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15 December 2009, Volume 36 Issue 6
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Progress of Laparoscopic Therapy in Gynecology XIA En-lan 2009, 36 (6):  413-416.  Abstract ( 2381 )   PDF (262KB) ( 6153 )   In recent few years, with the progress of update idea, instruments, the accumulation of experience and technology natural orifice endoscopic surgery, single orifice laparoscopic surgery and robotic surgery etc. new laparoscopic technique emerged. Traditional laparoscopic techniques have made innovations, eg gasless laparoscopic surgery is supplementary of gas laparoscopy. Indications and operating ability of operator were greatly emphasized on laparoscopic hysterectomy and myomectomy. Laparoscopic tubal conservative operation could get higher intrauterine pregnancy rate after surgery. Narrow band imaging improved laparoscopic endometriosis diagnostic accuracy. Laparoscopic surgery in gynecologic cancer was almost the same with laparotomy. Progress of laparoscopic equipment and instruments increased the safty of laparoscopic surgery. Related Articles | Metrics

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Visfatin and Pregnancy HUA Shao-fang;HAN Yu-huan 2009, 36 (6):  417-419.  Abstract ( 2583 )   PDF (188KB) ( 4851 )   Visfatin is a newly identified adipocytokine produced by visceral fat tissue. This protein plays an important role in adipose accumulation and may regulate the insulin sensitivity of many peripheral organs. During pregnancy, the variation of fat distribution and the existence of fetal appendage may affect visfatin production, which may be involved in physiological insulin-resistance and the start of labor. Abnormal secretion of visfatin is associated with fetal growth retardation, hypertensive and diabetic diseases during pregnancy. The detection of visfatin in pregnant women and its practical role in high risk pregnancy should be further studied. Related Articles | Metrics

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Apoptosis of Trophoblast Cells With Chorioamnionitis and Infection-related Preterm Labor ZHOU Xin;SUN Li-zhou 2009, 36 (6):  420-423.  Abstract ( 2326 )   PDF (291KB) ( 4952 )   Preterm labor is the leading cause of perinatal morbidity and mortality of pregnancies. The etiology of preterm labor and delivery is multiple, the onset of chorioamnionitis caused by a variety of microorganisms is closely associated with the development of infection-related preterm labor. However, the underlying pathogenesis mechanism is not yet completely clear. Recent study found that there are many changes in the local micro-environment when chorioamnionitis placental, in which, cytokines such as tumor necrosis factor-α（TNF-α）, γ-interferon（IFN-γ）, and other factors, like nitric oxide（NO）and its metabolites，whose related changes are associated with trophoblast cell apoptosis, while the apoptosis of trophoblast cells through a variety of ways, change the occurrence of infection-related preterm labor, By the time the study of trophoblast apoptosis is expected to offer new ideas and methods for the clinical prevention and treatment of prematurity when chorioamnionitis happen. Related Articles | Metrics

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Women Infected With Human Parvovirus B19 During Pregnancy LI Yan;GUO Dong-hui 2009, 36 (6):  424-426.  Abstract ( 1926 )   PDF (228KB) ( 5006 )   Parvovirus B19 infects erythroid precursor cells and it is a potent inhibitor of hematopoiesis. Parvovirus B19 infected in pregnancy can be transmitted vertically from mother to fetus. This infection can cause several serious complications in the fetus, such as fetal abortion, anemia, no immune fetal hydrops and intrauterine fetal death. There is no evidence that Parvovirus B19 is a significant teratogen in human. Testing maternal serum for IgM and IgG antibodies against Parvovirus B19 and DNA detection by PCR can confirm maternal infection. If maternal infection has occurred, ultrasound investigation of the fetus and measurement of the peak systolic flow velocity of the middle cerebral artery are sensitive non-invasive procedures to diagnose fetal anemia and hydrops. There are characteristic glassy and brick-red intranuclear inclusions in the infectious placenta. Intrauterine transfusion is currently the effective treatment to alleviate fetal anemia, and the prognosis is good. Women who often contact children should be counseled during pregnancy in order to reduce the risk of adverse fetal outcome. Related Articles | Metrics

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The Obstetrics Outcome in Women With Polycystic Ovary Syndrome ZHANG Ya-jie;ZHANG Ling 2009, 36 (6):  427-429.  Abstract ( 1898 )   PDF (184KB) ( 4801 )   Polycystic ovary syndrome（PCOS） is the most common endocrine disorder in women of reproductive age. The disease is associated with many characteristic features, including hyperandrogenaemia, insulin resistance and hyperinsulinism which may influence the pregnancy outcomes and induce more obstetric diseases such as spontaneous abortion, gestational diabetes mellitus and pregnancy induced hypertension disease. It has great clinical significance to explore the characters of PCOS in pregnant women. Related Articles | Metrics

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Updated Researches in Twin-twin Transfusion Syndrome ZHANG Guang-lan;FANG Qun 2009, 36 (6):  430-433.  Abstract ( 2437 )   PDF (221KB) ( 4843 )   The widely used Quintero staging system in the estimation of twin-twin transfusion syndrome （TTTS） is still controversial. A new staging system including fetal cardiac function assessment and placental A-A anastomosis detection is proposed. Alternatives for TTTS treatment include serial amnioreduction, septostomy, and selective fetoscopic laser photocoagulation. In severe TTTS cases, these methods can be used in combination for optimal effect. The etiology of TTTS remains unknown, while vasoactive mediators may participate in the pathophysiology of TTTS. Mathematical models describing the onset and development of the four stages of TTTS may contribute to the role of placental vascular connections in the pathogenesis of TTTS. Related Articles | Metrics

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Female Pelvic Floor Remodeling in Perinatal Period MAO Xiao-yuan;WU Qing-kai 2009, 36 (6):  434-436.  Abstract ( 1867 )   PDF (205KB) ( 4962 )   Pelvic floor dysfunction （PFD） is strongly correlated with pregnancy and childbirth. The mechanisms of pelvic floor injury leading to PFD are largely unknown. The female pelvic floor can undergo a series of remodeling to maintain the anatomic and functional stability. The pelvic floor remodeling contains nerve, muscle and connective tissue; it is also carried through the whole perinatal period and shows individual difference. Study of female pelvic floor remodeling is beneficial to demonstrating the pathogenesis of PDF and providing effective therapy. Related Articles | Metrics

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Related Factors and Research Progress of Postpartum Stress Urinary Incontinence YANG Chun-bo;JIN Hang-mei 2009, 36 (6):  437-439.  Abstract ( 1742 )   PDF (219KB) ( 4702 )   Stress urinary incontinence（SUI） is a common disease in gynecology. There is a higher morbidity of SUI in reproductive and postmenopausal women. SUI is mostly caused by pregnancy and childbirth, which lead to the pelvic floor injury. Women after delivery are in a special period, the pelvic floor has just been hurt during childbirth, and has not been well recovered. So the occurrence of SUI is on a high level after childbirth. To prevent and reduce the occurrence of SUI, we must reveal the etiology of SUI. By analyzing the SUI-related factors, we can find the high risk factors of postpartum SUI, which show us the way to prevent the occurrence of postpartum SUI. After reading related literature, we found that early postpartum pelvic floor muscle training is helpful for preventing and treating postpartum SUI. But there is still insufficient education and lack of aid to access more guidance. Overall, the new mothers require more guidance from community health workers or obstetricians as soon as possible. Related Articles | Metrics

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MicroRNA and Cervical Cancer ZHANG Jia-rong;LI Shuang-di;WAN Xiao-ping 2009, 36 (6):  440-442.  Abstract ( 2164 )   PDF (187KB) ( 4749 )   Cervical cancer is one of the most common malignant tumors,which is caused primarily by high risk human papilloma virus infection. MicroRNAs are endogenous noncoding small RNAs, which take part in many processes including virus infection and tumorigenesis. Great concern has been raised regarding cancer-related microRNAs recently. In cervical cancer, several microRNAs（miR-21, -143, -146a, -199a, et al） have been found to be de-expressed. Here we discuss the role of microRNAs in the development and progression of cervical cancer. Related Articles | Metrics

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The Advance of Research on Relationship of Telomerase With Cervical Cancer LIU Hong-qian;WANG He 2009, 36 (6):  443-446.  Abstract ( 1883 )   PDF (208KB) ( 4739 )   Telomerase is a ribonucleoprotein enzyme which has reverse transcriptase activity. Increased telomerase activity may be very critical in the early steps of carcinogenesis. The human telomerase is composed of two important subunits including telomerase transcriptase protein （hTERT） and telomerase RNA template （hTERC）. Many studies showed both components were required for a functional telomerase holoenzyme. Recently many researches find that telomerase activity and hTERT/hTERC genomic instability are strongly associated events in the progression of uterine cervical dysplasia to invasive cancer. Such study in cervical cancer has been gradually carried out, which would provide new idea and means for early screening in cervical cancer. Related Articles | Metrics

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Nerve-sparing Radical Hysterectomy in Cervical Carcinoma WU Jia-han;LU Xi 2009, 36 (6):  447-449.  Abstract ( 2015 )   PDF (211KB) ( 4811 )   Radical hysterectomy has been proved highly effective as management of early-stage cervical carcinoma. Clinical strategy and individual treatment including surgical approaches, radiotherapy and chemotherapy have been determined according to age, fertility preservation and clinical stage of patients with cervical carcinoma. As we all know that the ideal surgical management of cervical carcinoma should be tailored on the basis of prognostic factors and quality of life. Moreover the classical radical hysterectomy（RH） often causes many complications, including bladder dysfunction, ano-rectal mobility disorders, and sexual dissatisfaction, etc. The new concept of nerve-sparing radical hysterectomy （NSRH） is becoming a promising achievement as an alternative treatment to reduce these complications. This paper reviews the historical innovation of NSRH and its recent achievements. Related Articles | Metrics

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The Correlation Between MAPK Signal Transduction and Ovarian Cancer JIAO Jin-wen;SHANG Xue;ZHU Yi-di;WEN Fang 2009, 36 (6):  450-453.  Abstract ( 1744 )   PDF (234KB) ( 4753 )   Mitogen-activated protein kinases （MAPK） signal transduction pathway is a class of serine/threonine protein kinase existed broadly in mammalian cells. It is closely related to cell proliferation and apoptosis. In recent years it is mostly studied in signal transduction research. Studies show that they play an important role in occurrence, invasion, metastasis and chemoresistance of tumor cells. It is proved that MAPK signal transduction pathway significantly increased in ovarian cancer cells, and participated in ovarian cancer chemoresistance. At this stage many experiments are basic researches, and its clinical research need further progress. Those reseaching progresses will provide new treating targets for ovarian cancer treatment. This review summarizes the current status of research on MAPK signal transduction pathway, emphatically on the relationship between MAPK signal transduction and ovarian cancer and the chemotherapy-resistant mechanism. There is also a discussion about the use of MAPK pathway inhibitors in cancer prevention and treatment in this review. Related Articles | Metrics

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New Discoveries on β-catenin in Ovarian Neoplasms LI Jun;LU Xin 2009, 36 (6):  454-457.  Abstract ( 2190 )   PDF (208KB) ( 4664 )   β-catenin is mainly involved in Wnt signaling pathway and E-cadherin-mediated cell-cell adhesion. Abberant β-catenin expression occurrs in most human malignancies. Recent studies demonstrated that deregulation of Wnt/β-catenin signaling pathway was related to the pathogenesis of ovarian neoplasms. Meanwhile, alteration of E-cadherin/β-catenin complex plays a significant role in the invasiveness and metastasis of ovarian cancer. Furthermore, the establishment of mouse models confirmed β-catenin′s role in the development of ovarian tumors. This review will summarize the new discoveries on β-catenin in ovarian neoplasms. Related Articles | Metrics

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Advances on Serum Tumor Markers of Early Diagnosis of Ovarian Cancer LUAN Xiao-rui;LI Wei-ping;DI Wen 2009, 36 (6):  458-461.  Abstract ( 1893 )   PDF (214KB) ( 4956 )   Ovarian cancer is the first leading cause of cancer deaths among women. Because of early stage ovarian cancer′s hidden clinical symptoms, we lack effective early diagnostic methods causing more than 70% of patients diagnosed at advanced stage. Early stage ovarian cancer is associated with a 5-year survival rate of 70%-90%, 5-year survival rate for patients with advanced ovarian cancer is only 20%. Therefore, early diagnosis of ovarian cancer has an important impact on prognosis. In recent years, people committed to search for serum tumor markers of high specificity and sensitivity such as CA125, HE4, SMRP, CA72-4, Hk, OPN, and combined detection as well. Also they have made a series of progress which will be reviewed in this article. Related Articles | Metrics

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The Study Progress in the Immune Function of Cancer Patients Treated With Chemotherapy Drugs FENG Qin-mei;DI Wen 2009, 36 (6):  462-464.  Abstract ( 2017 )   PDF (214KB) ( 4857 )   Operation and chemotherapy can reduce the tumor burden, however systematical chemotherapy induces lymphocytopenia. So conventional idea consider chemotherapy may inhibit immunologic function, which furthermore interfere with sequential immunotherapy. But some great breakthroughs have been archived by recent research which proves evidence that systematical chemotherapy can improve anti-tumor immune function through multiple mechanisms while companying temporary lymphocytopenia and synergistic antitumor activity of chemotherapy with immunotherapy has been investigated. These findings open a novel field of investigations for future clinical trial design, taking into account the immunostimulatory capacity of chemotherapeutic agents, and using them in combined chemo-immunotherapy strategies. Related Articles | Metrics

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The Relationship Between Tissue Factor Pathway Inhibitor-2 and Gynecological Tumors ZHANG Qiao;ZHANG Shu-lan 2009, 36 (6):  465-468.  Abstract ( 1806 )   PDF (279KB) ( 4842 )   Tissue factor pathway inhibitor-2（TFPI-2） belongs to the Kunitz-type serine proteinase inhibitor family, and it is a broad-spectrum inhibitor of serine proteinase. A great number of studies show that, TFPI-2 can inhibit and degrade matrix metalloproteinase, inhibit the angiogenesis and the signal transduction pathway mediated by TF-FVIIa compound and induce apoptosis of tumor cells to accommodate the invasion and metastasis of some malignant tumor. In this article, we reviewed progress in research on the feature of molecular biological of TFPI-2, its relationship with the invasion and metastasis of malignant tumor, and with gynecological tumors. Related Articles | Metrics

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Functional Hypothalamic Amenorrhea and the Hormones of Central Nervous System GU Fang;XU Yan-wen 2009, 36 (6):  469-471.  Abstract ( 2263 )   PDF (214KB) ( 5007 )   Functional hypothalamic amenorrhea（FHA） is a non-organic and reversible disorder which is due to the disorder of gonadotropin-releasing hormone（GnRH） pulsatile secretion. Nowadays, a lot of hormones of central nervous system are found to play an important role in the regulation of GnRH pulsatile secretion and thus be involved in the pathophysiology of functional hypothalamic amenorrhea. The purpose of this review is to update practitioners on the mechanisms of functional hypothalmaic amenorrhea and the related hormones in order to explore the new therapeutic strategy for FHA. Related Articles | Metrics

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Noninvasive Animal Models in Endometriosis Research LIU Bin;WANG Ning-ning 2009, 36 (6):  472-475.  Abstract ( 1763 )   PDF (223KB) ( 4771 )   The animal model used for studying the etiological and therapeutic aspects of endometriosis needs improvement. Previous studies using invasive observation and pathological anatomy showed many disadvantages. In the article, we reviewed literature over the past five years where non-invasive endometriosis animal models were used. The principle, method and the application of each approach is analyzed. The pros and cons of the various kinds of models are listed, with the addition of suggested improvements of methods. This essential information will benefit basic research and the clinical management of endometriosis. Related Articles | Metrics

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Relationship Between the Expression of PKR and High Risk HPV in Human Cervical Cancer and Pre-malignant Lesion LI Lei;QU Quan-xin 2009, 36 (6):  476-478.  Abstract ( 2155 )   PDF (323KB) ( 4792 )   Objective: To study the expression of PKR, high risk HPV（HPV16/18） in cervical cancer and pre-malignant lesion, and discuss the significance and the possible mechanism in occurrence and development of cervical cancer and pre-malignant lesion by PKR. Methods: From February, 2006 to February, 2007, we took patients with cervical cancer（n=37） and patients with cervical intraepithelial neoplasia（CIN, n=56） treated in the department of gynecology in Tianjin first central hospital and Huanghe hospital, and compared with healthy donor （n=30）. In the 123 cases, we use immuno-histochemical SABC staining method to detect the expression of PKR and HPV16/18 E6 and analyze the happening and developing of cervical cancer and pre-malignant lesion and the effect in cervical lesion induced by PKR. Result: The positive rate of PKR expression in cervical cancer tissues was 54.1%. The positive rate of PKR expression in the cancer group is higher than CIN groups and the normal cervical group（P <0.05）. In the cancer group, the expression of PKR and HPV has inverse correlation （r =-0.554, P <0.05）, and in the CINⅢ group, the expression of PKR and HPV has inverse correlation（r =0.480, P =0.032）. Conclusion: PKR was strongly associated with a decreased risk of developing cervical cancer, and HPV E6 gene has relation to modulate PKR expression. The expression of PKR and E6 could be an indicator in the prognosis of cervical cancer. Related Articles | Metrics

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Efficacy and Safety of Quadrivalent HPV Vaccine in Preventing Cervical Cancer and Infection and Diseases Associated With Vaccine-type HPV: a Meta-analysis SONG Yun-huan;LI Li 2009, 36 (6):  479-482.  Abstract ( 2093 )   Objective: To assess the efficacy and safety of prophylactic quadrivalent human papillomavirus （HPV） vaccine in preventing cervical cancer and infection and diseases associated with vaccine-type HPV. Methods: The Cochrane library, MEDLINE, EMBASE, NGC, CBM were searched, the randomised controlled trials （RCTs） about the efficacy and safety of prophylactic quadrivalent HPV vaccine were included. Two reviewers independently abstracted the data and assessed the quality. The data were input and analyzed by RevMan 4.2 software. Results: Five RCTs involving 23, 617 women met the inclusion criteria, meta-analysis showed that prophylactic HPV vaccination was associated with a significant reduction in the frequency of grade2 or 3 cervical intraepithelial neoplasia, adenocarcinoma in situ, grade2 or 3 vulvar intraepithelial neoplasia or vaginal intraepithelial neoplasia and genital warts caused by vaccine-type HPV strains compared with those in the control groups. The major adverse events were minor. The incidence of serious adverse events was balanced between the vaccine and control groups. Conclusion: Prophylactic HPV vaccination was efficacious and safe in preventing cervical cancer and genital diseases associated with vaccine-type HPV. Related Articles | Metrics