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15 December 2018, Volume 45 Issue 6
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Research Progress in Sphingosine-1-phosphate and Ovarian Cancer SONG Ke-qi，DAI Lan，DI Wen 2018, 45 (6):  605-608.  Abstract ( 1083 )   PDF (713KB) ( 6236 )   Sphingosine1-phosphate (S1P)， a bioactive sphingolipid produced by the metabolism of sphingomyelin ，is an important signaling regulator involved in tumor progression in multiple neoplasms. The formation of S1P is catalyzed by sphingosine kinases (SphKs)， coupled with S1P receptors (S1PR) to exert effects. In recent years, studies involving S1P and ovarian cancer suggest that S1P is highly expressed in ovarian cancer patients. S1P，who can promote the proliferation and metastasis of ovarian cancer cells, inhibit apoptosis, change the tumor-associated microenvironment, is involved in the regulation of key cellular processes that contribute to ovarian cancer initiation and progression. Moreover, agents（S1P，SphK1，S1PR，etc.） who block the S1P signaling pathway inhibit ovarian cancer cell growth or induce apoptosis. Hence, current evidence suggests that S1P may become a potential molecular target for ovarian cancer therapy. This article briefly reviews the physiological functions of S1P signaling pathway in ovarian cancer and the research progress of related drugs. Related Articles | Metrics

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Circulating Tumor Cells in the Value of Prediction and Prognosis of Ovarian Cancer ZHANG Qian，LI Li 2018, 45 (6):  609-615.  Abstract ( 961 )   PDF (820KB) ( 6196 )   The early stage of ovarian cancer lacks specific symptoms and reliable early detection methods. About 75% of ovarian cancer patients have advanced stage at the time of their initial diagnosis. There is no effective monitoring and treatment measures for advanced stage. As a result, ovarian cancer mortality remains high, about 70% of patients survived for less than 5 years. Circulating tumor cells (CTCs) in the blood of cancer patients have the same epigenetic and other bioinformatics characteristics as the original tumor cells. They are the core content of liquid biopsy technology and show important predictive and prognostic value in a variety of solid tumors. In the past, the main route of metastasis of ovarian cancer was considered to be intraperitoneal direct metastasis, whereas distant metastasis occurred in less than one third of the patients. It is presumed that only a very small number of patients dropped off after CTCs. Recently, studies have demonstrated the important role of hematogenous transmission in ovarian cancer. Therefore, detection of CTCs can monitor mutations in the process of tumorigenesis and development in a non-invasive, continuous and real-time manner. It is a potential important monitoring indicator for early diagnosis, individualized treatment evaluation and clinical follow-up of ovarian cancer. This article reviews the application value of CTCs in the prediction and prognosis of ovarian cancer, hoping to lay a foundation for future liquid biopsy of ovarian cancer. Related Articles | Metrics

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Advances in Research of Relationship between DNA Methylation and Drug Resistance in Ovarian Cancer WANG Yan-qing，YANG Xiao，XIAN Shu，ZHANG Li，CHENG Yan-xiang 2018, 45 (6):  616-620.  Abstract ( 987 )   PDF (732KB) ( 6140 )   Ovarian cancer is one of the common malignant tumors in women, with high malignancy and poor prognosis. The current chemotherapy strategy for treating ovarian cancer patients is based on a combination of platinum and paclitaxel. Although most ovarian cancer patients are sensitive to chemotherapy, many initial responders eventually develop chemotherapy resistance. Previous studies have suggested that oncogene activation and tumor suppressor gene inactivation are mainly DNA sequence changes caused by gene mutations and deletions. However, existing studies have shown that many important tumor genes are not mutated or deleted. Gene expression abnormalities are mainly achieved by DNA methylation, DNA methylation and other epigenetic modifications may be reversible. This makes epigenetic factors a candidate for disease prevention and regaining sensitivity to chemotherapeutic drugs. Numerous studies have also confirmed differential expression of DNA methylation levels in drug-resistant and sensitive ovarian cancer cells. DNA methylase inhibitors have also been used to inhibit DNA methylation in order to reverse the resistance of ovarian cancer cells. The relationship between DNA methylation and ovarian cancer resistance is reviewed in this article. Related Articles | Metrics

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Molecular Characteristics of Endometrial Carcinoma Guide for Postoperative Chemo and Radiotherapy YANG Feng-bo，WANG Jian-liu，ZHOU Jing-yi 2018, 45 (6):  621-627.  Abstract ( 1416 )   PDF (2078KB) ( 7283 )   Endometrial carcinoma is a common malignant tumor in female genital tract. The incidence of endometrial carcinoma is second only to cervical cancer in China. The treatment methods include surgical treatment and adjuvant therapy (radiotherapy, chemotherapy, endocrine therapy), which are usually used in patients with stageⅠb ~ Ⅳ. However, overtreatment and ineffective treatment may lead to recurrence in some patients with stage Ⅰ to Ⅱ, and lead to significant differences in clinical outcomes of endometrial endometroid carcinoma (EECs) with high grade (grade 3, G3). The evaluation of molecular characteristics can be used to guide the accurate treatment of endometrial carcinoma with pathological difficulties and rare types. The resistance to platinum chemotherapy in endometrial carcinoma with polymerase ε gene (POLE) mutation is high. Anti-cytotoxic T lymphocyte antigen 4/programmed death protein 1 (CTLA4/PD1) antibody and phosphatidylinositol kinase 3/mitogen activator inhibitor (PI3K/MEK) were effective for POLE. Mismatch repair gene expression deficient endometrial carcinoma is highly resistant to conventional radiotherapy and chemotherapy. Anti-cell programmed death protein ligand 1/fusion protein (PD-L1/B7-H4) antibody is effective in the treatment of microsatellite instability. The combination of PI3K and cyclin dependent kinase (CDK) inhibitors could be used to reduce the level of regional  gene expression in copy number high group. Double microbody protein 4 (MDM4) inhibitors may be effective in the treatment of copy number low group. By hierarchical cluster analysis, some prognostic genes were found to be significantly correlated with the prognosis, and the expression level of these genes could be combined with molecular typing to predict the prognosis of endometrial carcinoma. We will summarize the clinical significance of TCGA molecular typing and the prognostic genes found by our team in precise adjuvant therapy of endometrial carcinoma. Related Articles | Metrics

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Research and Application of Sentinel Lymphnode in Gynecological Malignant Tumor LI Qing，MA Xiao-xin 2018, 45 (6):  628-633.  Abstract ( 1078 )   PDF (844KB) ( 6226 )   The sentinel lymph node (SLN) is the first site of lymphatic metastasis of primary malignant tumors. It is possible to predict tumor metastasis in the entire lymphatic drainage area by detecting whether lymph node metastasis is in the SLN. At present, the research on SLN has been applied to the clinical diagnosis and treatment of malignant tumors such as breast cancer and melanoma. In gynecologic oncology, the researchers first carried out SLN research in vulvar cancer, and then carried out research on SLN detection and sentinel lymph node biopsy (SLNB) in cervical cancer and endometrial cancer, and have been applied in clinical practice. In this paper, the research status of SLN in endometrial cancer, cervical cancer, vulvar cancer and ovarian cancer at home and abroad and the problems that have yet to be solved are briefly summarized. Related Articles | Metrics

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The Research Progress of RNA Molecule in Cervical Cancer CHEN Chang-xian，XIE Yu-xuan，MO Ling-zhao，SONG Hong-lin，LI Li 2018, 45 (6):  634-637.  Abstract ( 1068 )   PDF (696KB) ( 6196 )   The RNA molecules, including messenger RNA (mRNA), microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA), are interrelated and coordinated to form a dynamic molecular network, that is, competitive endogenous RNA (ceRNA) regulatory network. Recent studies have revealed that ceRNA regulatory network plays an important role in the regulation of the pathogenesis, development and prognosis of cervical cancer. Abnormality of any RNA molecule in the ceRNA regulatory network may lead to cervical cancer cell proliferation, invasion, migration or apoptosis through multiple signaling pathways. In this review, we focus on the relationship between RNA molecules such as mRNA, miRNA, lncRNA and circRNA and cervical cancer on the basis of the research progress, aiming at elucidating the molecular mechanism of RNA associated with cervical cancer, so as to provide new ideas for the diagnosis and treatment of cervical cancer. Related Articles | Metrics

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Application Analysis of GnRH-a in the Treatment of Uterine Fibroids GE Guan-nan，SHI Xiao-rong 2018, 45 (6):  638-642.  Abstract ( 1192 )   PDF (758KB) ( 6493 )   Uterine fibroids are the most common benign tumors in the female reproductive system, which can cause abnormal uterine bleeding, compression symptoms, abdominal pain and infertility. Currently the drug treatment effect is limited, it mainly relies on surgical treatment. GnRH-a inhibits the hypothalamic-pituitary-gonadal axis from a high position, reduces estrogen and progesterone in the blood of patients, reduces the volume of fibroids, and improves anemia and pelvic compression symptoms. Compared with oral drugs, it is easier to use, patient compliance is good, and the treatment effect is exact. The volume of the fibroids is reduced, which makes the laparoscopic surgery and the preservation of the uterus less difficult, and the postoperative recovery is fast. In patients with menopausal transition, with severe comorbidities and intolerance to surgery, the use of GnRH-a can also prevent surgery or suspend surgery, and control comorbidities. Pituitary gonadotropin secretion can be restored within 2 weeks, and normal menstrual cycle can be reconstructed after 6-8 weeks after stopping the usage of GnRH-a. Related Articles | Metrics

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The Relationship between Long Non-Coding RNA Overexpression and Clinicopathological Features and Prognosis in Endometrial Cancer: A Meta Analysis SHEN Yan，XIAO Cheng-yu，LIAN Ran-fang，LUO Pan，WU Jing，WANG Hong-bo 2018, 45 (6):  643-647.  Abstract ( 970 )   PDF (1125KB) ( 6116 )   Objective：To analyze the correlation between the high expression of lncRNAs and the pathological characteristics and prognosis of endometrial carcinoma, and systematically to evaluate its prognostic value in endometrial cancer. Methods: We searched the electronic databases such as Pubmed, Embase, Web of science, CNKI, Wan Fang, VIP from inception to October 9, 2017. Literature selection was performed according to inclusion and exclusion criteria, then quality assessment was carried out, and data was extracted. Revman 5.3 and stata 12.0 software were used for meta analysis. Results: 9 studies (1 Chinese, 8 English) and 775 endometrial cancer patients met the inclusion criteria. The results of meta-analysis showed that high expression of lncRNAs was associated with FIGO stage (OR=2.41, 95%CI: 1.11-5.25, P=0.03), histological grade (OR=2.01, 95%CI: 1.19-3.41, P=0.009), the myometrial invasion (OR=2.29, 95%CI: 1.16-4.51, P=0.02) and lymph node metastasis (OR=4.00, 95%CI: 2.40-6.66, P＜0.000 01), lncRNAs had nothing to do with the PR and ER positive expression (P＞0.05). Patients with high expression of lncRNAs had a shorter OS compared with low expression (HR=2.43, 95%CI: 1.55-3.80). In a subgroup analysis, HOTAIR correlated with OS (HR=3.73, 95%CI: 1.21-11.49). Conclusions: LncRNAs overexpression has an important predictive value for prognosis in endometrial cancer patients. The higher the expression of LncRNAs, the higher the clinical stage and histological grade, the deeper the infiltration of myometrium and the increased risk of lymph node metastasis, the shorter the os and the worse the prognosis. Related Articles | Metrics

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Analysis of Prognostic Factors for Stage ⅢC or Ⅳ Epithelial Ovarian Cancer LIU Chuan-zhong，LI Li，ZHAO Bing-bing 2018, 45 (6):  648-651.  Abstract ( 1044 )   PDF (1067KB) ( 6058 )   Objective：To explore the prognostic factors of stage ⅢC or Ⅳ epithelial ovarian cancer and to provide data support for clinical diagnosis and treatment. Methods：Clinical date of patients with stage ⅢC or Ⅳ epithelial ovarian cancer in our hospital were analyzed retrospectively, including age, clinical stage, histopathological type and grade, size of postoperative residual disease and number of postoperative chemotherapy cycles. The effects of these factors on the prognosis of patients with stage ⅢC or Ⅳ epithelial ovarian cancer were evaluated. Results：Univariate analysis showed that age, size of postoperative residual disease and number of postoperative chemotherapy cycles were closely related to the prognosis of the patients. Clinical stage, histopathological type and grade were not statistically significant. Multivariate analysis using COX regression model showed that age ≥50 (RR=0.493, 95%CI: 0.308-0.790), size of postoperative residual disease ≥1 cm (RR=2.527, 95%CI: 1.585-4.028) and number of postoperative chemotherapy cycles ＜6 (RR=2.294, 95%CI: 1.464-3.593) were independent risk factors for prognosis in patients with stage ⅢC or Ⅳ epithelial ovarian cancer. Conclusions： For patients with stage ⅢC or Ⅳ epithelial ovarian cancer, they would have worse prognosis if the  patient is the older or the size of postoperative residual disease is larger or the number of postoperative chemotherapy cycles is less. Related Articles | Metrics

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Quantitative Proteomics Analysis of BV6 Inducing Apoptosis in Human Ovarian Cancer SKOV3 Cells ZHANG Hong，CHEN Si-si，CHEN Qi，ZHAO Xiao-nan 2018, 45 (6):  652-657.  Abstract ( 1028 )   PDF (1828KB) ( 6206 )   Objective：To investigate the possible mechanism of Smac mimetic BV6 affecting the growth of human ovarian cancer SKOV3 cells by quantitative proteomics. Methods：MTT assay was used to detect the growth inhibition rate of SKOV3 cells treated with BV6 for 48 hours. Calculate the drug concentration at 50% inhibition rate as half the inhibitory concentration（IC50） and the subsequent experiments were performed at 0.05, 0.1, 0.2 μmol/L BV6. The control group and 0.05 μmol/L BV6 treatment group were observed under light microscope, after 48 h the cell morphology was changed. Application of isobarictags for relative and absolute quantitation (iTRAQ) techniques combined with Liquid Chromatography Tandem Mass Spectrometry to Screen Differential Protein Parallel Bioinformatics Analysis; Western blotting was used to detect the expression of caspase-3 in the control group and different concentrations of BV6. Results：BV6 can inhibit the proliferation of SKOV3 cells in a dose-dependent manner, and the variance analysis between groups and the comparison between any two groups were statistically significant (all P＜0.05). According to the formula, the IC50 of BV6 acting on SKOV3 cells for 48 h was 0.40 μmol/L. Based on FDR＜1%, 349 differential proteins were screened in the control group and 0.05 μmol/L BV6 for 48 h，251 were up-regulated and 98 down-regulated. Bioinformatics analysis showed differential protein and RNA transcription and protein. Translation, cell division and proliferation, apoptosis signal regulation and tumor angiogenesis were closely related. Western blotting showed that Caspase-3 protein expression was increased in the high, medium and low concentrations of BV6 for 48 h after treatment with SKOV3 cells. The expression of Caspase-3 protein was highest in the high concentration BV6 intervention group. Significance (all P＜0.05). Conclusions: BV6 promotes the death of SKOV3 cells by inhibiting RNA transcription, protein translation, cell division and proliferation, and tumor angiogenesis, and promoting the activation of Caspase-3 apoptosis. Related Articles | Metrics

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Clinical Analysis of Human Papillomavirus Infection after Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia ZHANG Jing，ZHANG De-yu，WANG Dan-bo 2018, 45 (6):  658-661.  Abstract ( 1374 )   PDF (724KB) ( 6167 )   Objective：To assess relevant factors of human papillomavirus infection and prognosis after loop electrosurgical excision procedure (LEEP) in patients with cervical intraepithelial neoplasia (CIN). Methods: A retrospective study was performed with 297 women suffered CIN and treated with LEEP at China Medical University affiliated Shengjing Hospital between Jan 2013 and Dec 2015. Participated in at least one follow-up were analyzed retrospectively. The clinicopathological factors, HPV genotype, postoperation residual and recurrence factors were analyzed. Results: HPV positive rate was 14.5% (43/297) after LEEP. HPV positive was significantly related to margin positive and CIN accompanied with vaginal intraepithelial neoplasia (VAIN) and/or vulval intraepithelial neoplasia (VIN) (P＜0.05). 69.8% (30/43) of HPV positive was at first visit after LEEP. 30.2% (13/43) of HPV positive was occurred after turning negative. The positive rate of high-risk HPV after LEEP was significantly correlated with the residual or recurrence of lesions (r=0.401, P＝0.000). The risk of persistent infection of the same type of HPV before and after operation was significantly higher than that of different types of HPV infection (χ2=5.619, P＝0.046). The most common genotypes were HPV16 and HPV58. Conclusions: Preoperative CIN combined with VAIN and/or VIN and positive incision margin are high risk factors for HPV infection. HPV typing after LEEP plays an important role in predicting residual or recurrence of lesions. References | Related Articles | Metrics

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Total Laparotomic Hysterectomy of Giant Cervical Myoma: Case Report and Review of the Literature Mi ri gu li·ya sheng，He bei er jiang，LIU Pei 2018, 45 (6):  662-664.  Abstract ( 1144 )   PDF (2870KB) ( 6065 )   In order to summarize the experience of the diagnosis and treatment of cervical giant myoma, and further improve level of the diagnosis and treatment of cervical giant myoma. A rare case of 9 kg giant cervical myoma was reported. Literature review was carried out in combination with the progress of diagnosis and treatment of cervical giant myoma. The clinical diagnosis of cervical giant myoma should be combined with medical history, physical examination and B-model ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and other auxiliary examinations. Surgical treatment can choose laparotomy or laparoscopic myomectomy or total hysterectomy to develop individualized treatment programs. Related Articles | Metrics

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The Progress in Treatment of Infertility with Uterine Leiomyoma TAO Xin-li，ZHONG Bi-ting，GAO Tian-yang，OUYANG Zhen-bo 2018, 45 (6):  668-671.  Abstract ( 965 )   PDF (752KB) ( 6163 )   Uterine leiomyoma is the most common benign tumor of female reproductive system. With the delay of childbearing age and the opening of China′s second child policy, many patients with uterine leiomyoma still have fertility requirements. However, the best treatment for such patients has not yet been determined. Although some suggestions have been given for the treatment of infertility with uterine fibroids in relevant consensus or guidelines at domestic and abroad, these suggestions are often ambiguous and sometimes contradictory. Some guidelines point out that hysteromyomectomy is not recommended for women with reproductive needs unless hysteromyoma has caused complications of pregnancy. Some guidelines consider that uterine fibroids combined with infertility is a treatment indication, while others suggest that the treatment of uterine fibroids with infertility should be based on the type of uterine fibroids. It is recommended to perform surgery on submucosal fibroids or intramural fibroids that cause changes in endometrium, and other areas of fibroids are not recommended to treat, regardless of the size of the fibroids. Based on the literature reports and relevant guidelines, this paper discusses the basic principles of treatment of infertility complicated with uterine leiomyoma, in order to provide reference for its standardized treatment. Related Articles | Metrics

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Effect of Penyanqing Suppository Combined with Cefaclor on Chronic Pelvic Inflammatory BAO Tian-yu，DU Meng-jun 2018, 45 (6):  672-676.  Abstract ( 1695 )   PDF (854KB) ( 6169 )   Objective：To investigate the effects of Penyanqing suppository combined with cefaclor on serum monocyte chemotactic protein-1 (MCP-1) and T cell subsets in patients with chronic pelvic inflammation. Methods: 110 patients with chronic pelvic inflammatory disease, who were diagnosed and treated in our hospital from January 2016 to August 2017, were randomly divided into observation group and control group with 55 cases in each group. The control group was treated with cefaclor, while the observation group received penyanqing suppository combined with cefaclor. After 2 courses of treatment, the curative effect, hemorheology, uterine artery blood flow, serum MCP-1 and T lymphocyte subsets were observed in the two groups. Results: The total effective rate of observation group was 92.73%, which was significantly higher than that of the control group (74.55%) (P＜0.05). There were no significant differences in hemorheology, uterine artery perfusion index (PI), resistance index (RI), serum MCP-1 and T cell subsets between the two groups before treatment (P＞0.05). After treatment, hematocrit, platelet aggregation rate, blood viscosity, fibrinogen, uterine artery blood flow PI in two groups were significantly decreased,  observation group decreased significantly compared with the control group, the difference was significant (P＜0.05). After treatment, the MCP-1 of the two groups decreased significantly, and observation group was lower than control group, and the difference was statistically significant (P＜0.05). After treatment, the CD4+ of the two groups increased, the observation group increased more than control group, the CD8+ of the two groups decreased, the observation group decreased significantly, the CD4+/CD8+ level of the observation group was  higher than  control group, the difference was significant (P＜0.05). Conclusions: Penyanqing suppository combined with cefaclor is effective in treating chronic pelvic inflammatory disease. It can improve hemorheology effectively, reduce the level of serum MCP-1, T lymphocyte subsets, which can be widely used in clinic. Related Articles | Metrics

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Placenta Accreta: Risk Assessment and Strategy of Diagnosis and Management SHAO Ming-yu，FENG Wei-wei 2018, 45 (6):  676-680.  Abstract ( 1656 )   PDF (719KB) ( 6339 )   Placenta accreta occurs when a defect in the decidua basalis allows the chorionic villi to attach directly to or invade into the myometrium. The morbidly adherent placenta including placenta accreta, increta, percreta based on the depth of invasion and may cause reverse maternal outcome including excessive postpartum hemorrhage, transfusion, coagulopathy, emergency peripartum hysterectomy or death. Ultrasound complement with magnetic resonance imaging is the main method of antenatal diagnosis of placenta accreta. It is necessary to establish a scoring system to evaluate the risk of placenta accreta and improve the peripartum care. A multidisciplinary team is required in placenta increta or percreta. To preserve the future fertility, peripartum hysterectomy could be avoided by appropriate incision, compression sutures, devascularization and leaving placenta in situ. Hysterectomy remains the definitive surgical treatment when lack of sufficient supports for maternal safety. Related Articles | Metrics

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Application of Low Molecular Weight Heparin in Common Obstetric Diseases SHI Hai-xia，LI Gui-qing，FU Ting，GU Ye-long，WU Si-yu 2018, 45 (6):  681-685.  Abstract ( 1136 )   PDF (1016KB) ( 6095 )   Low molecular weight heparin(LMWH) can reduce the risk of bleeding caused by heparin while achieving effective anticoagulation, which has certain clinical application value. The application of low molecular heparin in obstetric diseases has draw extensive attention. It has been used in the prophylaxis and treatment of pre-eclampsia(PE) and fetal growth restriction(FGR) caused by thrombophilia besides the prevention of deep venous thrombosis(DVT). The use of LMWH may be considered after assessing the risk factors of DVT in gestational period and puerperium. More researches have found the improvement of outcome of LMWH in the non-thrombophilia pregnancy. It can reduce the risk of preeclampsia and FGR in high-risk groups (pregnancy women with history of placental abruption and early-onset PE), and improve their pregnancy outcome, such as prolonging the gestational age, improving newborn survival rate and birth weight. We reviewed recent studies about the application of LMWH in DVT, PE and FGR. Related Articles | Metrics

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The Research Progress on the Effect of Endometriosis on Pregnancy Outcomes ZHANG Xiu-xiang，A zha ti gu li·a bu la，GAO Gui-qin，Mi ri gu li·ya sheng 2018, 45 (6):  686-690.  Abstract ( 1056 )   PDF (745KB) ( 6159 )   Endometriosis（EMs） is a common gynecological disease, which often occurs in women of reproductive age. Pelvic pain and infertility are the main manifestations, which seriously disturb the physical and mental health of reproductive women. Recent studies have found that EMs can not only cause infertility, but also lead to adverse pregnancy outcomes. Studies have shown that women with EMs had a statistically significantly higher risk of miscarriage, ectopic pregnancy in the early pregnancy outcomes, and preterm birth, placenta previa, gestational hypertension and preeclampsia, small for gestational age, and cesarean delivery in the middle-late pregnancy outcomes compared with the healthy controls. EMs is associated with these above adverse pregnancy outcomes. The mechanism of EMs leading to infertility and adverse pregnancy outcomes is complex. It involves the pathophysiological changes of EMs during its occurrence and development. It is important to elucidate the mechanism of EMs for the prevention and treatment of adverse pregnancy outcomes in EMs patients. Related Articles | Metrics

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A Meta-Analysis on the Association between Adiponectin Gene rs266729(-11377C/G) and Gestational Diabetes Mellitus WU You，SHEN Yan-ting 2018, 45 (6):  691-695.  Abstract ( 940 )   PDF (859KB) ( 6010 )   Objective：To systematically review the association between rs266729(-11377C/G) of adiponectin gene and gestational diabetes mellitus (GDM). Methods: We electronically searched the following databases: PubMed, Web of Science, CBM, CNKI, WanFang Data, and VIP to identify all the case-control trials which was related to the association between rs266729(-11377C/G) of adiponectin gene and GDM. Two reviewers independently filtrated literature and extracted data according to the inclusion and exclusion criteria. Then, they assessed the quality of the included studies and performed meta-analysis using RevMan 5.3 software. Results: Totally 7 studies were recruited (943 GDM pregnant women and 999 normal pregnant women), including two Chinese studies and five English studies. The results of meta-analysis showed that there was no significant difference in the genotype frequency of rs266729(-11377C/G) between the two groups. The pooled OR values and 95%CI values of GG vs. GC, GG vs. CC and GC vs. CC were 0.87 (0.59-1.28), 1.03 (0.71-1.48), 1.12 (0.91-1.39), respectively. There was also no significant difference in the dominant and recessive genetic models between the two groups. The pooled OR value of dominant genetic model was 1.22 (0.98-1.51), and the pooled OR value of recessive genetic model was 0.95 (0.66-1.36). For the allele frequencies, a significant difference was found between the two groups in non-han Chinese (P＜0.05), the pooled OR(95%CI) value of G vs. C was 0.65 (0.52-0.83), while there was no significant difference between the two groups in the Han Chinese women (P＞0.05), the pooled OR(95%CI) value of G vs. C was 1.15 (0.91-1.45). Conclusions: rs266729 (-11377C/G) of adiponectin gene in non-han Chinese pregnant women was associated with GDM. The sub-allele gene G of this site was a protective gene, which would be of some value in the prevention and diagnosis of GDM. Related Articles | Metrics

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Risk Assessment and Prediction of Combined Screening for Fetal Growth Restriction in Early and Mid Pregnancy ZHONG Hai-yan，LUO Wen-bin，WANG Dong-ju，XIAO Xiao-min 2018, 45 (6):  696-699.  Abstract ( 1136 )   PDF (849KB) ( 6195 )   Objective：To establish a mathematical model through early and middle pregnancy, and to explore the value of different models for risk assessment and prediction of fetal growth restriction (FGR). Methods：2 621 cases of pregnant women were selected from January 2010 to December 2015 at the First Affiliated Hospital of Jinan University, which were combinated prenatal ultrasound screening in early and middle stage of pregnancy. Forty-nine cases(1.87%) were finally diagnosed as FGR. The age of pregnant women, pre-pregnancy body mass index (BMI), nuchal translucency (NT), free human beta chorionic gonadotropin (β-hCG), pregnancy related protein A (PAPP-A), pulsation index value of uterine artery (UtA PI) and middle cerebral artery pressure (MAP) were collected at the early stage of pregnancy. In the mid-term screening, biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) were screened. At the same time, NT, UtA PI, MAP, BPD, HC, AC and FL were expressed by the median multiplier (MoM). Group A include all original parameters. Group B include them but β-hCG, PAPP-A, UtA PI and MAP were represented by MOM. Group C include them but β-hCG, PAPP-A, UtA PI, MAP, NT, BPD, HC, AC and FL were represented by MOM. The stepwise regression analysis method were used to establish the prediction model of FGR. Reciever operating characteristic curve (ROC) analysis was conducted to compare the sensitivity and specificity of the models. Results：The results of ROC curve calculation showed that area under the curve (AUC) of three groups of regression models were 0.69 (95%CI: 0.61-0.76), 0.69 (95%CI: 0.61-0.77), 0.71 (95%CI: 0.64-0.78), respectively, and under the condition of 5% false positive rate, the detection rates were 12.26%, 14.29%, 16.32%, respectively, and the sensitivity was 10.2%, 10.2%, 16.3%, respectively. The specificity was 97.3%, 97.2% and 96.8%, respectively. Conclusions：MOM value can improve the detection rate of FGR combined prediction in early and mid pregnancy screening. Related Articles | Metrics

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Clinical Analysis of Risk Factors for Postpartum Urinary Retention in 97 Primiparas Through Vaginal Delivery YANG Cai-xia，TANG Shu-wen，LAN Shu-hai，CHEN Jin-ling 2018, 45 (6):  700-703.  Abstract ( 1080 )   PDF (774KB) ( 6286 )   Objective：To explore the risk factors of postpartum urinary retention after vaginal delivery, to provide theoretical basis for reducing the incidence of postpartum urinary retention and reducing postpartum complications. Methods：Using the method of retrospective analysis, 97 cases of postpartum urinary retention in vaginal delivery from January 2016 to December of Baodi Clinical College of Tianjin Medical University were selected as the observation group (A group, with labor analgesia group was A1 group, and without labor analgesia group was A2 group), and 88 cases of non urinary retention in the same period were randomly selected as the control group (B group, the labor analgesia for the B1 group, no analgesia for the B2 group). Record the general information of 2 groups of patients, pregnancy complications, complications during pregnancy, the situation during childbirth, postpartum hemorrhage and neonatal body mass, retrospective analysis was performed. Results：There were no significant differences in pregnancy complications, complications during pregnancy, pregnancy times, premature rupture of membranes, left anterior occipital position, third stage of labor and neonatal body mass between the two groups (all P＞0.05). There were significant differences in pregnant weeks, labor analgesia, forceps delivery, episiotomy, first stage of labor, second stage of labor and postpartum hemorrhage (P＜0.05). Logistic stepwise regression analysis showed that the risk factors of PUR were pregnant weeks (OR=1.619, 95%CI: 1.121-2.339), forceps delivery (OR=4.981, 95%CI: 2.184-11.361), postpartum hemorrhage (OR=3.429, 95%CI: 1.024-11.488), episiotomy (OR=2.419, 95%CI: 1.058-5.531). Analysis of the risk factors of postpartum urinary retention by ROC curve, the best critical age was 26.50, the best critical value of the gestational week is 40.36 weeks, the best critical value of newborn weight was 3 372.50 g, the best critical value for the first labor process of labor analgesia was 402.50 min, the second birth process time of labor analgesia was 61.50 min, the best critical value for the first labor process of no labor analgesia was 230.00 min, the second birth process time of no labor analgesia was 34.50 min. Conclusions：The occurrence of postpartum urinary retention can be reduced by proper intervention on factors such as pregnant weeks, labor analgesia, forceps delivery, episiotomy, first stage of labor, second stage of labor and postpartum hemorrhage. Related Articles | Metrics

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The Clinical Analysis of Two Cases of Multiple Pregnancy with Cervical Incompetence Treated by Reduction of Fetus and Cervical Cerclage FANG Lian-sha，LI Ying-tao，ZHONG Cai-juan，GUO Hui，WANG Zhen-yu，CHEN Min，LI Zhi-hua 2018, 45 (6):  704-707.  Abstract ( 1064 )   PDF (4032KB) ( 6358 )   Multiple pregnancies and cervical incompetence are high risk factors for miscarriage or premature delivery. If multiple pregnancies complicated with cervical incompetence, the risk of miscarriage or premature delivery is higher. Two cases of multiple pregnancy complicated with cervical incompetence were reported. Multifetal pregnancy reduction was performed at 11+5 weeks of gestation and 20+5 weeks of gestation. Cervical cerclage was performed at 13+4 weeks of gestation and 21+6 weeks of gestation respectively. The cervical length was monitored by vaginal ultrasound and preterm delivery was prevented. The cases of multiple pregnancy complicated with cervical incompetence were born at 36 weeks of gestation and 33+4 weeks of gestation respectively. The clinical course was analyzed and evaluated. Cervical cerclage is a remedy to improve pregnancy outcome in multiple pregnancies. Cervical cerclage can repair the cervical function after multifetal pregnancy reduction. Periodic follow-up is very important to prevent premature delivery, so are clinical medication and removing cervical cerclage stitches in time to improve maternal and fetal prognosis. When multiple pregnancy complicated with cervical incompetence, multifetal pregnancy reduction combined with cervical cerclage is a choice for clinic practice. Related Articles | Metrics