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BackgroundThe aim of this study was to analyze the differences in vaginal microecological factors and genital tract infections among pregnant women of different ages.Material/MethodsThis study included 751 pregnant women from West China Second University Hospital, Sichuan University, China, from January 2015 to April 2017. After gram staining, the vaginal microecological factors of these cases were observed, including vaginal cleanliness, lactobacillus number, bacterial density, flora diversity, dominant bacteria, pH, clue cells, Candida species, and Trichomonas vaginalis.ResultsThere was no significant difference in bacterial density, flora diversity, vaginal cleanliness, or lactobacillus number among pregnant women of different age groups. Of the 32.62% of pregnant women who had genital tract infections, the incidence of bacterial vaginosis, Candida albicans infection, non-albicans Candida infection, and T. vaginalis infection were 20.91%, 14.91%, 4.26%, and 1.73%, respectively. The amalgamative incidence of bacterial vaginosis was 9.19%. The incidence of non-albicans Candida infection in the optimum reproductive age group was higher than in the older age group (P=0.0433). The incidence of T. vaginalis infection in the younger age group was higher than in the optimum reproductive age group and higher than in the older age group (P=0.0010 and P=0.0041).ConclusionsThe microecological status of pregnant women was basically the same as that of normal women. The most frequent genital tract infection was bacterial vaginosis. While bacterial vaginosis is amalgamative with vulvovaginal candidiasis and T. vaginalis infection, there was no significant difference in vaginal microecological observations among pregnant women in different age groups except that the non-albicans Candida infection incidence in the optimum reproductive age group and the T. vaginalis infection incidence in the younger age group was higher than in the other groups.

There were vaginal microecological imbalances in all developing stages of RVVC. As for vaginal flora, diverse sorts changed to normal Lactobacillus dominantly with the development of RVVC. In the first occurrence of RVVC, after antifungal treatment, Lactobacillus is suggested to be timely supplemented to restore vaginal microecological balance.

In the study, C. albicans was the commonest pathogenic species in patients with VVC, in which the phenotypic switching was easy to occur. The susceptible rates of C. albicans to all antifungal drugs were higher than that of non-albicans Candida species. The susceptible rate to fluconazole was all influenced by the phenotypic switching in C. albicans and non-albicans Candida species.

The gene, structural maintenance of chromosomes 4 (SMC4) plays important role in chromosomes condensing and mitotic sister chromatid segregation, which has been revealed in regulating multiple cancer development and carcinogenesis. However, the role of SMC4 in acute myeloid leukemia (AML) propagation and its function in regulation of leukemia stem cells (LSCs) is not yet clear. Using an MLL-AF9 induced AML mouse model, we demonstrated that down modulating of SMC4 expression could prolong the survival time of AML mice. Furthermore, we found that knockdown SMC4 expression decreased the proportion of LSCs and affected its leukemia-initiating capacity. Cell cycle assay demonstrated that more LSCs were arrested in G0 phase by SMC4 knockdown. This activity was accompanied by increased expression of the Cdkn1a (P21) and Cdkn1b (P27) as well as decreased expression of CDK4. Therefore, our study revealed the critical role of SMC4 during AML progression and provided new insights into the mechanism of LSC maintenance.

Objective This study aimed to determine the characteristics of vulvo-vaginal infections in 14- to 18-year-old girls in late puberty. Methods From July 2016 to June 2019, 487 14- to 18-year-old girls with vulvo-vaginal infection in late puberty in West China Second University Hospital were retrospectively studied. The incidence of bacterial vaginosis (BV), the intermediate type of BV, vulvo-vaginal candidiasis (VVC), Trichomonas vaginalis (TV), and differences among the incidence of these infections for patients with different ages were analyzed. Results The incidence of BV, the intermediate type of BV, TV, VVC, and unknown pathogenic vaginitis was 25.67%, 19.30%, 2.46%, 29.37%, and 23.20%, respectively. The incidence of BV and VVC was significantly higher than that of TV. The incidence of BV in the 17-year-old group was significantly higher than that in other age groups. The incidence of VVC and non- albicans Candida infection in the 17- and 18-year-old groups was significantly higher than that in the 14-year-old group. Conclusion Girls in late puberty are more susceptible to suffer from BV and VVC than TV infections. Therefore, more attention should be paid to the effects of menstrual hygiene, female estrogen levels, the vaginal internal environment, and hygiene in vulvo-vaginal infection at this stage.

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