Loading...

Table of Content

    For Selected: Toggle Thumbnails
    Obstetric Physiology & Obstetric Disease Review
    Advances in Research on Hydroxychloroquine in the Improvement of Placenta-Mediated Pregnancy Complication
    LI Jia-po, CHEN Bing-nan, ZHANG Li-yang, LI Fan, FU Yue, QIAO Chong
    2021, 48 (3):  241-246.  doi: 10.12280/gjfckx.20200867
    Abstract ( 2379 )   HTML ( 358 )   PDF (758KB) ( 7422 )  

    Hydroxychloroquine (HCQ) is a widely used antimalarial drug that inhibits cellular autophagy. HCQ can be used in women with rheumatic diseases who planning pregnancy and is recommended for continued use during pregnancy. In recent years, the use of HCQ in pregnancy has received increasing attention due to its immunomodulatory and endothelial protection effects in autoimmune diseases. There is a clear benefit in pregnant patients with autoimmune diseases, such as systemic lupus erythematosus and antiphospholipid syndrome, but it remains unclear whether there is a general benefit for patients without autoimmune diseases. HCQ has anti-inflammatory, immune regulation, anticoagulant, antithrombotic, antioxidant and endothelial protection effects. The modulation of immunity in pregnancy can be multifaceted, multi-level. This paper discusses the mechanisms and advances in the use of HCQ in pregnancy and the improvement of placenta-derived pregnancy complications.

    References | Related Articles | Metrics
    Advances in Research on Misfolded Protein and Preeclampsia
    WEN Ning-ning, DU Juan
    2021, 48 (3):  247-250.  doi: 10.12280/gjfckx.20200692
    Abstract ( 2492 )   HTML ( 183 )   PDF (643KB) ( 6827 )  

    Preeclampsia is a systemic heterogeneous pregnancy complication, its specific pathogenesis is not clear, and there is still a lack of accurate and reliable prediction, diagnosis and effective treatment. It is known that misfolded proteins are the product of oxidative stress in the endoplasmic reticulum, and that misfolded proteins are associated with the occurrence and development of many human diseases. Recently, some scholars have found that there are misfolded proteins in placenta, blood and urine of preeclampsia pregnant women, and the misfolded protein in preeclampsia patients has the property of congophilia. The misfolded protein in the urine of preeclampsia patients can be detected by Congo red (CR) staining. If the test result of Congo red dot (CRD) test paper is positive, it may show preeclampsia-related symptoms within the next 14 days, and the misfolded protein may be used as a biomarker for predicting preeclampsia.

    References | Related Articles | Metrics
    Expression of Galectins in Pregnancy
    ZHAO Tong-tong, SUN Li-qiang, SHAO Dan-hui, MU Wen-yu, HAN Qiu-yu
    2021, 48 (3):  251-254.  doi: 10.12280/gjfckx.20200706
    Abstract ( 1397 )   HTML ( 121 )   PDF (680KB) ( 6746 )  

    Galectins are a phylogenetically conserved family of soluble β-galactoside binding proteins, consisting of 15 different types, each with a specific function. Of the 13 galectins found in humans, 7 are expressed in the placenta and regulate immunity and development. Galectins contribute to placentation by regulating trophoblast development, migration, and invasion during early pregnancy. In addition, galectins are critical players regulating maternal immune tolerance to the embedded embryo. Recently, the role of galectins in pregnancy-associated process has gained attention. Altered expression of galectins is associated with abnormal pregnancies and infertility. This review focuses on the role of galectins in pregnancy-associated processes and discusses its relevance as potential therapeutic targets in pregnancy disorders.

    References | Related Articles | Metrics
    Research Progress of NLRP3 Inflammasome and Pregnancy
    ZHAO Lu, YANG Hua, LIU Guo-yan
    2021, 48 (3):  255-258.  doi: 10.12280/gjfckx.20200965
    Abstract ( 2215 )   HTML ( 98 )   PDF (655KB) ( 6761 )  

    Inflammasome are an important part of the natural immune system and participate in many inflammatory reactions including pregnancy. NLRP3 inflammasome is the most widely studied inflammasome, which is an important factor of host defense response. It can regulate innate immunity, various environmental stimuli, various microorganisms, endogenous or exogenous danger signals, pathogens and different PAMPs/DAMPs can activate NLRP3 inflammasome to release cytokines,induce caspase-1 dependent apoptotic process,and participate in various inflammatory disease processes, but the regulatory mechanism is not clear. In recent years, it has been found that NLRP3 inflammasome is associated with the mechanism of delivery, and the NLRP3-mediated immune response is initiated during pregnancy. The abnormal expression of NLRP3 inflammasome is associated with the development of gestational diseases such as recurrent miscarriage, premature birth, preeclampsia and gestational diabetes. This article reviews the research progress of NLRP3 inflammasome and pregnancy.

    References | Related Articles | Metrics
    Research Progress of Compound Pregnancy after In Vitro Fertilization and Embryo Transfer
    SHEN Wei-chen, LU Xiao-sheng, LYU Jie-qiang
    2021, 48 (3):  259-263.  doi: 10.12280/gjfckx.20200724
    Abstract ( 1357 )   HTML ( 93 )   PDF (787KB) ( 6791 )  

    Compound pregnancy (heterotopic pregnancy, HP) is an extremely dangerous ectopic pregnancy. The incidence of HP in natural conception is not high, but in recent years, the popularization of in vitro fertilization and embryo transfer (IVF- ET) and ovulation induction techniques, the incidence of HP has increased compared with the previous period. Patients with HP usually only have non-specific symptoms such as abdominal pain and vaginal bleeding in the early stage. Due to the existence of intrauterine gestation sac, their ectopic gestational sac is especially easy to be misdiagnosed and missed, which can easily lead to the continued development of the patient′s ectopic gestational sac and can cause serious life-threatening consequences such as hemorrhage in the abdominal cavity or even shock. Therefore, a full understanding of the related risk factors of HP, corresponding measures to prevent the occurrence of HP before ET or ovulation induction technology. Early diagnosis after HP and effective treatment after diagnosis will improve the prognosis of patients and it seems particularly important. This review summarizes the progress in diagnosis and management of HP after IVF-ET.

    References | Related Articles | Metrics
    Obstetric Physiology & Obstetric Disease Original Article
    Analysis of the Efficacy of Plasma Exchange Combined with Hemodialysis on Three Cases of Postpartum Hemolytic Uremic Syndrome
    LIU Hong-yu, ZHAO Xiu-bao, LIU Wei
    2021, 48 (3):  264-267.  doi: 10.12280/gjfckx.20200681
    Abstract ( 1519 )   HTML ( 91 )   PDF (798KB) ( 6741 )  

    Objective: To explore the efficacy of plasma exchange (PE) combined with hemodiafiltration (HDF) on postpartum hemolytic uremic syndrome (PHUS). Methods: The clinical data of 3 cases of PHUS patients treated with PE combined with HDF admitted to Tianjin First Central Hospital from September 2017 to September 2019 were retrospectively analyzed. The changes of clinical symptoms and laboratory examination results before and after treatment were compared and analyzed, and follow-up was conducted. Results: After PE combined with HDF, the clinical symptoms of the patients were significantly improved, platelets (PLT) and lactate dehydrogenase (LDH) returned to normal, hemoglobin (Hb) and renal function both improved. Follow-up for 2-4 months showed that 2 patients recovered, while 1 patient was left with chronic renal insufficiency due to severe renal injury. Conclusions: PE combined with HDF can be used as an effective treatment for PHUS. Early diagnosis and timely treatment are conducive to the recovery of PHUS patients, which is great significance to improve the prognosis and ensure mother′s health.

    Figures and Tables | References | Related Articles | Metrics
    Obstetric Physiology & Obstetric Disease Case Report
    A Case of Maternal Death Caused by HELLP Syndrome Complicated with Hepatic Infarction and A Review of the Literature
    JIANG Ming-bo, ZHANG Yao, CAO Yu, HUANG Jian, LI Yao-qi, TENG Hong
    2021, 48 (3):  268-271.  doi: 10.12280/gjfckx.20200993
    Abstract ( 1841 )   HTML ( 183 )   PDF (958KB) ( 6798 )  

    Hepatic infarction is an extremely rare and fatal complication associated with HELLP syndrome characterized by hemolysis, elevated liver enzymes, and low platelets. It can develop from acute liver failure and increase maternal and neonatal mortality. A 38-year-old woman with a history of gestational hypertension developed HELLP syndrome after delivery at 31+3 weeks of gestation. Multiple organ failure followed. Despite plasma exchange and symptomatic treatment, the patient′s condition gradually deteriorated with sepsis and shock, followed by biliary enzyme isolation and gradual deterioration of liver function. Finally, imaging findings showed extensive liver infarction and she died 21 days after delivery. The management of HELLP syndrome with hepatic infarction should be multidisciplinary. Plasma exchange using fresh frozen plasma is one of the most effective methods, but if liver infarction progresses to irreversible liver damage, liver transplantation as the only radical treatment, if applicable, is worth trying.

    Figures and Tables | References | Related Articles | Metrics
    Gynecological Disease & Related Research Review
    Research Progress of Vascular Endothelial Growth Factor and Related MicroRNA in Endometriosis
    LIU Na-na, TANG Xiao-han, LU Mei-song
    2021, 48 (3):  272-276.  doi: 10.12280/gjfckx.20200905
    Abstract ( 1200 )   HTML ( 95 )   PDF (689KB) ( 6707 )  

    Endometriosis (EMs) is a common gynecological benign disease, but it has characteristics similar to malignant tumors in behavior, such as distant cell metastasis, invasion, implantation, neovascularization etc. Its pathogenesis has many theories, but its specific mechanism is still under continuous study. The survival and growth of endometriotic lesions depend on adequate blood supply, and angiogenesis is one of the key links. Vascular endothelial growth factor (VEGF) , a heparin-binding growth factor specific for vascular endothelial cells, induces angiogenesis and is the most common proangiogenic factor in the endometrium. MicroRNA(miRNA), a class of short endogenous RNAs, plays an important role in the regulation of gene expression by binding to complementary nucleotide sequences of the targeted messenger RNA. Many studies have shown that miRNA are differentially expressed in EMs and are involved in multiple links in the pathogenesis of EMs. In recent years, more and more studies have shown that miRNA affect angiogenesis in EMs by regulating the expression of VEGF. By analyzing the role of VEGF and its related miRNA in the development of EMs, the pathogenesis of EMs was explored and new targets for EMs treatment were sought.

    References | Related Articles | Metrics
    Research Progress of MicroRNA in Endometriosis
    HONG Ya-yi, TANG Xiao-han, LU Mei-song
    2021, 48 (3):  277-280.  doi: 10.12280/gjfckx.20200903
    Abstract ( 1252 )   HTML ( 94 )   PDF (703KB) ( 6747 )  

    Endometriosis(EMs) is a highly recurrent and invasive benign disease, which seriously affects the quality of life of female between puberty and menopause. The lack of effective biomarkers in clinic is one of the important causes leading to the delay of diagnosis. With the progress of the disease, it brings serious health damage and economic burden to patients. At present, laparoscopy is the method for the diagnosis of EMs, but its application in clinic is limited because of its invasiveness, operative complications and high cost. The exploration of biomarkers with good sensitivity and specificity is very important for the non-invasive early diagnosis of EMs. MicroRNA (miRNA) is a kind of non-coding small molecule RNA, with high tissue specificity and stability. Recent studies have shown that miRNA can be used as a potential biomarker for the diagnosis of EMs. Early recognition is helpful for timely diagnosis and treatment of patients. This article reviews the research progress of miRNA in EMs.

    References | Related Articles | Metrics
    Research Progress of BDNF in Endometriosis and Related Pain
    LI Jin-ming, WANG Lin
    2021, 48 (3):  281-285.  doi: 10.12280/gjfckx.20200799
    Abstract ( 1335 )   HTML ( 162 )   PDF (683KB) ( 6671 )  

    Endometriosis (EMs) is a common gynecological benign disease that affects the majority of women of childbearing age. The early diagnosis and treatment of EMs is an urgent problem in clinical work. There are three recognized pathological types of EMs: peritoneal type, ovarian type and deep invasive type. However, regardless of the pathological type, pain is the most prominent clinical manifestation of EMs patients, including menstrual abdominal pain, chronic pelvic pain and sexual intercourse pain, which seriously affects women′s physical and mental health and increases economic burden. Brain derived neurotrophic factor (BDNF) is one of the members of the neurotrophic protein family. It is not only widely distributed in the central and peripheral nervous system, but also widely distributed in the female reproductive system. It plays an important role in many pathophysiological processes, such as inflammatory reaction, tumor development, neuroangiogenesis and so on. BDNF is also an important regulator of pain formation and maintenance in various chronic diseases. It has been found that BDNF is highly expressed in serum and tissues of patients with EMs, and has gradually become a hot spot in EMs research.

    References | Related Articles | Metrics
    Advances in Non-Hormonal Drugs of Endometriosis
    WANG Ying-qiao, LI Yong, KONG Cheng-cai
    2021, 48 (3):  286-289.  doi: 10.12280/gjfckx.20200970
    Abstract ( 1153 )   HTML ( 91 )   PDF (670KB) ( 6698 )  

    With the development of the research on the pathogenesis of endometriosis(EMs), EMs is no longer a hormone-dependent disease, inflammation, immune dysfunction and oxidative stress disorder are also involved in the adhesion, invasion and growth of endometriosis fragments in "different places". These abnormalities in the endometrial microenvironment provide new research directions for the treatment of EMs with non-hormonal drugs. This review focuses on the research progress of non-hormonal drugs such as TNF-α inhibitors, HMG-CoA reductase inhibitors, macrolides, leptin and leptin receptor antagonist and plants, for clinical workers to better understand the therapeutic prospect of non-hormonal drugs.

    References | Related Articles | Metrics
    Research Advance of Biocomposite Materials in Promoting Endometrial Regeneration
    LI Wen-zhu, XU Bu-fang
    2021, 48 (3):  290-294.  doi: 10.12280/gjfckx.20200948
    Abstract ( 1290 )   HTML ( 86 )   PDF (679KB) ( 6642 )  

    Intrauterine adhesion (IUA) is a fibrosis repair disorder caused by endometrial injury, and may be accompanied by menstrual abnormalities and lead to infertility. The current mainstream clinical treatments have varying degrees of limitations. For example, mechanical damage and high inflammatory conditions caused by surgery may further aggravate the severity of fibrosis and bring adverse pregnancy outcomes. And there are also low retention rates for local drug treatment and stem cell therapy leading to poor effect of promoting endometrial regeneration. Tissue engineering to promote endometrial regeneration is a novel and promising idea that has been widely studied. The biocompatible materials as a carrier to deliver drugs or stem cells into the uterine cavity which are released slowly have good therapeutic effects. Among them, there are few reports of biocomposites in the treatment of IUA, but the effect is significant. Now, biocomposites using by the tissue engineering methods to promote endometrial regeneration will be reviewed as follow.

    References | Related Articles | Metrics
    Transvaginal Ultrasound Diagnosis in Endometrial Thickening of Postmenopausal Women
    JU Rui, RUAN Xiang-yan, XIN De-mei, ZHAO Gui-jun
    2021, 48 (3):  295-299.  doi: 10.12280/gjfckx.20200624
    Abstract ( 2072 )   HTML ( 109 )   PDF (733KB) ( 6871 )  

    Thickened endometrium in postmenopausal women has been got more and more attention due to the improvement of the awareness in health-related quality of life in Chinese women. Endometrial cancer is one of the most common type of gynecologic cancer. Vaginal bleeding and thickened endometrium are common manifestations in postmenopausal women with endometrial carcinoma. Transvaginal ultrasonography usually is a first approach for an initial evaluation for endometrial cancer in postmenopausal women with thickened endometrium. The relationship between thickness endometrium and endometrial cancer in asymptomatic postmenopausal women is unclear. It should be applicable that make an individually assessment for the risk of endometrial cancer according to the existence of high-risk factors in asymptomatic postmenopausal women with thickened endometrium. Proper evaluation of endometrial diseases is not only of great significance for early diagnosis and treatment of endometrial cancer in postmenopausal women, but also can avoid unnecessary worry about endometrial cancer and reduce excessive invasive diagnosis and treatment. In this article, we had reviewed the characteristics of endometrial diseases and the evaluation of endometrial thickening by transvaginal ultrasound in postmenopausal women.

    References | Related Articles | Metrics
    Research and Application of KNDy Neuron in Female Reproductive Endocrine
    XU Yang-ying, HAO Cui-fang, ZHANG Yu, FU Yan-mei
    2021, 48 (3):  300-304.  doi: 10.12280/gjfckx.20200671
    Abstract ( 2551 )   HTML ( 86 )   PDF (700KB) ( 7483 )  

    Kisspeptin/ neurokinin B/Dynorphin (KNDy) neurons are a subgroup of Kisspeptin neuron. They are the target cell of sex hormone negative feedback. It produces Neurokinin B (NKB) and Dynorphin A (Dyn). NKB stimulates while Dyn inhibits. These two work together to regulate the control of kisspeptin on GnRH pulse frequency through autocrine and paracrine, maintaining and controlling the secretion of pituitary FSH and LH. It is involved in the initiation of puberty, the regulation of gonadal hormones, the development of female sexual characteristics and the maintenance of reproductive functions, what is more it is closely related to the pathological process of a variety of endocrine disorders, such as thalamic amenorrhea, central precocious puberty and polycystic ovary syndrome, etc. The discovery of KNDy neuron gradually reveals the upstream regulatory mechanism of GnRH, which makes people have a new understanding of reproductive hypothalamic pituitary ovary (HPO) axis. These new understandings have promoted our understanding and thinking of the physiological and pathological mechanisms of reproductive endocrine and related diseases. In this paper, we would review the research and application of KNDy neuron in the field of female reproductive endocrine and provide reference for clinical and scientific researchers.

    References | Related Articles | Metrics
    Progress in Laparoscopic Treatment of Pelvic Abscess
    ZHANG Jun, ZHANG Ai-hua
    2021, 48 (3):  305-308.  doi: 10.12280/gjfckx.20201166
    Abstract ( 1452 )   HTML ( 80 )   PDF (718KB) ( 6800 )  

    Pelvic abscess is one of the most common acute abdominal diseases in women of childbearing age. Traditional antibiotic conservative treatment is usually delayed and difficult to completely cure. Some patients can fail conservative treatment and switch to surgery. Pelvic abscess not only causes chronic pelvic pain, but also affects female reproductive and endocrine functions. Severe cases can endanger the patient′s life. Laparoscopy is the gold standard for the diagnosis of pelvic abscess. Compared with open surgery, laparoscopic surgery is safe and effective. In patients undergoing early operation, the course of disease was significantly shortened and symptoms were alleviated in the aspects of operation time, intraoperative blood loss, postoperative body temperature recovery and intestinal function recovery. Patients have a high rate of tubal recanalization, and have more chances to retain the uterus and appendix, improve reproductive endocrine function, reduce pelvic recurrence, and improve quality of life. Laparoscopic surgery should be performed as early as possible in patients who are expected to fail in simple antibiotic conservative therapy and in young women with fertility requirements. In addition, individual surgical procedures should be formulated. Because the operation of pelvic abscess is relatively complicated, it is recommended to be performed by a gynecologist who is proficient in laparoscopic techniques.

    References | Related Articles | Metrics
    Gynecological Disease & Related Research Original Article
    Effects of Human Umbilical Cord Mesenchymal Stem Cells on the Proliferation and Differentiation of Endometrium in Rats with Intrauterine Adhesions
    WANG Sha, GUO Zheng-chen, TANG Yi-qun, DUAN Hua
    2021, 48 (3):  309-313.  doi: 10.12280/gjfckx.20201077
    Abstract ( 1595 )   HTML ( 62 )   PDF (8889KB) ( 6679 )  

    Objective: To evaluate the effect of human umbilical cord mesenchymal stem cells (hUCMSC) on the proliferation and differentiation of injured endometrium in rats with intrauterine adhesions. Methods: 20 SD rats of intrauterine adhesions model was established on the principle of self-own control. After 14 days,they were randomly divided into the stem cell group (n=10) and the control group (n=10). hUCMSC were isolated from human umbilical cord specimens, and then cultured and identified for the further study. hUCMSC in passage 3 were used to transplant into the stem cell group of uterus with intrauterine adhesions and phosphate buffer saline solution were injected into the control group of uterus with intrauterine adhesions. Immunofluorescence staining was used to detect the distribution of human nuclear antibodies, endometrial epithelial cell marker cytokeratin (CK) antibody and mesenchymal cell marker vimentin antibody in rat uterus to evaluate the location and differentiation of hUCMSC in rat uterus. Immunohistochemical staining was used to observe the expression of proliferating cell nuclear antigens Ki-67 and CK in hUCMSC and mRNA of Ki-67 and CK in rat uterus were detected by quantitative reverse transcription polymerase chain reaction. Results: The modeling side of endometrial tissue of the rat uterine showed narrow of the uterine cavity,lack of the endometrial glands and luminal epithelium,increased areas without cell structure in the stroma. Cultured cells were conformed to have the characteristics of hUCMSC in terms of cell morphology and immunophenotype. In the stem cell group, red and green fluorescence were co-developed in the same cell in the co-stained sections of human nucleus and vimentin. The average optical density and mRNA expression of Ki-67 and CK in the stem cell group were higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusions: hUCMSC can survive and colonize in the injured endometrium and may improve the tissue repair microenvironment by up-regulating the expression of Ki-67 and CK, rather than by differentiation into endometrial cells.

    Figures and Tables | References | Related Articles | Metrics
    Gynecological Disease & Related Research Original Article
    Risk Factors for Recurrence after Laparoscopic Conservative Surgery in Patients with Stage Ⅲ-Ⅳ Endometriosis
    HU Lai-hua, CHEN Yan, ZHOU Ying, HU Wei-ping
    2021, 48 (3):  314-317.  doi: 10.12280/gjfckx.20200868
    Abstract ( 1832 )   HTML ( 124 )   PDF (4397KB) ( 6670 )  

    Objective: To investigate the influencing factors for recurrence after laparoscopic conservative surgery in patients with stage Ⅲ-Ⅳ endometriosis and provide evidence for making personal treatment plans. Methods: A total of 538 patients with stage Ⅲ-Ⅳ endometriosis who underwent laparoscopic conservative surgery in the Provincial Hospital Affiliated to Anhui Medical University from January 2016 to January 2019 were selected as study subjects. Combined with clinical data and follow-up information, SPSS 26.0 software was used to analyze the factors affecting postoperative recurrence and postoperative pregnancy. Results: In this study, the postoperative follow-up time of all patients was 16-53 months, and the median follow-up time was 35.1 months, a total of 77 cases recurred during this period. Univariate analysis showed that r-AFS scores, preoperative dysmenorrhea, postoperative GnRHa treatment time and postoperative pregnancy can affect the recurrence after stage Ⅲ-Ⅳ endometriosis surgery (P<0.05). Multivariate Cox regression analysis showed that dysmenorrhea and r-AFS scores≥77.5 were independent risk factors for postoperative recurrence of ovarian endometriosis (P<0.05). Postoperative GnRHa treatment for 6 months and postoperative pregnancy were protective factors for postoperative recurrence (P<0.05). Compared with the natural pregnancy rate in the second year(27.27%) and the third year(18.75%) after surgery,the pregnancy rate in the first year after surgery was the highest (45.9%),and the difference was statistically significant (P<0.0167). Conclusions: The recurrence rate of patients with stage Ⅲ-Ⅳ endometriosis after laparoscopic conservative surgery is relatively high, dysmenorrhea and r-AFS score are risk factors for postoperative recurrence, which should be quantified and included in the model to predict the risk of recurrence. Postoperative GnRHa treatment for 6 months and postoperative pregnancy can reduce the recurrence rate. Patients with fertility desire are encouraged to actively prepare for pregnancy after GnRHa treatment.

    Figures and Tables | References | Related Articles | Metrics
    Gynecological Disease & Related Research Case Report
    Type Ⅱ Vaginal Atresia: A Case Report and Literature Review
    ZHANG Guo-wei, FU Mei-qi, JIANG Ying-xian, ZHENG Yu, XIANG Mei
    2021, 48 (3):  318-321.  doi: 10.12280/gjfckx.20200830
    Abstract ( 1547 )   HTML ( 123 )   PDF (6058KB) ( 6786 )  

    The congenital atresia of vagina is caused by abnormal development of the urogenital sinuses and the ends of the Mullerian tubes and does not form a normalvagina, which is less common. Complete vaginal atresia, also known as type II vaginal atresia, is associated with dysplasia of the cervix, dysplasia of the uterine body, or uterine deformity, and is more rare clinically. In this paper, one case of type II vaginal atresia who was admitted to the Second Hospital of Jilin University and then transferred to Peking Union Medical College Hospital in October 2018 was clinically analyzed, we also reviewed related literature and summarized the progress of the diagnosis, classification and treatment at home and abroad, in the hope of a doctor to better understand the genital tract malformation, patients to receive individualized treatment and achieve a better prognosis.

    Figures and Tables | References | Related Articles | Metrics
    Research on Gynecological Malignancies Review
    Progress of CircRNAs as A Promising Biomarker and Therapeutic Target for Cervical Cancer
    LI He-tong, WANG Wei, HAO Min
    2021, 48 (3):  322-327.  doi: 10.12280/gjfckx.20200836
    Abstract ( 1272 )   HTML ( 115 )   PDF (755KB) ( 6709 )  

    Circular RNAs (circRNAs) are single-stranded, covalently closed noncoding RNAs without 3′ and 5′ ends. Evidence demonstrated that circRNAs are abundant, stable and able to show cell/tissue-specific expression, which structure features show potential for noninvasive molecular biomarkers of tumors. CircRNAs express differentially and play an important role in many kinds of neoplasms by miRNA sponges, interaction with RNA binding proteins, modulating the stability of mRNAs, regulating gene transcription and translation proteins. There are no specific biomarkers for early warning and potential therapeutic targets currently. Many studies have demonstrated differential expression of circRNAs function vitally on singnal pathway and gene expression in the initiation and development of cervical cancer. CircRNAs involve in circRNA-miRNA-target gene axis mainly through miRNA sponges to promote cervical cancer cell proliferation, invasion and metastasis, and associate with tumor size, clinical stage, metastatic lymph nodes and poor prognosis.

    Figures and Tables | References | Related Articles | Metrics
    Research Progress of MiR-144 in Cervical Cancer
    WANG Jun, YU Cai-xian, WANG Xia, LI Zheng
    2021, 48 (3):  328-332.  doi: 10.12280/gjfckx.20200940
    Abstract ( 1377 )   HTML ( 109 )   PDF (684KB) ( 6628 )  

    Globally, the morbidity and mortality of cervical cancer are ranked fourth among female malignancies, seriously threatening women′s health, so early diagnosis and treatment are very important. MicroRNAs (miRNAs) are a class of non coding endogenous small RNAs about 21-25 nucleotides in length, and a large number of studies have now revealed that miRNAs have important roles in multiple regulatory pathways in the human body, including the control of cell differentiation, apoptosis, proliferation as well as tumor development. It exerts its biological functions mainly through base binding to the 3′- untranslated region (3′-UTR) of target mRNAs, thereby regulating the expression of genes at the post transcriptional level. Therefore, miRNAs become a new hotspot in tumor research at the moment. At present, several studies have found that miR-144 is aberrantly expressed in many malignancies and plays an important role as well. In cervical cancer, miR-144 expression is downregulated, and it promotes the occurrence and development of cervical cancer, which is expected to be a biomarker for the early diagnosis of cervical cancer; meanwhile, studies have confirmed that miR-144 is involved in regulating the sensitivity of cervical cancer to chemoradiotherapy, which is expected to be a potential therapeutic target for cervical cancer. In this review, we summarize the biological functions of miR-144 and its roles and molecular mechanisms in cervical cancer.

    References | Related Articles | Metrics
    New Trends in Surgical Methods of Early-Stage Cervical Cancer
    Adilai Alimu, HAN Li-li, Dilinaer Aishanjiang
    2021, 48 (3):  333-336.  doi: 10.12280/gjfckx.20200715
    Abstract ( 1619 )   HTML ( 78 )   PDF (683KB) ( 6753 )  

    Cervical cancer is one of the most common malignant tumors in women. The treatment methods mainly include surgery and radiotherapy. Chemotherapy is widely used in combination with surgery and radiotherapy and the treatment of advanced recurrent cervical cancer. Among them, early cervical cancer is often used surgical treatment via open or minimally invasive route. The results of the clinical trial of the Laparoscopic Approach to Cervical Cancer (LACC) published in 2018 first questioned the short-term and long-term therapeutic effects and oncological risks of minimally invasive surgery for early-stage cervical cancer. They believed that the disease-free survival rate and overall survival rate of minimally invasive surgery for cervical cancer were lower than those of open surgery, which caused the global gynecologists to rethink the surgical methods. Due to the lack of reliable clinical evidence, minimally invasive surgery is still the standard treatment for cervical cancer. After a dispute between "laparotomy" and "minimally invasive surgery", a number of clinical studies have proved that minimally invasive surgery has higher recurrence rate, mortality rate and lower survival rate than open surgery in radical hysterectomy. Therefore, to delete the minimally invasive surgery of radical hysterectomy in the latest clinical guidelines, recommend open surgery is the standard path of radical hysterectomy for early cervical cancer, and point out the new trends of surgical treatment for early cervical cancer for gynecologists.

    References | Related Articles | Metrics
    Research Progress on Treatment and Prognosis Prediction of High-Grade Cervical Intraepithelial Neoplasia
    LIU Ming-yue, HAN Xu
    2021, 48 (3):  337-342.  doi: 10.12280/gjfckx.20200855
    Abstract ( 1548 )   HTML ( 61 )   PDF (704KB) ( 6861 )  

    Cervical intraepithelial neoplasia has been confirmed as a precancerous lesion of cervical cancer. In 2014, WHO changed the three-level classification of cervical intraepithelial neoplasia, dividing it into low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial neoplasia. Among them, high-grade squamous intraepithelial lesions of the cervix have the potential to become cancerous and are prone to progress, which seriously threaten the physical and mental health of Chinese women. At present, the common surgical methods of cervical cold knife conization and circular electric resection are used to treat high-grade squamous intraepithelial lesions. Generally, good treatment results can be achieved, but intraoperative and postoperative bleeding and incision infection may still occur. Cervical stenosis, endometriosis, intestinal injury and other complications may also occur. Relevant studies have shown that human papillomavirus (HPV) classification, positive resection margins, and menopausal status are closely related to the risks of postoperative lesions, recurrence, and progression, which can help predict adverse outcomes after cervical conization, strengthen the centralized management of such patients, prevent and block the path of disease progression in advance, and reduce the prevalence and mortality of cervical cancer. At present, the safety and effectiveness of the preventive HPV vaccine have been fully affirmed, and it has significant effects on reducing HPV infection and preventing postoperative disease recurrence. However, the effect of postoperative vaccination in patients with cervical lesions needs to be explored.

    References | Related Articles | Metrics
    Research Progress on the Effect of Adenomyosis on Endometrial Cancer and Related Mechanisms
    GUO Zheng-chen, DUAN Hua, WANG Sha
    2021, 48 (3):  343-346.  doi: 10.12280/gjfckx.20200850
    Abstract ( 1652 )   HTML ( 127 )   PDF (675KB) ( 6585 )  

    Endometrial cancer is one of the most common gynecological malignancies, and adenomyosis is also a common benign gynecological disease, with unknown etiology. Adenomyosis and endometrial cancer are not only two independent gynecological diseases, but also have intricate connections. From the epidemiological and clinicopathological characteristics,adenomyosis may be a risk factor for endometrial cancer, but it is also a protective factor to inhibit the progression of endometrial cancer. From the pathogenesis, the two disease have common mechanisms on molecular signaling pathways, effects of estrogen and its receptors, and mismatch repair gene deficiency, and because of the molecular and mechanical blocking effects of adenomyosis on endometrial cancer, the progression of endometrial cancer is hindered. Clarifying the relationship between the two and the corresponding mechanism will contribute to the accurate clinical diagnosis and follow-up of endometrial cancer and adenomyosis, and improve the effect of diagnosis and treatment.

    References | Related Articles | Metrics
    The Value and Dispute of Uterine Manipulator in Gynecological Tumor Minimally Invasive Surgery
    SUN Yu-shu, YI Xiao-fang
    2021, 48 (3):  347-350.  doi: 10.12280/gjfckx.20200844
    Abstract ( 1933 )   HTML ( 89 )   PDF (768KB) ( 6672 )  

    With the widespread application of minimally invasive surgery in gynecological tumors, the use of uterine manipulator has become more and more important. However, with the reports on the adverse effects of minimally invasive surgery on patients with gynecological tumors, the importance of the use of uterine manipulator is also be questioned. It is questioned whether the use of uterine manipulator during surgery will increase the spread of tumor cells and affect the prognosis of patients. Improvements to traditional uterine manipulator have been continuously proposed to reduce the damage to tumor tissues during minimally invasive gynecological tumor surgery, to ensure the exposure of the surgical field and sufficient scope of operation, and to increase the application range of uterine manipulator. In recent years, the safety and effectiveness of new uterine lifting methods such as uterine suspension have been continuously confirmed, and they have become an important surgical method to replace traditional uterine manipulator to assist in minimally invasive gynecological tumor surgery. The comparison and continuous improvement of uterine lifting methods will provide new surgical ideas for minimally invasive gynecological tumor surgery and help patients recover quickly after surgery.

    References | Related Articles | Metrics
    Research on Gynecological Malignancies Original Article
    Analysis of BRCA Gene Mutation Status and Clinical Significance in 74 Patients with Epithelial Ovarian Cancer
    RAO Yang, LI Xiao, XU De-huan, ZHU Xue-ping, QU Peng-peng
    2021, 48 (3):  351-355.  doi: 10.12280/gjfckx.20210068
    Abstract ( 2650 )   HTML ( 98 )   PDF (788KB) ( 6632 )  

    Objective: To analyze BRCA germline mutation in patients with epithelial ovarian cancer (EOC) and its relationship with clinical pathological features. Methods: The BRCA germline mutation results of 74 patients with EOC who received therapy at Tianjin Central Hospital of Gynecology Obstetrics from January 2017 to January 2020 were collected. Statistical analysis was performed on the relationship between BRCA mutation and clinical pathological features. Results: In 74 patients of EOC, the mutation rate of BRCA1 and BRCA2 were 24.3% and 9.5% respectively. The main mutation mode includes 15 cases of frame shift mutations and 5 cases of nonsense mutations. The mutations are mainly appears in the exon coding region (CDS9 and CDS10). There was no significant difference in the FIGO stage, pathological type, lymphatic metastasis status, serum levels of CA-125, family history of malignant tumor between BRCA-mutated patients and wild-type patients in this study (P>0.05). The recurrence-free survival (RFS) of patients with BRCA-mutated is longer than that of patients without BRCA-mutated, and the difference is statistically significant (Z=-1.931, P=0.027). Statistically significant correlations were observed between BRCA-mutated status and family history of hereditary breast cancer ovarian cancer syndrome (HBOC) ( χ 2=4.059, P=0.044). Conclusions: All female members of the family of EOC patients with family history of HBOC should undergo BRCA gene testing, which is an effective way to screen high-risk patients for ovarian cancer.

    Figures and Tables | References | Related Articles | Metrics
    Research on Gynecological Malignancies Case Report
    Secondary Surgery for Advanced Ovarian Cancer Combined with Primary Immune Thrombocytopenia: A Case Report and Literature Review
    LIU Yuan, CHEN Si-lu, SONG Kai-rong, LIU Chang, GAO Li, YANG Yong-xiu
    2021, 48 (3):  356-360.  doi: 10.12280/gjfckx.20200717
    Abstract ( 1552 )   HTML ( 86 )   PDF (711KB) ( 6726 )  

    Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease. It is often associated with the presence of platelet antibodies in the body. ITP can be secondary to a variety of benign and malignant diseases, among which cooccurrence with solid tumors is rare, and cooccurrence with ovarian cancer is even rarer. This paper reports a case of advanced ovarian cancer complicated with ITP during the second operation, and reviews the relevant literature, in order to arouse people′s attention and understanding of this disease, and to add experience for the future clinical diagnosis and treatment.

    Figures and Tables | References | Related Articles | Metrics