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15 April 2017, Volume 44 Issue 2
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Study on the Relationship between Epigenetic and Drug Resistance in Ovarian Cancer CHEN Jia-ye，FEI Jing，ZHOU Jian-wei 2017, 44 (2):  125-128.  Abstract ( 1185 )   PDF (756KB) ( 6773 )   Ovarian cancer is one of the most common malignant tumors of the three cancers female genital organs, and its mortality rate ranks first in gynecological malignancies. The research shows that the occurrence and development of tumor resistance is related to epigenetics. The related research also confirmed that epigenetics regulated the occurrence and development of ovarian cancer and drug resistance, such as DNA methylation, histone modification and MicroRNA genes. The epigenetics such as DNA methyltransferase inhibitors or histone deacetylase inhibitors can significantly improve the curative effect of ovarian cancer. The study of epigenetics and drug resistance in ovarian cancer are expected to provide new ideas and basis for clinical treatment of ovarian cancer. Related Articles | Metrics

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The Interaction between Mesenchymal Stem Cells and Ovarian Cancer. GAO Tong，JIANG Wei 2017, 44 (2):  129-132.  Abstract ( 1286 )   PDF (729KB) ( 6981 )   Mesenchymal stem cells (MSCs) can be chemotaxis to tumor site, participate in the formation of stroma and interact with tumor cells. According to different reports, MSCs can promote ovarian cancer cells proliferation by secreting cytokines and promote tumor stem cells differentiation;different types of MSCs can interact with ovarian cancer cells and promote or inhibit the invasion and metastasis of ovarian cancer; MSCs can promote the chemotherapeutic drug resistance of ovarian cancer by activating PI3K/Akt and BMP4/HH signaling pathways; MSCs can also be used as carriers to construct a targeted drug delivery system. These results indicate that MSCs play an important role in ovarian cancer and give us new research ideas, but the specific role and mechanism is still controversial and further studies are needed. Here, we reviewed the effects and mechanisms of MSCs or modified MSCs on the growth, metastasis and chemo-resistance of ovarian cancer,our purpose is to explore new ideas for ovarian cancer treatment. Related Articles | Metrics

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Regulation of autophagy in ovarian cancer cells by signaling pathways of EGFR LI Yan，TANG Xiao-han，LU Mei-song 2017, 44 (2):  133-136.  Abstract ( 1223 )   PDF (752KB) ( 6824 )   【Abstract】EGFR is the epidermal growth factor receptor, and its downstream signaling pathways affect many physiological activities of cells, including the regulation of autophagy. Autophagy is a process of cell self digestion, which is not only the self protection mechanism of cells under adverse conditions, but also can induce cell death and drug resistance. In ovarian cancer cells, EGFR-Ras-Raf-JNK, EGFR-PI3k-Akt-mTOR, and EGFR-JAK-STAT3 three pathways both promote and inhibit activation of autophagy. In recent years, EGFR inhibitors attempt to block the EGFR signaling pathways and inhibit autophagy activity and reverse drug resistance. The aim of this review is to illustrate the regulatory role of EGFR three main signaling pathways in the regulation of autophagy in ovarian cancer cells, and to provide a new target for ovarian cancer therapy and anti-drug resistance. Related Articles | Metrics

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Progress of Research on Ovarian Yolk Sac Tumour SHE Xiang-dong，NI Guan-tai 2017, 44 (2):  137-141.  Abstract ( 1358 )   PDF (739KB) ( 7342 )   【Abstract】  Ovarian yolk sac tumour （OYST）, also called ovarian endodermal sinus tumour （ＯＥＳＴ） are rare and highly malignant tumours of utmost importance occurring in children and young adults. AFP and glypican-3 are characteristic immunohistochemical markers. Cisplatin-based chemotherapy has dramatically improved the prognosis of OYST. Fertility-sparing surgery seems a reasonable approach in initial treatment even for patients with advanced stage. Three courses of BEP （bleomycin, etoposide, cisplatin） is the current standard therapy and four courses is recommended in case of bulky residual disease after surgery. There is a rare situation of ovarian yolk sac tumour complicating pregnancy in which adjuvant chemotherapy must be given after laparotomy. It can increase the risk of fetal malformation and pregnant death during gestation period. It may have an influence on prognosis in the case that tumor tissue types, selection of chemotherapy regimens, staging, not satisfied with the residual, preoperative and postoperative level of serum AFP. On the other hand, the choice of operation method has little impact on the prognosis of patients. Minimal invasive technique, assisted reproductive technology and protection of ovarian function during chemotherapy can make benefit in patients with malignant ovarian germ cell tumours. Related Articles | Metrics

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Progress in the Research of Cross-reacting Material 197 in Drug-resistant Ovarian Cancer CHEN Xin-yue，TANG Xiao-han，LU Mei-song 2017, 44 (2):  142-145.  Abstract ( 1226 )   PDF (705KB) ( 6943 )   Insidious onset of ovarian cancer, most advanced-stage patients with ovarian cancer relapse and become refractory to conventional chemotherapy，seriously threatening the lives and health of female. Therefore, a critical restrictor to cure ovarian cancer is the development of chemoresistance. Heparin-binding epidermal growth factor-like growth factor (HB-EGF), a member of the EGF family of growth factors, has been proven to be a promising chemotherapeutic target for ovarian cancer. Cross-reacting material 197 (CRM197), a non-toxic mutant of diphtheria toxin, which could inhibit the chemoresistance of ovarian cancer through binding and inhibiting to HB-EGF specifically. Studies have indicated that CRM197 has a significant role in the treatment of multiple tumors and the chemoresistance of ovarian cancer, but the specific mechanisms remain to be further studied in drug-resistant ovarian cancer. The feather of CRM197 will be reviewed. We will also discuss the application of CRM197 in tumor therapy and the research progress that the combination of paclitaxel and cisplatin with CRM197 in paclitaxel- and cisplatin-resistant ovarian cancer.   Related Articles | Metrics

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The Research Development of Time-of-flight Mass Spectrometry in the Diagnosis and Treatment of Ovarian Cancer LIU Gui-fen, SONG Yi-yi, SUN Peng-ming 2017, 44 (2):  146-149.  Abstract ( 1354 )   PDF (671KB) ( 6945 )   【Abstract】  Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) is a kind of mass spectrometry technology, and it has successfully detected many new biomarkers, which is related to diseases, especially in the aspects of diagnosis and treatment of tumor，moreover it can quickly detect specific proteins expressed in cancer patients, aid to set specific treatments, and predict the outcome of treatment and the possibility of recurrence. In recent years, domestic and foreign scholars have carried out a number of MALDI-TOF-MS study ，which is about the analysis of differential promoetic and the detection of molecular protein related to drug resistance in ovarian cancer. The origin and present situation of MALDI-TOF-MS technology，the research progress in the diagnosis and treatment of ovarian cancer, the challenges and application prospect, will be discussed in this paper. These will provid new ideas and methods for ovarian cancer prevention, diagnosis and treatment. Related Articles | Metrics

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The Research Progress of Long Non-coding RNA in Endometrial Carcinoma LI Yi-bing，MA Xiao-xin 2017, 44 (2):  150-154.  Abstract ( 1986 )   PDF (744KB) ( 9406 )     Long non-coding RNA (lncRNA) plays an extremely important role of regulation in many pathophysiological processes of organism, whose dysfunction is much related to the development and progression of tumors. It has become a research hotspot of many disease mechanisms recently due to its large number, variety and polytropic function. Endometrial carcinoma is one of the most common malignant tumors in female reproductive system, which has much relation with lncRNA. The research of lncRNA in endometrial carcinoma is becoming more and more. With the progressing of techniques and methods of the research, it will help reveal the development and progression of endometrial carcinoma to explore the regulation mechanism of lncRNA to endometrial carcinoma. It can also provide a new pathway to the primary diagnosis and treatment of this disease, and is likely to become a novel marker related to prognosis or a target of drug treatment. This article will summarize the research progression of lncRNA in endometrial carcinoma. Related Articles | Metrics

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Advance in Screening Methods of Endometrial Cancer SUN Jin，HU Wei-ping 2017, 44 (2):  155-158.  Abstract ( 2049 )   PDF (663KB) ( 9456 )    Endometrial cancer （ＥＣ） is the most common malignant tumor in female genital system, now the morbidity of EC is increasing gradually with a trend of attacking young adults, so the screening of precancerous lesion is increasingly important. It means we should take some examination in common people, pay attention to the lesion, and recognize the disease in time, now clinical diagnosis methods include serological examination, TVS, endometrial cytology test（ECT）, pathological diagnosis and immunohistochemical, however these inspections have their virtues and disadvantages, it′s impractical to choose one of them as a reliable way applying to general population, so it needs a lot of exploration to find a available method and put into use. When it′s necessary, we should combine some examinations to help diagnosis. Related Articles | Metrics

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Research Progress in Adiponectin，Insulin Resistance and Endometrial Carcinoma DANG Jie-mei，LIU Chan-zhen，ZHANG Jie-qing 2017, 44 (2):  159-162.  Abstract ( 1460 )   PDF (673KB) ( 6953 )   Adiponectin is an endogenous peptide specifically secreted by adipose tissues. Adiponectin exerts its biological effects by binding to its receptor（AdipoR）. Low levels of plasma adiponectin was associated with obesity and insulin resistance，and its degree was associated parallel with insulin resistance. Clinical study showed the decrease of adiponectin level was associated with the occurrence of endometrial cancer. With increase of clinical stage and histological grade, muscular invasion, lymph node metastasis, the expression of AdipoR was significantly decreased, and it was negatively correlated with progression free survival time and survival rate. Adiponectin binding to AdipoR, following to activate downstream of a variety of signal transduction pathways, and also interact with the insulin signaling pathway, and directly led to inhibit proliferation and induce apoptosis. Therefore, the decreased adiponectin and insulin resistance may be the independent risk factors to promote endometrial cancer. Related Articles | Metrics

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The Effects of Inhibiting CXCR7 Gene Expression on Migration and Invasion of HeLa Cells and Expression of Cervical Cancer Tissues WANG Jing-wen，WANG Si-nian，SUN Suo-zhu，ZHANG Xin，YU Nan，LI Feng-sheng 2017, 44 (2):  163-166.  Abstract ( 1183 )   PDF (865KB) ( 6851 )   【Abstract】  Objective：To investigate the effect of chemokine receptor 7 (CXCR7) silencing on invasion and migration of HeLa cells and its expression in cervical carcinoma and normal cervical tissues. Methods：Respectively, after the HeLa cells were transfected with plasmid expressing CXCR7 shRNA (CXCR7-shRNA) or negative control shRNA (Ctrl-shRNA), detecting the changes in cell migration and invasion of them by Transwell method. Immunohistochemistry was used to detect the expression of CXCR7 in cervical cancer tissues and non cancerous cervical tissues. Results：CXCR7 protein was positive in 16 cases of cervical cancer tissrues. Transwell invasion and migration assay showed that the number of CXCR7-shRNA transfected group was significantly lower than that of Ctrl-shRNA transfection group and non transfection group. Conclusions：The expression of CXCR7 was significantly higher in cervical cancer tissues, and the expression of CXCR7 could inhibit the invasion and migration of cervical cancer cells. Therefore, CXCR7 may be an important target for the prevention and treatment of cervical cancer. 【Keywords】  Related Articles | Metrics

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Clinical Analysis of 24 Cases Atypical Polypoid Adenomyoma of Endometrium ZHOU Qiao-yun，LIU Yu-huan，XIA En-lan 2017, 44 (2):  167-170.  Abstract ( 1535 )   PDF (746KB) ( 7151 )   Objective：To study the clinical features, diagnosis, treatment and prognosis of patients with atypical polypoid adenomyoma (APA). Methods：This is a retrospective study of 24 cases who suffered from APA admitted in Fuxing Hospital, Capital Medical University from January 2006 to June 2015. Their clinical features, diagnosis, treatment and prognosis were analyzed. The clinical feature of 17 cases (70.8%) were vaginal bleeding, 1 case (4.2%) vaginal discharge, 3 cases (12.5%) primary infertility. Ultrasound had shown occupied lesions within uterine cavity in 3 patients (12.5%). Twenty two patients were performed hysteroscopic surgery. Diagnosis was confirmed by pathological report. Results：Diagnosis of 24 cases were confirmed by pathologic report. The diagnosis of polyp by hysteroscopy and color ultrasound were 61.1% and 68.4% separately. The diagnosis of submucous myoma by hysteroscopy and color ultrasound were 11.5% and 15.8% separately. The differences were no significantly. The operating time was (23.7±8.6) min (5-40 min), the operating bleeding was (6.5±2.9) mL (5-20 mL). Postoperative follow-up consisted 1 to 10 years for 24 cases. Four cases lose follow-up. Three patients were performed hysterectomy after hysteroscopic polypectomy and postoperative follow-up was normal. At 3 months later hysteroscopic second look still shown APA in 1 case who was performed hysteroscopic polypectomy again and intramuscular injection GnRHa, till pathological report was normal levonorgestrel-releasing intrauterine system(LNG-IUS) was inserted into uterine cavity. Up to now 2 years follow-up there was no abnormalities. One case was performed hysterectomy 8 years later because of endometrial intraepithelial neoplasia. Fifteen cases follow-up so far no abnormality. There were 2 infertile patients got pregnancy and term delivery after surgery. Conclusions：As an effective treatment of APA hysteroscopic surgery has many advantages: positioning accuracy, mini-invasive and low recurrence rate. Owing to APA had the possibility of recurrence and malignant change, after surgery continuously and closely follow-up is still important. References | Related Articles | Metrics

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子宫血管肌纤维母细胞瘤一例并文献复习 2017, 44 (2):  173-175.  Abstract ( 1210 )   PDF (719KB) ( 6969 )   Related Articles | Metrics

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Uterine Spiral Artery Remodeling and Pathology Pregnancy DONG Sheng-wen，GUO Jie，SONG Dian-rong 2017, 44 (2):  176-179.  Abstract ( 1960 )   PDF (672KB) ( 7930 )   Uterine spiral artery remodeling is the key procedure in normal pregnancy. The proliferation and invasion of trophoblast cells is necessary for vascular remodeling process. When the trophoblast invasion is not fully enough, the spiral artery embolism is uncomplete, maternal-fetal circulation occurs earlier, the villi are damaged mechanically and directly. Oxidative stress cause cellular dysfunction and injury indirectly, followed by placental degeneration; cyclin-dependent kinase inhibitor 1A（CDKN1A） and Bax gene expressing abnormally caused by the pathway mediated TP53 protein, the apoptosis of trophoblast over regulated by miR-520 may lead to the emergence of the recurrent spontaneous abortion. The abnormal expression of MMP-9 produced by trophoblast cells and the release of a large number of inflammatory factors cause placental ischemia and hypoxia. The decrease of the vascular density, the volume of villus space, the degree of differentiation of trophoblast cells，hypoxia in microenvironment and the low level expression of synapse defective 1 (SDYE1) in placental villi may be an important cause of fetal growth restriction. So the study of spiral artery remodeling process has important significance for early diagnosis and treatment of pathological pregnancy. 【Keywords】  Related Articles | Metrics

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Progress of Study on Dysfunction of the Uterine Spiral Arteries Reconstruction of Recurrent Spontaneous Abortion XU Chun-yue，GUO Jie，SONG Dian-rong 2017, 44 (2):  180-184.  Abstract ( 1532 )   PDF (733KB) ( 7212 )   Recurrent spontaneous abortion is a common complications of pregnancy, which etiology and pathogenesis has not been fully elucidated. Sufficient uteroplacental blood flow is crucial for normal pregnancy, which depends on the maternal-fetal blood circulation system of high flow / low resistance resulted from physiologic transformation of the spiral arteries widespread throughout the placenta. Uterine spiral artery blood flow provides plenty of placental blood flow and nutrient to meet the development of embryos. The invasion extravillous trophoblast and apoptosis of uterine spiral artery cells are two key processes in the remodeling of the uterine spiral arteries. Failure of physiologic transformation of the spiral arteries will limit maternal blood flow into the placenta and the embryo therefore develops in a low blood flow / oxygen environment, which may lead to a series of pathological pregnancies. Early research has shown that decidual tissue of patients with recurrent spontaneous abortion were lack of trophoblast invasion, and performance the failure of physiologic transformation of the spiral arteries. Related Articles | Metrics

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Gene Therapy Advances of CRISPR/Cas9 in β-thalassaemia LI Huan-rong，LI Zeng-yan 2017, 44 (2):  185-188.  Abstract ( 2254 )   PDF (715KB) ( 9487 )   【Abstract】  β-thalassaemia is a genetic disease of human β-globin (HBB) gene mutation, there is no cure possible, leading to the disorder of globin expression. CRISPR/Cas system, as the acquired immune system of bacteria and archaea, can transform the genome of many organisms at present. CRISPR/Cas9 systems is widely used for the advantages of easy programming, inexpensive construction, high specificity and multiplexed genome editing. The latest study using CRISPR/Cas9 systems combined with induced pluripotent stem cells to correct human HBB has become possible，meanwhile produces normal hemoglobin to reduce the symptom of patients with β-thalassaemia. The outcome will be a tremendous disasters, if off-target effect occured in human, that′s scientist worried about. To increase the safety of CRISPR/Cas9 gene editing, the latest research avoid the off-targets effect by increasing the specificity of CRISPR resection and controlling the Cas9 effectively. We reviewed the latest researches on the CRISPR/Cas9 systems and deal with off target effects. 【Keywords】  Related Articles | Metrics

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Advance of Non-immune Hydrops Fetalis LI Ying，HAN Ping 2017, 44 (2):  189-193.  Abstract ( 1366 )   PDF (735KB) ( 7060 )   【Abstract】  Hydrops fetalis, classified into either immune or non-immune hydrops, is a pathological condition in which there is an excess of total body fluid, primarily within the fetal interstitial spaces or body cavities, its etiology and pathological and physiological mechanism is complex, the overall prognosis is poorer. At present, the diagnosis of hydrops fetalis mainly rely on the system of ultrasonic inspection, after which the etiology should be cleared, the clinical treatment mainly depends on the specific cause. In recent years, the further report of genetics research and development of the noninvasive prenatal diagnosis technology have deeply analyzed the etiology of hydrops fetalis. Reviewing the latest research reports about the pathological and physiological mechanism, causes, diagnosis with hydrops fetalis, for which providing reliable basis for early clinical intervention, so as to achieve early recognition, early diagnosis and early treatment. Related Articles | Metrics

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First Trimester Uterine Artery Doppler Predictive Value of Preeclampsia DAI He-liu，LI Chang-sheng，LI Bin，KE Li-na 2017, 44 (2):  194-196.  Abstract ( 1148 )   PDF (691KB) ( 6831 )   【Abstract】  Early recognition of the pregnant women with preeclampsia can reduce the risk of maternal and fetal morbidity and mortality. Uterine artery doppler waveform analysis for prediction of second trimester pregnancy preeclampsia markers have been widely studied. And the use of uterine artery doppler in first trimester pregnancy to predict preeclampsia become a research hotspot in recent years. Uterine artery doppler parameters as individual markers, its sensitivity is not high. First-trimester uterine artery doppler parameters (such as pulse index) combined with the maternal characteristics and biochemical markers (such as: pregnancy associated plasma protein A and placental growth factor) can achieve more than 90% rates of detection of early-onset preeclampsia. But in combination with biochemical markers increased costs, the future research direction is early screening of optimal combination forecasting model to predict preeclampsia. Related Articles | Metrics

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Current Research Progress of Labor Analgesia HUANG Xia，YANG Juan，YANG Yong-xiu 2017, 44 (2):  197-201.  Abstract ( 1230 )   PDF (750KB) ( 7121 )   【Abstract】  There are many methods of labor analgesia. At present, the best choice for labor analgesia is neuraxial blockade, which includes a epidural, spinal, or a combined spinal-epidural technique. Newer technique is dural puncture epidural technique. Others in conjunction with neuraxial blockade or by itself involve inhalation anesthesia and intravenous anesthesia. In addition, there are some non-pharmacological alternative, such as acupuncture, transcutaneous electronic nerve stimulation, hypnotism, hydrotherapy, yoga, birth ball, massage, relaxation techniques and so on. There are limited data on these methods in the management of labor analgesia. These therapies may be considered as an adjuvant because the analgesic efficiency is inferior to that provided by typical standard pharmacotherapy. This review will focus on the current updates and recent trends mainly about the effects of neuraxial blockade on stage and manner of labor, breast feeding, maternal fever or newborns, and about the progress of various neuraxial blockade techniques, to deepen the consensus, to understand the characteristics of labor analgesia, to guide further research. Related Articles | Metrics

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Effects of PM2.5 on Human Placental Trophoblast Cells by iTRAQ Combined with 2D LC-MS/MS QIN Zhe，FU Feng，XU Zhong-wei，HOU Hai-yan，CHEN Ya-qiong 2017, 44 (2):  202-207.  Abstract ( 1169 )   PDF (1082KB) ( 6872 )   【Abstract】  Objective：To preliminarily screened the protein molecules and biological processes that may be involved in PM2.5 increases the rate of adverse pregnancy by affecting the placental trophoblast cells using proteomic technology. Methods：HTR-8/SVneo cells were exposed to 0, 30, 60, 120 and 200 μg/mL PM2.5 for 24 h and 48 h, respectively, to observe the cell proliferation; finally, we selected 120 μg/mL PM2.5 treated with HTR-8/SVneo cells for 24 h and 48 h for follow-up experiments. After extraction of intracellular protein and enzyme digestion, peptides and differentially expressed proteins were analyzed and identified by isobaric tags for relative and absolute quantitation (iTRAQ) combined with two-dimensional liquid chromatography tandem mass spectrometry (2D LC-MS/MS) technology. Finally, bioinformatics analysis of the data was carried out. Results：The survival rates of cells treated with 120 μg/mL PM2.5 for 24 h and 48 h were 86.09% and 52.36%, respectively, which were also remarkably decreased compared with that of control cells (P＜0.05). There were 182 differentially expressed proteins in the cells exposure to 120 μg/mL PM2.5 for 24 h, involved in 22 cell biological processes (BP); meanwhile, cells exposed for 48 h had 486 differential proteins, involving 217 BP. Conclusions：PM2.5 can affect a large number of BP in HTR-8/SVneo cells. iTRAQ with LC-MS/MS 2D technology is an effective way for high sensitivity and throughput screening of differentially expressed proteins in cells after exposure to PM2.5, which provides a basis for the future research on the mechanism of PM2.5 increased the risk of adverse pregnancy outcomes. Related Articles | Metrics

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Perinatal Outcomes Analysis of Repeated OGTT Examinations to Diagnose Gestational Diabetes Mellitus CHEN Lei，JIA Hong-mei，CAO Dong-ru，YANG Ming-fang 2017, 44 (2):  208-210.  Abstract ( 1064 )   PDF (665KB) ( 6646 )   【Abstract】  Objective：To research the perinatal outcomes of the gestational diabetes mellitus （ＧＤＭ） women who were diagnosed by repeated oral glucose tolerance test (OGTT） examinations. Methods：188 women were diagnosed GDM by preliminary OGTT examinations as GDM1 group, 38 women were diagnosed GDM by repeated OGTT examinations as GDM2 group, and 200 pregnant women with normal blood glucose as control group. Compared 3 groups′perinatal outcomes, such as postpartum hemorrhage, preterm labour, PROM, macrosomia. Results：GDM2 group had significantly more postpartum hemorrhage, PROM, large for gestational age fetus than control group（P＜0.05）. GDM2 group had more macrosomia than GDM1 group, the difference had statistic significance（P＜0.05）. Conclusions：Repeated OGTT examinations can improve the GDM diagnosis ratio, so that we can early diagnose and actively intervene GDM, and improve pregnancy outcomes. Related Articles | Metrics

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The Effects of the Diet on Labor and Delivery Outcomes in Term Labor XU Ya-juan，REN Li-dan，ZHAI Shan-shan，HONG Teng，LIU Rui，RAN Li-min，LUO Xiao-hua，YU Yan-ru，BAN Yan-jie 2017, 44 (2):  211-214.  Abstract ( 1158 )   PDF (786KB) ( 6985 )   【Abstract】  Objective：To observe the effects of diet on labor and delivery outcomes in term labor. Methods：In the Third Affiliated Hospital of Zhengzhou University Hospital expectant pregnant 338 cases, which were divided into liquid diet group, 162 cases (control group) and free diet group 176 cases (observation group). The first and second stage of labor duration, vomiting, incidence of ketosis and birth outcomes were observed in both groups. Results：①The duration of the first and the second stage of labor continued time in the observation group were significantly longer than the control group (P＜0.05). ②The difference of the maternal vomiting incidence rate in control group and observation group was not statistically significant (P＞0.05). Maternal ketosis incidence rate in the observation group were lower than the control group, and the difference has statistical significance (P＜0.05). ③There were on differences in the rate of oxytocin use and the lateral perineal resection and transfering to cesarean section between two groups (P＞0.05). ④The differences of the newborns 1 minute, 5 minute Apgar score and neonatal intensive care unit (NICU) occupancy rate between the control group and the observation group, were not statistically significant (P＞0.05). There were no severe complications such as choking in both groups. Conclusions：In the process of delivery, the duration of the first and second stage of labor with the free diet of pregnant women was relatively prolonged, but it could reduce the incidence of ketosis in the pregnant women, without increasing labor intervention. And free diet also did not affect the outcome of mothers and newborns, not increase the vomiting incidence. References | Related Articles | Metrics

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Mode of Delivery for Pregnancy after Prior Cesarean when Spontaneous Labor PENG Lan，CHEN Da-li，WU Xiao，CHAI Li-qiang 2017, 44 (2):  215-218.  Abstract ( 1203 )   PDF (789KB) ( 6699 )   【Abstract】  Objective：To discuss the mode of delivery for the pregnant women after prior cesarean when spontaneous labor. Methods：A retrospective study was conducted, which included 230 pregnant women attending Suzhou Municipal Hospital from Jan. 2015 to Apr. 2016. All women had a previous cesarean and a singleton pregnancy with cephalic presentation, also spontaneous labor when admitted. The cases were divided into two groups according to the women′s preferences, trial of labor after cesarean (TOLAC) group and refused TOLAC group. The TOLAC group were further divided into successful TOLAC and failed TOLAC groups. The demographic characteristics, relevant factors about prior cesarean, pregnancy outcomes and socioeconomic performance were evaluated. Results：In all 230 pregnant women, 98 women eligible for TOLAC. TOLAC led to vaginal birth in 87 women (88.78%), 11 women failed due to fetal distress or a non-progress of labor. The BMI in failed TOLAC group was significantly higher than the other two groups (both P＜0.05). In total, 2 women who eligible for TOLAC [2.04% (2/98)] and 2 women refused TOLAC [1.52% (2/132)] had uterus scar rupture, there was no significant difference in two groups (χ2=0.091, P=0.767). The mean intrapartum blood loss in successful TOLAC group was significantly lower than the other two groups (both P＜0.05); when failed TOLAC group compared with refused TOLAC group, there was no significant difference (P=0.434). The proportion who required bold transfusion in successful TOLAC group was significantly lower than failed TOLAC group (P＜0.05), however there were no significant differences in the proportion in failed TOLAC group and refused TOLAC group (P=0.092). The proportion of neonates who had to be admitted to intensive care did not differ significantly by mode of delivery. Conclusions：Based on sufficient evaluate, under strict supervision and administration, TOLAC is a reasonable option, particularly when spontaneous onset of labor. Vaginal birth will be much safer and more reliable than emergency cesarean. Related Articles | Metrics

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The Effect of Serum Uric Acid Level Forecasting on Maternal-fetal Pregnancy Outcomes with Pre-eclampsia SONG Jian，HUANG Ya-juan，LU Ji-hong 2017, 44 (2):  219-221.  Abstract ( 1216 )   PDF (689KB) ( 6729 )   【Abstract】  Objective：To investigate the value of serum uric acid level within 1 months before delivery on maternal-fetal pregnancy outcomes with pre-eclampsia. Methods：A retrospective study was conducted on 152 pregnant women with pre-eclampsia who had delivered in Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiaotong University from April 2014 to December 2015. According to whether complicated with severe index and the onset gestational weeks, all selected patients with pre-eclampsia were divided into severe group (n=106), non severe group (n=46), early onset group (n=75) and late onset group (n=77). Indexes of pregnant women within one month before delivery contain serum uric acid (the above indicators were selected for the most serious condition); pregnancy complications such as pleural or peritoneal effusion, liver or kidney dysfunction; perinatal health indicators such as newborn birth weight, the Apgar score and the ratio of peak systolic to least diastolic flow velocity of fetal umbilical artery (S/D). Results：The serum uric acid level in early onset or severe pre-eclampsia was significantly higher than that in late onset or mild pre-eclampsia. The Logistics regression analysis showed that elevated level of serum uric acid might be one of risk factors for adverse maternal-fetal pregnancy outcomes with pre-eclampsia. According to receiver operating characteristic curves (ROC), we found that: when the serum uric acid level was increased to 388-440 μmol/L, there was statistical significance for forecasting adverse maternal-fetal pregnancy outcomes (P＜0.01). Conclusions：The serum uric acid level has important predictive value to patients with pre-eclampsia on maternal-fetal pregnancy outcomes and the opportunity of pregnancy termination. Related Articles | Metrics

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Clinical Effect of Reduced Glutathione Combined with S-adenosylmethionine in the Treatment of Pregnancy Complicated with Biliary Sludge XIE Ping，WANG Ying，YIN Yan-ping 2017, 44 (2):  222-224.  Abstract ( 1090 )   PDF (809KB) ( 6729 )   【Abstract】  Objective：To study the clinical effect of reduced glutathione combined with S-adenosylmethionine (SAM) in the treatment of intrahepatic cholestasis of pregnancy (ICP). Methods：117 patients with ICP in our hospital from January 2012 to June 2015 were selected by SPSS 16.0 software to generate random number table and divided into the joint group 58 cases and control group 59 cases. The control group was treated with SAM, joint group was treated with SAM + glutathione, the therapeutic effect were compared after four weeks. Results：Before treatment, There was no significant difference in blood TBA, ALT, AST levels and pruritus severity score between the combination group and the control group before treatment (P＞0.05). The blood TBA, ALT, AST levels and pruritus severity score were significantly reduced after treatment in both group (P＜0.05). After treatment, the blood TBA, ALT, AST levels and pruritus scores of the combined group were significantly lower than the control group patients (P＜0.05). There were no differences in gestational age, fetal distress, Apgar scores and birth weight between two groups (P＞0.05). The cesarean section rate in combined group was significantly lower than the control group (P＜0.05). Conclusions：Glutathione combined SAM was more effective than single SAM in the treatment of intrahepatic cholestasis of pregnancy. Related Articles | Metrics

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The Risk Factors on Prognosis in Acute Fatty Liver of Pregnancy PAN Hua；ZHANG Li-juan；XIA Ai-bin 2017, 44 (2):  225-227.  Abstract ( 933 )   PDF (756KB) ( 6661 )   【Abstract】  Objective：To investigate the factors influencing the prognosis of patients with acute fatty liver of pregnancy (AFLP), and to provide a clinical basis for improving the prognosis of AFLP patients. Methods：62 patients with AFLP were retrospectively analyzed. They were divided into 2 groups, Survival group and death group, according to the prognosis. Single factor and multivariate logistic regression were used to analyze the general data and the laboratory indexes of patients. Results：There were no significantly difference between survival group and death group on red blood cell count, hematocrit, hemoglobin, platelets, total protein, total bilirubin, alanine aminotransferase, aspartate aminotransferase, albumin, direct bilirubin, creatinine, PT, Fib, APTT in plasma, and the time from treatment to termination of pregnancy time and onset to termination of pregnancy (P＜0.05). Furthermore the time during treatment to termination of pregnancy over 24 h and the time during onset to termination of pregnancy over 14 d were the risk factor on prognosis of patients with AFLP. Conclusions：The time during treatment to termination of pregnancy and the time during onset to termination of pregnancy play a key role on prognosis in AFLP. Related Articles | Metrics

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Research Progress of Anti-Mullerian Hormone Levels in Patients with Endometriosis DONG Zhen-zhu，XIE Xi，MAO Xiao-dan，SUN Peng-ming 2017, 44 (2):  228-231.  Abstract ( 1083 )   PDF (729KB) ( 6797 )   【Abstract】  Endometriosis (EMs) is a common disease in women of reproductive age, including three types: peritoneal type, deep-infiltration type and ovarian type. EMs is estimated to affect around 2% of reproductive period women. Ovarian endometriomas are presented in 40% of women with endometriosis, of which 40%-50% are infertility and have the characteristics of a high relapse rate. The therapy includes drugs and surgery. In recent years, studies have reported the cystectomy of ovarian endometrioma may cause the decline of ovarian reserve and even premature ovarian failure, but endometriosis itself, especially the effect of ovarian endometriosis on ovarian reserve is rarely reported. Anti-Mullerian hormone (AMH) is a reliable marker of ovarian reserve in recent years. By analyzing the the AMH basal level in different types of endometriosis to evaluate the effect of endometriosis on ovarian reserve, so as to guide the clinical work. Related Articles | Metrics

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The Expression of Toll-like Receptors in Eutopic and Ectopic Endometrium and Its Implication in the Inflammatory Pathogenesis of Adenomyosis JIANG Cai-xia，LIU Chao，GUO Jing，CHEN Li，LUO Ning，QU Xiao-yan，REN Qing，CHENG Zhong-ping 2017, 44 (2):  232-236.  Abstract ( 1049 )   PDF (917KB) ( 6687 )   【Abstract】  Objective：To investigate the expression profiles of Toll-like receptors (TLRs) in eutopic endometrium (EU) and ectopic endometrium (EC) and its implication in the inflammatory pathogenesis of adenomyosis. Methods：A total of 24 adenomyosis patients who underwent laparoscopy were recruited in this study. The mRNA and protein expressions of TLRs, and the mRNA expression of IL-6 and IL-8 in EU and EC of adenomyosis patients, and the control endometrium without adenomyosis (CE) from healthy women were detected. Results：The mRNA expression of IL-6, IL-8 in EU was significantly higher than that in CE, and was the highest in EC (P＜0.01). The mRNA expression of TLR1-6, 8, 9 in EU was significantly higher than that in CE (P＜0.05), and were the highest in EC except TLR2 (P＜0.01). The mRNA expression of TLR7 in EU was significantly higher than that in CE (P＜0.05), but there was no significant difference in TLR7 expression between EC vs. CE, EU vs. EC. The protein expression of TLR1, 4-6, 8, 9 in EU was significantly higher than that in CE, and was the highest in EC (P＜0.01). The protein expression of TLR2 in EC was significantly higher than that in CE (P＜0.05), but there was no significant difference between EU vs. CE, EU vs. EC. The protein expression of TLR3, 7 in EC was significantly higher than that in EU and CE (P＜0.05), but there was no significant difference between EU vs. CE. Pearson correlation analysis showed that the expression of TLR2, 4, 5 and 9 in EU and EC was positively correlated with that of IL-6 and IL-8 (P＜0.05). Conclusions：Our results showed that adenomyosis was a state of inflammatory pathology. High expression of TLRs in EU and EC were positively correlated with IL-6 and IL-8, which may be involved in the inflammatory pathogenesis of adenomyosis. Related Articles | Metrics

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Effect of the Combination of Metformin and Roflumilast in Patients with Polycystic Ovary Syndrome YAO Chao，CHEN Yan，QUAN Yan 2017, 44 (2):  237-240.  Abstract ( 1068 )   PDF (792KB) ( 6677 )   Objective: To evaluate the combination of metformin and roflumilast in patients with polycystic ovary syndrome (PCOS). Methods：A total of 53 obese women with PCOS from June 2013 to June 2015 were investigated in this study. They were randomized to divide into control group （treatment with metformin, the initial 25 cases） and observed group (ｔreatment with metformin and roflumilast, followed by 28 cases）. Each group has been treated for three months. The weight, BMI, waist circumference, glucose, insulin, HOMA-IR, luteinizing hormone, follicle-stimulating hormone, androstenedione, and total and free testosterone were calculated before and after treatment. Results：After treatment with 3 months, the weight, BMI and waist circumference in observed group were significantly decreased （P＜0.05）, and there were significantly difference between two groups （P＜0.001）. Besides, the glucose and HOMA-IR were significantly difference between treatment groups （P＜0.05）. In addition, statistically significant within- and between-treatment differences were found in free testosterone and androstenedione （P＜0.05）. No difference was observed in serum total cholesterol （ＴＣ）, triglycerides （TG）, high-density lipoprotein-cholesterol （HDL-C） and  low-density lipoprotein-cholesterol （LDL-C） before treatment, however there was significantly difference between two groups after treatment （P＜0.05）. Conclusions：Combined treatment with roflumilast and metformin could reduce body weight in obese women with PCOS, and it encourage further exploration of the use of this drug for PCOS. Related Articles | Metrics