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15 August 2017, Volume 44 Issue 4
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Research Progress of LSD1 in Gynecological Malignancies LIN Le-qian, WANG Wei, HAO Min 2017, 44 (4):  365-368.  Abstract ( 1150 )   PDF (705KB) ( 6403 )   Histone lysine specific demethylase 1 (LSD1) is a kind of flavin adenine dinucleotide (FAD) dependent monoamine oxidase, which can specifically demethylate monomethylated and dimethylated K4 and K9 of histone H3 (H3K4, H3K9) as well as can specifically demethylate non histone proteins dimethylation (K370me2) at K370, which result in inhibition of p53 function by inhibiting the interaction of p53 with p53-binding protein 1(53BP1) repressing the activity of the p53 gene. In recent years, many studies have found that LSD1 plays an important role in chromatin regulation, by regulating the proliferation, invasion and metastasis of tumor cells, affecting the occurrence and development of a variety of malignant tumors. The special role of LSD1 makes it possible to become a new anti-tumor target. Nowadays, the reports about the expression of LSD1 on the role of gynecological malignancy are rare. In this paper, structure and function of LSD1 and the latest research progress of LSD1 in cervical cancer, ovarian cancer and endometrial cancer will be reviewed. Related Articles | Metrics

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Research Progress of the Correlation between Human Epididymis Protein 4 and Gynecologic Oncology LI Fang，WU Su-hui 2017, 44 (4):  369-373.  Abstract ( 1036 )   PDF (846KB) ( 6818 )   Human epididymis protein 4(HE4) is a new tumor biomarker in recent years, many scholars at home and abroad have researched about it. HE4 originally found in people distal epididymal epithelial cells which have the ability to inhibit proteases and express in multiple tissue of the human body. HE4 has important value in diagnosis of ovarian cancer, especially in the early ovarian cancer which can diagnose of benign and malignant ovarian tumors, and also has superiority in monitoring recurrence. At the same time, research has shown that HE4 has a guiding significance  in diagnosis, prognosis and staging of endometrial carcinoma. In addition, HE4 can also be used for the diagnosis and monitoring of benign disease of gynecology such as endometriosis, uterine adenomyosis, etc. We has been adopting the recommended HE4 reference value of America as a diagnostic criteria for the lack of crowd HE4 reference research in China. In view of this, HE4 Chinese population reference multicenter study was officially launched in 2012. Through the study of the large sample of people in our country, it provided the reference range of HE4 levels, which will guide Chinese doctor to apply HE4 results for clinical diagnosis and treatment, effectively improve the clinical management of gynecological oncology. Related Articles | Metrics

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Research Progress on the Fertility-Sparing Therapy in Early Cervical Cancer Patients ZHOU Ying, SHEN Zhen, QIAN Li-li, WU Da-bao 2017, 44 (4):  374-380.  Abstract ( 1006 )   PDF (1278KB) ( 6441 )   Radical hysterectomy and pelvic lymphadenectomy is still the routine treatment for young patients with early cervical cancer, which leads to loss of their fertility. In this review, we retrospectively analyze the latest research progress of vagina and lymph node metastasis after radical surgery of cervical cancer both at home and abroad, finding that only 27% of the patients with early cervical cancer have lymph node metastasis, and then conclude the clinical application prospects of sentinel lymphadenectomy and the research status of "minimal and effective" surgical treatment for fertility-sparing therapy. Sentinel lymph node resection can improve the accuracy of the intraoperative diagnosis of lymph node metastasis, reduces unnecessary excessive treatment, which can be an alternative to the pelvic lymphadenectomy. At present there are 6 kinds of fertility-sparing operations including cervical conization, simple cervical resection, wide resection of the cervical, vaginal radical trachelectomy, laporotomic radical trachelectomy, and laparoscopic robot assisted laparoscopic resection of the cervix. For patients with lesions ＞2 cm, 3-4 course NACT before operation are recommended, then combine gynecologic examination and radiographic evidence, decide the cervical resection range and choose the operation method. Related Articles | Metrics

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Application Progress of HPV Genotyping Test in High-Grade Cervical Lesions after Treatment LIN Ting-ting, SUN Peng-ming, SONG Yi-yi 2017, 44 (4):  381-384.  Abstract ( 1033 )   PDF (771KB) ( 6456 )   High risk human papillomavirus (HR-HPV) persistent infection is the major cause of cervical intraepithelial neoplasia(CIN) and cervical cancer. Women after standard treatment for high-grade CIN(HG-CIN) are at higher risk of subsequent disease compared to the general population. After treatment, HR-HPV positive, cytological abnormalities, positive margins were the predictors of residual/recurrent disease after treatment of cervical high-grade lesions. HPV genotyping can be used to identify the different infection status of HR-HPV after treatment, which is helpful for detecting the high-risk groups. The persistent infection of the same type HR-HPV was closely associated with the residual lesions or recurrence after treatment of HG-CIN compared with the HR-HPV new infection or recurrent infection. HPV16/18 is the most common type of persistent infection in patients with HG-CIN, which has a higher risk of residual lesions or recurrent disease and need to closely follow-up. HPV genotyping increases sensitivity for the detection of residual or recurrent disease after treatment for HG-CIN than cytology and HR-HPV testing, remains equal or better sensitivity. Related Articles | Metrics

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Progress of the Regulation of Macrophage Polarization by Ovarian Tumor Microenvironment and Long Noncoding RNA LIU Li，WANG Xi-peng 2017, 44 (4):  385-389.  Abstract ( 1036 )   PDF (756KB) ( 6395 )   Tumor associated macrophages(TAMs) are the most common immune cells in the tumor microenvironment. They exist in tumor，distant pre-metastatic niche，as well as metastatic lymph node, and they are related to tumor progression and poor prognosis. There are many TAMs infiltrating into ovarian tumor and patients′ ascites, while the underlying mechanism is still unclear. Recently, role of lncRNA in the regulation of cell physiology has drawn more and more attention. LncRNA can affect the expression of coding gene by competing miRNA, directly interacting chromatin or protein, then regulate the function of cells. LncRNA has also been reported to regulate the differentiation of macrophages，for there are large number of lncRNAs differently expressing in M1 macrophages and M2 macrophages. Furthermore, lncRNA may play a role in the regulation of antigen presentation and phagocytosis of macrophages. Therapeutic methods targeting TAMs has been proved to be effective to reduce growth of ovarian cancer and production of ascites, and researches  trying to investigate the application of lncRNA inhibition in tumor therapy has also progressed to some extent in recent years. Related Articles | Metrics

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Advances in Clinical Management of Stage Ⅱ Endometrial Cancer ZHANG Tian-yu, WANG Yi-qin, WANG Jian-liu 2017, 44 (4):  390-395.  Abstract ( 1109 )   PDF (838KB) ( 6537 )   The incidence of stage Ⅱ endometrial cancer accounts for about 12% of endometrial cancer. The combination of the dilationand curettage, hysteroscopy and the imaging technique is a good choice for diagnosis. At present, the surgical approach of stage Ⅱ endometrial cancer is controversial, different studies have come to different conclusions, to expand the resection range to reduce the recurrence rate also increased intraoperative and postoperative complications. We should carefully balance the benefits of prognosis and increasing risk of surgery in selecting the surgical range. More prospective experiments are needed. Postoperative radiotherapy can reduce the recurrence rate, but have no effect on the overall survival rate. And vaginal brachytherapy may be better than pelvic radiotherapy. Adjuvant chemotherapy is needed in high-risk stage Ⅱ endometrial cancer. The three year survival rate of stage Ⅱ endometrial cancer is 79%-85%. The diagnosis, treatment and prognosis of stage Ⅱ endometrial cancer, which is the endometrial cancer patients with cervical stromal involvement [new International Federation of Gynecology and Obstetrics (FIGO) stage Ⅱ] are reviewed. Related Articles | Metrics

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The Study of Salidroside on Inhibition of Cervical Cancer HeLa Cells Proliferation ZHANG Yang, DONG Tian-rui, NI Jin-hong 2017, 44 (4):  396-398.  Abstract ( 1151 )   PDF (860KB) ( 6392 )   Objective: To discuss different concentrations of salidroside on inhibition of cervical cancer HeLa cells proliferation and its mechanism. Methods: Concentration of 5, 50, 500 μg/mL salidroside cultured in vitro after 24 h, were determined by MTT method to observe for growth inhibition, flow cytometry technique and Hoechst staining were used to observe apoptosis of HeLa cells, and colorimetry was used to detect the expression of apoptosis related factor Caspase-3 and Caspase-9. Results: The survival rate of different dose of salidroside were (82.00±3.65) %, (59.33±2.39)%, and (54.00±2.61) %, the difference was statistically significant (P＜0.05) compared with negative control group (97.33±3.45) %; Flow cytometry technology results showed that the percentage of apoptosis cells in low, medium and high concentration salidroside group were (20.53±5.76) %, (32.43±3.53) % and (42.40±3.39) % respectively, the difference was statistically significant (P＜0.05) compared with negative control group (1.33±0.95) %; Hoechst33258 nuclear staining method showed that salidroside could increase the number of apoptosis cells, in addition, salidroside could also increase expression level of Caspase-3 and Caspase-9. Conclusions: Salidroside inhibited cervical cancer HeLa proliferation by enhancing the expression of Caspase-3 and Caspase-9, inducing its apoptosis, which indicated that salidroside may play a certain role in the treatment of cervical cancer. Related Articles | Metrics

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A Quality of Life Investigation about Spouses of Patients with Cervical Cancer Undergoing Radiotherapy and Chemotherapy XIA Wei-shu，PENG Li-zhen，XIONG Yan 2017, 44 (4):  399-401.  Abstract ( 1023 )   PDF (793KB) ( 6292 )   Objective: To investigate the quality of life of spouses of patients with cervical cancer undergoing radiotherapy and chemotherapy. Methods: The spouses of patients with radiotherapy and chemotherapy for cervical cancer treated in the Department of Oncology of Jiangxi Provincial Maternal and Child Health Hospital from March to June of 2016 were selected as the study group, the spouses of patients in gynecological ward were selected as the control group in the same period, 60 cases in each group. The quality of life questionnaire (GQOLI-74) was assessed in 2 groups. Results: Of the study group, physical function dimension score was 47.72±5.51, psychological function dimension score was 53.58±8.43, social function dimension score was 51.15±7.62, and total score of overall quality of life was 201.45±18.63; Of the control group, physical function dimension score was 60.26±5.86, psychological function dimension score was 64.92±8.71, social function dimension score was 62.43±7.29, and the overall quality of life score was 242.51±21.33. The 3 dimensions and overall quality of life score of study group were lower than that of control group (P＜0.05). In the material life dimension, the score of the study group was 54.42±6.30, while that of the control group was 56.48±6.45, and there was not statistical significance in the 2 groups（P＞0.05）. Conclusions: The quality of life of spouses of cervical cancer patients with radiotherapy and chemotherapy have been greatly changed, the quality of life decreased significantly, nursing staff can inform the spouses of patients with cervical cancer by non-infectious and of the importance of sex life, assist in maintaining vaginal lubrication and elasticity to promote sex life quality, and actively treating chemotherapy side effects and other measures to help them to improve the quality of life of spouses. Related Articles | Metrics

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Research Progress on the Role of Decidual Natural Killer Cells in Pregnancy Complications LIAO E，SHAO Yong 2017, 44 (4):  406-411.  Abstract ( 1004 )   PDF (1077KB) ( 6393 )   Decidual natural killer (dNK) cells accumulate in the maternal decidua during pregnancy and are found in direct contact with fetal trophoblasts. However, the mechanisms of dNK cells during pregnancy are mostly unknown. By secreting cytokines/chemokines and angiogenic factors, dNK cells participate in normal placentation including feto-maternal tolerance, spiral artery remodeling and neovascularization during decidualization in a successful pregnancy. In recent years, dNK cells have been found to be closely related to the occurrence and maintenance of normal pregnancy. It has also been found that abnormal changes of DNK cell cytology and immunology and other aspects are common in complications of pregnancy such as recurrent spontaneous abortion, pre-eclampsia, etc. This review intended to summarize and discuss recent data that may challenge the conventional view of dNK cells, including quantitative, phenotypic, secretory cytokines and angiogenic factors, and possible mechanisms of dNK cells in the pathogenesis of pregnancy complications. To elucidate latest knowledge on dNK cells, may guide the prevention and treatment of complicated pregnancies. Related Articles | Metrics

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Research Progress of Microbiome in Related Organs in Pregnancy ZHANG Xin-hong, WANG Feng-ying, LIAO Qin-ping 2017, 44 (4):  412-414.  Abstract ( 1092 )   PDF (711KB) ( 6375 )   Pregnancy is a time of dramatic immune and physiological changes that serve to accommodate the growing fetus. During pregnancy, alterations in the gut and vaginal microbiome populations occur. These alterations might influence the maternal metabolic profile and contribute to the mebabolic and immunological health of the offspring. Recently, the role of gut microbiome in pregnancy has become the subject of considerable interest. It has been reported that the maternal microbiota from the third trimester of normal pregnancy show signs of gain weight and insulin insensitivity similar to those observed in obesity.Lately, the vaginal microbiota of pregnant women become more and more important. The lactobacillus is also dominant in vagina in conception, but the correlation of vaginal microbiota and pregnancy outcome still need investigate furtherly. Further, it has recently become clear that the placenta has a microbiome. The placental microbiome is associated with preterm birth, indicating that the crosstalk between bacterial communities and the pregnant women may be of great importance. Related Articles | Metrics

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Clinical Analysis of TSH Variation in Twin Pregnancy MENG Xiao, ZHANG Li, LIU Yu, JIA Rui-zhe, CHENG Qing 2017, 44 (4):  415-417.  Abstract ( 1388 )   PDF (817KB) ( 6553 )   Objective: Detect thyroid level of twin pregnancies, to analyze the relationship between pregnancy complications and thyroid level. Methods: Select 136 women with twin pregnancies who were enrolled in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from June 2016 to January 2017. These pregnant women were classified into two groups: one with complicated pregnancy (92 cases), the other with uncomplicated pregnancy (44 cases). The control group consisted of 50 normally single pregnant women. Compare thyroid stimulating hormone (TSH) and serum free thyroxine (FT4) between these three groups. Calculate the cut-off value of TSH in predicting complications of twin pregnancy with the ROC (receiver operating characteristics) curve. Results: TSH level in group of twin pregnancy women with complications was obviously high compared with the other groups, the difference was statistically significant (P＜0.05); There was no statistical difference between TSH level in uncomplicated group and that in normally single pregnancy group(P＞0.05). There were no statistical differences between FT4 in these three groups(P＞0.05). When the cut-off value of TSH was 5.18 mIU/L，the susceptibility and specificity was 63% and 91% respectively. Conclusions: TSH level increased in twin pregnancy women with complications. To detect TSH level has a high value of predicting the complications in twin pregnancy women. Related Articles | Metrics

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Pregnancy Outcomes Following Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia: A Meta-Analysis YAN Jian-ying，CHEN Min 2017, 44 (4):  418-429.  Abstract ( 1032 )   PDF (8006KB) ( 6166 )   Objective：To analyze the association of the treatment safety and the related pregnancy outcomes with previous treatment of the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia(CIN). Methods：A thorough search of PubMed, Cochrane Library, CNKI, CBM, Wanfang and CqVip electronic databases was performed. Case-control studies about pregnancy outcomes after previous treatment of LEEP for CIN were collected and meta-analysis was carried out with RevMan 5.3 software. Results：Forty case-control studies including 9 002 patients were enrolled in this study with 4 196 patients in study group and 4 806 patients in control group. For women with previous LEEP for CIN, meta-analysis revealed that: (1)The incidence of miscarriage was significantly increased in study group as compared with that of control group (RR=1.34, 95%CI: 1.14-1.57, P＜0.05), no significant difference was found in the incidence of pregnancy, ectopic pregnancy and induced labor with respect to the first, mid trimester of pregnancy between study group and control group (P＞0.05 each); (2)① For maternal, LEEP was associated with a higher risk of preterm delivery (RR=1.60, 95%CI: 1.37-1.86, P＜0.05), preterm premature rupture of membranes (RR=2.72, 95%CI: 1.46-5.07, P＜0.05), no significant difference was found in the incidence of premature rupture of membranes, cesarean section, placenta previa, postpartum hemorrhage in regard to the perinatal period (the late trimester of pregnancy) between study group and control group(P＞0.05 each); ② For perinatal infants, the incidence of low birth weight was obviously increased in study group (RR=1.35, 95%CI: 1.10-1.66, P＜0.05), no significant difference was found in the incidence of fetal distress, neonatal asphyxia and neonatal mortality during perinatal period between study group and control group (P＞0.05 each); ③ For delivery way and complications, LEEP was not associated with a significantly increased risk of precipitate labour, forceps delivery and vacuum extraction delivery, and cervical laceration (P＞0.05 each). Conclusions：LEEP is associated with an increased risk of miscarriage, preterm delivery, preterm premature rupture of membranes and low birth weight. For CIN patients with fertility preservation, the risk of adverse pregnancy outcomes should be fully informed before LEEP. Related Articles | Metrics

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The Safety of Maternal and Perinatal of Trial of Labor after Previous Cesarean Delivery Versus Elective Repeat Cesarean Delivery: A Meta-Analysis CHEN Hong-xiao, TIAN Xiu-fang 2017, 44 (4):  430-435.  Abstract ( 1031 )   PDF (912KB) ( 6341 )   Objective：The aim of this study was to compare the trial of labor with elective repeat cesarean delivery (ERCD) among women with previous cesarean delivery. Methods：We searched CENTRAL, Medline, Embase, Ovid, Wanfang, CNKI databases about the safety of maternal and perinatal of trial of labor after previous cesarean delivery (TOLAC) versus ERCD from 1989 through 2016. Results：Eleven studies with a total of 91 975 women were included. 51 428 women undergoing TOLAC, 40 547 women undergoing ERCD. Uterine rupture occurred more frequently among women undergoing TOLAC than among those undergoing ERCD (RR=2.78, 95%CI: 1.24~6.22, P=0.01). Mothers undergoing TOLAC were less likely to have hysterectomy (RR=0.57，95%CI: 0.44~0.74，P＜0.000 1). There were no differences in maternal puerperal infection (RR=1.10, 95%CI: 0.78~1.56, P=0.58), require transfusion(RR=1.09, 95%CI: 0.62~1.92, P=0.75) and maternal mortality (RR=0.71, 95%CI: 0.26~1.92，P=0.50） risk between the 2 groups. Asphyxia of newborn (RR=2.30，95%CI: 1.74~3.03，P＜0.000 01) and fetal or neonatal death  (RR=1.71，95%CI: 1.29~2.25，P=0.000 1) were more frequent in the TOLAC group than the control group. Conclusions：In order to reduce the rate of cesarean section, we should encourage TOLAC. Its security is very important, which required adequate prenatal assessment, strict and standardized monitoring of the delivery process for the maximum guarantee of maternal and child safety, but also a reasonable and scientific assessment of each cesarean section indications is necessary. Related Articles | Metrics

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The Treatment of Cornual Pregnancy and Its Influence on Postoperative Fertility YU Xin-mei 2017, 44 (4):  436-439.  Abstract ( 1168 )   PDF (859KB) ( 6649 )   Objective: To analyze the clinical effect of different treatment regimens of cornual pregnancy and its effect on postoperative fertility. Methods: 95 cases of cornual pregnancy patients admitted in our hospital from January 2012 to December 2015 were retrospectively analyzed. They were divided into 5 groups according to the treatment methods: uterine curettage group (n=21), laparotomy group (n=27), laparoscopic surgery group (n=33), reduction group (n=5), drug treatment group (n=9). To analyze the clinical effect of different treatment regimens and the effect on postoperative fertility. Results: All surgical patients were treated successfully an no adverse reactions occurred after surgery. The bleeding volume in the laparotomy group was the largest and the uterine curettage group was the smallest (P＜0.05). The operation time of the uterine curettage group was shorter than that of laparotomy group and laparoscopic surgery group (P＜0.05), but there was not statistical difference between laparotomy group and laparoscopic surgery group (P＞0.05). The decline of postoperative 3 d β-hCG of uterine curettage group was significantly more than that of laparotomy group and laparoscopic group (P＜0.05). The hospitalization days of uterine curettage group was the shortest and the laparotomy group was the longest (P＜0.05). In the 9 patients of drug treatment group, 8 cases of gestational sac were completely discharged and the discharge time of the gestational sac was 3-5.5 h, averaged (4.1±1.2) h; the vaginal bleeding time was 5-8 d, averaged (7.2±1.4) d. The remaining 1 case treated by uterine curettage due to incomplete miscarriage of labor. After following-up for 1 year after treatment, 5 cases of reduction group delivered successfully. 41 cases in another planned pregnancy 81 cases were intrauterine pregnancy. The re-pregnancy rate in the drug treatment group was the highest and the laparotomy group was the lowest (P＜0.05). Conclusions: In the development of treatment programs, we should give full consideration to the patient′s condition, the size of the gestational sac, the location and whether rupture, the patients′ wishes and physicians′ practical experience and surgical techniques. Minimally invasive surgery is the development trend of cornual pregnancy treatment. Related Articles | Metrics

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The Effect of Hysteroscopic Resection Endometrial Polyp and the Influence Factors of Natural Gestation after Surgery TIAN Zong-ru, LIU Shao-xia, QUAN Xiu-ling 2017, 44 (4):  440-442.  Abstract ( 1090 )   PDF (685KB) ( 6571 )   Objective: To explore the effect of transcervical resection by hysteroscopy in the management of endometrial polyps and influencing factors in pregnancy. Methods: Sixty infertile patients due to endometrial polyps treated in our hospital from February 2013 to November 2014 were collected as research object. All patients were treated with hysteroscopic resection. 3 months, 6 months and 18 months of follow-up were made. The incidence rates of abnormal vaginal bleeding, recurrence rates, and spontaneous pregnancy rates were counted. Influence factors in spontaneous pregnancy rate of patients with endometrial polyps underwent transcervical resection were analyzed. Results: After surgery, the incidence rate of abnormal vaginal bleeding was 3.33%. The recurrence rate was 1.67%. Three months after surgery, the accumulated spontaneous pregnancy rate was 28.33%. Six months after surgery, the accumulated spontaneous pregnancy rate was 50.00%. Eighteen months after surgery, the accumulated spontaneous pregnancy rate was 65.00%. Single factor analysis showed the difference of spontaneous pregnancy rate of patients underwent surgery between ages was statistically significant(P＜0.01), the difference of spontaneous pregnancy rate of patients underwent surgery between duration of infertility, the kind of infertility, and polyp size were not statistically significant(P＞0.05). Logistic regression analysis showed age＞30 was the influence factor in spontaneous pregnancy rate of patients with endometrial polyps underwent transcervical resection (OR=11.00, 95%CI: 4.108-29.454, P=0.000). However, primary infertility, duration of infertility＞3 years, polyp size＞1 cm or more polyps did not influence spontaneous pregnancy of patients underwent surgery (P＞0.05). Conclusions: For infertile patients due to endometrial polyps, the hysteroscopic resection treatment had good therapeutic effect. The younger the age, the higher the spontaneous pregnancy rate after hysteroscopic surgery. Related Articles | Metrics

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Study on Spiral Artery Transformation and Pregnancy Outcome of Recurrent Spontaneous Abortion Mice Treated with Shoutaiwan XU Chun-yue，GUO Jie，SONG Dian-rong，ZHAO Lin，WANG Ya-nan，DONG Sheng-wen 2017, 44 (4):  443-447.  Abstract ( 1147 )   PDF (2463KB) ( 6726 )   Objectives: To observe the spiral artery transformation and pregnancy outcome of recurrent spontaneous abortion mice treated with Shoutaiwan, explore the mechanism of Shoutaiwan in mice with recurrent spontaneous abortion. Methods: The abortion-prone CBA/J×DBA/2 matings were established as the model of recurrent spontaneous abortion（43 mice） and the nonabortion-prone CBA/J×BALB/c matings were established as the model of normal pregnancy（12 mice）. The pregnant mice of CBA/J×DBA/2 were randomly divided into 4 groups. From the 4th to 9th day of pregnant mice of every group were oral administration in different doses. All pregnant mice were killed on the 14th day of pregnancy. Then counted the embryo absorption to calculate the absorption rate. The incidence of spiral arterial physiological changes in decidual tissue was observed under light microscope. And the diameter of lumen and wall thickness of spiral artery were measured. The ultrastructure of spiral artery in decidual tissue was observed under transmission electron microscope. Results: The embryo absorption rate of the recurrent spontaneous abortion model are higher than that of the normal pregnancy group (29.49% vs. 4.55%, χ2=18.887，P=0.000). The embryo absorption rate of low-dose, middle-dose and high-dose Shoutaiwan groups were significantly decreased than recurrent spontaneous abortion model group (P＜0.05). The spiral artery transformation rate of the recurrent spontaneous abortion model are lower than that of the normal pregnancy group (11.90% vs. 44.68%， χ2=11.522，P=0.001). Shoutaiwan could expand lumen diameter of the spiral artery and attenuate the thickness of spiral arteries wall. Conclusions: Shoutaiwan could promote the spiral artery transformation of recurrent spontaneous abortion mice. Related Articles | Metrics

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Mitochondrion Dysfunction and Ovarian Aging HOU Hai-yan，YU Qi 2017, 44 (4):  450-454.  Abstract ( 1150 )   PDF (737KB) ( 6648 )   Mitochondria are centers for cellular energy supply. Mitochondrial dysfunction has been implicated in cellular senescence in general and ovarian aging in particular. Mitochondria are one of the most important organelles in oocytes, which play a key role in early embryo development. Dysfunctional mitochondria is discussed as major factor in predisposition to chromosomal nondisjunction during meiotic division and mitotic errors in embryos, and in reduced quality and developmental potential of aged oocytes and embryos. Oocytes quality reduction is associated with abnormal spindle, chromosome alignment, telomere shortening and absence of fibronectin in meiosis, which could result in aneuploid oocytes and infertility. Mitochondrial DNA (mtDNA) copy number is a potential biomarker of oocytes quality and embryo viability. The usage of mitochondrial nutrients and autologous mitochondrial transfer will be a potential treatment for poor ovarian function and response. Related Articles | Metrics

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The Role of Endothelial Progenitor Cells in the Vasculogenesis of Endometriosis LI Lin-han，QIAN Huan-huan，ZHU Shu，XU Wei，WANG Xiu-li 2017, 44 (4):  455-458.  Abstract ( 977 )   PDF (709KB) ( 6294 )   Endometriosis is a complex disease with a multifactorial pathogenesis, which is crucially dependent on the neovascularization. The present review highlights the fact that the neovascularization of endometriotic lesions is not only driven by angiogenesis, but also involves de novo formation of microvessels from circulating endothelial progenitor cells (EPC). This process, termed vasculogenesis, is a characteristic of various pathogenic conditions, such as tumour growth and atherosclerosis, and typically comprises the activation, mobilization and recruitment of bone marrow-derived EPC to the sites of tissue hypoxia. Recent studies indicate that part of the microvascular endothelium of ectopic endometrial tissue originates from EPC, and controlled by the stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor type 4 (CXCR4) axis. Accordingly, blockade of EPC recruitment effectively inhibits the formation of microvascular networks in developing endometriotic lesions, indicating that vasculogenesis represents an integral part of the pathogenesis of endometriosis. The involvement of vasculogenesis in endometriosis may offer the exciting opportunity for the future establishment of novel diagnostic and therapeutic strategies for this frequent gynecological disease. Related Articles | Metrics

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Progress of the Diagnosis in Deep Infiltrating Endometriosis YU Gui-yuan, JIN Ping 2017, 44 (4):  459-462.  Abstract ( 1254 )   PDF (706KB) ( 6467 )   Deep infiltrating endometriosis (DIE) is a special type of endometriosis (EMs), which specifically refers to the infiltration depth of ≥ 5 mm of EMs lesions, involving in different parts of the pelvic cavity, mainly located in the posterior pelvic cavity, such as the uterosacral ligament, rectovaginal septum, colorectum, etc. At present, there are many ways to diagnose DIE, such as medical history, gynecological examination, ultrasound, magnetic resonance imaging (MRI), laparoscopy combined with pathological examination, but due to the limitation of the operator and other reasons of lack of experience or technology, the majority of patients were clinically misdiagnosed or missed. At present, researchers have proposed improved methods for the low detection rate of DIE, such as 3D or 4D ultrasound, fusion imaging, 3D-MRI, mehrzeilen-spiral CT colon water expansion (msCT-c) technique, etc., may improve the diagnostic rate of DIE. Related Articles | Metrics

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Clinical and Pathological Features of the Polypoid Endometriosis SONG Yu-fang，HAN Lu 2017, 44 (4):  463-467.  Abstract ( 1597 )   PDF (731KB) ( 6443 )   The polypoid endometriosis (PEM) is a rare subtype of endometriosis (EMs), and it can appear anywhere of the body. The age of PEM incidence is wide, ranging from 23 to 78 years of age, different areas reported a different age. PEM is the excessive growth of local ectopic endometrium. The exact mechanisms of PEM remain controversial and still need more researches. PEM′s clinical manifestations are associated with the growth sites, showing diversity. The main clinical manifestations are the mass or the symptoms and signs caused by tumor of the lesions，such as pelvic mass, inguinal mass, vaginal bleeding, hydronephrosis, waist pain, bladder mass and so on. Some manifestations are similar to malignant tumors′ behavior. Generally characterized by a cyst inside, or pedunculated polyp-like masses. Endoscopic characteristics have ordinary EMs pathology, the lesions are composed of endometrial glandular and stromal components, but more than the ordinary EMs diversity. The expressions of immunohistochemistry of ER, PR, CD10 and Vimentin are positive in the PEM tissues. The diagnosis of PEM is mainly based on pathology, and abnormal increase of the serum CA125 and MRI may be helpful for the diagnosis. The treatment is mainly surgical resection, and the bilateral variectomy is equally effective in case of vaginal and pelvic multiple sites without complete resection. The prognosis of the disease is good. Related Articles | Metrics

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Prevention of Complications and Side Injuries by Gynecological Laparoscopic Surgery Energy Equipment PANG Hui, YUE Xiu-ying 2017, 44 (4):  468-472.  Abstract ( 1258 )   PDF (860KB) ( 6819 )   With the development of medical science, the laparoscopic surgery has been widely used in clinical  treatment. Its advantages mainly lie in relatively small operation scars, faster wound recovery, less pain, and earlier recovery of bowel functions, etc. Because of these advantages, laparoscopic surgery is playing an increasingly significant role in gynecological tumor treatment. Meanwhile, laparoscopic surgery is energy equipment-dependent. The research and application of more energy devices have made the laparoscopic surgery more powerful, the scope larger, and hemostasis more convenient, thereby lower down the surgical difficulty. These devices fully display the features of minimally invasive surgery. With these devices, the laparoscopic surgeries are simplified, the surgical scopes are extended, and the surgical precisions are improved. While such medical advancement brings more opportunities to doctors, at the same time it bings more challenges. Especially, the side injuries caused by the energy devices has always been paid great attention. This article systemically explains the side injuries and relevant prophylactic-therapeutic measures, and aims at helping more doctors to gain a deeper understanding on the surgical devices, to operate these devices more accurately, and to further reduce side injuries. Related Articles | Metrics

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The Research of Expression of LC3 and VMP1 in Eutopic Endometrium of Endometriosis LI Lin, LIU Kui-ran 2017, 44 (4):  473-475.  Abstract ( 1136 )   PDF (689KB) ( 6357 )   Objective: To investigate the expression of LC3 and VMP1 in eutopic endometrium of endometriosis and normal endometrium and to evaluate the relationship of them. Methods: Specimens were selected from January 2010 to June 2016 in the endometrial tissue of patients treated by Shengjing Hospital of China Medical University, detection the expression and relationship of LC3 and VMP1 in eutopic endometrium in 54 cases of patients with ovarian endometriosis and 40 cases of patients without endometriosis by immunohistochemistry, further discuss the relationship of them. Results: ①The positive expression rate of LC3 (22/54, 40.74%) and VMP1 (26/54, 48.15%) in eutopic endometrium of endometriosis was significantly lower than that in normal endometrium (36/40, 90.00%; 32/40, 80.00%), the difference was statistically significant (P＜0.05); ②The positive expression rate of LC3 (8/34, 23.53%) and VMP1 (10/34, 29.41%) in stage Ⅲ and Ⅳ endometriosis patients was significantly lower than that in stage Ⅰ and Ⅱ patients (14/20, 70%; 16/20, 80% ); ③The expression of LC3 was not correlated with the expression of VMP1 in eutopic endometrium of endometriosis (P＞0.05). Conclusions: LC3 and VMP1 in eutopic endometrium of patients with endometriosis are lower and eutopic endometrium of patients with endometriosis is related to the down-regulation of autophagy. Related Articles | Metrics

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Genetic Polymorphisms of FcRL3 （-169T/C） and FOXP3 （-2398T/C）with the Risk of Endometriosis LU Yu-xuan, MAO Yao-nan, ZHOU Hong-mei, WEI Run-xin 2017, 44 (4):  476-480.  Abstract ( 1142 )   PDF (2309KB) ( 6343 )   Objective: In this study, a meta-analysis was performed to clarify the relationship between the genetic polymorphisms of Fc Receptor Like-3 (FcRL3) (-169T/C) and Forkhead box P3 (FOXP3) (-2383T/C) and the risk of endometriosis (EMs).  Methods: Published literatures from PubMed, Embase, CNKI, WanFang, CBM databases were retrieved. Pooled odds ratio (OR) with 95% confidence interval (CI) was calculated using fixed- or random-effects model according to the heterogeneity. Results: Five studies with 883 cases and 1 241 controls for FcRL3 gene polymorphism and three studies with 679 cases and 690 controls for FOXP3 gene polymorphism were included in the final meta-analysis. The polymorphisms of FcRL3 and FOXP3 was associated with EMs risk in allele model (FcRL3: OR=2.40, 95%CI: 1.77-3.27, Z=5.57, P＜0.000 1; FOXP3: OR=5.95, 95%CI: 5.05-7.01, Z=21.40, P＜0.000 1). And in other models: heterozygote model (TC vs. CC) (FcRL3: OR=1.23, 95%CI: 0.80-1.88, Z=0.93, P=0.352; FOXP3: OR=1.75, 95%CI: 0.80-3.83, Z=1.39, P=0.165); homozygote model (TT vs. CC) (FcRL3: OR=1.27, 95%CI: 0.54-2.97, Z=0.99, P=0.323; FOXP3: OR=0.69, 95%CI: 0.11-4.33, Z=-0.40, P=0.69); Recessive model (TT vs. TC+CC) (FcRL3: OR=1.25, 95%CI: 0.72-2.14, Z=0.79, P=0.427; FOXP3: OR=1.40, 95%CI: 0.66-2.95, Z=0.88, P=0.380); Dominant model (TT+TC vs. CC) (FcRL3: OR=0.90, 95%CI: 0.50-1.64, Z=-0.34, P=0.737; FOXP3: OR=1.65, 95%CI: 0.99-2.73, Z=1.94, P=0.053). Conclusions: Our analysis showed that the polymorphisms of FcRL3(-169T/C) and FOXP3(-2383T/C) were risk factors for EMs. Related Articles | Metrics