Table of Content

15 October 2019, Volume 46 Issue 5
Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Factors Related to Pre-Eclampsia after Pregnancy with Assisted Reproductive Technology LIU Ying, WANG Chen-hong 2019, 46 (5):  485-489.  Abstract ( 855 )   PDF (746KB) ( 6365 )   Pre-eclampsia is one of the main reasons that seriously affect the health of mother and infant and cause their death. Assisted reproductive technology (ART) is a risk factor for pre-eclampsia. As infertility patients increases year by year ,the proportion of pregnancies obtained through ART is increasing, and the incidence of pre-eclampsia is also increasing. Recent studies at home and abroad have found that endometriosis, polycystic ovary syndrome, obesity, multiple embryo transfer, frozen embryo transfer, oocyte donation pregnancy, elevated estradiol peak during implantation, and low concentration human chorionic gonadotropin in early pregnancy are risk factors for pre-eclampsia, while progesterone is a protective factor for pre-eclampsia. These factors affect the development of pre-eclampsia alone or in combination. Early identification of risk factors for pre-eclampsia, early prevention and early intervention are the key to reduce pre-eclampsia morbidity and improve maternal and infant adverse outcomes. This article reviews the related factors of assisted reproductive pregnancy complicated with pre-eclampsia, and provides important reference for future perinatal health care of assisted reproductive pregnancy. References | Related Articles | Metrics

Select

The Research Progress in the Mechanism of P27 Gene in Pre-Eclampsia Pathogenesis FAN Zhuo-ran, GU Yan, HUA Shao-fang 2019, 46 (5):  490-493.  Abstract ( 909 )   PDF (708KB) ( 6306 )   Pre-eclampsia (PE) is a disease special to pregnancy. Its occurrence and development is an important reason for the increase of maternal and infant morbidity and mortality. Normal proliferation, migration and differentiation of trophoblasts in placenta are closely related to it. P27 acts as a cyclin dependent kinase inhibitors (CKIs), which regulates cell cycle by binding to cell cycle factors. Compared with normal pregnant women, the expression of P27 gene in placental trophoblasts of PE patients increased significantly, which may be related to the dysfunction of trophoblast proliferation and invasion. Nodal, as a member of transforming growth factor β (TGF-β), up-regulates the level of P27 mRNA and protein in trophoblast cells through various mechanisms, improves the stability of P27 protein and induces phosphorylation of P27 protein at S10, promotes the transfer of P27 protein and CDK2 to cytoplasm, and enhances the binding of P27/CDK2/CDK5/Stathmin, thus inhibiting cell proliferation and migration，transfer and invasion. P27 protein is phosphorylated at many siｔｅｓ, oxidative stress, protein kinase B (Akt), protein O-fucosyltransferase 1 (poFUT1), fructose-2-kinase/fructose-2, 6-diphosphatase (PFKFB1-4) affect the ubiquitin-proteasome degradation pathway by phosphorylating P27 protein. References | Related Articles | Metrics

Select

Progress in Risk Factors of Gestational Diabetes Mellitus QIAN Ting-ting, CHEN Dan-qing 2019, 46 (5):  494-498.  Abstract ( 911 )   PDF (730KB) ( 6372 )   Gestational diabetes mellitus (GDM) is a common metabolic complication during pregnancy, which seriously endangers the health of mother and infant. Its prevalence rate has been rising steadily in the past decades, and its exact etiology and pathogenesis are still not completely clear. Early detection of high-risk factors leading to GDM before pregnancy and in early pregnancy and taking targeted preventive measures is of great significance for the control of GDM. Current research suggests that the development of GDM involves many risk factors, including older age, overweight or obesity, etc. At the same time, more and more studies have proved that lifestyle, the history of polycystic ovary syndrome, serum vitamin D concentration, environmental exposure and genetic material are significantly related to the incidence of GDM. This article reviews the research progress of high risk factors of GDM. References | Related Articles | Metrics

Select

The Progress in Application of Calcium in Obstetrics XUE Hong-fang, DONG Qu-long, CHEN Juan, XING Jing 2019, 46 (5):  499-502.  Abstract ( 932 )   PDF (673KB) ( 6462 )   Calcium is one of the essential minerals in human body, which is an important component of skeleton system, especially in fetal period, a period when a large amount calcium intaking from the maternal is needed for its bone growth. In recent years, with the continuous development of medicine, people′s understanding of the role calcium in pregnancy is no longer limited to the single layer of calcium which only provides minerals for fetal bone growth. It was found that calcium was associated with fetal growth and development, premature delivery, hypertensive disorder complicating pregnancy, postpartum hemorrhage and gestational diabetes mellitus, which has good application value. In order to improve obstetricians′ understanding of the role of calcium in obstetrics and to provide reference for clinical management of related diseases, we referred to the related literature and latest research materials at home and abroad and reviewed the application progress of calcium in obstetrics. References | Related Articles | Metrics

Select

The Expressions of MiR-21 and IGFBP-3 in Serum of Patients with Intrahepatic Cholestasis of Pregnancy and Their Relationships with Perinatal Fetal Outcomes XIE Yan-hua, GAO Yan, HE Xue-lian 2019, 46 (5):  503-506.  Abstract ( 730 )   PDF (887KB) ( 6293 )   Objective：To investigate the expressions of miR-21 and insulin-like growth factor binding protein-3 (IGFBP-3) in serum of patients with intrahepatic cholestasis of pregnancy (ICP) and their relationships with perinatal fetal outcomes. Methods: 62 ICP patients admitted to Sichuan Provincial Hospital for Women and Children were selected as the study group, and 62 healthy pregnant women with physical examination were selected as the control group. We collected their antepartum venous blood, detected the relative expression of miR-21 and IGFBP-3 in serum by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) , and compared the correlation between miR-21 and IGFBP-3 and perinatal outcome. Results: The level of serum miR-21 in the study group was higher than that in the control group, and the level of IGFBP-3 in the study group was lower than that in the control group, and the difference was statistically significant (both P＜0.05). There was a negative correlation between the expression of miR-21 and IGFBP-3 in ICP patients (r=-783, P=0.000). The incidences of premature delivery, cesarean section and meconium stained of amniotic fluid in patients with miR-21 high expression were higher than those in patients with miR-21 low expression, and the gestational age of delivery and birth weight of neonates were lower than those of miR-21 low expression group, difference of which was statistically significant (all P＜0.05). There was no significant difference in the incidence of neonatal asphyxia and fetal death between the two groups (all P＞0.05). The incidences of premature delivery, cesarean section and meconium stained of amniotic fluid in IGFBP-3 low expression group were higher than those in IGFBP-3 high expression group, the gestational weeks and birth weight of neonates were lower than those of IGFBP-3 high expression group, and the difference was statistically significant (all P＜0.05). There was no significant difference in the incidences of neonatal asphyxia and fetal death between the two groups (all P＞0.05). Conclusions: The high expression of miR-21 and the low expression of IGFBP-3 in serum of ICP patients were negatively correlated with each other. The incidence of perinatal adverse outcome was higher in ICP patients with high expression of miR-21 and low expression of IGFBP-3, which should be paid attention to in clinic. References | Related Articles | Metrics

Select

Survey of Pregnancy Complications and Outcomes of the Multiparous Maternal with Extremely Advanced Age JIA Zhao-xia, HUANG Li-li, ZHAO Yong-xian, WU Ming-hui 2019, 46 (5):  507-511.  Abstract ( 908 )   PDF (807KB) ( 6310 )   Objective：To explore the characteristics of perinatal complication and pregnancy outcome in elderly multipara, and to provide guidance for prevention of adverse perinatal outcomes in elderly multiparas. Methods: Six midwifery institutions from the Chaoyang and Haidian districts in Beijing were selected. All of multiparous maternal who were pregnant over 28 weeks and delivered in these six institutions from November 2016 to February 2017 were divided into three groups according to the age of maternal. There were 198 multiparas in super-advanced age group (≥ 40 years old), 1 110 cases in general advanced age group (35~39 years old) and 1 645 cases in non-advanced age group(＜35 years old). This article makes a cross-sectional investigation on the general demographic data, pregnancy coexisted diseases and complications, and the health status of the newborn, and compares the differences of pregnancy complications and adverse pregnancy outcomes among different groups of women. Results: ①The proportions of C-section in the super-advanced age group and the general advanced age group was higher than that in the non-advanced age group. It was 27.3%, 22.1%, and 16.8%, respectively, and the differences were statistically significant (all P ′＜0.017). The gestational age of delivery in the super-advanced age group were smaller than that in the non-advanced age group (P ′＜0.017). ②After adjusting for factors such as weight gain during pregnancy, mode of delivery, number of foetuses and gestational age of delivery, the risk of gestational hypertension, gestational diabetes mellitus, postpartum hemorrhage and multiple (≥2) abortion in the super-advanced age group was higher than that in the non-advanced age group. The odds ratios （OR） were 3.70, 1.98, 1.74, 3.44, respectively (all P＜0.05). The risk of thyroid diseases (including hypothyroidism, subhypothyroidism, and hyperthyroidism) was lower than that of non-advanced age group (OR=0.40, P=0.032). The risk of placental-related diseases and critically illnesses showed no statistically significant among the two groups. The risk of gestational hypertension, gestational diabetes, multiple (≥2) abortions in general advanced age group was higher than that in non-advanced age women, and their OR values were 1.92, 1.57, 1.76, respectively. The differences were statistically significant. ③Compared with non-advanced age group, the risk of neonatal transferred to neonatal intensive care unit (NICU) and the risk of neonatal respiratory distress syndrome were higher in super-advanced age group. The OR values were 2.11 and 4.28, and the differences were statistically significant. The risk of neonatal respiratory distress syndrome in the general advanced age group was higher than that in the non-advanced age group (OR=2.11). The difference was statistically significant. Conclusions：The risk of adverse pregnancy outcomes in super-advanced age group is higher than that of non-elderly maternal. For women of childbearing age who are likely to become parturients of super-advanced age, their physical health should be fully evaluated before pregnancy, and health management before pregnancy should be strengthened. Perinatal follow-up and management should be carried out strictly for those who have become very parturients of super-advanced age, so as to reduce the occurrence of adverse pregnancy outcomes. References | Related Articles | Metrics

Select

Analysis of Adverse Reactions of Blood Transfusion and Related Risk Factors in Obstetrics FU Wen-jun, ZHAO Xian-lan, SHAO Qing-qing, LIU Lu, YANG Kai 2019, 46 (5):  511-514.  Abstract ( 927 )   PDF (713KB) ( 6350 )   Objective：To investigate the occurrence and related risk factors of adverse reactions of obstetric blood transfusion, and to provide evidence for prevention and treatment of adverse reactions of obstetric blood transfusion. Methods: A retrospective analysis was made on obstetric patients who received blood transfusion from January 2016 to December 2017 in the First Affiliated Hospital of Zhengzhou University. The observation group (75 cases, a total of 76 times) had adverse transfusion reactions, while the control group (1 243 cases) had no adverse transfusion reactions. Analyze the adverse reactions of obstetric blood transfusion and analyze the risk factors related to adverse reaction of blood transfusion by univariate and multivariate Logistic regression analysis. Results: There was a total of 2 778 times for blood transfusion in obstetrics, and the incidence of adverse reactions in obstetrics was 2.74% (76/2 778), including allergic reaction (63.16%), non-hemolytic fever (23.68%) and other adverse reactions (13.16%). The adverse reaction rate of platelet collection was higher than that of suspended red blood cells of which the difference was statistically significant (χ2=22.594, P＜0.001), and the adverse reaction rate of platelet collection was higher than that of cryoprecipitation of which the difference was statistically significant (χ2=10.146, P=0.001). There was no significant difference between the two groups (χ2=0.025, P=0.874) according to whether antiallergic drugs were used in each bag of blood products. There were significant differences in blood transfusion history, adverse reaction history, times and types of blood transfusion between the two groups (all P＜0.05), and no significant differences in maternal type and allergic history (all P＞0.05). Multivariate logistic regression analysis showed that history of blood transfusion (OR=9.888, 95%CI: 5.813-16.820) was a risk factor for adverse transfusion reactions. One transfusion (OR=0.464, 95%CI: 0.277-0.777) was a protective factor for adverse transfusion reactions. Conclusions: Blood transfusion history and times of blood transfusion ≥2 are risk factors for adverse reactions of obstetric blood transfusion. Therefore, the indications of blood transfusion should be strictly controlled and blood transfusion should be reasonable. References | Related Articles | Metrics

Select

Investigation of Different Serotype Distribution of Group B Streptococcus in Women with Late Pregnancy in Shenyang Area GAO Shuang, SUN Xiao-juan, LIU Zhong-yang, CONG Gui-min, RUAN Qiang 2019, 46 (5):  515-518.  Abstract ( 891 )   PDF (1117KB) ( 6405 )   Objective：To investigate the distribution of different serotypes of Group B Streptococcus (GBS) in late pregnant women in Shenyang area and the difference of drug resistance among different serotypes. Methods: 19 122 cases of late pregnant women visited to obstetrics department of Shenyang Materal and Infant Hosipital from May 2016 to August 2017 and were identified as GBS positive. The pure culture strain of GBS colleted from the pregnant women who had lived in Shenyang for more than 3 years will be selected as specimens. The serum types of GBS were determined by polymerase chain reaction (PCR) and gene sequencing. The rates of drug resistance and premature rupture of membranes were compared among different serotypes of GBS. Results: Among the 19 122 cases of late pregnant women, 572 cases were GBS positive, with a GBS carrier rate of 3.0%. Among 251 cases of pure culture strains from Shenyang area, GBS serotypes mainly were Ⅰa (44.22%) ,Ⅴ (38.65%) , Ⅲ (13.94%) , and serum NT with high homology to serotype Ⅴ was found. No resistance to Penicillin, Ampicillin, Vancomycin, Meropenem, Linezolid was found in serotypes Ⅰa, Ⅲ, Ⅴand NT. There was no significant difference in the resistance rates of Erythromycin, Clindamycin, Levofloxacin and Tetracycline to the four serotypes (All P＞0.05). There were significant differences in the resistance rates of Erythromycin, Clindamycin, Levofloxacin and Tetracycline among serotypes Ⅰa, Ⅲ, Ⅴ(P＜0.05). However, there was no statistical significant difference in drug resistance rate of serotype NT to four drugs (P＞0.05). The incidences of premature rupture of membranes in late pregnant women with serotype Ⅰa, Ⅲ, Ⅴ and NT respectively were 23.42%, 34.28%, 10.31% and 25.00%. There was significant difference ( χ2=11.128, P=0.011). Conclusions: The carrying rate of GBS was 3.0% in Shenyang area, and the main serotypes were Ⅰa, Ⅴ and Ⅲ. There was no difference in drug resistance among different serotypes. Attention should be paid to the screening of GBS in the third trimester of pregnancy, and anti-infection therapy should be given according to the screening results to reduce the occurrence of adverse pregnancy outcomes. References | Related Articles | Metrics

Select

Investigation the Ways for Mid-Trimester Induced Abortion with Placenta Previa WU Wen-juan，NIU Lei-lei，WANG Yu 2019, 46 (5):  519-522.  Abstract ( 1017 )   PDF (838KB) ( 6537 )   Objective：To explore the suitable method of induced labor in the condition of placenta previa during middle pregnancy. Methods：Retrospective analysis of 89 cases of placenta previa patients induced abortion in Department of Obstetrics of Henan Provincial People′s Hospital. Group A was induced by Mifepristone combined with Ethacridine (64 cases), which received oral mifepristone 50 mg twice a day for 5 days and followed by amniocentesis administration of Ethacridine 100 mg under the guidance of color doppler ultrasound on the 5th day afternoon. Group B was treated with abdominal hysterotomy (25 cases). The general situation, induction of labor and repregnancy of the 2 groups were compared. Results：The amount of bleeding and hospitalization cost in group A were significantly lower than those in group B, and the difference was statistically significant (P＜0.05). The success rate of induced labor in patients with incomplete placenta previa and complete placenta previa were 96.3% (52/54) and 70% (7/10), respectively. The rate of cesarean section of the former is significantly lower than that of the latter (P=0.024). When re-pregnancy, the probability of abnormal placenta in group A was significantly lower than that in group B, and the difference was statistically significant (P=0.014). Conclusions：For patients with placenta previa in the second trimester, induction of labor by amniocentesis after oral administration of Mifepristone can reduce the amount of bleeding during labor, reduce the cost of hospitalization, and reduce the injury of parturient by abdominal hysterotomy. It can reduce the probability of placental abnormity in the second pregnancy and can be used as one of the clinical choices. References | Related Articles | Metrics

Select

A Case Analysis of Ederly and High-Risk Pregnant Women and Literature Review LI Jie，BAI Yu-fang，MU Wan-ru，NAN Lian-ling，ZHANG Hong 2019, 46 (5):  523-526.  Abstract ( 905 )   PDF (697KB) ( 6414 )   With the liberalization of the second-child policy, the number of elderly mothers is increasing, thus the age of pregnant women is increasing, and the incidence of internal and surgical disease is also increasing, which also leads to an increase in the adverse outcomes of older pregnant women and perinatal children. Before the implementation of the "two-child policy", the rate of cesarean section in many hospitals in China was much higher than the 15% level recommended by the World Health Organization. With the "two-child policy" landing, the elderly women who originally chose cesarean section once again gave birth to new life. With the increase of age, the body functions of women of childbearing age gradually declines, and reproductive system function also gradually declines, while scar uterus gradually become aging and its contraction ability declines. How to ensure the safe delivery of elderly women with scarred uterus and a variety of internal and surgical diseases is a new difficult problem for obstetricians. By consulting relevant literatures and summarizing the cases of advanced pregnancy with cerebral aneurysm, carotid aneurysms, intrahepatic cholestasis of pregnancy, and gestational diabetes in Qinghai University Affiliated Hospital, this article deepen obstetricians′ attention and understanding of related diseases. References | Related Articles | Metrics

Select

A Case of Pregnancy Complicated with Recurrent Venous Thrombosis of Lower Limbs with a Family History of Thrombosis and Literature Review ZHAO Zhe，JIAN Wen-wen，YU Qing，WANG Min，ZHAO Shu-hui，WANG Yu-jia，YANG Shu-li 2019, 46 (5):  526-529.  Abstract ( 925 )   PDF (669KB) ( 6413 )   This article analyzes the clinical data of a case of recurrent venous thrombosis of the lower extremity with familial thrombosis in pregnancy admitted to the Second Hospital of Jilin University and retrospectively analyzes the relevant literatures as well as data in the past. The risk of venous thromboembolism (VTE) of lower extremity in pregnant women is about 5 times higher than that in non-pregnant women. The history of VTE in pregnant women and family history of VTE in pregnant women are the high risk factors of VTE. This patient had a recurrence after thrombolytic therapy for venous thrombosis in the lower extremity during the puerperium. No adverse effects were observed after this anticoagulant therapy. For VTE high-risk pregnant and lying-in women, appropriate anticoagulant therapy has more advantages than disadvantages, especially in puerperium. Moreover, the increased rate of cesarean section increases the risk of postoperative VTE. Therefore, prenatal evaluation, close observation after delivery and appropriate anticoagulation therapy can reduce the recurrence rate of pregnancy-related VTE. References | Related Articles | Metrics

Select

Early Sonographic Diagnosis of Fetal Single Ventricle, Single Atrium, Persistent Truncus Arteriosus: A Case Report GUAN De-feng，ZHANG Ping，YANG Yong-xiu 2019, 46 (5):  530-531.  Abstract ( 981 )   PDF (608KB) ( 6421 )   Fetal cardiovascular abnormalities, which coexists with complex and multi-malformation, are a key factor of neonatal mortality. Combination of multiple ultrasound imaging techniques before delivery can accurately diagnose fetal congenital cardiac malformations, make accurate classification and detect accompanying malformations, which is of great significance to offer proper prenatal consultation, evaluation, decision-making and post-birth treatment, so as to achieve the goal of eugenics. This article reports the clinical data of a case of early sonographic diagnosis of fetal single ventricle, single atrium, and persistent truncus arteriosus. The characteristic structural changes under ultrasound are observed to improve the technical level of ultrasound physician in diagnosing this disease, so that makes it possible to detect complex fetal abnormalities in the early and middle stages of pregnancy. References | Related Articles | Metrics

Select

Research Status of Immune Dysfunction and Development of Endometriosis JIANG Xue, ZHANG Zong-feng 2019, 46 (5):  532-535.  Abstract ( 857 )   PDF (708KB) ( 6349 )   Endometriosis (EMs) is an estrogen-dependent disease, usually associated with chronic pelvic pain and infertility, affecting approximately 10% to 15% of women of childbearing age. In recent years, immune dysfunction has been shown to be a key factor in promoting the growth of ectopic lesions after endometrial debris retrograded. Almost all the immune cell functions in patients with EMs have changed, such as T cell reactivity and NK cell toxicity decrease, B cell polyclonal activation and antibody production increase, and the number of peritoneal monocytes increase. In addition, the high estrogen environment in EMs and the abnormal distribution of estrogen receptor subtypes have also been shown to affect the recruitment and function of immune cells. However, it is controversial whether immune dysfunction is the initial cause of EMs or the consequence of the disease. References | Related Articles | Metrics

Select

Research Progress on Immune Mechanism of Endometriosis WANG Xin-dan，ZHENG Ping 2019, 46 (5):  536-540.  Abstract ( 860 )   PDF (728KB) ( 6379 )   Endometriosis is a common gynecological disease with chronic pelvic pain, dysmenorrhea, coital pain and infertility as the main symptoms, the pathogenesis of which is not yet clear. Studies have shown that abnormal immune responses in the peritoneal microenvironment are essential for attachment, invasion and angiogenesis of ectopic endometrial cells. The growth of ectopic endometrium accumulates a large number of diverse immune cells, triggering a strong inflammatory response in which pro-inflammatory cytokines, growth factors, and angiogenesis increase. Almost all types of immune cells exhibit abnormal immune functions in patients with endometriosis, such as T-cell reactivity and natural killer (NK) cell toxicity decreased, B cell polyclonal activation and antibody production increased, the number and activation of peritoneal macrophages increased and changes in inflammatory mediators. Further study on the mechanism of homeostatic imbalance of the immune system mediated by ectopic endometrium and understanding the mechanism of immune escape induced by ectopic endometrium may become the target of new non-hormone therapy，so as to develop a more comprehensive approach to treat EMs. References | Related Articles | Metrics

Select

The Effect of Gynecological Surgery on Ovarian Reserve Function with Anti-Müllerian Hormone LI Zheng，YANG Hua 2019, 46 (5):  541-544.  Abstract ( 802 )   PDF (696KB) ( 6290 )   With more and more gynecological operation methods, especially the extensive development of minimally invasive surgery, how to protect the ovarian reserve function to the maximum is a common topic for doctors and patients. Ovarian reserve reflects a woman′s fertility and refers to the quantity and quality of fertilizable oocytes in the ovary, as measured by age, basal follicle stiminulating hormone, estradiol, luteinizing hormone, and Inhibin B, the number of basal antral follicles and the volume of ovaries, but there are some limitations. Anti-Müllerian hormone (AMH), which is secreted by the ovarian granulosa cells, remains relatively stable throughout the menstrual cycle and is not affected by the menstrual cycle, thus AMH is a reliable predictor of ovarian reserve. This article reviews the effects of different gynecological operations on ovarian reserve. References | Related Articles | Metrics

Select

Advances in the Study of Markers for Predicting Cardiovascular Disease Associated with Polycystic Ovary Syndrome CHEN Jing-jing，CHANG Hui，CHEN Ying-ying，YU Jia-rui，WU Xiao-ke，ZHANG Duo-jia 2019, 46 (5):  545-548.  Abstract ( 849 )   PDF (690KB) ( 6326 )   Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of childbearing age. In addition to polycystic ovarian changes, sparse ovulation or anovulation under B-mode ultrasonography, hyperandrogenism, insulin resistance and abnormal lipid metabolism and so on are also observed in the patients. At the same time, it is closely related to many diseases such as obesity, type 2 diabetes, cardiovascular disease (CVD) and depression. Among them, PCOS combined with CVD has gradually attracted academic attention. However, its specific pathogenesis is not yet clear, and there are no specific related screening indicators, which can not block the development of the disease in time. Therefore, to find out the predictors of PCOS with CVD and to make timely diagnosis and intervention is one of the important methods to improve the quality of life and reduce the incidence of PCOS in clinic. In this paper, we summarize the predictive markers related to PCOS complicated with CVD in recent years, including hypersensitive C-reactive protein, homocysteine, galectin-3, blood lipid parameters and anthropometric parameters, etc., and summarize their properties and predictive efficacy. References | Related Articles | Metrics

Select

Acute Vaginal Bleeding Caused by Cervical Endometriosis: A Case Report and Literature Review XU Qian, DUAN Hua, JIN Tong, ZANG Chun-yi 2019, 46 (5):  549-551.  Abstract ( 993 )   PDF (633KB) ( 6795 )   Cervical endometriosis is a special type of endometriosis associated with active vaginal bleeding, which has been reported in many cases at home and abroad. In this case, a 40-year-old nulliparous woman, G3P0, visited to emergency room with massive vaginal hemorrhage on the second day after menstruation. The volume of vaginal hemorrhage is 4 to 5 times of normal menstruation. Ultrasound revealed dilatation of the cervix. The bleeding stopped after treatment with oxytocin. After bilateral uterine artery embolization in hospital, the hysteroscopy revealed a large amount of old blood in the diverticulum-like cystic space at 8 o′clock in the cervical canal. Then, hysterscopic resection and electrocoagulation of the cystic space were performed. Postoperative pathology revealed a cervical endometriosis cyst. The second hysteroscopy was performed in 2 years later and showed a defect the cavity of the original cervical lesion and scar repair in the wall of the cyst. There was no recurrence in the follow-up so far. This article reviews the literature on the pathogenesis, clinical presentation, diagnosis, and treatment of endometriosis cyst of the cervix, and concludes with lessons learned from this case. References | Related Articles | Metrics

Select

Research Progress of S100A14 Protein in Gynecologic Oncology Development CHEN Ying, ZHANG San-yuan 2019, 46 (5):  552-555.  Abstract ( 861 )   PDF (698KB) ( 6337 )   At present, reproductive system tumors account for 15% of female systemic tumors, so there is an urgent need to find a biomarker that can guide treatment and evaluate prognosis. S100A14 protein is a member of the calcium-binding protein family and its expression is abnormal in many kinds of tumor tissues，which is closely related to the occurrence, development, invasion and metastasis of tumor. In recent years, more and more studies have shown that the expression of S100A14 is related to the clinicopathologic stage, differentiation and lymph node metastasis of gynecological tumors, and is expected to be a specific tumor marker. At present, the mechanism of S100A14 in the occurrence and development of gynecological tumors is not clear. It is accepted that S100A14 can activate the signal transduction pathway of related cells and cause the change of the expression level of related cytokines, so as to affect the normal regulation of the cell cycle. Further study on the mechanism of S100A14 in gynecological tumors and targeted intervention in the process of action can provide a new idea for clinical treatment of gynecological tumors. This article reviews the expression and mechanism of S100A14 in gynecological tumors. References | Related Articles | Metrics

Select

Advances in Research on the Relationship between Leptin and Gynecological Malignant Tumors HU Rui-jiao, JIANG Ji-yong, WANG Xiu-ying 2019, 46 (5):  556-559.  Abstract ( 845 )   PDF (691KB) ( 6290 )   Obesity may increase the incidence of gynecological malignant tumors and affect the prognosis by various mechanisms, such as chronic inflammation, dysregulation of sex hormones or abnormal secretion of adipokines, among which Leptin is one of the important adipokines and plays an important role in the occurrence and development of various gynecological malignant tumors. In different types of gynecological malignant tumors, leptin levels are different so it can be used as an independent risk factor for endometrial cancer. Leptin can activates a variety of signal transduction pathways by acting on Leptin receptors thus increasing tumor cell proliferation, migration, enhancing tumor cell invasiveness, promoting tumor angiogenesis and inhibiting tumor cell apoptosis. Understanding the relationship between Leptin and gynecological malignant tumors is helpful to better understand the pathogenesis of gynecological malignant tumors and has important clinical significance for preventing tumorigenesis, early diagnosis and prognosis of patients with advanced disease. In-depth research in this field will provide a new idea for the diagnosis and treatment of gynecological malignant tumors. References | Related Articles | Metrics

Select

Current Status and Progress in the Treatment of Uterine Serous Carcinoma ZHANG Jia-jun, WANG Xiao-hui 2019, 46 (5):  560-563.  Abstract ( 1719 )   PDF (691KB) ( 6334 )   Uterine Serous Carcinoma [USC, also known as uterine papillary serous carcinoma (UPSC)] is a special pathological type of type Ⅱ endometrial cancer, with the characteristics of strong invasiveness, high postoperative recurrence rate, prone to distant metastasis, poor prognosis and so on. Because of its low incidence and lack of prospective randomized controlled trials, combining with the treatment recommendations of the National Comprehensive Cancer Network (NCCN) for USC in recent years, it is recommended that USC be treated by comprehensive staged surgery, combined with chemotherapy, radiotherapy, molecular targeted therapy and immunotherapy. At present, there is no consensus on the best treatment for uterine serous cancer. Now I will elaborate on the current status and progress of the treatment of uterine serous carcinoma related treatment, and hope to be helpful for clinical treatment. References | Related Articles | Metrics

Select

Advances in Lynch Syndrome Associated with Endometrial Carcinoma ZHANG Qun, WANG Ling, HAN Li-ying 2019, 46 (5):  564-567.  Abstract ( 996 )   PDF (700KB) ( 6541 )   Lynch syndrome (LS) is an autosomal dominant hereditary disease, formerly known as hereditary nonpolyposis colorectal cancer (HNPCC), which is caused by mismatch repair (MMR) gene mutations in the germline of MLH1, MSH2, MSH6 and PMS2. LS patients have a variety of canceration tendency, low age of onset and family susceptibility, and can develop colorectal cancer, endometrial cancer (EC), ovarian cancer, gastric cancer, and breast cancer at the same or different time. EC is most closely related to it in female patients. At present, there is still insufficient understanding of LS-EC in China, and no complete diagnosis and treatment standards or guidelines have been formed. Therefore, this paper reviews the molecular mechanism, clinicopathological characteristics, screening and diagnostic methods, clinical treatment methods and prevention of LS-EC to improve the understanding of LS-EC. References | Related Articles | Metrics

Select

Advances in Epigenetics and the Mechanism of Endometriosis Associated Ovarian Cancer YANG Pan-pan，LIU Chang，CHAI Yi-hong，WANG Xiao-hui 2019, 46 (5):  568-571.  Abstract ( 801 )   PDF (697KB) ( 6311 )   Endometriosis (EMs) refers to the presence of endometrial tissue outside the uterine cavity. It is a chronic, hormone-dependent gynecological disease affecting millions of women worldwide. Although EMs is benign in morphology, it is characterized by proliferation, infiltration and recurrence of malignant tumors in clinical behavior. There is sufficient evidence to indicate that it can increase the risk of malignant transformation through various mechanisms, but the specific mechanism of the malignant transformation of EMs is unclear currently. There is increasing evidence that epigenetic modification is not only involved in the development of EMs, but also plays an important role in the pathogenesis of malignant transformation of endometriosis, including DNA methylation and demethylation, histone modification, abnormal expression of microRNAs (miRNAs), etc. This paper reviews the research progress on the mechanism of epigenetics and endometriosis associated ovarian cancer (EAOC) in order to find out some risk factors that may be related to the malignant transformation of endometriosis. References | Related Articles | Metrics

Select

Long Non-Coding RNA-Mediated Signal Pathways in Cervical Cancer SHEN Ning-mei，JIANG Pin-ping，FU Shi-long 2019, 46 (5):  572-576.  Abstract ( 782 )   PDF (778KB) ( 6363 )   Cervical cancer is the second largest female malignant tumor after breast cancer. The main pathogenic factor of cervical cancer is human papillomavirus (HPV) infection. The incidence and mortality of cervical cancer have been decreased thanks to the use of HPV vaccine and advances in surgery and chemoradiotherapy. However, metastasis, recurrence and drug resistance are still great challenges in clinical therapeutics. Long-stranded non-coding RNA (lncRNA) is longer than 200 nt, most of which can not encode proteins, and only a few of which are translated into peptides. LncRNAs such as H19 and HOTAIR have been proved to play an important role in the initiation and progression of cervical cancer, and are closely related to the abnormal activation of PI3K/Akt, Wnt and other signaling pathways. LncRNA involved in the development of cervical cancer and its signal pathways are reviewed to explore potential biomarkers for diagnosis or prediction of prognosis, or effective targets for gene therapy. References | Related Articles | Metrics

Select

Residual, Recurrence and Pregnancy of Lesions after Treatment of High-Grade High-Grade Cervical Squamous Intraepithelial Lesions SUN Pei-song, CHENG Xiang-hong, WANG Tian, HU Yuan-jing 2019, 46 (5):  576-579.  Abstract ( 1230 )   PDF (709KB) ( 6632 )   High-grade cervical squamous intraepithelial lesion (HSIL) is internationally recognized as precancerous lesions of the cervix. About 17% of untreated HSIL patients are likely to develop into a invasive cancer. Therefore, accurate and standard treatment of cervical lesions, especially HSIL, is an important means to prevent cervical cancer. The American Society of Colposcopy and Cervical Pathology (ASCCP) recommends cold knife conization (CKC) and loop electrosurgical excision procedure (LEEP) as the primary methods of diagnosis and treatment. However, some patients still have the risk of residual lesions, recurrence and progression after treatment. At present, there are great differences in residual lesions, recurrence and progression after HSIL treatment, and the risk factors of residual lesions, recurrence and the mode of follow-up after HSIL treatment are still uncertain. The purpose of this article is to review the risk factors, management, follow-up and pregnancy-related issues of residual and recurrent lesions after HSIL treatment, so as to guide clinical treatment. References | Related Articles | Metrics

Select

Expression of CD24 and Its Prognostic Role in Ovarian Cancer: An Analysis Based on the Data-Mining of Oncomine Database LIU Heng-wei, LYU Li-qun 2019, 46 (5):  580-584.  Abstract ( 809 )   PDF (2341KB) ( 6292 )   Objective：To investigate the expression and clinical value of CD24 in ovarian cancer． Methods: Data about CD24 expression in ovarian cancer were retrieved from the Oncomine database, then the prognostic value of CD24 was retrieved from an online survival analysis tool "Kaplan-Meier Plotter" (KM plotter) database. Results: For different types of cancer in Oncomine, there were 353 studies concerning expression of CD24, of which 64 studies were of statistically significance (41 up-regulated and 23 down-regulated). 5 149 samples of 7 studies assessed the expression of CD24 in ovarian cancer tissues and normal tissues. The expression of CD24 was significantly higher in the ovarian cancer tissue compared with the normal tissues (P＜0.05). And negatively associated with the overall survival rate (P＜0.05). Subgroup analysis revealed that CD24 expression showed negative relation to the prognosis of ovarian endometrioid adenocarcinoma patients and ovarian serous cystadenocarcinoma patients. Conclusions: CD24 is overexpression in ovarian cancer and negatively associated with the overall survival rate, which may be used as an important target of medication for ovarian cancer． References | Related Articles | Metrics

Select

Research on Clinical Characteristics and Incidence Trend of the Cervical Cancer during Past Eleven Years in the First Hospital of Lanzhou University LI Yong-xia，YANG Yong-xiu，WANG Xin，HU Dan 2019, 46 (5):  585-590.  Abstract ( 1201 )   PDF (9797KB) ( 6170 )   Objective：To analyze and discuss the spatial distribution, incidence trend and clinical features of the patients with the cervical cancer diagnosed in the First Hospital of Lanzhou university from 2007 to 2017. Methods: Collect the clinical data of 1023 cases of cervical cancer diagnosed in our hospital from 2007 to 2017. Trend analysis and Chi-square test were used to explore its distribution, age changes, clinical features, pathological characteristics and incidence trend. Results:①The cervical cancer patients admitted to our hospital in the past 11 years were mainly in the southeast of Gansu Province, of which Tianshui was the most (173 cases) , followed by Lanzhou (168 cases) , and the northwest of our province was the least, especially Dunhuang (9 cases) . ②The interannual change of the total number of cervical cancer patients treated in our hospital showed increasing trend, the rate of change was 6.98 persons per year, among which Lanzhou had the largest increase at 1.33 per year, and Tianshui had the least change. ③The patients′ age was mainly 40-49 and 50-59 years old, and there was a tendency of aging, that is, the number of 50-59 years old patients increased, while the number of 40-49 years old patients decreased. The proportion of patients in other age groups was small, and there were no significant changes. The average age of the patients ranged from 50 to 59 years old, mainly in the southeast of Gansu Province, including Jiayuguan, Jinchang, Qingyang, etc. The patients aged from 40 to 49 years old were mainly in Gannan Tibetan Autonomous Prefecture and Jiuquan. ④High incidence age of Stage Ⅰa, Ⅰb, Ⅱa and Ⅳ were all 40~49 years old, while Stage Ⅱb and Ⅲ were 50-59 years old. Squamous cell carcinoma was the main pathological type (94.53%) , followed by adenocarcinoma, and adenosquamous carcinoma was less common. ⑤ There were all no statistically significant differences in clinical stage, pathological type or the age of onset of the cervcial cancer patients in 2007-2011 and 2012-2017 (P＞0.05). Conclusions: The confirmed cases of cervical cancer in our hospital are mainly distributed in the southeast of Gansu Province, the annual change is increasing, the age of which is mainly 50~59 years old with an aging trend. The age of onset of stage Ⅰ and Ⅱa cervical cancer was mainly 40-49 years old, and that of Stage Ⅱb and Ⅲ was 50-59 years old, and squamous cell carcinoma was the main pathological type in these age groups. References | Related Articles | Metrics

Select

Effect of Intensity-Modulated Radiotherapy Combined with Chemotherapy on Oncogene in Patients with Endometrial Carcinoma ZHANG Ming-chuan, WANG Li 2019, 46 (5):  591-594.  Abstract ( 1026 )   PDF (938KB) ( 6449 )   Objective：To explore the effect of intensity modulated radiation therapy (IMRT) combined with chemotherapy on endometrial cancer and on the expression of oncogene in the patients. Methods: A total of 100 patients with endometrial cancer who were treated in the Tumor Hospital Affiliated to Zhengzhou University from January 2017 to January 2018 were randomly divided into chemotherapy group and combined group, 50 cases in each group. The chemotherapy group was treated with paclitaxel plus platinum (TC) chemotherapy regimen, and the combined group was treated with intensity modulated radiotherapy (IMRT) based on the chemotherapy group. The quality of life of the two groups was scored before and after treatment; the therapeutic effects of the two groups were compared, and the proto-oncogenes c-erbB2, c-myc, K-ras and tumor suppressor genes P53, P16 and PTEN were detected by real-time fluorescence quantitative RT-PCR. The incidence of adverse reactions in the two groups during treatment was counted. Results: There was no significant difference in the scores of life function between the two groups before treatment (P＞0.05); after treatment, the scores of life function of the two groups were higher than those before treatment, and those of the combined group was higher than those of the chemotherapy group, the difference was statistically significant (P＜0.05). The total effective rate of combined group was higher than that of chemotherapy group (P＜0.05). The expression levels of proto-oncogenes c-erbB2, c-myc and K-ras in the two groups after treatment were lower than those before treatment, and the expression levels in the combined group were lower than those in the chemotherapy group (P＜0.05). After treatment, the expression of tumor suppressor genes P53, P16 and PTEN in the two groups were higher than those before treatment, and the expression of tumor suppressor genes in the combined group was higher than that in the chemotherapy group (P＜0.05). The incidence of adverse reactions in combined group was lower than that in chemotherapy group (P＜0.05). Conclusions: IMRT combined with chemotherapy after endometrial cancer surgery can effectively improve the treatment effect, improve the quality of life of patients and the expression of proto-oncogene and anti-oncogene, with fewer adverse reactions, which is worthy of clinical application. References | Related Articles | Metrics

Select

A Case of Vulva Lichen Sclerosis Combined with Vulva Squamous Cell Carcinoma ZHANG Yan，GUO Feng-he 2019, 46 (5):  595-596.  Abstract ( 1152 )   PDF (610KB) ( 6617 )   Vulva Lichen Sclerois(VLS) is a chronic refractory skin disease in women. It mainly occurs in vulval and perianal skin. It mainly occurs in Vulvar and perianal skin and is characterized by whitening and pruritus of vulvar skin. Patients with obvious vulvar pain and induration should be alert to develop Vulvar squamous-cell Carcinoma (VSCC). This article introduces a 56-year-old woman with a history of VLS for more than 40 years. Taking the material from the Labia Majoris, the histopathology showed "VLS, mild". Later the separation of vulva adhesion was performed for the adhesion of the clitoris and obvious pain, showing that the clit was dark red and cauliflower-shaped. After two biopsies with biopsy forceps and cold knife, VSCC was confirmed by histopathology, then extensive eulvectomy plus bilateral inguinal lymphadenectomy was performed. Further radiotherapy and chemotherapy were given after the operation. It is suggested that VLS with a long history of local induration and obvious pain should be alert for canceration. If the clitoris is painful and sticky, it should undergo adhesion separation, expose the clitoris, and repeat the material when necessary, so as to avoid misdiagnosis. References | Related Articles | Metrics

Select

Clinical Analysis of 2 Cases of Brain Metastasis of Ovarian Cancer SUN Hao, ZHOU Yang, ZHANG Yi, WU Yu-xian, JIN Zhi-jun 2019, 46 (5):  597-599.  Abstract ( 1232 )   PDF (673KB) ( 6425 )   We described the clinical dates of 2 cases of patients with brain metastases of ovarian cancer of 443 cases of patients with ovarian cancer in detail, including general data of the patients, treatment before and after the diganosis of brain metastases of ovarian cancer, the survival time after brain metastasis of ovarian cancer and so on. We found that the incidence of brain metastases of ovarian cancer is 0.5% in this hospital and the one from the literature is 0.29%-12%. Age and treatment are the most important factors affecting the prognosis. In this study one patient has survived 30 months after treated with multimode comprehensive therapy when diagnosed of brain metastasis of ovarian cancer. The interval time of the other patient between the diagnosis of ovarian cancer (age＜50) and the diagnosis of brain metastasis of ovarian cancer (age=60) is 13 years, providing evidence of the factors influencing the morbidity and prognosis of brain metastasis of ovarian cancer reported in the literature in recent years，and the multimode comprehensive therapy, surgery combined with chemotherapy and radiotherapy can effectively alleviate the symptoms of ovarian cancer and prolong the survival period. We also found that the expression of androgen receptor and BRCA gene mutation were expected to be the landmark events of brain metastasis of ovarian cancer. References | Related Articles | Metrics