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15 February 2020, Volume 47 Issue 1
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Research Progress on Correlation between Vaginal Microenvironment and HPV Infection WANG Qiang，GUO Jie，SONG Dian-rong 2020, 47 (1):  5-9.  Abstract ( 1243 )   PDF (838KB) ( 7554 )   HPV infection is the only clear pathogenic factor that can lead to cervical cancer, but HPV infection is not equal to cervical cancer or cervical precancerous lesions, which suggests a possibility of developing cervical lesions. Therefore, effective screening and prevention are effective measures to reduce the incidence of HPV infection and cervical lesions. The cervical vagina is in the vaginal microenvironment. The normal vaginal microenvironment is composed of vaginal anatomy, microbial flora, local immunity and endocrine regulation of the body. They interact with each other and are always in a state of dynamic balance. When the vaginal flora, pH value, local immunity, and estrogen and progesterone levels change, the body′s susceptibility to HPV increases, and the clearance is reduced. In view of the close relationship between vaginal microenvironment and HPV infection, this article reviews the literature on the relationship between HPV infection and vaginal microenvironment. References | Related Articles | Metrics

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Research Progress on Cervical Cancer Related Significantly Mutated Genes FU Pei-qiang, WANG wei, HAO Min 2020, 47 (1):  10-14.  Abstract ( 2001 )   PDF (768KB) ( 7714 )   Cervical cancer is the most common gynecological malignant tumor. In developing countries, the incidence and mortality of cervical cancer are always high. Although the research on cervical cancer has been widely carried out, its specific mechanism and synergistic factors have not yet been elucidated. In recent years, more and more attention has been paid to the relationship between gene mutations and cervical cancer. Numerous studies have shown that changes in oncogenes, tumor suppressor genes and related regulatory genes are closely related to the development of cervical cancer and the progression of the disease. With the application of genome sequencing technology in cancer, more gene mutations are found in cervical cancer, and the identification of significant mutations can help further lock cancer-driven genes, so significant mutations may be the key to discover the underlying mechanisms of cancer. This overview of recent research status of the newly discovered significant mutations ErbB-3, HLA-A, CASP8 and TGFBR2 in cervical cancer may provide new ideas for the mechanism research, diagnosis and targeted therapy of cervical cancer. References | Related Articles | Metrics

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Research Progress of Endometrial Cancer Classification JIN Ming-zhu, DI Wen 2020, 47 (1):  15-18.  Abstract ( 2506 )   PDF (734KB) ( 10225 )   Endometrial carcinoma is one of the three major malignant tumors in gynecology. The standard treatment is surgery with/without radiotherapy and chemotherapy; for those who desire to retain their fertility can be treated conservatively after consultation and accomplish the operation after childbirth. In 1983, Bockman proposed clinical classification of endometrial cancer, which was divided into typeⅠ（estrogen-dependent） and typeⅡ（non-estrogen-dependent）; in 1994, Poulsen classified endometrial cancer into adenocarcinoma, serous adenocarcinoma, mucinous adenocarcinoma, clear cell carcinoma, squamous cell carcinoma, mixed carcinoma, and undifferentiated carcinoma by histopathology; in 2013, endometrial carcinoma was divided into four types based on different mutation patterns and copy number by the Cancer Genome Atlas （TCGA）: polymerase epsilon（POLE） mutated, microsatellite instability, copy number-low and copy number-high. The molecular classification has important guiding significance for the precise treatment of patients with different subtypes and prognosis prediction of patients. In this review, we summarize three classifications of endometrial carcinoma, list their advantages and limitations, and highlight the clinical significance of endometrial cancer. The continuous improvement of classification of endometrial cancer will help to understand the heterogeneity in prognosis, guide the choice of treatment strategies, and lay a theoretical foundation for standardized, individualized and humanized treatment in the era of precision medicine. References | Related Articles | Metrics

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Long Non-Coding RNA and Endometrial Cancer: A Review LI Mu-bai, WANG Ting-ting, CHEN Jing-xin, MA Hong-li 2020, 47 (1):  19-24.  Abstract ( 1218 )   PDF (821KB) ( 7626 )   Endometrial cancer is one of the common malignant tumors in gynecology, and its incidence is increasing year by year. Long non-coding RNA (lncRNA) is a member of the non-coding RNA family. In recent years, it has been found that it plays an important regulatory role in the pathological process of endometrial cancer and has become a research hotspot. LncRNA can be used as a promoter gene via human chromosome 10 deletion with phospho- and tensin homologue/phosphatidylinositol-3 kinase/protein kinase B/mammalian rapamycin target protein (PTEN/PI3K/AKT/mTOR), Wnt/β-catenin (Wnt/β-Catenin), extracellular signal-regulated kinase/adenylate-activated protein kinase (ERK/AMPK) and other signaling pathways to regulate proliferation, migration, invasion, and apoptosis of endometrial cancer cells. LncRNA can also inhibit the process of endometrial cancer through the PTEN/PI3K/AKT/mTOR pathway. In the process of lncRNA regulation of endometrial cancer, the formation of lncRNA-miRNA axis can be used as a new direction for future intervention therapy. LncRNA can also affect the drug resistance of chemotherapeutic drugs, and has important value for the diagnosis and prognosis of endometrial cancer. This review summarizes the recent studies of lncRNA and endometrial cancer, providing a theoretical basis for the diagnosis, prognosis or therapeutic targets of endometrial cancer. References | Related Articles | Metrics

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Reseach Progress of Epithelial Ovarian Cancer Related Long Non-Coding RNA TAN Fang-chun, LI Li 2020, 47 (1):  24-27.  Abstract ( 1077 )   PDF (733KB) ( 7549 )   Ovarian cancer is the second most common malignant tumor in the female reproductive system. Its development involves a variety of genetic and environmental factors. Its low survival rate and easy recurrence have become the focus and difficulty of research. The genome project has shown in recent years that less than 2% of the nucleic acid sequences in the genome sequence can be used to encode proteins, and the remaining 98% of the sequences do not encode any proteins. These gene sequences were once considered "non-functional sequences", but recent studies have shown that these non-functional sequences contain a wealth of information and functions. Most of these non-functional sequences are long non-coding RNAs (lncRNAs) with more than 200 bases. LncRNAs are a group of endogenous cellular RNAs encoded by the mammalian genome that are more than 200 bp in length. Many researchers at home and abroad have discovered a few lncRNAs related to malignant tumors, and they believe that lncRNAs may play a role in regulating tumorigenesis and invasion. This article summarizes the research progress of lncRNA in ovarian cancer. References | Related Articles | Metrics

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Advances in Research of Exosome MiRNAs in Ovarian Cancer ZHANG Li, YUAN Meng-qin, WANG Yan-qing, LIU Shi-yi, YANG Xiao, CHENG Yan-xiang 2020, 47 (1):  28-32.  Abstract ( 994 )   PDF (758KB) ( 7615 )   The ovarian cancer (OC) mortality rate ranks first among tumors of female reproductive system. Due to lack of early typical symptoms, most patients are diagnosed at advanced stage. Moreover, it is inclined to relapse because of resistance to chemotherapy, resulting in poor prognosis. Therefore, finding effective early diagnosis and treatment is of great significance for early prediction, evaluation, prognosis and recurrence of OC. Exosome is a hotspot in recent years, which is rich in lipids, proteins, RNA and DNA, etc. It is released into the extracellular environment through fusing with cell membranes, affecting the biological behavior of adjacent or distant cells. Furthermore, exosome participates in intercellular communication in the tumor microenvironment and affects the progression of the tumor by transmitting oncogene or tumor suppressor molecules. MicroRNAs (miRNAs) can be encapsulated in exosomes and delivered to recipient cells, playing an important role in tumor progression. This paper reviews the research of exosome miRNAs in OC. References | Related Articles | Metrics

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Diagnosis and Treatment of LEEP for High-Grade Cervical Squamous Intraepithelial Lesions in Postmenopausal Women ZHANG Bo，MA Xiao-li，MENG Ge 2020, 47 (1):  33-36.  Abstract ( 1347 )   PDF (762KB) ( 7404 )   Objective: To investigate the clinical value of loop electrosurgical excision procedure (LEEP) in the diagnosis and treatment of high-grade cervical squamous intraepithelial lesions in postmenopausal women. Methods: 142 patients with high-grade squamous intraepithelial lesion (HSIL) who underwent LEEP in Department of Gynecology Minimal Invasive Center of Beijing Obstetrics and Gynecology Hospital from February 2017 to December 2018 were collected，including 40 patients in postmenopausal group, 102 patients in premenopausal group. All results of patients′ thinprep cytologic test (TCT), human papilloma virus (HPV) test, colposcopy and biopsy pathology, postoperative pathological examination and pathological examination of incision margin were collected. The data were compared between the two groups. Results: The difference of the cervical transformation zone type under colposcopy was significant between the two groups (χ2=28.658，P=0.000). The consistence rate of pathology between colposcopic biopsies and post-LEEP was 50.00% (20/40) in the group of postmenopausal women, and that in the group of premenopausal women was 51.96% (53/102). There was no statistical difference between the two groups ( χ2=0.044, P=0.854). In the group of postmenopausal women, 1 case of the pathological examination results after LEEP was escalated to cervical cancer. In the group of premenopausal women 1 case was escalated to cervical adenocarcinoma in situ. 8 cases′ surgical margins were positive in the group of postmenopausal women. The cases with positive surgical margins were 16 in the group of premenopausal women. The difference was not significant ( χ2=0.381, P=0.537). The difference of the results of TCT and HPV test after LEEP in the two groups was not significant (P＞0.05). Conclusions: LEEP is suitable for the diagnosis and treatment of HSIL in postmenopausal women without obvious cervical atrophy. It helps to avoid missed diagnosis and overtreatment. References | Related Articles | Metrics

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The Expression Levels and Significances of DR5 and FADD in Uterine Leiomyoma TANG Liang, WANG Min, ZHANG Li-jun, WANG Mei, XIAO Yan 2020, 47 (1):  37-40.  Abstract ( 1122 )   PDF (4373KB) ( 7473 )   Objective: To investigate the expressions of death receptor 5 (DR5) and apoptosis promoting protein (FADD) in uterine leiomyoma and their clinical significances. Methods: 72 patients who underwent hysteromyomectomy in our hospital from March 2017 to May 2018 were selected as the study subjects. The uterine leiomyoma tissue resected surgically was used as the myoma tissue group and the adjacent tissue 5 cm away from the edge of the tumor was used as the adjacent tissue group. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expressions of DR5 and FADD, the expressions of DR5 and FADD were detected by immunohistochemistry, TUNEL method was used to count apoptosis, and the correlations between DR5, FADD and apoptosis and the correlation between them was analyzed. Results: The positive expression rates of DR5 mRNA and protein in the myoma tissue group were higher than those in the adjacent tissue group (P＜0.05), and the positive expression rates of FADD mRNA and protein were lower than those in the adjacent tissue group (P＜0.05). AI in the myoma tissue group was lower than that in the adjacent tissue group, PI was higher than that in the adjacent tissue group (P＜0.05). In uterine leiomyoma, the expression of DR5 was negatively correlated with AI (P＜0.05), and positively correlated with PI (P＜0.05), the expression of FADD was positively correlated with AI (P＜0.05), and negatively correlated with PI (P＜0.05). DR5 was negatively correlated with FADD (P＜0.05). Conclusions: In uterine leiomyoma, DR5 is highly expressed, FADD expression is low, and they are negatively correlated. Both of them are significantly correlated with AI and PI, which may participate in the occurrence and development of uterine leiomyoma. References | Related Articles | Metrics

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The Expression and Clinical Significance of Annexin A8 in Ovarian Epithelial Serous Tumors ZHU Lian-cheng，GOU Rui，GUO Qian，LI Xiao，LIU Juan-juan，YU Guan-nan，HAO Ying-ying，YAN Li-mei，JIN Shan，LIN Bei 2020, 47 (1):  41-45.  Abstract ( 892 )   PDF (4216KB) ( 7459 )   Objective：To detect the expression of Annexin A8 (ANXA8) in ovarian tissues and to investigate the relationship between its expression and clinicopathological parameters as well as prognosis in patients with ovarian epithelial serous carcinoma. Methods：Immunohistochemical (IHC) staining (SP method) for ANXA8 was conducted on tissues of 11 cases of normal ovaries, 13 cases of benign serous ovarian tumors, 17 cases of borderline serous ovarian tumors and 34 cases of malignant epithelial serous ovarian tumors, IHC results were compared to the clinical pathological parameters and prognosis of these malignant tumors. Results：The expression of ANXA8 was mainly located in cell membrane and cytoplasm, its high positive expression rate in epithelial serous ovarian carcinoma (23/34, 67.65%) was significantly higher than those in normal (1/11, 9.09%), benign (3/13, 23.08%) and borderline (5/17, 29.41%) epithelial serous ovarian tumors (P=0.001, 0.006, 0.010, respectively). Among these 34 cases of epithelial serous ovarian carcinoma, the high positive expression rate of ANXA8 in FIGO Stages Ⅲ-Ⅳ (21/24, 87.5%) was significantly higher than Stages Ⅰ-Ⅱ (2/10, 20.0%), P＜0.001; and the high positive expression rate of ANXA8 in patients with residual tumor size ＞1 cm (15/17, 88.2%) was significantly higher than ≤1 cm (8/17, 41.2%), P=0.010. Kaplan-Meier survival analysis showed that FIGO stage, lymph node metastasis, residual tumor, as well as high expression of ANXA8 were associated with a shorter overall survival (OS, all P＜0.05), multivariate Cox survival analysis demonstrated that high expression of ANXA8 was an independent risk factor for prognosis of epithelial serous ovarian carcinoma patients (P=0.019, HR=11.465, 95%CI: 1.498-87.757). Conclusions：The expression of ANXA8 was obviously increased in epithelial serous ovarian cancer and associated with poor prognosis of ovarian carcinoma, it can be used for clinical monitoring of patients with epithelial serous ovarian carcinoma. References | Related Articles | Metrics

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Inhibitory Effects of ABC294640 on Invasion and Metastasis of Ovarian Cancer SONG Ke-qi, DAI Lan, TIAN Qi, DI Wen 2020, 47 (1):  46-49.  Abstract ( 783 )   PDF (8402KB) ( 7388 )   Objective：ABC294640 has shown its unique efficacy in the treatment of cancer. The purpose of this study was to investigate the inhibitory effect of ABC294640 on invasive and metastatic abilities of ovarian cancer cells and to explore its mechanism. Methods：Transwell experiments were preformed to detect the effect of ABC294640 on invasion and migration of ovarian cancer cells, and the regulatory effect of ABC294640 on the expression of c-Myc protein in ovarian cancer cells was analyzed by Western blotting. An intra-abdominal xenograft tumor model of ovarian cancer was set up to observe the effect of ABC294640 on the metastasis in vivo. Results：The ability of invasion and metastasis of ovarian cancer cells were significantly inhibited after the treatment with 50 μmol ABC294640 and the expression of c-Myc protein in ovarian cancer cells significantly decreased (P＜0.01). In the intra-abdominal xenograft tumor model of ovarian cancer in nude mice, the tumor number of abdominal metastases in ABC294640 group was significantly reduced compared with the control group. The expression level of c-Myc in tumor tissue was significantly lower than that in control group (P＜0.01). Conclusions：ABC294640 inhibited the invasion and migration of ovarian cancer cells, and its anti-invasion and metastasis mechanism might be related to the down-regulation of c-Myc protein expression. References | Related Articles | Metrics

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Severe Hyponatremia Caused by Cisplatin Chemotherapy: A Case Report and Literature Review LI Guang, WANG Hui, LI Zi-yang, LIU Guo-bing 2020, 47 (1):  50-54.  Abstract ( 1014 )   PDF (979KB) ( 7456 )   Cisplatin is widely used in clinic. It is often used in combination with other chemotherapeutic drugs in the treatment of lung cancer, head and neck cancer, esophageal cancer, gynecological and urinary system cancer. Hyponatremia caused by cisplatin chemotherapy is uncommon in clinic, with the incidence of 4%-10%. Severe hyponatremia is rare. Special attention should be paid to the occurrence of hyponatremia in the course of chemotherapy with platinum-containing chemotherapy regimen. The symptoms of the disease are atypical and the mechanism is different. It needs timely and accurate diagnosis and effective treatment. This paper reports a case of severe hyponatremia in gestational trophoblastic neoplasm during chemotherapy. The etiology was analyzed and treatment suggestions were put forward. References | Related Articles | Metrics

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Ovarian Fibroma with Massive Ascites and Increased CA125: A Case Report and Literature Review CHU Qi，MA Shuai，ZHENG Lian-wen 2020, 47 (1):  54-55.  Abstract ( 1096 )   PDF (706KB) ( 7564 )   Ovarian fibroma originates from the sex cord stroma. About 10%-15% of ovarian fibroma may be combined with hydrothorax or ascites, also known as Meigs syndrome. The clinical data of a case of ovarian fibroma with increased CA125 and Meigs syndrome admitted to the Obstetrics and Gynecology Department of Jilin University Second Hospital in February 2019 were retrospectively analyzed. The patient with CA125＞1 000 U/mL, which was highly suspected of ovarian malignancy, was admitted due to abdominal distension for 2 months. Postoperative pathological diagnosis was fibroma of ovarian stromal origin. After surgery, CA125 of the patient fell to the normal range and ascites disappeared. It is suggested that clinicians should consider the possibility of ovarian fibroma combined with Meigs syndrome in young patients presented with ascites, ovarian mass, and increased CA125, so as to avoid misdiagnosis as ovarian malignant tumor. References | Related Articles | Metrics

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Effects of Trace Elements on Pregnancy and Fetal Development WU Wang-shu，ZHU Xin-ye，JIANG Chen-yi，SHI Lei，YU Cheng-xuan，WANG Zhi-jie，LIU Yue，DING Zhi-de 2020, 47 (1):  56-60.  Abstract ( 1108 )   PDF (777KB) ( 7603 )   Trace elements, involved in many physiological processes in human body, are important to pregnancy and fetal development. The lack or excess of trace elements can increase the risk of pregnancy complications and affect normal fetal development. For instance, iron deficiency can result in iron-deficiency anemia (IDA), increasing the risk of maternal infection and fetal brain development impairment. Decreased maternal serum zinc level is associated with an increased risk of gestational diabetes mellitus (GDM) and pre-eclampsia (PE), as well as abnormal body and nervous system development of fetus. Maternal exposure to manganese can impair the fetal nervous system development. Low copper concentration in maternal serum is related to a variety of adverse pregnancy outcomes, including spontaneous abortion, fetal growth restriction (FGR), premature rupture of membranes (PROM), etc. Selenium deficiency is also closely associated with an increased risk of GDM and PE, however, excess selenium intake can lead to increased lipid level in umbilical cord blood. Reviewing the effects of trace elements on pregnancy and fetal development can devote a great deal of clinical significance to avoiding the pregnancy risk and promoting fetal normal development as well. References | Related Articles | Metrics

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Research Progress of MAPK1/ERK2 Regulating Neutrophil Elastase Secretion through SRF in the Pathogenesis of Pre-Eclampsia WANG Fei, WANG Yong-hong 2020, 47 (1):  61-63.  Abstract ( 1094 )   PDF (739KB) ( 7578 )   Pre-eclampsia(PE) is a gestational idiopathic disease involving multiple organs of the body and one of the leading causes of maternal and perinatal death. The mechanism includes excessive oxidative stress, excessive activation of inflammation and immune system, and dysfunction of vascular endothelial, etc. Among them, the key link is that neutrophils over-activate and release elastase, leading to damage of vascular endothelial cells. It was found that levels of mitogen-activated protein kinase 1 (MAPK1) and neutrophil elastase(NE) were significantly increased in neutrophils of PE. Serum response factors（SRF） are downstream target proteins of MAPK1 pathway, which cause adhesion and migration of activated neutrophils and damage of endothelial cells. MAPK1 may be involved in the pathogenesis of PE by regulating SRF and thereby leading to the over-activation of neutrophils and the release of NE. The mechanism of MRPK1 regulating NE secretion through SRF will be reviewed in this paper. References | Related Articles | Metrics

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Role of TNF-α in Regulating MPO Secretion in the Pathogenesis of Pre-Eclampsia XU Zhen-hua，WANG Yong-hong 2020, 47 (1):  64-67.  Abstract ( 795 )   PDF (748KB) ( 7451 )   Pre-eclampsia (PE) is a pregnancy-specific idiopathic disease that causes an increase in maternal and neonatal morbidity and mortality worldwide. At present, the cause is not completely clear, and it is difficult to predict changes by a single biomarker. Termination of pregnancy is the only effective treatment for patients with PE who show no improvement or progressive deterioration after active treatment. Scholars believe that vascular endothelial cell injury is the main pathogenesis of PE. Recent studies have found that abnormal expression of tumor necrosis factor alpha (TNF-α) in plasma of PE patients is involved in the occurrence and development of the disease. Upon binding of TNF-α to related receptors, activation of the mitogen-activated protein kinase (MAPK) signaling pathway results in upregulation of the downstream target protein myeloperoxidase (MPO). The release of MPO after excessive activation of neutrophils, and its increased expression level is a key factor of vascular endothelial cell injury. To review the research progress on the mechanism of TNF-αregulating MPO in the pathogenesis of PE. References | Related Articles | Metrics

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Exploration of YY1 in the Regulation of Trophoblast Function Through TGF-β1 Signal Axis XIAN Shu, WANG Yan-qing, CHENG Yan-xiang 2020, 47 (1):  68-72.  Abstract ( 925 )   PDF (6941KB) ( 7302 )   Objective: To investigate the effects of YY1-TGF-β1-MMPs signal axis on trophoblast cell activity, invasion and migration. Methods: HTR8/SVneo trophoblast cell line was used as the research object to construct the cell model of the YY1 knockdown (siYY1) group and the normal expression (NC) group. The experimental groups were divided into NC group, siYY1 group and siYY1+SD-208 (TGF-β inhibitor, 1 μmol/L, 48 h) group. RT-PCR and Western blotting were used to detect the expression of the signaling pathway related molecules; CCK-8 was used to detect cell viability; scratch assay and Trans-well assay were used to detect cell migration and invasion. Results: The cell viability, migration and invasion ability of siYY1 group were significantly attenuated, and the expression levels of MMP-2 and MMP-9 were significantly decreased, while TIMP1 and TIMP2 were significantly increased. In addition, the expression levels of TGF-β1, Smad2 and Smad3 were significantly increased, while the expression of inhibitory Smad7 was decreased. Subsequent treatment with TGF-β inhibitors significantly improved the activity, invasion and migration of YY1 knockdown cells. Conclusions: The signal axis of YY1-TGF-β1 can regulate the activity, invasion and migration of trophoblast cells, which may be involved in embryo implantation and placental development, resulting in miscarriage. References | Related Articles | Metrics

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Nested Case Control Study of Sleep-Disorder Breathing and Spontaneous Preterm Birth LI Yan, ZHANG Hua, MA Xiu-hua 2020, 47 (1):  73-76.  Abstract ( 921 )   PDF (807KB) ( 7414 )   Objective：To explore whether sleep-disorder breathing is a risk factor of spontaneous preterm birth in late pregnancy. Methods：This is a nested case control study, from October 2018 to May 2019, pregnant women in the late pregnancy in People′s Hospital of Beijing Daxing District were collected as subjects. Relevant data of pregnant women were collected, including demographic information, medical history information, Berlin Questionnaire (BQ), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Spontaneous preterm birth was diagnosed according to the clinical diagnosis and treatment guidelines for preterm birth in China (2014). The spontaneous preterm birth group (46 cases) and the term birth group (407 cases) without complications at the same time were determined. The general situation of pregnant women, sleep disorders of breathing questionnaire scores were compared between the two groups. The independent risk factors of spontaneous premature birth were analyzed. Results：The age, body mass index before pregnancy, previous abortions frequent, and the history of preterm birth of the pregnant women in the spontaneous preterm birth group were higher than those in the term birth group, and the education level was lower than that in the term birth group, the differences were statistically significant (P＜0.05). The PSQI score and the high risk of obstructive sleep apnea (BQ-positive) in spontaneous preterm birth group were higher than those in the term birth group (P＜0.05). Logistic regression analysis showed that the risk of spontaneous preterm birth in BQ-positive pregnant women was 2.61 times higher than that in BQ-negative pregnant women (OR=2.61, 95%CI: 1.21-5.64, P=0.015). Conclusions：Pregnant women with high risk of obstructive sleep apnea are more likely to have spontaneous preterm birth. References | Related Articles | Metrics

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Analysis of Clinical Features of Pregnancy-Associated Fulminant Type 1 Diabetes Mellitus YAO Yi-qian，WU Xiao-xian，WANG Yun 2020, 47 (1):  77-80.  Abstract ( 944 )   PDF (761KB) ( 7467 )   Objective: To investigate the clinical features as well as maternal and neonatal outcomes of pregnancy-associated fulminant type 1 diabetes mellitus (PF). Methods: A case of PF was reported in our hospital. A total of 35 cases of PF were reported in a literature case. The characteristics of PF, laboratory examination, and maternal and neonatal outcomes were retrospectively analyzed. Results: The mean age of patients was (27.62±4.70) years old, the median time from symptom onset to treatment was 1 d, the blood glucose at the time of admission was (33.19±9.11) mmol/L. Urine ketone body was 1+ to 4+, mean serum creatinine was (141.43±98.54) umol/L, glycated hemoglobin (HbA1c) averaged (6.39±0.74)%, blood K+ average (5.76±1.37) mmol/L, blood Na+ average value was (128.83±4.64) mmol/L, the average value of pH in blood gas analysis was(7.06±0.14). Among the 36 cases, the incidence of stillbirth in the second trimester was 90%, and the perinatal mortality rate was 90.48%. No maternal deaths occurred. Twenty-six of the 36 maternal women were followed up to post-partum insulin therapy. Conclusions: Patients with PF rapidly progress to critical illness, which may cause abortion or fetal death. Clinicians should improve their understanding of the disease in order to improve maternal and child outcomes through early detection and early intervention. References | Related Articles | Metrics

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Case Report about a Successful Delivery by the Natural Cycle of IVF-ET after the Operation and Chemical Treatment of Ovarian Yolk Sac Tumor, and Literature Review LI Ya, BAI Xiao-hong, ZHAO Xiao-hui 2020, 47 (1):  81-84.  Abstract ( 1034 )   PDF (764KB) ( 7551 )   Ovarian yolk sac tumor is a kind of ovarian malignant germ cell tumor, accounting for 1% of ovarian malignant tumors. As malignant ovarian germ cell tumors are more common in children and young women, fertility preservation is the key. Ovarian yolk sac tumor is sensitive to chemotherapeutic drugs. Operation combined with postoperative adjuvant chemotherapy is the standard treatment. For the contralateral ovary and uterus not affected by tumor, fertility preservation surgery should be carried out. However, the tumor itself, surgery and chemoradiotherapy may cause infertility in patients, assisted reproductive technology may be needed after surgery. In this paper, through a case report of a patient with ovarian yolk sac tumor undergoing NC-IVF-ET after surgery and postoperative chemotherapy and literature review, the fertility assisted strategy of patients with ovarian yolk sac tumor was discussed. References | Related Articles | Metrics

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Advances in Research on Metabolic Syndrome in Perimenopausal Women HUANG Zhi-ying, DING Yan 2020, 47 (1):  84-87.  Abstract ( 875 )   PDF (744KB) ( 7410 )   etabolic syndrome is a serious threat to the health and quality of life of perimenopausal women. Diabetes and dyslipidemia are main parts of it，its central link is abdominal obesity and insulin resistance. Due to the decline of ovarian function, sex hormone levels of perimenopausal women have a series of changes, which have a certain impact on lipid metabolism and bone mineral density. However, the specific mechanism of women developing MS at this stage has not been fully clarified. Genetic factors and environmental factors may be related to the occurrence of MS in perimenopausal women. Individualized life style interventions and hormone replacement therapy can reduce the incidence of MS in postmenopausal women. This article reviews the relationship between female sex hormones and MS, the prevalence, treatment as well as management of MS. References | Related Articles | Metrics

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Research Progress on Irisin and Metabolic Disorders of Polycystic Ovary Syndrome LI Yang，YAN Hong-liang，HU Tong-xiu，SHANG Yu-min 2020, 47 (1):  88-91.  Abstract ( 960 )   PDF (738KB) ( 7371 )   Polycystic ovary syndrome (PCOS) is a common reproductive and metabolic disorder in women of childbearing age. It is often accompanied by metabolic abnormalities such as obesity, insulin resistance, androgen excess, and dyslipidemia. The metabolic disorder of PCOS is more complicated than simple reproductive disorders. Newly discovered myokine-Irisin is abnormally expressed in PCOS patients, which mainly induces "browning" of white adipose tissue, thereby increasing heat production and energy consumption. Previous studies shows that Irisin plays a protective role in obesity, type Ⅱ diabetes, lipid metabolism and cardiovascular diseases, non-alcoholic fatty liver and other metabolic disorders, but its role in the study of the occurrence and progression of PCOS disease is still unclear. Learning the role of Irisin in the pathogenesis of metabolic disorders in patients with PCOS provides new ideas for the diagnosis and treatment of PCOS. References | Related Articles | Metrics

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Epithelial-Mesenchymal Transition in Adenomyosis WANG Sha，DUAN Hua，ZHENG De-xuan 2020, 47 (1):  92-96.  Abstract ( 993 )   PDF (814KB) ( 7451 )   Adenomyosis (ADS) is a common benign gynecological disorder characterized by the invasion of endometrial glands and stroma into the myometrial wall, which may result in uterine focal or diffuse enlargement. However, the pathogenesis of ADS has not been illuminated yet. Currently, most researchers think that abnormal proliferation of the basal endometrial cells and their invasion to the myometrium are the leading cause of adenomyosis. Whereas, the precise factors that induce to the aberrant invasion of endometrium are still unknown. During the process of epithelial-mesenchymal transition (EMT), epithelial cells lost cell polarity, and cell tight junction and adhesive junction both weaken. They acquire infiltration and migration ability and become cells like mesenchymal cells. EMT induces cell migration and infiltration during tumorgenesis. The biological behavior of endometrial cells invading myometrium of ADS is very similar to the EMT. It has been demonstrated that EMT plays an important role in the development of ADS. As for the clinical treatment of ADS is facing many challenges, illuminating the pathogenesis of ADS would be the key to explore an effective way for prevention and treatment of ADS. References | Related Articles | Metrics

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Advances in Research on the Pathogenesis of Inflammatory Factors and Adenomyosis SUN Yao-qi, JIANG Hui-ci, LIU Jie 2020, 47 (1):  96-100.  Abstract ( 954 )   PDF (779KB) ( 7464 )   Adenomyosis is a benign gynecological disease with proliferative, invasive and metastatic ability. It is more common in women aged 40-50 years old. It often causes menorrhagia, progressive dysmenorrhea and infertility, which greatly affects women′s physical and mental health. Domestic and foreign literature reports that the pathogenesis of adenomyosis may be related to estrogen, tissue injury and repair mechanisms, genetics and immunity. However, because its specific pathogenesis has not yet been elucidated, effective prevention and treatment of the disease has always been a difficult problem for gynecologists. In recent years, it has been found that the abnormal expression of immune cells and immune factors in patients with this disease may be closely related to the onset and progression of adenomyosis. For example, abnormal elevation of interleukin-1β (IL-1β) induces the activation of endometrial inflammation, increased expression of IL-6 enhances the proliferation and invasion of the endometrium, abnormal expression of IL-10 leads to dysregulation of normal immunosuppressive function in patients with adenomyosis. IL-18, IL-8 and TNF-α are also involved in the inflammatory response of the endometrium, and thus adenomyosis is gradually considered to be a chronic inflammatory disease. Therefore, this paper reviews the research progress of the role of inflammatory factors in the pathogenesis of adenomyosis in recent years, aiming to provide new ideas for the diagnosis and treatment of adenomyosis. References | Related Articles | Metrics

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The Role of Epithelial-Mesenchymal Transition in the Pathogenesis of Endometriosis MA Xue-song, ZHANG Zong-feng 2020, 47 (1):  101-105.  Abstract ( 1059 )   PDF (804KB) ( 7441 )   Endometriosis, an estrogen-dependent chronic disease, is common in reproductive-age women and seriously affects the physical and mental health and quality of life of the majority of women. Although various pathogenic theories have been proposed, the underlying mechanism of endometriosis remains unclear. Epithelial-mesenchymal transition（EMT） is a process that epithelial cells lose polarity and cell-to-cell connection to obtain the invasion and movement ability of mesenchymal cells. These changes are also considered to be prerequisites for the initial establishment of EMs lesions. However, there is no study exactly indicates which type of EMT occurs in endometriosis. Besides, hypoxia and estrogen can activate the EMT process in endometriosis through different pathways. Those pathways involve many cytokines and signal transduction pathways, ultimately leading to cell proliferation and migration. This paper mainly summarized the types of EMT, stimulating signals, cytokines and pathways, in order to provide new ideas for clinical diagnosis and treatment of EMs. References | Related Articles | Metrics

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Research Progress in the Route of Sacrocolpopexy WEI Ying，WU Zhen-zhen，WANG Jian，MAO Bao-hong，WANG Yan-xia，LIU Qing 2020, 47 (1):  106-110.  Abstract ( 979 )   PDF (770KB) ( 7462 )   Pelvic organs prolapse (POP) is one of the pelvic floor disorders (PFD), which is one of the prevalent diseases among the middle-aged and elderly women. POP significantly affects quality of life and the mental condition in different ways, while not affects the safety of life. The treatment included conservative treatment and surgeries. Surgeries, including traditional surgeries and reconstructive surgeries. Limited by the irreversible disadvantages of traditional surgery and high postoperative recurrence rate, and with the progress of surgical technology and equipment, reconstructive surgery is developing day by day. The sacrocolpopexy, one of the new surgeries, is set up as the gold standard. The operation way has gradually developed from traditional open surgery to laparoscopic or transvaginal surgery with less damage. Along with the Da Vinci surgical robot, the robotic assisted sacrocolpopexy occurred. All the differences between the routes are unclear and inconsistent including the surgeries outcomes, intraoperative complications or postoperative problems. This article reviewed the routes hoping to provide a theoretical basis for the development of relevant clinical interventions. References | Related Articles | Metrics

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Clinical Progress of Tubal Patency Tests BIAN Jin-xia, HOU Jing, WANG Sheng-li 2020, 47 (1):  111-114.  Abstract ( 919 )   PDF (741KB) ( 7871 )   Tubal Patency tests include procedures like hydrotubation, hysterosalpingography (HSG), hystero-salpingo contrast sonography (HyCoSy) and laparoscopic hydrotubation. Hydrotubation is seldomly undertaken due to its invisibility. HSG is the first choice of tubal patency test, which evaluates tubal patency based on the distribution of lipiodol contrast. Adverse contrast reactions and radiation injury may occur. As the "gold standard" for tubal patency test, laparoscopic hydrotubation is not our preferred choice due to expensiveness. In recent years, HyCoSy has become a research hotspot because of its real-time dynamic, visualization, radiationless and other advantages. With the development of ultrasound contrast agents and the application of low-pressure injection pump and pressure monitor, HyCoSy is expected to surpass HSG and become the preferred method for tubal patency test. References | Related Articles | Metrics

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The Clinical Application of Laparoendoscopic Single-Port Surgery with Conventional Instruments in the Treatment of Benign Gynecological Diseases CHEN Min, ZHANG Bo-hua, LI Dan-hong, MA Xiao-ling, ZHOU Yun, WANG Yuan-ju 2020, 47 (1):  115-118.  Abstract ( 810 )   PDF (6571KB) ( 7587 )   Objective：To probe into the clinical value of laparoendoscopic single-port surgery(LESS) in the treatment of benign gynecological disease. Methods：68 patients who underwent transumbilical single-port laparoscopic surgery at the gynecological department of our hospital between January 2018 and April 2019 were selected as the research group, and another 70 patients with same diseases who underwent conventional multiple ports laparoscopic surgery were chosen as the control group. The indexes such as intraoperative bleeding volume, highest postoperative body temperature, postoperative time for passage of gas by anus, postoperative out of bed activity time, postoperative hospitalized duration, 24 h postoperative VAS, BIS (body image scale) score and incision aesthetic satisfaction CS score, surgical duration and perioperative complications in both groups were compared. Results：The surgeries for patients in both groups were completed smoothly, no intraoperative assisted manipulation was needed and no conversion to laparotomy was done. No severe intraoperative or postoperative complications occurred. There were no significant differences between the intraoperative bleeding volume, highest postoperative body temperature, postoperative time for passage of gas by anus, postoperative activity time, postoperative hospitalized duration in both groups (P＞0.05). However, the differences between surgical duration, 24 h postoperative VAS among patients，body image scale BIS score and incision aesthetic satisfaction CS score were statistically significant (P＜0.05). Conclusions: The transumbilical single-port laparoscopy with conventional instruments do not need special instruments or devices, which conforms to the characteristics of health economics; it is equipped with good cosmetic effect and the advantage of convenient specimen extraction; the application of LESS in the treatment of benign gynecological diseases is safe and feasible. References | Related Articles | Metrics