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15 August 2013, Volume 40 Issue 4
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Care about the Reproductive Ability of Gynecological Cancer Patients WEI Li-hui 2013, 40 (4):  285-287.  Abstract ( 1289 )   PDF (431KB) ( 5104 )   The number of cancer patients is increasing and show a younger trend in recent years. With the clinical diagnosis and treatment improved，cancer has become a chronic disease. In addition to treat the disease， we should also pay attention to their reproductive function of patients. Oncofertility emphasizes the importance of disease assessment and the knowlege of the damage of chemotherapy and radiotherapy to reproductive organs and fertility. At present，we have already had some reproductive protection guideline to follow up and many new methods are in study. With the progress of science and the methods of diagnosis and treatment，the quality of life of malignant patients would improve greatly. Related Articles | Metrics

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The Related Issues about Borderline Ovarian Tumors SONG Kun;KONG Bei-hua 2013, 40 (4):  288-293.  Abstract ( 1292 )   PDF (581KB) ( 5071 )   Borderline ovarian tumor（ovarian tumor of low malignant potential） is characterized by histopathologic features and biologic behaviour intermediate between clearly benign and frankly malignant ovarian tumors. Most patients are younger. Most diseases are early staged with better prognosis，but in the advanced and implanted cases the prognosis is relatively worse. The main pathological types are serous and mucinous borderline ovarian tumor. Generally，comprehensive staging surgery should be performed for the patients. For the young patients the fertility-sparing surgery could be a treatment modality. Post-operational adjuvant therapy is not needed in the cases of early stage and low risk，but adjuvant therapy could be chose in advanced and invasive implanted cases. Long term follow-up should be done because of the late relapses of this kind of diseases. Related Articles | Metrics

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Gynaecologists Minimally Invasive Concept and Skills LING Bin 2013, 40 (4):  294-296.  Abstract ( 1240 )   PDF (504KB) ( 5070 )   The concept of minimally invasive belongs to the category of philosophy. It is the essence of advanced ａｃｔｉｖｅ ｓｕｂｊｅｃｔｉｖｅ ｔｈｏｕｇｈｔ， ｅｍｂｏｄｉｅｓ ｔｈｅ ｉｎｔｅｇｒｉｔｙ， ｌｏｙａｌｔｙ ａｎｄ ｋｉｎｄｎｅｓｓ ｔｏ ｐａｔｉｅｎｔｓ ａｎｄ ｍｅｄｉｃｉｎｅ． Ｍｉｎｉｍａｌｌｙ ｉｎｖａｓｉｖｅ ｔｅｃｈｎｏｌｏｇｙ ｉｓ ｔｈｅ ｏｒｉｇｉｎａｌ ｐａｓｓｉｖｅ ｃｌｉｎｉｃａｌ ｔｅｃｈｎｏｌｏｇｉｃａｌ ｍｅａｎｓ， ｒｅｑｕｉｒｅｓ ｈｉｇｈｌｙ ｓｋｉｌｌｅｄ ａｎｄ ｗｏｎｄｅｒｆｕｌ ａｒｔｉstry ｅｘｃｅｌｌｉｎｇ ｎａｔｕｒｅ． Ｍｉｎｉｍａｌｌｙ ｉｎｖａｓｉｖｅ ｃｏｎｃｅｐｔ ｄｅｔｅｒｍｉｎｅｓ ｍｉｎｉｍａｌｌｙ ｉｎｖａｓｉｖｅ ｔｅｃｈｎｉｑｕｅｓ， ｐｒｅｄｉｃｔｓ ｔｈｅ ｆｕｔｕｒｅ ｏｆ ｃｌｉｎｉｃａｌ ｍｅｄｉｃｉｎｅ， ａｃｃｅｐｔｓ ｃｒｉｔｉｃａｌ ｔｈｉｎｋｉｎｇ， ｃｈａｌｌｅｎｇｅｓ ｔｒａｄｉｔｉｏｎａｌ ｍｅｄｉｃｉｎｅ ｂｅｈａｖｉｏｒ ａｎｄ ｐｒｏｍｏｔｅｓ ａｃｃｕｒａｔｅ ｔｒｅａｔｍｅｎｔ． Ｍｉｎｉｍａｌｌｙ ｉｎｖａｓｉｖｅ ｃｏｎｃｅｐｔ ａｄｖｏｃａｔｅｄ ｔｏ ｒｅｔａｉｎ ｏｒｇａｎｓ ａｎｄ ｆｕｎｃｔｉｏｎｓ， ｂｏｔｈ ｔｏ ｒｅｓｉｓｔ ｅｘｃｅｓｓｉｖｅ ｔｒｅａｔｍｅｎｔ， ａｌｓｏ ｄｏｎ′ｔ ａｇｒｅｅ ｗｉｔｈ ｉｎｓｕｆｆｉｃｉｅｎｔ ｔｒｅａｔｍｅｎｔ． Ｃｌｉｎｉｃａｌ ｍｉｎｉｍａｌｌｙ ｉｎｖａｓｉｖｅ ｗｉｓｅ ｄｅｃｉｓｉｏｎ ｌｉｅｓ ｉｎ ｔｈｅ ｐｒｏｐｅｒ ｄｅｆｉｎｉｔｉｏｎ ｏｆ ｄｅｇｒｅｅ ｏｆ ｒｅｍｏｖａｌ ｏｆ ｏｒｇａｎｓ． Ｉｎ ｔｈｅ ｆａｃｅ ｏｆ ｔｈｅ ｃｈａｎｇｅ ｏｆ ｄｉｓｅａｓｅ， ｉｆ ｔａｋｉｎｇ ｃｏｎｓｔａｎｔ ｓｔｒａｔｅｇｙ ｏｆ ｔｒｅａｔｍｅｎｔｓ ｆｏｒ ｖａｒｉｏｕｓ ｄｉｓｅａｓｅｓ， ｔｈｅ ｄｅｇｒｅｅ ｏｆ ｔｒｅａｔｍｅｎｔ ｉｓ ｕｎａｖｏｉｄａｂｌｙ biased. Related Articles | Metrics

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Review of Fertility Preservation in Early-stage Cervical Cancer Patients with Radical Trachelectomy LU Ke-xin;WANG Jian-liu 2013, 40 (4):  297-300.  Abstract ( 1332 )   PDF (657KB) ( 5130 )   The popularization of cervical cytological test significantly reduced the incidence of cervical cancer. However，cervical cancer is still the leading cause of death of the global gynecological cancer patients and the age of the patients is getting younger and younger. The young patients with early-stage cervical cancer can be treated with radical trachelectomy and bilateral pelvic lymph node dissection by vaginal， abdominal or laparoscopic methods， to preserve their fertility， which has been reported at home and abroad. By reviewing the related literature， this article gives us a brief summary of the indications，surgical progress and the pregnancy after the radical surgery of cervix. Related Articles | Metrics

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Advances in Study of Fertility-sparing Surgery in Borderline Ovarian Tumor CHEN Rui-fang;LU Xin 2013, 40 (4):  301-304.  Abstract ( 1201 )   PDF (697KB) ( 5103 )   Borderline ovarian tumors （BOT） are characterized by histopathologic features and biologic behaviors intermediate between clearly benign and frankly malignant ovarian tumors. They typically present at younger women，one-third of whom have not completed childbearing. Thus， increasing studies have focused on the potential of fertility-preserving surgery in BOT. The majority of BOT diagnosed at stageⅠhave an excellent overall prognosis. Moreover，the increased usage of laparoscopic management may provide another choice in surgery procedure for patients with BOT. This review discussed the clinical and fertility outcome of patients with conservative surgery and the application of laparoscopy technology in BOT. Related Articles | Metrics

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Ｖｕｌｖａｒ Ｉｎｔｒａｅｐｉｔｈｅｌｉａｌ Ｎｅｏｐｌａｓｉａ ＧＡＯ Ｚｈｉ－ｈｕａ;ＷＡＮＧ Ｄｅ－ｈｕａ 2013, 40 (4):  305-309.  Abstract ( 1695 )   PDF (766KB) ( 5108 )   With the vulvar cancer increases in incidence and younger age of onset， vulvar intraepithelial neoplasia lesions are more concerned about as precancerous lesions. This paper describes the vulvar intraepithelial neoplasia lesions of the etiology and classification， clinical features， pathology character， treatment progress and treatment options， recurrence and progression. The therapeutic approach for vulvar intraepithelial neoplasia is variours. The objectives of treatment are not only eliminating lesions to prevent development of invasive vulvar cancer， but also including preservation of normal vulvar function and anatomy. The recurrence ，even after extensive surgical procedures， are common. Surgical excision is currently the standard treatment for vulvar intraepithelial neoplasia， The new treatment modalities， including immunotherapy， focused ultrasound therapy and photodynamic therapy， are easy accepted by patients because of the effectiveness and maintaining relatively normal-appearing and functioning anatomy. Imiquimod is possibly an alternative to currently available methods of treatment. Vaccine against Human Papillomavirus is going to be a dominant modality to prevent vulvar intraepithelial neoplasia. Related Articles | Metrics

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High-resolution Anoscopy Examination Technique and Clinical Application XIAO Jing-jing;SUI Long 2013, 40 (4):  310-313.  Abstract ( 1428 )   PDF (722KB) ( 5202 )   The technique of high-resolution anoscopy was to apply colposcopy to the anal canal and perianal region. Presently，it is an effective way to diagnose anal intraepithelial neoplasia and anal cancer. The diagnosis results of high-resolution anoscopy of anal diseases are correct and reliable，having the advantage of high sensitivity，especially for high-grade squamous intraepithelial lesion. High-resolution anoscopy technique has a significant value of clinic application in screening anal intraepithelial neoplasia and reducing the incidence of anal cancer. However，false positive and misdiagnosis are also existed in high-resolution anoscopy technique. Now，refering to related foreign literature，the clinic application of high-resolution anoscopy technique in recent years is reviewed in this paper. Related Articles | Metrics

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To Evaluate the Diagnostic Value of C-MYC Gene on High Grade Squamous Intraepithelial Lesion of Cervix：A Meta-analysis OU Ya-meng-lan;LI Li;GAO Kun 2013, 40 (4):  314-317.  Abstract ( 1225 )   PDF (758KB) ( 5098 )   Objective： To evaluate the diagnostic value of C-MYC gene on high grade squamous intraepithelial lesions of cervix. Methods： We search the database of PubMed， EMbase， Cochrane Library， CBMR and etc， from checkable date to March 31， 2012. We evaluate documents quality based on the diagnostic test accuracy quality evaluation tools （QUADAS） and the studies meet the requirements were included， data analysis was conducted by Meta-Disc 1.4 software. Results：7 studies with a total of 1180 cases in C-MYC gene were included. The results of meta-analysis showed that the sensitivity，specificity，diagnostic odds ratio of C-MYC gene on high grade squamous ontraepithelial lesion of cervix were 0.52（95% CI 0.47-0.57）， 0.80（95% CI 0.77-0.83）， 3.60（95% CI 1.55-8.39）， respectively. Conclusions： Diagnosis value of C-MYC gene were medium in alone diagnosis high grade squamous ontraepithelial lesion of cervix， and it can be used as an auxiliary clinical diagnosis method with other diagnostic method. Related Articles | Metrics

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Application of TERC Gene Combined with Colposcopy and Human Papillomavirus Test on Diagnosing the Early Cervical Lesions YANG Zhi-hui;LI Gui-mei;MEI Jia;GU Fei-fei 2013, 40 (4):  318-320.  Abstract ( 1286 )   PDF (813KB) ( 5121 )   Objective： We tested the amplification of TERC gene and HPV infection at all grade cervical lesions combined with colposcopy，and discussed the clinical value. Methods：219 patients were preliminarily diagnosed as cervical lesions with colposcopy. hTERC gene amplification（n=219） was tested by Fluorescence in situ hybridization（FISH）， and HPV infection（n=132） by SPR assay. The results were statistically analyzed. Results：①59 cases were diagnosed CIN I， 76 cases CIN II， 56 cases CIN III and 28 cases cervical cancer. There had correlation between the colposcopic diagnosis and histological diagnosis（P<0.05）. ②The positive amplification rates of hTERC gene at all levels of cervical lesions were 7.9%， 10.9%， 44.6%， 63.2%， 82.6% respectively， the differences among the groups were statistically significant（P<0.000 1）. ③Among 132 patients， there were 54 cases of high-risk HPV infection， 29 cases of low-risk HPV infection， 49 case of HPV negative. There was a statistically difference between HPV Isoforms infection and cervical intraepithelial neoplasia（P<0.05）. ④At the same time， the hTERC gene and HPV were tested also. In 54 cases with infection of high risk HPV, 33 cases were with abnormal hTERC gene amplification. And in 27 cases for low-risk HPV there were 7 cases with abnormal hTERC gene amplification. There was statistically difference between groups（P<0.001）. Conclusions： Colposcopy， as one method for diagnosing early cervical lesions， maybe leads to missed diagnosis or over-diagnosis. High risk HPV subtype infection may be one of factors which lead to abnormal hTERC gene amplification. hTERC gene amplification and HPV infection is closely related to the progress of high-grade cervical lesions， which may be the direct cause of cervical cancer. Colposcopy combined with HPV and hTERC gene may be an effective means for diagnosing early cervical lesions. Related Articles | Metrics

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Total Laparoscopic Radical Trachelectomy in the Treatment of Early Squamous Cell Cervical Cancer：a Pilot Study LU Qi;ZHANG Yun-he;WANG Shu-zhen;GUO Shu-li;LIU Chong-dong;ZHANG Zhen-yu 2013, 40 (4):  321-323.  Abstract ( 1335 )   PDF (783KB) ( 5098 )   Objective： To evaluate the surgical，oncologic，and obstetrical outcomes of total laparoscopic radical trachelectomy（TLRT） in patients with early-stage cervical cancer who want to preserve their fertility. Methods： Twenty-five patients with early-stage cervical cancer were treated by TLRT from January 2005 to December 2009. Data regarding operational time，blood loss， intraoperative-and post-operative complications， recurrence， and subsequent pregnancies were recorded. Results：The median age of the patients was 27 years（range， 22-34 years）. The median surgical time was 233 min（range， 200-320 min）. The median blood loss was 153 mL（range， 50-200 mL）， and the median length of hospitalization was 3.3 days （range， 2-4 days）. No intra-operative complications occurred；three patients had post-operative complications. The median follow-up time was 58 months（range， 36-82 months）， and no recurrences were observed. Eight patients attempted to conceive during the follow-up period， and four patients succeeded. Conclusions： TLRT is an effective and safe procedure for patients with early-stage cervical carcinoma who want to preserve fertility. A large prospective study is needed to confirm our data. Related Articles | Metrics

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The Impact of High-risk HPV Infection and Follow-up on the Prognosis of CIN Ⅰ JIANG Hua 2013, 40 (4):  324-326.  Abstract ( 1278 )   PDF (825KB) ( 5108 )   Objective： To investigate the impact of high-risk human papillomavirus （HR-HPV） infection fate of mild cervical intraepithelial neoplasia（CIN Ⅰ）， and seek reasonable clinical treatment for CIN Ⅰ. Methods：Select the outpatient women who were diagnozed by pathology for CIN Ⅰ in the Dagang Community Hospital of Tianjin Binhai New Area from January to December in 2010， and divided these women into simple follow-up group and the physical therapy group in accordance with HR-HPV test results and patient wishes of the individual， regular follow-up of TCT and HR-HPV. Results： After 6， 12， and 24-month follow-up， HR-HPV（-） group had no cases of disease progression； HR-HPV（+） group has four cases in cumulative progression； progress physical therapy group has one case of disease progression. Compared HR-HPV（-） group with the HR-HPV（+） group， the difference in disease prognosis between the two groups was statistically significant（P＜0.01）； compared HR-HPV（+） group with the physical therapy group， the rate of disease progression in physiotherapy group was less than HR-HPV（+） group， the difference was statistically significant（P<0.01）. The persistent HR-HPV infection led to the likelihood of progression of CIN Ⅰ. Conclusions： Persistent HR-HPV infection is the risk factors for CIN Ⅰ progression，which should chose a reasonable treatment，the treatment for CIN Ⅰ should be promoted standardizeuy， individualizelly，and humanistically. Related Articles | Metrics

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Research Progress on Human Endometrial Tumor Stem Cells ZHANG Ji-wen;SONG Dian-rong 2013, 40 (4):  327-330.  Abstract ( 1238 )   PDF (850KB) ( 5085 )   Endometrial tumor is one of the most common gynecological malignancies afflicting the lives and health of the women. Endometrial tumor stem cells， which may be the main reason why anti-endometrial tumor therapy fails， are possibly responsible for the development， progression， metastasis and recurrence of the endometrial tumor disease. At present endometrial stem cells have been successfully separated and identified. Endometrial tumor stem cells may originate from normal endometrium stem cells or its differentiated cells， exploration of whose surface markers， separation and identification methods has obtained some achievements. This article overviewed the progress in experiments of endometrial tumor stem cells. Related Articles | Metrics

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Progress of Human Epididymis Protein 4 in Differential Diagnosis of Gynecologic Oncology ZHANG Shuang-ge;ZHANG Hong 2013, 40 (4):  331-334.  Abstract ( 1516 )   PDF (847KB) ( 5130 )   Human epididymis protein 4 （HE4） was firstly found in epididymis epithelial cells，located in chromosome 20q12-13.1. It stretches approximately 12 kb. HE4 alone，or together with CA125 can not only help to identify benign or malignant ovarian tumors，and diagnose first stage ovarian cancer，but is also an important index to monitor post-operation effect and predict the possible recurrence after operation. HE4 in endometrial cancer patients of all stages would unexceptionally rises. HE4 diagnosing of early patients is more sensitive than CA125. HE4 is connected with the depth of the invasion of endometrial cancer. HE4 is a useful index for determining if lymph cleaning is necessary before operation. Risk of ovarian malignancy algorithm（ROMA） can successfully predict the high-risk patients with pelvic masses. In diagnosing gynecological diseases by HE4， the interference of lung cancer should be ruled out. Related Articles | Metrics

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Research Progress of Three Dimensional Power Doppler Ultrasonography Used in Diagnosis of Ovarian Tumor GUO Lin-na;ZHANG Zhi-kun;HUANG Fan 2013, 40 (4):  335-338.  Abstract ( 1540 )   PDF (877KB) ( 5176 )   Conventional two-dimensional ultrasound（2D-US） had been widely used for the evaluation of adnexal mass， include morphological assessment， color and pulsed Doppler sonographic assessment. Three dimensional power Doppler（3DPD） ultrasound could offer more three dimensional morphology information than 2D-US， including qualitative assessment of adnexal masses，preoperative 3DPD histogram analysis， quantitative assessment of the vascularization and blood flow of adnexal masses. It had high reproducibility， and could elevate the diagnosis accuracy of discriminating ovarian tumor. These new techniques may assist in the evaluation of adnexal malignancy， and had more advantages relative to conventional 2D-US. 3DPD ultrasound may become an important method in future gynecologic oncology research and in the evaluation of adnexal malignancy used in clinical practice. Related Articles | Metrics

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Advances in the Medical Treatment of Uterine Leiomyomas Fibroids ZHANG Hui-ying;XUE Feng-xia 2013, 40 (4):  339-342.  Abstract ( 1856 )   PDF (945KB) ( 6642 )   Uterine leiomyoma is the most common benign tumor of female reproductive system, which approximately 20% of women during reproductive years suffer from. Some patients are asymptomatic, while some suffer from severe anemia because of menorrhagia. As for treatment, surgery is the preferred solution for radical cure. However, due to the patients′ age and different fertility requirement, some patients do not want surgery, and some are not suitable for operation. Then gonadotropin-releasing hormone agonists and other drugs such as mifepristone can help reduce estrogen levels to inhibit the growth of myoma, and to make the myoma shrink, so as to improve clinical symptoms, which is one of another important treatments for uterine leiomyoma. Related Articles | Metrics

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Uterine Surgery for Reproductive Ability Improvement HOU Hai-yan;LIAN Li-fen;CHEN Ya-qiong 2013, 40 (4):  343-346.  Abstract ( 1468 )   PDF (876KB) ( 5247 )   Endometriosis，endometriotic cyst，uterine fibroids， endometrial polyps，septum and intrauterine adhesions were associated with female infertility. Surgery treatment could improve postoperative pregnancy rate and decrease recurrence rate compared with drug therapy. Reproductive surgery played an important part in improving IVF outcomes and fertile ability. Ovary endometriotic cyst would not affect the pregnancy rate of IVF， but it′s efficient for improving reproductive ability and decreasing pain by surgery. Adhesions and ovary damage should be prevented in the surgery. Endometrium and intrauterine diseases could affect IVF outcomes. Hysteroscopy examination should be used when IVF failed more than once to correct intrauterine diseases. Gynecological operation provided to women in reproductive age should follow the fundemental of microdamage and reproductive ability protection. Related Articles | Metrics

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Aberrant Apoptosis in the Pathogenesis of Endometriosis LI Sha;YUAN Ming;WANG Wen-wen;WANG Shi-xuan 2013, 40 (4):  347-349.  Abstract ( 1354 )   PDF (910KB) ( 5137 )   Endometriosis is a common benign gynecologic disease which is characterized by invasion， vascularization， recurrence and other malignant behaviors， while the exact pathogenic mechanisms of endometriosis remain unsolved. Apoptosis is recognized as a programmed cell death controlled by specific genes. It plays an important role in maintaining tissue homeostasis and eliminating excess or dysfunctional cells， which also involves in the development of various cancers. Recently， reduction in apoptosis has been observed in both eutopic and ectopic endometrium of women with endometriosis and leads to the development of endometriosis through related pathways. It reviews the recent literatures focused on the influencing factors of apoptosis in endometriosis and expects to find a new therapy to control this possible factors. Related Articles | Metrics

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The Application and Progress of Single-port Laparoscopic Techniques in Gynecological Surgery CHEN Yan;LI Huai-fang 2013, 40 (4):  350-352.  Abstract ( 1432 )   PDF (933KB) ( 5091 )   Under the background of “no scarring”， single-port laparoscopic techniques emerged. With the rapid development of the techniques in surgical areas， the application of single-port laparoscopic techniques in gynecologic area also increased gradually in recent years. In order to overcome the problems of “chopsticks effect”，“operation triangle”， multiport trocar， flexional minimally invasive devices and articulating mechanism were invented， even robotic-assisted laparoendoscopic single-site surgery and new three-dimensional head-mounted display system appeared one after another. The application of single port laparoscopy in gynecologic area ranged from single-port access laparoscopic-assisted vaginal hysterectomy to completely single port multi-visceral resection， from benign lesion surgery to malignant lesion surgery. In this paper，the application and progress of single-port laparoscopic techniques in gynecological surgery are reviewed. Related Articles | Metrics

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Recurrent Spontaneous Abortion Caused by Abnormal Complement Activation SU Xiao-ling;ZHAO Ai-min;LIN Qi-de 2013, 40 (4):  353-357.  Abstract ( 1298 )   PDF (972KB) ( 5235 )   Recurrent spontaneous abortion is that a patient suffered from spontaneous abortion for three times or more than three times continuously with the same man. Appropriate complement inhibition is an absolute requirement for normal pregnancy. Uncontrolled complement activation in the maternal-fetal interface leads to fetal death and recurrent spontaneous abortion including other pregnancy complications. It is said that complement system is abnormally activated by classical pathway or alternative pathway in murine models in RSA， and C3a or C5a may lead to RSA by sFlt-1 pathway and tissue factor way. However， there is still dispute on key pathways for complement activation， indispensable complement constituent， and the effector mechanisms leading to fetal loss， which need more researches to explore. Related Articles | Metrics

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Time-lapse in Human Assisted Reproductive Technology SHI Jiang-xia;ZHANG Shuo-ping;GONG Fei;LU Guang-xiu;LIN Ge 2013, 40 (4):  358-363.  Abstract ( 1541 )   PDF (1115KB) ( 5107 )   One of the most extensively used methods in human assisted reproductive technology（ART） is in vitro fertilization-embryo transfer（IVF-ET）. Due to the multiple embryos obtained per ovulation induction treatment，how to select the most potential embryo for clinical transfer in order to guarantee clinical pregnancy rate and simultaneously reduce the number of transferred embryos remains the hotspot in ART area. At present，embryo evaluation is based on morphology，which is static. The newly developed time-lapse technology is available to monitor the whole development process so as to more precisely evaluate the embryo quality. And its advantages are gradually manifested. Related Articles | Metrics

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The Feasibility of Preoperative Prediction for Fascia Defect Needing Mesh Repair in Patients with Abdominal Wall Endometriosis DENG Shan;LENG Jin-hua;LANG Jing-he;LIU Zhu-feng;SUN Da-wei;ZHU Lan;FAN Qing-bo;SHI Hong-hui 2013, 40 (4):  364-368.  Abstract ( 1397 )   PDF (746KB) ( 5110 )   Objective：To explore and compare the clinical and sonographic characteristics of grouped patients with abdominal wall endometriosis（AWE） in terms of whether use mesh or not to repair the fascia defect when wide excision was done，and to find reliable indicators of preoperative prediction. Methods：161 cases of pathologically proved AWE with history of transverse incisional cesarean section during 6-year period（2005—2010）in the department of Obstetrics and Gynecology of Peking Union Medical University Hospital（Beijing，China） were analyzed retrospectively. Patients were divided into two groups according to whether the mesh was needed to repair the fascia defect. Clinical and ultrasound（US）findings were compared between them. Prediction formula and single-index threshold were obtained by Logistic′s regression analysis and ROC curve method respectively. The similar surgical cases of 49 patients admitted in 2011 were used to test accuracy and feasibility of two methods prospectively as previously mentioned. Results：Compared with simple excision group， patients who needed artificial mesh to repair abdominal wall had larger size of foci（3.9 cm vs. 2.5 cm，P=0.001）; more vascular signals by US（41.7% vs. 27.9%，P=0.038）；higher level of serum CA125 means（48.6 U/mL vs. 32.2 U/mL，P=0.041）；more chance of entering intra- abdominal cavity（79.4% vs. 18.9%，P=0.000）；larger fascia defect（6.4 cm vs. 1.6 cm，P=0.000）；more perioperative bleeding（73.1 mL vs. 29.5 mL，P=0.000）; higher frequency of using incisional drainage（76.7% vs. 9.0%， P=0.000）; and longer hospital stays（10.2 d vs. 6.4 d，P=0.000）. In terms of mean age，time since onset of symptoms，character of pain，number and margin of foci， there is no significant difference between two groups. The threshold of maximal diameter by US was 3 cm by ROC curve. Logistic′s regression formula was P（mesh）=1/［1+e-（-3.141+0.408max diameter of foci by US+0.019 serumCA125）］. The predictive outcomes of 49 cases were compared with surgical outcomes. The overall compliance rate were 81.6% and 91.3% respectively，which underestimated rate were 7.7% and 27.3%，overestimate rate were 22.2% and 2.9% respectively. Conclusions：The longest diameter of ultrasound lesion has good predictive value of discriminating fascia defect and use of mesh，with 3 cm as warning value. The Logistic regression formula with serum CA125 involved in，does not significantly improve the prediction performance. For positive predicted patients，it is recommended to strengthen counseling and a full range of preparations. Related Articles | Metrics

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Screening for Specific Biomarkers in Serum for Diagnosis of Adenomyosis Using SELDI-TOF-MS Technology LONG Xiao-ｙｕ;ＪＩＡＮＧ Ｐｉｎｇ;ＺＨＯＵ Ｌｉａｎ－ｅ;ＷＡＮ Ａｎ－ｘｉａ;ＸＩＡＯ Ｑｕｎ;ＺＨＡＮＧ Ｗｅｉ-yuan 2013, 40 (4):  369-371.  Abstract ( 1345 )   PDF (980KB) ( 5172 )   Objective： To detect specific serum biomarkers of adenomyosis by surface-enhanced laser ｄｅｓｏｒｐｔｉｏｎ／ｉｏｎｉｚａｔｉｏｎ ｔｉｍｅ－ｏｆ－ｆｌｉｇｈｔ ｍａｓｓ ｓｐｅｃｔｒｏｍｅｔｒｙ（ＳＥＬＤＩ－ＴＯＦ－ＭＳ） ｔｅｃｈｎｏｌｏｇｙ． Ｍｅｔｈｏｄｓ： Serum samples from women with adenomyosis were compared with normal control groups by SELDI-TOF-MS technology. After finding the biomarkers, the diagnostic models were evaluated and blinded test was performed to exam the sensitivity and specificity. Results：In this study, the difference between the adenomyosis and control groups was ｓｉｇｎｉｆｉｃａｎｔ ｆｏｒ １２ ｐｒｏｔｅｉｎ ｐｅａｋｓ（Ｐ＜０．０５）． Ａｍｏｎｇ ｔｈｅｍ ｔｗｏ ｐｒｏｔｅｉｎ ｐｅａｋｓ ｗｉｔｈ ｍ／ｚ ｏｆ ２．７４８ ｋu ａｎｄ ５．７５９ ｋu were protected be of high value in the diagnosis of adenomyosis. Then we set up the diagnostic model of ａｄｅｎｏｍｙｏｓｉｓ ｗｉｔｈ ｕｓａｇｅ ｏｆ ｔｈｅｓｅ ｔｗｏ ｐｒｏｔｅｉｎ ｐｅａｋｓ， ｔｈｅ ｓｅｎｓｉｔｉｖｉｔｙ ａｎｄ ｓｐｅｃｉｆｉｃｉｔｙ ｗｅｒｅ １００％ ａｎｄ ８０％． Ａｎａｌｙｓｉｓ of spectra from the completely blinded test set accurately classified with a sensitivity and specificity of 86% and 100%. Conclusions： SELDI-TOF-MS technology plays an important role on screening the diagnostic biomarker of adenomyosis. The pattern of combined markers provides a powerful and reliable diagnostic method for adenomyosis with high sensitivity and specificity. Related Articles | Metrics

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Determination of Paclitaxel in Ovarian Neoplasm Patients′ Plasma by HPLC DONG Bin-hua;SUN Peng-ming;SONG Yi-yi;ZENG Fan-xiang;LIN Fen;MAO Xiao-dan 2013, 40 (4):  372-374.  Abstract ( 1228 )   PDF (916KB) ( 5112 )   Objective： An HPLC method was established for determination of paclitaxel′s concentration in ovarian neoplasm patients′ plasma. Methods：Each test 500 μL plasma sample was alkalinized by sodium bicarbonate firstly，and then extracted by diethyl ether. Docetaxel was used as the internal standard. Analytical column was Ultimate Acclaim?誖120 C18（5 μm， 4.6 mm×250 mm）. The isocratic mobile phase was the acetonitrile and 0.1% phosphoric acid with the rate of 55∶45（V/V）. The flow rate was 1.3 mL/min， the temperature of chromatographic column was 20 ℃ and the detective UV wavelength was 227 nm. Results：The calibration curve was linear over the concentration range of 0.1-10.0 mg/L（r=0.998 9）. The limit of detection was 0.04 mg/L（S/N=3）， the relative recovery was（98.5±4.1）% and the RSD of intra-day and inter-day were lower than 10% respectively. Conclusions： The method is simple, rapid and repeatable. It is suitable for chemotherapeutic drug monitoring and the pharmacokinetics studying in ovarian neoplasm patients. Related Articles | Metrics

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Expression of E-cadherin and Beta-catenin in Endometrial Carcinoma FENG Lan-qing;WANG Ming-bo;WANG Xiao-ping;LIU Sui;CHEN Chang-wei 2013, 40 (4):  375-378.  Abstract ( 1176 )   PDF (972KB) ( 5168 )   Objective： To detect the relationship between expression of E-cadherin and beta-catenin with endometrial carcinoma. Methods： A total of 65 specimens of endometrial carcinoma，38 normal endometrial tissues and 36 atypical hyperplasia endometrium tissues were evaluated by immunohistochemical technique with monocolonal antibodies against E-cadherin and beta-catenin. Results：The aberrant expression rates of E-cadherin and beta-catenin increased obviously from normal endometrial tissues，atypical hyperplasia endometrium tissues to endometrial carcinoma tissues（P<0.05）. Expression of E-cadherin was positively correlated with tumor grade，mymetrial invasion，surgical stage and lymphnode matastasis（P<0.05）. Expression of beta-catenin was also significantly correlated with tumor grade，surgical stage and lymphnode matastasis（P<0.05）. Conclusions： The aberrant expression of E-cadherin and beta-catenin was positively related to oncogenesis，invasion，metastasis and prognosis of endomentrial carcinoma. It should be considered to a certain extent as an index of malignant degree and prognosis of endomentrial carcinoma. Related Articles | Metrics

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The Relationship between Maternal Serum 25-hydroxyvitamin D3 and Gestational Diabetes Mellitus in Mid-term Pregnant Women HUANG Yi-ying;YING Hao 2013, 40 (4):  379-381.  Abstract ( 1313 )   PDF (969KB) ( 5106 )   Objective： This study investigated the relationship between 25-hydroxyvitamin D3 concentrations and gestational diabetes mellitus at 13-16 gestational weeks. Methods： A nested case-control study of 132 cases was conducted in September 2011 at Shanghai First Maternity and Infant Hospital， Tongji University School of Medicine. Among them， 44 GDM cases were ascertained and 88 women who were not diagnosed with GDM， preeclampsia， multiple pregnancy， multiparas were selected as the control group. The concentration of serum 25-hydroxyvitamin D3 was measured at 13-16 gestational weeks. Percentiles of 25-hydroxyvitamin D3 was calculated. The corresponding mobidity of GDM was determined for each percentile cut-off point. The sensitivity， specificity， Youden index， positive predictive value， and negative predictive value were also estimated. Results：①Maternal serum 25-hydroxyvitamin D3 concentrations in GDM were significantly lower than that in the control gruop[（49.8±22.0） nmol/L vs. （63.1±22.4） nmol/L， P＜0.01].② The Youden index was the highest（22.73） when the concentrations of 25-hydroxyvitamin D3 was 45.201 0 nmol/L（P35）， OR=0.375（95% CI： 0.176-0.797）. ③ Among GDM cases， 25-hydroxyvitamin D3 difficiency were significantly correlated with hyperglycemia at 1-hour OGTT [（42.56±17.04） nmol/L vs. （55.32±23.93） nmol/L， P＜0.05]. Conclusions： The study suggest that maternal 25-hydroxyvitamin D3 deficiency at 13-16 gestational weeks is significantly associated with an elevated risk for GDM. 25-hydroxyvitamin D3 difficiency is obviously correlated with hyperglycemia at 1-hour OGTT. Related Articles | Metrics