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15 February 2014, Volume 41 Issue 1
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Research Progress on Pathogenesis of Tubal Ectopic Pregnancy CHEN Jun-xia;ZHANG Xin-mei 2014, 41 (1):  3-6.  Abstract ( 1167 )   PDF (447KB) ( 5251 )   Tubal ectopic pregnancy is the most common ectopic pregnancy，and constitutes almost 98% of that.However，the etiology and accurate mechanisms of tubal ectopic pregnancy are not completely understood still. For a long time，tubal anatomy morphology distruction such as abnormal endotubal morphology，inflammatory adhesions and tubal stenosis or obstruction，which result from risk factors such as fallopian tube surgery or genital tract infection and so on，are deemed to be the main etiology of tubal ectopic pregnancy. The current literature suggests that abnormal embryo-tubal transport including changes of tubal smooth muscle contractility or ciliary beat activity and alterations in the tubal environment may be important potential pathological mechanisms of tubal ectopic pregnancy. Besides，immunity and cytokines may also play a relevant role in the formation of tubal ectopic pregnancy. Related Articles | Metrics

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The Current Research of Thrombotic Thrombocytopenic Purpura in Pregnancy WANG Tian-hong;CHENG Cheng;LI Ying-tao 2014, 41 (1):  7-9.  Abstract ( 1148 )   PDF (545KB) ( 5268 )   Thrombotic thrombocytopenic purpura （TTP） is a rare life-threatening disorder. It is characterized by microangiopathic hemolytic anemia，progressive thrombocytopenia，central nervous system disorder，fever and acute renal failure. It is caused by the absent or severe deficiency of the von Willebrand factor-cleaving protease named ADAMTS13. The pathogenesis of TTP is unknown，usually triggered after pregnancy. It causes maternal morbidity and fetal loss. Prompt aggressive management should include timely termination of pregnancy，plasma transfusion and/or plasma exchange. Related Articles | Metrics

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The Diagnosis and Treatment of Cesarean Scar Pregnancy SHI Teng-fei;TONG Xiao-wen 2014, 41 (1):  10-13.  Abstract ( 1263 )   PDF (606KB) ( 5286 )   Implantation of conception tissue within a cesarean section scar，named cesarean scar pregnancy（CSP），is an extremely rare form of ectopic pregnancy with devastating complications，such as uterine rupture and intractable bleeding，which may also lead to other life-threatening complications such as the pregnancy advances，loss of subsequent fertility，or even maternal death. Recently，the diagnosis of CSP is increasing，which attributed to growing awareness，expanding use of early pregnancy transvaginal ultrasound and rising rates of caesarean delivery. While the mechanism which contributes to cesarean scar pregnancy is still unclear，and the most notable mechanism is that the blastocyst invades myometrium through a microscopic dehiscent tract，which is believed to develop from the trauma of a previous cesarean section or any other uterine surgery. Although ultrasonographic devices are used adequately for precise diagnosis，but there is still a lack of consensus concerning management strategies. Moreover，the optimal management of CSP is unclear and a variety of therapeutic strategies are used，without clear management consensus at this time. The current primary intervention is early interruption of the pregnancy. Both medical and surgical approaches to the management of CSP are reported. The article is a review of the diagnosis and treatment of cesarean scar pregnancy. Related Articles | Metrics

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The Role of Androgen and Its Receptor in Ovary WANG Fang-fang;PAN Jie-xue;REN Jun;HUANG He-feng 2014, 41 (1):  14-17.  Abstract ( 1604 )   PDF (650KB) ( 5245 )   Androgen mediate their action primarily via transcriptionally activating the androgen receptor（AR），an important factor of androgen signaling pathway. The roles of androgen and AR in female reproductive physiology arise from their biological effect on follicle growth and development both in vitro and in vivo. Although the pivotal role of androgen in male reproductive function is well established，the precise mechanism of it in female reproductive physiology and pathology remains blurred. Recent studies have established several animal models with specific disruption of the AR gene，and this helps us understand the role of AR-mediated action in maintaining female fertility. Here we reviewed androgen and AR signaling pathway in ovary. Related Articles | Metrics

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Endometriosis and Infertility ZHEN Xin;SUN Hai-xiang 2014, 41 (1):  18-21.  Abstract ( 1217 )   PDF (636KB) ( 5242 )   Endometriosis is common in reproductive-age women and often associated with impaired fecundity and infertility. This endometriosis-related infertility could be treated with surgery or different kinds of assisted reproduction techniques inculding in vitro fertilization，ovarian hyperstimulation and intrauterine insemination. Due to the limited effect of traditionaltreatment ，assisted reproduction techniques have been used as first-choice treatment in these patients，especially the in vitro fertilization techinique which could offer a relatively high pregnancy rate. But large trials are still warranted for ovarian funtion control，endometriosis-related pregnant complications，etc. Related Articles | Metrics

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Development in Research of Endometriosis and Foxp3 QIAN Cheng;BAI Yan-qing 2014, 41 (1):  22-24.  Abstract ( 1159 )   PDF (655KB) ( 5236 )   Endometriosis is a common benign gynecologic disease, which causes pelvic pain and infertility, but the pathogenesis is unknown at present. CD4+CD25+ regulatory T cells are essential for the active suppression of autoimmunity.Transcription factors Foxp3 expression on CD4+CD25+ regulatory T cells specifically, which can be used as a specific symbol of regulatory T cells. Foxp3 is a critical regulator of CD4+CD25+ regulatory T cell development and function. The role of regulatory T cells in endometriosis has been paid attention to. In this review，we focus on the relevance between the expression of Foxp3 and the pathogeny of endometriosis. Related Articles | Metrics

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Research Progress of Stem Cells in the Treatment of Premature Ovarian Failure ZUO Xia;CHEN Lei 2014, 41 (1):  25-28.  Abstract ( 1487 )   PDF (659KB) ( 5344 )   Premature ovarian failure（POF） refers to failure of follicle function which is caused by a variety of causes. About eighty percentages of POF belongs to idiopathic POF. Therapy of POF is very tricky. In recent years，stem cell therapy has obtained some achievements in the restoration of ovarian function in animal experiments at home and abroad. These achievements bring hope in aspect of recovery of ovarian function and fertility for patients with POF. Stem cell includes embryonic stem cells and adult stem cells. Study in embryonic stem cell therapy is restricted because of ethical controversy. The adult stem cell therapy includes germline stem cell therapy，bone marrow mesenchymal stem cell therapy，fetal mesenchymal stem cells therapy. Stem cells may differentiate into oocytes or inhibit follicle apoptosis through paracrine to restore damaged ovaries. This article mainly reviews research progress about stem cell therapy of POF. Related Articles | Metrics

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Progress of the Relationship between Perimenopausal Hot Flush and Cardiovascular Disease WANG Qian;SHI Hui-rong 2014, 41 (1):  29-31.  Abstract ( 1176 )   PDF (684KB) ( 5299 )   Hot flush is complained by three out of four perimenopausal women. The exact etiology of hot flush is unclear，which may underline menopausal-associated hypoestrogenism. The altered sympathetic nervous activity and core body temperature adjust mechanism is also related with menopausal-associated hypoestrogenism. Enhanced sympathetic tone may change vascular endothelial dysfunction，blood pressure，lipids and insulin resistance，which are associated with cardiovascular disease （CVD）. Many researches indicate that perimenopausal hot flush is significantly related to CVD .This article reviews the relation between perimenopausal hot flush and CVD，and the guide role to hormone therapy（HT）. Related Articles | Metrics

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The Mechanism of Prevention and Treatment of Estrogen in Alzheimer′s Disease RAO Yan-qiu;WANG Wen-jun 2014, 41 (1):  32-34.  Abstract ( 1386 )   PDF (711KB) ( 5268 )   Going with the social olden，the incidence rate of Alzheimer′s disease increase evidently，the treatment become more important. More and more studies show that estrogen can prevent Alzheimer′s disease. Estrogen can lower brain Aβ content, suppress tau phosphorylation, improve the acetylcholinesterase activity, regulate apolipoprotein-E expression, increase cerebral blood, decrease inflammation and maintain the balance of calcium. This review recapitulates the important role of estrogen in the mechanism of the prevention of AD from the angle of the pathogenesis of AD，in order to provide basis for clinical treatment. Related Articles | Metrics

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Study on Relationship between Metastasis and Interaction of Tumor Cells and Lymphatic Endothelial Cells LIU Ying-lei;XIE Jing-yan 2014, 41 (1):  35-38.  Abstract ( 1528 )   PDF (775KB) ( 5153 )   Tumor lymphatic metastasis is one of the most sophisticated medical problems with undetermined etiology and high mortality，demanding prompt solutions. Although various hypotheses have been introduced previously and researches have focused on the tumor cells themselves，none of which can fully elucidate the pathogenesis of lymphatic metastasis. Recent researches have shown the interaction between tumor cells and other cells in the tumor microenvironment. Lymphatic endothelial cell （LEC） is an important one in the tumor microenvironment，closely relating with tumor lymphatic metastasis. Therefore，further study on interaction of LEC and tumor cells may bring a new dawn for the etiology of lymphatic metastasis as well as traditional anti-cancer treatment. Related Articles | Metrics

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Current Study on HPV16 E5 Protein in Cervical Cancer YU Yu;ZHANG Shu-lan 2014, 41 (1):  39-42.  Abstract ( 1573 )   PDF (719KB) ( 5297 )   HPV16 virus is the most correlative HPV type to cervical cancer and Encoding E5 protein. HPV16 E5 protein as one of membrane integration of proteins，mainly distributed in the golgi apparatus and endoplasmic reticulum. Numerous studies have demonstrated that HPV16 E5 protein regulates cervical cancer cell proliferation and invasion by promoting the activity of the epidermal growth factor receptor signal transduction pathway and COX -2 pathway，increasing the host cell immune evasion ,regulating the cell cycle，promoting cell transformation and reducing cell apoptosis. This paper summarized the research progress of the relationship between the HPV16 E5 protein of molecular biology and invasion of cervical cancer proliferation. Related Articles | Metrics

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Advances in Endometrial Polyps HUANG Li-hua;XIANG Mei 2014, 41 (1):  43-46.  Abstract ( 1939 )   PDF (747KB) ( 6344 )   Endometrial polyps is one of the most common gynecological diseases，which can induce menstrual period extended，postmenopausal bleeding，infertility and other clinical symptoms. After treatment，endometrial polyps also are easy to relapse，have certain malignant transformation rate，whose etiology and pathogenesis is not clear. In recent research，this disease is correlated with genetic factors，local imbalanced steroid hormone receptor，proliferation and apoptosis，chronic inflammatory stimulation，certain drugs and cell factor. Age，postmenopausal，anomalistic uterine bleeding，use of tamoxifen，obesity，hypertension，diabetes mellitus may involved in its progression. Through translational ultrasonography，sonohysterography，hysteroscopy，uterine iodine oil imaging play an important role in its treatment process. Now from the epidemiology，pathogenesis，clinical symptoms，diagnosis and treatment，recurrence，malignant related factors，prevention of endometrial polyps，we do a review，for we can more inclusively and more correctly promulgate the mechanism and characteristics of endometrial polyps，and then we can better guide further clinical research and therapy. Related Articles | Metrics

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ZEB Family in Epithelial-mesenchymal Transition of Epithelial Ovarian Cancer LI Yi-ying;JIANG Hua 2014, 41 (1):  47-51.  Abstract ( 1673 )   PDF (845KB) ( 5268 )   Epithelial ovarian cancer （EOC） is one of the most malignant tumor in women，which is inclined to get invasion and metastasis. Epithelial-mesenchymal transition （EMT） is an important phenomenon in tumor progression. It involves many signal transduction pathways and complex molecular mechanisms. Zinc finger E-box-binding protein （ZEB），an essential transcription factor during EMT，can inhibit the expression of E-cadherin and polar protein，and thus promote the EMT process. Researches of ZEB and EMT in EOC will provide effective target to block the metastasis of EOC in the future. Related Articles | Metrics

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The Relationship between Metformin and Ovarian Cancer ZHU Jie;SUN Hong 2014, 41 (1):  52-56.  Abstract ( 1262 )   PDF (782KB) ( 5264 )   Metformin is the first-line oral drug for type 2 diabetes currently. While it plays an important role as an anti-diabetes drug，the anti-neoplastic activity of metformin has also been reported in epidemiological and animal studies in many cancers such as ovarian cancer，as it could reduce the risk of ovarian cancer and improve the survival rate. The mechanisms by which metformin exerts these effects are unknown, which may include decreasing fasting glucose and insulin level，activating the AMP-activated protein kinase （AMPK），inhibiting the mitochondrial complexⅠ，inducing cell cycle arrest，selectively killing the ovarian cancer stem cell and promoting apoptosis，etc. Many key problems need to be solved before the design of best clinical trials. Further laboratory investigation and large population prospective clinical trials are required to elucidate the mechanisms of metformin anti-neoplastic actions in ovarian cancer. Related Articles | Metrics

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Application of Disposable Staining Agent in Fast Cervical Cytological Microbiology Diagnosis and Cervical Cancer Screening WANG Xiao-yin;ZHU Feng;WANG Zai-xue;ZHANG Sheng-dong;FANG Yao-wu;HE Fang-li;JIN Ming-li;ZENG Li-ping;GAO Xiao-li;ZHANG Xue-xia;MA Min 2014, 41 (1):  57-59.  Abstract ( 1375 )   PDF (907KB) ( 5267 )   Objective: The dying effect of fast cytological microbiology diagnosis and cervical cancer screening through using the method of disposable staining agent was determined. Methods: Put one drop of staining agent in smear. Flush excess dye after 3-5 minutes. Microscope was used to examine the results. Results: The celluar morphology was great through using the disposable staining agent. In addition, this method can stain various pathogenic microorganisms, cancer cells and other cells in the leucorrhea by one step. Conclusions: Disposable staining agent method represented excellent dying effect, simple and time-saving operation, and accurate results. Related Articles | Metrics

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Correlation of AQP5 Up-regulation and Carcinogenesis of Cervical Carcinoma and Its Clinicopathological Characteristics HU Le;YANG Yong-xiu;GE Yan 2014, 41 (1):  60-62.  Abstract ( 1152 )   PDF (880KB) ( 5230 )   Objective：To investigate the expression of aquaporin 5 （AQP5） in cervical carcinoma and its clinicopathological significance，and the potential effect of AQP5 during the malignant transformation of normal cervical endotheliment. Methods：The expression of AQP5 were detected by western blotting and immunohistochemistry in 30 cases of normal cervical tissues，28 cases of cervical intraepithelial neoplasia （CIN） and 56 cases of cervical squamous cell carcinoma. The clinicopathological parameters of the protein were analyzed statistically. Results：The relative quantity of AQP5 in normal cervical endotheliment, CIN and cervical carcinomas increased gradually. There were significant difference between the 3 groups（F=38.516，P=0.000）. The mean percentage of positive cells were 15.12%,23.18% and 36.08% respectively. There were significant difference between the 3 groups( χ2=22.404，P=0.000). Overexpression of AQP5 was significantly correlated with lymph node metastasis （r=0.351，P=0.008）. No correlation was found between AQP5 protein expression and age，tumor size，histological grade or FIGO stage. Conclusions：These observations suggest that increased expression of AQP5 were related to the malignant transformation of normal cervical endotheliment and the carcinogenesis of cervical carcinoma and therefore may provide a novel therapeutic target as well as a prospective biomarker for cervical carcinoma. Related Articles | Metrics

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Expression and Significance of Twist2 and E-cadherin in Cervical Squamous Cell Carcinoma GE Yan;YANG Yong-xiu;HU Le;LIU Chang;ZHU Jun 2014, 41 (1):  63-65.  Abstract ( 1119 )   PDF (951KB) ( 5215 )   Objective：Study Twist2 and E-cadherin expression in cervical intraepithelial neoplasia and cervical squamous cell carcinoma，and explore their roles and significance in the process of cervical cancer. Methods：Using western blot （Western blot） and immunohistochemistry method to detecte Twist2，E-cadherin expression in normal cervical tissue （control group），group CINⅠ，CINⅡ-Ⅲ group，cervical squamous cell carcinoma. Results：The differences of the positive expression rate of Twist2 and E-cadherin in four groups were statistically significant （χ2=48.163，P=0.000；χ2=43.169，P=0.000）. The positive expression rate of Twist2，E-cadherin in cervical squamous cell differentiation，clinical stage，lymph node metastasis between the groups，the difference was statistically significant （P＜0.05），no statistically significant difference between the different age groups（P＞0.05）. Twist2 and E-cadherin expression was negatively correlated （r=-0.401，P=0.003） in cervical squamous cell carcinoma. Control group，CIN group，cervical squamous cell carcinoma relative expression levels of Twist2，E-cadherin difference was statistically significant（F=652.225，P=0.000；F=299.112，P=0.000）. Conclusions：Twist2，E-cadherin may participate in the process of malignant transformation of cervical squamous cell carcinoma，joint detection Twist2，E-cadherin help to determine the degree of malignancy of cerical cancer and its prognosis. Related Articles | Metrics

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Human Papillomavirus Types in Invasive Cervical Cancer in Xuzhou Region REN Ling;YANG JJNG;SHI Qi-ming;PANG Yong-hong;ZHANG Rong-rong 2014, 41 (1):  66-68.  Abstract ( 1229 )   PDF (922KB) ( 5229 )   Objective:This study investigated regional distribution in the contribution made by different human papilloma (HPV) types to invasive cervical cancer (ICC), and to analyze the relation of HPV and clinical biological behavior in cervical cancer in Xuzhou region. Methods: Using nucleic acid hybridization technique to estimate and statistic analysis the HPV prevalence through 142 women with ICC. Results: ①Among the 142 women with ICC, a total of 136 participants (95.78%) had HPV infection. 19 of the 136 women (13.97%) who developed ICC were multiple HPV types infection, and 117 of them (86.03%) demonstrated a single HPV infection(P＜0.01). ②The 13 most common HPV types were identified by this study. The 8 HPV types in single infection were, in order of decreasing prevalence, HPV16(66.18%), 18(6.62%), 31(5.88%), 58(2.21%), 45(2.21%), 33(1.47%), 6(0.74%) and CP8304(0.74%); other HPV types in mutiple infections were HPV 68(2.94%), 52(2.21%), 66(1.47%), 39(0.74%), 11(0.74%). HPV16 (77.94%) were found more commonly than other HPV types and these differences were statistically significant(P＜0.01). Total infection of HPV18 was 7.35%. These were no statistically significant between HPV18 and HPV31，58，33(P＞0.05). ③There was not considerable variation in the rate of HPV infection between different cervical cancer clinical stage and histopathological grading(P＞0.05). ④Multiple infections seemed to have no relation to risk of ICC, whereas, to be decreasing with increasing pathological grade. Conclusions: A majority of ICC was associated with single HPV infection and approximately HPV16 was the predominant type followed by HPV１８，31 and 58 in Xuzhou regions. Also there was not an increased risk of ICC associated with an abnormal cytology at baseline high-risk HPV types (HR-HPV) mutiple infections. HPV infection did not appear to be associated with progress of ICC and differentiation of the tumor cells. Related Articles | Metrics

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The Clinical Characteristics Analysis of 20 Cases with Early Onset Endometrial Carcinoma WANG Hu-sheng;WU Yue-qian;SUN Jing;WANG Xi-peng 2014, 41 (1):  69-72.  Abstract ( 1271 )   PDF (817KB) ( 5246 )   Objective：To study clinical characteristics of patients with endometrial carcinoma under 40 years old. Methods：To study endometrial carcinoma cases who were treated from December 2004 to December 2012 retrospectively. Those patients were divided into two groups，which were 20 cases（4%，20/498） at age of less than 40 years in early onset group and 478 cases with more than 40 years age in general group. Clinical characteristics，risk factors，treatment，pathological type，histological grading，myometrial invasion，lymph node metastasis and adnexal metastasis between two groups were reviewed and compared. Results：The percentage of primary infertility patient in early onset group was 30.0%（6/20），The percentage of normal group was 4.2%（20/478）. The difference was statistically significant（χ2=25.855，P=0.000）. The incidence of hypertension in early onset group is lower than the normal group（χ2=7.954，P=0.003）. All early onset group patients were endometrioid adenocarcinoma. The percentage of endometrioid adenocarcinoma in normal group was 78.5%（375/478），the difference was statistically significant between two groups（χ2=5.433，P=0.020），90% early onset group patients were histological grade G1，49.8% normal group patients were histological grade G1，the percentage of stage Ⅰ in early onset group was 80%，the percentage of stage I in normal group was 74.1%，the difference between histological grade （Z=-8.259，P=0.000） and clinical stage （Z=-9.488，P=0.000） was statistically significant. There were no statistical significance between two groups in deep myometrial invasion, cervical invasion and lymph node metastasis，adnexal metastasis and positive abdominal dropsy cytology （P＞0.05）. Conclusions：Young women occupy a certain proportion of endometrial cancer，infertility is a high risk factor for endometrial cancer whose age is under 40 years，major pathological type is endometrioid adenocarcinoma，histological grade tend to be G1，young patients tend to be diagnosed at an early stage，deep myometrial invasion，cervical invasion and lymph node metastasis，adnexal metastasis and positive abdominal dropsy cytology are similar to the elderly patients，etc. Related Articles | Metrics

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Clinical Outcome of 107 Women Treated with Local Excision of Uterine Adenomyoma FENG Xiao;DAI Zhi-yuan;SUN Jing;MA Jun;YANG Tian-ru 2014, 41 (1):  73-76.  Abstract ( 1211 )   PDF (1000KB) ( 5662 )   Objective：To study the feasibility and safety of the local excision of uterine adenomyoma. Methods：To retrospective analyze 107 women with symptomatic uterine adenomyoma in Nanjing Medical University Affiliated Suzhou Hospital from October 2005 to March 2012，who refused to receive hysterectomy. All of them received the local excision of uterine adenomyoma，100 of them received the operation with routine abdominal small incision，and 7 received the operation with laparoscopy. Comparative analyze the operative time，intraoperative amount of bleeding，postoperative dysmenorrhea，menstrual quantity and uterine adenomyoma recurrence. Results：In 6 months follow-up，the dysmenorrhea symptom of 79 women were all disappeared completely，the menorrhagia symptom of 43 women were all disppeared. 48 months follow-up of 28 cases，the dysmenorrhea of 2 women（7.1%） were relieved ＜50% took oral painkiller；60 months follow-up of 14 cases，the dysmenorrhea of 2 women（14.3%） were relieved ＜50%. 1 case took oral painkiller，1 case was given Mirena IUD；dysmenorrhea degree of 2 women（14.3%） were the same level，60 months after the local excision，both of them got hysterectomy. In 7 infertility women，1 woman got pregnant 3 years after the operation andterm birth，the other 3 women who already had child，got pregnant two months to 1 year after the operation，all of them received drug abortion, the other 3 infertility women were still infertile. Conclusions：By analyzing the follow-up data，the majority women with symptomatic uterine adenomyoma could achieve the complete relief of dysmenorrhea and menorrhagia through the local excision of uterine adenomyoma. The local excision of uterine adenomyoma can gradually replace hysterectomy for uterine adenomyoma，and it is worth clinical application. Related Articles | Metrics

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The Research of Ovarian Cancer with High Accuracy Continuous Circulation Intraperitoneal Hyperthermic Chemotherapy and Intravenous Chemotherapy CUI Huan;ZHANG Ju-xin 2014, 41 (1):  77-79.  Abstract ( 1208 )   PDF (972KB) ( 5235 )   Objective：Observe the clinical efficacy of the high accuracy continuous circulation intraperitoneal hyperthermic chemotherapy （IPHC） and intravenous chemotherapy for ovarian cancer. Methods：50 patients of The People′s Hospital of Zhengzhou University with satisfied ovarian cancer reductive surgery were divided into two groups：IPHC group, 28 patients with high accuracy continuous circulation intraperitoneal hyperthermic chemotherapy and intravenous chemotherapy;Control group, 22 patients with ″paclitaxel liposome 135 mg/m2 + oxaliplatin 135 mg/m2 ″（PT） intravenous chemotherapy，observed clinical treatment effect of two groups patients. Results：Compared the percentage of nomal CA125 of two groups patients after 1 month, 3 months, the difference was statistically significant （all P＜0.05）. Two group patients one month, three months ascites treatment efficiency difference was statistically significant（P＜0.05）. Compared the grade Ⅱ side effect of chemotherapy，IPHC group was lower than control group （χ2=7.417，P=0.006）；and IPHC group′s improment rate of life quality was higher than control group′s （χ2=5.936，P=0.015）. Conclusions：High accuracy continuous circulation intraperitoneal hyperthermic chemotherapy and intravenous chemotherapy can improve the clinical efficacy of ovarian cancer，control of malignant ascites of ovarian cancer patients effectively，reduce side effects of chemotherapy and improve quality of life. Related Articles | Metrics