Table of Content

15 December 2019, Volume 46 Issue 6
Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Advances of Laparoscopic Pectopexy in the Treatment of Pelvic Organ Prolapse ZHANG Ti-shuo，WANG Ling，TIAN Di，ZHANG Qun，HAN Li-ying 2019, 46 (6):  605-608.  Abstract ( 1136 )   PDF (1019KB) ( 6699 )   In the daily life of middle and old aged women, the negative impact of pelvic organ prolapse (POP) is worse and worse, and its incidence is also increasing year by year. Prolapse of uterus or vault caused by pelvic defect is not uncommon in POP. The recurrence rate after operation is closely related to whether the repair is up to the standard. The application of laparoscopy surgery and implantable mesh makes the operation more minimally invasive and biologically reconstructed, reducing the recurrence rate and the incidence of complications. At present, laparoscopic sacrocolpopexy (LSC) or laparoscopic sacrohysteropexy (LSH) has become the gold standard in the treatment of pelvic prolapse, but it is difficult to perform in patients with narrow pelvic space (caused by obesity or adhesions, etc.) and defecation problems (especially constipation) are the most common complications. So many surgeons have improved the procedure by fixing the mesh to the top of the sacral promontory. However, the fixation of this site led to a change in the direction of the abdominal wall. Laparoscopic pectopexy has high subjective satisfaction and low recurrence rate. It can restore the physiological and anatomical structure of the pelvic floor and has good clinical effect. References | Related Articles | Metrics

Select

Research Progress on the Application of Diffusion Tensor Imaging in Uterus and Uterine Diseases ZHANG Wen-ting，YIN Hua-bin 2019, 46 (6):  609-613.  Abstract ( 887 )   PDF (455KB) ( 6375 )   Diffusion tensor imaging (DTI) is able to quantify the velocity and direction of water molecules in human tissues, thus to reflect micro-structure of tissues as well as physiological and pathological changes. DTI related parameters fractional anisotropy (FA) and apparent diffusion coefficient (ADC) value can reveal microscopic structure quantitatively. Fiber tractography (FT) can visually display the direction and distribution of fiber bundles, providing more anatomical details non-invasively. Presently, the application of DTI in uterus has come to increasingly attention. DTI can well display fibrous structure of normal uterus and also be applied in uterine diseases, for instance, the differentiation of ordinary to degenerative uterine leiomyoma and postoperative efficacy evaluation after ultrasound ablation, the preoperative staging of endometrial and cervical cancer, determination of lymph node metastasis and prognosis evaluation, showing the microstructure of sacral nerve root to reflect the pathophysiological changes of endometriosis, providing more information for clinical diagnosis and contributes to the follow-up treatment options and prognosis evaluation. References | Related Articles | Metrics

Select

Application and Prospect of Enhanced Recovery after Surgery in Obstetrics and Gynecology SONG Zhen-zhen，ZHAO Qian，GUO Rui-xia，HAI Pan-pan，WANG Shi-hui 2019, 46 (6):  614-617.  Abstract ( 919 )   PDF (561KB) ( 6369 )   The Danish surgeon Kehlet comprehensively optimized the perioperative management measures. In 1997, he first proposed the concept of enhanced recovery after surgery(ERAS). In recent years, the concept has been widely promoted in Europe and the United States, and has gradually been adopted and applied domestically. From the perspective of evidence-based, ERAS strives to reduce the physiological and psychological traumatic stress response of surgical patients. Through the close cooperation of departments such as surgery, anesthesia, nursing, and nutrition, it takes a variety of interventions to optimize the perioperative clinical pathway, reduce perioperative traumatic stress response and the incidence of postoperative complications, promote rehabilitation, shorten hospital stay, and reduce medical expenses. This theoretical system has been promoted and applied in various surgical fields since it was officially put forward in 1997. At present, ERAS has been applied to the perioperative period of thoracic surgery, general surgery, colorectal surgery, obstetrics and gynecology. In recent years, there have been many successful cases in which ERAS and the perioperative management model of obstetrics and gynecology have been combined. The current application of the concept of surgery in the clinical practice of obstetrics and gynecology is reviewed. References | Related Articles | Metrics

Select

Clinical Study of High-Intensity Focused Ultrasound Ablation Combined with GnRHa in the Treatment of Adenomyosis XU Feng，TAN Li-xia，LI Pan，GUO Qing 2019, 46 (6):  618-620.  Abstract ( 817 )   PDF (847KB) ( 6552 )   Objective：High-intensity focused ultrasound（HIFU） ablation combined with gonadotropin releasing hormone agonists （GnRHa） was used in the treatment of adenomyosis, and its clinical application value was discussed. Methods：Patients of adenomyosis diagnosed and treated in the Department of Obstetrics and Gynecology of the First Hospital of Shijiazhuang from January 2015 to January 2018 was taken as the research objects. The cases were divided into two groups: the combined GnRHa group (n=41) was treated with HIFU ablation combined with GnRHa, and the simple HIFU group (n=48) was treated with HIFU ablation alone. The curative effect indexes of the two groups were compared after one year′s follow-up. Results：The lesion volume and uterine volume reduction rates in the combined GnRHa group were higher than those in the simple HIFU group (P＜0.05), and the hemoglobin level was higher ( P=0.044). The VRS score of dysmenorrhea in the combined GnRHa group was also better than that in the simple HIFU group ( P=0.018). There was no significant difference in serum CA125 level and incidence of adverse reactions between the two groups (P＞0.05). Conclusions：Compared with HIFU ablation alone, the combination of HIFU and GnRHa has better lesion volume reduction rate and uterine volume reduction rate, and hemoglobin level and dysmenorrhea symptoms improve better. References | Related Articles | Metrics

Select

Clinical Analysis of 159 Patients with Atypical Endometrial Hyperplasia Treated by Hysterectomy NIE Ming-yue，YE Hong 2019, 46 (6):  621-624.  Abstract ( 965 )   PDF (557KB) ( 6664 )   Objective：This study investigated the clinical characteristics of patients diagnosed with atypical endometrial hyperplasia (AEH) and explored the risk factors of AEH upgraded to endometrial cancer (EC) after hysterectomy. Methods：159 cases of women with AEH who underwent hysterectomy during January 2015 to December 2018 in our hospital were recruited in this retrospective study. All patients were divided into two groups according to their pathological results after hysterectomy, the non-EC group (n=134, 84.3%) and the EC group (n=25, 15.7%). Results：Results showed that the incidence of obesity, menopause, abnormal blood flow signals indicated by ultrasound and diabetes were different between two groups (P＜0.05). Multivariate Logistic analysis showed that obesity (OR=3.196, 95%CI: 1.147-8.902, P=0.026) and diabetes (OR=3.866, 95%CI: 1.019-14.673, P=0.047) were independent risk factors of upgraded pathological results. Conclusions：The incidence of EC coexisted with AEH is high. For AEH patients with obesity and diabetes, comprehensive assessments and individualized treatment are needed. These high-risk patients can be overlooked until final pathology. References | Related Articles | Metrics

Select

A Case Report of IUD Fracture and Incarcerated for 39 Years with Intrauterine Calcification CHEN Qing，ZENG Li-ping，WU Rui-fang 2019, 46 (6):  625-626.  Abstract ( 865 )   PDF (4002KB) ( 6426 )   Intrauterine device (IUD) is currently the most widely used contraceptive tool in China. IUD is easy to break, incarcerate and ectopic when placed for a long time. Once IUD is found to be broken, incarcerated, and ectopic, diagnosis should be made. A safe, reliable, and minimally invasive surgical procedure should be chosen to improve the success rate of removing the IUD and to avoid serious complications. Due to direct vision and minimally invasive, hysteroscopy provides a new method for removing the IUD. For elderly women with menopausal time of more than 2 years and IUD partial deformation, fracture and residual, the difficulty of removing the IUD is large and the complications are many. Patients can be hospitalized and underwent hysteroscopic under ultrasound to reduce the incidence of complications and improve the success rate of removing the IUD. Peking University Shenzhen Hospital admitted a 72-year-old female patient on March 11, 2019. The patient was admitted to the hospital with intrauterine device rupture. After admission, hysteroscopic was performed under ultrasound to remove the IUD successfully. This article reviews the relevant literature for the case report. References | Related Articles | Metrics

Select

Advances in the Prediction of Preterm Labor by Inflammatory Mediators Associated with Amniotic Fluid in the Second Trimester WU Yang，ZHOU Xin 2019, 46 (6):  627-631.  Abstract ( 771 )   PDF (642KB) ( 6377 )   Preterm labor refers to the delivery between 28 weeks and less than 37 weeks of gestation. The immature development of multiple organ systems of premature infants and related complications are important causes of neonatal morbidities and mortalities. The difficulty of the prevention and treatment of preterm labor is mainly due to its multiple causes. Currently, the pathogenesis is still not clear. A few studies have shown that infection is the main factor, which will produce inflammatory mediators that induce uterine contraction through many ways, thus promoting preterm labor. In the past, fetal fibronectin(FFN), transvaginal cervical tube length and serum inflammatory mediators were widely used to predict the occurrence of late symptomatic preterm labor, while the application of mid-term prediction of preterm labor was limited. It has been confirmed that the related inflammatory mediators such as interleukin-6(IL-6), IL-16, C-reactive protein (CRP), adiponectin, antimicrobial peptide, etc. produced by gestational tissue in chorioamnionitis directly enter amniotic fluid and meanwhile amniocentesis is commonly used in the field of prenatal diagnosis. Therefore, further study on the inflammatory mediators in amniotic fluid in the second trimester of pregnancy is expected to provide a new method for the prediction of preterm labor in the second trimester. References | Related Articles | Metrics

Select

Research Progress on the Associations of Vitamin D and Maternal Pregnancy Complications LI Xiang，WU Xiao-ke 2019, 46 (6):  632-635.  Abstract ( 874 )   PDF (630KB) ( 6430 )   As one of the essential nutrients, Vitamin D (VD) participates in regulating various biological processes in the human body. VD supplementation is mainly used to prevent and treat rickets, osteoporosis and so on. VD receptors are widely distributed in tissues and cells of the body widely. Studies have shown that VD plays an important role in modulating immune system functions. Meanwhile, it is involved in the pathogenesis of several disorders, such as nervous, endocrine and circulatory system diseases. Besides, VD is also crucial for maintaining maternal and fetal well-being during pregnancy. It has been reported that VD insufficiency or deficiency has been implicated in the increasing incidence of numerous maternal pregnancy complications. Moreover, severe VD deficiency is also associated with adverse maternal and fetal outcomes. In this article, we summarize the association between VD deficiency and maternal pregnancy complications and discuss the potential mechanism by consulting domestic and foreign literature published in recent years, aiming to provide theory basis for early screening, diagnosis and prompt treatment for VD deficiency. References | Related Articles | Metrics

Select

The Research Progress in Intraoperative Cell Salvage in Cesarean Section ZHU Lu，YU Hong 2019, 46 (6):  636-640.  Abstract ( 910 )   PDF (745KB) ( 6366 )   Postpartum hemorrhage is still the leading cause of maternal mortality worldwide so far. Blood transfusion plays a very important role in the treatment of postpartum hemorrhage, especially massive postpartum hemorrhage and intractable postpartum hemorrhage. In clinical practice, allogeneic blood transfusion is the main method, while autologous blood transfusion is rare. The intraoperative cell salvage (IOCS) may lead to iatrogenic amniotic fluid embolism, allogeneic hemolysis and so on, which, to some extent, has hindered the development of IOCS in cesarean section. However, in recent years, with the increase of pregnant women with high risk, scar uterus and so on and the improvement of autotransfusion related technologies, the clinical application of IOCS in cesarean section has gradually increased, and its effectiveness and safety have been confirmed. It can not only reduce allogeneic blood transfusion, avoid its related complications and adverse reactions, but also solve the problem of scarcity of blood resources to some extent, at the same time reduce maternal and social economic burden, reduce the occurrence of adverse pregnancy outcomes, and even save maternal life. This article reviews the problems and clinical applications of blood salvage and blood doping in cesarean section. References | Related Articles | Metrics

Select

Research Progress in the Pathogenesis of Preterm Premature Rupture of Fetal Membranes ZHANG Ci-min，ZHANG Yan 2019, 46 (6):  641-644.  Abstract ( 817 )   PDF (649KB) ( 6351 )   Preterm premature rupture of fetal membranes (PPROM) is a common and troublesome obstetric complications. It causes many preterm births. And if it is not handled in time, it would seriously threaten the mothers and infants. In many low- and middle-income countries, the biggest impact of PPROM is neonatal death caused by premature birth. Many factors are related to the occurrence of PPROM, such as infection, uterine overdistention, smoking and genetic. Their pathways to membrane degradation and ultimate rupture overlap. The etiology and pathogenesis of PPROM are very complicated. Recent investigations identify matrix metalloproteinases (MMPs), amniotic cell apoptosis, and oxidative stress as primary mechanisms in these processes. This article reviews the latest research progresses on the pathogenesis of PPROM. By discussing the risk factors and mechanism of membrane weakening, which can provide clues to reduce the incidence of PPROM. References | Related Articles | Metrics

Select

Study on Vitamin D Levels of Maternal and Umbilical Cord Blood in Overweight/Obese and Nonobese Pregnant Women with Gestational Diabetes MIAO Jun，WANG Hui-yan，SHE Guang-tong，LIU Ke-zhuo 2019, 46 (6):  645-648.  Abstract ( 767 )   PDF (713KB) ( 6366 )   Objective: This study aims to compare the serum vitamin D (VD) levels in maternal and umbilical cord blood between obese and overweight-obese pregnant women with gestational diabetes (GDM). The possible influencing factors were analyzed. Methods: Pregnant women with full term deliveries in Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University from Jan. 2015 to Apr. 2017 were selected as study objects. The patients were divided into two groups: normal glucose tolerance group(NGT, 70 cases) and GDM group(70 cases). They were divided into four subgroups according to BMI further: NGT without obesity group (N1) , NGT with overweight-obese group (N2) , GDM without obese group (G1) and GDM with overweight-obese group (G2), with 35 cases respectively. The levels of serum 25(OH)D in maternal peripheral blood and umbilical cord blood were tested. The maternal fasting blood glucose (FBG), fasting insulin (FINS) were also tested and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Results: There was no statistical difference in maternal age, gravidity and parity history, gestational age, calcium and VD intake, time of sun exposure between these 4 groups(both P＞0.05). The VD levels of GDM were significantly lower than NGT group (G1 was lower than N1, G2 was lower than N2), the VD levels of obese pregnant women were significantly lower than non-obese pregnant women (N2 was lower than N1, G2 was lower than G1), the VD level of GDM with obese women was the lowest (P＜0.05). The level of VD in cord blood of neonates in GDM group was lower than that in NGT group (G1 was lower than that in N1, G2 was lower than that in N2), and the VD level of overweight and obese pregnant women in NGT group was lower than that in non-obese pregnant women (N2 was lower than that in N1), the difference was statistically significant (P＜0.05). Maternal VD level was negatively correlated with FBG and BMI before pregnancy, positively correlated with VD intake and duration of sun exposure in pregnancy, and umbilical cord blood VD level was positively correlated with maternal VD (P＜0.05). Conclusions: The VD levels of GDM pregnant women are generally low, which is more obviously seen in overweight and obese pregnant women. The blood vitamin D level of neonates is affected by maternal blood, while the maternal blood VD level is affected by FBG, BMI before pregnancy, VD intake during pregnancy and sun exposure time. References | Related Articles | Metrics

Select

Effect of Cardiac Correction on Pregnancy Outcomes in Women with Congenital Heart Disease：A Meta-Analysis HUANG Chu-bing，WANG Chen-hong，LIU Ying，WU Tan 2019, 46 (6):  649-656.  Abstract ( 797 )   PDF (4689KB) ( 6484 )   Objective：To evaluate the effect of cardiac correction on pregnancy outcomes in women with congenital heart disease. Methods：The studies published before September 2018 about the effect of cardiac correction on pregnancy outcomes in women with congenital heart disease were searched in PubMed, Cochrane Library, CNKI, VIP, WanFang data. Quality assessment and data collection were performed. The Meta-analysis was performed using RevMan 5.3 software. Results：A total of 17 cohort studies were included, including 1 181 patients. There were 457 patients in the operation group and 724 patients in the non-operation group. The results of the Meta-analysis showed that，for women with congenital heart disease, pre-pregnancy cardiac correction can improve cardiac function and reduce the incidence of heart failure，cesarean section, premature birth, fetal growth restriction, small for gestational age infant, neonatal asphyxia and perinatal mortality, all of which are statistically significant (P＜0.05). However, the difference between the operation group and the non-operation group was not statistically significant in terms of maternal mortality and neonatal heart disease incidence (P＞0.05). Conclusions：Women with congenital heart disease who underwent cardiac surgery correction before pregnancy generally had better pregnancy outcomes than women who did not undergo cardiac surgery correction. References | Related Articles | Metrics

Select

Changes of Antibiotic Resistance and Serotype Distribution of Group B Streptococcus in the Reproductive Tract of Pregnant Women during Perinatal Period XIE Yun，YANG Liu，QU Lei，WANG Li-bin，MENG Gai-li，YANG Jun-lan 2019, 46 (6):  657-660.  Abstract ( 825 )   PDF (701KB) ( 6489 )   Objective：To investigate the distribution characteristics of group B Streptococcus(GBS) serotypes isolated from pregnant women in Xi′an and the resistance spectrum of GBS to conventional antibiotics. Methods：A total of 498 GBS strains were collected from cultures of vaginal swabs of pregnant women in late pregnancy who received prenatal GBS screening in obstetrics department of Northwest Women′s and Children′s Hospital from January 2015 to December 2017． The serotype of GBS was determined by multiple PCR and the antibiotics sensitivity test and phenotype screening test were carried out. Results：All GBS isolates were sensitive to penicillin, ceftriaxone, vancomycin and linezolid. The resistance rates of GBS to erythromycin, clindamycin and levofloxacin were 76.7%, 73.5% and 58.0% respectively, and the resistance rate of erythromycin was increasing year by year. The predominant resistance phenotype was cMLSB(88.2%) among erythromycin-resistant strains, while iMLSB and M type strains accounted for only 5.5% and 6.3%. The most common serotypes were serotype Ⅲ, followed by Ⅰa, Ⅴ, type Ⅰb, Ⅱ and Ⅵ. Conclusions：(1) The vaginal colonization prevalence of GBS of pregnant women in Xi′an was similar to or slightly lower than that in other areas of China; (2) Six serotypes were identified with type Ⅲ being predominant; (3) The resistance rates of erythromycin, clindamycin and levofloxacin were higher than those of other areas, and the resistance rates of erythromycin were increasing year by year. References | Related Articles | Metrics

Select

Etiological Analysis and Exploration of 9 Cases of Complete Uterine Rupture ZHOU Xiao-yan，ZHANG Li，ZHAO Ai，ZHANG Mu-ling 2019, 46 (6):  660-663.  Abstract ( 885 )   PDF (687KB) ( 6373 )   Objective: To investigate the etiology, clinical characteristics and outcome of complete uterine rupture. Methods: A retrospective analysis was performed on the case data of 9 patients with complete uterine rupture admitted to the Affiliated Huai′an No.1 People′s Hospital of Nanjing Medical University from 2016 to 2018, and the general information and treatment process of the patients were summarized. Results: Nine patients with complete uterine rupture: Induced labor caused 4 cases of uterine rupture(2 cases were in the uterine body and 2 cases were in the original incision scar of the lower uterine segment), and placental implantation caused 1 case of uterine rupture (in the lower portion of the original incision scar). 1 case of unexplained uterine rupture(with a history of induced abortion, located at the bottom of the uterus) and one case of scar rupture after laparoscopic corner surgery (located at the uterine corner). Two cases of previous cesarean section scar incision rupture after uterine contraction (the original incision scar in the lower uterus). Two cases had persistent lower abdominal pain, 4 cases had irregular lower abdominal pain, 1 case had persistent umbilical pain, and 2 cases didn't have obvious abdominal pain. There were 6 cases with vaginal bleeding, and 3 cases without. Seven patients underwent uterine rupture repair and two underwent total hysterectomy. Of the 5 non-labored cases, 1 case of intrauterine fetal death, and the remaining 4 cases had good neonatal outcomes. Conclusions: Scarred uterus re-pregnancy is a high incidence of uterine rupture. Pregnant women with a history of uterine cavity operations such as placenta previa, multiple cesarean sections and abortions, and uterine surgery should be alert to the risk of uterine rupture. References | Related Articles | Metrics

Select

Effects of Active Labor Analgesia on Postpartum Cognitive Function in Women with Vaginal Delivery WU Ya-ping，QU Fu-juan，GUO Chu 2019, 46 (6):  664-667.  Abstract ( 826 )   PDF (739KB) ( 6311 )   Objective：To analyze the occurrence and influencing factors of postpartum cognitive dysfunction in active labor analgesia and non-labor analgesia. Methods: The 217 women with vaginal delivery in our hospital from January 2016 to December 2018 were selected as the research objects. According to the principle of voluntary selection, the women were divided into the labor analgesia group (82 cases) and the non-labor analgesia group (135 cases). The pain scores at different stages of labor and the incidences of cognitive dysfunction on the first and 42nd day of postpartum were compared between the two groups, and the influencing factors were analyzed. Results: The visual analogue score(VAS) score at 6 cm and 10 cm of uterine in the labor analgesia group were significantly lower than those in the non-labor analgesia group (P＜0.001), and there was no statistical difference in the VAS score at 3 cm in labor analgesia group (P＞0.05). The scores of the Montreal cognitive assessment(MoCA) and the symbol digit modalities test(SDMT90) in the labor analgesia group were significantly higher on the first day of postpartum, and the incidence of cognitive dysfunction was lower than those in the non-labor analgesia group (P＜0.05). There were no significant differences in the scores of MoCA and SDMT90 and the incidence of cognitive dysfunction between the two groups on the 42nd day of postpartum (P＞0.05). Non-labor analgesia and VAS score＞5 at 3 cm, 6 cm and 10 cm of uterine opening were the influence factors of cognitive dysfunction on the first day of postpartum (P＜0.05). Age ≥35 years and graduated from high school and below were not correlated with cognitive dysfunction on the first day of postpartum (P＞0.05). Conclusions: Labor analgesia can reduce the risk of postpartum cognitive dysfunction on the first day of postpartum by effectively relieving labor pain while non-labor analgesia and labor pain are independent risk factors of postpartum cognitive dysfunction. References | Related Articles | Metrics

Select

Persisting Pregnancy of Unknown Location: A Case Report and Literature Review JIAN Gui-li，REN Yu-huan，NAN Lian-ling，LIU Hui-fang，ZHANG Yu-fang 2019, 46 (6):  667-669.  Abstract ( 839 )   PDF (654KB) ( 6479 )   Pregnancy of unknown location is a pregnancy state and has a variety of clinical outcomes, such as intrauterine pregnancy, ectopic pregnancy, abortion of pregnancy of unknown location and persisting pregnancy of unknown location. Persisting pregnancy of unknown location is a clinical outcome that is less common in pregnancy of unknown location. Because of its lack of specificity in clinical manifestations and the location of the gestational sac can not be found, so it is difficult to diagnose and easy to be misdiagnosed. If the treatment is not timely, it may endanger the patient′s life because of rupturing of the gestational sac or bleeding or necrotizing of the gestational area. In the clinic, it is usually necessary to combine the blood hCG value, progesterone value and vaginal ultrasound results for diagnosis and treatment. In order to summarize the experience of the diagnosis and treatment of persisting pregnancy of unknown location, and further improve level of the diagnosis and treatment of persisting pregnancy of unknown location, a rare case of persisting pregnancy of unknown location was reported. References | Related Articles | Metrics

Select

One Case of Gestational Trophoblastic Neoplasia with Cerebral Hemorrhage as the Primary Manifestation WANG Hui-fei，GUO Yu-jing，LIU Yi，WANG Min，JIA Zan-hui 2019, 46 (6):  670-673.  Abstract ( 872 )   PDF (1650KB) ( 6355 )   Gestational trophoblastic neoplasia(GTN) is a group of heterogeneity related lesions caused by abnormal proliferation of placental trophoblastic cells, which can occur after full-term birth, preterm birth, miscarriage and other types of pregnancy, but its clinical manifestations are diverse. A case of trophoblastic tumor with cerebral hemorrhage as the primary manifestation is reported. The patient was admitted to hospital with cerebral hemorrhage and cerebral hernia, and was diagnosed as GTN with brain metastasis and pulmonary metastasis after completing relevant examinations. It is suggested that the possibility of brain metastasis of GTN should be considered when unexplained cerebral hemorrhage occurs in patients of reproductive age, especially those with recent pregnancy history, which has certain practical application value in clinical practice. References | Related Articles | Metrics

Select

Research Progress of the Relationship Between Perfluoroalkyl and Polyfluoroalkyl Substances and Ovarian Cancer LUO Cong-cong，LIN Pei-juan，YANG Yu-ni，LI Ping-fen，WANG Qu-yuan 2019, 46 (6):  674-678.  Abstract ( 876 )   PDF (797KB) ( 6375 )   Perfluorinated and polyfluoroalkyl substances(PFASs) are a new type of persistent organic pollutants(POPs) that are widespread in the environment and organisms and have many aspects of toxicity. Some experimental and epidemiological findings have shown that PFASs exposure is associated with ovarian cancer in women. In recent years, domestic and foreign reports on the relationship between PFASs and ovarian cancer have been increasing, among which the toxicology, epigenetics and the corresponding carcinogenic mechanism of PFASs exposure have become an important topic of discussion.This paper reviews the latest research progress on the relationship between PFASs and ovarian cancer, and discusses the existing problems and future research directions of PFASs. References | Related Articles | Metrics

Select

Research Status and Progress of Ovarian Carcinosarcoma QING Li-mei，LIU Cui-ping，TAO Fang-chun，ZHANG Jia-jun，LIU Chang，WANG Xiao-hui 2019, 46 (6):  679-683.  Abstract ( 1198 )   PDF (782KB) ( 6272 )   Ovarian carcinosarcoma is a highly invasive malignant tumor, which is more common in postmenopausal women. The tissue contains both cancerous and sarcoma components, and the incidence is low. Early diagnosis is difficult, and most of the visits are late. Compared with epithelial ovarian cancer, it is more malignant, less sensitive to chemotherapy, and has a worse prognosis. Because of its relatively rare nature, it is difficult to conduct large-scale prospective clinical studies, making the establishment of systematic treatment guidelines a huge challenge. Current treatments are mostly based on retrospective studies or treatment experience of epithelial ovarian cancer. Tumor cytoreductive surgery is the main surgical treatment. Regarding postoperative adjuvant chemotherapy, there is no standardized chemotherapy regimen in the world. Most studies support platinum-based combination chemotherapy, the role of radiotherapy is uncertain, and targeted therapy is under further study. References | Related Articles | Metrics

Select

New Progress in Lynch Syndrome-Associated Ovarian Cancer LIU Chang，DU Jing-ran，YANG Pan-pan，WANG Xiao-hui 2019, 46 (6):  684-687.  Abstract ( 929 )   PDF (782KB) ( 6408 )   Lynch syndrome (LS) is an autosomal dominant tumor syndrome, which is caused by a embryogenic mutation in a DNA mismatch repair (MMR) gene that causes the cell to have a microsatellite instablility-high (MSI-H) of super mutation or lack of MMR protein expression and thus causes the occurrence of tumor. Mutant carriers get a high risk of elaborating a range of malignancies such as colorectal cancer, endometrial cancer and ovarian cancer. Although the most common LS is colorectal cancer, about 60% of LS first cancers are gynecological malignancy (such as endometrial cancer, ovarian cancer), and they are diagnosed at an earlier age, most of the histopathology is endometrial or non-serous type, and the overall survival rate is good. Therefore, the timely discovery of the subclass of Lynch syndrome-associated ovarian cancer (LSAOC) is of great significance for preventing the occurrence of other tumors in LS patients and improving the survival rate of LS patients. At present, there are new explorations on the pathogenesis, histopathology and other aspects of LS. This paper reviews the latest progress of early diagnosis, histopathology, screening and risk reduction programs for LSAOC. References | Related Articles | Metrics

Select

Progress in the Application of Circulating Tumor DNA Detection in Ovarian Cancer LIU Yu，LIU Bin，QING Li-mei，LIU Cui-ping，XU Li-yuan，YANG Yong-xiu 2019, 46 (6):  688-692.  Abstract ( 887 )   PDF (792KB) ( 6376 )   Ovarian cancer has insidious onset and seriously endangers women′s health. The 5-year survival rate is extremely low due to lack of effective treatment. The mortality rate ranks first among gynecological malignant tumors. Therefore, the early diagnosis, early detection of recurrence and metastasis about ovarian cancer is of great significance, which is an urgent clinical condition waiting for improvement. However, the previous pathological examination and imaging examination of solid tumors cannot better change this situation. Circulating tumor DNA (ctDNA) is a kind of circulating free DNA (cfDNA) released after tumor cell necrosis and apoptosis, which carries all the epigenetic characteristics of tumor genome. As one of liquid biopsy method, ctDNA detection can reflect the state of tumor constantly and dynamically. In recent years, ctDNA detection has played an increasingly important role in early diagnosis, drug resistance prediction and efficacy evaluation of ovarian cancer. The article reviews application progress of ctDNA in clinical diagnosis and treatment of ovarian cancer, discusses the problems that need to be solved, and provides potential directions for its application in ovarian cancer. References | Related Articles | Metrics

Select

Genetic Predisposition in Gynecologic Cancers WANG Xin，HU Dan，LI Yong-xia，ZHANG Jia-jun，YANG Yong-xiu 2019, 46 (6):  693-697.  Abstract ( 806 )   PDF (811KB) ( 6401 )   Gynecological malignancy is a serious threat to women′s health. In recent years, with the development of technology, genetic susceptibility has been paid more and more attention in many factors affecting the development of gynecological tumors. Studies show that up to 10 percent of tumors can be attributed to genetic mutations which increases an individual′s susceptibility to certain cancers. The biggest challenge for individuals at particular risk of cancer is to develop and popularize better testing methods to detect high-risk groups in a timely manner. In this field, China started late and developed slowly and genetic screening programs have not been widely popularize to current screening program of gynecological oncology. In this review, the most common hereditary cancer syndromes in gynecological hereditary tumors, including hereditary breast-ovarian cancer syndrome, Lynch syndrome and multiple hamartoma syndrome, are reviewed from the aspects of clinical features, gene and gene detection, prevention and treatment, so as to increase people′s comprehensive understanding to hereditary cancer syndromes. This paper emphasizes that all high-risk groups should be screened for relevant genes, and clinical intervention should be implemented before the onset of disease, which can benefit patients. References | Related Articles | Metrics

Select

Advances in Parasitic Leiomyoma DAI Chun-yang，HAN Lu 2019, 46 (6):  698-701.  Abstract ( 942 )   PDF (778KB) ( 6301 )   Parasitic leiomyoma is a special type of uterine leiomyoma, and its incidence is very low. The causes may be related to the level of estrogen and progesterone, peritoneal metaplasia, genetic factors and iatrogenic factors. In recent years, the cases of secondary parasitic leiomyoma after laparoscopic surgery have been paid more and more attention. Because the clinical manifestations of most of the patients were non-specific, only some of the symptoms such as pelvic and abdominal pain were found during routine physical examination or other operations, so the actual incidence of the disease may be higher than the reported incidence. Making a good assessment before the operation, reducing the operation of the suspected malignant tumor, using a specimen bag, strictly abide by the principle of surgical non-tumor, using transvaginal or umbilical incision to remove the path, the surgical closure of the full washing of the abdominal cavity, instruments and punctures are the key methods to prevent the occurrence of parasitic leiomyoma. References | Related Articles | Metrics

Select

Compassion of Screening Methods for Cervical Precancerous Lesions in Postmenopausal Women LIU Rong，MA Yan 2019, 46 (6):  702-705.  Abstract ( 967 )   PDF (797KB) ( 6563 )   Objective：To explore the role of cervical cytology and human papillomavirus (HPV) screening of cervical precancerous disease in postmenopausal women. Methods：113 postmenopausal cases who underwent colposcopic biopsy due to screening abnormality were performed in a retrospective analysis from October 2017 to September 2018. The detection of cervical lesions by different TCT and HPV results was analyzed. The sensitivity, specificity, PPV and NPV of TCT and HPV detection in high squamous intraepithelial lesions (HSIL) were compared. Results：There was no significant difference between the distribution of high-risk HPV (HR-HPV) infection and cervical lesions in postmenopausal women ( χ2=0.809, P=0.303). It had statistically significance that those with high-risk in cytology or positive results in immunohistochemistry had severer cervical diseases than the counterparts( χ2=29.018, P=0.000; r=0.389, P=0.000). Sensitivity, specificity, PPV and NPV of TCT and HR-HPV testing in postmenopausal women were separately 78.38%, 75.00%, 60.42%, 87.69% and 94.59%, 10.13%, 33.98%, 80.00%. Conclusions: Postmenopausal women with high TCT level and positive immunohistochemistry have the risk of high-level cervical lesions, which should be paid attention to by clinicians. References | Related Articles | Metrics

Select

Risk Factors of Urinary Incontinence after Radical Resection of Cervical Cancer LI Xing-chen，DONG Yang-yang，YANG Xiao，SHEN Bo-qiang，CHENG Yuan，WANG Jian-liu 2019, 46 (6):  706-708.  Abstract ( 1270 )   PDF (792KB) ( 6233 )   Objective: To investigate the risk factors of postoperative urinary incontinence (UI) in patients with cervical cancer (CC) and provide evidence for prevention and individualized treatment of UI after radical resection of CC. Methods: This is a retrospective analysis of patients who had UI or no postoperative complications after radical resection of CC at Peking University People′s Hospital from January 2013 to December 2018. 14 patients with urinary incontinence in stage ⅠA1 to ⅡA2 after surgery were assigned to UI group and another 43 patients who were treated with radical CC resection at the same time without UI were selected as the control group. The general data and clinicopathological data were recorded and the risk factors of CC complicated with UI were analyzed. Results: Univariate analysis showed UI was closely related with difference in hemoglobin levels before and after surgery, number of resected lymph nodes, operative time, length of vaginal amputation and difference between annual surgery frequencies of surgeons (P＜0.05). Multivariate Logistic analysis revealed that the high hemoglobin difference levels before and after surgery (OR=1.164, 95%CI: 1.006-1.348, P=0.042), longer operative time (OR=79.896, 95%CI: 2.033-3 139.492, P=0.019) and low annual surgery frequencies of the surgeon (OR=13.116, 95%CI: 1.046-164.436, P=0.046) were significantly associated with postoperative UI. Conclusions: For CC patients with high hemoglobin difference levels before and after surgery, longer operative time and low annual surgery frequencies of the surgeon, effective comprehensive measures should be taken in time to prevent UI. References | Related Articles | Metrics

Select

A Case Report of Primary Ovarian Mature Cystic Teratoma Complicated with Thyroid Carcinoid Disease XIA Wei-hao，ZHOU Wei，CHEN Wen-jing，ZHOU Yi-hui 2019, 46 (6):  709-712.  Abstract ( 1467 )   PDF (4296KB) ( 6418 )   Ovarian mature cystic teratoma complicated with thyroid carcinoid is a rare ovarian malignant tumor. Thyroid carcinoid is derived from endodermal sinus tumor in germ cell tumor, and its incidence rate is very low, accounting for only about 0.1% of ovarian malignancies thyroid carcinoid is a low grade neuroendocrine tumor with low malignancy and good prognosis. Metastatic cancer should be excluded first in the diagnosis, and then differentiated from ovarian granulosa cell tumor, supporting cell tumor, malignant ovarian goiter and so on. The main treatment is surgery, but because of the disease is rare, the standard of treatment plan has not yet been established. In recent years, there have been new advances in clinical features, pathology, immunohistochemistry, and treatment for primary ovarian mature cystic teratoma complicated with thyroid carcinoid. This article reports a case and discusses the research progress of the disease, providing a reference for follow-up treatment. References | Related Articles | Metrics