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15 February 2019, Volume 46 Issue 1
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The Role of Androgens in the Pathogenesis and Treatment of Female Reproductive Endocrine Diseases XU Xiao，LI Xue-lian 2019, 46 (1):  5-10.  Abstract ( 2080 )   PDF (827KB) ( 10130 )   Androgens play a vital role in maintaining the health of the female reproductive system. Either excessive or deficient androgens may result in the occurrence of female reproductive endocrine diseases. Hyperandrogenism is one of the important characteristics and pathogenic factors of polycystic ovary syndrome (PCOS). Hyperandrogenism may play its pathogenic role in women with PCOS by influencing epigenetic modification, hypothalamic neuroendocrine, follicular development, ovarian function and metabolism. The mechanism of androgens action in recurrent spontaneous abortion mainly affects endometrial receptivity and embryo implantation. Women with premature ovarian insufficiency often have low testosterone levels. Androgen deficiency may be associated with granulosa cells apoptosis and diminished ovarian reserve. The treatment of androgen reduction is an important part of the clinical treatment of PCOS, while androgen supplements can be used in women with low function ovarian reserve, whereas further studies are needed due to the lack of long-term safety and efficacy. Related Articles | Metrics

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The Influence of Obesity on Menopausal Symptoms WANG Xue，CHEN Yi-jie，DU Yi-ni, ZHANG Zhi-fen 2019, 46 (1):  11-14.  Abstract ( 1376 )   PDF (749KB) ( 7414 )   Obesity is a chronic disease characterized by excess or abnormal accumulation of body fat, more and more people are suffering from various diseases and complications which are caused by obesity. Obesity has become a serious and worldwide public health problem. Menopausal women is an important part of the obesity due to drop of estrogen level, decline of ovarian function and lose control of weight gain. They not only face the problem of increasing body weight during menopause, but also suffer from various symptoms such as tidal fever, sexual dysfunction, osteoporosis, urination disorders, sleep disorders，et al, which severely impairs women′s physical and mental health and quality of life. The occurrence and development of menopausal symptoms are affected by the body and weight, yet the association and mechanism between obesity and menopausal symptoms are still unclear. This paper reviews the effects of obesity and weight control on menopausal symptoms. Related Articles | Metrics

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The Progress in the Diagnosis and/or Treatment of Endometrial Hyperplasia YAO Ying-sha，CHENG Xiao-dong 2019, 46 (1):  15-19.  Abstract ( 1154 )   PDF (781KB) ( 7379 )   Endometrial hyperplasia is defined as endometrial thickening with a proliferation of irregularly sized and shaped glands and an increased gland-to-stroma ratio. The specific cause of this disorder is unclear, the endometrium proliferation by estrogenic stimulation without progesterone resistance is believed to be the main etiological factor for developing the condition. Endometrial hyperplasia is currently mainly classified as endometrial hyperplasia with and without atypical hyperplasia according to the pathology. An atypical endometrial hyperplasia is considered as a pre-malignant conditions of the type Ⅰ endometrium. The diagnosis of endometrial hyperplasia should be taken into account of medical history, imaging and cytology, and its final diagnosis is based on histological results. The treatment of endometrial hyperplasia is mainly divided into medication and surgery. The specific treatment regimen should be based on the type of endometrial hyperplasia and the fertility requirements of the patient. This article reviews the endometrial hyperplasia definition, mechanism, diagnosis, classification, and treatment. Related Articles | Metrics

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Progress of Intestinal Dysfunction Associated with Deep Infiltrating Endometriosis TIAN Qi，YI Xiao-fang 2019, 46 (1):  20-22.  Abstract ( 1117 )   PDF (772KB) ( 7190 )   Deeply infiltrating endometriosis(DIE) is the most serious type of endometriosis (EMs). It related with intestinal dysfunction, such as cyclical defecation pain and hematochezia, intestinal cramping, diarrhea, bloating, even intestinal stenosis, which seriously affects the quality of life of patients. Yet these symptoms are often omitted in current clinical practice. Surgery is still the first choice for symptomatic patients. However, the improvement of intestinal symptoms after surgery and postoperative intestinal dysfunction are not clear. There are many factors affecting the recovery of intestinal function. Therefore, it is necessary to evaluate intestinal function in detail by various methods and formulate treatment regimen by multidisciplinary cooperation, then further explore possible ways to improve intestinal function. Ultimately, we hope to improve the symptoms and promote the comprehensive recovery of patients. Related Articles | Metrics

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Reproductive Prognosis and Assisted Reproductive Strategy in Patients with Adenomyosis Combined with Infertility ZHANG Pan-pan，LI Meng，LU Mei-song 2019, 46 (1):  23-26.  Abstract ( 1033 )   PDF (773KB) ( 7291 )   Among abnormal uterine structure diseases, the prevalence of adenomyosis is higher in childbearing age women. With the improvement of medical image technique and treatment, more and more findings show that adenomyosis may affect the fertility of childbearing age women. Currently, the mechanism of adenomyosis resulting in infertility is unclear, abnormal receptivity of the endometrial, abnormal structures of the uterine junctional zone, and dysfunction of immune in uterine can cause the infertility in these patients. The main treatment options are drug therapy, assisted reproductive technology (ART), and surgical resection of adenomyosis for women with fertility inspiration. The gonadotropin-releasing hormone analogs has a positive effect on reproduction function, while ART can improve the pregnancy outcome in infertile women with adenomyosis, both have important value in the treatment of infertility in women with adenomyosis. This article reviews the mechanisms, pregnancy outcomes and therapeutic strategies of infertility in women with adenomyosis to investigate the associations between adenomyosis and infertility. Related Articles | Metrics

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Progress about Surgical Treatment of Female Pelvic Floor Dysfunction FAN Xiao-dong,ZHU Ying-jun 2019, 46 (1):  27-31.  Abstract ( 1035 )   PDF (757KB) ( 7357 )   Female pelvic floor dysfunction (PFD) is a series of disease of pelvic organ prolapse secondary to pelvic floor support structure dysfunction with a variety causes. With China′s aging society, the prevalence of PFD is increasing. It not only affects the quality of life in elderly women, but also cause the mental and psychological disorders. For the patients with moderate or severe PFD, surgical treatment is the first choice at present. PFD surgery has a long history and various operations. With the development of new medical materials and technologies and updated surgical concepts, many surgical methods have been continuously improved. From vaginal surgery to laparoscopic surgery, from autologous tissue repair to the reconstruction of the entire pelvic floor with synthetic mesh, the success rate of surgery has significantly increased. However, new complications are occurrence along with new techniques and new materials. Though diversity of surgery provides more selections for patients, each surgical method has advantages and disadvantages as well as individualized differences, comprehensive consideration should be made according to age, symptoms, signs, medical history, living habits, sexual life demands and general conditions. Optimal surgical regimen and adequate communication should be made to achieve the best treatment effect. Related Articles | Metrics

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Advances in the Neurobiology of Women with Chronic Pelvic Pain LIU Yan-min,JIANG Xiu-xiu 2019, 46 (1):  32-36.  Abstract ( 875 )   PDF (769KB) ( 7275 )   Pelvic pain is one of the common gynecological diseases in women, which mainly presents as chronic pelvic pain. It has not only a great impact on women′s posture and balance ability, but also severe influence on the quality of life and health. However, the biological basis and etiology of chronic pelvic pain are still unclear. Its evaluation and treatment are complicated, which brings great difficulties to the treatment and rehabilitation. We aim to review the innervation of internal and external reproductive systems, the imaging changes and pain susceptibility of central nervous, the interaction between cytokines and peripheral nerve fibers, the role of inflammation factor in reducing peripheral nerve sensitivity, the pain signals transmission and neurons kinase signaling pathways activation mediated by sodium channel to further provide a theoretical basis for the prevention and treatment of female pelvic pain. We focus on the role of signaling pathways and cytokines in the pathogenesis of pain. Related Articles | Metrics

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Vesico-Vaginal Fistula Caused by Transumbilical Laparoendoscopic Single-Site Hysterectomy：One Case Report DONG Chun-lin, ZHANG Bing, YU Jin-jin 2019, 46 (1):  37-38.  Abstract ( 1027 )   PDF (658KB) ( 7298 )   Related Articles | Metrics

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The Research Advances in the Mechanism of Macrophage Effects on Maternal-Fetal Immune HUANG Jin-hua，LIANG Meng-chen，JIANG Meng-qi，LIU Yue，DING Zhi-de 2019, 46 (1):  39-43.  Abstract ( 957 )   PDF (771KB) ( 7248 )   Blastocyst implantation is a critical stage in the pregnancy process, including apposition, adhesion and invasion of blastocysts in the endometrium. The blastocyst is a semi-allogeneic transplant for the uterus. The successful implantation dependents on the immune tolerance established and maintained by maternal immune cells located in the uterus. As the second largest immune cell group at the maternal-fetal interface, macrophages play a critical role in establishing and maintaining maternal-fetal immune tolerance and remodeling tissue and spiral arteries. Recent studies have found that abnormal differentiation or dysfunction of macrophages is significantly correlated with pathological pregnancy. Thus, studies on the types and functions of decidual macrophages will help us to improve the diagnosis and treatment of pathologic pregnancy. This review is mainly focused on research progresses in the derivation and classification of macrophages at the maternal-fetal interface as well as the roles of the macrophages in blastocyst implantation and pathological pregnancy. Related Articles | Metrics

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Advances in the Prediction of Premature Rupture of Membranes with Chorioamnionitis by IL-1β, MMP-8 and Fetal Thymus ZHOU Li, WANG Yong-hong 2019, 46 (1):  44-47.  Abstract ( 774 )   PDF (747KB) ( 7305 )   Premature rupture of membrane (PROM) often occurs in the second and third trimester. After the membrane rupture, the pathogenic microorganisms in the vagina can induce chorioamnionitis (CA) when enter the amniotic cavity via the broken membrane, resulting in serious complications such as fetal distress or neonatal infection sepsis which associated with high mortality in perinatal children. Most patients are absent of clinical symptoms in the short-term after PROM, and early warning and treatments can significantly reduce the prevalence and mortality of perinatal infants, such as the screening and treatments of type B hemolytic streptococcus in the third trimester. Recently, studies indicated that in addition to traditional laboratory predictions such as interleukin-6 (IL-6), IL-1β, matrix metalloproteinase-8 (MMP-8) and ultrasound measurements of fetal thymus had certain prediction value for CA. Therefore, this review summarized the markers to predict CA in early stage in women complicated with CA in recent years. Related Articles | Metrics

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Advances in Fetal Inflammatory Response Syndrome TANG Qin, SHAO Yong 2019, 46 (1):  48-52.  Abstract ( 916 )   PDF (761KB) ( 7371 )   The fetal inflammatory response syndrome (FIRS) is a subclinical state in which the fetal immune system is activated. It is a special situation of systemic inflammatory response syndrome (SIRS) in the fetal period. Intrauterine infection and chronic hypoxia are two important reasons of FIRS. The "Uncontrolled" systemic inflammatory response due to infection or hypoxia is the main mechanism of FIRS. FIRS is closely related to adverse neonatal outcome such as premature delivery, bronchopulmonary dysplasia, neonatal early-onset sepsis, neonatal brain injury, and neonatal necrotizing enterocolitis. The clinical performance of FIRS is often atypical and easily overlooked, but may result in serious outcomes in the neonatal period, such as cerebral palsy, multiple organ failure, and even death. This article summarizes the research progress in the clinical diagnosis, pathogenesis and adverse neonatal outcome of FIRS in recent years. Related Articles | Metrics

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Advances in the Inference Factors of Uterine Rupture during Pregnancy LI Mi-qi，HUANG Su-fang 2019, 46 (1):  53-56.  Abstract ( 862 )   PDF (820KB) ( 7386 )   Uterine rupture is a sever complication in obstetrics. Thought its prevalence is low, the influences of maternal and perinatal outcome are greater. Many factors can result in uterine rupture, of which scarred uterus following casarean section and other uterus surgery is the most common risk factor. With the two-child policy, the potential risk of uterine rupture increased after pregnancy in women with scarred uterus. In addition to scarred uterus, the other factors including abnormal structures of uterus, dystocia, age, gravidity, parity，and medicine. It cannot be ignored because it′s affected by the gravida′s condition, family support and social context. Uterine rupture during pregnancy should be put more attention than delivery due to the devastating complications. We summarized the risk factors of uterine rupture during the pregnancy and provided the suggestion of screening and assessment of uterine rupture, which aims to prevent the uterine rupture during pregnancy. It also provided the basis for the detection, diagnosis and treatment of uterine rupture in early stage to avoid serious maternal and prenatal complications. Related Articles | Metrics

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Study on the Expression of Cell-Invasion Related Signal Paths in Placenta of Early-Onset Pre-Eclampsia Patients and Their Interaction DU Qu-xiao，LIU Bei-bei 2019, 46 (1):  57-61.  Abstract ( 848 )   PDF (16749KB) ( 6956 )   Objective：To assess the expression of Notch1 and Wnt1 in placental tissues of early-onset pre-eclampsia patients and their interaction. Methods：176 early-onset pre-eclampsia patients were hospitalized in People′s Hospital of Zhengzhou from June 2016 to December 2017, of whom 102 were mild and 74 were severe. 60 healthy pregnant women were taken as control group. Placental tissue samples of all subjects were collected after delivery. The expressions of Notch1 and Wnt1 proteins in placentas were measured by immunohistochemistry and the levels of Notch1, Jagged1, Wnt1 and β-catenin were measured by Western blotting. The correlation of the expression of each protein were analyzed. Results：There were significant differences of Notch1 and Wnt1 expressions intensity among groups (P＜0.05), the positive rates of Notch1 and Wnt1 in the mild group and severe group were lower than those in the control group, and the positive expression rates in the severe group were lower than those in the mild group (both P＜0.05). There were statistical differences of the levels of Notch1, Jagged1, Wnt1 and β-catenin protein among groups (P＜0.05). The Notch1, Jagged1 and Wnt1 levels in the severe group and mild group were significantly lower than those in control group (all P＜0.05). The Notch1, Jagged1, Wnt1 and β-catenin expression levels in the severe group were lower than those in the mild group (all P＜0.05). Only β-catenin level in the severe group was significantly lower than that in the control group. The expressions of Notch1 and Jagged1 (r=0.826, P=0.000) and Wnt1 and β-catenin (r=0.531, P=0.000) were positively correlated, while Wnt1 and Notch1 (r=－0.167, P=0.010) and Wnt1 and Jagged1 (r= -0.136, P=0.037) were negatively correlated. Conclusions：The low expressions of Notch1 and Wnt1 were associated with the occurrence and progression of early-onset pre-eclampsia, and there may be some interaction between Notch and Wnt signaling pathways in this process. Related Articles | Metrics

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External Validation of fullPIERS Model for Prediction of Adverse Outcomes in 398 Women with Pre-Eclampsia PENG Lan，WU Xiao，KANG Yan，YAO Yi-qian，HONG Xiang-lan 2019, 46 (1):  62-66.  Abstract ( 843 )   PDF (1070KB) ( 7077 )   Objective：To validate the prediction value of adverse pregnancy outcomes of fullPIERS model in women with pre-eclampsia (PE). Methods: This was a retrospective study. 398 pregnant women with PE hospitalized in Suzhou Municipal Hospital from January 2014 to December 2015 were included to analyze. The fullPIERS was applied to predict the adverse pregnancy outcomes within 48 h and 2-7 days after hospitalization. The discrimination (ROC AUC), risk stratification and calibration (H-L test and calibration plot) of the model were assessed. The comprehensive external validation of fullPIERS model was accomplished. Results: Among 398 pregnant women with PE, 67 (16.8%) of whom had adverse outcomes, including 41 (10.3%) within 48 h and 21 (5.3%) within 2-7 days. The area under the curve of fullPIERS model to predict adverse outcomes was 0.855 within 48 h，and 0.826 with in 2-7 days after hospitalization. The negative prediction value (NPV) of model to predict adverse outcomes within 48 h and 2-7 days were 96.9% (286/295) and 98.7% (312/316), while the positive prediction value (PPV) were 31.1% (32/103) and 20.7% (17/82). The calibration of fullPIERS model was good ( χ2=6.431, P=0.599) within 48 h, but was poor ( χ2=36.778, P=0.000) within 2-7 days. Conclusions: The fullPIERS model performed well to predict the adverse pregnancy outcomes in women with PE in single center of east China, especially within 48 h after hospitalization. The model might be used as a routine test to predict the adverse pregnancy outcomes in women with PE. Related Articles | Metrics

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Clinical Analysis of 61 Cases of Septic Shock in Pregnant and Puerperal Women ZHAO Xian-lan, FANG Yu-jie 2019, 46 (1):  67-70.  Abstract ( 911 )   PDF (762KB) ( 7131 )   Objective：To investigate the common clinical factors and preventions of the septic shock in pregnant and puerperal women. Methods: Retrospectively analyzed 61 cases with septic shock hospitalized in the Obstetric Department of The First Affiliated Hospital of Zhengzhou University from January 2012 to December 2017. According to the clinical outcome, the patients were divided into the survival group (45 cases) and the death group (16 cases), then the clinical characteristics between two groups were analyzed. Results: A total of 61 patients, 24 patients were in gestation, 37 patients were in the puerperium, 16 patients (26.23%) died. There was a statistical difference for the score system of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) between two groups (t=4.170, P=0.001). Compared with survival group, the rate of preterm premature rupture of membranes (PROM) and multiple organ dysfunction syndrome (MODS) significantly increased in the death group (both P＜0.05). The death group also had lower platelet (PLT) and fibrinogen (FIB), but higher prothrombin time (PT) and procalcitonin (PCT). Logistic regression analysis showed that higher APACHE Ⅱ score, coexisting PROM or MODS were risk factors of maternal prognosis. Conclusions: The mortality rate is high in pregnant and puerperal women with septic shock. Once diagnosis of septic shock, in addition to monitoring biochemical indicators such as PLT, PT, FIB and PCT, more clinical management should be performed in patients with higher APACHE Ⅱ score, occurrence of PPOM or MODS to improve maternal poor prognosis. Related Articles | Metrics

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The Influence of Induction Time for Premature Rupture of Membranes in Term Pregnancy on Pregnancy Outcomes MA Li-yuan, LI Chao, ZHAN Ying, PENG Wei, MA Chun-ling, LU Cai-xia, LI Can 2019, 46 (1):  71-74.  Abstract ( 893 )   PDF (904KB) ( 7335 )   Objective：To investigate the influence of induction time on pregnancy outcomes in women with premature rupture of membranes (PROM) in full-term pregnancy. Methods: A total of 1 474 pregnant women with PROM were selected from Affiliated Hospital of Qingdao University and Linyi Central Hospital from January 2015 to December 2017. They were divided into four groups according to Bishop score and induction time including group A (Bishop score ≥6 points, and patients were induced by oxytocin without labor after 2 h of rupture), group B (Bishop score ≥6 points, and patients were induced by oxytocin without labor after 12 h of rupture), group C (Bishop score＜6 points, and patients were induced by oxytocin without labor after 2 h of rupture), group D (Bishop score＜6 points, and patients were induced by oxytocin without labor after 12 h of rupture). We analyzed the pregnancy outcomes in the four groups. Results: The rate of vaginal delivery had no significant difference between group A and group B (P＞0.05). The vaginal deliver rate in group D was higher than that in group C (P＜0.05). The rates of puerperal infection and complications of induction in group A were lower than those in group B (P＜0.05). The rate of complications of induction, fetal distress and neonatal admission in group C were higher than those in group D (P＜0.05). Conclusions: The induced labor can be conducted after 2 h of rupture when the cervical is mature in patients with PROM, otherwise it should be delay to after 12 h． Related Articles | Metrics

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A Meta-Analysis of Pregnancy Outcomes in Rh-Negative Pregnant Women ZHANG Lu，LI Xiao-hong，ZHANG Su-mei 2019, 46 (1):  75-79.  Abstract ( 926 )   PDF (1022KB) ( 7051 )   Objective：To evaluate the pregnancy outcomes in Rh-negative pregnant women. Methods：We searched the CNKI, VIP, WanFang database, PubMed and Embase databases for the studies about the pregnancy outcomes in Rh-negative pregnant women by computers. Dated from January 1st 1980 to 30th January, 2018. Two reviewers independently screened research paper according to the inclusion and exclusion criteria, extracted data and assessed the risk bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results：Only 9 studies with total of 4 122 cases (679 cases were Rh-negative pregnant women and 3 443 were Rh-positive pregnant women)were included in the Meta-analysis. The results of meta-analysis showed that, the incidence of newborn hemolytic disease (RR=6.29, 95%CI: 3.64-10.85, P＜0.000 01) and premature birth (RR=3.05, 95%CI: 1.80-5.15, P＜0.000 1) in Rh-negative pregnant women are higher than Rh-positive pregnant women. Conclusions：Rh-negative pregnant women were prone to neonatal newborn hemolytic disease and premature birth. Therefore, Rh-negative pregnant women and the Rh antibody should be monitored during pregnancy regularly, in order to reduce perinatal complications. Related Articles | Metrics

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Tubal Pregnancy with Ovarian Pregnancy after Assisted Reproductive Technology：A Case Report ZHU Hai-ying, LUO Xiao-rong, ZHANG Xue-hong 2019, 46 (1):  80-82.  Abstract ( 935 )   PDF (718KB) ( 7137 )   Related Articles | Metrics

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Retroperitoneal Pregnancy: A Case Report and Review of the Literature ZHOU Jia-wen, HOU Shun-yu, LIANG Bao-quan, YUE Yong-fei 2019, 46 (1):  82-84.  Abstract ( 882 )   PDF (1941KB) ( 7107 )   Related Articles | Metrics

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Epidemic Hemorrhagic Fever with Pregnancy：A Case Report LI Guang, WU Shuai, SHENG Chao, LIU Guo-bing 2019, 46 (1):  85-87.  Abstract ( 1033 )   PDF (682KB) ( 7130 )   Related Articles | Metrics

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One Case of Wharton Jelly Thickening of Umbilical Cord LIANG Qiu-feng, XI Jie, YANG Li-xin, HONG Xi-ping, CHEN Jie, WANG Xia-hong 2019, 46 (1):  88-89.  Abstract ( 1311 )   PDF (4092KB) ( 7833 )   Related Articles | Metrics

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Effects of MiRNA and LncRNA and Their Associated Signal Transduction Pathways on Infiltration Function of Trophoblast Cells and Their Mechanisms TANG Xi-yang，SHI An-ping，ZHAO Shou-jie，ZHU Xiao-ming 2019, 46 (1):  90-93.  Abstract ( 889 )   PDF (854KB) ( 7017 )   MicroRNA (miRNA) is a small non-coding RNA expressed endogenously, which can regulate approximately 30% gene expression via posttranscriptional function. Many studies indicate that miRNA plays a critical role in regulating the proliferation, migration and invasiveness of trophoblast. Long non-coding RNA (lncRNA) is such a kind of non-coding RNA with length more than 200 nucleotides, which can regulate the proliferation, migration and invasiveness of trophoblast through epigenetic effect, the regulation of cellular cycle and cell differentiation. Moreover, the regular transduction of cellular signal pathway can keep the normal invasiveness of trophoblast to prevent it grows and invades without restriction like the tumor cells. Different RNA or signal pathway has different targets, which results in the change of invasiveness of trophoblast in different procedure. This paper aims at illuminating the effects and mechanisms of miRNAs, lncRNAs and related signal pathway on the invasiveness of trophoblast. Related Articles | Metrics

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The Research of the Impact of Mesothelin in Tumor Microenvironment of Ovarian Cancer WANG Lu-yao，JIANG Jing，YUE Xin，LU Hao，HUO Li-ting，WANG Hao，WANG Bei-di，GC GOMA，LI Pei-ling 2019, 46 (1):  94-98.  Abstract ( 938 )   PDF (794KB) ( 7068 )   It is very important to improve the early diagnosis rate of ovarian cancer due to its high mortality rate and difficult to diagnose early. Mesothelin (MSLN) plays an important role in the occurrence and development of ovarian cancer and in the microenvironment of ovarian cancer. MSLN is a glycoprotein with overexpression in many cancers, including ovarian cancer and mesothelioma, it is closely related to cell survival, proliferation, tumor progression and adhesion. CA125 is a ligand of MSLN which binds to CA125 to form a complex of MSLN: CA125, the later mediates peritoneal implantation of ovarian cancer cells. The specific expression of MSLN can be used for early diagnosis, evaluation of the therapeutic effect of ovarian cancer, detection of the distribution of primary tumors and metastatic lesions, and as a new therapeutic target and tumor immunotargeting therapy. Although the studies of MSLN targeting immunotoxins, anti-MSLN chimeric antibodies and clinical cancer vaccines suggest that MSLN can be used as a potential target for cancer treatment to improve the clinical efficacy, more studies are needed to confirm the role of MSLN in cancer metastasis and its treatment options. Related Articles | Metrics

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The Progression of Methods for Risk Prediction of Cervical Lesions in HR-HPV Positive Patients LI Bo-han, TAN Gui-chun, QU Peng-peng 2019, 46 (1):  98-103.  Abstract ( 919 )   PDF (857KB) ( 7203 )   The main mechanism of cervical cancer is closely related to the persistent infection of high risk human papillomavirus (HR-HPV), and HR-HPV tests have become a main means of recognizing cervical lesions. But they have high sensitivity and poor specificity. Therefore, it is crucial to assess the risk of cervical lesions and screen out abnormality from patients with persistent HR-HPV infection. With the in-depth study for mechanism of cervical lesions, several new detection technologies are gradually applied in clinic. HR-HPV load detection can exclude some patients with transient infection. P16/Ki67 detection makes cytological examination more objective. HPV DNA methylation, host cell DNA methylation and miRNA cervical cancer screening not only has relatively high sensitivity and specificity, but also makes self-sampling possible. Immune microenvironment can reflect the degree of lesion and immune status. Meanwhile, these new examination methods provide a good clinical value for the risk prediction of cervical lesions while providing colposcopy triage in patients with HR-HPV. The paper summarizes some new methods of the triage for HPV positive patients, and provides a reference for further examination and risk prediction after HPV positive. Related Articles | Metrics

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Advances in Etiology of Cervical Adenocarcinoma HUANG Gen-ping，LI Bao-hua 2019, 46 (1):  104-108.  Abstract ( 1008 )   PDF (772KB) ( 7342 )   Cervical cancer is the second-largest female malignancy in the world, with about 520,000 new cases a year. With the continuous improvement of cervical cancer screening technology and strategy, the incidence of cervical squamous cell carcinoma has decreased, while the incidence of cervical adenocarcinoma is still rising. The treatment strategy and biological behavior of cervical adenocarcinoma are different from cervical squamous cell carcinoma and the prognosis of cervical adenocarcinoma is poor. Although more and more studies have been conducted on cervical adenocarcinoma, its etiology is still unclear, mainly including the following four aspects: ①The infection of long-term continuous high-risk human papillomavirus. ②Molecular biological factors such as epigenetic variation, cell mutation and apoptosis. ③Changes in tumor microenvironment caused by chronic inflammation. ④Sexual behavior, hormone levels and reproductive factors and other individual heterogeneity. Cervical adenocarcinoma is difficult to be detected, progresses rapidly and has a poor prognosis, so it is urgent to have a deep understanding of its etiology and find better preventive measures. This paper is summarized the research progress of cervical adenocarcinoma etiology at home and abroad, and provided reference for the formulation of cervical adenocarcinoma prevention strategies in the future. Related Articles | Metrics

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Influencing Factors of Parametrial Involvement in the Conization Specimens of Early-Stage Cervical Cancer LI Zhi-wei，JIANG Ji-yong 2019, 46 (1):  109-111.  Abstract ( 1224 )   PDF (727KB) ( 7100 )   Objective：To explore the influencing factors of parametrial involvement (PI) in the conization specimens of early-stage cervical cancer. Methods: A retrospective analysis of 200 patients with cervical carcinoma stage Ia2-Ib1 who were diagnosed as cervical cancer through cervical conization, and who had the operation of radical hysterectomy (RH) and pelvic lymphoadenectomy during their visit to Dalian Women and Children′s Hospital between January 2008 and February 2018. To analysis the influencing factors of PI in early-stage cervical cancer. Results: Of the 200 patients, 15 (7.5%) had PI positive, 185 (92.5%) were PI negtive. Univariate analysis showed that age, pathological type, International Federation of Gynecology and Obstetrics (FIGO) stage, histopathological grade, tumor size and margin status were uncorrelated with PI (both P＞0.05), but which was correlated with lymph-vascular space invasion (LVSI) and positive lymph nodes（both P＜0.05）. Multivariate analysis showed that LVSI positive (OR=5.456, 95%CI: 1.669-17.833, P=0.005) and lymph nodes positive (OR=6.725, 95%CI: 1.833-24.669, P=0.004) were independent risk factors of PI. Conclusions: LVSI in the cervical conization specimens and lymph nodes positive and PI are correlated. Those factors can be used as predictors of PI. Related Articles | Metrics

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Laparoscopic Excision of A Pelvic Retroperitoneal Tumour Miriguli·yasheng, Azhatiguli·abula, Hebeierjiang, Aliya·halike, ZHANG Xiu-xiang, GAO Gui-qin, ZHANG Li-cheng 2019, 46 (1):  112-114.  Abstract ( 961 )   PDF (4763KB) ( 7233 )   Related Articles | Metrics

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Pseudomyxoma Peritonei Misdiagnosed as Ovarian Tumor：One Case Report YANG Lin, LI Zhi-ru, YU Hai-rui, FU Mei-qi, ZHANG Guo-wei, XIANG Mei 2019, 46 (1):  115-118.  Abstract ( 1070 )   PDF (5070KB) ( 7776 )   Related Articles | Metrics