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15 April 2013, Volume 40 Issue 2
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Progress of the Influence Factors of Angiogenesis in Ovary Transplantation WANG Lin;YING Ying-fen;XU Jian 2013, 40 (2):  108-111.  Abstract ( 1180 )   PDF (272KB) ( 5041 )   Advances in the diagnosis and treatment has gradually increased the long-term survival rates of female cancer patients. Unfortunately，operation and chemo/radiotherapy can result in ovarian failure. Besides，part of the female patients is not suitable for ovulation in vivo. Therefore ovarian transplantation is being a promising research. The major objective of ovarian transplantation is to preserve fertility by minimizing loss of primordial follicles and oocytes and optimizing follicular development. Transplanted fragments of the ovaries are prone to ischemic damage during the early period after transplantation. Thus， reducing the duration of ischemia and accelerating graft revascularization is the urgent challenge. The angiogenesis of the ovarian tissue is influenced by the size of graft，the site of transplantation，freeze-stored or not，the usage of gonadotropin，VEGF， surgical wounds and so on. This review will have a comprehensive introduction into the influence factors of angiogenesis which provide the reference for improving the survival rate of graft and follicles development. Related Articles | Metrics

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Residual Ovarian Syndrome TIAN Ying;LANG Yu-ping 2013, 40 (2):  112-115.  Abstract ( 1319 )   PDF (324KB) ( 5106 )   Following hysterectomy for benign diseases with one or two ovaries preservation，a few patients develop residual ovarian syndrome（ROS） with the incidence of pelvic mass，pelvic pain，and dyspareunia. ROS is caused by pelvic adhesions after hysterectomy，ovarian dysfunction，and changes in the position of the ovary. The common pathological findings are involved with adnexitis，corpus luteum hematoma，follicular cysts，bleeding ovarian cysts，endometriosis，benign neoplasm and ovarian carcinoma. However，there is no indication of hysterectomy increasing the risk of residual ovarian cancer. Sugery types of hysterectomy have influence on the incidence of ROS. Suppression of ovulation by using drugs and surgery to remove residual ovaries are two general treatments for ROS. Advanced operation method for hysterectomy can help in prevention of ROS. Related Articles | Metrics

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Dehydroepiandrosterone Supplementation in Diminished Ovarian Reserve LIU Xiao-gu;ZHOU Hui-fang 2013, 40 (2):  116-119.  Abstract ( 1254 )   PDF (267KB) ( 5116 )   As a result of temporary social trends，many women select to postpone their first pregnancy to a later stage in life. A large part of this population will be infertile by the time they decide to conceive，mainly because of a decreasing ovarian reserve（DOR）and low oocyte quality resulting from age. Dehydroepiandrosterone （DHEA）is now utilized in approximately one third of all IVF centers world wide，which provide a new idea for the treatment of patients with poor ovarian function.It has been reported to improve oocytes yields and pregnancy rate with DOR. However，these studies have not been widely recognized due to the drawbacks of the research methods and the small sample size. Increasing DHEA utilization and publication of a first prospectively randomized trial now warrants a systematic review. Related Articles | Metrics

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Hyperglycosylated Human Chorionic Gonadotropin in Obstetric and Gynecological Application CHENG Yu;LU Xin 2013, 40 (2):  120-122.  Abstract ( 1241 )   PDF (223KB) ( 5102 )   Hyperglycosylated hCG is a subtype of hCG produced by trophoblast cells in early pregnancy and tumor cells. Hyperglycosylated hCG promotes trophoblast invasion in choriocarcinoma，growth of cytotrophoblast cells and placental implantation in pregnancy. Hyperglycosylated hCG is a reliable bio-marker of gestational trophoblastic diseases and a valuable marker for Down syndrome screen，hypertensive disorder prediction in pregnancy and gestational trophoblastic tumor management. Related Articles | Metrics

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The Research of Anti-Müllerian Hormone in Women′s Reproductive System CHEN Xiu-ying;LI Bin 2013, 40 (2):  123-125.  Abstract ( 1159 )   PDF (228KB) ( 5482 )   Anti-Müllerian hormone （AMH） belongs to the transforming growth factor-β（TGF-β） superfamily，and it plays an important role in male sex differentiation. In women，it is only produced by the granulosa cells（GC） and exerted through specific receptors which are present on the target-organs. AMH level in serum can accurately reflect the size of ovarian follicle pool， so it may be an idea marker of ovarian reserve，and may also be a valuable tool in assisted reproduction technology. More and more investigations show that the elevation of AMH level in serum may be a candidate marker for the diagnosis of granulosa cell tumors and monitor the clinical recurrence of tumor. Moreover，AMH inhibits cell proliferation，invasion and migration of epithelial ovarian cancer cell lines，and it can probably be used as a new drug for chemotherapy in the future. Related Articles | Metrics

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Thrombospondin and the Correlation of Preeclampsia WU Hui-fen;WANG Chen-hong 2013, 40 (2):  126-128.  Abstract ( 1215 )   PDF (218KB) ( 5087 )   Recently research indicate that an imbalance of maternal circulating pro-and anti-angiogenic factors may play a role in the pathogenesis of preeclampsia. Thrombospondin（TSP） is a protein expressed in various cells such as platelet， endothelial cells，matrix fiber cells，vascular smooth muscle cells，interstitial cells and immunocyte，which acts as a potent antiangiogenic agent. TSP affects several cellular functions，including proliferation，motility，adhesion，apoptosis and infiltrate make the endometrial spiral arterioles vessel tone stricture and rejection，induce placenta blood flow reduce，then induce preeclampsia. Related Articles | Metrics

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The Historical Innovation of Surgical Treatment of Early-stage Cervical Cancer and Its Recent Achievements SUN Yun;NI Guan-tai 2013, 40 (2):  134-137.  Abstract ( 1498 )   PDF (247KB) ( 5205 )   Cervical cancer is one of the most commom diseases in gynecologic oncology. The treatment of clinical cervical cancer include surgical approaches，radiotherapy and chemotherapy. But the surgical approaches is main treatment for early-stage cervical cancer. The traditional method of treatment is radical hysterectomy. In recent years，with the cervical cancer incidence tends to be younger and the appearance of laparoscopy and robotics ，the surgery has been also changing，especially the minially invasive surgery has been paid more and more attention. The surgical treatment of cervical cancer is gradually moving towards individualized，humane and minially invasive. This paper reviews as the follow. Related Articles | Metrics

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Human Papillomavirus in Cervical Diseases：An Update JI Wen-ting;DI Wen 2013, 40 (2):  138-141.  Abstract ( 1861 )   PDF (237KB) ( 6112 )   Cervical cancer is one of the most common gynecologic malignant tumors. There are a number of studies have confirmed that human papillomavirus（HPV） infection is a necessary condition for cervical cancer，proteins which encoded by HPV leaded to inhibition of tumor cell apoptosis and tumor immune escaping. But the development of cervical cancer is also effected by the individual，family，geography and other factors. A lot of studies have pointed out that due to the self-healing capacity of the HPV self-limiting，cervical lesions are a long-term，reversible pathological changes in the process. Only high-risk subtypes of HPV persistent infection，will eventually lead to the occurrence of cervical lesions. This paper will introduce the literature of different HPV subtypes and cervical lesions. We obtained that persistent infection of high-risk HPV subtypes will increase the risk of cervical cancer and the HPV exam should be widely used in cervical cancer early screening. Following up HPV in cervical cancer or precancerous lesions of patients who received treatment is conducive to risk assessment and prognosis. Related Articles | Metrics

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Roles of Slit/Robo Pathway in Gynecological Tumorigenesis YUAN Lei;LIU Xi-shi 2013, 40 (2):  142-145.  Abstract ( 1443 )   PDF (305KB) ( 5160 )   As important axon guidance molecules，the Slit family of secreted proteins acts through the Roundabout （Robo） receptors to direct axonal growth and repel axonal migration during central nervous system development. Recent research has revealed that the Slit/Robo pathway might play roles in some pivotal processes in tumorigenesis，such as cell migration and tumor angiogenesis. However，the role of Slit/Robo in gynecological tumorigenesis remains largely unknown. This review will examine the roles of this pathway in the physiology and pathology of the reproductive system and highlight areas for future research. Related Articles | Metrics

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The Research Progress of Relationship between YKL-40 and Gynecological Diseases YIN Xu-ai;GAN Ning 2013, 40 (2):  146-148.  Abstract ( 1385 )   PDF (209KB) ( 5220 )   YKL-40 is one of mammalian chitnase members and secreted by macrophage， neutrocyte， chondrocyte， endotheliocyte，vascular smooth muscle cell and some entity tumor cells. Immunohistochemical assay has found that YKL-40 is expressed in many human tissues with a varying degree. In healthy young group，the expression of serum YKL-40 is in low level and has no deference between male and female. Studies suggest that there are a high expression of YKL-40 protein in the peritoneum of peritoneal endometriosis，eutopic and ectopic endometrium of adenomyosis，ovarian cancer tissues and endometrial cancer tissues. Serum YKL-40 is elevated in ovarian cancer，endometrial cancer and cervical cancer and is related with shortened survival，elevated serum YKL-40 level before treatment indicates a poor prognosis. Related Articles | Metrics

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Development of Relativity between M2-Tumor Associated Macrophage and Ovarian Cancer ZHANG Hong-xiu;CHEN Yan;JIN Ping 2013, 40 (2):  152-155.  Abstract ( 1273 )   PDF (201KB) ( 5117 )   Tumor-related inflammation including lymphocyte infiltration into tumor tissue. Tumor-associated macrophages（TAM） are important regulator of cells，mainly involved in tumor-associated inflammatory. While M2-tumor associated macrophage is the main subtype macrophages which expression in the tumor microenvironment，promote and coordinate neoplastic growth. M2-type TAM inhibite the anti-tumor activity of T cells and promote angiogenesis by over expressing CCL-18，VEGF，and MMP-9. M2-type TAM infiltration in tumor tissue might be an important indicator of tumor development，metastasis and prognosis，and providing a new approach to treatment of ovarian cancer. Polarization-type tumor-associated macrophages play an important role in the development of ovarian cancer and provide a new direction in early diagnosis and treatment of ovarian cancer . Related Articles | Metrics

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The Progress of Diagnosis and Treatment for Granulosa Cell Tumors XI Teng-teng;FENG Lan-lan;LIU Xue-ying;ZHANG Jian-ping 2013, 40 (2):  156-159.  Abstract ( 1224 )   PDF (343KB) ( 5443 )   Granulosa cell tumours （GCTs） are relatively rare sex cord stromal tumours of the ovary. Most of them are hormone-producing，and can be initially diagnosed in early stage. Molecular biology markers are useful in diagnosis and follow-up. Surgery is an important treatment，while chemotherapy，radiotherapy，hormone therapy and molecular-targeted therapy also play important roles. With appropriate treatment，a better survival rate can be achieved against other ovarian malignancies. Related Articles | Metrics

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Progress of Diagnosis and Treatment of Primary Pelvic Retroperitoneal Tumor XIN Xing;XIA Zhi-jun;SONG Yu 2013, 40 (2):  160-163.  Abstract ( 1270 )   PDF (306KB) ( 5115 )   PPRT is rare and can be challenging to diagnose and treat. Because the presacral space contains multiple embryologic remnants derived from various tissues，the tumors that develop in this space are heterogeneous. Most lesions are benign，characterized by a poor and non-specific symptomatology and by a late diagnosis. The imaging investigations used in diagnosing PPRT mainly including ultrasound，computed tomography，magnetic resonance imaging. The main treatment is surgical resection，consisting in either total or partial excision of the tumor. Major determinate factors of PPRT prognosis include differentiation of tumor and either in total or partial excision of the tumor. Related Articles | Metrics

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Analysis of the Effect of Pelvic Floor Muscle Training in Postpartum Pelvic Floor Dysfunction YANG Xiao;LIU Yu-ling 2013, 40 (2):  164-166.  Abstract ( 1244 )   PDF (221KB) ( 5141 )   Objective：To analysis of the effect of pelvic muscle training （biofeedback，electrical stimulation，rehabilitation exercise） in early postpartum pelvic floor dysfunction. Methods：236 cases in 42 days after childbirth in the Second Affiliated Hospital of Zhengzhou University in 2010 December to 2011 June in department of gynecology and obstetrics，were randomly divided into treatment group（n=78） or dumbbell group（n=78） or control group（n=80）. The treatment group received biofeedback，electrical stimulation and vaginal rehabilitation exercise，the dumbbell group received rehabilitation exercise，the control group received postpartum health education. Three groups at 3 months postpartum，6 months were finished with pelvic floor muscle testing，epidemiological survey，ICIQ-SF，POP-Q index. Results：The treatment group was better than that of pelvic floor muscle strength recorvery dumbbell，dumbbell set of pelvic floor muscle strength recorvery better than the control group. In 3 months postpartum，pelvic floor muscle fiber treatment group class I，class II muscle fiber fatigue were lower than the control group，and treatment group class I，class II muscle fiber voltage were higher than the control group （P＜0.05）. In 3 months and 6 months postpartum， the incidence rate of SUI in the treatment group and dumbbell group were lower than those of the control group，the differences were statistically significant（P＜0.05）. In 3 months postpartum，the incidence rate of S+P has no statistical significance in three groups（P＞0.05），and in 6 months postpartum， the incidence rate of S+P in the treatment group were lower than that of the dumbbell group and the control group， the differences were statistically significant（P＜0.05）. Conclusions：Postpartum pelvic floor muscle rehabilitation training is an effective method to improve the pelvic floor muscle，which can effectively reduce the incidence of SUI and POP. Related Articles | Metrics

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Choice of Different Treatment of Secondary Infertility and Analysis of Pregnancy Outcome BI Fang-fang;YANG Qing;LI Jing-xi;WANG Rui-cong 2013, 40 (2):  167-168.  Abstract ( 1420 )   PDF (242KB) ( 5143 )   Objective：To investigate the effect of various methods in the treatment of infertility. Methods：Summarize 955 cases of secondary infertility diagnosed in our hospital from 2007 to 2009，and analyze the various treatment methods and pregnancy outcome. Results：① In ovulation disorders patients，65 cases undergo ovulation induction therapy and the pregnancy rate was 47.69%；laparoscopic fenestration of 29 cases and the pregnancy rate was 65.52%；14 cases of in vitro fertilization and embryo transfer（IVF-ET） and the pregnancy rate was 57.14%. ② 95 cases with tubal-line treatment and the pregnancy rate was 33.68%；81 cases of tubal plastic surgery under laparoscope and the pregnancy rate was 60.49% in tubal factor infertility. ③ 94 cases with artificial cycle therapy and the pregnancy rate was 60.63%；168 cases with surgery treatment and the pregnancy rate was 61.31%；67 cases of IVF-ET and the pregnancy rate was 26.87% in uterine factor infertility. ④ 23 cases of IVF-ET in unexplained secondary infertility and the pregnancy rate was 21.74%. Total of pregnancy rate was 37.35% in IVF-ET therapy. Conclusions：The right treatment may improve the pregnancy rate for different causes of infertility. Related Articles | Metrics

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Analysis of Labor Mode in Primipares with Fetal Macrosomia ZHU Jin-song;BI Xue-han;ZHAO Qin-li 2013, 40 (2):  169-170.  Abstract ( 1277 )   PDF (224KB) ( 4996 )   Objective：To observe the birth process characteristics of primiparas via vaginal delivery macrosomia and the influence on maternal and infant，so as to make reasonable arrangements to the delivery mode of macrosomia，ensure the safety of maternal and infant. Methods：From January 2008 to December 2010 in our hospital，the data of 88 cases of fetal macrosonia with trial of labor and 60 normal newborns with trial of labor，60 cases of fetal macrosonia with selective cesarean section were subjected to retrospective analysis. Results：Of 88 deliveries of primiparas，43 cases succeeded in vaginal delivery compared with the normal controls，the study group showed shortened latent phase of labor（P＜0.05），prolonged active phase and second stage of labor（P＜0.05），while the total duration of labor were not significantly different between the two groups（P＞0.05）. 45 cases of failed vaginal delivery primiparas were mainly in the protracted active phase，when cervical dilatation was usually 3- 5 cm. Vaginal delivery failure did not increase the rate of postpartum hemorrhage，puerperal infection，and neonatal asphyxia. Conclusions：If there is no obvious cephalopelvic disproportion，normal delivery could be tried. If there is abnormal stages of labor，such as protracted active phase，it needs to divert cesarean section in time，which can reduce the damage of the macrosomia on maternal and infant. Related Articles | Metrics

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Clinical Diagnosis Analysis of Acute Fatty Liver WANG Jing;LI Zeng-yan 2013, 40 (2):  171-173.  Abstract ( 1233 )   PDF (218KB) ( 5005 )   Objective：To explore the characteristics，approach to patient care，complications and outcome of acute fatty liver of pregnancy in order to increase the survival probability of maternal and infant. Methods: Retrospectively analyze the 14 patients who were diagnosed as AFLP during the last 7 years in our hospital and their diagnosis and treatment and prognosis. Results: 1 patient died of acute fatty liver of pregnancy，8 postpartum hemorrhage and 2 MODS，1 case of neonatal mild choking， 2 cases of severe suffocation，1 case of death in the womb. Conclusions: It is necessary to early diagnosis，termination of pregnancy and the cooperation among the different offices for acute fatty liver of pregnancy. There is high possibility for AFLP patients to occur postpartum hemorrhage and MODS，it should be monitored strictly，adjusted coagulation function and liver and kidney function to avoid postpartum hemorrhage and MODS，and increase the livability of maternal and infant. Related Articles | Metrics

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Comparison on Clinical Application of Vessel Sealing System and Bipolar Electric Coagulation in Gynecological Laparoscopic Surgery PANG Hui;YUE Xiu-ying;YUE Tian-fu 2013, 40 (2):  174-175.  Abstract ( 1241 )   PDF (232KB) ( 5022 )   Objective：To compare the effects and safety of LigaSure vessel sealing system and bipolar electric coagulation in gynecological laparoscopic surgery. Methods：Analyzed retrospectively 180 cases of gynecologic laparoscopic surgery patients（salpingectomy，oophorectomy，hysterectomy）. In 90 cases，LigaSure vessel sealing system was applied to occlude the ovarian and uterine vessels. In another 90 cases，bipolar electric coagulation was used. The operation time，intra-operative blood loss，recovery condition after the operation and post-operative early complications were compared. Results：In both group， recovery condition after the operation and postoperative early complications were similar. There were significant differences between two methods in the postoperative morbidity. Conclusions：LigaSure vessel sealing system is safer than bipolar coagulation in effective vascular closure，reducing the amount of bleeding and shorten the operation time，reduce postoperative morbidity. Related Articles | Metrics

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The Success and Significance of shRNA of ALDH1A1 Gene Transfection to HeLa Cell Lines LIU Long-yang;YAO Ting-ting;YI Juan-juan;CHEN Qing;ZHANG Bing-zhong;ZHOU Hui;PENG Yong-pai;LIN Zhong-qiu 2013, 40 (2):  176-178.  Abstract ( 1566 )   PDF (3990KB) ( 5148 )   Objective：To construct the interfering effects of ALDH1A1 expression in HeLa cells with shRNA transfection，and next to explore the relationship between ALDH1A1 and the biological characteristics of HeLa cells. Methods：HeLa cells line were cultured in vitro. To determine the best screening concentration with different concentration of G418 solution. ALDH1A1 interfering of shRNA（including ALDH1A1-1719，ALDH1A1-574，ALDH1A1-740，ALDH1A1-921，and one of them has the best effective） and negative control recombinant plasmids（shNC） were transfected into human cervical HeLa cells line using Lipofectamine 2000 reagent. All of the ratio of shRNA to Lipo were 0.2 μg:1 μL，and the blank control group was only plused with Lipo 2000. The medium was changed after 6 hours，and observing the results of transfection under fluorescent microscope after 24 hours. Results：The best screening concentration of G418 was 400 mg/L，and five kinds of recombinant plasmids were successfully transfected into HeLa cells. And the transfection effective of ALDH1A1-1719，ALDH1A1-574，ALDH1A1-740，ALDH1A1-921，shNC were 4.67%，1.16%，12.45%，3.42%，1.02%，respectively. Conclusions：The shRNA of interfering ALDH1A1 expression transfection to HeLa cells was feasible and the effect was good. Related Articles | Metrics

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Risk Assessment of Cervical Lesion by Combined Detection of Papillomavirus L1 Capsid Protein and Human Papillomavirus Genotyping，Thinprep-cytology Test SONG Xiao-xia;LIU Yu-ling;YANG Xiao;WANG Li-li 2013, 40 (2):  179-181.  Abstract ( 1377 )   PDF (227KB) ( 5057 )   Objective：To explore risk assessment of cervical lesion and guidance of the best clinical triage management and treatment by combined detection of human papillomavirus L1 capsid protein and human papillomavirus（HPV） genotyping，thinprep cytology test（TCT）. Methods：Retrospective analysis of 1 593 women of cervical cancer screening in the gynecological clinic of the Second Affiliated Hospital of Zhengzhou University from September 2010 to December 2011，and TCT and genotyping of HPV-DNA testing at the same time，in which 592 patients who was HPV-positive or TCT positive or both abnormal were sent to colposcopic biopsy for pathological examination and who was HPV-DNA typing-positive were detection of HPV L1 capsid protein expression. Results：TCT combined with HPV-DNA detection in cervical intraepithelial neoplasia Ⅲ（CIN Ⅲ） and the above cases had the highest rate and reached 100% positivity in squamous cell carcinoma（SCC）；the positive rate of HPV L1 capsid protein expression show a decreased trend with the increasing level of cervical lesions，the expression of HPV L1 capsid protein and SCC was 0. The positive expression rate of HPVL1 capsid protein in each group was significantly different （P＜0.05）. Conclusions：It is an essential indicator that TCT combined HPV genotyping in cervical lesions screening，and HPVL1 capsid protein detection had important guiding value on risk assessment of cervical lesions. Three factors effective combination can be timely and accurate diversion and treatment of patients with cervical lesions. Related Articles | Metrics

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Study on Clinical Factors Affecting Concordance between Frozen Section and Paraffin Pathology in Endometrial Cancer WU Yue-qian;ZHU Hui-ting;LI Ying;SUN Jing;WANG Xi-peng 2013, 40 (2):  182-186.  Abstract ( 1751 )   PDF (417KB) ( 5053 )   Objective：To investigate clinical factors affecting the concordance of intraoperative frozen section （FS） pathology and postoperative paraffin section（PS） findings in endometrial cancer. Methods：From Jul 1996 to Sep 2011，389 endometiral cancer patients undergoing treatment in Department of Gynecology，Renji Hospital，Shanghai Jiao Tong University and Department of Gynecology，Shanghai First Maternity and Infant Hospital，Tongji University were enrolled in this retrospective study. The results of intraoperative FS and postoperative PS findings were compared and clinical factors affecting concordance of tumor grade and tumor invasion were studied. Results：①According to the PS results，the overall concordance rate of tumor grade was 78.6%（147/182）. The concordance of G1，G2，G3 was 88.6%，60.6%，95.2% and respectively. With increasing tumor grade and deeper tumor invasion by PS diagnosis，the higher concordance of grade were observed（P=0.008，P=0.002）. ②The overall concordance rate of depth of myometrial invasion was 97.8%（178/182）. It was observed that the increasing grade of tumor cell by PS would result in decreased concordance rate in myometrial invasion between FS and PS（P=0.027）. Conclusions：The diagnosis depth of myometrial invasion by FS is relatively accurate. However，the clinical accuracy in tumor grade of FS might not be so satisfied. Related Articles | Metrics

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Clinical and Pathological Analysis of Endometrial Cancer Coexisting with Uterine Myoma or（and）Adenomyosis LIU Song-song;ZHANG Hong;YANG Chao 2013, 40 (2):  187-190.  Abstract ( 1308 )   PDF (292KB) ( 5216 )   Objective：To analyze the clinical and pathological characteristics of patients of endometrial cancer coexisting with uterine myoma or（and） adenomyosis，and compare the high risk factors between endometrial cancer with uterine fibroids or （and） adenomyosis and pure endometrial cancer. Methods：The clinical and pathological data of 370 patients with endometrial carcinoma hospitalized to Tianjin Central Hospital of Gynecology Obstetrics from August 2010 to March 2012 were retrospectively analyzed. Patients were divided into merger uterine myoma group（group A，35.6%），merger adenomyosis group（group B，12.4%），merger uterine myoma and adenomyosis group（group C，16.1%），pure endometrial cancer group（group D，35.9%）. Results：GroupA，C are more early in clinie-pathologic staging （Zc=2.10，2.06），more superficial in myometrium invasion（Zc=1.99，2.23），more well in tissue differentiation（Zc=2.18），higher in ER，PR tested positive rate（χ2=10.83，5.78；7.75，4.13）than group D，and all differences have statitical significance（P＜0.05）. Group B is more well in tissue differentiation（Zc=2.01），higher in PR tested positive rate（χ2=3.86） than group D，and differences have statitical significance（P＜0.05）. While the other factors has no significancy compareed with group D；and there was no significant difference in groupA，B and C（P＞0.05）. The peritoneal cytology，lymph node metastasis and pathological type showed no signifiicant difference among the four groups（P＞0.05）. Conclusions：Endometrial carcinoma combined with uterine myoma mostly belongs to an estrogen-dependent tumor，with well-differentiated tissue and superficial myometrial invasion，with less high risk factors. While pure endometrial cancer mostly with more high risk factors. Related Articles | Metrics

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Clinical Analysis of 32 Struma Ovarii Cases MAO Jing-xin;WANG De-hua;YUAN Bi-bo;JIANG Chang-xin 2013, 40 (2):  191-193.  Abstract ( 1204 )   PDF (2942KB) ( 5147 )   Objective：To investigate the clinicialpathoiogy，diagnostic approachs，therapies，and prognosis of struma ovarii. Methods：From Jan. 1994 to Mar. 2012，the data of 32 patients with struma ovarii in the Department of Gynecology in Tianjin Medical University General Hospital，were analyzed retrospectively. Results：Struma ovarii occured within ovarian teratomas at rate of 4.3%（32/745），and the rate of malignant change was 6.25%（2/32）. The average age of the patients was 46.8 years old（range from 22 to 78）. The patients mainly presented as pelvic or adnexal mass，accompanying with hypogastralgia， abdominal distension，ascites，urgent urination，or frequent micturition. The average diameter of turmors was 6.9 cm （range from 3.0 to 15.0 cm）. The mean of CA125 level was 28.6 U/mL，and elevated serum CA125 of 4 cases was detected in different level （range from 38.1-174 U/mL）. There was no feature in image examinations. Final diagnosis based on pathology. No reoccurrence found within mean follow-up of 58 months after operation. Conclusions：Struma ovarii is rare in clinical. Because of no obvious clinical feature，the preoperative misdiagnosis rate is high，but the prognosis is good for most of patients. Meanwhile，it is necessary to pay more attention to these patients with malignant transformation，mixture with brain tissue，or hyperthyroidism. Related Articles | Metrics