Endocrine disorders

organic disease

adolescence Irregular menstrual cycle Sexual intercourse related issues vaginal inflammation Childbearing age (20-39 years old) endometriosis Uterine fibroids Infect Postmenopausal (40 years and older) endometrial hyperplasia endometrial cancer Dry and weak tissue Pregnancy early pregnancy bleeding Abnormal position of the placenta or placental abruption

puberty Inflammation during adolescence hygiene habits Childbearing age (20-39 years old) Infection – Trichomonas or bacterial hygiene habits Postmenopausal (40 years and older) endometrial cancer Dry and weak tissue Pregnancy Infect Placental abruption or abnormal placenta accreta

1. White blood cell count (WBC) [Normal reference range] Adults (4.0～10.0)×109/L; Newborns (15.0～20.0)×109/L 2. Red blood cell count (RBC) [Normal reference range] Newborn: (6.0～7.0)×1012/L Infant: (5.2～7.0)×1012/L Children: (4.2～5.2)×1012/L Adult male: (4.0～5.5)×1012/L L Adult female: (3.5～5.0)×1012/L 3. Platelet count [Normal reference range] (100～300)×109/L

Seven items of coagulation Prothrombin time (PT): 10-14 seconds Activated partial thromboplastin time (APTT): 20-40 seconds Thrombin time (TT):11-14 seconds Fibrinogen (FIB): 2-4g/L Fibrin(ogen) degradation product (FDP): 0-5mg/L (0-5ug/ml) D-Dimer: 0-0.55mg/L FEU (people under 60 years old) Antithrombin III (AT-III): (activity): 80%-120%

Alanine aminotransferase (ALT): 7-40 U/L (unit/L) Aspartate aminotransferase (AST): 13-35U/L (unit/L) Total bilirubin (TBIL): 0-23 μmol/L (micromol/L) Direct bilirubin (DBIL): 0-8μmol/L (1-4mg/L) Indirect bilirubin (IBIL): 1.0-14μmol/L

Blood tests mainly assess the glomerular filtration rate. The indicators examined are creatinine, urea nitrogen, and uric acid.

Classification 1. Drugs that inhibit the fibrinolytic system (tranexamic acid) 2. Drugs that promote the function of the coagulation system (vitamin K) 3. Drugs that constrict blood vessels (pituitrin) 4. Drugs that reduce capillary permeability (ethylamine) 5. Others: Topically applied hemostatic drugs (Yunnan Baiyao)

Sexual intercourse without contraception for at least 12 months without pregnancy is called infertility in women, and infertility in men.

Cause: Female: Pelvic factors Ovulation disorder Male: Abnormal semen. Abnormal semen caused by congenital or acquired reasons. Male sexual dysfunction refers to abnormalities of organic or psychological reasons Other factors such as immune

Diagnosis: Male: History collection Physical examination semen analysis Other auxiliary examinations female: Medical history collection physical examination full body examination Infertility related auxiliary examinations

Treatment: (1) Correction of organic pelvic lesions (2) Induction of ovulation (3) Treatment of unexplained infertility (4) Assisted reproductive technology

principle

Indications ·The lesion is limited to the uterine body ·Suspected/existing tumor infiltration in the cervix ·Lesions extending beyond the uterus ·The standard surgical procedure is extrafascial total hysterectomy plus bilateral adnexectomy ·Pelvic and para-aortic lymph node dissection - high-risk patients

hysterectomy

salpingo-oophorectomy

Pelvic lymph node dissection Para-aortic lymph node dissection

Chemotherapy: Paclitaxel (inhibits mitosis of cancer cells and triggers apoptosis)/carboplatin (interferes with DNA synthesis)/Trastuzumab (inhibits cell growth and promotes apoptosis of tumor cells)

Radiotherapy: Vaginal brachytherapy External radiotherapy

There is a strong desire for fertility and no contraindications to pregnancy. The histological type was endometrioid adenocarcinoma. The tissue differentiation type is highly differentiated. The lesions were limited to the endometrium, with no myometrial infiltration, no extrauterine spread, and no lymph node involvement. There are no contraindications related to treatment drugs (applicable to those taking progesterone treatment). Patients are fully informed and able to comply with treatment and follow-up visits

Within 2 to 3 years after the end of treatment, reexamination should be done every 3 to 6 months, then every six months, and once a year after 5 years.

Content: (1) Ask about symptoms (2) Physical examination (3) Vaginal cytology examination is not recommended under special circumstances (4) CA125 and HE4 detection. (5) Imaging examination

①Irregular vaginal bleeding before and after menopause (generally no contact bleeding) ②Vaginal discharge ③Intermittent pain caused by late-stage irregular uterine contractions ④Others: swelling and pain in lower limbs, hydroureter, kidney atrophy; Symptoms of systemic failure such as anemia, weight loss, fever, and cachexia.

obesity hypertension Diabetes (the “endometrial triad”) Menstrual disorders Early menarche and late menopause Maternity Polycystic Ovary Syndrome Ovarian Cancer atypical endometrial hyperplasia exogenous estrogen

General type

microscopy

FIGO Phase (2023)

TNM staging system

Ann Arbor staging - lymphoma - I, II, III, IV

Dukes staging – colorectal cancer

TCT examination

clinical examination Early general gynecological examinations often reveal nothing. The uterus is not large, the cervix is ​​smooth, and there are no abnormalities in the appendages. In the advanced stages of the disease, the uterus is larger than the corresponding age

B-ultrasound examination The size, location, and degree of myometrial invasion of endometrial cancer in the uterine cavity, and whether the tumor penetrates the uterine serosa or involves the cervical canal

hysteroscopy Observe the location, size and boundaries of the cancer, whether it is localized or diffuse, whether it is exophytic or endophytic, and whether the cervical canal is involved; perform a biopsy on suspicious lesions

retroperitoneal lymphography It can determine whether there is metastasis of pelvic and para-aortic lymph nodes

CT and magnetic resonance imaging Accurately describe the size and scope of the tumor, and determine the metastasis of uterine tumors to surrounding connective tissues, pelvic and para-aortic lymph nodes, pelvic wall, and peritoneal metastases, etc.

The gold standard: endometrial biopsy