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15 June 2013, Volume 40 Issue 3
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The Role and Regulation of the Apoptotic Cascade during Pregnancy LUO Jin-hua;Qi Rong-yi;TIAN Ya-ping 2013, 40 (3):  198-202.  Abstract ( 1451 )   PDF (437KB) ( 4994 )   Apoptosis is a cascade of events played an important role during pregnancy，it plays crucial roles in cytotrophoblast differentiation into syncytiotrophoblast. Trophoblast invasion ensures the anchoring of the placenta within the uterine wall and the access of the fetus to the maternal vascular system to assure the supply of oxygen and nutrients. Apoptosis of EVT limits uterine invasion. Peptides from apoptotic EVT cells serve as inducers to establish a local tolerance during the 2nd trimester. The apoptotic cascade monitoried by the mother's immune system. The immune status of pregnant women is not significantly reduced in comparison with that of non-pregnant women. Maternal immune system is able to recognize and react against the foreign antigens of the "fetal transplant". A specific tolerance induction mechanism interconnects EVT limitation and tolerance at the feto-maternal interface. Cytokines are secreted predominantly by T-cells and NK cells，and Leukocytes exert their action through cytokines which resemble paracrine immune response modulators. Apoptotic process regulated by genes，hormones，and oxidative stress，etc. Related Articles | Metrics

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The Advanced Study of SOCS3 and Pregnancy ZHOU Xin;SUN Li-zhou 2013, 40 (3):  203-206.  Abstract ( 1198 )   PDF (467KB) ( 4989 )   SOCS3 is the suppressor of Cytokine Signaling 3；has been characterized as a regulator in the cytokine signaling pathway，which has a role in a variety of cells and cytokines. And it is the crucial effector in inflammation and apoptosis. During pregnancy there are lots of cytokines in the maternal-fetal unit of microenvironment. Cytokines involve in embryo implantation and the formation of placenta，fetal growth，childbirth，and so on，are controlled exactly by various factors，that contain a stable state conductive to the normal pregnancy. SOCS3 as a cytokine signal transduction regulator involve in the process of pregnancy and childbirth. Abnormal expression of SOCS3 is related to the occurrence and development of miscarriages，premature delivery，gestational hypertension，gestational diabetes，and other pregnancy sickness. An in-depth study of SOCS3′s role in diseases of pregnancy has provided a theoretical basis for the pregnancy-associated disease diagnosis and treatment. Related Articles | Metrics

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Application of Proteomic Technologies for Prenatal Screening and Diagnosis WANG Cheng-dong;WANG Rui-li;MA Hua-gang 2013, 40 (3):  207-210.  Abstract ( 1333 )   PDF (443KB) ( 4931 )   Current screening for fetal aneuploidies relies mainly on biochemical markers from maternal blood to reduce the frequence of abnormal fetal，and the accuracy and false positive rate needs to be improved to reduce the number of pregnant women subjected to invasive diagnostic procedures，such as amniocentesis. Advances in technologies associated with mass spectrometry-based proteomic techniques have added a new research platform to the field of biomarker research. Comparisons of proteomes of normal fluids with those from aneuploidy pregnancies will allow for the identification of either one protein marker or a panel of candidate markers for prenatal screening of fetal aneuploidies that could be usefully employed for diagnostic purposes or improvement of the current screening methods. Proteomics-based indentification of biomarkers for fetal abnormalities in maternal plasma or amniotic fluid has made significant progress in the last several years. Many researches have demonstrated that discovery of additional markers via quantitative proteomic comparisons could drastically improve current conventional screening. However，for maximum diagnostic ability in clinical utility，biomarkers should be selected for further comparative analysis of expression modifications in large numbers of samples from chromosomally normal and abnormal pregnancies. Related Articles | Metrics

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Research Progress of Preeclampsia and Advanced Glycation End Products JIANG Ling-ling;YAN Jian-ying 2013, 40 (3):  211-214.  Abstract ( 1315 )   PDF (535KB) ( 4965 )   Advanced glycation end products（AGEs） are formed by non-enzymatic reactions between carbonyl groups of reducing sugars and free amino groups of macromolecules such as proteins， lipoproteins and nucleic acids. AGEs can directly lead to cell damage， but also can play a biological effect by binding to the receptor. Studies have shown that AGEs had a closely relationship with mitochondrial oxidative stress damage and lipid metabolism disorders. Pre-eclampsia， a hypertensive disorder which occurs only during pregnancy， is a major cause of maternal-fetal morbidity and mortality. However， the mechanisms responsible for the pathogenesis of pre-eclampsia are not completely understood. It is generally agreed that mitochondrial oxidative stress damage and lipid metabolism disorders are involved in the pathogenesis of preeclampsia. This article reviews the role of AGEs in preeclampsia. Related Articles | Metrics

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Progress of Epigenetics on Preeclampsia TANG Yao;GU Wei-rong 2013, 40 (3):  215-218.  Abstract ( 1357 )   PDF (543KB) ( 4940 )   Preeclampsia is a severe obstetrical complication，accompanying by maternal irreversible multiple system damage and fetal intra-uterine growth restriction. Once diagnosed with preeclampsia，the only cure was to terminate pregnancy and deliver the placenta. Although there are many hypotheses in the mechanisms of preeclampsia，the etiology of preeclampsia is still unclear. Different from genetics，epigenetics is to elucidate inheritable changes of organism without change of genomes sequence. The role of epigenetic factors in the etiology of PE is poorly characterized. Certainly，the main analyzed epigenetics factors in preeclampsia are DNA-methylations，miRNA and gene imprinting. Related Articles | Metrics

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Lipid Level and Its Impact on Syncytiotrophoblast Microparticles Inducing Preeclampsia LI Liu-ye;HUANG Ya-juan 2013, 40 (3):  219-221.  Abstract ( 1181 )   PDF (477KB) ( 4908 )   Microparticles are cell fragments that derived from cell activation and/or apoptosis. Cycling microparticles can serve as vehicles carrying and transporting varieties of proteins and frangements of DNA or RNA. Microparticles can promote thrombus formation， mediate pro-inflammatory effects and may cause endothelial dysfunction directly. Most kinds of cells in human can produce microparticles. Studies have found a much higher formation of syncytiotrophoblast microparticles in preeclampsia women than normal pregnancies. Studies in vitro also found that the lipid levels in microparticles can impact their abilities of inhibiting proliferation and promoting apotosis in human umbilical vein endothelial cell. The higher lipid levels， the stronger abilities to inhibit proliferation and promote apoptosis. In another study， volunteers intaking high fat diet have higher level of total circulation microparticles than normal diet. Related Articles | Metrics

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The Significance of Clinical Studies of sFlt-1 and PLGF in Preeclampsia YANG Zhi-yu;CHEN Li-fen 2013, 40 (3):  222-225.  Abstract ( 1317 )   PDF (543KB) ( 4957 )   This summary aims to generalize the pathological process of the preeclampsia and its relationship with sFlt-1 and placental growth factor（PLGF）. PLGF is a member of the VEGF family，PLGF binds with Flt-1 receptor，and promotes angiogenesis and trophoblast proliferation. These biological functions can be blocked by sFlt-1 receptor，sFlt-1 plays an important role in regulation PLGF. sFlt-1 concentrations are higher in preeclampsia serum and prior to the onset of the disease. Levels of PLGF are lower in preeclampsia serum compare to normal. This summarizes up the roles sFlt-1 and PLGF have played in the prediction of the diagnosis of preeclampsia as well as its seriousness， exploring the significance of the application of sFlt-1 and PLGF in the clinical diagnosis of preeclampsia. Related Articles | Metrics

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Progress in the Prediction and Tocolysis Treatment in Preterm Delivery ZU Xiao-xia;WANG Dong-mei 2013, 40 (3):  226-229.  Abstract ( 1300 )   PDF (588KB) ( 5049 )   Premature birth is considered the main cause of neonatal morbidity and mortality，remains a complex medial and social problem. Obstetric scholars have done a lot of researches on many aspects to predict and prevent preterm birth. Current surveys and collected evidences find predicted factors including fetal fibronectin（fFN），insulin-like growth factor binding protein-1（IGFBP-1），serum relaxin（SRLX） and multiple proteins in maternal serum，amniotic fluid and cervical secretions to predict preterm labour. The usage of tocolysis decreases the odds of delivery within 48 hours，but has not consistently been shown to improve neonatal and perinatal outcomes. A delay of delivery for 48 hours allows for corticosteroid administration or maternal transfer. Adrenergic beta-agonists，calcium channel blockers，magnesium sulfate，oxytocin antagonists，progesterone and cyclooxygenase inhibitors may provide alternative choices for the treatment of preterm. The author reviewed the progress in prediction and therapeutics of preterm to assess the predicted factors and available tocolytic agents in clinical applications. Related Articles | Metrics

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miRNAs and Cognitive Impairment ZHANG Min;WU Jie 2013, 40 (3):  230-233.  Abstract ( 1234 )   PDF (554KB) ( 4931 )   miRNAs are small noncoding regulatory RNAs of 22 nucleotides in length that always become and pay close attention to the focus in the field of medicine and molecular biology. miRNAs play a role at posttranscriptional level by inhibiting sequence-specific translation or degrading mRNA via binding to target genes during the hyperplasia，differentiation and death of cell as well as hormone secretion. Recently，a link between miRNAs and development of the central nervous system，such as the differentiation of neural stem cells，synaptic connections，dendritic spinesor or neuroprotective effects，is becoming increasingly clear. Therefore，the central aim of this review is to highlight recent findings in the field of miRNAs inhippocampus，and a potential interaction between microRNAs and neurodegenerative diseases including cognitive impairment and Alzheimer′s disease，that provides newideas for future prevention and treatment of diseases. Related Articles | Metrics

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Anti-angiogenic Research Progress of Endometriosis JI Hui;MAO Yun-dong 2013, 40 (3):  234-236.  Abstract ( 1274 )   PDF (558KB) ( 4992 )   Angiogenesis plays an important role in the pathogenesis of endometriosis. Based on this observation，many substances capable of inhibiting blood vessel formation have been tested to treat the disease during the last decade. These include growth factor inhibitors，endogenous angiogenesis inhibitors，statins，cyclo-oxygenase-2 inhibitors，immunomodulators，dopamine agonists and peroxisome proliferator-activated receptor agonists. This review will summarize recent anti-angiogenic researches of endometriosis and discuss the potential role of anti-angiogenic substances in the treatment of endometriosis. Related Articles | Metrics

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Research Progress of MAP Kinase Signal Pathway and Endometriosis ZHANG Hua;ZHU Ying-jun 2013, 40 (3):  237-240.  Abstract ( 1249 )   PDF (919KB) ( 4934 )   Endometriosis（EMs） is an estrogen-dependent disease characterized by extrauterine implantation and ectopic growth of endometrium and it’s a common disease of women of reproductive age. The invasive implantation of ectopic endometrium is a complicated procedure，which involves in multiple factors and a few signaling pathways and mitogen activated protein kinase signaling pathway plays the important role. The signaling regulation between MAPK pathway and ERs is intimate. The interaction between MAPK and ER plays important roles in stimulating the proliferation of endometriotic cell，the production of inflammatory factors and the neovascularization.On this basis，this article reviewes the relationship between MAPK signal pathway and the pathogenesis of endometriosis to better understand the mechanism of endometriosis with new ideas. Related Articles | Metrics

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Research Progress in Toluidine Blue Staining in the Diagnosis of Endometrial Pathologies CUI Shu-min;KONG Xian-chao 2013, 40 (3):  241-243.  Abstract ( 1522 )   PDF (588KB) ( 5103 )   Toluidine blue（TB）is a vital dye used for nucleic acid staining. We can use the staining for detection of the early malignant or premalignant endometrium lesions. Since the 1980s，TB staining has been used in the investigation of oral，vulvar，and upper gastrointestinal tract malignancies. With the development of science and technology，advantages of TB staining in endometrial pathological diagnosis has gradually aroused great attention from domestic and foreign experts，however，due to the limit of techniques，equipment and many other factors，the research of the TB staining in endometrial cancer and endometrial precancer is still at its initial stage.Based on the above，this paper reviews the research progress of toluidine blue staining in the diagnosis of endometrial carcinoma and precancerous lesions. Related Articles | Metrics

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Relationship between Enzyme of Histone Modifications and Endometrial Cancer LI Qing;FENG Wei-wei 2013, 40 (3):  244-246.  Abstract ( 1199 )   PDF (608KB) ( 4928 )   Epigenetic change consists of DNA methylation，histone modification，Micro RNA，genome imprinting. Histone is the key component of nucleosome，displaying a significant role in epigenetics. Nowadays，the role of histone modification on the carcinogenesis and cancer development becomes a research hot spot. However，the relationship between histone modification and endometrial cancer has not been thoroughly studied. Relevant articles of the past five years were summarized in this article，focusing on histone acetylation，histone methylation，and the relationship between histone modification and DNA methylation in endometrial cancer. Related Articles | Metrics

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Development in the Treatment of Early Stage Endometrial Carcinoma by Saving the Function of Reproductive Endocinology WANG Chun-yan;HU Yuan-jing 2013, 40 (3):  247-250.  Abstract ( 1328 )   PDF (626KB) ( 4996 )   Endometrial carcinoma（EC） is one of three most common malignant female genital carcinomas. The incidence of EC has been increased recently. Although it occurs mainly in the postmenopausal women，there are still 25% patients are pre-menopausal and 3%-14% patients are below 40 years old. It is hard for the younger nulliparous patients to accept the fact that they may lose their ability to give birth and the endocrine function of the ovaries. Thus，to preserve the fertility and endocrine function of the ovaries for the younger EC patients will be the attention problem. Recent years，present study indicates that primary treatment with megestrol acetate may be an effective and relatively safe choice of treatment of women with well-differentiated endometrial adenocarcinoma who wish to preserve the function of reproductive endocrinology. This article reviewed current literature of fertility and ovary function preservation treatment for those young patients with EC. Related Articles | Metrics

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HE4 as A Biomarker for Gynecology Oncology YU Ye;LIN Zhong-qiu 2013, 40 (3):  251-254.  Abstract ( 1494 )   PDF (608KB) ( 5047 )   Human sapiens epididymis specific protein 4（HE4） is a recently discovered tumor marker. It shows promising prospective in early and differential diagnosis of ovarian cancer. HE4 compared to CA125，potentially is a better marker for prognosis of OC and could be an important indicator of the recurrence of the disease. There are aslo some researches about the value of HE4 in endometrium carcinoma. HE4 as a new tumor biomarker has greater potential than CA125 in the diagnosis， differential diagnosis and prognosis of OC and endometrium carcinoma. HE4 could be in value for diagnosis of begin diseases such as uterus myoma or endometriosis. Related Articles | Metrics

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Research Progress of Correlation between Forkhead Transcription 3 and Malignant Gynecology Tumor MA Ning-ye;ZHANG Shu-lan 2013, 40 (3):  255-257.  Abstract ( 1411 )   PDF (664KB) ( 4980 )   FOXP3 is a member of winged helix transcription family，specific expressed in CD4+CD25+Treg（regulatory T cell），which decide the development and function of Treg. The expression of Treg can prevent the immune surveillance of cancer，inhibits the effective immune reaction of tumor antigen，which makes FOXP3 become the study hotpot of tumor immune. In ovarian cancer， research says the high expression of FOXP3 is an independent prognostic factor of survival rate；In breast cancer，FOXP3 is a significant mark of tumor progression and metastasis，and it is the transcription inhibitor of breast cancer gene SKP2;While in cervical cancer，no matter in blood，cervical mucosa and cervical biopsy，it can all be tested highly expressed. Related Articles | Metrics

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Research on Molecular Marker to Predict the Neoadjuvant Chemotherapy Efficacy in Advanced Cervical Cancer SU Liang-di;HUANG Jin 2013, 40 (3):  258-261.  Abstract ( 1233 )   PDF (639KB) ( 4985 )   Neoadjuvant chemotherapy（NACT） as one way of the comprehensive therapy mainly used in the case for stageⅠB2 toⅡA disease. Many researchers believed neoadjuvant chemotherapy before surgical can shrink the tumor volume，improve the operability and resection rate. At the same time， it lows the postoperative complications. And the effectiveness is more than 80% including 9%-18% proved completely relived by pathology.However，NACT may delay the patients treatment who can not respond to it and lead to suffering and waste. In recent years，foreign and domestic investigators are trying to find out some molecular markers and hope to predict the efficacy by certain molecular marker and find out the non-responder as early as possible. It can improve the prognosis and survival rate. This paper will summarize the research on prediction efficacy molecular marker in advanced cervical cancer. Related Articles | Metrics

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New Advances of the Treatment of Uterine Sarcoma LI Gui-lan;QU Peng-peng 2013, 40 (3):  262-265.  Abstract ( 1597 )   PDF (626KB) ( 4957 )   Uterine 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. Surgery as the main treatment，emphasizes the standardization and individuation. Postoperative radiation treatment does not improve both disease-free survival rate and overall survival rate of uterine leiomyosarcomas patients. Adjuvant chemotherapy can improve overall survival rate of carcinosarcomas patients，therefore it is considered as the standard of therapeutic regimen. Trabectedin has demonstrated effective and reasonably safe for patients with advanced uterine leiomyosarcomas. The medical target therapy of uterine sarcoma is still at the exploratory stage. Related Articles | Metrics

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Laparoscopic Uterine Artery Occlusion for Treatment of Symptomatic Uterine Fibroids YANG Wei-hong;CHENG Zhong-ping 2013, 40 (3):  266-270.  Abstract ( 1321 )   PDF (693KB) ( 4897 )   In recent years，with the development of gynecologic laparoscopy technology， uterine artery occlusion by laparotomy（UAOL） was performed as a primary treatment for symptomatic uterine fibroids. According to the documents reported，UAOL for treatment of uterine fibroids showed favorable clinic outcomes，including of relieving menometrorrhagia，decrease of uterine volume and decline of recurrence rate of fibroids. However，the therapeutic mechanism of UAOL remains unclear. It was thought that the mechanism of UAOL was mostly related to uterine blood supply and uterine intramural arterial paths and the difference in coagulation-fibrinolysis system between uterine myometrium and fibroids. So，the study reviewed and generalized many documents about clinic effects and therapeutic mechanism of UAOL. Related Articles | Metrics

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The Value of Insulin-Like Growth Factor Bingding Protein-1 and Cervical Index in the Prediction of the Diagnosis-Delivery Interval for Premature Delivery WANG Huan-hua;WANG Chen-hong 2013, 40 (3):  271-273.  Abstract ( 1345 )   PDF (666KB) ( 4947 )   Objective：To assess the efficacy of cervical phosphorylated insulin-like growth factor binding protein-1（phIGFBP-1） in combination with cervical index measurement for the prediction of the diagnosis-delivery interval（DDI） for preterm delivery. Methods：A total of 188 threatened premature delivery women complaining with uterine contractions were recruited in this study，who received cervical swabs for phIGFBP-1 detection and transperineal ultrasound scan to assess cervical index. According to these results，all the patients are divided into three groups：double-positive group，one-positive group， double-negative group，they were followed until delivery. An analysis of the DDI between groups was carried out. Results：The DDI of double-positive group was shorter than that of double-negative group and one-positive group（P＜0.05）. When combining the two methods in forecasting DDI within one week，the values of the sensitivity，specificity，the positive predictive value and the negative predictive value were 100.0%（33/33），30.3%（47/155），65.0%（26/40），100.0%（47/47） respectively. In double-positive group，all the patients deliveried within one week and 85.7% of them deliveried within 48 hours when their cervical index were more than 0.8. The negative predictive value of double-negative group for delivery within two weeks was 100%（47/47）. Conclusions：The combination of cervical phIGFBP-1 and cervical index measurement may serve as an objective indication for the prediction of the DDI for premature delivery，and as a guide for clinical treatment. Related Articles | Metrics

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Chorioamniotic Membrane Separation after Invasive Intrauterine Intervene LI Man-chao;FANG Qun;ZHOU Yi;HE Zhi-ming;LUO Yan-min;GAO Yu 2013, 40 (3):  274-276.  Abstract ( 1562 )   PDF (849KB) ( 4955 )   Objective：To investigate the clinical characteristics of the chorioamniotic membrane separation （CMS） after invasive intrauterine treatment. Methods：Retrospective review of a maternal population undergoing intra uterine therapy at a single center following the postoperative ultrasound to follow-up for membrane separation. The intrauterine procedures consisted of cord coagulation reduction，amnioreduction，intrauterine transfusion in Center of Fetal，the First Affiliated Hospital of Sun Yat-sen University from 2001 July to 2010 June. Results：From 2001 to 2010，we found 9 cases of CMS in 269 cases after invasive procedure. 4 cases（4/213，1.88%） had amnioreduction，1 case（1/28，3.6%） had intrauterine transfusion and 4 cases（4/28，14.3%）had cord coagulation reduction. Conclusions：There was a higher risk of CMS after fetoscopic cord coagulation reduction. Related Articles | Metrics

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Related Factors of Secondary Tubal Infertilities after Induced Abortion ZHANG Wen-ke;HOU Hai-yan;CHEN Xiao;HU Chun-xiu;CHEN Ya-qiong 2013, 40 (3):  277-279.  Abstract ( 1253 )   PDF (799KB) ( 5034 )   Objective：To investigate the related factors of secondary tubal infertilities after induced abortion. Methods：The case group included 170 tubal infertility patients treated with induced abortions and hysteroscope combined with laparoscope operation from December 2008 to October 2010，and 171 primary infertility patients as control group. The investigators carried out questionnaire survey，including the general conditions，menstrual history，reproductive history，and so on. All the above data were inputted to Access System，proof reading and finished. Results：The proportion of primary sexual life younger than 21 years old and more than 2 sexual partners in the case group are higher than the control group（P＜0.05）；the pelvic inflammation incidence of the case group was more than the control group（χ2=5.62，P=0.02；OR=1.95，95%CI：1.12-3.40）； The patients treated with more than twice induced abortion had higher incidence of thinner endometrium than control group（χ2=4.86，P=0.03；OR=2.37，95%CI：1.06-5.31）. There was no significant difference between the tubal infertility treated with induced abortion and primary infertility at fallopian tube obstruction，hydrosalpinx，tubal infertilities，mesosalpinx cyst and pelvic adhesion by the laparoscope. Conclusions：There is no direct relation between induced abortion and tubal infertility，but induced abortion could cause pelvic inflammation and thinner endometrium，and the sexual history had close relation with induced abortion. Related Articles | Metrics

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The Value of Diagnosis of Serum Squamous Cell Carcinoma Antigen in Uterine Cervical Cancer and CIN Ⅲ WANG Cheng-jin;ZHANG Yue-xiang;LI Qiu-li 2013, 40 (3):  280-282.  Abstract ( 1436 )   PDF (685KB) ( 4987 )   Objective：To investigate the serum squamous cell carcinoma antigen（SCCAg） in the diagnosis of cervical carcinoma，efficacy was assessed in terms of value，and its relationship with clinical stage and histological differentiation. Methods：We selected from 2011 September to 2012 March in Tianjin Central Hospital of Gynecology Obstetrics，145 patients，all suspicious cervical cancer patients，diagnosed by histopathology and divided into group CIN（55 cases） and malignant group （90 cases）. Using a chemiluminescence method for the detection of preoperative serum SCCAg concentration，combined with clinical data and histopathological diagnosis， using statistical analysis to evaluate the value of SCCAg in diagnosis of cervical cancer， and the clinical staging， histological differentiation degree of correlation， the preoperative and postoperative evaluation value of SCCAg detection in the evaluation of curative effect. Results：The serum SCCAg concentration between cervical intraepithelial neoplasia and cervical cancer having significant differences，is a good marker of squamous cell carcinoma of the cervix；after treatment，SCCAg levels decreased significantly after treatment，the difference was statistically significant（P=0.000）；according to FIGO stage，group discussion，with the progression of the disease， clinical staging of exacerbations， SCCAg higher， positive rate increased， the two have positive correlation；in suspicious cervical cancer， detection sensitivity of SCCAg is 71.1%，specificity is 72.7%，accuracy is 71.7%，and negative predictive value is 60.6%，positive predictive value is 81.0%；CIN Ⅲ positive rate was 27.3%，in stage I patients testing positive for squamous cell carcinoma of the cervix rate is 66.7%. Conclusions：Squamous cell carcinoma antigen in squamous cell carcinoma of the cervix has diagnostic value on curative effect monitoring and prognosis，also has important clinical significance in early diagnosis，but still have limitations，relation with cervical pathological types，clinical stage，and is unconcerned with tissue differentiation degree. Related Articles | Metrics