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15 June 2015, Volume 42 Issue 3
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Inflammasome Antiviral Signaling Pathway and Cervical Cancer LUO Yuan-cai;ZHANG Yu-hua 2015, 42 (3):  245-248.  Abstract ( 1058 )   PDF (403KB) ( 5407 )   The inflammasome is large molecule and multiprotein complex existing in immune active cells，which can feel external pathogens such as bacteria and viruses to activate cysteinyl aspartatespecific protease 1（caspase-1），and promote the precursors of interleukin 1 β（IL-1β） and IL-18 to process and mature，involve in the body′s inflammatory response and immune response，induce a special type of cell death called pyroptosis. Pyroptosis is a kind of programmed cell death which is different from apoptosis and necrosis，its characteristics is that osmotic collapse occurs during the process of cells death and releases large amounts of inflammatory cytokines，produces proinflammatory effects on adjacent cells，starts innate immune quickly and fights against tumor formation. The inflammasome antiviral signaling pathway research progress associated with cervical cancer in recent years are reviewed. Related Articles | Metrics

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The Cervical Cancer Microenvironment: an Immunologic Role in Disease CAO Jian-fang;HAO Min;ZHAO Wei-hong 2015, 42 (3):  249-252.  Abstract ( 1268 )   PDF (461KB) ( 5465 )   Cervical cancer is the second leading cause of cancer deaths for women globally worldwide. Persistent infection of high risk human papillomavirus（HR-HPV） is the main etiological factor for cervical cancer development. The changes of body immune system status especially microenvironment in situ is capable of mounting efficient immune responses against tumor antigens, so that most of the infected women can eliminate the virus and cervical precursor lesions displaying a central role in tumor progression. It is possible that vaginal microflora，vaginal mucosal defense system，immune cells and cytokines have been modulated in the cervical microenvironment. Any abnormality in the process will result in changing HPV natural history in the development of cervical intraepithelial neoplasias（CIN） and cervical cancer. The mechanism of cervical microenvironment immune dysfunction increased the risk of cervical cancer has not yet clearly known，and remains to be deeply investigated. Related Articles | Metrics

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The Advanced Treatments of Pelvical Sarcoma YE Dan;YUAN Lei;YAO Liang-qing 2015, 42 (3):  253-255.  Abstract ( 1427 )   PDF (469KB) ( 5349 )   Sarcoma is a rare uterine malignant tumor with a high grade of malignancy and pool prognosis, which is easy to have local recurrence and distant metastasis. According to the different positions, pelvical sarcoma can have different subtypes, including uterine sarcoma, ovarian sarcoma, sarcoma of the cervix, vaginal, vulva and fallopian tubes. The mainstay of treatment is surgery, the principle is tumor reduction surgery. For uterine sarcoma, the mainstay of surgery is hysterectomy, for leiomyosarcoma（ＬＭＳ）, adnexectomy is not influencing the prognosis much, but for endometrial sarcoma（ＥＳＳ） and carcinosarcoma(CS), the mainstay is hysterectomy-bilateral oophorectomy, according to the different types and different stages, whether having lymphadenectomy or not is still in dispute, is lymphadenectomy helpful to the prognosis is controversial for years. Adjuvant therapy of pelvical sarcoma consists of chemotherapy, radiotherapy, hormonal therapy and target therapy which are at the exploratory stage. Because of the biological differences of different sarcoma subtypes, emphasizing the characteristic of sarcomas and individuation therapy is quite important. Related Articles | Metrics

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Effects of ARID1A Gene in Ovarian Clear Cell Carcinoma ZHU Jue;ZHANG Ke;MA Sheng-lin 2015, 42 (3):  256-259.  Abstract ( 1130 )   PDF (501KB) ( 5456 )   Ovarian clear cell carcinoma（OCCC） is a special histological type in epithelial ovarian cancers（EOC）. The incidence of OCCC is about 5 to 25 percent of EOC. In early stage，OCCC often has better prognosis，furthermore，some patients do not need secondary treatment. But the advanced stage often has poor prognosis，as to its insensitive to conventional chemotherapy. OCCC is closely related to the occurrence of endometriosis. Recent studies have shown that tumor suppressor genes involved in chromatin remodeling-AT-rich binding domain 1A gene（ARID1A） is related to the pathogenesis of OCCC. ARID1A protein is a subunit of SWI/SNF complex, which plays important roles in replication，transcription, repair, and restruction of DNA, inhibits cell proliferation and tumor growth. Mutations of ARID1A are often seen in gynecologic cancers, especially in OCCC （46%-57%）. Mutations of ARID1A arise apoptosis and mismatch repair defects, through upregulation of the PI3K/Akt pathway, particularly through mutations of PI3KCA and inactivation of PTEN, and also which can enhance the activity of pathways involved in angiogenesis and have impact on HER2. The depth and comprehensive study of ARID1A gene can provide a basis for earlier diagnosis and effective intervention molecular target therapy. This article is about the role of ARID1A gene in OCCC. Related Articles | Metrics

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The Advancement of Diagnosis and Treatment in Mucinous Epithelial Ovarian Cancer WU Jia-yue;DI Wen 2015, 42 (3):  260-264.  Abstract ( 1133 )   PDF (571KB) ( 5430 )   Mucinous epithelial ovarian cancer（mEOC），as a special subtype of epithelial ovarian cancers，has its own unique characteristics，including low incidence of primary mEOC，unilaterality，large size，low rate of lymphatic metastases，platinum resistance，worse prognosis in advanced stage，and distinct mutational profiles，as KRAS mutations are common，but p53 and BRCA mutations are infrequent. These characteristics lead to specific guide in clinical management. In apparent early stage disease，fertility preservation is allowed by the conservation of the normal appearing uterus and contralateral ovary. Appendectomy is not essential as long as the appendix appears normal and there is no evidence of pseudomyxoma peritonei. New directions include the combination use of Oxaliplatin and 5-FU in chemotherapy. Related Articles | Metrics

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Application of Video-assisted Thoracoscopic Surgery in Advanced Ovarian Cancer with Thoracic Metastasis CHENG Feng;ZHU Jian-qing 2015, 42 (3):  265-267.  Abstract ( 1138 )   PDF (509KB) ( 5340 )   Ovarian cancer is a common malignant tumor in female becoming one of the major causes of mortality among malignant gynecologic diseases, which threaten to the life and health of women seriously. Most women present with advanced-stage disease, Intraperitoneal dissemination is the most common route of spread of ovarian cancer. The pleural cavity is the most frequent extra-abdominal metastatic site. The rate of pleural involvement was probably underestimated in patients with advanced ovarian carcinoma, and pleural lesions have not been paid enough attention. In recent years, video-assisted thoracoscopic surgery (VATS) was gradually used in advanced ovarian cancer, which could delineate the extent of intrathoracic disease and modify the management strategy. It can also make more accurate surgical staging, and permits complete cytoreduction in some patients. VATS is safe and feasible. Related Articles | Metrics

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Meta-analysis on Tumor Necrosis Factor-α 308 G/A Polymorphism and Cervical Cancer Susceptibility WANG Dai-yan;LI Lin-feng;HE Lian 2015, 42 (3):  268-272.  Abstract ( 1181 )   PDF (641KB) ( 5387 )   Objective：To evaluate the relationship between tumor necrosis factor-α（TNF-α） 308G/A polymorphism and cervical cancer risk. Methods：By searching PubMed，Embase，Cochrane Library，China Academic Journals Full-text database（1979-2014.1），VIP Database（1989—2014.1），Wanfang database（2000—2014.1），we collect the study on TNF-α 308G/A polymorphism and cervical cancer susceptibility. According to the inclusion and exclusion criteria to select test and evaluate the quality，and then extract the valid data. Results：We included 16 case-control study. Meta-analysis showed that the total population，TNF-α 308G/A polymorphism is associated with cervical cancer susceptibility[A vs. G：OR=1.242，95%CI（1.044-1.478），P=0.014]. Subgroup analysis also showed as follow，Asian populations：the genotypes were not increase the risk of cervical cancer（P＞0.05）；Caucasian populations：[A vs. G：OR=1.299，95%CI（1.052-1.603），P=0.015；AA vs. GG：OR=1.627，95%CI（1.044-2.534），P=0.031；AA vs.（GA+GG）：OR=1.616，95%CI（1.033-2.527），P=0.036]；African populations：[GA vs. GG：OR=1.533，95% CI（1.023-2.297），P=0.039；GA vs.（AA+GG）：OR=1.531，95%CI（1.024-2.291），P=0.038]. By Bgger′s and Egger′s test to determine publication bias，the results showed that there have publication bias [A vs. G（P=0.029，0.030）]. Conclusions：The results of the current research of Meta-analysis showed that the TNF-α 308G/A gene may increase the risk of cervical cancer，but still need a large sample of high-quality researches further confirmed. Related Articles | Metrics

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Polyamide-amine Mediated Drug Resistance Gene ABCG2 Silencing to Treat the Cervical Cancer Side Population Cells YUAN Li;JIANG Zhong-min;SHENG Feng;LIU Xiao-zhi 2015, 42 (3):  273-276.  Abstract ( 1203 )   PDF (743KB) ( 5360 )   Objective：To detect treatment effect on cervical cancer side population cells by nano-molecular polyamide-amine （PAMAM）-mediated drug resistance gene ATP-binding cassette superfamily G member 2（ABCG2） silencing. Methods：The cervical cancer side population cells were isolated by flow cytometry assay from cervical cancer cells. The protein level of ABCG2 was detected by immunofluorescence method. MTT assay was used to detect the inhibition rate of tumor cells induced by doxorubicin. According to the experimental requirements, the three groups, siRNA group, antisense group and control group are set up. After the design and synthesis of siRNA targeting ABCG2 gene，it was transfected into tumor cells by PAMAM，then the ABCG2 gene expression was detected by western blot，and the restore of tumor cells to doxorubicin sensitivity by detected by MTT assay. Finally，these cells were transplated into the subcutaneous of de-thymus mice and the tumor volume was detected. Results：The protein level of ABCG2 in cervical cancer side population cells was higher than that of nonside population cells（P＜0.05）；The inhibition rate of doxorubicin to non side population cell was significantly higher than that of side population cells （P＜0.01） by MTT，after ABCG2 gene silence，the inhibition rate in siRNA group recoverd to（69.4±11.3）%, showing significant differences with the control group and the non sense group（P＜0.01）. The animal experimental results show that the tumor volume in siRNA treatment group was significantly lower than the control group and antisense sequence group（P＜<0.05）. Conclusions：PAMAM can induce ABCG2 gene silencing in cervical cancer side population cell mass，to restore its treatment sensitivity to chemotherapeutic agents. Related Articles | Metrics

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Effects of Alarelin on Human Endometrial Carcinoma Xenografts in Nude Mice and the Expression of DEDD WANG Mei-ting;ZHANG San-yuan;ZHANG Xing-lin 2015, 42 (3):  277-280.  Abstract ( 1172 )   PDF (745KB) ( 5365 )   Objective：To evaluate Alarelin on human endometrial carcinoma HEC-1-B cells in nude mice and its mechanism. Methods：Establishment of endometrial carcinoma xenografts in nude mice，according to the nude volume，32 nude mice were randomly divided into 4 groups（n=8）：control group, Alarelin groups （20，40，80 μg/kg，respectively）. The growth curves of xenografts in nude mice were drawn and inhibition rates were measured. The morphological features were detected by hematoxylin and eosinstaining. The protein expression levels of DEDD were measured by immunohisto chemistry. Results：The growth curve showed that tumor volume in nude mice treated with Alarelin was smaller than that of control group. The rate of tumor inhibition in low，medium and high-dose Alarelin group were 12.65%，27.38% and 35.43％，all with a statistically significant difference（P＜0.05）. HE staining showed that tumor cells arranged in dense，with clear atypia，large nuclei，stained emitotic more ，less interstitial in control group. Compared with control group，tumor cell morphology，cell arrangement sparse，showing large unstructured necrosis，tumor cell nuclei stained pyknotic more mitotic less in different dose group. Results of immunohistochemical showed that in the gray values of DEDD protein expression in low，medium and high dose groups were 156.20±5.10，142.85±7.27 and 113.65±4.38 respectively，they were significantly lower than the control group（171.75±8.21，all P＜0.001）. Conclusions：Alarelin can effectively inhibit the growth of tumor，the mechanism may be correlated with increasing expressions of DEDD. Related Articles | Metrics

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Reflection and Current Situation in Diagnosis and Treatment Upon Female Stromal Tumors Misdiagnosed as Gynecologic Tumors of China from 2003 to 2013 LUO Wen-xiang;ZHANG Hong-hui;CUI Xiang-hua;SHI Li-fang;LIU Jie-na;WANG Lu;YANG Xiu-lan;ZHANG Jian 2015, 42 (3):  281-285.  Abstract ( 1111 )   PDF (799KB) ( 5440 )   Objective：Investigating the current situation in treatment on female stromal tumors misdiagnosed as gynecologic tumors of China from 2003 to 2013. Methods： 2 misdiagnosed cases as gynecologic tumors in the 454 hospital of PLA and 33 relative literatures were reviewed，in a total of 63 cases. Results： ①Diagnosis and treatment. There were 51 cases of GIST and 12 cases of EGIST. All were diagnosed accurately only by routine postoperative pathological diagnosis. One case was performed biopsy prior to operation and 18 were given intraoperative frozen section, which failed to confirm the diagnosis. After operation，4 cases took oral administration of imatinib mesylate，one case was given intravenous chemotherapy with cyclophosphamide and cisplatin for a course of treatment. ②The stromal tumor origin. In 51 cases GIST, 36 cases from small intestine；each 3 from small bowel mesentery and ileum;and 2 from stomach；1 from jejunum，colon，right colon，cecum，appendix each; 2 from intestinal（unrecorded parts）. 12 cases EGIST：4 cases were from intraperitoneal; 3 from ovarian，2 from broad ligament，and 1 from uterine bladder peritonea; 2 from vaginal wall. ③11 cases were recorded of follow-up，4 have been dead，2 were halfway lost，5 cases were normal. Conclusions：The main methods to completely cure early-stage stromal tumor is tumor removal operation. Inappropriate biopsy may cause tumor rupture，hemorrhage and increased a danger of tumor dissemination. The cases suspected of tumor metastasis in lymph node or other malignant tumors，may be considered to be treated with the frozen biopsy，without routine pelvic lymph node resction. The cases which are not sensitive to chemotherapy and radiotherapy can assist with the molecular targeted drug therapy to prevent，reduce and delay the recurrence and metastasis of tumor. Related Articles | Metrics

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Vaginal Myomectomy and Laparoscopic Myomectomy Treatment of Uterine Flesh Tumor Contrast Effect HU Ling-ling;PENG Bo 2015, 42 (3):  286-287.  Abstract ( 1482 )   PDF (933KB) ( 5420 )   Objective： To compare the clinical effects of uterine fibroids treated with transvaginal and laparoscopic hysteromyoma. Methods：80 patients with uterine fibroids from February 2009 to February 2011 were treated, according to the random number table they were divided into transvaginal groups（40 cases） and laparoscopic group（40 cases）. Two group of patients for surgical trauma, postoperative pain and postoperative morbidity rates were compared. Results：The operative time，blood loss，postoperative anal exhaust time，postoperative pain and postoperative morbidity rate of vaginal hysterectomy excision are better than laparoscopic myomectomy， the differences are statistical significant（P＜0.05）. Conclusions：On selecting the appropriate indications, vaginal hysterectomy excision and laparoscopic myomectomy are both safe and effective minimally invasive surgical clinic. But vaginal hysterectomy surgery is much better with the advantages of less trauma, lighter pain and postoperative pain surface without scars，etc. Related Articles | Metrics

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Clinical Analysis of 59 Cases Vulvar Squamous Cell Carcinomas HE Ying-hui;WEN Xin;XU Yan;ZHENG Xiang-mei;HAN Xue;LI Bo;OUYANG Ling 2015, 42 (3):  288-290.  Abstract ( 1073 )   PDF (944KB) ( 5461 )   Objective： To study the clinical features，selection of operation methods and prognosis of vulvar squamous cell carcinomas. Methods：59 patients with vulvar squamous carcinoma for surgical treatment from February 2006 to October 2012 in Shengjing Hospital Affiliated to China Medical University were retrospectively analyzed. Results：59 patients of survival difference with different pathological stages and clinical stages was statistically significant difference，ⅠA best prognosis in patients with; In different ages，the worst prognosis was the onset age less than 45. Different ways of operation in patients with follow-up survival rate difference was statistically significant. Conclusions：The prognosis of vulvar squamous cell carcinomas were relate age，tumor site，tumor infiltration depth and size，pathological type，operation method and postoperative adjuvant radiation and chemotherapy，and individualized treatment should be considered. Related Articles | Metrics

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Research Progress of Estrogen Regulation of Telomerase Activity in Anti-aging CEN Jia-ping;ZHANG Hong-yan;LIU Yuan-wei;DENG Miao;ZHANG Zhi-fen 2015, 42 (3):  294-297.  Abstract ( 1049 )   PDF (788KB) ( 5362 )   Telomeres are located at the ends of eukaryotic chromosomes DNA repeat sequence. The capacity of cell proliferation will gradully lose result from telomeres deletion and result in cellular senescence and death. Telomerase has the ability to catalyze the synthesis of telomeric DNA, which can help maintain telomere in length. Human telomerase catalytic subunit (hTERT) can activate telomerase activity, extend the ends of chromosomes DNA, maintain the stability and integrity of the genome thus to extend the cell ageing. Studies have confirmed the existence of a close relationship among estrogen, telomeres, telomerase and body aging, and estrogen can activate telomerase through various mechanisms to delay aging and influence the promoter activity of hTERT. In this paper, the mechanism of estrogen regulated telomerase activity anti-ageing were been summarized. Related Articles | Metrics

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4G/5G Polymorphism in Promoter Region of PAI-1 Gene and Polycystic Ovary Syndrome LIU Yuan-wei;DENG Miao;CEN Jia-ping;ZHANG Hong-yan;ZHANG Zhi-fen 2015, 42 (3):  298-300.  Abstract ( 2050 )   PDF (741KB) ( 5382 )   Polycystic ovary syndrome（PCOS） is the most common reproductive endocrine disorders，affecting those women of childbearing age，but its pathogenic factors is unknown so far. PCOS has a high degree of familial aggregation，indicating genetic factors play an important role in the pathogenesis. Plasminogen activator inhibitor-1（PAI-1）is the main physiological inhibitor of fibrinolytic system，and a large number of studies have shown that 4G/5G polymorphism in promoter region of PAI-1 gene can effect insulin sensitivity by elevating the level and activity of plasma PAI-1，involved in the formation of insulin resistance (IR). IR is the mainly pathophysiology of PCOS，closely related to obesity and spontaneous abortion of PCOS，prompting that PAI-1 gene 4G/5G polymorphism may have a close relationship with the occurrence and development of PCOS. Therefore,the related research about 4G/5G polymorphism in promoter region of PAI-1 gene and PCOS has become a hot spot in recent years, mainly involved the pathogenesis，obesity，IR，spontaneous abortion and the forward complicated with cardiovascular disease of PCOS，but the conclusion is still controversial. Related Articles | Metrics

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Research Progress on Gene Polymorphism of Polycystic Ovary Syndrome GAO Jing;CHEN Chen 2015, 42 (3):  301-305.  Abstract ( 1213 )   PDF (757KB) ( 5451 )   Polycystic ovary syndrome（PCOS） is a common, complex endocrine/metabolic disease characterized by hyperandrogenism, ovulatory dysfunction, insulin resistance and polycystic ovaries. PCOS occurs in approximately 4%-12% women of reproductive age, and is the leading reason for anovulatory infertility. It has been proven to be a familial inheritance; however, genes that may be involved in the etiology of PCOS have not been fully investigated. Up to date, the susceptible genes are mainly related to the androgen, insulin resistance and fat metabolic. Because of the heterogeneity of the syndrome, we still have no idea of a definite pathogenic gene. It is thought that PCOS is the concomitant result of many genes and environmental factors. Currently，the research methods of PCOS include the transmission disequilibrium tests，the candidate gene study and the genome-wide association study（GWAS）. Especially the GWAS, which was said to achieve a major milestone. Related Articles | Metrics

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Relevant Research Progress of Platelet Micropaticles JIANG Lu;WANG Xi-peng 2015, 42 (3):  306-310.  Abstract ( 1080 )   PDF (765KB) ( 5453 )   Platelet microparticles（PMP） are the most abundant microparticles in the bloodstream which constituting microparticles come from a variety of cells. PMP are a heterogeneous population of vesicles. They are not only different from the exosomes which generated from the intracellular multivesicular bodies，but also different from the microparticles derived from megakaryocytes. PMP have intact membrane glycoprotein and lipid composition that is same with platelet. The diversity of PMP which induced by different activators play an important role in physiological function. PMP can work in coordination with platelet. Furthermore，it is now accepted that PMP mediate intercellular transfer of bioactive molecules for a better promotion of cell-cell communication，for instance，delivering membrane receptors，cytoplasmic proteins and even RNA to recipient cells. Recent researches have shown that the unusual level of PMP had found in patients with certain diseases，such as immune thrombocytopenic purpura，prostate cancer，rheumatoid arthritis，etc. This article reviewed the formation and diversity，generation，biological function of PMP and its related clinical diseases so as to promulgate the properties of PMP and multiple pathology progresses and relevant molecular mechanisms more inclusively and more correctly，to better guide the further clinical research，providing theoretical basis for new treatment methods. Related Articles | Metrics

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Oxidative Stress and Female Reproductive Health LIU Zhong-hui;HAO Cui-fang 2015, 42 (3):  311-314.  Abstract ( 1110 )   PDF (1026KB) ( 5438 )   Oxidative stress refers to the oxidant/antioxidant imbalance in the state in the body，plays an important role in the development of atherosclerosis，diabetes，cancer，neurodegenerative，aging and other diseases. Oxidative stress can damage the female reproductive capacity，and is related to endometriosis，polycystic ovary syndrome，unexplained infertility and other reproductive-related diseases. Oxidative stress indicators such as reactive oxygen species and its associated malonaldehyde，advanced oxidation protein products，superoxide dismutase antioxidant，glutathione and total antioxidant capacity are studied more. This review summarized the potential value of oxidative stress markers in female reproduction. Related Articles | Metrics

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Effect of OGG1 Gene on the Repair Schizandrin B Prevent Benzo[a]-pyrene Induced DNA Oxidative Stress in HTR8-SVneo Cells ZHANG Yan-yan;HOU Hai-yan;CHEN Xiao;CHEN Ya-qiong 2015, 42 (3):  315-318.  Abstract ( 1031 )   PDF (820KB) ( 5308 )   Objective：To explore the effect of OGG1 gene on the repair Schizandrin B（Sch B） prevent Benzo[a]pyrene（BaP） induced DNA oxidative stress in HTR8-SVneo cells. Methods：BaP damage HTR8-SV neo cells for oxidative stress damage model，the cells were divided into blank group，20 μmol/L BaP group，and Sch B（0.1，0.5，2.0 μmol/L） groups to detect cellular ROS，cellular 8-OHdG，the levels of cellular OGG1 mRNA and OGG1 protein. Results：Compared with blank group， the levels of OGG1 mRNA and OGG1 protein in BaP group were reduced（P＜0.05），but the levels of ROS and 8-OHdG were increased（P＜0.05）. Compared with of BaP group，the levels of OGG1 mRNA and OGG1 protein were increased in Sch B groups（P＜0.05），but the levels of ROS and 8-OHdG were reduced（P＜0.05）. Conclusions：Sch B can protect HTR8-SVneo cells DNA from BaP oxidatie stress injuries. The antioxidant activity may change with OGG1 gene expression levels，which affects the repair of DNA in the cell. Related Articles | Metrics

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The Test of DNA Methyltransferase Expression in Serum and Peritoneal Fluid of Endometriosis WANG Guo-ping;HU Qi-cai;ZHAO Jing-hui;ZENG Li-ping;HE Fang;WU Rui-fang 2015, 42 (3):  319-321.  Abstract ( 1147 )   PDF (1078KB) ( 5409 )   Objective：To study the methylation alteration in menstrual proliferative and secretory period of endometriosis through testing the expression level of DNMT1 and DNMT3B in serum and peritoneal fluid. Methods：Choose the women received the hysteroscopy-laparoscopy surgery in Peking University Shenzhen Hospital from July 2013 to December 2013. The study group divided by 61 cases of endometriosis （EMs）, with 39 cases of Ⅰ-Ⅱ stages (group A) and 22 cases of Ⅲ-Ⅳ stages (group B). The control group divided by 27 cases of no-endometriosis (group C). Use the enzyme linked immunoabsorbent assay method to test DNMT1 and DNMT3B expression level in serum and peritoneal fluid. Results：①In the proliferative period，group B had higher DNMT1 expression in serum than group A and C, group A and B had higher DNMT3B expression in serum than group C, both with a statistically significant difference （P＜0.01）. ②In the proliferative period, group A had higher DNMT3B expression in peritoneal fluid than group B and C, with a statistically significant difference （P＜0.01）. ③In the secretory period, there were no statistically significant difference of DNMTs expression in serum and peritoneal fluid among three groups（P＞0.05）. Conclusions：In the proliferative period，methylation obviously change in EMs，methylation differently change in different EMs stages，indicating that the DNA methylation alteration in the proliferative period play an important role in the genesis and development of EMs. Related Articles | Metrics

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The Detection and Significance of the Cytokines of Patients with Systemic Lupus Erythematosus during Pregnancy LIU En-ling;ZHOU Yu-xiu;CHAI Lian-hai 2015, 42 (3):  322-324.  Abstract ( 1151 )   PDF (1114KB) ( 5383 )   Objective： To explore the changes of cytocines in pregnancy for systemic lupus erythematosus and guide the clinical treatment. Methods: We select 53 single pregnancy patients with systemic lupus erythematosus as study group and 50 normal single pregnancy pregnant women as control group. The serum IL-1α，IL-1β，IL-2，IL-6，IL-8，IL-10，IL-12p70，IFN-γ and TNF-α were detected by using enzyme-linked immunosorbent assay. Results: The Th1 cytokines （IL-1α，IL-1β，IL-2，IL-8，IL-12 p70，IFN-γ and TNF-α） significantly decreased in late pregnancy for healthy women comparing with the early pregnancy （P＜0.05）. But IL-6 and IL-10 were not obvious changes （P＞0.05）. In SLE patients，Th1 type only IL-1α decreased obviously in late pregnancy（P=0.001），and other Th1 cytokines and Th2 cytokines （IL-6，IL-10） had no obvious changes. IL-10 of SLE patients in early and late pregnancies were significantly higher than that of control group （both P=0.000）. In late pregnancy for control group，the ratio of IFN -γ/IL-6 was significantly lower than that of early pregnancy （0.65±0.22 vs. 1.05±0.17，t=10.17，P=0.000）. The IFN-γ/IL-6 ratio in SLE patients had no significant difference（0.53±0.16 vs. 0.48±0.18，t=1.51，P=0.067）. The ratio of IFN -γ/IL - 10 in early pregnancy and late pregnancy for healthy women were significantly higher than those of SLE patients （2.16±0.47 vs. 0.79±0.13，t=19.91，P=0.000；3.35±0.96 vs. 1.26±0.26，t=14.89，P=0.000）. Conclusions: The changes of cytokines in patients with systemic lupus erythematosus during pregnancy are complex and diverse. The level of IL-10 in SLE patients was significantly higher than that of control group. The monitoring of cytokines in SLE during pregnancy helps to determine disease activity and judgement condition change in SLE. Related Articles | Metrics

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Progress of High-mobility Group Box-1 and Its Receptors in Premature Birth QIU Xiao-yuan;YIN Li-rong 2015, 42 (3):  327-329.  Abstract ( 1111 )   PDF (797KB) ( 5390 )   Infection has been associated with premature birth. Alarmin，a concept has just been coined for less than ten years, has emerged as a key mediator in the regulation of immune responses to infection. High-mobility group box protein 1（HMGB1） is a multifunctional alarmin involved in many human diseases including infectious diseases. Recent reports indicated that HMGB1 was involved in infection-induced premature birth through its receptors toll-like receptor 4（TLR4） and receptor for advanced glycation end products（RAGE）. In this review，we will discuss the role of HMGB1，as well as its receptors TLR4 and RAGE in premature birth. Acute inflammation induced by TLR4 and chronic inflammation mediated by RAGE may contribute to inflammation-induced premature birth. HMGB1 and its receptors could become important biomarkers of premature birth. Related Articles | Metrics

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Changes in Thyroid Function during Pregnancy and Its Influence on the Fetus FAN Xiang-wei;LIU Xia 2015, 42 (3):  330-334.  Abstract ( 1254 )   PDF (843KB) ( 5548 )   Due to the large changes in specific physiological indicators of thyroid during pregnancy, the gestational thyroid hormone production, circulation, metabolism, regulating and immunity will change according to the different stages of pregnancy. Thyroid hormone is essential for fetal brain development, the deficiency of it seriously affect fetal brain development, in recent years, the incidence of gestational thyroid dysfunction increased significantly, it can lead to adverse pregnancy outcomes. This article reviews the changes of thyroid function on pregnant women and fetus, as well as the incidence of thyroid disorders in pregnant women and the adverse effects on their fetus. The correct diagnosis of thyroid disease and reasonable protection designed to prevent thyroid dysfunction during pregnancy from bringing a series of obstetric complications, and adverse pregnancy outcomes, to avoid affecting the quality of long-term survival of the newborn. Related Articles | Metrics

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The Diagnosis and Treatment of Cesarean Scar Diverticulum HEN Li-mei;SUI Long 2015, 42 (3):  335-338.  Abstract ( 1357 )   PDF (886KB) ( 5429 )   Cesarean scar diverticulum （CSD） is a late complication of cesarean section. More and more patients are suffered from CSD with symptoms such as prolonged menstruation，postmenstrual spotting，chronic pelvic pain，infertility and even uterine rupture in the late pregnancy. So doctors are gradually paying more attention to CSD because of its increasing incidence in recent years. Clinical diagnosis of CSD depends on its typical clinical manifestations and auxiliary examinations. Ultrasound is most commonly used. Magnetic resonance imaging（MRI） is the most accurate auxiliary examination. Others includes hysteroscopy and hysterosalpingography（HSG） etc. The current therapy for this disease is oral contraceptives（OCs） and surgeries，which include abdominal interventions，transvaginal repair，hysteroscopic niche resection，laparoscopic niche repair，or combined surgery of them. Among these, abdominal interventions are seldom used, hysteroscopic niche resection is the most minimally invasive and it′s suitable for the patients whose diverticulum to serosal layer ＞2 mm under MRI measurement, that whose diverticulum to serosal layer＜2 mm are usually choose the laparoscopic niche repair or transvaginal repair or combined surgery. This review is about CSD and its clinical treatment. Related Articles | Metrics

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The Status and Cause Analysis of Caesarean Section HAN Dai-hua;HE Xin-rong;LIANG Yu-jie;HUANG Fang;WANG Yang;LI Hong-ying 2015, 42 (3):  339-341.  Abstract ( 1225 )   PDF (841KB) ( 5417 )   With the maturity of the technology of caesarean section，the application of the antibacterials and the improvement of the ability of anesthesia and monitoring，the safety of caesarean section has greatly improved. The caesarean section has played a positive role in solving pregnancy complications and reducing the child and maternal mortality. But on the other hand，the high rate of caesarean section has brought the hidden troubles，increased the risks of adverse pregnancy outcomes，which also has become the problem that the whole world should face together,especially in China. In reaction to the phenomenon，this paper analyses the status of caesarean section at home and abroad，summarizes the effect factors，and points out the primary causes which lead to increase the rate of caesarean section are not only the medical factor but also the social factor. The latter has played the increasingly important role in the high rate of caesarean section. Only by the joint efforts of medical staff and society can reduce the rate of caesarean section effectively，guarantee health and safe of the mother and infant. Related Articles | Metrics

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The Relationship between the Result of Protecting Fetus from Late Threatened Abortion and Blood Leukocytes，Neutrophils and the CRP REN Juan-juan;YU Xiao-hui 2015, 42 (3):  342-344.  Abstract ( 1399 )   PDF (1136KB) ( 5410 )   Objective： To explore the relationship between the result of protecting fetus from late threatened abortion and blood leukocytes，neutrophils and the C-reactive protein（CRP）. Methods：A total of 227 patients with late threatened abortion to protect the fetus，from April 2012 to March 2013 in Dalian Obstetrics and Gynecology Hospital，were performed routine blood and CRP examination，subjects were divided into two groups，181 of them protected the fetus successfully with the success rate 79.7%，and 46 cases resulted in inevitable abortion，with the rate 20.3%. And relationship of the blood leukocyte，neutrophil percentage，neutrophils absolute value，and CRP between the two groups were analyzed. Results：Compared with the inevitable abortion group and successfully protected the fetus group，their blood WBC，neutrophil percentage，neutrophils absolute value and CRP were found with statistically difference（P＜0.05）. The successfully protected the fetus group showed an negative correlation with CRP，white blood cell and neutrophil absolute value，while the inevitable abortion and the percentage of neutrophils was positively correlated（P＜0.05）. By ROC curve analysis to predict the inevitable abortion with WBC，neutrophil percentage，neutrophils absolute value and CRP，the area under the curve were calculated to be 0.881，0.800，0.800，0.779，the sensitivity to be 87.0%，76.1%，71.7% and 73.9%，and the specific degree 75.7%，76.2%，69.6% and 81.2% respectively. Conclusions：A certain correlation existed between the risk of late threatened abortion and infection，and blood cells，neutrophils and CRP have moderate predictive value for late inevitable abortion，which provide a certain basis for clinical treatment. Related Articles | Metrics

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Expression of Human Beta-defensin-3 in Premature Rupture of Fetal Membranes of Pregnant Women YANG Xiao-hong;XIONG Qiong-ying;ZUO Hui-ping;DAI Xiao-hong;LIU Lan;YANG Ai-hua 2015, 42 (3):  345-347.  Abstract ( 1156 )   PDF (1168KB) ( 5405 )   Objective： To investigate the expression and its clinical significance of human beta-defensin-3（hBD3） in premature rupture of fetal membranes of pregnant women. Methods：Randomly selected 45 cases who delivered in the department of obstetrics and gynecology of our hospital and diagnosed primiparous patients with preterm premature rupture of membranes as PPROM group，and selected 45 cases of normal pregnancy during the same period as control group. Detected the expression of hBD3 in fetal membranes by immunohistochemical，and determined serum TNF-α，hBD3 content by enzyme linked immunosorbent assay. Results：Premature rupture of the epithelial cells observed in the brown staining was positive expression. PPROM group beta defensin 3（+） expression in 33 cases，12 cases were negative; the control group beta defensin 3（+） expression in 13 cases，32 cases were negative，there was significant difference between two groups（P＜0.05）. Compared with the control group，serum TNF-α，hBD3 increased significantly at admission and delivery of premature rupture of membranes（P＜0.05），and PPROM group serum TNF-α，hBD3 delivery were higher than the admission（P＜0.05）. Conclusions：hBD3 may be involved in the natural immune responses against microorganism mediated by TNF-α. Related Articles | Metrics

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Clinical Analysis of 23 Cases with Pneumonia during Pregnancy CHENG Shuai;XIE Yu-zhen;HE Qing;LI Ying-tao 2015, 42 (3):  348-351.  Abstract ( 1575 )   PDF (1108KB) ( 5378 )   Objective： To investigate the clinical characteristics of pregnancy with pneumonia. Methods：A retrospective review of all admissions from January 1，2005 to December 30，2013 included 23 women who had been hospitalized with pneumonia during pregnancy in our hospital. 23 cases were divided into three groups according the first trimester，the second trimester and the third trimester. Data of clinical manifestations，laboratory examinations，treatment and prognosis of these patients were obtained and studied. Results：The incidence of respiratory system disease during pregnancy was 3.652%，pneumonia accounted for 0.965%，the incidence of community-acquired pneumonia（CAP） was 78.3%（18/23），hospital-acquired pneumonia（HAP） was 21.7%（5/23）. 2 cases （8.7%） were in the first trimester，10 cases （43.5%） were in the second trimester，and 11 cases（47.8%） were in the third trimester. It suggested that the incidence of pregnancy with pneumonia accompanied with the trimester. The incidences of cough，fever，and shortness of breath and expectoration were 82.6% （19/23），65.2% （15/23），60.9%（14/23） and 43.5%（10/23），and shortness of breath is particularly evident in the third trimester，the difference was statistically significant（P＜0.05），but cough，expectoration，chills，fever and other symptoms has no significant differences in different trimesters （P＞0.05），the differences of blood count and biochemistry index were not statistically different in the different trimesters（P＞0.05）. On the other hand，cases with anemia was 43.5%（10/23），which was one of the risk factors of pregnant with pneumonia. The incidence of spontaneous abortion and premature delivery were 8.7%（2/23），and mature delivery were 82.6%（19/23），and no neonatal death. Conclusions：Pneumonia may be more severe in the pregnant woman，and carries significant risk to both mother and fetus. The incidence of CAP in the third trimester is higher than in the first and second trimester，and the clinical manifestations were similar with nonpregnant women，but has higher asthma incidence in the third trimester with pneumonia. Anemia is one of the risk factors of pregnancy complicated with pneumonia. Related Articles | Metrics

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The Application of Real-time Tissue Elastography in Evaluating Cervical Maturity during Pregnancy PENG Fang-hua;ZHANG Zhi-kun;LIU Yu-meng;KONG De-xuan 2015, 42 (3):  352-354.  Abstract ( 1195 )   PDF (1081KB) ( 5456 )   Objective： To study the ultrasound real-time tissue elastography technique used in the evaluation of cervical maturity during pregnancy. Methods：145 pregnant women were divided into 3 groups according to the gestational weeks. All pregnant women in the routine obstetric ultrasound examination were voluntary to take transvaginal ultrasound cervical evaluation. Cervical length was measured based on two-dimensional ultrasound image，followed by real-time tissue elastography，and then strain rate in the cervical region of interest was gotten during early，mid and late pregnancy. Results：Cervical length and cervical defined region of interest differ at each pregnancy group had statistical significance （P＜0.05）, and the early and mid pregnancy group of cervical length is longer than the third trimester group, cervical defined region of interest differ is less than the late pregnancy group, the difference was statistically significant（P＜0.05）, while there was no statistically significant difference between the early and mid pregnancy group（P＞0.05）. The cervical length was negatively correlation with the strain rate（r=-0.95，P=0.032）. Conclusions：Ultrasound real-time tissue elastography technology during pregnancy plays an important role in cervical maturity evaluation，and it provides accurate index about the cervical maturity. Also, it offers a new examination way to predict premature. Related Articles | Metrics

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The Clinical Application of Intravenous Contrast-enhanced Ultrasound in Uterine Cesarean Scar Pregnancy LI Hui-dong;ZHANG Zhi-kun;YANG Hua;GUO Shuang;CHAI Yi-qing 2015, 42 (3):  355-357.  Abstract ( 1041 )   PDF (844KB) ( 5425 )   Objective：To investigate the clinical value of intravenous contrast-enhanced ultrasound（CEUS） in uterine cesarean scar pregnancy. Methods：The CEUS were performed in 20 cases of suspected pregnancy within uterine cesarean. Contrast agents were the second generation of acoustic contrast agent SonoVue made in Italian Bracco company. The agents appearance and disappearance time and intensity in the leision，perfusion pattern and the relationship between lesion and serosa layer/muscular layer，were observed. Results：The lesions types can be divided into gestation sac type and mass type. The CEUS shows that high intensity and fast accumulation of contrast agents are observed in cesarean leisions，compared with myometrium nearby. Contrast model is fast entrance and slow disappear；The CEUS can also identify the integrity of serosal layer and muscular layer，and the intrusion or not of the lesion to the muscular layer , even serosal layer，while the 2D-ultrasound can not distinguish the verge of leisions and muscular layer. Conclusions：The CEUS can give more important diagnositic information in caesarean scar pregnancy ，and guide clinical treatment followed. Related Articles | Metrics

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The Intervening Measures on Reducing Caesarean Section Rate ZHANG Hong-zhe;LI Shu-lai;REN Hui 2015, 42 (3):  358-360.  Abstract ( 1138 )   PDF (1144KB) ( 5409 )   Objective：Research continued measures to reduce the cesarean section rates under the premise of ensuring medical safety. Methods：Statistically analyzed all the delivery data from Maternal Health Care Management System of five midwifery organizations in Tanggu, Binhai New Area, Tianjin, from 2001 to 2013. Results：Cesarean section rate increased from 40.09% in 2001 to 53.81% (peak rate) in 2008, which was an increasing trend year by year. Undergoing health care, control weight gain during pregnancy and good technique traning, cesarean section rate decreased to 37.74 % in 2013. Cesarean section rate decreased year by year between 2008-2013 . Social factors ranked 6th in cesarean section indications, and gradually increased until 2008 ranked second, uterine scar ranked first in 2013. Conclusions：Processing pregnancy care and control weight gain, improving skills is the effective methods to decrease the rate of cesarean section. In the future, vaginal delivery after cesarean section will be effective prevention methods. Related Articles | Metrics