCRD2)exhibited the binding ability to various microorganisms including Escherichia coli,Micrococcus luteus,Pichia pastoris,and Beauveria bassiana,and the cell wall components including lipopolysaccharide from E.coli,peptidoglycan from M.luteus or Bacillus subtilis,and curdlan from Alcaligenes faecalis.The binding further induced the agglutination of E.coli,M.luteus,and B.bassiana in the presence of calcium,the phagocytosis of Staphylococcus aureus by the hemocytes,in vitro encapsulation and melanization of nickel-nitrilotriacetic acid beads,and a significant increase in phenoloxidase activity of plasma.In addition,rIML-4 significantly enhanced the phagocytosis,nodulation,and resistance of O.furnacalis to B.bassiana.Taken together,our results suggest that OfIML-4 potentially works as a PRR to recognize the invading microorganisms,and functions in the innate immune response in O.furnacalis.
文摘Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.
基金Supported by Qiandongnan Prefecture Science and Technology Support Plan,No.[2021]11Training of High Level Innovative Talents in Guizhou Province,No.[2022]201701。
文摘BACKGROUND Postpartum hemorrhage(PPH)is a leading cause of maternal mortality,and hysterectomy is an important intervention for managing intractable PPH.Accurately predicting the need for hysterectomy and taking proactive emergency measures is crucial for reducing mortality rates.AIM To develop a risk prediction model for PPH requiring hysterectomy in the ethnic minority regions of Qiandongnan,China,to help guide clinical decision-making.METHODS The study included 23490 patients,with 1050 having experienced PPH and 74 who underwent hysterectomies.The independent risk factors closely associated with the necessity for hysterectomy were analyzed to construct a risk prediction model,and its predictive efficacy was subsequently evaluated.RESULTS The proportion of hysterectomies among the included patients was 0.32%(74/23490),representing 7.05%(74/1050)of PPH cases.The number of deliveries,history of cesarean section,placenta previa,uterine atony,and placenta accreta were identified in this population as independent risk factors for requiring a hysterectomy.Receiver operating characteristic curve analysis of the prediction model showed an area under the curve of 0.953(95%confidence interval:0.928-0.978)with a sensitivity of 90.50%and a specificity of 90.70%.CONCLUSION The model demonstrates excellent predictive power and is effective in guiding clinical decisions regarding PPH in the ethnic minority regions of Qiandongnan,China.
文摘Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.
文摘Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed by an obstetric gynaecologist (230 patients, 96.2%), an obstetric gynaecology resident (six patients, 2.5%), or a general practitioner with district surgical expertise (three patients, 1.3%). In the majority of cases (180 patients, 75.3%), total hysterectomy was performed. The incidence of maternal mortality (26 patients, 10.9%), and perinatal mortality (223 newborns, 93.4%) was notably elevated in our series. Conclusion: Our findings are in close alignment with those previously documented in the literature. The practice of emergency obstetric hysterectomy is a common occurrence in our region. It is considered a last resort when conservative procedures have failed or are not an option. Improved obstetric management would result in a reduction in the number of cases of haemostatic hysterectomy. The availability of blood products is expected to improve maternal prognosis.
文摘Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.
文摘目的比较不同复合全麻策略对腹腔镜子宫切除术患者的临床效果及对血清CRP、BNP、B细胞及NK细胞的影响。方法选取2021年7月至2023年11月池州市第二人民医院收治的122例行腹腔镜子宫切除术患者为观察对象,采用抽样便利法将其分为A组(硬膜外阻滞复合全麻)、B组(静脉复合吸入全麻),各61例。比较两组麻醉相关指标(麻醉时长、恢复自主呼吸时长、术后完全清醒时间、拔管时长、术后住院时长)、疼痛情况、生命体征(MAP及心率)、血清CRP及BNP、B细胞及NK细胞及不良反应总发生率。结果A组麻醉时长长于B组,恢复自主呼吸时长、术后完全清醒时间、拔管时长、术后住院时长均短于B组,差异有统计学意义(P<0.05)。术后6 h、12 h、24 h、48 h,两组VAS评分均降低,且术后12 h、24 h、48 h A组VAS评分均显著低于B组,差异有统计学意义(P<0.05)。A组气腹后MAP高于B组,气腹后、术毕心率低于B组,差异有统计学意义(P<0.05)。较麻醉前,两组术后1 d、术后3 d血清CRP、BNP水平均出现上升,但A组术后1 d、术后3 d上述指标水平显著低于B组,差异有统计学意义(P<0.05)。较术前,两组术后30 min B细胞及NK细胞均升高,但A组术后30 min NK细胞低于B组,差异有统计学意义(P<0.05);两组术前、术后30 min B细胞比较,差异无统计学意义(P>0.05)。结论腹腔镜子宫切除术中,硬膜外阻滞复合全麻在镇痛、生命体征、抗炎护心、免疫及安全性等方面均优于静脉复合吸入全麻,可为麻醉策略选择提供有力依据。
