Journal of International Obstetrics and Gynecology

Research Progress on the Immunological Pathogenesis and Treatment of Premature Ovarian Failure

WANG Xiao-qiu;LI Da-jin

2016, 43 (3): 245-249.

Abstract ( 2748 )

PDF (542KB) ( 8892 )

The premature ovarian failure (POF) generally describes a syndrome of gonadal failure before the age of 40. In recent years, the incidence of POF in fertile woman has increased year by year and there is the development trend of younger age. POF, a serious life-changing condition that affects young women. Low estrogen levels also affect cardiovascular system and skeletal system, etc. Infertility is a common consequence of this entity. The known cause of this condition includes: genetic aberrations, autoimmune ovarian damage, infection, enzyme defect and iatrogenic factors, although in majority of cases the underlying cause is not been identified. A growing body of research suggests that autoimmunity is one of the important pathogenesis of POF. Autoantibody and abnormal cellular immunity function are thought to play an important role in the pathogenesis of POF. Currently, there are no ideal treatment options for POF. To elucidate the molecular immunology mechanism of POF and its relationship with neuroendocrine function will be the key to seek effective prevention and treatment.

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Research Progress on the Immunological Pathogenesis and Treatment of Premature Ovarian Failure

WANG Xiao-qiu;LI Da-jin

2016, 43 (3): 245-249.

Abstract ( 394 )

PDF (542KB) ( 5031 )

The premature ovarian failure (POF) generally describes a syndrome of gonadal failure before the age of 40. In recent years, the incidence of POF in fertile woman has increased year by year and there is the development trend of younger age. POF, a serious life-changing condition that affects young women. Low estrogen levels also affect cardiovascular system and skeletal system, etc. Infertility is a common consequence of this entity. The known cause of this condition includes: genetic aberrations, autoimmune ovarian damage, infection, enzyme defect and iatrogenic factors, although in majority of cases the underlying cause is not been identified. A growing body of research suggests that autoimmunity is one of the important pathogenesis of POF. Autoantibody and abnormal cellular immunity function are thought to play an important role in the pathogenesis of POF. Currently, there are no ideal treatment options for POF. To elucidate the molecular immunology mechanism of POF and its relationship with neuroendocrine function will be the key to seek effective prevention and treatment.

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The Advances in the Etiology and Therapy of Intrauterine Adhesions

CHEN Can-ming;WANG Yi-fang;GU Xiao-yan;REN Wei-juan

2016, 43 (3): 250-253.

Abstract ( 1571 )

PDF (441KB) ( 6791 )

Intrauterine adhesions is an important factor affecting the fertility of women. With the development of medicine, more and more risk factors were identified by epidemiological investigation and clinical observation research，including curettage after pregnancy, cesarean section, trophoblastic disease evacuation, Müllerian dut malformation, genital tuberculosis infection, diagnostic curettage, abdominal myomectomy, uterine artery embolization, hysteroscopic surgery, insertion of intrauterine device（IUD） and uterine compressive sutures for post-partum hemorrhage，etc. It can provide a useful method to prevent and cure intrauterine adhesions. The treatment strategy of intrauterine adhesions could be summarized in four main steps scientists. In order to find the best treatment strategy for intrauterine adhesions, scientists researched the following four respects: surgical treatment; re-adhesion prevention; restoring normal endometrium and post-operative assessment. The case report, using stem cells transplantation technique followed by conception in a patient of severe Asherman′s syndrome，which opens up a new way for the treatment of intrauterine adhesions.

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The Advances in the Etiology and Therapy of Intrauterine Adhesions

CHEN Can-ming;WANG Yi-fang;GU Xiao-yan;REN Wei-juan

2016, 43 (3): 250-253.

Abstract ( 527 )

PDF (441KB) ( 4993 )

Intrauterine adhesions is an important factor affecting the fertility of women. With the development of medicine, more and more risk factors were identified by epidemiological investigation and clinical observation research，including curettage after pregnancy, cesarean section, trophoblastic disease evacuation, Müllerian dut malformation, genital tuberculosis infection, diagnostic curettage, abdominal myomectomy, uterine artery embolization, hysteroscopic surgery, insertion of intrauterine device（IUD） and uterine compressive sutures for post-partum hemorrhage，etc. It can provide a useful method to prevent and cure intrauterine adhesions. The treatment strategy of intrauterine adhesions could be summarized in four main steps scientists. In order to find the best treatment strategy for intrauterine adhesions, scientists researched the following four respects: surgical treatment; re-adhesion prevention; restoring normal endometrium and post-operative assessment. The case report, using stem cells transplantation technique followed by conception in a patient of severe Asherman′s syndrome，which opens up a new way for the treatment of intrauterine adhesions.

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Advances of Perioperative Estrogen Therapy in Patients with Intrauterine Adhesions

CHEN Xi-ting;CHEN Qing;LIU Chang-hao;HUANG Miao-ling;GUAN Mei-mei

2016, 43 (3): 254-257.

Abstract ( 1284 )

PDF (537KB) ( 6464 )

Recently, with the popularity of intrauterine operation, the incidence of intrauterine adhesions(IUA) is increasing gradually. Hysteroscopic adhesiolysis has become an effective treatment of IUA. Estrogen use as an perioperative adjuvant therapy has been extensively applied to clinical practice，however the treatment remains empirically based. The purpose of this article was to review the literature to understand changes of endometrium with intrauterine adhesions and to analyze the mechanism and efficacy of estrogen therapy. Furthermore, this article summarized the dose,duration and other treatment strategies of estrogｅｎ，ｗhich provide evidence to use estrogen as perioperative adjuvant therapy in IUA.

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Advances of Perioperative Estrogen Therapy in Patients with Intrauterine Adhesions

CHEN Xi-ting;CHEN Qing;LIU Chang-hao;HUANG Miao-ling;GUAN Mei-mei

2016, 43 (3): 254-257.

Abstract ( 439 )

PDF (537KB) ( 4848 )

Recently, with the popularity of intrauterine operation, the incidence of intrauterine adhesions(IUA) is increasing gradually. Hysteroscopic adhesiolysis has become an effective treatment of IUA. Estrogen use as an perioperative adjuvant therapy has been extensively applied to clinical practice，however the treatment remains empirically based. The purpose of this article was to review the literature to understand changes of endometrium with intrauterine adhesions and to analyze the mechanism and efficacy of estrogen therapy. Furthermore, this article summarized the dose,duration and other treatment strategies of estrogｅｎ，ｗhich provide evidence to use estrogen as perioperative adjuvant therapy in IUA.

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Impairment of Airborne Fine Particulate Matters PM2.5 to the Fertility of Female Rats

WU Si-yu;HOU Hai-yan;ZHANG Li-wen;HAN Bin;LYU Qi;CHEN Ya-qiong

2016, 43 (3): 258-262.

Abstract ( 1140 )

PDF (666KB) ( 6493 )

Objective: To explore the toxicity of fine particulate matter (PM2.5) on the fertility of female rats. Methods：Adult female SD rats were randomly divided into 5 groups: saline group (as negative control), low-, middle- and high-dose PM2.5 groups, and BaP group (as positive control). PM2.5 was given by trachea instillation and BaP was given by intra-gastric administration from 15 days pro-gestation to 6 days after gestation. On the gestational day 6.5 (GD6.5), female rats were sacrificed. Lungs were observed by naked eye. Uterine weight and embryos counts were recorded. Vein blood was collected for detecting the concentration of blood heavy metals including lead (Pb), mercury (Hg), cadmium (Cd), arsenic (As) and antimony (Sb). Tissues of uterus and ovaries were stained by HE. Results：Compared with the saline group, body weight of rats in the high-dose PM2.5 group significantly decreased and the lung histology also changed. While the dose of PM2.5 raised, the mating and GD6.5 pregnancy index decreased nevertheless rats in BaP group showed no difference. Then GD19.5 pregnancy index of BaP group decreased apparently as compared with saline group. Embryos counts，uterine and embryos weight in three PM2.5 groups significantly reduced. The As level increased in the three PM2.5 groups, which negatively related to the number of embryos，as well as Sb level. There was no significant change in pathology of uterine or ovarian tissue. Conclusions：PM2.5 could impair the fertility of female rats, and the increased As and Sb levels could be related to the reproductive toxicity. BaP impairs the viability of implanted embryos.

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Impairment of Airborne Fine Particulate Matters PM2.5 to the Fertility of Female Rats

WU Si-yu;HOU Hai-yan;ZHANG Li-wen;HAN Bin;LYU Qi;CHEN Ya-qiong

2016, 43 (3): 258-262.

Abstract ( 349 )

PDF (666KB) ( 4839 )

Objective: To explore the toxicity of fine particulate matter (PM2.5) on the fertility of female rats. Methods：Adult female SD rats were randomly divided into 5 groups: saline group (as negative control), low-, middle- and high-dose PM2.5 groups, and BaP group (as positive control). PM2.5 was given by trachea instillation and BaP was given by intra-gastric administration from 15 days pro-gestation to 6 days after gestation. On the gestational day 6.5 (GD6.5), female rats were sacrificed. Lungs were observed by naked eye. Uterine weight and embryos counts were recorded. Vein blood was collected for detecting the concentration of blood heavy metals including lead (Pb), mercury (Hg), cadmium (Cd), arsenic (As) and antimony (Sb). Tissues of uterus and ovaries were stained by HE. Results：Compared with the saline group, body weight of rats in the high-dose PM2.5 group significantly decreased and the lung histology also changed. While the dose of PM2.5 raised, the mating and GD6.5 pregnancy index decreased nevertheless rats in BaP group showed no difference. Then GD19.5 pregnancy index of BaP group decreased apparently as compared with saline group. Embryos counts，uterine and embryos weight in three PM2.5 groups significantly reduced. The As level increased in the three PM2.5 groups, which negatively related to the number of embryos，as well as Sb level. There was no significant change in pathology of uterine or ovarian tissue. Conclusions：PM2.5 could impair the fertility of female rats, and the increased As and Sb levels could be related to the reproductive toxicity. BaP impairs the viability of implanted embryos.

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The Efficacy Analysis in the Treatment of Proximal Tubal Obstruction Using Laparoscopy-guided Hysteroscopic Tubal Catheterization

CHEN Jun;HOU Hai-yan;DONG Qu-long;CHEN Ya-qiong;CHEN Xiao;HU Chun-xiu;YANG Zhen-hua

2016, 43 (3): 263-266.

Abstract ( 1200 )

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Objective: To investigate the efficacy in the treatment of proximal tubal obstruction using laparoscopy-guided hysteroscopic tubal catheterization （LHTC）. Methods: Data from 336 patients with proximal tubal obstruction who accepted LHTC treatment in the Affiliated Hospital of Logistics College of the Chinese People′s Armed Forces from January 2010 to December 2012 were analyzed. After LHTC, a follow-up within 24 months was performed, then pregnancy rate and pregnancy outcome were recorded. Results: The successful recanalization rate was 54.70% per tube and 63.10% per patient. The cumulative pregnancy rate and live birth rate in 2 years of the group whose at least one fallopian was 43.40% and 33.96%；in the group whose fallopian was failed to recanalized, the cumulative pregnancy rate and live birth rate was 8.06% and 7.26%. The difference between the two groups was significant(P＜0.05). Conclusions: Successful tubal cannulation led to significant improvement in the pregnancy rate as similar efficacy as IVF, which suggests that women with a proximal tubal block could be considered for LHTC as the first choice.

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The Efficacy Analysis in the Treatment of Proximal Tubal Obstruction Using Laparoscopy-guided Hysteroscopic Tubal Catheterization

CHEN Jun;HOU Hai-yan;DONG Qu-long;CHEN Ya-qiong;CHEN Xiao;HU Chun-xiu;YANG Zhen-hua

2016, 43 (3): 263-266.

Abstract ( 315 )

PDF (679KB) ( 4890 )

Objective: To investigate the efficacy in the treatment of proximal tubal obstruction using laparoscopy-guided hysteroscopic tubal catheterization （LHTC）. Methods: Data from 336 patients with proximal tubal obstruction who accepted LHTC treatment in the Affiliated Hospital of Logistics College of the Chinese People′s Armed Forces from January 2010 to December 2012 were analyzed. After LHTC, a follow-up within 24 months was performed, then pregnancy rate and pregnancy outcome were recorded. Results: The successful recanalization rate was 54.70% per tube and 63.10% per patient. The cumulative pregnancy rate and live birth rate in 2 years of the group whose at least one fallopian was 43.40% and 33.96%；in the group whose fallopian was failed to recanalized, the cumulative pregnancy rate and live birth rate was 8.06% and 7.26%. The difference between the two groups was significant(P＜0.05). Conclusions: Successful tubal cannulation led to significant improvement in the pregnancy rate as similar efficacy as IVF, which suggests that women with a proximal tubal block could be considered for LHTC as the first choice.

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Meta Analysis of Efficacy and Safety between Kuntai Capsule and Hormone Replacement Therapy for Patients with Perimenopausal Syndrome

DU Xiao-qin;HENG Ming-li;XU Ling

2016, 43 (3): 267-271.

Abstract ( 1375 )

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Objective: To evaluate the efficacy and safety between Kuntai capsule and hormone replacement in treating patients with perimenopausal syndrome. Methods: Such databases as the Cochrane Library, PubMed, CNKI, VIP and Wanfang Data and others were electronically searched. A systemic review and meta-analysis of publication from November 2004 to February 2015 was performed. The review was limited to randomized controlled trials that compared Kuntai capsule and hormone replacement therapy in treatment of perimenopausal syndrome and therapy period was at least 3 months. The primary outcome assessed was the efficacy at 3 month-time point，including the effective rate of Kupperman Menopausal Scores，blood E2 and FSH level. Safety index mainly includes the incidence of adverse reactions（such as gastrointestinal complains，breast distending pain or vaginal bleeding，etc）. Results: Fifteen studies，including 1 243 total participants were included. The total effective rate and change of blood FSH level showed no significant difference between Kuntai capsule group and the hormone replacement therapy group（P＞0.05）. The Kupperman Menopausal Scores and blood E2 level in the hormone replacement therapy group were higher than Kuntai capsule group（P＜0.05）. Adverse reaction，such as gastrointestinal complains，breast distending pain or vaginal bleeding，Kuntai capsule group was inferior to hormone replacement therapy group in terms of adverse reactions（P＜0.05）. Conclusions: The current limited evidence showed that， Kuntai capsule could also improve climacteric symptoms and reduce the incidence of adverse reaction.

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Meta Analysis of Efficacy and Safety between Kuntai Capsule and Hormone Replacement Therapy for Patients with Perimenopausal Syndrome

DU Xiao-qin;HENG Ming-li;XU Ling

2016, 43 (3): 267-271.

Abstract ( 587 )

PDF (742KB) ( 4902 )

Objective: To evaluate the efficacy and safety between Kuntai capsule and hormone replacement in treating patients with perimenopausal syndrome. Methods: Such databases as the Cochrane Library, PubMed, CNKI, VIP and Wanfang Data and others were electronically searched. A systemic review and meta-analysis of publication from November 2004 to February 2015 was performed. The review was limited to randomized controlled trials that compared Kuntai capsule and hormone replacement therapy in treatment of perimenopausal syndrome and therapy period was at least 3 months. The primary outcome assessed was the efficacy at 3 month-time point，including the effective rate of Kupperman Menopausal Scores，blood E2 and FSH level. Safety index mainly includes the incidence of adverse reactions（such as gastrointestinal complains，breast distending pain or vaginal bleeding，etc）. Results: Fifteen studies，including 1 243 total participants were included. The total effective rate and change of blood FSH level showed no significant difference between Kuntai capsule group and the hormone replacement therapy group（P＞0.05）. The Kupperman Menopausal Scores and blood E2 level in the hormone replacement therapy group were higher than Kuntai capsule group（P＜0.05）. Adverse reaction，such as gastrointestinal complains，breast distending pain or vaginal bleeding，Kuntai capsule group was inferior to hormone replacement therapy group in terms of adverse reactions（P＜0.05）. Conclusions: The current limited evidence showed that， Kuntai capsule could also improve climacteric symptoms and reduce the incidence of adverse reaction.

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The Effect of the Different Diet Pattern to the Lipids of the Menopausal Female

ZHANG Ya-lin;WANG Hong-xing

2016, 43 (3): 272-273.

Abstract ( 938 )

PDF (656KB) ( 6309 )

Objective: To analyze the influence of the different diet structure to the lipids of the menopausal women. Methods: From February 2014 to February 2015, 24 hours recall method for 3 consecutive days of dietary survey were carried among the 392 light physical labor menopausal feminine who hospitalized in the department of internal medicine in Nantong Maternal and Child Health Care Hospital, excluded the impact of the other factors. Then we analyzed the dietary patterns and divided these women into different group according to the energy and the situation of the ratio among the three capacity nutrients, then compared the blood lipids among the groups. Results: After investigation we found that there are 6 kinds of different dietary patterns including high energy intake group (group A, n=62), normal energy high carbohydrate intake group (group B, n=53), normal energy high fat energy intake group (group C, n=58), normal energy high protein intake group (group D, n=59), normal energy normal ratio intake group (group E, n=116) and low energy intake group (group F, n=44). There was a significant difference in the numerical value of cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol between the 6 groups of women, the same as the incidence of abnormal(P＜0.05). Conclusions: High energy, high fat, high carbohydrate intake may cause abnormal lipid metabolism, especially the high carbohydrate intake may be more prone to blood lipid abnormalities, and the high energy and high fat intake can also cause the abnormalities of cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol.

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The Effect of the Different Diet Pattern to the Lipids of the Menopausal Female

ZHANG Ya-lin;WANG Hong-xing

2016, 43 (3): 272-273.

Abstract ( 356 )

PDF (656KB) ( 4924 )

Objective: To analyze the influence of the different diet structure to the lipids of the menopausal women. Methods: From February 2014 to February 2015, 24 hours recall method for 3 consecutive days of dietary survey were carried among the 392 light physical labor menopausal feminine who hospitalized in the department of internal medicine in Nantong Maternal and Child Health Care Hospital, excluded the impact of the other factors. Then we analyzed the dietary patterns and divided these women into different group according to the energy and the situation of the ratio among the three capacity nutrients, then compared the blood lipids among the groups. Results: After investigation we found that there are 6 kinds of different dietary patterns including high energy intake group (group A, n=62), normal energy high carbohydrate intake group (group B, n=53), normal energy high fat energy intake group (group C, n=58), normal energy high protein intake group (group D, n=59), normal energy normal ratio intake group (group E, n=116) and low energy intake group (group F, n=44). There was a significant difference in the numerical value of cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol between the 6 groups of women, the same as the incidence of abnormal(P＜0.05). Conclusions: High energy, high fat, high carbohydrate intake may cause abnormal lipid metabolism, especially the high carbohydrate intake may be more prone to blood lipid abnormalities, and the high energy and high fat intake can also cause the abnormalities of cholesterol, triglyceride, low density lipoprotein cholesterol and high density lipoprotein cholesterol.

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The Effects of Zika Virus Infection on Fetal Brain and Nervous System Development during Pregnancy

CHEN Jia-wen;REN Tai;NI Yun-xiang;DING Zhi-de

2016, 43 (3): 274-278.

Abstract ( 1059 )

PDF (732KB) ( 6311 )

In recent years, the Zika virus outbreak is ongoing in South-America, followed by increasing morbidity of neurological disorders, including Guillain-Barré syndrome and congenital microcephaly. By the end of March, 2016, thirty-three countries in America were involved, with suspected cases over 190 000. Besides, imported cases have also been reported in Europe and Asia. The correlation between Zika virus infection during the pregnancy and fetal neurogenesis defects raises global severe concern immediately. The potential mechanism can be divided into two pathways: ①The blood-placenta barrier may be penetrated by Zika virus and the virus has a characteristic of neurotropism. Subsequently Zika virus can impair neurogenesis directly. ②Zika virus might disrupt fetal neurogenesis indirectly by other mediators, such as fetal inflammatory cytokines or antibodies in cross-immune response. Although the precise mechanism has not been completely elucidated yet, to review the effects of Zika virus infection in pregnancy on fetal neurogenesis promptly as well as the prevention and control of Zika virus outbreak in our country will have both critical clinical and long-term social significances.

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The Effects of Zika Virus Infection on Fetal Brain and Nervous System Development during Pregnancy

CHEN Jia-wen;REN Tai;NI Yun-xiang;DING Zhi-de

2016, 43 (3): 274-278.

Abstract ( 372 )

PDF (732KB) ( 4795 )

In recent years, the Zika virus outbreak is ongoing in South-America, followed by increasing morbidity of neurological disorders, including Guillain-Barré syndrome and congenital microcephaly. By the end of March, 2016, thirty-three countries in America were involved, with suspected cases over 190 000. Besides, imported cases have also been reported in Europe and Asia. The correlation between Zika virus infection during the pregnancy and fetal neurogenesis defects raises global severe concern immediately. The potential mechanism can be divided into two pathways: ①The blood-placenta barrier may be penetrated by Zika virus and the virus has a characteristic of neurotropism. Subsequently Zika virus can impair neurogenesis directly. ②Zika virus might disrupt fetal neurogenesis indirectly by other mediators, such as fetal inflammatory cytokines or antibodies in cross-immune response. Although the precise mechanism has not been completely elucidated yet, to review the effects of Zika virus infection in pregnancy on fetal neurogenesis promptly as well as the prevention and control of Zika virus outbreak in our country will have both critical clinical and long-term social significances.

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Animal Research on the Relationship between Mothers′ Exposure to High Fat Diet and Offspring′s Metabolic Syndrome in the Adulthood

SU Li-jun;HUA Shao-fang

2016, 43 (3): 279-281.

Abstract ( 978 )

PDF (635KB) ( 6295 )

Metabolic syndrome (MS) is a group of metabolic disorders of unknown etiology, obesity, insulin resistance (IR), dyslipidemia and hypertension form its core components. MS is related to the incidence of cardiovascular diseases and it may increase the risk of cardiovascular diseases. There is a certain correlation between mothers′ exposure to high fat diet and offspring′s MS in the adulthood. Early exposure to high-fat diet could increase the incidence of obesity, IR, dyslipidemia and hypertension in the adulthood, which is high risk factor of MS. Various changes in the environment of progestation, gestation and lactation of mothers will influence the metabolic status of offspring, and can affect the health of offspring for a long time in the adulthood. It′s time to pay attention to mothers′ health care before conception and during pregnancy particularly in order to reduce the occurrence of MS. The progress of animal research about the relationship is reviewed.

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Animal Research on the Relationship between Mothers′ Exposure to High Fat Diet and Offspring′s Metabolic Syndrome in the Adulthood

SU Li-jun;HUA Shao-fang

2016, 43 (3): 279-281.

Abstract ( 335 )

PDF (635KB) ( 4811 )

Metabolic syndrome (MS) is a group of metabolic disorders of unknown etiology, obesity, insulin resistance (IR), dyslipidemia and hypertension form its core components. MS is related to the incidence of cardiovascular diseases and it may increase the risk of cardiovascular diseases. There is a certain correlation between mothers′ exposure to high fat diet and offspring′s MS in the adulthood. Early exposure to high-fat diet could increase the incidence of obesity, IR, dyslipidemia and hypertension in the adulthood, which is high risk factor of MS. Various changes in the environment of progestation, gestation and lactation of mothers will influence the metabolic status of offspring, and can affect the health of offspring for a long time in the adulthood. It′s time to pay attention to mothers′ health care before conception and during pregnancy particularly in order to reduce the occurrence of MS. The progress of animal research about the relationship is reviewed.

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Progress on Glucocorticoid-induced TNF Receptor Mediated by Tregs in Immune Tolerance

TAN Yan;WANG Chen-hong

2016, 43 (3): 282-286.

Abstract ( 1201 )

PDF (699KB) ( 6264 )

Glucocorticoid-induced tumor necrosis factor receptor (GITR) is an important functional molecular of regulatory T cells (regulatory T cells，Tregs) expressed in thymus and peripheral lymphoid organs. Numerous studies have shown the key role of GITR in differentiation and extension of Tregs. Furdermore，GITR is an effective marker of Tregs and play an important role in immune regulation. GITR has many important biological activities，including cell proliferation，differentiation，survival and apoptosis，etc. The interactions of them can break immune tolerance mediated by Tregs，induce or aggravate autoimmune diseases，such as asthma，diabetes，arthritis and systemic lupus erythematosus，etc. All pregnancies comply with the rules of immune tolerance，Tregs play an important role in protecting fetus from immune attack. Many studies have shown that interruption of the interaction in Tregs during the pregnancy can lead to the generation of fetal specific antigen，which in turn will lead to adverse pregnancy outcome. Now a review will be made here on GITR mediated by Tregs in immune tolerance.

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Progress on Glucocorticoid-induced TNF Receptor Mediated by Tregs in Immune Tolerance

TAN Yan;WANG Chen-hong

2016, 43 (3): 282-286.

Abstract ( 487 )

PDF (699KB) ( 4801 )

Glucocorticoid-induced tumor necrosis factor receptor (GITR) is an important functional molecular of regulatory T cells (regulatory T cells，Tregs) expressed in thymus and peripheral lymphoid organs. Numerous studies have shown the key role of GITR in differentiation and extension of Tregs. Furdermore，GITR is an effective marker of Tregs and play an important role in immune regulation. GITR has many important biological activities，including cell proliferation，differentiation，survival and apoptosis，etc. The interactions of them can break immune tolerance mediated by Tregs，induce or aggravate autoimmune diseases，such as asthma，diabetes，arthritis and systemic lupus erythematosus，etc. All pregnancies comply with the rules of immune tolerance，Tregs play an important role in protecting fetus from immune attack. Many studies have shown that interruption of the interaction in Tregs during the pregnancy can lead to the generation of fetal specific antigen，which in turn will lead to adverse pregnancy outcome. Now a review will be made here on GITR mediated by Tregs in immune tolerance.

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Research Progress in Early Prediction of Gestational Diabetes Mellitus

WANG Yuan-yuan;ZHANG Yan

2016, 43 (3): 287-290.

Abstract ( 1121 )

PDF (728KB) ( 6316 )

Gestational diabetes mellitus (GDM) as the prophase of type 2 diabetes (T2DM) and the onset of the key points is insulin resistance (IR). Current of GDM screening time is during 24-28 weeks of pregnancy. However, this time has been the middle and late pregnancy, before delivery to the GDM intervention time is short and the test is time-consuming, laborious and increase the potential of pregnant women with GDM glucose load, therefore, looking for early prediction of GDM factors, not only to improve the efficiency of GDM screening, but also to prevent and reduce the occurrence of GDM play an important role. There have been a large number of early screening GDM related research in the world, which focus on inflammatory factors, adipocytokines, liver enzymes and other aspects of metabolism. More and more research support of T2DM is in the status of chronic inflammation hypothesis, there is a higher inflammatory factor concentration increased. Liver and adipoes tissue as the main places of IR, involved in carbohydrate metabolism and maintain glucose homeostasis. In recent years, a study shows that there is a correlation between the liver metabolism, adipocytokines and the pathogenesis of GDM. In this paper, the research progress of the early prediction of GDM in recent years is reviewed.

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Research Progress in Early Prediction of Gestational Diabetes Mellitus

WANG Yuan-yuan;ZHANG Yan

2016, 43 (3): 287-290.

Abstract ( 360 )

PDF (728KB) ( 4794 )

Gestational diabetes mellitus (GDM) as the prophase of type 2 diabetes (T2DM) and the onset of the key points is insulin resistance (IR). Current of GDM screening time is during 24-28 weeks of pregnancy. However, this time has been the middle and late pregnancy, before delivery to the GDM intervention time is short and the test is time-consuming, laborious and increase the potential of pregnant women with GDM glucose load, therefore, looking for early prediction of GDM factors, not only to improve the efficiency of GDM screening, but also to prevent and reduce the occurrence of GDM play an important role. There have been a large number of early screening GDM related research in the world, which focus on inflammatory factors, adipocytokines, liver enzymes and other aspects of metabolism. More and more research support of T2DM is in the status of chronic inflammation hypothesis, there is a higher inflammatory factor concentration increased. Liver and adipoes tissue as the main places of IR, involved in carbohydrate metabolism and maintain glucose homeostasis. In recent years, a study shows that there is a correlation between the liver metabolism, adipocytokines and the pathogenesis of GDM. In this paper, the research progress of the early prediction of GDM in recent years is reviewed.

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Application Value of Lower Abdominal Aorta Balloon Occlusion in Pernicious Placenta Previa

LI Xiao-yan;WANG Xiao-li;LI Lei;YU Xiao-yan;CUI Qing

2016, 43 (3): 291-294.

Abstract ( 1235 )

PDF (714KB) ( 6241 )

Incidence of pernicious placenta previa present a trend of rising in recent years. Pernicious previa complicating placenta increta is the leading cause of postpartum hemorrhage. The clinical treatment of the above condition is rather difficult and poses a serious threat to maternal life. The main contributory factor is the imbalance between uterine decidua development and chorionic villi cells invasion during uterin scaring formation process. Effective treatment of intrapartum and postpartum hemorrhage is the key to deal with pernicious placenta previa. Nowadays, treatment options for placenta previa include internal and external compression of uterine, selective devascularization by ligation of the upper branch of the uterine artery, local compression with uterine sutures, iliac artery embolization and uterine artery embolization. Lower abdominal aorta balloon occlusion is a feasible procedure that can effectively reduce the amount of bleeding, requires a short X-rays exposure time, does not impair fetal, less affect maternal blood circulation, makes surgery area clear, and gives operator the chance to consider carefully to make a decision. Lower abdominal aorta balloon occlusion presents more and more advantages to treat pernicious placenta previa and may be an effective preventive measure to reduce postpartum hemorrhage in the future.

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Application Value of Lower Abdominal Aorta Balloon Occlusion in Pernicious Placenta Previa

LI Xiao-yan;WANG Xiao-li;LI Lei;YU Xiao-yan;CUI Qing

2016, 43 (3): 291-294.

Abstract ( 284 )

PDF (714KB) ( 4807 )

Incidence of pernicious placenta previa present a trend of rising in recent years. Pernicious previa complicating placenta increta is the leading cause of postpartum hemorrhage. The clinical treatment of the above condition is rather difficult and poses a serious threat to maternal life. The main contributory factor is the imbalance between uterine decidua development and chorionic villi cells invasion during uterin scaring formation process. Effective treatment of intrapartum and postpartum hemorrhage is the key to deal with pernicious placenta previa. Nowadays, treatment options for placenta previa include internal and external compression of uterine, selective devascularization by ligation of the upper branch of the uterine artery, local compression with uterine sutures, iliac artery embolization and uterine artery embolization. Lower abdominal aorta balloon occlusion is a feasible procedure that can effectively reduce the amount of bleeding, requires a short X-rays exposure time, does not impair fetal, less affect maternal blood circulation, makes surgery area clear, and gives operator the chance to consider carefully to make a decision. Lower abdominal aorta balloon occlusion presents more and more advantages to treat pernicious placenta previa and may be an effective preventive measure to reduce postpartum hemorrhage in the future.

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The Effect of Delayed Cord Clamping on Neonatal and Maternal Outcomes

LI Xing;CHANG Ying;CHEN Xu

2016, 43 (3): 295-297.

Abstract ( 1229 )

PDF (694KB) ( 6274 )

Controversy has long existed about the optimal time to clamp and cut the umbilical cord for full-term and preterm infants. Policies for timing of cord clamping vary in different countries, with immediate cord clamping generally carried out in the first 15 seconds after birth, whereas delayed cord clamping usually involves clamping more than 30 seconds after the birth or when cord pulsation has ceased. Delayed cord clamping can increase the placental transfusion volume to infants, short term benefits associated with delayed cord clamping include increased hemoglobin level, prevention of intraventricular hemorrhage and late onset neonatal sepsis, without increasing the incidence of postpartum hemorrhage, long term benefits include increased iron storage and prevention of anemia in infancy.

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The Effect of Delayed Cord Clamping on Neonatal and Maternal Outcomes

LI Xing;CHANG Ying;CHEN Xu

2016, 43 (3): 295-297.

Abstract ( 500 )

PDF (694KB) ( 4819 )

Controversy has long existed about the optimal time to clamp and cut the umbilical cord for full-term and preterm infants. Policies for timing of cord clamping vary in different countries, with immediate cord clamping generally carried out in the first 15 seconds after birth, whereas delayed cord clamping usually involves clamping more than 30 seconds after the birth or when cord pulsation has ceased. Delayed cord clamping can increase the placental transfusion volume to infants, short term benefits associated with delayed cord clamping include increased hemoglobin level, prevention of intraventricular hemorrhage and late onset neonatal sepsis, without increasing the incidence of postpartum hemorrhage, long term benefits include increased iron storage and prevention of anemia in infancy.

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Placental and Villous Concentrations of Estradiol in the Pregnancy and Its Significance

LIU Jie;ZHANG Yuan;CUI Yu-gui;GAO Li;GONG Yi-ming;LIU Jia-yin

2016, 43 (3): 298-301.

Abstract ( 1147 )

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Objective: To test estradiol(E2) levels in the maternal peripheral blood, villi and placenta in the first trimester and term parturition, as well as the estradiol level of umbilical artery blood in term delivery. Culture trophoblast cell line BeWo in vitro to investigate the role of E2. Methods：This study included 20 unwilling pregnant women who want to have early artificial abortion and 20 pregnant women of full term cesarean delivery. The levels of E2 in the tissues of early abortion, peripheral blood of pregnant women and umbilical artery blood, placenta tissue of the women during labor were measured by chemiluminescence immunoassay(CLIA). After BeWo cells in monolayer culture, those cells were treated with E2 of 0 mol/L, 5×10-7 mol/L, 5×10-8 mol/L and 5×10-9 mol/L for 1, 3, 6 and 12 h, and then transepithelial resistance (TEER) was measured by millicell ESR-2 to observe the integrity of the tight junctions between BeWo cells.　Results：E2 were lower in peripheral plasma from early pregnancy[（3.44±1.30）nmol/L] compared with that from third trimesters[（509.78±197.82 ) nmol/L]（t=10.2,P＜0.001）. However, E2 were higher in tissue obtained from villus[（30.82±13.91） pmol/mg] than that from third trimesters placenta[（17.21±5.37）pmol/mg]（t=4.1, P＜0.001）. A decrease of TEER was observed after the treatmeat of E2 at a concentration of 5×10-7 mol/L for 12 hours(P＜0.05). The other two concentrations, 5×10-8 mol/L and 5×10-9 mol/L, had no significant effect on the TEER of BeWo cells at all time points(P＞0.05). Conclusions： The concentrations of E2 in villus obtained from first trimester is higher; E2 in full-term birth placenta tissues is relatively lower; In vitro, different concentrations of E2 may affect the maintenance of junction between trophoblast cells, 5×10-7 mol/L can be used as the effective concentrations of estradiol to treat with BeWo cells.

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Placental and Villous Concentrations of Estradiol in the Pregnancy and Its Significance

LIU Jie;ZHANG Yuan;CUI Yu-gui;GAO Li;GONG Yi-ming;LIU Jia-yin

2016, 43 (3): 298-301.

Abstract ( 422 )

PDF (824KB) ( 4768 )

Objective: To test estradiol(E2) levels in the maternal peripheral blood, villi and placenta in the first trimester and term parturition, as well as the estradiol level of umbilical artery blood in term delivery. Culture trophoblast cell line BeWo in vitro to investigate the role of E2. Methods：This study included 20 unwilling pregnant women who want to have early artificial abortion and 20 pregnant women of full term cesarean delivery. The levels of E2 in the tissues of early abortion, peripheral blood of pregnant women and umbilical artery blood, placenta tissue of the women during labor were measured by chemiluminescence immunoassay(CLIA). After BeWo cells in monolayer culture, those cells were treated with E2 of 0 mol/L, 5×10-7 mol/L, 5×10-8 mol/L and 5×10-9 mol/L for 1, 3, 6 and 12 h, and then transepithelial resistance (TEER) was measured by millicell ESR-2 to observe the integrity of the tight junctions between BeWo cells.　Results：E2 were lower in peripheral plasma from early pregnancy[（3.44±1.30）nmol/L] compared with that from third trimesters[（509.78±197.82 ) nmol/L]（t=10.2,P＜0.001）. However, E2 were higher in tissue obtained from villus[（30.82±13.91） pmol/mg] than that from third trimesters placenta[（17.21±5.37）pmol/mg]（t=4.1, P＜0.001）. A decrease of TEER was observed after the treatmeat of E2 at a concentration of 5×10-7 mol/L for 12 hours(P＜0.05). The other two concentrations, 5×10-8 mol/L and 5×10-9 mol/L, had no significant effect on the TEER of BeWo cells at all time points(P＞0.05). Conclusions： The concentrations of E2 in villus obtained from first trimester is higher; E2 in full-term birth placenta tissues is relatively lower; In vitro, different concentrations of E2 may affect the maintenance of junction between trophoblast cells, 5×10-7 mol/L can be used as the effective concentrations of estradiol to treat with BeWo cells.

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Effect of Different Psychological Intervention on the Anxiety and Depression Symptoms in Different Degrees of GDM Women and Their Families

BAO Yi-rong;SU Ping-ping;XIE Han;CHEN Hua;GAO Xiao-ling;LIAN Jing-chao;LI Yan;LIU Qian-qian;YING Hao

2016, 43 (3): 302-307.

Abstract ( 1014 )

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Objective：To analyze the influence of different psychological intervention on anxiety, depression and pregnancy outcomes in different degrees of gestational diabetes mellitus (GDM) women and their families. Methods：300 GDM women and their families (their husband or mother) who accepted regular inspection and delivered at Shanghai First Maternity and Infant Hospital from April 2013 to November 2014 were randomly divided into a collective intervention group, a face to face psychological intervention group and a control group according to the intervention mode. Psychological intervention during pregnancy were six times, the GDM patients in each group were divided into GDM A1 (who were treated with diet therapy and exercise therapy) and GDM A2 (who need insulin therapy), compared the SAS, SDS scores and pregnancy outcome of GDM A1 and GDM A2 and their family members in each group before intervention (a week after the initial diagnosis of GDM), after intervention (36 weeks of pregnancy, 48 hours postpartum. 42 days postpartum). Results：The SAS and SDS scores of GDM women and their families in three groups were no significant difference before intervention (all P＞0.05). After psychological intervention, the SAS and SDS scores of GDM A1 and GDM A2 patients and their families in the collective intervention group and the face to face psychological intervention group were less than the scores of before intervention (both P＜0.01), meanwhile the SAS and SDS scores in the collective intervention group and the face to face psychological intervention group were less than that in control group (P＜0.01), and the SAS and SDS scores in collective intervention group were less than face to face psychological intervention group, the difference was significant (both P＜0.01). There was no significant difference in the pregnancy outcome of the three groups (P＞0.05). But, the incidence of maternal complications and the rate of caesarean section in the intervention group had the trend of lower. Conclusions：Psychological intervention can effectively improve GDM women and their families the symptoms of anxiety and depression, and the collective intervention was more conductive to the improvement of the symptoms of anxiety and depression of GDM patients and their families, it is worth in clinical promotion.

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Effect of Different Psychological Intervention on the Anxiety and Depression Symptoms in Different Degrees of GDM Women and Their Families

BAO Yi-rong;SU Ping-ping;XIE Han;CHEN Hua;GAO Xiao-ling;LIAN Jing-chao;LI Yan;LIU Qian-qian;YING Hao

2016, 43 (3): 302-307.

Abstract ( 336 )

PDF (975KB) ( 4893 )

Objective：To analyze the influence of different psychological intervention on anxiety, depression and pregnancy outcomes in different degrees of gestational diabetes mellitus (GDM) women and their families. Methods：300 GDM women and their families (their husband or mother) who accepted regular inspection and delivered at Shanghai First Maternity and Infant Hospital from April 2013 to November 2014 were randomly divided into a collective intervention group, a face to face psychological intervention group and a control group according to the intervention mode. Psychological intervention during pregnancy were six times, the GDM patients in each group were divided into GDM A1 (who were treated with diet therapy and exercise therapy) and GDM A2 (who need insulin therapy), compared the SAS, SDS scores and pregnancy outcome of GDM A1 and GDM A2 and their family members in each group before intervention (a week after the initial diagnosis of GDM), after intervention (36 weeks of pregnancy, 48 hours postpartum. 42 days postpartum). Results：The SAS and SDS scores of GDM women and their families in three groups were no significant difference before intervention (all P＞0.05). After psychological intervention, the SAS and SDS scores of GDM A1 and GDM A2 patients and their families in the collective intervention group and the face to face psychological intervention group were less than the scores of before intervention (both P＜0.01), meanwhile the SAS and SDS scores in the collective intervention group and the face to face psychological intervention group were less than that in control group (P＜0.01), and the SAS and SDS scores in collective intervention group were less than face to face psychological intervention group, the difference was significant (both P＜0.01). There was no significant difference in the pregnancy outcome of the three groups (P＞0.05). But, the incidence of maternal complications and the rate of caesarean section in the intervention group had the trend of lower. Conclusions：Psychological intervention can effectively improve GDM women and their families the symptoms of anxiety and depression, and the collective intervention was more conductive to the improvement of the symptoms of anxiety and depression of GDM patients and their families, it is worth in clinical promotion.

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Clinical Value of Soluble Fms-like Tyrosine Kinase-1，Placental Growth Factor，25-hydroxyvitamin D，D-dimer，von Willebrand Factor，P-selectin for the Risk Assessment of Preeclampsia during the First Trimester of Pregnancy

HE Xue-yi;WANG Chen-hong

2016, 43 (3): 308-311.

Abstract ( 1060 )

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Objective：To evaluate the signification of serum soluble fms-like tyrosine kinase－１（ｓＦｌｔ－１），placental growth factor（ＰlＧＦ），25-hydroxyvitamin D（25-OH-VD），D-dimer，von Willebrand factoｒ（ｖＷＦ），P-selectin for predicting risk of pre-eclampsia（PE） during the first trimester of pregnancy. Methods：In this nested cohort ，we recruited 1 081 consecutive women who presented for antenatal care between 10 and 13+6 weeks of gestation from Shenzhen Maternity and Child Healthcare Hospital from January 2013 to December 2013. Of the 1 081 pregnant women studied，50 patients were diagnosed with PE as case group. There are 352 normal pregnant women without complications as control group. Serum sFlt-1，PLGF，25-OH-VD，D-dimer，vWF and P-selectin were detected by ELISA. Using ROC curve to evaluate the value of diagnosis preeclampsia for the six index alone or combination. Results：During 10-13+6 weeks of gestation serum levels of sFlt-1，D-dimer，vWF，P-selectin of gravida with PE were significantly higher than the control group （P＜0.05）. The serum PlGF and 25-OH-VD levels in case group was significantly lower than that in the control group（P＜0.05）. Combining total multiple of median （MoM） of serum sFlt-1，PlGF，25-OH-VD，D-dimer，vWF，P-selectin using ROC curve analysis can get a sensitivity of 78% and a specificity of 100% for predicting the risk of PE. Conclusions：Combining screening of different biomarkers such as serum sFlt-1，PlGF,25-OH-VD，D-dimer，vWF and P-selectin could increase the predictive value of PE at the first trimester pregnancy.

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Clinical Value of Soluble Fms-like Tyrosine Kinase-1，Placental Growth Factor，25-hydroxyvitamin D，D-dimer，von Willebrand Factor，P-selectin for the Risk Assessment of Preeclampsia during the First Trimester of Pregnancy

HE Xue-yi;WANG Chen-hong

2016, 43 (3): 308-311.

Abstract ( 483 )

PDF (812KB) ( 4779 )

Objective：To evaluate the signification of serum soluble fms-like tyrosine kinase－１（ｓＦｌｔ－１），placental growth factor（ＰlＧＦ），25-hydroxyvitamin D（25-OH-VD），D-dimer，von Willebrand factoｒ（ｖＷＦ），P-selectin for predicting risk of pre-eclampsia（PE） during the first trimester of pregnancy. Methods：In this nested cohort ，we recruited 1 081 consecutive women who presented for antenatal care between 10 and 13+6 weeks of gestation from Shenzhen Maternity and Child Healthcare Hospital from January 2013 to December 2013. Of the 1 081 pregnant women studied，50 patients were diagnosed with PE as case group. There are 352 normal pregnant women without complications as control group. Serum sFlt-1，PLGF，25-OH-VD，D-dimer，vWF and P-selectin were detected by ELISA. Using ROC curve to evaluate the value of diagnosis preeclampsia for the six index alone or combination. Results：During 10-13+6 weeks of gestation serum levels of sFlt-1，D-dimer，vWF，P-selectin of gravida with PE were significantly higher than the control group （P＜0.05）. The serum PlGF and 25-OH-VD levels in case group was significantly lower than that in the control group（P＜0.05）. Combining total multiple of median （MoM） of serum sFlt-1，PlGF，25-OH-VD，D-dimer，vWF，P-selectin using ROC curve analysis can get a sensitivity of 78% and a specificity of 100% for predicting the risk of PE. Conclusions：Combining screening of different biomarkers such as serum sFlt-1，PlGF,25-OH-VD，D-dimer，vWF and P-selectin could increase the predictive value of PE at the first trimester pregnancy.

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Influence of Serum Thyroid Antibody with Euthyroidism on Pregnancy Outcome

GAO Hong;MA Xiao-li;ZHANG Lin;SUN Tao

2016, 43 (3): 312-314.

Abstract ( 977 )

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Objective：To investigate whether pure serum thyroid peroxidase antibody (TPO-Ab) positive in early gestation women with euthyroidism can influence their pregnancy complications and outcomes. Methods：The clinical data of pregnant women with euthyroidism and gestational age were less than 13 weeks in our hospital was collected. All subjects were divided into two groups,on basis of TPO-Ab negative-TPO-Ab group(＜60 kU/L, 793 cases), positive-TPO-Ab group (≥60 kU/L, 88 cases). Follow up the change of thyroid function, compare the difference of pregnancy outcome in two groups. Results：The serum level of TSH in positive-TPO-Ab group was higher than negative-TPO-Ab group (t=2.079, P=0.038). The incidence rate of premature rupture of membrane, fetal growth restriction (FGR) and infant of low-birth weight in positive-TPO-Ab group were higher than negative-TPO-Ab group (7.95% vs. 1.89%, χ2=9.598, P=0.002; 2.27% vs. 0.37%, χ2=5.126, P=0.024; 5.68% vs. 2.12%, χ2=4.180, P=0.041). Conclusions：Positive-TPO-Ab was likely to have adverse effect on pregnancy complications and outcomes.

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Influence of Serum Thyroid Antibody with Euthyroidism on Pregnancy Outcome

GAO Hong;MA Xiao-li;ZHANG Lin;SUN Tao

2016, 43 (3): 312-314.

Abstract ( 408 )

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Objective：To investigate whether pure serum thyroid peroxidase antibody (TPO-Ab) positive in early gestation women with euthyroidism can influence their pregnancy complications and outcomes. Methods：The clinical data of pregnant women with euthyroidism and gestational age were less than 13 weeks in our hospital was collected. All subjects were divided into two groups,on basis of TPO-Ab negative-TPO-Ab group(＜60 kU/L, 793 cases), positive-TPO-Ab group (≥60 kU/L, 88 cases). Follow up the change of thyroid function, compare the difference of pregnancy outcome in two groups. Results：The serum level of TSH in positive-TPO-Ab group was higher than negative-TPO-Ab group (t=2.079, P=0.038). The incidence rate of premature rupture of membrane, fetal growth restriction (FGR) and infant of low-birth weight in positive-TPO-Ab group were higher than negative-TPO-Ab group (7.95% vs. 1.89%, χ2=9.598, P=0.002; 2.27% vs. 0.37%, χ2=5.126, P=0.024; 5.68% vs. 2.12%, χ2=4.180, P=0.041). Conclusions：Positive-TPO-Ab was likely to have adverse effect on pregnancy complications and outcomes.

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The Value of Cardiovascular Profile Score to Assess Fetal Cardiac Insufficiency

WU Chao;WANG Ling-hong;LIU Li-ping

2016, 43 (3): 315-317.

Abstract ( 1364 )

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Objective：To explore the value of cadiovascular profile score （CVPS）to estimate fetal cadiac insufficiency. Methods：All pregnant women in ultrasound department，Tianjin Central Hospital of Gynecology Obstetrics proceeded routine examinations between Jan. 2013 and Jan. 2016. Fetal cardiac insufficiency (enlarged heart and myocardial contraction fatigue) were found out. CVPS were recorded. Meanwhile fetal cadiography were performed to define if congenital heart disease were accompanied. All cases divided in two groups based on the follow up results: live birth group and adverse pregnancy outcome group. Results：38 cases of fetal cardiac insufficiency were found out. 35 cases were singleton pregnancy. 3 cases were twins pregnancy. 12 cases were in live birth group (all of them were singleton pregnancy), 10 cases were healthy children, 2 cases were accompanied by congenital heart disease: 1 case was mild pulmonicstenosis, 1 case was tetralogy of Fallot. 21 cases were in adverse pregnancy outcome group. 18 cases were singleton pregnancies: 9 cases were intrauterine fetal demise, 2 cases were stillbirth, 7 cases were induced labour: 5 cases progressed to heart failure because of CVPS declined continuously and fetal cadiac insufficiency worsen, 2 cases were accompanied by fatal congenital heart disease. 2 cases of twins pregnancy were intrauterine fetal demise because of twin to twin transfusion syndrome (TTTS). 1 case of twins pregnancy was induced labour because of hydrocephaly and intracranial hemorrhage. 5 cases were loss to follow up. CVPS of live birth was 7.62 (7.00) and CVPS of adverse pregnancy outcomes was 5.67 (3.50). Statistics analysis: ROC curve analysis, area under ROC: 0.823, cut off value was 6.5, P=0.002, difference was statistically significant. The score of umbilical artery doppler spectrum, vein doppler spectrum and cardiac valve function in two groups were significant difference (P＜0.05). Conclusions：CVPS declined when fetal cardiac insufficiency worse, dangerous cut off value of CVPS was 6.5, CVPS is an effective index for continuous dynamic assessment of fetal cardiac insufficiency. The score of umbilical artery doppler spectrum, vein doppler spectrum and cardiac valve function were valuable to predict adverse pregnancy outcomes.

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The Value of Cardiovascular Profile Score to Assess Fetal Cardiac Insufficiency

WU Chao;WANG Ling-hong;LIU Li-ping

2016, 43 (3): 315-317.

Abstract ( 428 )

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Objective：To explore the value of cadiovascular profile score （CVPS）to estimate fetal cadiac insufficiency. Methods：All pregnant women in ultrasound department，Tianjin Central Hospital of Gynecology Obstetrics proceeded routine examinations between Jan. 2013 and Jan. 2016. Fetal cardiac insufficiency (enlarged heart and myocardial contraction fatigue) were found out. CVPS were recorded. Meanwhile fetal cadiography were performed to define if congenital heart disease were accompanied. All cases divided in two groups based on the follow up results: live birth group and adverse pregnancy outcome group. Results：38 cases of fetal cardiac insufficiency were found out. 35 cases were singleton pregnancy. 3 cases were twins pregnancy. 12 cases were in live birth group (all of them were singleton pregnancy), 10 cases were healthy children, 2 cases were accompanied by congenital heart disease: 1 case was mild pulmonicstenosis, 1 case was tetralogy of Fallot. 21 cases were in adverse pregnancy outcome group. 18 cases were singleton pregnancies: 9 cases were intrauterine fetal demise, 2 cases were stillbirth, 7 cases were induced labour: 5 cases progressed to heart failure because of CVPS declined continuously and fetal cadiac insufficiency worsen, 2 cases were accompanied by fatal congenital heart disease. 2 cases of twins pregnancy were intrauterine fetal demise because of twin to twin transfusion syndrome (TTTS). 1 case of twins pregnancy was induced labour because of hydrocephaly and intracranial hemorrhage. 5 cases were loss to follow up. CVPS of live birth was 7.62 (7.00) and CVPS of adverse pregnancy outcomes was 5.67 (3.50). Statistics analysis: ROC curve analysis, area under ROC: 0.823, cut off value was 6.5, P=0.002, difference was statistically significant. The score of umbilical artery doppler spectrum, vein doppler spectrum and cardiac valve function in two groups were significant difference (P＜0.05). Conclusions：CVPS declined when fetal cardiac insufficiency worse, dangerous cut off value of CVPS was 6.5, CVPS is an effective index for continuous dynamic assessment of fetal cardiac insufficiency. The score of umbilical artery doppler spectrum, vein doppler spectrum and cardiac valve function were valuable to predict adverse pregnancy outcomes.

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Progress of Menopausal Hormone Therapy in Gynecological Malignant Tumors

WU Wan-li;YU Ai-jun

2016, 43 (3): 318-322.

Abstract ( 963 )

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The morbidity of cervical cancer，endometrial cancer and ovarian cancer are increasing each year, and show younger trend. Many patients become iatrogenic menopause because of treating gynecologic cancer, show serious climacteric symptoms rapidly, and lead to lower quality of life. Menopausal hormone therapy（MHT） can control menopausal symptoms, relieve urogenital atrophy and prevent osteoporosis effectively. Studies indicate that it is relative safety for cervical squamous carcinoma，endometrial carcinoma of stage Ⅰ and ovarian epithelial carcinoma to receive MHT；ｃervical adenocarcinoma，endometrial carcinoma of stage Ⅱ and more than stage Ⅱ，granulose cell tumor of ovary and endometrial stromal sarcoma of low grade are not be suggested to receive MHT. Low dose MHT may have lighter adverse reactions while improve menopausal symptoms. The reports of the therapeutic advantages in gynecologic cancer patients increase day by day, but there have been no large-scale studies about it. In clinical usｅ，ｗe should give individual MHT combining with the situation. The application of MHT in gynecological malignant tumors is remained to be explored.

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Progress of Menopausal Hormone Therapy in Gynecological Malignant Tumors

WU Wan-li;YU Ai-jun

2016, 43 (3): 318-322.

Abstract ( 331 )

PDF (873KB) ( 4819 )

The morbidity of cervical cancer，endometrial cancer and ovarian cancer are increasing each year, and show younger trend. Many patients become iatrogenic menopause because of treating gynecologic cancer, show serious climacteric symptoms rapidly, and lead to lower quality of life. Menopausal hormone therapy（MHT） can control menopausal symptoms, relieve urogenital atrophy and prevent osteoporosis effectively. Studies indicate that it is relative safety for cervical squamous carcinoma，endometrial carcinoma of stage Ⅰ and ovarian epithelial carcinoma to receive MHT；ｃervical adenocarcinoma，endometrial carcinoma of stage Ⅱ and more than stage Ⅱ，granulose cell tumor of ovary and endometrial stromal sarcoma of low grade are not be suggested to receive MHT. Low dose MHT may have lighter adverse reactions while improve menopausal symptoms. The reports of the therapeutic advantages in gynecologic cancer patients increase day by day, but there have been no large-scale studies about it. In clinical usｅ，ｗe should give individual MHT combining with the situation. The application of MHT in gynecological malignant tumors is remained to be explored.

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The Relationship between Inflammation and Endometrial Cancer

LI Li-li;FAN Jiang-tao

2016, 43 (3): 323-326.

Abstract ( 1233 )

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Recent evidences show that inflammation plays a significant role in the development of endometrial cancer. Overexpressing of inflammatory factors is often closely related to the diseases. Studies detected that serum inflammatory factor level in cancer patients is higher than normal people. Inflammatory mediators in the tumor microenvironment are conducive to the tumor proliferation, migration and angiogenesis. And the chemokine might inhibit the apoptosis of tumor cells through the inflammatory signaling pathways. So is in endometrial cancer. Inflammation can promote the development of the endometrial cancer through a variety of inflammatory factors and inflammation cells, and endometrial cancer also shows a variety of inflammatory features, which can help the cancer cells to proliferate and metastasize. Inhibiting inflammatory pathways may become a kind of interventions for the treatment of endometrial cancer. So it is important to explore the correlation between inflammation and endometrial cancer. This paper reviewed the relationship between inflammation and endometrial cancer, providing a new method for the treatment of endometrial cancer.

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The Relationship between Inflammation and Endometrial Cancer

LI Li-li;FAN Jiang-tao

2016, 43 (3): 323-326.

Abstract ( 425 )

PDF (972KB) ( 4884 )

Recent evidences show that inflammation plays a significant role in the development of endometrial cancer. Overexpressing of inflammatory factors is often closely related to the diseases. Studies detected that serum inflammatory factor level in cancer patients is higher than normal people. Inflammatory mediators in the tumor microenvironment are conducive to the tumor proliferation, migration and angiogenesis. And the chemokine might inhibit the apoptosis of tumor cells through the inflammatory signaling pathways. So is in endometrial cancer. Inflammation can promote the development of the endometrial cancer through a variety of inflammatory factors and inflammation cells, and endometrial cancer also shows a variety of inflammatory features, which can help the cancer cells to proliferate and metastasize. Inhibiting inflammatory pathways may become a kind of interventions for the treatment of endometrial cancer. So it is important to explore the correlation between inflammation and endometrial cancer. This paper reviewed the relationship between inflammation and endometrial cancer, providing a new method for the treatment of endometrial cancer.

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Progress on Factors Related with Resistance and Relapse in Patients with Low-risk Gestational Trophoblastic Neoplasia

CHEN Jin-juan;YI Xiao-fang

2016, 43 (3): 327-330.

Abstract ( 1063 )

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Approximately all low-risk gestational trophoblastic neoplasia (LR-GTN) can be cured by chemotherapy. After first single-agent treatment 10 to 67 percent of patients become drug resistant, while 1.3 to 8.3 percent relapse, which not only brings heavy load to their economy, but also casts dark shadow physically and psychologically. Experts from home and abroad have paid more and more attention to this issue, with the expectation of improving prognosis through adequate clinical interventions at an early stage of the disease. Researches have manifested different possible related factors, certain experience been learned, such as some items within the FIGO system, FIGO total score and others including β-hCG modeled residual production (hCGres), uterine artery pulsatility index (UAPI), certain image changes of lesions through TVS, choriocacinoma, consolidation course number and drugs and regimens chosen, but they are still controversial. The current knowledge about risk factors associated with resistance and recurrence in LR-GTN cases after initial single chemotherapy was reviewed.

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Progress on Factors Related with Resistance and Relapse in Patients with Low-risk Gestational Trophoblastic Neoplasia

CHEN Jin-juan;YI Xiao-fang

2016, 43 (3): 327-330.

Abstract ( 343 )

PDF (828KB) ( 4803 )

Approximately all low-risk gestational trophoblastic neoplasia (LR-GTN) can be cured by chemotherapy. After first single-agent treatment 10 to 67 percent of patients become drug resistant, while 1.3 to 8.3 percent relapse, which not only brings heavy load to their economy, but also casts dark shadow physically and psychologically. Experts from home and abroad have paid more and more attention to this issue, with the expectation of improving prognosis through adequate clinical interventions at an early stage of the disease. Researches have manifested different possible related factors, certain experience been learned, such as some items within the FIGO system, FIGO total score and others including β-hCG modeled residual production (hCGres), uterine artery pulsatility index (UAPI), certain image changes of lesions through TVS, choriocacinoma, consolidation course number and drugs and regimens chosen, but they are still controversial. The current knowledge about risk factors associated with resistance and recurrence in LR-GTN cases after initial single chemotherapy was reviewed.

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The Effect of Phosphoglycerate Dehydrogenase in Tumors

ZHANG Jing;ZHANG Shu-lan

2016, 43 (3): 331-334.

Abstract ( 1105 )

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Phosphoglycerate dehydrogenase (3-PGDH or PHGDH) is the key enzyme of de novo serine biosynthesis. The PHGDH gene located in human chromosomes 1p12, which is highly expressed in normal tissue, especially for the nervous system function. Recently, it was shown that a part of intermediate metabolites of glycolysis flew to serine biosynthesis. It was found PHGDH gene amplification and over expression in some tumor, PHGDH regulated tumor cell proliferation, apoptosis and invasion. Cell metabolism of tumor is benefit to tumor oncogenesis and progression. The study found that silence PHGDH can inhibit tumor cell proliferation, invasion and increase cell apoptosis. And PHGDH may be a potential treatment target. In this paper, we will review briefly the studies on PHGDH, including structural features, biological function and the genesis and development effect in some tumor.

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The Effect of Phosphoglycerate Dehydrogenase in Tumors

ZHANG Jing;ZHANG Shu-lan

2016, 43 (3): 331-334.

Abstract ( 474 )

PDF (924KB) ( 4767 )

Phosphoglycerate dehydrogenase (3-PGDH or PHGDH) is the key enzyme of de novo serine biosynthesis. The PHGDH gene located in human chromosomes 1p12, which is highly expressed in normal tissue, especially for the nervous system function. Recently, it was shown that a part of intermediate metabolites of glycolysis flew to serine biosynthesis. It was found PHGDH gene amplification and over expression in some tumor, PHGDH regulated tumor cell proliferation, apoptosis and invasion. Cell metabolism of tumor is benefit to tumor oncogenesis and progression. The study found that silence PHGDH can inhibit tumor cell proliferation, invasion and increase cell apoptosis. And PHGDH may be a potential treatment target. In this paper, we will review briefly the studies on PHGDH, including structural features, biological function and the genesis and development effect in some tumor.

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Fn14 Enhances Cisplatin Sensitivity in Human Epithelial Ovarian Cancer Cells by Regulating Apoptosis

WU An-yue;QIU Li-hua

2016, 43 (3): 335-339.

Abstract ( 1008 )

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Objective: To investigate the effects of Fn14 on regulating cisplatin(DDP) sensitivity in human ovarian cancer cells. Methods: Fn14 protein expression levels in SKOV3, CAOV3, OVCAR3, ES2, 3AO, A2780 and A2780/DDP were detected through Western blotting. The expression of Fn14, caspase-3， cleaved caspase-3 and Bcl-2 were accessed by Western blotting in lowest expression of Fn14 cell line when transfected with Fn14 plasmid. The half cell lethal dose(IC50) of DDP and the ability of proliferation in A2780/DDP cells were assayed by CCK-8 kit. The ratio of apoptosis in A2780/DDP cells were determined by flow cytometry. Results: A2780/DDP cells exhibited the lowest expression of Fn14 in these cell lines. Fn14 transfer had no effect on the proliferation of A2780/DDP cells, whereas it could reduce the IC50 of DDP in A2780/DDP cells(P＜0.05). When Fn14 was transferred, the apoptosis induced by DDP was increased in A2780/DDP cells, meanwhile, the expression of apoptosis-correlated protein caspase-3 was up-regulated and anti-apoptotic protein Bcl-2 was down-regulated(P＜0.05). Conclusions: Fn14 may increase chemosensitivity to DDP by apoptosis pathway in human epithelial ovarian cancer cells.

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Fn14 Enhances Cisplatin Sensitivity in Human Epithelial Ovarian Cancer Cells by Regulating Apoptosis

WU An-yue;QIU Li-hua

2016, 43 (3): 335-339.

Abstract ( 352 )

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Objective: To investigate the effects of Fn14 on regulating cisplatin(DDP) sensitivity in human ovarian cancer cells. Methods: Fn14 protein expression levels in SKOV3, CAOV3, OVCAR3, ES2, 3AO, A2780 and A2780/DDP were detected through Western blotting. The expression of Fn14, caspase-3， cleaved caspase-3 and Bcl-2 were accessed by Western blotting in lowest expression of Fn14 cell line when transfected with Fn14 plasmid. The half cell lethal dose(IC50) of DDP and the ability of proliferation in A2780/DDP cells were assayed by CCK-8 kit. The ratio of apoptosis in A2780/DDP cells were determined by flow cytometry. Results: A2780/DDP cells exhibited the lowest expression of Fn14 in these cell lines. Fn14 transfer had no effect on the proliferation of A2780/DDP cells, whereas it could reduce the IC50 of DDP in A2780/DDP cells(P＜0.05). When Fn14 was transferred, the apoptosis induced by DDP was increased in A2780/DDP cells, meanwhile, the expression of apoptosis-correlated protein caspase-3 was up-regulated and anti-apoptotic protein Bcl-2 was down-regulated(P＜0.05). Conclusions: Fn14 may increase chemosensitivity to DDP by apoptosis pathway in human epithelial ovarian cancer cells.

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The Expression and Its Significance of Cell Signal Transduction Pathways MEK in Cervical Precancerous Lesions and Cervical Cancer

FU Min;QU Quan-xin

2016, 43 (3): 340-342.

Abstract ( 1127 )

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Objective：To explore the expressssion of mitogen-activated extracellular signal-regulated kinase（MEK） signaling pathways in cervical precancerous lesions and cervical cancer. Methods: A total of 92 patients with cervical lesions were collected between January 2013 and April 2014 in the department of gynecology of Tianjin First Central Hospital. According to the degree of cervical lesions, the patients were divided into three groups: normal group（30 cases）, high level cervical intraepithelial neoplasia（CIN） group（30 cases）, cervical cancer group（32 cases）. Using immunohistochemical SP method to detect the MEK expression in different tissues. Results: In normal group, high level CIN group and cervical cancer group, the positive rates of MEK were 20.0%，56.7%，68.8% respectively. MEK positive expression rate is highest in the cervical cancer group, higher than that of the high level CIN group and normal group（P＜0.05）. The difference between the normal group and the high level CIN group was the statistical significant（P=0.003）. MEK positive expression rate had no correlated with patients′ age, cervical cancer pathological type, degree of tumor differentiation, tumor size and clinical stage（P＞0.05）. Conclusions: MEK pathway may play a certain role in cervical cancer and precancerous lesion development.

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The Expression and Its Significance of Cell Signal Transduction Pathways MEK in Cervical Precancerous Lesions and Cervical Cancer

FU Min;QU Quan-xin

2016, 43 (3): 340-342.

Abstract ( 414 )

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Objective：To explore the expressssion of mitogen-activated extracellular signal-regulated kinase（MEK） signaling pathways in cervical precancerous lesions and cervical cancer. Methods: A total of 92 patients with cervical lesions were collected between January 2013 and April 2014 in the department of gynecology of Tianjin First Central Hospital. According to the degree of cervical lesions, the patients were divided into three groups: normal group（30 cases）, high level cervical intraepithelial neoplasia（CIN） group（30 cases）, cervical cancer group（32 cases）. Using immunohistochemical SP method to detect the MEK expression in different tissues. Results: In normal group, high level CIN group and cervical cancer group, the positive rates of MEK were 20.0%，56.7%，68.8% respectively. MEK positive expression rate is highest in the cervical cancer group, higher than that of the high level CIN group and normal group（P＜0.05）. The difference between the normal group and the high level CIN group was the statistical significant（P=0.003）. MEK positive expression rate had no correlated with patients′ age, cervical cancer pathological type, degree of tumor differentiation, tumor size and clinical stage（P＞0.05）. Conclusions: MEK pathway may play a certain role in cervical cancer and precancerous lesion development.

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Preliminary Clinical Study of Laparoscopic Retroperitoneal Lymph Node Dissection in Patients with Locally Advanced Cervical Cancer

JIANG Die;YAO De-sheng;LU Yan;LI Fei;PAN Zhong-mian

2016, 43 (3): 343-347.

Abstract ( 1017 )

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Objective: To investigate the feasibility and application of laparoscopic retroperitoneal lymph node dissection（LRLD） in locally advanced cervical cancer （LACC）. Methods: 41 cases in Tumor Hospital Affiliated to Guangxi Medical University diagnosed by pathology and FIGO 2009 staging of cervical cancer patients with stage ⅡB ~ ⅥA were divided into the LRLD group（n=21） and the abdominal cavity group（n=20），we performed laparoscopic abdominal aorta by abdominal cavity and peritoneal lymph nodes+pelvic lymph adenectomy. Results: 21 cases LRLD group （1 case failed to establish pneumoperitoneum process），the abdominal cavity group 20 cases were operated smoothly，including extraperitoneal group with the mean operation time（199.94±12.37） min，mean recovery time of gastrointestinal（13.54±2.35） h and urine tube（6.42 ±0.74） h function，and the time between surgery and radiotherapy（10.50 ±2.90） d，mean blood loss（55.20±10.52） mL，has statistically significantly lower than abdominal cavity group （all P＜0.05）. Conclusions: LRLD has more advantages in the application of LACC than abdominal cavity, compensate for the insufficient of imaging examination in diagnosis of cervical lymph node metastases.

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Preliminary Clinical Study of Laparoscopic Retroperitoneal Lymph Node Dissection in Patients with Locally Advanced Cervical Cancer

JIANG Die;YAO De-sheng;LU Yan;LI Fei;PAN Zhong-mian

2016, 43 (3): 343-347.

Abstract ( 422 )

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Objective: To investigate the feasibility and application of laparoscopic retroperitoneal lymph node dissection（LRLD） in locally advanced cervical cancer （LACC）. Methods: 41 cases in Tumor Hospital Affiliated to Guangxi Medical University diagnosed by pathology and FIGO 2009 staging of cervical cancer patients with stage ⅡB ~ ⅥA were divided into the LRLD group（n=21） and the abdominal cavity group（n=20），we performed laparoscopic abdominal aorta by abdominal cavity and peritoneal lymph nodes+pelvic lymph adenectomy. Results: 21 cases LRLD group （1 case failed to establish pneumoperitoneum process），the abdominal cavity group 20 cases were operated smoothly，including extraperitoneal group with the mean operation time（199.94±12.37） min，mean recovery time of gastrointestinal（13.54±2.35） h and urine tube（6.42 ±0.74） h function，and the time between surgery and radiotherapy（10.50 ±2.90） d，mean blood loss（55.20±10.52） mL，has statistically significantly lower than abdominal cavity group （all P＜0.05）. Conclusions: LRLD has more advantages in the application of LACC than abdominal cavity, compensate for the insufficient of imaging examination in diagnosis of cervical lymph node metastases.

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The Immunosuppression of Cervical Carcinoma Cell Line HeLa after Inoculating by LHC

ZHANG Wen-ke;CHEN Ya-qiong

2016, 43 (3): 348-352.

Abstract ( 969 )

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Ｏｂｊｅｃｔｉｖｅ：To study the variation of immunosuppression of HeLa inoculated by LHC. Methods：HeLa was inoculated by LHC，for 48 h，the supernatants were collected（LHC-S1），after centrifuging the cellｓ，and then adjusted the concentration of HeLa，inoculated for 48 h，centrifuged cells, collect the supernatants（ＬＨＣ－Ｓ２），adjusted the concentration of HeLa，inoculated for 48 h, after centrifuging the cells collected the supernatants（LHC-S3）. Compared with the HeLa′s supernatant without LHC, which was inoculated in the same condition, collected the supernatant for 3 times（Control -S1, Control -S2, Control -S3）, test the TGF-β1 and IL-10 by ELISA, PGE2 by ultraviolet spectrophotometry, by means of MTT to detect the proliferation of PHA induce PBMC and antibody-dependent cellular cytotoxicity of CTL. Flow cytometry （ＦＣＭ）ｔo analyze the subpopulation of peripheral blood lymphocytes, which was inoculated by the supernatants. Results：（１）The TGF-β1，IL-10 and PGE2 A278 nm of control group had no significant difference in statisticｓ（Ｐ＞０．０５）；ｉｎ LHC-group the difference were statically significant(P＜0.05); TGF-β1 gradually decreased, IL-10 was similarity in LHC-S1 and LHC-S２，ｌess than that in LHC-S3, PGE2 A278 nm was the minimum in LHC-S２；except in LHC-S2，IL-10 was less than the control grouｐ. （2）All the supernatants of the control group could inhibit the proliferation of PHA induced PBMC and cytotoxicity of CTL, had no significant statistic difference（P＞0.05）, the inhibition to CTL in LHC group and corresponding control group had no significant statistic difference（P＞0.05）; in LHC group, the inhibition ratio in LHC-S1 was the lest. （3）All the supernatants could influence the expression of the subpopulation of lymphocyte, it had statistic difference（P＜0.05）; Compared with control group, the percentage of CD3+，CD4+，CD25+ and CD4+CD25- increased in LHC-S1 and LHC-S2 group, the percentage of CD4+CD25+ decreased（P＜0.05), in the LHC-S3 group，ｔhe difference was not significant（P＞0.05）. Conclusions：The immunosuppressive molecules of HeLa could be reduced by LHC; LHC could decrease the inhibition of the proliferation of PHA induce PBMC; LHC also could increase the percentage of CD3+，CD4+，CD25+ and CD4+CD25-, reduce CD4+CD25+; LHC could reverse the immunosuppression of HeLa to a certain degree.

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The Immunosuppression of Cervical Carcinoma Cell Line HeLa after Inoculating by LHC

ZHANG Wen-ke;CHEN Ya-qiong

2016, 43 (3): 348-352.

Abstract ( 429 )

PDF (1094KB) ( 4721 )

Ｏｂｊｅｃｔｉｖｅ：To study the variation of immunosuppression of HeLa inoculated by LHC. Methods：HeLa was inoculated by LHC，for 48 h，the supernatants were collected（LHC-S1），after centrifuging the cellｓ，and then adjusted the concentration of HeLa，inoculated for 48 h，centrifuged cells, collect the supernatants（ＬＨＣ－Ｓ２），adjusted the concentration of HeLa，inoculated for 48 h, after centrifuging the cells collected the supernatants（LHC-S3）. Compared with the HeLa′s supernatant without LHC, which was inoculated in the same condition, collected the supernatant for 3 times（Control -S1, Control -S2, Control -S3）, test the TGF-β1 and IL-10 by ELISA, PGE2 by ultraviolet spectrophotometry, by means of MTT to detect the proliferation of PHA induce PBMC and antibody-dependent cellular cytotoxicity of CTL. Flow cytometry （ＦＣＭ）ｔo analyze the subpopulation of peripheral blood lymphocytes, which was inoculated by the supernatants. Results：（１）The TGF-β1，IL-10 and PGE2 A278 nm of control group had no significant difference in statisticｓ（Ｐ＞０．０５）；ｉｎ LHC-group the difference were statically significant(P＜0.05); TGF-β1 gradually decreased, IL-10 was similarity in LHC-S1 and LHC-S２，ｌess than that in LHC-S3, PGE2 A278 nm was the minimum in LHC-S２；except in LHC-S2，IL-10 was less than the control grouｐ. （2）All the supernatants of the control group could inhibit the proliferation of PHA induced PBMC and cytotoxicity of CTL, had no significant statistic difference（P＞0.05）, the inhibition to CTL in LHC group and corresponding control group had no significant statistic difference（P＞0.05）; in LHC group, the inhibition ratio in LHC-S1 was the lest. （3）All the supernatants could influence the expression of the subpopulation of lymphocyte, it had statistic difference（P＜0.05）; Compared with control group, the percentage of CD3+，CD4+，CD25+ and CD4+CD25- increased in LHC-S1 and LHC-S2 group, the percentage of CD4+CD25+ decreased（P＜0.05), in the LHC-S3 group，ｔhe difference was not significant（P＞0.05）. Conclusions：The immunosuppressive molecules of HeLa could be reduced by LHC; LHC could decrease the inhibition of the proliferation of PHA induce PBMC; LHC also could increase the percentage of CD3+，CD4+，CD25+ and CD4+CD25-, reduce CD4+CD25+; LHC could reverse the immunosuppression of HeLa to a certain degree.

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The Analysis of the Prognositic Factors between Uterine Sarcoma and Carcinosarcoma

YE Dan;YUAN Lei;YAO Liang-qing

2016, 43 (3): 353-356.

Abstract ( 1120 )

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Objective： To compare the clinical characteristic and prognositic factors between uterine sarcoma and carcinosarcoma. Methods：By performing a retrospective analysis，we identified 168 women with pathology identified as uterine sarcoma or carcinosarcoma by Obstetrical and Gynecological Hospital of Fudan University from January 2003 to December 2012，and analysed their clinical information and follow up mortality and recurrence. Kaplan-Meier used to draw survival line and do single factor analysis，Log-rank test to compare two or more groups′ survival difference，multi-factor cox-regreesion model to screen the risk factors of prognosis. Results：Uterine sarcoma and carcinosarcoma′s median survival time were（125.76±4.99） months and （86.65±7.84） months respectively. Uterine sarcoma′s overall survival（OS） is significantly longer than carcinosarcoma（P=0.003），according to Cox multi-factors regression analysis，the risk factor for uterine sarcoma′s OS is tumor pathological stage（P=0.006），the risk factors for carcinosarcoma′s OS and progress-free survival （PFS） are not only stage（OS P=0.002，PFS P=0.007），but also lympha-node dissection（OS P=0.042，PFS P=0.042）. Conclusions： Compare to carcinosarcoma，uterine sarcoma have a better prognosis，it has a longer survival time for uterine sarcoma，the later tumor pathological stage，the shorter OS. For carcinosarcoma，not only the stage，lympha-node dissection can also improve their OS，and delay recurrence significantly.

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The Analysis of the Prognositic Factors between Uterine Sarcoma and Carcinosarcoma

YE Dan;YUAN Lei;YAO Liang-qing

2016, 43 (3): 353-356.

Abstract ( 467 )

PDF (902KB) ( 4762 )

Objective： To compare the clinical characteristic and prognositic factors between uterine sarcoma and carcinosarcoma. Methods：By performing a retrospective analysis，we identified 168 women with pathology identified as uterine sarcoma or carcinosarcoma by Obstetrical and Gynecological Hospital of Fudan University from January 2003 to December 2012，and analysed their clinical information and follow up mortality and recurrence. Kaplan-Meier used to draw survival line and do single factor analysis，Log-rank test to compare two or more groups′ survival difference，multi-factor cox-regreesion model to screen the risk factors of prognosis. Results：Uterine sarcoma and carcinosarcoma′s median survival time were（125.76±4.99） months and （86.65±7.84） months respectively. Uterine sarcoma′s overall survival（OS） is significantly longer than carcinosarcoma（P=0.003），according to Cox multi-factors regression analysis，the risk factor for uterine sarcoma′s OS is tumor pathological stage（P=0.006），the risk factors for carcinosarcoma′s OS and progress-free survival （PFS） are not only stage（OS P=0.002，PFS P=0.007），but also lympha-node dissection（OS P=0.042，PFS P=0.042）. Conclusions： Compare to carcinosarcoma，uterine sarcoma have a better prognosis，it has a longer survival time for uterine sarcoma，the later tumor pathological stage，the shorter OS. For carcinosarcoma，not only the stage，lympha-node dissection can also improve their OS，and delay recurrence significantly.

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A Case Control Study of 55 Cases about Morcellation on the Impact of Unexpected Uterine Sarcomas

ZHAO Wan-cheng;YANG Qing

2016, 43 (3): 357-360.

Abstract ( 899 )

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Objective：A case control study of unexpected uterine sarcomas between laparoscopy and laparotomy was done to determine the influence of morcellation on the disease and to explore the early diagnosis by analyzing their characteristics. Methods：Between November 2008 and November 2014, all of uterine sarcomas diagnosed after operation for benign uterine fibroid were abstracted and the patients were divided into two groups, laparoscopy (8 cases) or laparotomy (47 cases). Morcellator was used in laparoscopy, but not in laparotomy. The clinical datas were reviewed. Results：The number of unexpected uterine sarcomas is 55 cases, 16 cases (7 laparoscopies and 9 laparotomies) underwent second surgery. Compared with laparotomy, laparoscopy had a higher risk of second surgery (87.5% vs. 19.1%, P=0.000) and pelvic planting and metastasis (2 cases vs. 0 case), and a lower rate of pathologic diagnosis (37.5% vs. 76.6%, P=0.038). Conclusions：Laparoscopic morcellation had a higher risk of second surgery and pelvic planting and metastasis, and a lower rate of pathologic diagnosis. This should be paid more attention by clinicians and some measures should be taken to avoid the risk.

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A Case Control Study of 55 Cases about Morcellation on the Impact of Unexpected Uterine Sarcomas

ZHAO Wan-cheng;YANG Qing

2016, 43 (3): 357-360.

Abstract ( 307 )

PDF (866KB) ( 4748 )

Objective：A case control study of unexpected uterine sarcomas between laparoscopy and laparotomy was done to determine the influence of morcellation on the disease and to explore the early diagnosis by analyzing their characteristics. Methods：Between November 2008 and November 2014, all of uterine sarcomas diagnosed after operation for benign uterine fibroid were abstracted and the patients were divided into two groups, laparoscopy (8 cases) or laparotomy (47 cases). Morcellator was used in laparoscopy, but not in laparotomy. The clinical datas were reviewed. Results：The number of unexpected uterine sarcomas is 55 cases, 16 cases (7 laparoscopies and 9 laparotomies) underwent second surgery. Compared with laparotomy, laparoscopy had a higher risk of second surgery (87.5% vs. 19.1%, P=0.000) and pelvic planting and metastasis (2 cases vs. 0 case), and a lower rate of pathologic diagnosis (37.5% vs. 76.6%, P=0.038). Conclusions：Laparoscopic morcellation had a higher risk of second surgery and pelvic planting and metastasis, and a lower rate of pathologic diagnosis. This should be paid more attention by clinicians and some measures should be taken to avoid the risk.

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