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Table of Content

    15 April 2019, Volume 46 Issue 2
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    Interactions between IL-2,IL-10 and High Risk Human Papillomavirus with Cervical Cancer
    ZHU Ruo-xi,ZHAO Wei-hong,HAO Min
    2019, 46 (2):  125-128. 
    Abstract ( 1176 )   PDF (753KB) ( 7223 )  
    As the collective name for precancerous lesions of cervical cancer,cervical intraepithelial neoplasia is closely related to cervical cancer. High-risk human papillomavirus (HR-HPV) infection is the most important cause of cervical cancer and precancerous lesions. By enhancing anti-infective immunity and anti-tumor immunity,most of the women can eliminate virus and diseased cells and prevent cervical cancer. Immune cells and their secreted cytokines play an important role in this. The cytokines IL-2 and IL-10 are low-molecular-weight soluble proteins produced and secreted by immune cells stimulated by immunogens or other factors,which have high affinity with receptors and participate in cellular immunity and humoral immunity of the body. IL-2 and IL-10 play an important role in the pathogenesis and development of cervical lesions,but its specific role and mechanism in cervical cancer and precancerous lesions are still unclear and controversial. This article summarizes the related literature reports and try to illustrate the relationship between cytokines IL-2,IL-10 with HR-HPV infection as well as cervical cancer.
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    Pretreatment Lymph Node Staging in Locally Advanced Cervical Cancer
    YANG Jie,YANG Jia-xin
    2019, 46 (2):  129-133. 
    Abstract ( 1041 )   PDF (737KB) ( 7176 )  
    Cervical cancer is a major world health problem and the fourth most common cancer for women, its staging is mainly based on clinical examination. The International Federation of Gynecology and Obstetrics (FIGO) released a revised new staging system of cervical cancer in October 2018, which emphasizes the metastatic status of pelvic and para-aortic lymph node. Pelvic and para-aortic lymph nodes metastasis is a main risk factor of failure in concurrent chemoradiation therapy (CCRT) in cervical cancer. Due to the key role of para-aortic lymph node status in determining the radiation field and unsatisfactory control rate in large lymph node, a surgical staging of lymph node dissection before chemoradiation therapy is utilized to personalize and optimize the effect of tumor reduction and determine the field of radiation. However, surgical staging may cause perioperative complications and delay of the radiation. Due to the lack of prospective randomized controlled trials, there is no consensus on surgical staging in cervical cancer. We review the literature of surgical staging before CCRT in patients with locally advanced cervical cancer.
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    Molecular Biological Functions of Circular RNA and Its Role in Ovarian Cancer
    CAI Yu-han,JING Lan-kai,LIN Qian-qian,LI Hua
    2019, 46 (2):  134-137. 
    Abstract ( 826 )   PDF (1138KB) ( 7166 )  
    Circular RNA (circRNA), a novel class of long noncoding RNAs, is characterized by a covalently closed continuous loop without 5′ or 3′ polarities structure and have been widely found in human bodies. CircRNA is more stable than liner RNA. It has better tissue specificity and the expression levels in normal tissue and tumor tissue are different. Its molecular biological functions especially the microRNA(miRNA) sponge make it possible to act as the new tumor biomarker and the new target for targeted therapy. Recent studies have revealed that circRNA plays an important role in tumorgenesis, early diagnosis, therapy, prognosis, radiosensitivity and chemosensitivity in malignant tumors. However, the research on the function and regulation machanism of circRNA in ovarian cancer is still in the initial stage and rare at present. This article reviews the researches on the molecular biological characteristics and functions of circRNAs in ovarian cancer.
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    Research Progress on the Relationship between Endometriosis and Ovarian Cancer
    MEN Wen-ting,HAN Chun-ying,LIU Shan-shan,WANG Qu-yuan
    2019, 46 (2):  138-141. 
    Abstract ( 1064 )   PDF (740KB) ( 7301 )  
    Endometriosis (EMs) is a benign gynecological disease with malignant behavior. Epidemiological and pathological studies have confirmed that EMs can increase the risk of ovarian cancer, especially clear cell cancer and endometrioid cancer. In recent years, reports on endometriosis associated ovarian cancer (EAOC) have been increasing both at home and abroad. Researches have confirmed that EAOC is a specific type of ovarian cancer. The research on the etiology, pathogenesis and clinical characteristics of EAOC has become a hot spot. Through reading a large number of literatures, this paper analyzed the risk factors, pathogenesis, clinical characteristics and diagnostic methods of EAOC reported so as to improve the understanding of the disease.
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    Application of Double-J Ureteral Tube in Laparoscopic Radical Surgery of Cervical Cancer
    ZHAI Qing-zhi,NING Jing,TENG Wei,ZHANG Wei-yi,YE Ming-xia,LI Li-an,LI Ya-li,GUAN Zheng
    2019, 46 (2):  142-145. 
    Abstract ( 1293 )   PDF (780KB) ( 7297 )  
    Objective:To determine the advantages and disadvantages of preoperative placement of ureteral double J tubes in laparoscopic radical surgery for cervical cancer. Methods: A retrospective analysis of 139 cases of laparoscopic radical resection of cervical cancer in the General Hospital of the People′s Liberation Army from January to December 2017, according to whether the double J tube was placed into the drainage group (n=75) or not (control group,n=64). Compare the general information, intraoperative condition and postoperative complication rate of the two groups. Results: The operation time of the drainage group was shorter than that of the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the amount of intraoperative blood loss and lymph node dissection between two groups (P>0.05). The incidence of postoperative urinary tract infection in the drainage group was higher than that of the control group (P<0.05). There was no significant difference in the incidence of postoperative urinary system injury and fever between two groups (all P>0.05). The incidence of urinary tract infection in the short-term group (20.0%) was lower than that of the long-term group (42.5%), and the difference was statistically significant (χ2=4.343, P=0.037); the incidence of pyelectasis in the short-term group (8.6%) was less than the long-term group (12.5%), but the difference was not statistically significant (P=0.716). Conclusions: Placement of ureteral double J tube before surgery has little effect on surgery for skilled doctors. Double J tube can reduce the operation time, but has little effect on intraoperative bleeding and lymph node dissection, and increases the risk of postoperative infection. If there isn′t urinary system damage, it can be removed together with the urinary catheter 2 or 3 weeks after surgery.
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    Clear Cell Adenocarcinoma of Cervical:Clinical Analysis of 13 Cases
    HU Rui,HOU Wen-jing,ZHANG Meng-zhen
    2019, 46 (2):  146-149. 
    Abstract ( 1919 )   PDF (749KB) ( 9490 )  
    Objective:To discuss the clinical and pathological characteristics, therapy and prognosis of clear cell adenocarcinoma of cervical(CCAC). Methods: We performed a retrospective review of 13 patients with CCAC who were diagnosed and treated at the First Affiliated Hospital of Zhengzhou University from April 2013 to December 2017. Result: The age of the patients was (53.6±13.9) years,of which 9 (69.2%) were older than 40 years and 4 (30.8%) were younger than 40 years, 2 were adolescents. The International Federation of Gynecology and Obstetrics stage: 46.15% (n=6) stage I, 46.15% (n=6) stage II, 7.7% (n=1) stage III. Twelve patients underwent surgery followed by radiotherapy and chemotherapy, including 3 patients treated by neoadjuvant chemotherapy, 9 postoperative adjuvant radiotherapy and/or chemotherapy. One patient was treated by radiotherapy alone. The median follow-up time was 24 months (6-60 months). 4 patients died and 2 patients had multiple metastases. The 1-year, 2-year and 5-year survival rates were 12/13、11/13 and 9/13, respectively. Conclusions: CCAC has low incidence, nonspecific clinical manifestations and poor prognosis with lymph node metastasis. The individualized comprehensive treatment of surgery followed by radiotherapy and chemotherapy can significantly improve the patient′s condition.
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    Risk Factors of Deep Venous Thrombosis in Patients with Endometrial Cancer during Perioperative Period
    DU Jing-ran,WANG Yan,YANG Yong-xiu
    2019, 46 (2):  150-153. 
    Abstract ( 1328 )   PDF (791KB) ( 7243 )  
    Objective:To investigate the risk factors of deep venous thrombosis in patients with endometrial cancer during perioperative period. Methods: A retrospective analysis of 516 cases of endometrial cancer diagnosed in the First Hospital of Lanzhou University from February 2013 to July 2018, 41 patients with deep venous thrombosis of lower extremity were selected as experimental group and 41 patients in the same period with endometrial carcinoma as control group. The two groups were compared in general condition, preoperative laboratory examination, intraoperative status and postoperative pathology. Results: Univariate analysis showed hypertension (P=0.012), diabetes (P=0.018), body mass index (BMI, P=0.028), platelets >300×109/L (P=0.018), cholesterol (P=0.000), D-dimer (P=0.023), operative time (P=0.025), intraoperative bleeding (P=0.029), lymph node metastasis (P=0.012), tumor differentiation (P=0.018), and tumor staging (P=0.002) showed statistically significant differences between two groups. Logistic regression analysis showed that patients with hypertension, patients with BMI>27 kg/m2, platelet count>300×109/L, increased operative time, increased bleeding, increased lymph node metastasis, low tumor differentiation, tumor FIGO staging are high risk factors for deep venous thrombosis in patients with endometrial cancer. Conclusions: For endometrial cancer patients with hypertension, BMI>27 kg/m2, platelet count>300×109/L, increased operative time, increased intraoperative blood loss, lymph node metastasis, low degree of tumor differentiation and late FIGO stage, it is necessary to control the above risk factors during the perioperative period and adopt other methods to prevent lower limb deep vein thrombosis.
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    Relationship between EMSY Gene Expression and Polymorphism and Prognosis in Patients with Early Stage Ovarian Cancer
    TONG Chun-yan,LIU Chun-tao,WANG Xue-hui,LIU Li-xia
    2019, 46 (2):  154-158. 
    Abstract ( 1009 )   PDF (1665KB) ( 7131 )  
    Objective:To investigate the relationship between EMSY gene expression and polymorphism and prognosis in early ovarian epithelial cancer. Methods: 118 cases of early ovarian epithelial cancer (study group) and 63 patients with benign tumor (control group) were selected. EMSY mRNA was analyzed by RT-PCR, 421+242A>G locus polymorphism was detected by PCR-RFLP, and the relationship between EMSY gene expression level and polymorphism and prognosis was further analyzed. Results: RT-PCR test showed that the relative expression of EMSY mRNA and BRCA2 mRNA of the study group were higher than those of the control group, the difference was statistically significant (t=33.592, P=0.000; t=25.046, P=0.000). Age, menopause, FIGO stage, differentiation degree, pathological type, postoperative chemotherapy and postoperative recurrence were associated with EMSY mRNA expression levels(P<0.05). The frequency of the three genotypes and the two alleles of the EMSY gene 421+242A>G locus in the study group were significantly different from those in the control group (P<0.05), and the total survival rate of GG genotype and the progression free survival rate of 421+242A>G locus of EMSY gene were statistically significant (Log-rank χ2=7.482, P=0.006; Log-rank χ2=8.406, P=0.004). High expression of EMSY mRNA affects the survival of the patient (OR=2.322, 95%CI: 1.277-5.031, P=0.027), and the AA genotype affects the progression free survival of the patients (OR=1.882, 95%CI: 1.192-4.323, P=0.039). Conclusions: EMSY gene expression and 421+242A>G polymorphism are related to the prognosis of early ovarian cancer, which can be further studied.
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    Ovarian Steroid Cell Tumor:A Case Report
    PEI Yan-ling,DUAN Xue-feng,WANG Bo-wei
    2019, 46 (2):  158-160. 
    Abstract ( 1017 )   PDF (2535KB) ( 7136 )  
    Ovarian steroid cell tumors are rare ovarian tumors. Most of these are benign diseases, but there are also risks of malignant transformation. They can produce steroid hormones, especially androgen. The imaging manifestations of this disease are unspecific. The diagnosis is based on histopathological and immunohistochemical markers. Surgical resection is the main treatment, but people have also begun to try gonadotropin releasing hormone analogues (GnRHα) to treat this disease in recent years. We analyze retrospectively the diagnosis and treatment process of 1 case of non-specific steroid cell tumor at the Second Hospital of Jilin University, and review related literature. We aim to present the progress of the clinical diagnosis and treatment of ovarian steroid cell tumor, as well as analyze its clinical characteristics, in order to improve the diagnosis and treatment level of the disease.
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    Ovarian Neoplasms with Hyperamylasemia:One Case Report
    YANG Bin,YANG Yong-xiu
    2019, 46 (2):  161-162. 
    Abstract ( 942 )   PDF (639KB) ( 7104 )  
    The incidence of ovarian neoplasms with high hematuria amylase is low, and it is easily misdiagnosed as malignant tumors with acute pancreatitis (AP). Clinically,AP should be excluded according to the population, imaging examination and typical etiology. The primary cause of amylase elevation should be considered by malignant tumor. This article reports a case of ovarian poorly differentiated serous adenocarcinoma with high blood urease amylase and misdiagnosed as AP, to analyze the pathogenesis and diagnostic considerations of high blood urease amylase, so as to deepen the understanding of the disease by clinicians and improve the level of diagnosis and treatment.
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    HPV-Negative Gastric Type Adenocarcinoma of the Uterine Cervix:A Case Report
    ZHANG Ye-xuan,ZHAO Yan-hui
    2019, 46 (2):  163-165. 
    Abstract ( 2359 )   PDF (2833KB) ( 7265 )  
    Gastric type adenocarcinoma of the uterine cervix (GAS) is a rare subtype of cervical mucinous adenocarcinoma and is usually unrelated to human papillomavirus (HPV) infection. However, its specific pathogenesis is still unclear. GAS is a disease with high malignancy, fast progression, no specific clinical manifestations and poor prognosis. Compared with other common cervical malignancies, screening methods are more limited, and early diagnosis is more difficult. A retrospective analysis of the diagnosis and treatment of a patient with GAS admitted to the Second Hospital of Jilin University, and relevant literature had been reviewed to analyze its clinical features to improve the diagnosis and treatment of clinicians.
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    A Case Report of Perivascular Epithelioid Cell Tumor of Uterus and Literature Review
    WANG Min,MA Shuai,JIAN Wen-wen,YU Qing,YANG Shu-li
    2019, 46 (2):  166-168. 
    Abstract ( 885 )   PDF (5025KB) ( 7199 )  
    Perivascular epithelioid cell tumor (PEComa) is a rare clinical mesenchymal tumor with diverse biological characteristics and undetermined malignant potential. It is extremely rare in the uterus and is easily misdiagnosed before surgery. Clinicians must pay enough attention. Therefore, we now review the data of a patient with uterine PEComa, and review the relevant literature to further explore its clinical manifestations, pathological features, immunophenotype, treatment and prognosis,in order to deepen the understanding of this disease and improve the ability to diagnose and treat.
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    Pre-Eclampsia and Gut Microbiota
    YU Ting, GUAN De-feng, ZHANG Dong-ping, PENG Yun-hua
    2019, 46 (2):  169-172. 
    Abstract ( 830 )   PDF (726KB) ( 7112 )  
    Gut microbiota is a complex and huge community of microorganism species living in the digestive tracts. Gut microbiota is capable of producing a diverse range of compounds that significantly affect host physiology, energy homeostasis, inflammatory process and immune function, and it plays an important role in maintaining body health. In recent years, the structure and physiological functions of gut microbiota, changes in gut microbiota during pregnancy, and the correlation between gut microbiota and pregnancy diseases have become hot topics. Although the etiology and pathogenesis of pre-eclampsia are still unclear, most of the findings are related to vascular factors, immune imbalance, and systemic inflammatory response factors. It has been found that gut microbiota may play a role in the occurrence and development of pre-eclampsia through vascular factors, immune response, inflammatory response. Adjusting the diet structure and supplementing the microecological regulator can regulate the intestinal flora disorder, thereby preventing or alleviating pre-eclampsia. It provides new targets and ideas for exploring the prevention and treatment of pre-eclampsia.
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    The Role of Thrombosis and Inflammation in the Initiation and Development of Preeclampsia
    LUO Dan,SHAO Shuai,JIANG Jing-hang,LIU Yang,LONG Ping,JIANG Mei,DING Tao
    2019, 46 (2):  173-176. 
    Abstract ( 745 )   PDF (715KB) ( 7079 )  
    Preeclampsia (PE) is a common complication during pregnancy and a major cause of poor pregnancy outcomes, which can even lead to maternal and child death in severe cases. PE involves multiple links, causing multiple organ, system involvement. Preeclampsia is a complex, multisystem disorder relate to abnormal trophoblast invasion of the placenta, anti-angiogenic responses, oxidative stress and inflammation. Although there are many studies on PE, the pathogenesis of PE is not clear, and its occurrence may be related to the age of pregnant women, chronic hypertension, diabetes, pre-pregnancy obesity and multiple pregnancy. Studies found that the related factors of thrombus formation and related inflammatory factors are related to the pathogenesis of PE, which can promote the pathogenesis of PE, but the specific mechanism is unknown. Clarifying the correlation of thrombosis and inflammation in the pathogenesis of PE can provide relevant strategies for the early prevention and treatment of PE. Therefore, this paper reviews the role of thrombus formation and inflammation in the pathogenesis and development of PE.
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    Progress Research of Platelet Parameters and Coagulation Function Related Indicators on Prediction of Pre-Eclampsia
    REN Dan-yu,WANG Yong-hong
    2019, 46 (2):  177-180. 
    Abstract ( 762 )   PDF (729KB) ( 7083 )  
    Pre-eclampsia (PE) is the main pregnancy-specific disease that causes maternal and perinatal death. In recent years, with the improvement of the level of treatment of premature infants, the active treatment of pre-eclampsia after 34 weeks of gestation will get good maternal and perinatal outcomes, but the treatment of early-onset pre-eclampsia patients is still unsatisfactory, so the prediction of pre-eclampsia has become a research hot spot. Studies found that pre-eclampsia is associated with the imbalance of coagulation-fibrinolysis system. In many researches, some factors are used to predict pre-eclampsia, for instance, platelet parameters, coagulation quadruple, PAI-1, vWF, P-selectin, and D-dimer. This article reviews the progress of these indicators to predict pre-eclampsia.
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    Research Progress of Acute Kidney Injury in Pregnancy
    LIU Qiang,PAN Zhi-jian
    2019, 46 (2):  181-184. 
    Abstract ( 721 )   PDF (763KB) ( 7122 )  
    The risk of kidney damage doubles during pregnancy. Acute kidney injury in pregnancy (P-AKI) is a high risk obstetrical disease that threatens the lives of mothers and their children. Despite the decline in the incidence of P-AKI in the past three decades, China still has a high incidence and mortality rate. P-AKI is a serious complication of pregnancy. It has clinical features of rapid onset, rapid progress and serious illness, often accompanied by respiratory, cardiovascular and digestive symptoms. P-AKI related diseases such as pre-eclampsia, acute fatty liver in pregnancy, HELLP syndrome and thrombotic microangiopathy have similar clinical manifestations and are prone to diagnosis difficulties. This article analyzes the pathophysiological changes, the incidence and causes of different countries, the diagnostic criteria, the related diseases of P-AKI and the preventive and therapeutic measures, further analyzes the dialysis for P-AKI. It aims to improve the prevention and treatment of P-AKI, reduce the incidence, mortality and disability, and improve maternal and child outcomes.
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    Effects of Oxidative Stress on Placental Life
    GUO Lin-lin,ZHAO Hui-dong,HU Hai-yan
    2019, 46 (2):  185-188. 
    Abstract ( 819 )   PDF (700KB) ( 7841 )  
    Oxidative stress is not only the imbalance between the generation of oxidants and the antioxidant defense system, but also the cause of various cell dysfunction and tissue damage. Oxidative stress related factors play an important role in a variety of diseases. It adjusts the homeostasis of intracellular environment through a variety of pathways. In recent years, studies have found that oxidative stress and the related oxidative damage is the main factor leading to many diseases. Indicators related to oxidative stress in pregnancy-specific diseases such as preeclampsia pregnancy and fetal growth restriction are highly expressed in maternal serum and trophoblast cells. Meanwhile, oxidative stress is involved in the pathogenesis of various chronic disorders such as cancer and hypertension. Oxidative stress, as a common pathway of pregnancy-specific diseases, has been deeply studied, among which the effect of oxidative stress on placental function has attracted much attention. This paper analyzes and summarizes the relationship between placenta and pregnancy-related diseases under different hypoxic conditions, to explore whether oxidative stress related factors have predictive effect for pregnancy-related disease prevention and treatment.
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    The Screening and Prenatal Diagnosis for SMN1 Gene in Pregnant Women
    REN Chen-chun, GUO Dong-hua, LIANG Yue-hong, WANG Wen-jing, TIAN Xiu-ying, CUI Hong-yan, CHEN Cheng-bin, WANG Ling-hong, YANG Wei-wei, ZHANG Hai-xia, LI Xiao-xu
    2019, 46 (2):  189-192. 
    Abstract ( 1953 )   PDF (2604KB) ( 7151 )  
    Objective:By conducting screening studies on the deletion mutations in exon 7 and exon 8 (E7, E8) of SMN1 gene in pregnant women, an accurate, rapid, simple, and high-throughput prenatal screening and diagnosis of this gene locus was established. SMA patients can be prevented. Methods:QF-PCR was used to screen the deletion of SMN1 gene E7 and E8 in 162 cases of women in mid-pregnancy. When the spouses were carriers of SMA pathogenic genes, fetal DNA was extracted to detect SMN1 gene deletion. The high-risk fetal MLPA genetic diagnosis was performed at the same time. Results:A total of 162 pregnant women were screened and the presence of SMN1 E7 heterozygous carriers were found in 6 cases. As for the QF -PCR test results of the carriers′ spouses,4 cases showed that E7 and E8 were all normal and 2 cases showed loss of heterogeneity. As to the two high-risk fetus whose both parents were SMA carriers,amniotic fluid DNA testing suggested that 1 fetus had E7 and E8 homozygous deletion, and the other one showed loss of heterogeneity. The results of MLPA were same with QF-PCR. Conclusions:QF-PCR can be used in the screening and diagnosis of SMA patients in large pregnant population. It has great clinical value to prevent the birth of SMA children.
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    The Delivery Outcomes and Neonatal Outcomes Analysis in the Treatment of Single-Birth Primipara Oligohydramnios in Labor Using Transvaginal Amnioinfusion
    CHANG Yu, DONG Qu-long, SUN Chao-ying, ZHANG Yan
    2019, 46 (2):  193-196. 
    Abstract ( 823 )   PDF (773KB) ( 7065 )  
    Objective:To analyze the delivery outcomes and neonatal outcomes in the treatment of single-birth primipara oligohydramnios in labor using transvaginal amnioinfusion. Methods: 358 patients with single-birth primipara oligohydramnios in labor who were hospitalized in the Characteristic Medicine Center of the Chinese People′s Armed Forces from April 2015 to March 2018 were divided into two groups, including the treatment group (166 women those who accepted the transvaginal amnioinfusion) and the control group (192 women those who did not accept the transvaginal amnioinfusion). The delivery outcomes including spontaneous labor rate, forceps delivery rate, cesarean section rate, postpartum hemorrhage rate and puerperal infection rate, and the neonatal outcomes including umbilical artery PH, umbilical artery lactate, 1 minute Apgar score after birth, incidence of meconium aspiration syndrome (MAS) and admission rate of newborn department, were compared between the two groups. Results: The spontaneous labor ratein the treatment group was higher than that in the control group, while the forceps delivery rate and cesarean section rate were both lower than that in the control group. The difference of these three indexes between the treatment group and the control group were all statistically significant (P<0.05). The difference of the postpartum hemorrhage rate and puerperal infection rate between the treatment group and the control group were both statistically insignificant (P>0.05). The umbilical artery pH and 1 minute Apgar score after birth in the treatment group were both higher than that in the control group, while the umbilical artery lactate, incidence of MAS and admission rate of newborn department in the treatment group were all lower than that in the control group, and the difference of the these five indexes between the two groups were all statistically significant (P<0.05). Conclusions: Transvaginal amnioinfusion is safe and effective in the treatment of single-birth primipara oligohydramnios in labor, which can improve obviously the delivery outcomes and neonatal outcomes.
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    Analysis of the Feasibility and Outcome of Laparoscopic Treatment of Hetertopic Pregnancy
    FAN Xiao-dong,WANG Yi,ZHU Ying-jun
    2019, 46 (2):  197-200. 
    Abstract ( 820 )   PDF (715KB) ( 7073 )  
    Objective:To explore the feasibility, safety of laparoscopic treatment of hetertopic pregnancy (HP) and the effect on the outcome of pregnancy. Methods:34 HP patients with tubal pregnancy admitted to our hospital from January 2011 to January 2018 were selected for retrospective analysis, to explore the high-risk factors of hetertopic pregnancy, the feasibility of laparoscopic surgery and the pregnancy outcome. Results:There were 34 cases. Special cases included: 1 case of intrauterine twin pregnancy with right tubal pregnancy, 1 case of intrauterine pregnancy with right tubal interstitial pregnancy, and 1 case of intrauterine twin right uterine pregnancy with left tubal pregnancy. All the patients were treated with laparoscopic surgery and recovered well after surgery, operation time was 15-110 minutes, (45.21±8.33) min on average. Intraoperative hemorrhage was 5-200 mL, with an average was (33.04±10.12) mL. 3 cases with preoperative intraperitoneal hemorrhage more than 800 mL were treated with blood transfusion therapy in the operations. No fever, incision infection or complications were observed. Ultrasound suggest intrauterine pregnancy is normal after the operation for each patient and all patient recovered well. Only one case of artificial abortion was performed with missed abortion. All the rest has live births without birth defects. Conclusions:For patients with intrauterine pregnancy with unilateral tubal pregnancy during first trimester, laparoscopic surgery can safely remove ectopic pregnancy in the fallopian tube, and the operation is safe and effective, without increasing the incidence of iatrogenic abortion and birth defects.
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    Investigation the Effects of Inducing Labor by Different Positions of Vaginal Balloon with Cervical Dilatation Double-Balloon
    WU Wen-juan, CHEN Rui, WU Hai-ying, LIU Li, LIANG Fei, WANG Yu
    2019, 46 (2):  201-203. 
    Abstract ( 921 )   PDF (737KB) ( 7053 )  
    Objective:To investigate the effects of inducing labor by different position of vaginal balloon with cervical dilatation double-balloon. Methods: Sixty full-term primiparous woman who delivered in department of obstetrics of Henan People′s Hospital were selected as the observation objects. 30 patients of observation group were induced with vaginal balloon inside the cervix(group A), and the other 30 patients were induced by outside the cervix(group B)randomly. Then the induced outcome and the fetal outcomes of the two groups were compared. Results: The cervical Bishop scores,the cervical flatness,cervical opening rate and the 24-hour birth rate of group A were higher than group B,and the differences were statistically significant (all P<0.05). The first labor time and the total delivery process of group A were shorter than group B, the differences were statistically significant (both P<0.05). There was no significant difference in cesarean section rate, newborn weight, discomfort score and neonatal asphyxia rate(P>0.05). Conclusions: When induced with cervical dilatation double-balloon, placing the vaginal balloon inside the cervix can shorten the first and total delivery process.
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    Uterine Rupture Caused by Cornual Pregnancy Combined with Placenta Implantation:A Case Report and Literature Review
    ZHU Qian-jing,LU Xue,REN Jun-ying,ZHANG Ye-xuan,WANG Jia,ZHAO Yan-hui
    2019, 46 (2):  204-206. 
    Abstract ( 930 )   PDF (669KB) ( 7099 )  
    Cornual pregnancy is a rare type of ectopic pregnancy, it could be easily missed because of its special location. To continued pregnancy may cause various complications such as miscarriage, placenta implantation and uterine rupture, etc.Penetrating placenta implantation is a more uncommon complication in obstetrics. When cornual pregnancy is combined with placenta implantation, it is very likely to cause uterine rupture and massive bleeding that endangers the lives of the mother and the infant. Here we report a case of uterine rupture caused by a cornual pregnancy combined with placenta implantation in the Second Hospital of Jilin University, and reviewed relevant literature. We investigate the causes, diagnosis and treatment of the disease, and provide ideas for clinical diagnosis and treatment.
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    Congenital Laryngeal Cyst of Newborn: 2 Cases Report and Literature Review
    ZOU Xiao-ping,ZHANG Jing-jing,SHI Hai-xia,HOU Hai-yan,KONG Xiang-ling
    2019, 46 (2):  207-209. 
    Abstract ( 948 )   PDF (692KB) ( 6995 )  
    Congenital laryngeal cyst is one of the causes of neonatal airway obstruction. The incidence of congenital laryngeal cyst ranges from 1.82/100,000 to 3.49/100,000, 50% of which were found in autopsy of asphyxiated children. Lack of awareness of the disease can lead to delays in the condition and even death of newborns. This paper reports 2 cases of congenital laryngeal cyst of newborn delivered by the Characteristic Medical Center of The Chinese People′s Armed Police Force. When newborns suffer from asphyxia of unknown cause, have low Apgar score and poor resuscitation effect after birth, besides obstetric factors, congenital laryngeal cyst to neonatal respiratory obstruction should also be considered. Laryngoscopy is recommended. Cyst puncture and drainage can be used in emergency to reduce the cyst volume in the shortest time and alleviate the critical situation of dyspnea. One step therapy wins the opportunity.
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    Spontaneous Rupture of The Right Anterior Wall Vessel of Uterus in Late Pregnancy: A Case Report
    LI Xu,DONG Qu-long,FANG Qian-yu,ZHANG Yan
    2019, 46 (2):  209-211. 
    Abstract ( 951 )   PDF (2317KB) ( 7128 )  
    Various reasons can contribute to induce spontaneous rupture of uterine vessels in late pregnancy including arteries and veins. Due to the abundant blood supply of uterus in the late pregnancy, it is very easy to cause abdominal hemorrhage, shock and intrauterine fetal death in pregnant women once uterine vessel rupture occurs. The incidence of spontaneous rupture of uterine vessels in late pregnancy is low, but it is extremely dangerous, and if the diagnosis is not timely or missed, it will seriously endanger the safety of the mother and the children. Now, in order to improve the understanding of spontaneous rupture of uterine vessels in late pregnancy, the clinical data of a patient with spontaneous rupture of uterine right anterior wall in late pregnancy was retrospectively analyzed, and the related literature was reviewed to further analyze its pathogenesis, auxiliary examination and clinical manifestations, so as to deepen the understanding of the disease by clinicians and improve the level of diagnosis and treatment.
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    The Application of Biomechanics in Female Pelvic Floor Dysfunction
    MAO Hui,HUANG Cheng-sheng,WU Qing-kai,ZHOU Yue-di
    2019, 46 (2):  212-215. 
    Abstract ( 905 )   PDF (707KB) ( 7053 )  
    Female pelvic floor dysfunction(PFD) is a common gynecological disease. Its clinical manifestations include stress urinary incontinence (SUI), pelvic organ prolapse (POP) and female sexual dysfunction (FSD), which seriously affect the health and quality of life of middle-aged and elderly women. In recent years, most countries in the world have begun to pay attention to this disease, and China has made the prevention of women′s PFD as a main task of the government. Its pathogenesis has not been unified, and the diagnosis is mostly based on the patient′s symptoms. Biomechanics, which was first used in orthopedics and plastic surgery, is gradually applied to the field of obstetrics and gynecology. The application of biomechanical methods provides a new reference standard for the pathogenesis, clinical diagnosis, treatment selection and efficacy evaluation of PFD. Especially, vaginal tactile imaging (VTI) can show vaginal wall pressure visually. It is a new and precise evaluation technique of pelvic floor biomechanics. This paper summarized the application and prospect of biomechanics in PFD.
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    Biological Effects of Sulforaphane and It′s Role in Female Reproductive System
    WU Hao, LU Xiao-sheng, LYU Jie-qiang
    2019, 46 (2):  216-219. 
    Abstract ( 1036 )   PDF (721KB) ( 7053 )  
    Sulforaphane (1-isothiocyanate-4-methanesulfonylbutane, SFN), also known as raphanin, is a bioactive substance extracted from broccoli plants, and is one of the strong antioxidant found so far. Once oxidative stress stimulus occurs, sulforaphane can induce the expression of various antioxidants and detoxifying enzymes by activating the Nrf2/ARE pathway to exert an antioxidant effect. The sulforaphane can also directly react with other cellular targets to exert biological effects such as inducing apoptosis and regulating inflammatory mediators. Sulforaphane has been used as an antioxidant in various disease research, such as digestive disease, respiratory diseases, cardiovascular diseases and tumors. However, there are few studies on its function in the female reproductive system. This article reviews the basic structure, biological effects and research progress of sulforaphane in female reproductive system.
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    Progress in Clinical Research of Endometrial Polyps with Infertility
    WANG Yang-xin,LI Meng,LU Mei-song
    2019, 46 (2):  220-224. 
    Abstract ( 853 )   PDF (796KB) ( 7226 )  
    Endometrial polyps (EP) are a common cause of reduced fertility in women and an independent factor affecting embryo implantation via artificial assisted techniques. Excessive exposure to estrogen, chronic inflammatory stimuli, or cell proliferation/apoptosis imbalance may be associated with its pathogenesis. The mechanism by which EP causes infertility is still unclear, and may be related to the formation of mechanical interference in the implantation of embryos in the uterine cavity and the alteration of the microenvironment of the endometrium. The probability of malignancy is very low. In most cases, EP with diameter <1 cm has the possibility of self-resolving, and you can choose expectant treatment. For infertile women, the choice of transcervical resection of polyp (TCRP) can improve the natural pregnancy rate and assisted reproductive success rate of infertile patients. There is currently no specific treatment regimen recommended for EP patients newly diagnosed during controlled ovarian hyperstimulation (COH). Related clinical studies have shown that frozen-thawed embryo transfer (FET) after TCRP can improve clinical pregnancy rate.
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    Iron-Overload and Its Relation with the Development of Endometriosis
    LIU Meng-na, XU Tian-min, ZHANG Kun
    2019, 46 (2):  224-228. 
    Abstract ( 760 )   PDF (770KB) ( 7135 )  
    Endometriosis(EMs) is a common gynecologic disorder with an estimated incidence of 10%-15% among women of reproductive age. While in itself a benign lesion, EMs shares several characteristics with invasive cancer and has been shown to undergo malignant transformation. It has been associated with an increased risk of epithelial ovarian carcinoma (EOC). Recent research focused on pelvic microenvironment found that iron overload plays an important role in the initiation and development of EMs. Higher levels of iron, which is probably released after lysis of erythrocytes or retrograde menstruation, has been found in the peritoneal fluid of patients with EMs. Free iron, which is a strong prooxidant, not only disturbs the balance of redox reaction causing oxidative stress damage, but also verwhelms peritoneal protection of macrophage. Iron overload is also implicated in activation of NF-κB signaling pathway, giving rise to the production of numerous inflammatory factors. Moreover, iron metabolism may interact with and modulate estrogen, involved in the malignant transition of EMs. Here we summarizes the most recent studies concerning with iron overload and its relation with the initiation and development of EMs.
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    Expression of MiR-200b and Target Gene VEGF in Serum of PCOS Rats and Its Clinical Significance
    ZHANG Ling, SHI Xu-feng, SONG Wan-yu, ZHANG Zhan
    2019, 46 (2):  229-232. 
    Abstract ( 759 )   PDF (8122KB) ( 6899 )  
    Objective:To study the effect of miR-200b on the expression of VEGF in PCOS rat model, and to explore the role of miR-200b and target gene VEGF in the pathogenesis of PCOS. Methods: Sixty female SD rats of six weeks age were randomly divided into three groups (20 rats for each group): experiment group and experiment control group,blank control group. Set up an animal model by using Letrozole. The estrus cycles changes and histologic changes in ovaries and serum hormone levels were examined. The miR-200b and VEGF in serum was detected by real-time quantitative PCR. Results: The estrus cycles of PCOS group become irregular, which indicated that the rats had no ovulation. Serum testosterone and LH levels were elevated, while FSH,progestone and estradiol levels were reduced (both P<0.01). Real-time-PCR results showed that the expression of miR-200b in the serum of PCOS rats decreased significantly (P<0.01). The expression of target gene VEGF in the serum of PCOS rats increased significantly (P<0.01). Conclusions: The level of miR-200b in serum of PCOS rats was reduced and it may play an important role in the development of PCOS by regulating its target gene VEGF. We hypothesized that circulating miR-200b may be a new non-invasive diagnostic marker for PCOS diagnosis.
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    Clinical Analysis of Perioperative Sepsis in Obstetrics and Gynecology
    TONG Tong, GAO Hong
    2019, 46 (2):  233-237. 
    Abstract ( 778 )   PDF (828KB) ( 6992 )  
    Objective:To analyze the characteristics of perioperative sepsis in obstetrics and gynecology, and to provide evidence for the prevention and treatment of sepsis. Methods: The cases of sepsis diagnosed in Beijing Obstetrics and Gynecology Hospital from January 2011 to December 2017 were collected. The characteristics of the cases were analyzed. According to the pathogens, the differences between the G- bacteria group and the G+ cocci group were compared. Results: The pathogens of perioperative sepsis in gynecology and obstetrics were mostly G- bacteria, accounting for 71.4%. The white blood cell count, C-reactive protein level and procalcitonin level were significantly increased in patients with sepsis. The fibrinogen (FIB) of the G- bacteria group was significantly lower than that of the G+ cocci group (P=0.045). The international normalized ratio (INR) of the G-bacteria group (P=0.043) and the D-dimer (DD) (P=0.039) was significantly higher than the G+ cocci group. The differences were statistically significant. 5 patients with septic shock were all G- bacteria infection. Conclusions: Perioperative sepsis in obstetrics and gynecology is mainly caused by G- bacteria infection.This type of sepsis has a strong inflammatory response, severe coagulopathy, and septic shock tendency. Early detection, empirical anti-infective therapy, and early application of low molecular weight heparin to prevent disseminated intravascular coagulation (DIC) are critical for improving prognosis.
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    Study on Recurrence Risk Factors after Laparoscopic Adenomyomectomy
    PENG Yan-zhen,DUAN Hua,GUO Yin-shu,CHENG Jiu-mei,ZANG Chun-yi,YE Hong
    2019, 46 (2):  237-240. 
    Abstract ( 1005 )   PDF (811KB) ( 7006 )  
    Objective:To investigate the clinical recurrence risk factors after laparoscopic adenomyoectomy. Methods:From Jan. 2010 to Jan. 2015, 109 patients undering laparoscopic adenomyomectomy were recruited in Gynecologic Minimally Invasive Center of Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University were recruited. The patients demographic, clinic characteristics, preoperative and postoperative information was reviewed and analyzed. Gonadotropin-releasing hormone agonist (GnRHa) therapy, surgical approach, follow-up information was also collected. Results:The culmulative rate of 12, 24 and 36 months after operation was 14.9%, 22.7% and 25.7% respectively. Age had a significant effect on postoperative recurrence rate. With the age increasing,the risk of relapse decreased 10% (RR=0.900, 95%CI: 0.822-0.986, P=0.023). The preoperative uterine volume was the risk factor of postoperative recurrence (RR=1.289, 95%CI: 1.121-1.678, P=0.005). Postoperative GnRHa therapy was a protective factor for postoperative recurrence (RR=0.407, 95%CI: 0.185-0.895, P=0.025). The patient′s pregnancy history, the preoperative dysmenorrhea score, the maximum size of the adenoma, the position of the adenoma, preoperative GnRHa therapy, surgical approach and endometriosis were not risk factors for postoperative recurrence rate. Conclusions:The age, preoperative uterine volume and no postoperative GnRHa therapy are the risk factors for recurrence after laparoscopic hysterectomy.
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