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15 August 2015, Volume 42 Issue 4
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The Relationship between Serum Uric Acid Level and Hypertensive Disorder Complicating Pregnancy CHEN Ji-ming;GAO Hong-yan;WANG Yun;CHEN Da-li;CHAI Li-qiang 2015, 42 (4):  365-368.  Abstract ( 1110 )   PDF (540KB) ( 5404 )   Hypertensive disorders complicating pregnancy （HDCP） is a common clinical disease specially correlated to pregnancy，which had serious harm on maternal and child health. The etiology and pathogenesis mechanism of HDCP is not yet entirely clear. The main pathophysiological change of HDCP is systemic small vessel spasm，endothelial injury and local ischemia. Serum uric acid （UA） is the end product of purine metabolism in human，which is mainly excreted by kidney. Previous studies confirmed that the relationship between HDCP and serum UA was extremely close，and they had both interaction and influence to each other. It might have an important significance to monitor serum UA level for assessment of the occurrence and development of HDCP，especially preeclampsia. However，there is still no small controversy on the clinical application of serum UA level for the prediction or early diagnosis of preeclampsia. It is not clear whether the predictive value could be effectively improved by combination with a variety of detection indexes and construction of a new detection model. A summarization will be established in this paper on the issues as follows： the basic pathophysiology of HDCP，and the interaction between HDCP and serum UA metabolism. The close relationship between serum UA and the pathogenesis of preeclampsia. The predictive value of serum UA on the clinical diagnosis along with the prognosis of mother and fetus in preeclampsia. Related Articles | Metrics

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The Nutritional Therapy of Obese Pregnant Women YU Fang;HAN Ling-xiao;AN Yan-chen 2015, 42 (4):  369-373.  Abstract ( 1025 )   PDF (851KB) ( 5398 )   Gestational obesity refers to the status of pregnant women with excessive accumulation of adipose tissue. Recent years, the incidence of gestational obesity showed a rapid growing, the increasing obesity bring serious influence on pregnant women and perinatal infants, resulting in a profound impact on human health. In order to control maternal weight under the premise of the nutrient supplies of maternal and fetal and to protect the health delivery, it is significant to understand the impact of various factors, recognize the influence of gestational obesity on mother and infant, and develop scientific and effective treatment and management project. According to extensive literature reference, the article starts from the metabolic characteristics of obese pregnant women, analyses the impact of obesity on pregnancy complications, stages of labor and the fetus, then, do a summary for obese pregnant women about the nutritional needs and diet prescriptions, so that it can provide a reference for doctors in clinical work. Related Articles | Metrics

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The Occurrence of Uterine Malformation and its Impact on Pregnancy ZHANG Li-dan;JIANG Xiu-xiu 2015, 42 (4):  374-377.  Abstract ( 931 )   PDF (757KB) ( 5418 )   The uterine malformation includes congenital uterine malformation and acquired uterine malformation. Congenital uterine malformation is one of common alloplasia in female genital system, including hypoplasia or agenesis, unicornuate, didelphus, bicornuate, septate, arcuate, DES drug related. Acquired uterine malformation is most usually caused by abortion, cesarean section, hysteroscopy and cervical surgery, including adhesion of cervix and uterine cavity, III degree of retroversion of uterus, anteflexion of uterus and deformity of cervix and uterus cavity. This paper focuses on the occurrence of uterine malformation and its impact on pregnancy, and hopes to provide some information for the treatment and prognosis of normal and adverse pregnancy outcomes of uterin malformation. Related Articles | Metrics

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The Association of Obestatin in Maternal Periphery or Cord Blood and Body Index in Obese Pregnant Women WANG Zheng;SHE Ye;GE Hong-yu;LIU Hui-huan;LI Zhen-ling;WU Wei-guang 2015, 42 (4):  378-380.  Abstract ( 947 )   PDF (463KB) ( 5324 )   Objective：To investigate the association between the Obestatin levels in maternal periphery or cord blood and maternal or neonatal body index. Methods：30 obese pregnant women in Obstetrics and Gynecology Department of Affiliated Hospital of Logistical College of Chinese People′s Armed Police Force from August 2013 to September 2014 were chose as the obese group and other 35 normal weight pregnant women were chose as the contro1 group. The venous blood sample was collected in later pregnancy and cord blood sample in parturient period was gathered. ELISA was used to detect serum Obestatin level in maternal periphery and cord blood. Meanwhile, body mass index (BMI) in pregnant women was recorded, and new birth weight was recorded after birth. The LANGE skinfold caliper was used to measure the neonatal subscapular skinfold thickness, thigh skinfold thickness, suprailiac skinfold thickness, triceps skinfold thickness and hypodermic fat thickness of abdomen within 24 hours after birth. Results：Compared with control group, the obestatin levels of maternal periphery or cord blood in the obese group were statistically significant decreased（t＝16.707，P＝0.000）. There was a negative relationship between obestatin level in maternal periphery and BMI in obese pregnant women（r=-0.898，P＝0.000）, and there was a negative relationship between Obestatin level in cord blood and antepartum weight and hypodermic fat thickness of abdomen（r=-0.789，P＝0.000；r=-0.840，P＝0.018）. Conclusions： There is relation between maternal periphery Obestatin level and body index, and there is relation between cord blood Obestatin level and antepartum body index in obese pregnant women. Related Articles | Metrics

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Potential Risk Factors and Perinatal Outcomes of Gestational Diabetes Mellitus GAO Wen;LI Wei-qin;LYU Feng-jun;LENG Jun-hong 2015, 42 (4):  381-383.  Abstract ( 986 )   PDF (426KB) ( 5410 )   Objective：We retrospectively analyze the potential risk factors and perinatal outcomes of the pregnant women with gestational diabetes mellitus (GDM), in order to provide evidence for prevention and treatment. Methods：Totally there were 47 118 pregnant women who accepted diabetes detection during pregnancy in Tianjin region from January 2014 to June 2014, including 3 650 women with gestational diabetes mellitus (GDM group) and 43 468 women without GDM (non-GDM group). Related variables of the two groups were compared by using statistical methods. Results：Significant difference was found between GDM group and non-GDM group in age, education, and pre-pregnant overweight/obesity status (P＜0.01). Logistic regression analysis showed that old age, city registration, high education, large pre-pregnancy BMI and multiple gestations were risk factors for GDM. Women with GDM have significantly high incidence of cesarean delivery, premature delivery, pregnancy-induced hypertension, macrosomia, low birth weight than women with non-GDM (P＜0.01). Conclusions：Varieties of factors would affect the incidence of GDM. More attention should be paid on risk factors. Strengthening management of pregnant women with GDM will reduce the incidence of maternal and neonatal complications. Related Articles | Metrics

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Amniotic Fluid Embolism Managed with Success during Labour: Report of A Severe Clinical Case and Review of Literature WU Si-yu;YU Fang;HOU Hai-yan;XING Jing;CHEN Ya-qiong 2015, 42 (4):  384-386.  Abstract ( 936 )   PDF (494KB) ( 5350 )   Amniotic fluid embolism（ＡＦＥ） is widely known as a disastrous rapid-progressing intrapartum complication. The incident ranges from 2/100 000 to 6/100 000. The mortality rate reaches 61%—86%. Neonatal survival is reported at 70%. We describe a case of severe AFE in our practice and review the relevant documents. A 33-year pluripara developed amniotic fluid embolism during labour. The mother identified as gestational anemia when came to our hospital with acute respiratory failure to be her initial symptom. A forceps delivery was performed. She showed extreme blood loss complicated by disseminated coagulopathy. A subtotal hysterectomy was performed due to approximately 3000 mL bleeding. Aggressive management was practiced with continuous transfusion of blood products. Haemodialysis was performed because of chronic renal failure after her being transmitted to ICU. The patient had been treated for 3 months and discharged from hospital with an improved condition and a survived baby without neurological damage. The patient receives dialysis regularly due to chronic renal failure. Related Articles | Metrics

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Study of the Relationship between Thyroid Autoantibodies and Recurrent Spontaneous Abortion CHENG Lan 2015, 42 (4):  387-389.  Abstract ( 1018 )   PDF (399KB) ( 5376 )   Objective：To investigate the relationship between antithyroid antibodies（ATA） and recurrent spontaneous abortion（RSA）. Methods：Collected the women undergoing the examinations before pregnancy in out-patient department from August 2013 to March 2014，and according with the criterion had made for the study. 92 women had RSA history were in the study group，and their chromosome and coagulation function tests were normal. 226 women without RSA history were in the control group. TgAb(+) and/or TPOAb(+) suggested ATA(+)。Results：① In study group，the position rate of ATA in 35 years old and above women and younger than 35 years old was 39.29%（11/28） and 26.56%（17/64） respectively. There was no statistical significance（P＞0.05）. And in control group was 25.00%（10/40） and 18.28%（34/186） respectively, no statistical significance（P＞0.05）. So we thought ATA positive rate in different age stage was similar.② ATA positive rate was 30.43%（28/92） in study group，higher than the control′s 19.47%（44/226），the difference had statistical significance（P＜0.05）. TPOAb positive rate in study and control group was 30.43%（28/92） and 11.95%（27/226），the difference had statistical significance（P＜0.05）. TgAb positive rate was 7.61%（7/92）in the study group，although it was higher than the control 7.52%（17/226），but no statistical significance（P＞0.05）. Conclusions：ATA was related with RSA significantly, especially TPOAb. Related Articles | Metrics

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The Progress in the Application of Biological Patch in Female Pelvic Floor Reconstruction QIU Cheng-li;LU Yong-xian 2015, 42 (4):  395-400.  Abstract ( 1102 )   PDF (1550KB) ( 5383 )   This paper resumes the classification of biological materials and common biological patch types at present. As a case study of porcine small intestinal submucosa（SIS）, introduces the composition of biological patches and their role in the tissue repair process. By analyzing the mechanical strength of various biological patches, it is concluded that the SIS with four layers is current application more biological patch, it not only with the enough mechanical strength to support the early repair of the pelvic floor, but also of the characteristics of the vaginal wall flexibility and full of elasticity. Based on the mechanical properties and biodegradable properties of biological patches, not all pelvic floor reconstruction can be repaired by biological patch, such as fornix sacral fixation and severe bulging bladder, where synthetic mesh may provide a better effect of anatomy. The success rate of biological patch is equivalent to synthetic mesh in the treatment of stress urinary incontinence. However, for sexually active patients, especially young women, to restore the normal anatomy of vaginal wall and retain its soft and full of elasticity, biological patch has a unique advantage. As a new material, biological patch application in pelvic floor reconstruction is still in the stage of exploration. But with the younger of pelvic organ prolapse patients, biological patch still has a potential development space. Related Articles | Metrics

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The Impact of the Uterine Ligament Damage and the Surgical Treatment in the Pelvic Floor Functional Disorder CHEN Qian-qian;LU Yuan;YAO Liang-qing 2015, 42 (4):  401-404.  Abstract ( 1212 )   PDF (517KB) ( 5429 )   Pelvic floor functional disorder is one of the women′s common diseases, seriously impact women′s quality of life. The normal structure and function of the pelvic floor depends on the composite support of the pelvic floor muscles and ligaments. Damage of connective tissue and its supporting ligaments of the vaginal is the common cause of the pelvic abnormal symptoms and pelvic organ prolapse, the connective tissue and muscle relaxation and contraction can be observed in the pelvic floor functional disorder. We summarize the molecular mechanism of collagen changes when the uterine ligament damage occurs and the surgical treatment of pelvic floor functional disorder, including simple repair and mesh implants, as well as the long-term therapeutic effect. Related Articles | Metrics

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Application and Significance of Finite Element Model of Female Pelvic Floor in the Pelvic Floor Dysfunction CHEN Qian;LU Yuan;YAO Liang-qing 2015, 42 (4):  405-408.  Abstract ( 940 )   PDF (708KB) ( 5368 )   Pelvic floor dysfunction is a common disease in elder women. The incidence increases year by year，it has a serious impact on the health and quality of life in elder women. With the development of medical imaging technology and computer technology，the finite element analysis of pelvic biomechanics becomes the hot spot in the study of pelvic floor dysfunction. At present，the finite element analysis has already been widely used in orthopedics，however，because of the complex anatomy of pelvic floor，and the difficulty of building a model accurately，the domestic research on the finite element of pelvic floor is still in its infancy. The establishment of the finite element model of pelvic floor and the mechanical analysis，not only can help the gynecologist to understand the mechanism of pelvic floor dysfunction，but also can help them to make the optimal surgical plan and to predict the efficacy of the treatment. With the continuous improvement of medical imaging technology and computer hardware，we believe that the application of finite element analysis method will play an important role in the gynecology. Related Articles | Metrics

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Endometriosis Stem Cells and Wnt/β-catenin Signaling Pathway LIU Jun;ZHAO Zhi-mei;XIA Tian;YAO Xiu-jie 2015, 42 (4):  409-412.  Abstract ( 997 )   PDF (589KB) ( 5376 )   Endometriosis（EMs） is characterized as class neoplastic disease because of its invasiveness，easy to relapse and other neoplastic diseases character. In recent years，with the development of EMs etiology study，the existence of stem cells in the endometrium and these stem cells are involved in the endometrial cyclical activities have been proposed and validated，and then EMs stem cell theory is gradually being recognized. In the research of stem cell as the application of molecular biology method，a growing number of genes and signaling pathways involved in stem cells proved to be take part in stem cell′s cyclical activity，of which Wnt/β-catenin signaling pathway is one of the most important research pathways of stem cells. Wnt/β-catenin signaling pathway is highly conserved in its structural complexity in the development of a variety of tumors by stem cell proliferation cycle play a role，meanwhile Wnt/β-catenin signaling pathway involved in endometrial stem cell regulation，which would provide new ideas for the occurrence, development and treatment of endometriosis. Related Articles | Metrics

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Current Situation and Progress of Uterus-Sparing Operative Treatment for Adenomyosis CHEN Li;CHENG Zhong-ping 2015, 42 (4):  413-416.  Abstract ( 945 )   PDF (519KB) ( 5328 )   Adenomyosis is a common benign disease that usually affects women of reproductive age, which is characterized by the growth of endometrial glands and stroma into the myometrium. Hysterectomy by laparotomy or laparoscopy is currently leading therapeutics for adenomyosis, applying to women without fertility requirements. Since the development and popularization applications of magnetic resonance(MRI) and transvaginal ultrasound(TVU) as well as other medical imaging technologies, female of adenomyosis were increasingly diagnosised at younger age，leading to a shift of the clinical treatment modalities. More and more women strongly hope for the integrity of uterus and fertility because of many factors, such as quality of life. Therefore, uterus-sparing operative treatment for adenomyosis, such as adenomyomectomy and uterine remodeling, partial resection of the lesion of adenomyosis plus uterine artery occlusion, is being developed, and is discussed in detail in this review. Related Articles | Metrics

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The Development of Therapy of Thin Endometrium GUO Huan-huan;SUN Peng-ming;LIN Yuan 2015, 42 (4):  417-420.  Abstract ( 1005 )   PDF (619KB) ( 5363 )   The main factors of successful implantation of embryo include the ability to bed, the good receptive endometrium, the interaction of embryo and maternal. Endometrial thickness has been evaluated as a possible predictor of endometrial receptivity. Endometrial thickness in menstrual cycle can reflect the state of endometrial function. Adequate proliferation and secretory changes during the luteal phase is considered to be one of the prerequisites for successful implantation of the embryo. Reports have shown that a thin endometrium is closely associated with lower implantation rates. Furthermore, thin endometrium is an important cause of female infertility. It is important to look for the etiology, active treatment, and improve the endometrium receptivity. Pretreatment to the thin endometrium and increasing endometrial thickness to normal condition will help to improve the rates of pregnancy and live birth. However, the treatments of thin endometrium are not ideal at present. In this paper，we will review the definition，etiology and clinical treatment of thin endometrium. Related Articles | Metrics

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Advances in the Relationship between Polymorphisms of Genes Involved in the Folate Metabolic Pathway and Birth Defects LUO Li;CHEN Yue-ming;WANG Xian-jun 2015, 42 (4):  421-424.  Abstract ( 1151 )   PDF (579KB) ( 5433 )   With birth mortality decreasing significantly，birth defects have become more serious in China. Increasing evidences supported the polymorphisms of genes involved in the folate metabolic pathway impact the occurrence of birth defects. MTHFR 677C＞T polymorphism impacting the occurrence of neural tube defects had reached a consistent conclusion. However，the relationship between MTHFR 677C＞T, MTHFR 1298A＞C and cleft lip/palate，congenital heart disease，Down′s syndrome is still controversial. Researches seldom took further study on the correlation between MTR 2756A＞G，MTRR 66A＞G，RFC-1 80A＞G polymorphism and birth defects. In this summary，we outlined the origination of folate，metabolic pathway and the association between the polymorphisms of genes involved in the pathway and birth defects. Related Articles | Metrics

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The Advanced Study on the Function of Nrf2-ARE Pathway DONG Qu-long;WANG Hua;HOU Hai-yan;CHEN Ya-qiong 2015, 42 (4):  425-428.  Abstract ( 871 )   PDF (556KB) ( 5375 )   Nuclear factor E2 related factor 2（Nrf2） is a pivotal regulator of antioxidative stress. Under normal condition，its degradation is mediated in the cytoplasm and therefore don′t exert physiologic function. When it was been activated by detrimental assault，Nrf2 can translocate into nuclear to bind with the antioxidant response element（ARE） then to form the Nrf2-ARE signal pathway，which subsequently activates a series of protective genes and proteins including catalase（CAT），superoxide dismutase （SOD），NAD（P）H:quinine oxidoreductase 1 （NQO1） and heme oxygenase-1 （HO-1）. These enzymes play an important role in protecting somatic cells from detrimental assault. Researches have demonstrated that the pathway is associated with inflammation，tumor，aging，apoptosis，nervous injury and fertility as well as obstetrical and gynecological diseases closely. In order to understand the physiologic function of the pathway comprehensively，the present review is proposed. Related Articles | Metrics

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Preparation of Blood Components and Their Applications and Infusion in Obstetrics and Gynecology WANG Ming-fang;FU Jian-hua 2015, 42 (4):  429-431.  Abstract ( 969 )   PDF (447KB) ( 5354 )   There has been hundreds of years since 1818 when Blundell transfused blood to a parturient who was suffering severe bleeding and 1900 when an Austrian pathologist Karl Landsteiner found RBC ABO, the first human blood group system. As one of the life energy materials, blood plays an irreplaceable role in clinical treatment and rescue. Featuring small capacity preparations, high concentration and purity, good curative effect, safe application, less adverse reactions, easy to usage and save, saving blood resources, reducing the occurrence of transfusion transmitted diseases and so on, blood components have been widely used in the clinic. Because bleeding onset abrupt, diseases change quickly and serious complications in obstetrics and gynecology, transfusion therapy has become a necessary mean in postpartum hemorrhage and disseminated intravascular coagulation in order to save the lives of the mother and baby. It should be noted that in the course of blood component transfusion, it is the key of ensuring the safety and the effectiveness of blood transfusion to master the characteristics of various blood components and operate in a scientific and reasonable way. Related Articles | Metrics

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Preliminary Analysis of Urodynamics in Patients with Pelvic Organ Prolapse before Pelvic Reconstructive Surgery ZENG Ying;ZHOU Li-mei;GAO Jing;XIA Liang-bin 2015, 42 (4):  432-436.  Abstract ( 939 )   PDF (684KB) ( 5342 )   Objective：Summarize the characteristics of urodynamics in patients with pelvic reconstructive surgery，and with PFIQ-7 questionnaire research，to discuss the relationship between pelvic reconstructive surgery and the stress urinary incontinence（SUI） surgery. Methods：Retrospectively analyzed the 129 patients who were done Prolift reconstructive surgery only from July 2012 to January 2014，all the people were divided into pelvic organ prolapse（POP）+SUI group（26 cases） and POP group（103 cases）, according to whether they were suffering SUI or not， compared the urodynamics results and urethral function in each age brackets between the two groups. PFIQ-7 questionnaires were then used to survey the last 60 patients（POP+SUI group：13 cases; POP group：47 cases） with pelvic reconstructive surgery before surgery and six months after surgery. Results： Score of Aa was higher in POP+SUI group[（2.133±0.417）cm] than POP group [（1.417±0.612）cm]，significant differences were detected between the two groups（P=0.027）. No significant differences were detected in urodynamic results except maximum urethral pressure and maximum urethral closure pressure（P=0.032；P=0.029）. Significant differences were detected in PFIQ-7 questionnaire total scores before and after surgery in the two groups respectively（P=0.021；P=0.047）, no significant differences were found between the two groups after surgery in PFIQ-7 questionnaires（P＞0.05）. Conclusions：Urodynamic was suggested before pelvic reconstructive surgery，and SUI prevention should be cautious in the pelvic reconstructive surgeries, ages, urodynamiacs and clinical materials were need to take into consideration. Related Articles | Metrics

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The Long-term Efficacy of Total Pelvic Floor Reconstruction and Transvaginal Traditional Surgery for Older Women with Pelvic Organ Prolapse WU Yan-xia;ZHANG Lei;LIU Rong-na 2015, 42 (4):  437-440.  Abstract ( 1204 )   PDF (656KB) ( 5300 )   Objective：To compare the clinical effects and long-period life quality between total pelvic floor reconstruction and transvaginal hysterectomy with vaginal anterior and posterior wall repair in older women with pelvic organ prolapse （POP）. Methods：From February 2008 to February 2009，sixty POP patients were reviewed in our study whose age was over 55 years old.They were all postmenopausal women and POP-Q were stage Ⅲ-Ⅳ. The study group contain of 30 cases used the mesh of total pelvic floor reconstruction，and the control group adopted conventional surgical transvaginal hysterectomy with vaginal anterior and posterior wall repair in 30 patients. We regular followed up all women last 5 years in outpatient by POP-Q and questionnaire （PFDI-20） which were used to evaluate the life quality. Results：In the study group and the control group，operation time [（107.83±13.00）min vs. （127.50±13.25）min]，bleeding [（194.67±21.13）mL vs. （220.67±28.15）mL]，total cost of hospitalization[（32 488.38±3 408.43）￥ vs. （13 811.41±2 634.89）￥]，had statistical significances （P＜0.05）. There was 1 case recurrence to Ⅱ stage in the study group and 5 cases in the control group by POP-Q score postoperative 5 years. Postoperative 5 years, PFDI-20 scores in the two groups were compared，there were no statistical significance after 1，6 months opposite. There were statistical significance after 1，2，5 years，the women had lower scores and higher quality of life in the study group. Conclusions：The total pelvic floor reconstruction was lower recurrence rate，higher quality of life and cost more than the traditional vaginal hysterectomy with vaginal anterior and posterior wall repair in older women with pelvic organ prolapse. Related Articles | Metrics

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Clinical Study on Therapeutic Effect of "Ataraxia Electroacupuncture" on Perimenopausal Syndrome ER Zhao-juan;CHEN Xue-jun;SU Hong-jun;ZHANG Hong-xiu;YUE Xiu-ying;WANG Guan-min 2015, 42 (4):  441-444.  Abstract ( 1022 )   PDF (782KB) ( 5312 )   Objective：To observe the curative effects of "ataraxia electroacupuncture" on perimenopausal syndrome（PMS）. Methods：60 cases of PMS were randomly divided into a treatment group and a control group，30 cases in each group．The treatment group were treated with "ataraxia electroacupuncture" and the control group with oral administration of Climen tablets for 3 courses of the treatment. The therapeutic effects and changes of scores of Kupperman index（KI） were investigated before and after treatment for 1 month，3 month，finished treatment for 3 month，and 6 month，and serum estradiol（E2），follicle stimulating hormone（FSH），luteinizing hormone（LH） levels before and after treatment were observed. Results：The total effective rate was 90.00％ in treatment group while 93.33% in control group，with no significant difference between the two groups（P＞0.05）. After treatment，the scores of KI in every time point was significantly decreased（P＜0.01），but there was no significant difference between the two groups in the same time point（P＞0.05）. And the scores of KI were increased slightly in 3 month and 6 month after treatment，which was more clear in the control group，but there was no significant difference between the two groups（P＞0.05）. And after treatment，serum E2，FSH and LH levels were all better than before treatment in both group（P＜0.01），but there were no significant differences between the two groups（P＞0.05）. Conclusions："Ataraxia electroacupuncture" is safe and effective for treatment of perimenopausal syndrome，and worth promoting. Related Articles | Metrics

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Study on the Role of TLR3 in Cervical HPV16 Persistent Infection and Cervical Lesions TANG Rong-rong;LIU Jia-jia;LIU Rong;ZHANG Li-zhi;LUO Yuan-cai;QU Quan-xin 2015, 42 (4):  445-448.  Abstract ( 1065 )   PDF (703KB) ( 5313 )   Objective：To explore the role of TLR3 in HPV16 persistent infection and cervical lesions. Methods：Collected 157 cases HPV 16 infected patients whose liquid-base cervical cytology report is no intraepithelial lesion or malignancy（NILM）. After 6 months observation, among them, 40 cases were detected HPV16 persistent infection（persistent infection group）, and the other 107 cases turned to be negative （non-persistent infection group）, meanwhile selected 206 cases HPV 16 infected patients and split them with different stages of cervical lesions into three groups :group A contains 119 cases （chronic cervicitis 102 cases and CINⅠ 17 cases）; group B contains 66 cases （CINⅡ-Ⅲ 57 cases and carcinoma in situ 9 cases）; group C contains 21 cases （cervical carcinoma 21 cases）. The expression of DNA TLR3 and IFN-β were detected by PCR. The mutation of TLR3 recycled productions were detected by gene sequencing respectively. Results：The expression levels of TLR3, IFN-β in persistent infection group were lower than those in non-persistent infection group, and the differences were statistically significant（P＜0.05）. TLR3 was positively correlated with IFN-β, which has statistically significant（P＜0.001）. The expressions of TLR3, IFN-β in different cervical lesions groups: in group A, B and C, the expression levels of TLR3 group A was higher than group B and group C （P＜0.05）; the expression levels of group B was higher than group C（P＜0.05）. The expression levels of IFN-β group A was higher than group B and group C （P＜0.05）; the expression levels of group B was higher than group C （P＜0.05). In three groups TLR3 was positively correlated with IFN-β, which has statistically significant（all P＜0.001）. Conclusions：The low expression level of TLR3 leads to cervical local immune dysfunction by down-regulating the expression of IFN-β. The reduction of TLR3 expression is not only related with the cervical HPV 16 persistent infection but also plays an important role in regulating the occurrence and progression of cervical lesions and cervical cancer. Related Articles | Metrics

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Research Progress of Long Non-coding RNA and Gynecologic Tumor WANG Xin-jing;WANG Xi-peng 2015, 42 (4):  449-452.  Abstract ( 1116 )   PDF (515KB) ( 5277 )   Long non-coding RNA（lncRNA） is a class of RNA with the length of more than 200 bases. Previously，lncRNA molecules are generally considered as byproducts formed during the transcription of the genome，and are defined as transcriptome "background noise" without biological functions since these special RNA molecules do not participate in the encoding of certain proteins. However，in recent years，an increasing number of studies have found that thousands of genes in mammalian genomes can transcribe into lncRNA. Then，after the mature processing，lncRNA molecules play a key role in animal embryonic development，regulation of gene expression and disease progress. Present studies have confirmed that the expression levels of specific clusters of lncRNA molecules change significantly during different periods of the disease progression in a variety of human tumor diseases. In gynecological malignancies，the changes of lncRNA expression levels and its regulatory roles in the development of the disease through the upstream or downstream targeting molecules have been reports in many studies. This review conclude the latest progress of this area. Related Articles | Metrics

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The Progress of Perivascular Epithelioid Cell Tumors Occurring in the Female Genital System LI Wei-hua;YANG Jia-xin 2015, 42 (4):  453-456.  Abstract ( 894 )   PDF (546KB) ( 5302 )   Perivascular epithelioid cell tumors（PEComas） are very rare mesenchymal neoplasms composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They have been described in different organs and are considered as an ubiquitous tumors. Its biological behaviour can be divided into benign, malignant and uncertain malignant potential, but the criteria for diagnosis of malignancy have not been fully established due to the rarity of the tumor. The uterus is the most common anatomic site for PEComas occuring in the gynecological tract. Most cases behave in a benign fashion,and the precise etiopathogenesis of PEComas is unclear, some cases are related to the genetic alterations of tuberous sclerosis complex. For the disease is lack of specificity in clinical manifestation and imaging changes，the diagnosis relies mainly on histopathology. At present, surgical excision is thought to be the most direct and effective treatment, then followed by adjuvant radiotherapy and chemotherapy, but its efficacy is uncertain. Recently，reports on recurrence and metastasis of malignant PEComas are gradually increasing, and the prognosis is poorer. In this review，we carry out a comprehensive survey based on published data and discuss our current understanding of the clinicopathologic features，diagnosis and differential diagnosis,treatment and prognosis of PEComas occurring in the female genital system. Related Articles | Metrics

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Research Progress of Ovarian Cancer Metastasis Related Molecular Markers and Targeted Therapy ZHAO Ting-ting;SHEN Guo-dong;HU Wei-ping 2015, 42 (4):  457-460.  Abstract ( 963 )   PDF (631KB) ( 5365 )   Ovarian malignant tumor is one of the three big malignant tumor in female reproductive system, the mortality rate is highest in gynecological tumors, which has become a serious threat to the female body health. According to the research of National Cancer Institute, ovarian cancer is one of the five female causes of death related to tumor. Epithelial ovarian cancer accounts for nearly 90% of all cases of ovarian cancer, and progress rapidly, but due to the lack of early clinical manifestations and specific symptoms, most are already late, when the patients see the doctors, surgery is difficult, and prognosis is poor. In recent years, there is an upward trend in the incidence of ovarian cancer, and it is easy to early metastasis and infiltration, which was the cause of the high mortality rate. Research on ovarian cancer metastasis of the malignant biological behavior has become a hot field. The early detection of effective ovarian cancer transfer related molecular markers and their targeted therapy is an important way to improve the survival rate of patients with ovarian cancer. In addition to the current clinical application of CA125，CD44，E-cadherin and ZEB1 is expected to become the molecular marker of early diagnosis of ovarian cancer metastasis. Related Articles | Metrics

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The Prospect and Application State of Laparoscopy Used in Gynecologic Oncology MA Yao-mei;QU Peng-peng 2015, 42 (4):  461-465.  Abstract ( 1069 )   PDF (618KB) ( 5427 )   Laparoscopic surgery has been more and more widely utilized in the field of gynecological oncology. It was confirmed that laparoscopic staging was the optimal surgery for endometrial cancer with evidence-based medicine, the oncological results of laparoscopic surgery for endometrial cancer is as good as an open approach with many benefits. Many retrospective studies conclude that a laparoscopic approach to radical hysterectomy for the treatment of early stage cervical cancer is feasible and safe, large-scale randomized clinical trial（RCT） is being performed. More and more tumor centers try to performed the laparoscopic cytoreduction of ovarian cancer，its feasibility and safety was preliminary confirmed. Single incision laparoscopic surgery started to used in gynecological surgery with higher advantage of cosmetic benefit. More and more evidence turned to indicate laparoscopic surgrey improved qualities of life of patient with less trauma and complications and without compromising oncologic outcomes. Laparoscopic operations are more and more important in gynecological oncology, and make more benefit in patients with gynecologic tumor. Related Articles | Metrics

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Application of HPV Vaccines in Preventing Development of the Cervical Cancer XIA Qiao-fan;HE Lian-zhi 2015, 42 (4):  466-469.  Abstract ( 962 )   PDF (564KB) ( 5357 )   Cervical cancer causes serious damage to women′s health. It is clear that human papillomavirus （HPV） infection is the major pathogenic factor. HPV invades the organism by subtle injures. When E6 or E7 oncoprotein is continous expression in the epithelial tissue, high-risk HPV infections contribute to tumorigenicity. Detection of high-risk HPV infection and virus oncoprotein still cannot prevent cervical cancer effectively. Researchers begin to develop a vaccine against the HPV virus, and to prevent HPV infections from the sources, hoping to achieve the primary prevention of cervical cancer. Currently bivalent vaccine Cervarix against HPV 16/18 and quadrivalent vaccine Gardasil against HPV 16/18/11/16 have been approved for marketing. Prophylactic HPV vaccines have been used widely on a global scale and obtained significant effect. A new generation of prophylactic HPV vaccines have made a breakthrough in solving problems including cost, persistence and broad-spectrum immune. Cervical cancer is expected to become the first preventable cancer in the history of human anti-tumor. This review concentrates on the biological characteristics and pathogenic mechanism of HPV and the current application and situation of prophylactic HPV vaccines. Related Articles | Metrics

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Study on Expression and Correlation of SUMO-1 and ERα in Endometrial Carcinoma YUAN Li;YUAN Meng-lan;CHEN Xu-hong;JIANG Zhong-min;LI Yan-xia;MA Xiao-fang;LIU Xiao-zhi 2015, 42 (4):  470-472.  Abstract ( 1040 )   PDF (519KB) ( 5347 )   Objective：To detect the expression level of small ubiquitin-like modifier protein-1 （SUMO-1） and estrogen receptor alpha（ERα）, and their correlation in endometrial carcinoma. Methods：50 cases of endometrial carcinoma samples and 35 cases of normal endometrial samples were collected in our hospital from 2006 January to 2013 December. The expression of SUMO-1 and ERα were detected in all tissues by immunohistochemical method, and their co-localization expression was detected by immunofluorescence method. Then the relationship between SUMO-1 and ERα, and their express level and the clinicopathological parameters were analyzed respectively. Results：The positive rates of SUMO-1 protein in endometrial carcinoma was higher than that in control group, while the expression of ERα protein was the opposite, and the difference between the two groups was statistically significant（Ｐ＜０．０５）. The positive rate of SUMO-1 and ERα in endometrial carcinoma patients were differ in different ages, menopausal status and different histological grades（all P＜0.05）, but the difference was not significant in different pathology subtypes（P＞0.05）. The expression of SUMO-1 and ERα protein had good consistency （Kappa=0.875, Z=5.473, P=0.001）. Conclusions：SUMO-1 and ERα were co-localization in endometrial carcinoma, and may play a synergistic role in the process and development of endometrial carcinoma. Related Articles | Metrics

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Expression of SULT1E1，ERα，ERβ，PRA and PRB Protein in Uterine Sarcoma SONG Yan;YAN Da-jing;WANG Min;ZHOU Ying-ying;LENG Xu 2015, 42 (4):  473-476.  Abstract ( 1164 )   PDF (513KB) ( 5384 )   Objective：To analyze the expression of SULT1E1，ERα，ERβ，PRA and PRB protein in uterine sarcoma in order to find their clinical significance. Methods：The immunohistochemical method was used to detect the expressions of SULT1E1，ERα，ERβ，PRA and PRB in 31 cases of endometrial stromal sarcoma，15 cases of leiomyosarcoma tissues，10 cases of uterine leiomyoma tissues and 10 cases of normal myometrium tissues far away the wrapping membrane of myoma. Results：①The positive rate of SULT1E1 protein in endometrial stromal sarcoma and leiomyosarcoma tissues is significantly lower than that in normal myometrium tissues（P＜0.016 7）. ②The positive rate of ERα protein in endometrial stromal sarcoma and leiomyosarcoma tissues is significantly lower than that in uterine leiomyoma（P＜0.016 7）. ③The positive rate of PRA protein in leiomyosarcoma is significantly lower than that in uterine leiomyoma（P＜0.016 7）. ④In endometrial stromal sarcoma tissues， SULT1E1 had negative correlation with ERα，PRA and PRB（rs=-0.463，P=0.009；rs=-0.389，P=0.031；rs=-0.421，P=0.018，respectively），and had no correlation with ERβ（rs=0.018，P=0.925）. ⑤In endometrial stromal sarcoma tissues, ERα had positive correlation with PRA and PRB（P＜0.01）. Conclusions：The diminution or deletion of SULT1E1 protein expression relates to the development uterine sarcoma；SULT1E1 has significantly negative correlation with ERα, PRA and PRB in endometrial stromal sarcoma，which may influence the development of endometrial stromal sarcoma. Related Articles | Metrics

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Primary Malignant Melanoma of the Cervix：Report of Four Cases and Review of the Literature DUAN Yao;GUAN Zheng;LIU Ai-jun 2015, 42 (4):  477-480.  Abstract ( 960 )   PDF (557KB) ( 5292 )   Objective：To study the clinical presentation，pathological features，treatment and prognosis of primary malignant melanoma（MM） of the uterine cervix. Methods：The clinical and pathological date of four patients with primary cervical MM of PLA General Hospital from 2002 to 2012 were analyzed retrospectively. Their follow-up records were all reviewed. Results： One patient of primary cervical MM were diagnosed FIGO stageⅠb1，one was FIGO stage Ⅱa, two patients was FIGO Stage Ⅲa. S-100 protein and HMB45 were positive in the four patients. Vimentin was positive in three of the patients. Melan-A was positive in two of the patients. The four patients all underwent surgical treatment. Two of them used chemotherapy and one used radiation as postoperative adjuvant therapy. One patient died 6 months and one died 40 months for metastasis. One patient died 25 months because of recurrence. One patient has survived for 34 months until now without metastasis and recurrence . Conclusions：Primary cervical MM is a extremely rare neoplasm with poor prognosis. The diagnosis is confirmed by histological examination and immunohistochemical study with exclusion of other sites of melanoma. Standardized treatment is not well established to date. The most popular treatment mode appears to be radical hysterectomy. Related Articles | Metrics