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15 June 2018, Volume 45 Issue 3
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The Research Progress of Glucose Regulation Protein 78 in Perinatal Medicine LU Ting-ting，YANG Ji-fen，JI Xiang-hong，WENG Zhan-ping 2018, 45 (3):  245-249.  Abstract ( 1002 )   PDF (701KB) ( 6885 )   Glucose regulation protein 78 (GRP78), one member of the family of heat shock protein 70,  is not only an important molecules in cells partner, but also a specific molecular marker of endoplasmic reticulum stress, which plays an important role during the protein folding and the transfer process, to adjust the stable of intracellular environment through various channels to maintain cells survive. In recent years, the study found that GRP78 highly expressed in maternal serum and placenta nourish cells of pregnancy idiopathic disease such as preeclampsia, gestational diabetes, at the same time involved in the chronic complications such as hypertension, diabetes, which is closely related to the occurrence and development of a variety of diseases. Now carry on the analysis and summary of the GRP78 biological function and its relationship with various pregnancy-related disease, to explore whether the protein has prediction effect, to provide new way of thinking for perinatal related diseases prevention and treatment. Related Articles | Metrics

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Advances in the Association between LncRNAs and Preeclampsia LIU Sha-sha，ZUO Jun-fang，CUI Hong-yan 2018, 45 (3):  250-253.  Abstract ( 817 )   PDF (668KB) ( 6906 )   Preeclampsia (PE) is an idiopathic hypertension syndrome that occur after 20th week of gestation, whose etiology and pathogenesis have not yet been completely elucidated. Long non-coding RNA (lncRNA) is classified as RNA greater than 200 nucleotides in length that do not produce a protein product. LncRNAs are expressed with cellular and temporal specificity and have been shown to play a role in many cellular events, including the regulation of gene expression, post-transcriptional modifications and epigenetic modifications. In the current study, expressions of lncRNA were abnormal in PE placenta. It was speculated that lncRNA may affect the growth and reproduction of placenta and play an important role in the pathogenesis of PE, therefore further study of PE-related lncRNA and its regulatory mechanism may be helpful to elucidate the pathogenesis of PE and provide new ideas for PE prevention and treatment. Here, we review the current literature surrounding the lncRNAs related to PE. Related Articles | Metrics

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Advances in Relationship between Vitamin B12 and Pregnancy-related Diseases LIU Xiao，CHEN Zhi-min 2018, 45 (3):  254-257.  Abstract ( 947 )   PDF (672KB) ( 7029 )   Vitamin B12 is one of the most important microelements in the body, the amount needed of which can be taken from food. As a coenzyme, vitamin B12 participates in a series of celluar reactions. In mammals, for example, it is involved in the synthesis and metabolism of homocysteine and methylmalonic acid and multi-system dysfunctions will happen when they accumulate in human body. When it is insufficient, multi-system dysfunctions will happen. In gestation period, enhanced protein biosynthesis and mitochondrial energy conversion increases the requisite amount of vitamin B12. Due to the increased requirement of it, vitamin B12 is more prone to suffer from deficiency. Absencing of vitamin B12, during gestation period, has implications including hypertensive disorder complicating pregnancy, intrahepatic cholestasis of pregnancy etc. Furthermore neonate methylmalonic acidemia, fetal intrauterine growth restriction and other diseases will be arised. Related Articles | Metrics

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Advances Research in Fetal Growth Restriction WANG Ming-yu，CHENG Lan, CUI Hong-yan 2018, 45 (3):  258-262.  Abstract ( 887 )   PDF (715KB) ( 7072 )   Fetal growth restriction (FGR) is a complex and multifactorial disease. The causes include maternal factors, fetal chromosomal or structural abnormalities, and placental dysfunction. It is significantly related to the morbidity and mortality of perinatal infants, and may have an important impact on the prognosis of perinatal infants, affecting the physical development and neuro development in children and adolescents, and causing adult cardiovascular disease. The most dangerous factor is long-term neurologic prognosis, but it is not clear that to what extent the fetus will have neurodevelopmental dysplasia. Doppler is noninvasive and its hemodynamic index is the main means to diagnose and monitor FGR. The changes in the Doppler blood flow of the umbilical artery, the middle cerebral artery, and the ductus venosus under the condition of FGR provide important diagnostic and prognostic information, while the Doppler parameters of ductus venosus is recommended by most European perinatal associations as effective means to manage FGR before 32 weeks. Though Doppler has been studied deeply in the field of FGR, it is still controversial in the management guide. It is not recommended to manage FGR alone. We should focus on the treatment of FGR, the prediction of the possible diseases of the children even adults with the history of FGR, and the primary prevention and reduction of the incidence of the disease in the future research. Related Articles | Metrics

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The Anticoagulation Regimen in Pregnant Women with Mechanical Prosthetic Heart Valves CUI Jin-shuai, LIN Hao, ZHANG Xiao-peng, GAO Bing-ren 2018, 45 (3):  263-266.  Abstract ( 893 )   PDF (692KB) ( 7110 )   With the rapid development of cardiac surgery, more and more patients with heart valve disease can improve cardiac function and life quality through heart valve replacement. However, life-long anticoagulant therapy is required after mechanical heart valve replacement, and it is particularly important during pregnancy. Although mechanical heart valve replacement is associated with high-risk pregnancies, there is a lack of uniformity in the management of cardiac mechanical valve replacement. Individualized treatment is generally emphasizes. Anticoagulation during pregnancy after mechanical heart valve replacement is controversial. Warfarin can prevent the formation of maternal thrombus during pregnancy, but warfarin can affect the development of the fetus through the placenta. Heparin can not affect the development of the fetus through the placenta, but poorly monitor the convenience and prevent thrombosis. The anti-platelet drugs and the use of new drugs have not been further study. We reviews the choice of anticoagulants and maternal fetal outcomes in recent years in order to better serve the clinic. Related Articles | Metrics

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The Application Value of Glycosylated Hemoglobin Level Combined with Fasting Blood Glucose in Diagnosis of Gestational Diabetes Mellitus LI Xue-jiao，CHEN Shu-qin 2018, 45 (3):  267-271.  Abstract ( 898 )   PDF (992KB) ( 7299 )   Objective：To establish the normal reference interval in the second trimester pregnant women of glycosylated hemoglobin (HbA1c) in the Tianjin Central Hospital of Gynecology Obstetrics, and evaluate the application value of HbA1c combined with fasting blood glucose (FPG) in the detection of gestational diabetes mellitus (GDM). Methods：According to the GDM diagnostic criteria of International Association of Diabetes and Pregnancy Study Groups (IADPSG) recommended, 196 GDM pregnant women and 320 health control with 75 g oral glucose tolerance test (OGTT) examination in our hospital from May 2016 to December 2016 during 24 to 28 weeks of pregnancy were enrolled, and the related clinical data were collected. Results：①The age, pre-pregnancy weight and pre-pregnancy BMI of the GDM group were significantly higher than those of health control group(P＜0.01), no significant difference were found in the gestational age and height between the two groups (P＞0.05). ②The average value of HbA1c, the blood glucose levels of OGTT in GDM women were significantly higher than the health control group (P＜0.01). ③The HbA1c level of all the 320 healthy pregnant women was in normal distribution. The HbA1c reference interval of the normal pregnant women in the second trimester of pregnancy was 4.4%-5.8%. ④The highest sensitivity and specificity in prediction of GDM were 44.9% and 77.5% respectively when the HbA1c was 5.35%. The ROC curve area of HbA1c in diagnosis of GDM was 0.665 (95%CI: 0.617-0.713); The curve area of the HbA1c（≥5.35%）combined with FPG（≥5.1 mmol/L） in diagnosis of GDM was 0.933 (95%CI: 0.909-0.957). Conclusions：The normal reference range of HbA1c of the pregnant women in our hospital was established. HbA1c combined with FPG detection was simple and convenient, and can be used as a powerful supplement to GDM diagnosis. Related Articles | Metrics

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Relationship between Platelet and Their Associated Factors with Endometriosis WANG Song，SONG Dian-rong 2018, 45 (3):  279-282.  Abstract ( 905 )   PDF (734KB) ( 6980 )   Endometriosis is a common and frequently encountered disease of gynaecology, it is a kind of chronic benign disease, affecting 10% to 15% of the women of childbearing age, with main symptoms of dysmenorrhea, pelvic adhesions and infertility, but its pathogenesis has not yet known clearly, many of the hypothesis. At home and abroad in recent years, scholars have found that platelets play an important role in the incidence of endometriosis, the main performance of platelet adhesion, aggregation function in patients with endometriosis was flawed, platelet count in patients with endometriosis, its relatively high blood coagulation state, and can be mediated inflammatory response and platelet associated factors such as P-select element, CD40L, platelet growth factors in the pathogenesis of endometriosis have different degrees of promoting function, platelet can affect patients with endometriosis and the expression of estrogen and its receptors, so the review on platelet abnormal function with the pathogenesis of endometriosis may exist, for the clinical application of platelet and provide theoretical basis for treatment of endometriosis. Related Articles | Metrics

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The Significance of Exosomes in the Development, Diagnosis and Treatment of Endometriosis DONG Xiao-xiao, YU Xiao-hui 2018, 45 (3):  283-286.  Abstract ( 867 )   PDF (689KB) ( 6828 )    Exosomes are vesicular structures that can stably exist in variety of body fluids，which can participate in transfering information and signal regulation among cells. The miRNAs and the proteins that they carry play an important role in many pathophysiological processes. It has received extensive attention due to its close relationship with the occurrence and development of many kinds of tumors and other diseases. Endometriosis is a disease that occurs in women of childbearing age, and has the characteristics of strong invasiveness, extensive pathological changes and easy recurrence. Exosomes, as an important signal regulators is involved in angiogenesis of endometriosis, proliferation and migration of ectopic endometrial cells, etc. It plays an important role in the occurrence and development of endometriosis, secondary lesions, and malignant transformation. However, the specific mechanism is not yet clear. This article reviews the role of exosomes in the development of endometriosis and provides new ideas for the early diagnosis and treatment of endometriosis Related Articles | Metrics

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Research Progress in Improvement of Polycystic Ovary Syndrome with Insulin Resistance by Traditional Chinese Herb Extracts ZHOU Xiao-meng，LI Xue-lian 2018, 45 (3):  287-290.  Abstract ( 875 )   PDF (728KB) ( 6905 )   Polycystic ovarian syndrome (PCOS) is a group of heterogeneous endocrine diseases which is characterized by oligoovulatory and anovulatory, infertility, hyperandrogenism and so on. Insulin resistance (IR) is an important endocrine manifestation of PCOS, besides it is also one of the possible pathogenesis of PCOS. Recently berberine (BBR), puerarin, cryptotanshintone, glycyrrhetinic acid and other traditional Chinese herb extracts have attracted widespread attention in the treatment of IR in PCOS patients. A large number of studies show that the mechanism includes adenosine 5′-monophosphate-activated protein kinase (AMPK), mitogen-activated protein kinase (MAPK) and so on. This article is a review of the possibly mechanism about traditional Chinese herb extracts in the improvement of PCOS with insulin resistance. Related Articles | Metrics

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103 Cases of Hysteroscopic Surgery for Symptomatic Cesarean Scar Defect LIU Lin-lin，HUANG Xiao-wu，XIA En-lan，ZHOU Qiao-yun，MA Ning 2018, 45 (3):  291-294.  Abstract ( 1003 )   PDF (854KB) ( 7124 )   Objective：To investigate the clinical effect of hysteroscopic surgery in the treatment of symptomatic cesarean scar defect. Methods：The clinical data were retrospectively analyzed for the 103 patients with symptomatic cesarean scar defect who underwent hysteroscopic surgery from January 2011 to November 2017 in Hysteroscopy Center, Fuxing Hospital Affiliated to Captial Medical University. The symptom improvement and pregnant outcomes were followed-up. Results：In total 103 patients, the average operation time was (11.0±3.3) min, the average days of hospital stay was (3.9±1.0) d, the average hospitalization cost was (6 217±556) yuan, and no complications occurred. The symptom improvement was followed-up after three months of surgery. The clinical symptoms of intermenstrual bleeding were significantly improved after hysteroscopic surgery with an improvement rate of 82.5% (85/103). Mean duration of bleeding prior and after the treatment were (13.83±3.41) d and (7.43±2.29) d respectively, and the differences were statistically significant (t=3.108, P=0.021). The pregnant outcomes were followed-up for 4-82 months after the initial surgery. For the 17 cases of secondary infertility patients, 14 cases got successful pregnancy. Conclusions：Hysteroscopic surgery can significantly improve postoperative symptoms of intermenstrual bleeding and pregnant outcome with symptomatic cesarean scar defect and is a safe, effective, and economical treatment. Related Articles | Metrics

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Fertility-preserving Treatment in Young Women with Early Stage Well-differentiated Endometrioid Endometrial Cancer CHEN Hao，MA Xiao-xin 2018, 45 (3):  295-300.  Abstract ( 1520 )   PDF (802KB) ( 7009 )   Endometrial carcinoma is a common invasive malignant neoplasm, and conservative management of endometrioid endometrial carcinoma may be a therapeutic option for young nulliparae. Conventional drugs for conservative treatment include progestin, gonadotropin releasing hormone analogue, aromatase inhibitors. Hysteroscopy combined progestogen therapy is a novel therapeutic treatment for young women with early stage well-differentiated endometrioid endometrial cancer, and gains advantages in regression, pregnancy, relapse and adverse effect over treatment using drugs alone. There is no consensus, however, regarding the surgical procedures and ideal progestin agent, dose, or duration of treatment. Morbidly obese patients should accept obesity therapy to decrease the risk of recurrence, among which bariatric surgery has a better effect. Bariatric surgery is an effective intervention for young patients with early stage well-differentiated endometrioid endometrial cancer whose BMI is over 35 kg/m2. Bariatric surgery should be considered for patients who are inadequately controlled by non-surgical treatment with BMI≥35 kg/m2 or metabolic syndrome/T2DM (BMI≥30 kg/m2). Related Articles | Metrics

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The Role of Vaginal Microbiota and Its Relationship with Cervical Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia CHEN Yu-lian, QIU Li-hua, GAO Hua, DI Wen 2018, 45 (3):  301-305.  Abstract ( 911 )   PDF (723KB) ( 7181 )   Human papillomavirus（HPV） infection is necessary to cervical precancerous lesion or cervical cancer. Vaginal microbial diversity might be related with persistence HPV infection status. A healthy female vaginal microbiome is defined as low diversity and dominated by one or two species of Lactobacillus. After the application of deep sequencing of barcoded bacterial 16SrRNA gene fragments, more and more researches reveal that increased vaginal microbial diversity with decreased proportion of Lactobacillus is associated with HPV infection and cervical diseases. Several microbiological biomarkers could interact with host cells and virus through different mechanisms, which lead to a local pro-inflammatory and immunosuppressive environment, thus resulting in persistence HPV infection and cervical disease. The restoration of balance of vaginal microbial environment, typically a Lactobacillus-dominated bacterial structure, could be a new approach to the treatment of HPV infection and related cervical disease in the future. This review aims to summarize the existed points of view concerning the influences of vaginal microbial diversity on HPV infection and cervical diseases. Related Articles | Metrics

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Progress of Ultrasound-guided Radiofrequency Ablation for Uterine Fibroids YOU Fang，HE Chun-ni，HONG Xin-ru 2018, 45 (3):  306-309.  Abstract ( 963 )   PDF (676KB) ( 7002 )    Uterine fibroids (UFs), also known as leiomyomas or myomas commonly seen at women of age of 30-50 years old, are the most prevalent benign tumors in female reproductive organs. UFs are composed of smooth muscle and connective tissue, reportedly occurring in 20% of this population. The treatment of UFs include conservative treatment and surgical treatment, of which radiofrequency ablation (RFA) is a minimally invasive treatment for the latter, and has been applied to a variety of diseases. Its value in the treatment of benign gynecological diseases has also been fully recognized. The ideal RFA is to use heat energy in a minimally invasive manner without damaging the adjacent normal tissue and to destroy the target tissue completely. This article shows a brief overview of RFA for uterine fibroids in the mechanisms, clinical application of ultrasonography, the evaluation of the curative effects, influence on fertility function, safety and effectiveness and the influencing factors of RFA of uterine fibroids. Related Articles | Metrics

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Research Progress of Cathepsin L in Ovarian Cancer LIU Li，WANG Xi-peng 2018, 45 (3):  310-313.  Abstract ( 880 )   PDF (682KB) ( 6965 )   The early detection rate of ovarian cancer is low, and more than 70 percentages of patients are diagnosed at advanced stages. The prognosis is too poor because of widespread metastasis and chemoresistance. Cathepsin L (CTSL) is an important member of cathepsin family, distributing intracellularly and extracellularly and participating in the degradation of diverse proteins. CTSL is overexpressed in a variety of malignant tumor tissues and the level of CTSL is high in ovarian cancer tissues and the serum of patients. CTSL can promote the growth, metastasis, chemoresistance and angiogenesis of ovarian cancer. Serum CTSL level is helpful in the diagnosis of ovarian cancer in combination with other biological markers. On the other hand, experimental researches have revealed that targeting CTSL is effective to control the progression of ovarian cancer. Therefore, investigating the role of CTSL in the progression of ovarian cancer more deeply is promising to supply more clues for the diagnosis and therapy of ovarian cancer, and here we will review the progression in this area. Related Articles | Metrics

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Mechanism of MiRNA in Ovarian Cancer Invasion and Metastasis SANG Yi-fei，LI Jia-rui 2018, 45 (3):  314-317.  Abstract ( 728 )   PDF (680KB) ( 7003 )   MicroRNA(miRNA) is a class of non-coding RNA molecule, 20-22 nucleotides in length, which affects the differentiation, proliferation, metastasis and necrosis of tumor cells by regulating target gene. It is fully reported that miRNA has a relationship with human malignant tumors and it has an abnormal expression in ovarian cancer. Ovarian cancer is one of the most common gynecologic malignant tumors, 90% of which are epithelial cancers, whose five-year survival rate is only 30%. Without obvious symptoms in early stage, it has a high metastatic rate when diagnosed. Many substances and pathways are involved in the mechanism of ovarian cancer invasion and metastasis. A large number of studies suggest that cancer stem cells related miRNA, epithelial-mesenchymal transition related miRNA, extracellular matrix related miRNA and angiogenesis related miRNA are relevant to invasion and metastasis of ovarian cancer. The abnormal expression of them are involved in invasion and metastasis of ovarian cancer by regulating the expression of downstream substance. In this article, we focus on the mechanism of miRNA in ovarian cancer invasion and metastasis. Related Articles | Metrics

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Clinical Application of Circulating Tumor Cells in Ovarian Cancer HE Yu-nan，ZHANG Yu 2018, 45 (3):  318-321.  Abstract ( 759 )   PDF (678KB) ( 6868 )   Liquid biopsy (LB), as a new generation detection technology, can more accurately evaluate the disease progress of tumor patients and become a valuable management tool of clinical medicine, which is expected to improve outcome of ovarian malignant tumor. It can be used in early screening, curative effect, assessing drug-resistance, relapse and prognosis of ovarian cancer via monitoring quantity changes of circulating tumor cells (CTCs) in body fluid. Comparing present clinical strategy depended on tumor markers, CTCs exhibit higher specificity and can be cytologically analyzed and cultured. However, the relationship between CTCs and the disease progression of ovarian tumors is not yet clear. Besides, more advanced molecular enrichment strategies needs to be applied to ovarian CTCs. Related Articles | Metrics

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The Application Progress of Immunological Checkpoint PD-1/PD-L1 in the Diagnosis，Treatment and Prognosis of Ovarian Cancer ZHANG Tao，WANG Xi-peng 2018, 45 (3):  322-326.  Abstract ( 1301 )   PDF (764KB) ( 6990 )   Ovarian cancer is the most fatal gynecologic malignant tumor. Because of its insidious onset, difficulty diagnosis in early stage, and has the characteristics of easy early metastasis, easy recurrence and resistance to chemotherapeutic drugs, it makes the mortality of patients with ovarian cancer very high. The application of immunotherapy in ovarian cancer has been a research focus in recent years. It plays an important role in killing tumor cells by enhancing the function of the patients′ immune cells or relieving the local immunosuppressive microenvironment. PD-1 and its ligand PD-L1 are important immune regulatory signaling molecules. PD-1/PD-L1 signaling pathway can affect T lymphocyte infiltration and function, and play an important role in the formation of local inhibitory immune microenvironment. Studies have shown that blocking the PD-1/PD-L1 signaling pathway can restore immune function of immune cells in the microenvironment to play the original antitumor function. Now we review the prognosis of PD-1/PD-L1 molecules in ovarian cancer and the application of molecular pathway blocking in the clinical diagnosis and treatment of ovarian cancer. Related Articles | Metrics

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Progress of Triptolide in Ovarian Cancer DU Qiu-yue, SHEN Yan 2018, 45 (3):  327-330.  Abstract ( 888 )   PDF (694KB) ( 6847 )    Ovarian cancer is a serious threat to women′s reproductive health, and the mortality is the first of various gynecological tumors. Multidrug resistance(MDR) is a major cause of post-treatment relapses, metastasis, and even death. The role of triptolide(TP) in the treatment of ovarian cancer has attracted much attention, especially in the treatment of MDR in ovarian cancer. In this review, the mechanism of TP on ovarian cancer is reviewed in the two aspects of inhibiting the proliferation and inducing the apoptosis of tumor cells. The toxicity of TP and the short half-life have limited the clinical application. However,the emergence of nano-drug delivery technology has provided  a broader prospect for the treatment of ovarian cancer by TP. Related Articles | Metrics

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The Clinical Significance of Expression of LYVE-1 and Prox-1 in Endometrial Tumor and Paracancer Tissues LIU Cai-yan, ZHANG Wen-wen, WU Hai-xia, SHEN Yan, QU Peng-peng 2018, 45 (3):  331-336.  Abstract ( 1071 )   PDF (886KB) ( 6987 )   Objective：To analyze the relationship between clinicopathological features and the expression levels of lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-l) and prospero-related homeobox 1 (Prox-1) in endometrial carcinoma. Methods: Selected 57 cases of paraffin section specimens and 38 cases fresh tumor tissues and paracancer tissues of endometrial carcinoma. Immunohistochemistry, Western blotting, and Realtime RT-PCR were used to detect the expression of LYVE-1 and Prox-1 in tumor tissues and paracancer tissues. Analysis of the relationship between the expression of these two proteins and the clinicopathological features in tumor tissues and paracancer tissues. Results: ①Immunohistochemical display: The positive expression rate in tumor tissues of Prox-1 in the histologic grade I patients was statistically higher than that of grade Ⅱ and grade Ⅲ patients, the difference was statistically significant（P＜0.05）. The positive expression rate of LYVE-1 in the paracancer tissues of LVSI patients was statistically higher than that of those without LVSI（P＜0.05）. The positive expression rate of Prox-1 of LVSI and advanced patients increased in the paracancer tissues, compared with those without  LVSI and the early patients, the difference was statistically significant（P＜0.05）. ②Realtime RT-PCR and Western blotting detection: compared with the paracancer tissues without lymph node metastasis, the expression of Prox-1 protein in the lymph node metastasis group was 1.250 0±0.008 2（P＜0.05） and the expression of LYVE-1 protein was 1.860 0±0.012 4（P＜0.05）. Compared with that in the paracancer tissues, the expression level of Prox-1 mRNA in the tumor tissues in the lymph node metastasis group was 0.693+0.083（P＜0.05） and the expression level of LYVE-1 mRNA was 0.42±0.16（P＜0.05）. Conclusions: LYVE-1 and Prox-1 may be potential markers for lymph node metastasis in endometrial carcinoma. The results also suggest that the generation of lymphatic vessels in paracancer tissue is related to lymph node metastasis. Related Articles | Metrics

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Study on Effect of S1P/S1PR on Angiogenesis in SKOV3 Ovarian Cancer Cells LIU Yi-xuan，DAI Lan，XIE Lei，GAO Hua，DI Wen 2018, 45 (3):  337-341.  Abstract ( 898 )   PDF (1943KB) ( 6951 )   Objective：The study was to explore the effect and mechanism of S1P/S1PR on angiogenesis in human ovarian cancer cell line (SKOV3). Methods：Tube formation assay was to explore the angiogenetic effect of S1P on ovarian cancer cells. QRT-PCR was used to identify IL-8, IL-6 and VEGF mRNA expression changes in SKOV3 ovarian cancer cells incubation with S1P. SKOV3 cells were transfected with siRNA interference sequences silencing S1PR1, S1PR2 and S1PR3 gene. S1PR mRNA levels were determined by qRT-PCR and protein levels were determined by western-blot. IL-8, IL-6 and VEGF change levels in S1PR gene silencing ovarian cancer cell lines were detected by qRT-PCR. Results：The tube formation essay of human umbilical vein endothelial cells was significantly increased by the culture supernatants of ovarian cancer cells treated with S1P (t=-3.667, P=0.021). The results showed that S1P promoted the pro-angiogenic ability of SKOV3. The mRNA expression of IL-8, IL-6 and VEGF were significantly increased by S1P in SKOV3 cells (P＜0.05). The mRNA expression levels of IL-8, IL-6 and VEGF in SKOV3 cells were significantly decreased in S1PR1 and S1PR3 gene silencing cells (all P＜0.05) and were not significantly changed in S1PR2 gene silencing cells. Conclusions：The study indicated that S1P could affect ovarian cancer cells through S1PR1/3 to promote ovarian cancer angiogenesis and IL-8, IL-6, VEGF may play a role in this process. S1P/S1PR pathway is expected to become a new target for ovarian cancer therapy. References | Related Articles | Metrics

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The Expression and Clinical Significance of HIF-1α and VEGF in the Tissues of Gestational Trophoblastic Disease CHEN Guang-xue，SUN Li-fang，LIU Hui-ning 2018, 45 (3):  341-345.  Abstract ( 926 )   PDF (2802KB) ( 6960 )   Objective：To detect the expression of HIF-1α and VEGF in the tissues of normal pregnancy villi, hydatidiform moles and gestational trophoblastic neoplasm (GTN), and to explore the clinical significance. Methods：20 cases of normal pregnancy villi (normal pregnancy villi group), 35 cases of hydatidiform moles (hydatidiform moles group), 28 cases of GTN tissues [concluding 14 cases of invasive moles (invasive moles group) and 14 cases of choriocarcinoma (choriocarcinoma group)] were collected. The protein expression of HIF-1α and VEGF in the tissues were detected by the immunohistochemistry assay. The expression of HIF-1α and VEGF in different age, FIGO stage of GTN patients were analyzed. The correlation between HIF-1α and VEGF expression in GTN tissue samples was analyzed. Results：There was no significant difference in the positive rate of HIF-1α and VEGF protein between the normal early pregnancy villi group and the hydatidiform mole group (P＞0.05). The positive rates of HIF-1α and VEGF in the normal pregnancy villi group and hydatidiform mole group were much lower than those in the invasive hydatidiform mole group and choriocarcinoma group (P＜0.05). Moreover, there was no difference in the positive rates of HIF-1α and VEGF between the invasive moles group and choriocarcinoma group (P＞0.05). In the GTN tissues, the expression of HIF-1α and VEGF were correlated with the FIGO stages (P＜0.05), but were not correlated with the age (P＞0.05). The expression of HIF-1α and VEGF were positively related in the GTN tissues (rs=0.995, P=0.000). Conclusions：HIF-1α and VEGF may play a synergistic role in the occurrence and malignant progression of GTN. Related Articles | Metrics

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Ovary Primary Primitive Neuroectodermal Tumor: Clinical Analysis of 4 Cases and Literature Review CHAO Xiao-pei, TAN Xian-jie 2018, 45 (3):  346-349.  Abstract ( 1084 )   PDF (676KB) ( 7020 )   Primitive neuroectodermal tumor (PNET) is divided into central and peripheral types. Peripheral PNET belongs to the family of Ewing′s sarcoma. Its occurrence is due to abnormal gene regulation, thus the primitive stem cells differentiate into different stages of neural epithelialcells which is similar to pediatric central nervous system tumors morphologically. The histological and clinical biological behavior of the peripheral PNET are similar to extra-osteous Ewing′s sarcoma. Ovarian primary PNET is peripheral PNET, belonging to the ovarian monoderm teratoma, which is extremely rare and metastasizes early, relapses easily with poor prognosis. The clinical manifestation is lack of specificity, and patients always show with chief complaints with abdominal pain, abdominal distention and pelvic mass. The pathology is the gold standard for diagnosis. There is still no exact guideline for treatment, and most articles regarding this neoplasm have been case reports because of its rarity. Only seventeen cases of ovarian primary PNET had been reported in the English language literature between 1975 and 2017. And we reported four additional cases treated at the Peking Union Medical College Hospital to depict the clinical behavior, treatment strategies and prognosis of the ovarian primary PNET. Related Articles | Metrics

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Diagnosis and Treatment of 10 Cases of Female Genital Angiomyofibroblastoma SHANG Hui-yu，HAN Lu，WANG Ya-ping，ZHANG Li-zhi，LI Zhen-mei 2018, 45 (3):  350-354.  Abstract ( 1267 )   PDF (5949KB) ( 7196 )   Objective：To investigate the clinicopathological features, diagnosis, treatment and prognosis of female genital angiomyofibroblastoma (AMF). Methods：Retrospective analysis of the clinical data of 10 female genital AMF patients treated during January 2012 to October 2017, combined with related literatures, summarized their clinical and pathological features, diagnosis, treatment and prognosis. Results：The average onset age was (49.90±7.62) years old in 10 patients with AMF. The patients had no obvious clinical symptoms, and no specificity in imaging examination. Under the microscope, the cell-rich area and cell-sparse area were alternately distributed, the tumor tissue was composed of significantly small lumen, thin tube wall and dilated blood vessels which were surrounded by eosinophilic circular or fusiform tumor cells, and the tumor matrix was loose, edema and mucus like, and nuclear fission was rare. All the 10 patients underwent partial complete resection. 8 cases were followed up and the median follow-up time was 37 months. No recurrence occurred. Conclusions：There is no specificity in the clinical manifestation and imaging of AMF which occurs in female genital organs. The diagnosis and differential diagnosis mainly depends on the pathological features and immunohistochemistry. The surgical treatment is the main treatment and the prognosis is good. Related Articles | Metrics