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    15 December 2011, Volume 38 Issue 6
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    述评
    Diagnosis,Treatment and Research Status of Female Reproductive Tract Infection in China
    LIAO Qin-ping;ZHANG Dai
    2011, 38 (6):  469-471. 
    Abstract ( 2074 )   PDF (258KB) ( 6234 )  
    Female reproductive tract infection is becoming the social and public health issue in China and even the world. Recently, the clinical practice and research of reproductive tract infections in China have achieved some advances. Since the establishment of Cooperative Grope of Infectious Diseases of Obstetrics and Gynecology Subcommittee of Chinese Medical Association, a large number of disease diagnosis and treatment guidelines have been developed. But the failure of their promotion resulted in the inappropriate or excessive treatment of such diseases. Besides, the diagnosis technology represented by the vaginal microflora evaluation system has not yet been widely used. Therefore, the main project for the prevention and treatment of China's female reproductive tract infection is to promote the key technology and train the clinicians about the diagnosis and treatment guidelines of such diseases. The current research interests in the field of reproductive tract infections including: pathogenicity of genital mycoplasmas, the diagnosis and treatment of "cervical erosion", cervical HPV infection, diagnosis and treatment of pelvic inflammatory disease and the treatment effect of traditional Chinese medicine.
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    Mixed Infections of Female Low Genital Tract
    XUE Feng-xia;YUE Ying-li
    2011, 38 (6):  472-474. 
    Abstract ( 1866 )   PDF (197KB) ( 4934 )  
    Mixed cervicovaginal infection and mixed vaginitis are two common mixed infections of female low genital tract. Mixed vagintis accounts for 20%~40% of all vaginitis. The clinical presentations of mixed infections of low genital tract are often nonspecific. A detailed history taken,careful gynaecological examination and microecological examination help to accurate diagnosis. Combined usage of multiple antimicrobial agents are the recommended treatment. The pathogenesis of mixed infections of low genital tract and the application of probiotics warrants further studies.
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    Focus on the Human Papilloma Virus
    ZHAO Shu-wang
    2011, 38 (6):  475-478. 
    Abstract ( 1928 )   PDF (246KB) ( 4808 )  
    Due to the correlation between HPV and human multi-organ cancers,HPV has become a research hotspot in recent years. The Ninth National Cervical Cancer Cooperative Group Working Conference and HPV vaccine and cervical cancer prevention symposium were held in Beijing on 23rd April 2011. Domestic and foreign experts and scholars addressed a variety of views at the conference,the view that HPV as a tumor virus was widely accepteded by scholars as well. This paper introduces and reviews the research status of HPV in recent years. In addition,some suggestions on prevention,screening and diagnosis of HPV in practical work are proposed,and some prospects of prevention and treatment of HPV are made,which can be discussed by vast numbers of clinical workers and researchers.
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    综述
    Research Progress in Vaginal Ecosystem
    XIAO Bing-bing;LIAO Qin-ping
    2011, 38 (6):  479-482. 
    Abstract ( 1765 )   PDF (247KB) ( 4978 )  
    The vagina is a dynamic and finely tuned ecosystem in which homeostasis depends on mutually beneficial interactions between a human female and her resident microorganisms. In recent years,the development and introduction of cultivation-independent molecular-based techniques have provided new information about the composition of normal vaginal flora,“normal flora” is a concept currently being redefined.Dominance by lactic-acid producing microbes appears to be the cornerstone of microbial health. Numerous factors(both internal and external) have the potential to disrupt the vaginal ecosystem's fragile balance,and different racial groups,different geographical region have significant difference in what is the dominant vaginal organisms.
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    Potential Effects and Mechanism of Pathogenic Microorganism on Female Reproductive Health
    ZHANG Dan;LI Jing-yi;HUANG He-feng
    2011, 38 (6):  483-486. 
    Abstract ( 2102 )   PDF (292KB) ( 4860 )  
    Human reproduction provides favorable opportunities for the transmission of infectious agents. Furthermore,at either stage of reproduction,from conception to parturition and the neonatal period,mother and her offspring exhibit distinct susceptibilities to infection. The impact of pathogens on reproduction can be extenuated or exacerbated depending on stage of acquisition during pregnancy. Similarly,factors such as maternal immune response, nutritional status,or concurrent infection may modify the effect of a specific infectious agent. In this review,we discuss associations between infectious agents and reproductive problems at each stage of female reproduction and its potential mechanisms.
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    Establishment and Clinical Application of Animal Model in Pelvic Inflammatory Disease
    CHAI Xin;WANG Jian-liu
    2011, 38 (6):  487-489. 
    Abstract ( 1360 )   PDF (247KB) ( 5000 )  
    Pelvic inflammatory disease (PID)is a serious and costly common disease for reproductive women. Studying an appropriate animal model will be useful for ascertaining its pathogenesis, selection and evaluation of anti-inflammatory medicines,and potential vaccine candidates. Until now, there are many methods for the PID animal models. However,the models have some limitations. It is needed further study afterwards. This article focuses on the establishiment and application of animal model in PID.
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    Diagnosis and Treatment Advancement of Vulvovaginal Candidiasis
    WU Wen-xiang;LIU Zhao-hui
    2011, 38 (6):  490-493. 
    Abstract ( 1569 )   PDF (293KB) ( 4862 )  
    Vulvovaginal Candidiasis(VVC)is a common gynecologic disease,especially in women of childbearing age.VVC usually is caused by Candida albicans,but occasionally is caused by non-albicans Candida. The diagnosis can be made in a woman who has signs and symptoms of vaginitis when mycologic laboratory examination is positive.American Center for Disease Control and Prevention has renewed the treatment guidelines of VVC in 2010.VVC is treated with a variety of anti-fungal drugs. Individual treatment should be recognized according to different classification of VVC. Other treatments about immunotherapy and lactobacillus administration are still at the research stage.
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    Mycoplasma and Infectious Diseases in Obstetrics and Gynecology
    ZHANG Dai;MI Lan
    2011, 38 (6):  494-499. 
    Abstract ( 1496 )   PDF (286KB) ( 4928 )  
    Mycoplasma and female reproductive tract infections have been widespreadly concerned. Current research focused on the pathogenic and detection methods of different types of mycoplasmas. According to the progress on mycoplasma research,this review describes its classification,epidemiology, clinical manifestations,detection method,diagnostic and treatment strategies. This review details the prevalence of different types of mycoplasma in the populations at home and abroad, as well as mycoplasma in women with carrying case and in relationship between vaginal infections,cervicitis,pelvic inflammatory disease and obstetric adverse pregnancy outcomes. The population carring rate of Ureaplasma urealyticum is very high,so we must treat the pathogenicity of UU with caution. Myoplama should be treated as conditional pathogen .
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    Pathogenicity of Ureaplasma Urealyticum and Toll-like Receptors
    KUANG Si-si;ZHANG Hong-wen;WU Xian-qing
    2011, 38 (6):  500-504. 
    Abstract ( 1429 )   PDF (264KB) ( 4860 )  
    Ureaplasma species (Ureaplasma parvum and Ureaplasma urealyticum) are commonly found in the lower urogenital tract of healthy human as a kind of important opportunistic Bacteria. It is proved Ureaplasma spp. is associated with many acute and chronic infections of the urogenital tract. Recent studies show that ureaplasma infection may be involved in HPV infection and cytological abnormalities of cervix, but the roles of Ureaplasma plays in the pathogenesis of HPV-positive and abnormal cytology of cervix are still unclear. The plasma membrane of Ureaplasma species contains a lot of lipoprotein, called lipid-associated membrane protein(LAMPs), which may be an important Pathogen-associated molecular pattern. The LAMPs of Ureaplasma species can bind to specific TLRs of host cells, activating signaling transduction pathways, starting gene transcription and translation of proinflammatory cytokines, and then releasing a variety of pro-inflammatory factors, triggering inflammatory responses of the host. This progress may be an important pathogenic mechanism of Ureaplasma species. Here, we will review the association of Ureaplasma species infection and HPV infection and the relationship between TLRs and The ureaplasma lipid-associated membrane proteins.
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    Gardnerella Vaginalis Biofilm——New Targets of Bacterial Vaginosis Treatment
    LIN Si-yao;LUO Xin;JIANG Xue-feng
    2011, 38 (6):  505-508. 
    Abstract ( 1826 )   PDF (289KB) ( 5631 )  
    Biofilm is an aggregate of microorganisms adhering to non-biological or biological surfaces,which is formed by matrix consisting of the polysaccharide,protein. Biofilm formation is an important pathogenic factor,because it increases bacterial resistance to antibiotics and anti-host immune defense system and Phagocytosis. As the biofilm bacterial immune system cannot be removed effectively,or cannot be killed by antibiotics,it often becomes chronic and persistent infection. Gardnerella vaginalis biofilm is detected in bacterial vaginosis women's vaginal mucosa or their sexual partners′ urine sediments. Using standard treatment by metronidazole or moxifloxacin,although the clinical symptoms disappear,after stopping treatment the bacterial biofilm mainly consisting of Gardnerella vaginalis will be revived after the biochemical inactivation,leading to recurrent bacterial vaginosis. Lactobacillus competes to become vaginal mucosa microflora,which have a good therapeutic effect of Gardnerella vaginalis in the plankton living and biofilm state. Promoting the growth of lactobacillus flora is beneficial to correct microflora disturbance and restore the normal vaginal environment. Further studies are needed to assess the Gardnerella vaginalis Biofilm structure and composition,which are better to understand the relationship between Gardnerella vaginalis and bacterial vaginosis and maybe provide future targeted therapy.
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    Diagnosis and Management of Genital Herpes
    PENG Yan-ting;FAN Shang-rong
    2011, 38 (6):  509-512. 
    Abstract ( 2006 )   PDF (246KB) ( 4834 )  
    Genital herpes simplex virus infection is a recurrent,lifelong uncurable disease with no cure. It can produces symptomatic disease and asymptomatic viral excretion. It is currently the main cause of genital ulceration and an important public health problem. Since clinical diagnosis is neither sensitive nor specific,virological and type-specific serological tests should be used routinely. Oral antiviral drugs for HSV infections are safe and effective and can be used to treat episodes and prevent recurrences.
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    Prospectives for Human Papillomavirus,Prophylactic Vaccine and Vaccination Policy
    ZHANG Chun-jie;LIU Hong-tu
    2011, 38 (6):  513-516. 
    Abstract ( 1499 )   PDF (291KB) ( 4851 )  
    Cervical cancer is a top leading cause of cancer deaths among Chinese women. Human papillomavirus infection is the essential factor in the development of nearly all cases of cervical cancer. The virus-like particle (VLP) derived from L1 gene coded by HPV genome induces the neutralization, as a result, the administration of VLP is effective against the infection of an HPV genotype. Since two HPV genotypes,i.e.,HPV16 and 18 are most prevalent in the cervical cancer,VLPs of both genotypes were developed as prophylactic vaccine for cervical cancer. So far,the clinical trial of HPV vaccines from two medical manufacturers showed safe,and more importantly, effective in the disease control of low grade cervical intraepithelial neoplasia, the pre-stage of cervical tumorgenesis. Based on the prospective effect from vaccination,the developed countries were in consideration for adjusting the control policy for cervical cancer.
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    论著
    The Established Animal Model of Sequelae of Pelvic Inflammatory Disease
    LI Jun-liang;LIU Heng;WANG Jian-liu;WANG Shi-jun;WEI Li-hui
    2011, 38 (6):  517-519. 
    Abstract ( 1559 )   PDF (379KB) ( 4808 )  
    Objective:to established a rabbit model of sequelae of pelvic inflammatory disease. Methods:Female New Zealand white rabbits of 5-6 months old were studied with an intrauterine insemination catheter for bacterial inoculation for the model of PID. The blood routine,body temperature,body weight were measured. The uterine and oviduct were observed under laparoscopy. The pathological examination of the uterine and oviduct of the rabbits were done in this study. Results:The 5 rabbits were all be inoculated with bacterial successfully. The white blood cell count of the rabbits was increased at the third day and maintened after 14th day of bacterial inoculation. The body weight gain became slowly at 10-20 days,after that showed a steady upward trend. Under laparoscopic observation,edema and exudation were distinguished within 14 days. The tube wall became thickness,thickening,and contracture afterwards. Conclusions:The rabbit model of sequelae of rabbit pelvic inflammatory disease can be established with bacterial inoculation. The rabbit acute pelvic inflammation can be observed within 14 days. The modeling,proliferate and scar repair of rabbit pelvic inflammatory disease are the main changes after two weeks inoculated with bacterial.
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    Study on Pathogenicity of Ureaplasma Urealyticum Serotype 3 and 8 in Female Rabbits′ Reproductive Tract
    LIU Shu-rong;ZHANG Hong-wen;WU Xian-qing;WANG Xin;ZHOU Ying;LI Han.
    2011, 38 (6):  520-523. 
    Abstract ( 1734 )   PDF (849KB) ( 4833 )  
    Objective:To study the pathogenicity of Ureaplasma urealyticum serotype 3(Uu3) and 8(Uu8) with the same concentration in Female Rabbits,s Reproductive tract. Methods:Fifty-two oestradiol-treated adult female rabbits were randomly divided into group A,B,C and D. Ureaplasma urealyticum serotype 3,8,3 and 8,with the same concentration of 106copy/g while 4 rabbits of control group(group D) inoculated sterile medium.They were detect Uu from cervical secretions by fluorescent quantitative polymerase chain reaction(FQ-PCR) at 1,3,7, 14, 21, 35,49,63,77,91,105 days. They were necropsied at 14,105 days of postinoculation randomly to observing tissues of cervix,endometria,fallopian tube by light microscope and cervical mucosa by scanning electron microscope. Results:①The total positive rabbits of Uu in three experimental groups show a significant difference(P<0.05),which were 27.3%(25/88),55.7%(49/88),69.3%(61/88). But before 35 days,the positive rate of the three experimental groups at the same time point in all of Female rabbits infected cervical secretions does not show a statistically significance(P>0.05),and the positive rate descended as the days of postinoculation lasting. The highest positive rates of three experimental groups were 87.5%(7/8),100.0%(8/8),100.0%(8/8) at 1 d after inoculation,but the conlisation didn't persist at 105 d. All rabbits of control group were negative. ②There was not statistical difference in the quantity of Uu among experimental groups(P>0.05). Their peak level were 364×104copy/g,401×104copy/g,493×104copy/g,reached at 1d,but the FQ-PCR values reduced as the days of postinoculation lasting.In the same experimental group at different time points,the concentrations was a significant difference(P<0.05).③The total pathogenicity rates of three groups were significantly different(P=0.015),which were 31.3%(5/16),62.5%(10/16),81.3%(13/16). But there were not statistical difference among experimental groups at 14 days(P>0.05),but 105 days later the pathogenicity rates of three groups were significant different(P=0.041). None of control group was positive. Conclusions:①In female rabbits′s reproductive tract,the pathogenicity of each experimental group was shown when inoculatin Uu with FQ-PCR value is 106copy/g. the pathogenicity rates of three groups were significantly different. the pathogenicity of the mixed group(group C) was the highest and Uu3 group(group A) the lowest,Uu8 group(groupB) was the Second. ②In Female Rabbits,s Reproductive tract,the infectivity and quantatitive value were significant different among experimental groups,the infectivity and quantatitive value of the mixed group (group C) was the highest and Uu3 group(group A) the lowest,Uu8 group(group B) was the Second when inoculating Uu with the same concentration. ③The pathogenic concentration of Uu3 and Uu8 may differ,Uu8 may be <106copy/g,so further research is needed confirm it.
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    Analysis of the Preoperation Vaginal Ecology and Correlative Factors in Infertile Patients
    CHEN Xiao;HOU Hai-yan;HU Chun-xiu;YANG Zhen-hua;CHEN Ya-qiong.
    2011, 38 (6):  524-527. 
    Abstract ( 1783 )   PDF (307KB) ( 4897 )  
    Objective:To investigate and analyze the vaginal secretion pathogen and ecology correlative factors in infertile patients. Methods:A retrospective survey included 850 infertile women who accepted the hysteroscopy and laparoscopy examination and be treated from Jan 2008 to Dec 2009. Collected history and vaginal secretion before operation. The Nugent grade was used to evaluate the vaginal bacteria. The patients were chosen to two groups,normal bacteria group(307 cases) and abnormal group(543 cases). The abnormal group was divided into five subgoups that were lactobacillus decreased group(325 cases), Gram positive bacillus small group(173 cases),bacterial vaginal disease group (26 cases), flora inhibit group (11 cases) and vulvovaginal candidiasis group(8 cases). Results: Patients had more than 5 years infertility history,postabortion complication and drug abortion history would get more chance to had abnormal vaginal ecology(P<0.05), OR and 95% CI was 1.42(1.07~1.89), 1.97(1.28~3.05) and 1.51(1.0~2.22) respectively.
    Patients that vaginal lactobacillus decreased had the highest incidence of drug abortion history(OR=1.66,95%CI:1.09~2.51), while the vaginal Gram positive bacillus small group had the highest incidence of postabortion complication(OR=1.86,95%CI:1.13~3.07). After adjusting age, education and family income, we found that postabortion complication was a risk factor for abnormal vaginal bacteria(OR=2.653,95%CI:1.16~6.07). Conclusions:Vaginal bleeding for a longer time, hypogastralgia and fever after abortion would increase the risk of abnormal vaginal bacteria. Taking precautions against the postabortion complication would have important clinical meaning for normal vaginal microenvironment protection.
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    综述
    Value of Clinical Application of CA72-4
    FENG Min-qing;LIN Zhong-qiu
    2011, 38 (6):  534-536. 
    Abstract ( 1657 )   PDF (203KB) ( 4772 )  
    Tumor markers are the specific and relatively specific substances which are lack or few in normal cells produced in the canceration process. They also may be the component of normal cells produced by host cells versus cancer cells,with different quantity and quality from that in normal condition or benign diseases. The detection of blood,body fluid,extract through technology of chemistry,immunity, and molecular biology plays an important role on diagnosis,treatment,prognosis of tumors. CA72-4 is a new tumor marker. People begin to attach importance to its role on diagnosis,differential diagnosis,illness monitoring and prognostic assessment of various cancers (such as gastric cancer,ovarian cancer and colorectal cancer,et al).Combined with other tumor markers,it will be beneficial to earlier detection,earlier diagnosis and earlier treatment.
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    Advancements of miR-21 and Gynecologic Neoplasms
    YAN Li-li;OUYANG Ling
    2011, 38 (6):  537-540. 
    Abstract ( 1507 )   PDF (244KB) ( 4777 )  
    MicroRNA(miRNA) are small,noncoding single-stranded RNA that are ubiquitous in both animals,
    plants and viruses. miRNA is concerned with tumor development and prognosis, and plays a crucial role in tumor hyperplasia, differentiation and apoptosis. Lots of results suggest that many miRNAs may play oncogenic or anti-oncogen role in the tumor development,and the miR-21 is paid the most attention. miR-21,one of the early discovered miRNAs in human cells,over-expressed in HeLa cells is a popular model applied functional study of human miRNAs. In this review,we have summarized the research of the relationship of miR-21 and gynecologic neoplasms.
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    Research Advance of Photodynamic Therapy in Cervical Intraepithelial Neoplasia
    YE Ting-lu;YU Bo;ZHONG Qi-li
    2011, 38 (6):  541-545. 
    Abstract ( 1664 )   PDF (263KB) ( 4843 )  
    Cervical intraepithelial neoplasia (CIN), a common disease of the cervix in the female adults,lacks of safe and effective conservative treatment at present. Photodynamic therapy(PDT),as a new choice for CIN,has a promising prospect for CIN because of its effectiveness and safety. The efficacy of PDT is associated with the photosensitizers and their concentrations,the time span between the topical application and the light activation of the photosensitizers,parameters of the illumination,operation methods,evaluation methods of the therapeutic effect,and so on. We should deeply research on PDT to make it more effective in the treatment of CIN.
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    New Progress of Laparoscopy Surgery of Cervical Cancer
    MA Yao-mei;QU Peng-peng
    2011, 38 (6):  546-549. 
    Abstract ( 1531 )   PDF (244KB) ( 4716 )  
    During the past 20 years, there has been an increasing interest on the possible role of laparoscopy in treatment of cervical cancer. Laparoscopic surgery is associated with less blood loss, faster recovery and improved recovery. From the currently existing data, there is no doubt that laparoscopy surgery is technically feasible and operational safety. It's also true that there is no multicenter randomized study to draw safe conclusions on its long-term oncological safety. Many laparoscopic centers carry out the laparoscopic nerve sparing radical cancer surgery(LNSS), try to reduce the incidence rate of postoperative bladder, bowel and sex dysfunction, and develop the quality life of the patients. Some laparoscopic centers began to research the feasibility and safety of laparoscopic radical trachelectomy for fertility sparing and laparoscopic pelvic lymphadenectomy as staging procedures in patients with advanced cervical carcinoma.
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    Progress in Study on Quality of Life of Patients with Cervical Carcinoma
    XI Mei-li;LU Xin
    2011, 38 (6):  550-553. 
    Abstract ( 1470 )   PDF (270KB) ( 4731 )  
    The improvement of quality of life in cancer patients became an important issue in clinic along with the progress of treatment and the increasing survival rate. Cervical cancer is the second common gynecological cancer in women. The patients with cervical cancer have good prognosis and long survival with free tumor. Recently,gynecological oncologists have made great progress in the field of improvement of quality of life in cervical cancer. Various modified operation procedures aiming to improve quality of life of which the safety and feasibility have been widely adapted in early-stage cervical cancer,such as fertility-sparing radical trachelectomy, ovarian transposition as well as nerve-sparing radical hysterectomy. Adjuvant therapies including chemotherapy and radiotherapy have been commonly used in improving prognosis of cervical cancer patients. However, the impacts on quality of life need to be considered because of sequentially complications.The progress in improving quality of life in cervical cancer patients has been reviewed in this article.
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    The Progress of Endometrial Stromal Sarcoma
    YAO Ting-ting;LIN Zhong-qiu;ZHANG Bing-zhong
    2011, 38 (6):  554-557. 
    Abstract ( 1576 )   PDF (242KB) ( 4809 )  
    Endometrial stromal sarcoma is origin from the mesenchymal tissue of uterine sarcoma. The cells of it resemble normal endometrial stromal cells in proliferative stage with strong invasiveness. It can be divided into three kinds including of low grade malignant endometrial stromal sarcoma,high grade malignant endometrial stromal sarcoma and extrauterine endometrial stromal sarcoma. Therefore,early diagnosis and treatment is very important. However, endometrial stromal sarcoma cells with multiple differentiation potential, endoscopic manifestations of complex and diverse, often lack the specificity of clinical symptoms. The rates of misdiagnosis and missed diagnosis are very high. It is necessary to understand the endometrial stromal sarcoma comprehensively.
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    Progress in the Research of Insulin-like Growth Factor Family in Ovarian Caner
    JIA Mei-qun;CHEN Zeng-yan;WU Xia
    2011, 38 (6):  558-561. 
    Abstract ( 1538 )   PDF (225KB) ( 4763 )  
    Insulin-like growth factors(IGF) plays a pivotal role in human ovarian cell proliferation,differentiation and apoptosis. Increasing evidences have revealed that IGF system is involved in the pathogenesis and progress of various malignancies including ovarian cancer. Recent studies in regard to IGF axis expression in the ovarian cell lines and tissues have shown that the IGF axis may contribute to the transformation and progression of ovarian cancer. The inhibition of IGF receptor signaling pathway may be a new strategy for the multimodality treatment of ovarian cancer. This article reviews the update progress in the research of IGF axis in ovarian cancer.
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    Tubal Intraepithelial Carcinoma
    ZHAO Jian-guo;QU Peng-peng
    2011, 38 (6):  562-565. 
    Abstract ( 1832 )   PDF (277KB) ( 4702 )  
    Tubal intraepithelial carcinoma is occult,which can be found in prophylactic salpingo-oophorectomies from women with BRCA mutations. Etilogy and the incidence of population is unknown. The incidence of women with BRCA mutations is 4.4%~8%. Positive peritoneal washings and pelvic implanted metastasis may appeared. The origin of the ovarian cancer has been debated. There are two ways of origin of ovarian cancer. High-grade serous carcinoma has been considered from fallopian. Tubal intraepithelial carcinoma has been diagnosed difficultly because of no early symptoms. Fallopian be required carefully checking after prophylactic salpingo-oophorectomies. Otherwise tubal intraepithelial carcinoma can be missed. Therapy is similar with ovarian cancer. We must attach importance to tubal intraepithelial carcinoma.
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    The Research Between Prediction of Preeclampsia and Vascular Endothelial Growth Factor Receptor-1,Placental Growth Factor,Placenta Protein 13
    LI Xiao-yan;JI Xiang-hong
    2011, 38 (6):  566-569. 
    Abstract ( 1607 )   PDF (256KB) ( 4717 )  
    Preeclampsia is a serious threat to maternal and child health during pregnancy,the etiology and pathogenesis of preeclampsia is complex. At present,we treat patient with clinical symptoms,however,maternal and fetus have been already subject to different degrees of damage. It has important clinical significance to predict the occurrence of preeclampsia prior to clinical symptoms appearance,screen out high-risk patients and make early intervention by strengthening the perinatal monitoring. According to reports of multiple centers worldwide,vascular endothelial growth factor receptor-1(Sfit-1),placental growth factor(PIGF) and placenta protein 13(PP13)are expected to be used as early effective predictors of preeclampsia. In this paper,we reviewed the progression of studies on prediction of preeclampsia.
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    论著
    Meta-analysis on Therapeutic Effect Between Single Laparoscopic Surgery and Postoperative Therapy by GnRHa in Endometriosis
    XU Yi;LUO Ruo-yu;ZHANG Qing;LI Hua;YI Yue-xiong;LI Jin-xin
    2011, 38 (6):  570-574. 
    Abstract ( 2000 )   PDF (2164KB) ( 4735 )  
    Objective:To evaluate the efficacy of laparoscopic surgery combined gonadotropin-releasing hormone agonist(GnRHa) with laparoscopic surgery alone in the treatment of endometriosis. Methods:Based on the principles of evidence-based medicine,use Cochrane systematic review method to retrieve randomized controlled trials(RCT) published on Cochrane Library,PUBMED,CNKI,CBM,Wanfang,Chongqing VIP database between 2000 and 2011,which were mainly about laparoscopic surgery combined GnRHa therapy and laparoscopic surgery alone therapy in the treatment of endometriosis. Then use RevMan 5.0 software to do Meta analysis. Results:8 RCT were included,862 patients in total. All of the trials reached grade B based on the quality evaluation methods of allocation concealment,blinding,loss to follow-up,baseline level comparison and grading description. According to meta analysis,Symptom release rate and pregnancy rate in laparoscopic surgery combined GnRHa group were both much higher than laparoscopic surgery alone group(OR=4.30, 95%CI为2.86~6.47,P<0.01). And the recurrence rate was much lower in laparoscopic surgery combined GnRHa group too(OR=0.18,95%CI:0.13~0.26,P<0.01). Conclusions:The efficacy of laparoscopic surgery combined GnRHa therapy is much better than laparoscopic surgery alone in the treatment of endometriosis.
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    Clinical Study of Levonorgestrel-releasing Intrauterine System in the Treatment of Endometriosis After Conservasive Laparoscopic Surgery
    LI Gai-ling;SHI Hui-rong;REN Fang
    2011, 38 (6):  575-577. 
    Abstract ( 1574 )   PDF (259KB) ( 4765 )  
    Objective:To investigate the clinical efficacy and side effects of levonorgestrel-releasing intrauterine system in the treatment of endometriosis(EMs)after conservasive laparoscopic surgery. Methods:seventy women of EMs with complain of dysmenorrhea were recruited, they were devided into two groups,35 women were placed LNG-IUS, 35 women were given GnRHa therapy. In addition,33 women of EMs who were given non-steroidal anti-inflammatory drug therapy after surgery were recruited as control group. The average followed up period was 14 months. The mean visual analogue scale(VAS)scores of their dysmenorrhea, serum CA125 levels,recurring rate among the three groups and between pretherapy and post-therapy were compared.Also the side effects of LNG-IUS,the continuation rate and the degree of satisfaction were evaluated. Results:In LNG-IUS group,significant difference(P<0.05) existed in VAS scores at the end of 3 months,6 months and 1 year treatment when compare with the preoperative situation. After one year's treatment,The VAS scores in LNG-IUS group were significantly lower than control group and GnRHa group(P<0.05). There was no significant difference(P>0.05) in serum CA125 between LNG-IUS group and GnRHa group at the end of 6 months treatment,but significant decrease(P<0.05) existed when comparison was made between LNG-IUS group and control group. After one year's treatment,the recurrence rate of LNG-IUS group and GnRHa group were obviously lower than the control group(P<0.05),there was no obvious difference between LNG-IUS group and GnRHa group(P>0.05). After one year's treatment,there were 25.0% of the patients with irregular uterine bleeding in LNG-IUS group,54.5% of the subjects were very satisfied or satisfied with the treatment,and the continuation rate of LNG-IUS was 94.0%. Conclusions:Placing LNG-IUS as an accessory treatment for patients with EMs after conservasive laparoscopic surgery is effective,with high degree of satisfaction and high continuation. Irregular uterine bleeding is the main side effect.
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    Study of Sersum Anti-mullerian Hormone as Marker for Diagnosis of Polycystic Ovary Syndrome
    ZHANG Fang;WANG Jian-hui
    2011, 38 (6):  578-580. 
    Abstract ( 1503 )   PDF (215KB) ( 4726 )  
    Objective:To explore whether anti-mullerian hormone(AMH) measurement in the serum could be a marker for diagnosis of polycystic ovary syndrome(PCOS). Methods:Serum AMH was measured with immunoassay in a cohort of 75 PCOS patients and 86 controls,and follicle number was estimated by ultrasound scanning. Results:Serum AMH levels were 4-fold higher in PCOS patients than in control group[(8.21±2.32) mg/L vs.(2.39±1.29) mg/L],and were significantly related to the follicle number in the two groups. In PCOS patients,AMH concentrations correlated with the number of ovarian follicles、testosterone、LH and LH/FSH(r= 0.489,0.215,0.312 and 0.256,P<0.05),but not related with FSH、E2 PRL and BMI(r=0.12,0.19,0.10 and 0.16,P>0.05).Conclusions:The serum AMH level was a marker which may be used for diagnosis of the PCOS.
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    Effect of Letrozole on the Expression of MMP-2 and TIMP-2 in Human Uterine Fibroids
    GONG Xia-hong;SHEN Qing-xiang;LIU Jue;ZHOU Shou-hong
    2011, 38 (6):  581-584. 
    Abstract ( 1663 )   PDF (414KB) ( 4712 )  
    Objective:To investigate the effect of letrozole on matrix metalloproteinases-2(MMP-2) and tissue
    inhibitor of metalloproteinase-2(TIMP-2) in the patients with uterine fibroids. Methods:Forty patients with uterine fibroids were divided into two groups. Treatment group patients were received myomectomy after treatment with letrozole tablets(2.5 mg/day) for three course of treatment. Control group were only received myomectomy. The volume of uterus and uterine fibroids were measured through B-mode ultrasonography. The expression of MMP-2 and TIMP-2 in uterine smooth muscle and uterine fibroids were detected by Real-time PCR and Western Blot. Results:Compared with control group and in the treatment group,the clinical symptom was significantly improved, the level of estradiol was significantly decreased, the volume of uterus and uterine fibroids were markedly diminished,the expression of MMP-2 in uterine smooth muscle and uterine fibroids was significantly decreased,the expression of TIMP-2 in uterine smooth muscle and uterine fibroids was markedly increased in the letrozole group. Conclusions:Letrozole diminishs the size of uterine fibroids in human,the mechanism which of may be related to the decrease of estradiol and MMP-2 expression and the increase of TIMP-2 expression induced by letrozole.
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    Distribution of Human Papillomavirus Types in Henan Women
    WANG Xiao-jing;LIU Yu-ling;TANG Fu-xiang. WANG Dong-liang.
    2011, 38 (6):  585-587. 
    Abstract ( 1855 )   PDF (241KB) ( 4708 )  
    Objective:Statistics in the distribution of data in all types of HPV and CINⅡ+ cases of cervical cancer in the distribution of data for HPV vaccine introduction in China and to provide baseline clinical trials for evaluation of the four HPV vaccine. Methods:SPF10-PCR,DEIA and LiPA technology were used to detect the type of HPV from paraffin-embedded cervical specimens. Results:It showed HPV positive in all the 91 paraffin-embedded cervical specimens by DEIA.And there are 89 postive cases by LiPA,among which 72 cases are single HPV type,17 cases are mixed HPV types. The top three prevalence of HPV types are follow:16,58,18. Conclusions:In Henan the most common HPV subtype is HPV 16 (80.9%),the second is HPV 58(10.1%), the current preventive vaccine has been developed to carry out the crowd in our vaccine provides a theoretical basis for intervention,while 58 was the importance of the study population for novel vaccine development challenges.
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    The Application Value of ThinPrep Cytology Test,Human Papillomavirus DNA,Human Telomerase RNA Component Gene Detection in Cervical Cancer Screening
    GANG Xiao-qing;ZHANG Ju-xin
    2011, 38 (6):  588-590. 
    Abstract ( 1772 )   PDF (247KB) ( 4702 )  
    Objective:To evaluate the application of Thin-Prep Cytology test(TCT)、human papillomavirus (HPV) DNA、human telomerase RNA component(hTERC)gene detection in cervical cancer screening. Methods:From December 2010 to March 2011 in Henan Province People's Hospital gynecology clinic 1000 cases,had TCT、HPV(SPR method)、hTERC detection(fluorescence in situ hybridization FISH technique )respectively,to screen the cervical carcinoma,the above three kinds of detection of any positive result underwent colposcopy and cervical biopsy,based on the histopathology as the gold standard to evaluate three methods of cervical screening sensitivity,specificity,Youden index and the coincidence rate. Results:One thousand cases of patients,average age 41±9,TCT abnormal results were 119 cases,accounting for 11.9%;HPV-positive 136 cases,accounting for 13.6%;hTERC gene amplification in a total of 58 positive cases,accounting for 5.8%. 229 routine colposcopy and cervical biopsy were done, in which 36 cases of cervical intraepithelial neoplasia(CIN), including 13 CINⅠ(5.68%),13 CINⅡ(5.68%),8 CINⅢ(3.49%),2 squamous cervical carcinoma(SCC)(0.87%). By single application of a screening program,TCT highest sensitivity(83.3%). Application of any two programs combined screening,TCT+HPV highest sensitivity(94.4%),but the lowest specificity(29.6%);TCT or HPV testing combined with hTERC gene,can make both higher sensitivity and specificity. With the increased CIN level of pathology,the detection rate of the screening program gradually increased(P<0.05). Conclusions:In the cervical cancer screening,combined screening is the best way than the single screening,HPV+hTERC joint screening of genetic testing best,but the highest cost. the TCT+HPV screening test regarded as a joint cost-effective screening program,can be carried as a basic screening. Screening should be based on economic conditions and cost options for the screening program.
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    Ovarian Nonspecific Steroid Cell Tumors——Two Case Reports and Literature Review
    LI Xiao-hong;ZHU Ting
    2011, 38 (6):  591-593. 
    Abstract ( 1381 )   PDF (227KB) ( 4728 )  
    Objective:To study the clinical,pathological manifestations,diagnostic and treatment methods of the ovarian nonspecific steroid cell tumors. Methods:The clinical data of patients diagnosed with ovarian nonspecific steroid cell tumors,during 2000—2010 were retrospective analyzed in our hospital. The relevant published articles were reviewed as well. Results:The two patients have been treated in our hospital during the period,one was benign and other was malignant. Both patients displayed with amenorrhea and masculine characteristics. Intraoperative and pathological findings are consistent with the descriptions of reported literatures. The benign patient was recovered uneventfully with conservative surgery and the biochemical parameters returned to normal level. The malignant one died 10 months after diagnosis with tumor recurrence despite aggressive surgery and postoperative adjuvant chemotherapy. Conclusions:Ovarian nonspecific steroid cell tumors,are rare ovarian tumor. Surgery should be preferred in treatment of such tumor. Some of the tumor was malignant and postoperative adjuvant chemotherapy should be added,while the prognosis is still very poor.
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