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15 August 2010, Volume 37 Issue 4
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Some Questions of Endometrial Carcinoma Treatment WANG Jian-liu 2010, 37 (4):  227-229.  Abstract ( 1797 )   PDF (249KB) ( 5079 )   Endometrial carcinoma is one of the common gynecological cancers. The guidelines of diagnosis and treatment of endometrial carcinoma have been used for many years in China and worldwide. However， some questions about endometrial carcinoma treatment such as hysterectomy and lymphodenectomy for early stage patient with endometrial carcinoma， endocrinal therapy， preserve fertility for the early stage endometrial carcinoma in young people， are still uncertain. This article shall review related data and discuss above questions briefly. Related Articles | Metrics

专家论坛

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Botanical Therapy for Relieving Menopausal Symptoms with Particular Reference to Cimicifuga Racemosa Eckehard Liske 2010, 37 (4):  230-236.  Abstract ( 2638 )   PDF (347KB) ( 5101 )   Results from the Women′s Health Initiative clinical trial have raised serious safety concerns for conventional hormone therapy in menopause symptoms management. For this reason alternative drugs may be more appropriate and the level of credibility in these alternatives is increasing since nowadays they are more frequently supported by evidence or scientific-based evaluations due to the growing number of well-designed clinical trials. Natural treatment of herbal origin are gradually gaining in importance and the development of phyto-pharmaceuticals recognizes the long-term use of botanicals in traditional medicine as therapeutic agents due to their medical properties. Nowadays，the use of botanicals as a medical treatment approach for menopause symptoms relief is very popular and particularly black cohosh is one of the most widely used and studied herb in this indication. The aim of this paper is an review of the scientific literatures of botanicals which are commonly used for treatment of menopause symptoms and with main emphasis to efficacy and safety profile of black cohosh. Related Articles | Metrics

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Roles and Regulations of the Gap Junction During Pregnancy HUANG Ke-hua;YAN Jian-ying 2010, 37 (4):  237-240.  Abstract ( 2854 )   PDF (267KB) ( 4987 )   Gap junctions， which are specialized regions in cellular membranes， allow intercellular communication and the transfer of ions， second messengers， and small metabolites between adjacent cells. They not only mediate electrical and biochemical coupling between cells but also regulate many physiological events， including cell proliferation， differentiation and metabolism. Due to the regulation of multiple mechanism， GJs exist dynamically. During one's pregnancy， GJs timely adjust the cells proliferation and differentiation in myometrium and endometrial， then regulate uterine contraction to suit different stages of pregnancy. Thus， GJs play an essential role in the embryo implantation， placenta and embryo development， onset of labor even the regulation of parturient and pregnancy outcome. Related Articles | Metrics

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Advancement in Correlation Study on Iron and Gestational Diabetes Mellitus JIANG Jing;CHENG Hai-dong 2010, 37 (4):  241-244.  Abstract ( 1817 )   PDF (281KB) ( 4992 )   Iron is an essential nutrient with crucial biological function. Sufficient amount of maternal iron store is the necessary condition to maintain the normal pregnancy. Recent studies have suggested that elevated maternal iron store is an independent risk factor of gestational diabetes mellitus（GDM）； while iron deficient anemia is a protective condition of GDM， which can reduce the incidence it. Increasing evidences suggest that oxidative stress related to high iron levels is the more likely mechanism that involved in the incidence and development of GDM. Related Articles | Metrics

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The Use of Recombinant Activated Factor Ⅶ in Intractable Postpartum Haemorrhage LIAO Qiu-ping;YAN Jian-ying 2010, 37 (4):  245-248.  Abstract ( 2780 )   PDF (274KB) ( 4947 )   Postpartum haemorrhage is one of the most common causes of maternal death worldwide. Recombinant activated factor Ⅶ（rFⅦa） has already been successfully used for the treatment of bleeding episodes in patients with hemophilia A or B with formation of inhibitiors to factor Ⅷ or factor Ⅸ after replacement therapy and in other partients with inhibition of thrombin generating. Recently， scholars have found that rFⅦa plays wider roles in treating haemorrhage in patients with trauma， major surgery and even intractable obstetric and gynaecological hemorrhage. This article reviews the progress in the use of rFⅦa in intractable postpartum haemorrhage. Related Articles | Metrics

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The Advanced Study of 3D Power Doppler Ultrasound for Prenatal Investigation of Placenta ZHOU Ji-zi;YAN Ying-liu 2010, 37 (4):  249-252.  Abstract ( 1866 )   PDF (238KB) ( 4982 )   The placenta is the vital organ to ensure the growth and development of the fetus during pregnancy.Perinatal complications，like pre-eclampsia （PE）， intrahepatic cholestasis of pregnancy （ICP）， gestational diabetes mellitus（GDM）， may lead to abnormal placental function. Some adverse pregnancy outcomes such as fetal growth restriction（FGR），fetal Intrauterine hypoxia， fetal distress have been proved to be related to placental dysfunction.This review will introduce the basic principles of 3D Power Doppler Ultrasound（3D-PDU），relevant research of its index，its values of predicting adverse pregnancy outcomes and detecting abnormal placenta，and its prospects. Related Articles | Metrics

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Expression and Regulation of Connexin 43 and Gap Junction in the Myometrial Smooth Muscle Cell HE Shu-qiong;YAN Jian-ying 2010, 37 (4):  253-256.  Abstract ( 2586 )   PDF (242KB) ( 4869 )   Gap junction plays a significant role in intercellular direct communication. Connexin 43 （CX43），the major protein in the intercellular gap junction, has specific expression in uterine myometrium. It can regulate the signaling pathway of myometrial smooth muscle cell，thereby affect the coordination of uterine contraction. The paper indicates the relationship between CX43 protein and gap junction, the role of CX43 in the expression in myometrial smooth muscle cell and how phosphorylation events regulate the signaling pathways in it， and how CX43 protein affect the coordination and contraction of uterine，then provides the theory support for the prevention of premature birth and postpartum hemorrhage caused by uterine inertia. Related Articles | Metrics

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Research Progress of the Association of Autoantibodies with Endometriosis WANG Xiao-yan;TANG Liang-dan 2010, 37 (4):  257-259.  Abstract ( 2339 )   PDF (216KB) ( 4950 )   Endometriosis is a common benign disease in reproductive age women, but it possesses the malignancy tendency to invade, plant and recur. Endometriosis mainly presents as dysmenorrhea, menstrual disorder and dyspareunia. Endometriosis is associated with infertility intimately, and the precise pathogenesis is not completely understood. In recent years, most scholars consider that endometriosis is a kind of autoimmune disease. Autoimmune response play a role in the pathogenesis, and detection of autoantibodies may provide a new auxiliary index on the early diagnosis of the endometriosis. Related Articles | Metrics

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The Role of SUN Cai-xia;WANG Hai-lin 2010, 37 (4):  260-263.  Abstract ( 1641 )   PDF (332KB) ( 4881 )   It has played an important role that the abnomal expression of SNAIL gene in gynecologic cacinoma invasion and metastasis. At the cellular level，Snail factors regulate cell-cell adhesion，trigger the epithelial-mesenchymal transition（EMT）and lead to the occurrence of tumor development，invasion and metastasis. Different inducing factors promote the over expression of SNAIL through different signaling pathways，activate the downstream target and cause tumor metastasis.The deep study for Snail family members can not only further clarify the mechanism of SNAIL superfamily，but also provide a theoretical basis for further research in the SNAIL related cancer treatment strategy. Related Articles | Metrics

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The Relation of Nrf2-Keap1-ARE Signaling Pathway to Chemoresistance LI Zhong-min;YI Xiao-fang;SUN Hong 2010, 37 (4):  264-266.  Abstract ( 1777 )   PDF (207KB) ( 5067 )   Chemoresistance is the main bottleneck which restricts the effect of chemotherapy on cancer cells. Why cancer cells produce chemoresistance and how to solve the problem is the urgent concern for oncologists. Although some mechanisms have been reported， such as the increase of drug effluence， the strengthening of non-specific detoxification process， the enhanced DNA damage repair and apoptosis inhibition， the major factor or dominant mechanism underling chemoresistance remains the main problem. Recent study has shown that the Nrf2-Keap1-ARE signaling pathway may be the key point which links a variety of mechanisms for chemoresistance， and through genetic engineering on this pathway cancer cells may regain chemosensitivity. The composition of Nrf2-Keap1-ARE signaling pathway will be described and the research on the correlation between this pathway and chemoresistance will be reviewed in this paper. Related Articles | Metrics

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Advances in Anticancer Function of Histone Deacetylase Inhibitors CAO Zhen-ping;LING Bin;FENG Ding-qing 2010, 37 (4):  267-270.  Abstract ( 1614 )   PDF (215KB) ( 4911 )   It has been shown that epigenetic modifications play an important role in tumorigenesis. Among the key chromatin modifying enzymes，chromatin histone acetylation influences gene expression，Balanced by the activities of histone acetyltransferases（HATs） and histone deacetylases（HDACs），determining the acetylation status of histones. With a consequent hypoacetylated state of chromatin that can be strictly correlated with low expression of either tumor suppressor or pro-apoptotic genes. Histone deacetylase inhibitors（HDACi）represent a new and promising class of antitumor drugs that influence gene expression by enhancing acetylation of histones in specific chromatin domains. HDACi have been shown to exert potent anticancer activities inducing cell cycle arrest and apoptosis. Several HDACi are currently under clinical investigation. Related Articles | Metrics

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The Progress in Anti-Vascular Target Therapy in Ovarian Cancer HU Yuan-jing;XUE Feng-xia 2010, 37 (4):  271-273.  Abstract ( 1771 )   PDF (236KB) ( 4904 )   Target therapy focus on the tumor's characteristics which are different from normal tissues. So as to gain higher therapeutic effect with lower adverse effect. At present，most of the research of target therapy is about anti-vascular therapy.Intense researches and development activities have resulted in a variety of investigational agents，a number of which are currently be used in clinical experiments. This paper reviewed the clinical trials of anti-vascular target therapy in ovarian cancer，in order to know about the current situation and the prospective research of the treatment in ovarian cancer. Related Articles | Metrics

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The Effects of Gonadotropin Releasing Hormone Analogues on Ovarian Cancer and Ovarian Function Protection ZHANG Ying;HUA Ke-qin 2010, 37 (4):  274-276.  Abstract ( 2153 )   PDF (254KB) ( 5061 )   Ovarian cancer is a hormone depended cancer. Endocrine therapy as an adjunctive therapy has a long history. Gonadotropin releasing hormone（GnRH）analogues can affect the proliferation and apoptosis of ovarian cancer cells. Many researches certified the ovarian function protection of the GnRH analogues after chemotherapy. For the patients of early stages and keeping the ovary，it has great clinical significance to treat ovarian cancer and protect ovarian function simultaneously with GnRH analogues. Related Articles | Metrics

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Treatment Progress in Epithelial Ovarian Cancer LI Rui;LINGHU Hua 2010, 37 (4):  277-280.  Abstract ( 2095 )   PDF (237KB) ( 4898 )   Epithelial ovarian cancer is one of the most common female reproductive malignancies. It holds high mortality because most patients are diagnosed at advanced stages. Patients are primarily managed with surgery and chemotherapy. With careful pre-operative evaluation for the existence and resectability of metastatic diseases, the first step of management should be accurate diagnosis, thorough staging, with optimal surgical cytoreduction of metastatic diseases. At present, paclitaxel plus carboplatin become the first-line chemotherapeutic regimen of advanced EOC. Palliative treatment is needed for bowel obstruction（a major end-of-life complication） . Howerver, new strategies for recurrent and resistant patients needs further developing. Related Articles | Metrics

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Treatment and Diagnosis of Pregnancy Combined with Malignant Ovarian Tumor ZHAO Jian-guo;QU Peng-peng 2010, 37 (4):  281-283.  Abstract ( 1875 )   PDF (206KB) ( 4912 )   Pregnancy combined with malignant ovarian tumor is extremely rare. It's easy to diagnosis by imaging examinations and serum markers. The treatment of the patients with malignant ovarian tumor who want to keep on gestation needs follow-up strictly in the first trimester， included imaging examinations and serum markers. Biopsy，a simple staging surgery，chemotherapy is managed in the second trimester. Cesarean section and comprehensive staging surgery are operated in third trimester，and postoperative chemotherapy needs be given completely. Pregnancy promotes growth and metastasis of tumor. Therapy and growth of tumor cause miscarriage，premature delivery，fetal distress， fetal growth retardation and so on. Related Articles | Metrics

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Expression and Correlation of P27，P73 and CyclinD1 in Endometrial Carcinoma MI Shu-ling;SU Yan-yan;YIN Li-rong;MA Hong-da;SUN Jun-jie 2010, 37 (4):  284-287.  Abstract ( 2690 )   PDF (510KB) ( 4910 )   Objective：The objective is to study the expressions of P27，P73 and CyclinD1 in endometrial carcinoma and the correlation of them. Methods：14 cases of normal proliferative endometrium，19 cases of atypical hyperplasia and 43 cases of endometrial carcinoma were detected for the expression of P27，P73 and CyclinD1 by means of immunohistochemical SP. Results: In endometrial carcinoma，P27 reduced or lowexpressed，and P73 and CyclinD1 overexpressed， which were statistically significant with the expressions in normal proliferative endometrium and atypical hyperplasia group（P <0.05 or P <0.01）. Lowexpression of P27 and overexpression of P73 were related to histological grade，while overexpression of CycinD1 were ralated to FIGO stages. The abnormal expression of P27，P73 and CyclinD1 in deep invasion was significant difference with that in superficial invasion（P ＜0.05）. In the samples with lymph metastasis，P73 and CyclinD1 both overexpressed. In endometrial carcinoma，there was a opposite correlation between P27 and CyclinD1（r =-0.362 7， P <0.05）， while there was a positive correlation between P73 and CyclinD1（r =0.392 3，P <0.05）. Conclusion: So we concluded that， in endometrial carcinoma，there were lowexpression of P27 and overexpressions of P73 and CyclinD1. If detected together，the levels of P27，P73 and CyclinD1 proteins may be molecular markers for early screening of high-risk groups， and to determine the biological behavior of endometrial carcinoma and prognosis in reference. Related Articles | Metrics

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Use the Conventional Papanicolaou Smear by Improved Take-samples in Screening Cervical Carcinoma in People WANG Guo-ping;LI Rui-zhen;WU Lan-na;LI Juan;LIU Zhi-hong;WANG Chun;HE Fang;ZHOU Yan- qiu;WENG Lei-ming;WU Rui-fang 2010, 37 (4):  288-290.  Abstract ( 3225 )   PDF (528KB) ( 5127 )   Objective：To investigate the value of conventional Papanicolaou smear （Pap） improved by take-samples in screening cervical carcinoma. Methods： Conventional Pap smear by improved take-samples, liquid-based cytology test, hybrid capture Ⅱ human papillomavarus test were performed in 500 women of 30-59 years old without screening cervical cancer in 3 years in Shang Mei-lin community of Shenzhen Futian region from December 2007 to March 2008. We obtained samples of Pap by a broom-type sampling device（take-samples used for LCT） with split-sampling method. The positive threhold of cervical cytology was atypical squamous cells of undetermined sign（ASCUS）. The women with either testing result of Pap，LCT or HPV positive received multi-spot biopsy under colposcopy. The pathology results were the final diagnosis criteria to evaluate the value of two cervical cytology for screening cervical cancer. Results：The best screening cervical intraepithelial neoplasia （CIN）Ⅱ threhold of cervical cytology was ASCUS；There were no significant differences of screening effectiveness and unsatisfactory rate between Pap with improved take-samples and LCT; The complete concordance of diagnosis between Pap and LCT was 86.8%，The higher grade cervical lesion，the better concordance of diagnosis between Pap and LCT. Conclusions：Pap smear with improved take-samples is economic and effective and is worth popularizing in screening cervical carcinoma. Related Articles | Metrics

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Abdominal Wall Endometriosis： a Review of 65 Cases LU Guang-sheng;LIN Wan-jun;ZHOU Li 2010, 37 (4):  291-293.  Abstract ( 3194 )   PDF (218KB) ( 5236 )   Objective：To explore the clinical characteristics， treatment as well as prevention of abdominal wall endometriosis（AWE）. Methods：65 cases of AWE treated at Tianjin Central Hospital of Obstetrics and Gynecology from year 2008 to 2009 were reviewed. The average age was（30.7±3.6）years，range from 23 to 37 years. All of whom undergone the first cesarean section presented with pain and mass of cesarean scar 8 to 36 months after surgery，were hospitalized 9 to 72 months after surgery. The size of mass was from 1 cm × 2 cm to 4 cm × 4.5 cm. The characteristics of mass include unclear edge，solid，hard，tenderness and inmovable. In 23 cases，CA125 were mildly elevated. Results：All the cases were secondry to cesarean section. Of 65 cases with AWE，49 were located in adipose layer，13 cases were as deep as rectus abdominis. Peritoneal were invaded in 3 cases. All cases were received surgical treatment while in 5 cases which lesion diameter > 4 cm were given gonadotropin releasing hormone agonist（GnRHa） treatment for 3 times（per 28-32 day）prior to surgery. No recurrence was observed during 4-20 month follow-up and postoperative administration for 3 months. Conclusions：AWE could be diagnosed according to its medical history，typical clinical manifestations as well as gynecological check-up. Surgical treatment is the preferred choice. A complete excision with clear margin is very important. Medicine treatment after operation can prevent recurrence. Appropriately preventive measure is important during cesarean section. Related Articles | Metrics

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The Clinical Observation of Expectant Treatment in Ectopic Pregnancy MA Jin-feng;ZHANG Wen-fu 2010, 37 (4):  294-295.  Abstract ( 1819 )   PDF (185KB) ( 5021 )   Objective：To observe the clinical efficacy of MTX combined with mifepristone. Methods：60 patients who suffered ectopic pregnancy through expectant treatment are analyzed with retrospective methods， including 31 cases by MTX combined with mifepristone（treatment group）and 29 cases by MTX（control group）. Results：The cure rate in treatment group is higher than that in control group; The consistency of β-hCG in treatment group became normal more quickly than that in control group；and the hospital stays in treatment group is less in control group. Conclusion：The treatment method of MTX combined with mifepristone is one of the effective methods to cure ectopic pregnancy through expectant treatment. Related Articles | Metrics

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Sex Hormones Characteristic and Differential Diagnosis of Diseases with Amenorrhoea GUO Yi-qian;BAI Wen-pei 2010, 37 (4):  296-298.  Abstract ( 1817 )   PDF (262KB) ( 4967 )   Diseases with amenorrhoea could be divided from genital tract abnormality， disease of uterus， abnormality of ovarian function， abnormality of hypophysis function， and abnormality of hypothalamus. We can detect the concentration of estrogen， progestin， follicle stimulating hormone and other hormone. They can be indicators in the diagnosis and differential diagnosis of disease with amenorrhoea. Related Articles | Metrics

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The Role of SNAIL Gene in Gynecologic Cacinoma Metastasis Mechanism SUN Cai-xia;WANG Hai-lin 2010, 37 (4):  360-263.  Abstract ( 1570 )   PDF (332KB) ( 4770 )   It has played an important role that the abnomal expression of SNAIL gene in gynecologic cacinoma invasion and metastasis. At the cellular level，Snail factors regulate cell-cell adhesion，trigger the epithelial-mesenchymal transition（EMT）and lead to the occurrence of tumor development，invasion and metastasis. Different inducing factors promote the over expression of SNAIL through different signaling pathways，activate the downstream target and cause tumor metastasis.The deep study for Snail family members can not only further clarify the mechanism of SNAIL superfamily，but also provide a theoretical basis for further research in the SNAIL related cancer treatment strategy. Related Articles | Metrics