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    Obstetric Physiology & Obstetric Disease: Review
    The Role of Autophagy in Fetal Growth Development and Pregnancy Complications
    WU Ya-mei, LI Meng, LI Jia-wen, YING Hao, HUANG Lu
    2023, 50 (2):  121-126.  doi: 10.12280/gjfckx.20220816
    Abstract ( 1385 )   HTML ( 375 )   PDF (761KB) ( 2115 )  

    Autophagy is a highly conserved intracellular material removal mechanism, which has the function of maintaining cell homeostasis and promoting metabolic recycling and maintaining energy balance. Autophagy is as well a self-stabilizing process which facilitates cell survival. Studies have demonstrated that autophagy plays an important role in the differentiation, development, invasion of trophoblast and the process of maternal spiral artery recasting. Autophagy sustains pregnancy by removing damaged mitochondria and endoplasmic reticulum to maintain cellular homeostasis. Autophagy runs through the whole process of fetal growth and development. Associated factors such as Beclin-1, damage-regulated autophagy modulator, microtubule-associated protein light chain 3B and so on, are continuously expressed in the placenta during the whole gestation period and remain at a relatively high level in the third trimester. Studies have shown that the dysfunction of autophagy is tightly related to pregnancy complications such as preeclampsia, fetal growth restriction and premature delivery, in which mitochondrial autophagy plays an important role.

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    Influence of Maternal Nutrition on Macrosomia during Pregnancy
    WANG Qin, HAN Ping, ZHANG Guo-ying
    2023, 50 (2):  127-131.  doi: 10.12280/gjfckx.20220813
    Abstract ( 1120 )   HTML ( 180 )   PDF (753KB) ( 2053 )  

    The birth weight of newborn can be used to measure the nutritional status of fetus in utero, and is closely related to pregnancy outcome. With the increase of newborn birth weight, the risk of injury, disability and death of the newborn and the mother during childbirth gradually increases, and the risk of cardiovascular and metabolic diseases are also higher in adulthood. Therefore, it is very necessary to improve the risk awareness of macrosomia and reduce the incidence of macrosomia, which is also an important aspect to improve the quality of pregnancy care. Maternal body mass index (BMI) and gestational weight gain (GWG) are indicators to measures the nutritional status of pregnant women. Obesity, high BMI and excessive GWG are associated with an increased risk of macrosomia and large for gestational age infants (LGA). Maternal nutrition is an important factor affecting newborn birth weight, which can be artificially intervened. Intake of adequate nutrition by pregnant women before and during pregnancy can reduce the birth rate of macrosomia.

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    Obstetric Physiology & Obstetric Disease: Review
    Research Progress of Embryonic Development and the Origin of Polycystic Ovary Syndrome
    MAO Jing-xia, PAN Yong-chao, WU Rui-jin
    2023, 50 (2):  132-137.  doi: 10.12280/gjfckx.20220695
    Abstract ( 1256 )   HTML ( 193 )   PDF (741KB) ( 2154 )  

    Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women, closely related to clinical manifestations such as metabolic disorders and ovulation disorders, the pathogenesis of which remains unclear. A growing number of researches have proposed that the embryonic developmental period is a critical stage in the origin of PCOS disease. Numerous genetic genes for PCOS have functions involved in hormone synthesis as well as regulation of the glucose and lipid metabolic pathways. The expression patterns and epigenetic regulation of genes during different gestational periods may also be relevant to fetal ovarian development. Altered maternal hormone status, exposure to environmental endocrine disruptors, unhealthy lifestyle and metabolic disorders during pregnancy may increase the risk of PCOS by interfering with the function of the hypothalamus-pituitary-ovary axis and varying the expression levels of genes, inducing endocrine disorders such as hyperandrogenemia, insulin resistance and disturbances in follicular development in the offspring. This article reviews the susceptibility genes and epigenetic regulation of PCOS, and to explore the mechanism of intrauterine environmental alterations inducing reprogramming of embryonic development, which will provide new perspectives for future studies on the pathogenesis and clinical treatment of PCOS.

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    Obstetric Physiology & Obstetric Disease: Review
    Research Progress of Lymphocytes Immunotherapy in Patients with Recurrent Spontaneous Abortion
    WANG Rui-qi, DENG Zhi-min, DAI Fang-fang, CHENG Yan-xiang
    2023, 50 (2):  138-141,160.  doi: 10.12280/gjfckx.20220746
    Abstract ( 1272 )   HTML ( 47 )   PDF (741KB) ( 2040 )  

    The incidence of recurrent spontaneous abortion (RSA) is increasing, which has become a serious problem for couples of reproductive age. The etiology of RSA is known to include chromosomal abnormalities, intrauterine diseases, endocrine abnormalities, infectious factors, etc., but the cause of 50% of RSA is still unknown, most of which are related to immune factors, and the specific mechanism is unknown. At present, immunotherapy such as lymphocytes immunotherapy has been applied to patients with negative blocking antibodies. Due to the lack of uniform standards for this treatment, some studies have widely different results, which make this treatment method not widely applied. Therefore, this article reviews the treatment methods to provide a basis for the clinical diagnosis and treatment, in order to improve the success rate of pregnancy in RSA patients.

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    Obstetric Physiology & Obstetric Disease: Original Article
    Clinical Analysis of Six Cases of Complete Hydatidiform Mole with Co-Existing Fetus
    LI Ling-yan, ZHAO Xian-lan
    2023, 50 (2):  142-146.  doi: 10.12280/gjfckx.20220945
    Abstract ( 1441 )   HTML ( 55 )   PDF (4097KB) ( 1985 )  

    Objective: To investigate the clinical characteristics, diagnosis and management of complete hydatidiform mole with co-existing fetus (CHMCF). Methods: The clinical data of 6 cases of twin pregnancy consisting of a CHMCF admitted to the First Affiliated Hospital of Zhengzhou University, from January 2019 to December 2021 were retrospectively analyzed, and the data were analyzed by descriptive methods. Results: The mean age of the six patients were (27.8±5.3) years old, with 3 (1-6) times of pregnancies. Six cases were identified at 14+1 (8+5-24) gestational weeks. Recurrent vaginal bleeding during pregnancy occurred in 4 cases, nausea and vomiting in 2 cases, and hyperthyroidism in mid-pregnancy in a case. In the 6 patients, the summit serum human chorionic gonadotrophin-β (β-hCG) level was 389 527 (225 354-1 323 961) U/L. The ultrasound results revealed that 5 cases of CHMCF, and a case was partial hydatidiform mole. Prenatal diagnosis is normal in a case, which was refused in the remaining cases. Four cases were induced due to recurrent vaginal bleeding, a case was found to require abortion in early pregnancy, and a case was delivered by cesarean section at 36 weeks of gestation. The gross examination of all 6 cases showed two separate tissues, one was normal placental and the other was mole. Normal placental villi were well developed with hydatidiform mole villi edematous. All short tandem repeat (STR) gene detections showed that the mole tissue was homozygous, conforming to complete mole. None of the 6 patients developed gestational trophoblastic neoplasia, and the median time of β-hCG turning negative was 2.5 (2-6) months. Conclusions: CHMCF is rare. Correct diagnosis is of great clinical significance for prognosis. STR gene detection can help confirm the diagnosis.

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    Obstetric Physiology & Obstetric Disease: Case Report
    Pregnancy Complicated by Myelodysplastic Syndrome: A Case Report
    YE Ling, MA Xue-ying, WANG Xiao-hui
    2023, 50 (2):  147-149.  doi: 10.12280/gjfckx.20220622
    Abstract ( 1301 )   HTML ( 48 )   PDF (660KB) ( 1994 )  

    Myelodysplastic syndrome (MDS) is an under-recognized group of hematologic clone malignancies with different leukemia transformation tendencies. MDS may present with varying degrees of anemia, neutropenia and thrombocytopenia. The cases of pregnant patients with MDS are rare, and there are few related clinical studies. At present, there are no standardized guidelines for the diagnosis and treatment of MDS at home and abroad. A retrospective analysis was made of the case data of a pregnant patient with MDS in the First Hospital of Lanzhou University, who was given lung maturation promotion, anemia correction and platelet enhancement therapy under the joint efforts of the department of hematology and obstetrics, and delivered a healthy baby successfully. The purpose of this study was to strengthen the understanding of the management of pregnant patients with MDS before pregnancy, pregnancy and peripartum, and to provide reference for clinical work.

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    Postpartum Hemorrhage Caused by Laceration of Broad Ligament in Vaginal Delivery: A Case Report and Literature Review
    LI Min, ZHANG Ying, JIANG Long-huan, ZHU Tong-yu, ZHANG Juan
    2023, 50 (2):  150-154.  doi: 10.12280/gjfckx.20220870
    Abstract ( 1393 )   HTML ( 32 )   PDF (2920KB) ( 1968 )  

    Postpartum hemorrhage is a common complication during delivery. However, postpartum hemorrhage caused by broad ligament laceration during vaginal delivery is rare. A 28-year-old primigravida was admitted to the hospital with 39+5 weeks of stopping menstruation, no signs of labor awaiting delivery. There was no abnormality in the past medical history, and the pregnancy examination was normal and spontaneous vaginal delivery with an uneventful labor. Four hours after delivery, the patient presented symptoms and signs such as vomiting, pale face, increased heart rate, decreased blood pressure, decreased hemoglobin, and non-clotting blood extracted by abdominal puncture, which were diagnosed as abdominal hemorrhage. We performed emergency small incision combined with gasless laparoscopy and found a rupture in the left broad ligament. Vascular clamp was used to clamp the blood vessel and suture the broad ligament. The operation was successful and the prognosis was good. Through the review and study of the above case, it is concluded that in order to choose the right way of delivery, the prenatal need to fully evaluated the physical condition of the pregnant women, pelvic conditions and fetal conditions. During vaginal delivery, attention should be paid to guide pregnant women to exert proper force and avoid excessive pressure. In case of postpartum hemorrhage, it is necessary to identify symptoms and signs as early as possible and make proper treatment. Laparotomy or laparoscopic exploration is the key when it is difficult to diagnose bleeding in hidden areas (broad ligament, etc.).

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    A Case Report of Intramural Pregnancy Uterine Rupture in the Second Trimester
    ZHOU Yan, XIAO Feng-yi, LI Bo, XU Dan, GU Fang, FANG Lian
    2023, 50 (2):  155-157.  doi: 10.12280/gjfckx.20220775
    Abstract ( 1246 )   HTML ( 40 )   PDF (1663KB) ( 1971 )  

    Intramural pregnancy is a special type of ectopic pregnancy that is extremely rare in clinic. If the pregnancy continues to second or third trimester of pregnancy, it is very likely to lead to uterine rupture, severe hemorrhage, shock, loss of fertility, and even fatal in severe cases. A case of an intramural pregnancy patient with uterine rupture at 19 weeks was reported. Combined with related case reports, firstly the initial abdominal pain of pregnancy was considered, and then it might be uterine rupture, finally the surgical and postoperative review analysis verified that it was intramural pregnancy rupture. By reviewing the diagnosis and treatment of this patient, summarizing and reviewing relevant literatures, we will strengthen the understanding of such rare pregnancy in order to detect, identify and treat this rare pregnancy earlier, so as to improve the adverse pregnancy outcomes of patients.

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    Scarred Uterine Rupture Complicated with DIC in Midterm Pregnancy: A Case Report
    HE Shu-yi, ZHAI Yao
    2023, 50 (2):  158-160.  doi: 10.12280/gjfckx.20220754
    Abstract ( 1306 )   HTML ( 24 )   PDF (4893KB) ( 2002 )  

    With the increase of caesarean section rates, and opening two-child, three-child policy, the number of pregnant women with scarred uterine is gradually increasing. The incidence of pregnancy complications, especially rupture of uterus is increasing year by year. Rupture of uterus is a serious complication of pregnancy in obstetrics, if not clearly identified, mishandled, can lead the pregnant women and fetuses to death. In this case, a pregnant woman with rupture of uterus at 14+2 w, went into hemorrhagic shock and disseminated intravascular coagulation(DIC). Exploratory laparotomy was performed while shock and DIC were corrected by transfusion and infusion, she improved and was discharged from hospital without serious complications. By reviewing the patient′s pregnancy and the treatment process, summarizing experience, strengthening clinicians′ cognition of such diseases and familiarity with related diagnosis and treatment plans, we can early identify rupture of uterine and timely perform operation, in order to reduce the possibility of emergency and critical conditions for patients.

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    Research Progress of Menstrual Blood-Derived Mesenchymal Stem Cells in the Treatment of Premature Ovarian Insufficiency
    GAO Yue-wen, LI Chang-zhong
    2023, 50 (2):  161-164.  doi: 10.12280/gjfckx.20220835
    Abstract ( 1266 )   HTML ( 34 )   PDF (690KB) ( 1966 )  

    Most patients with premature ovarian insufficiency exhibit reduced fertility due to reduced ovarian reserve. With the development of regenerative medicine, various mesenchymal stem cells are increasingly being considered for the treatment of premature ovarian insufficiency. Among them, mesenchymal stem cells derived from menstrual blood can improve ovarian function and promote the recovery of fertility by differentiating into targeting exogenous cells, targeting the homing and implantation of injured sites, and effective secretion of a series of parasecretory cytokines by exosomes, with the advantages of rich sources, non-invasive acquisition and low immunogenicity. It is considered as a promising new method for the treatment of premature ovarian insufficiency, but the clinical application of menstrual blood-derived mesenchymal stem cell transplantation is not yet widely used. This paper reviews the effects of menstrual blood-derived mesenchymal stem cells on ovarian function and the possible mechanisms of treating premature ovarian insufficiency, providing theoretical basis for further research and clinical treatment.

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    Gynecological Disease & Related Research: Review
    Study on Methylation of Estrogen and Progesterone and Their Receptor Genes in Endometriosis
    WANG Xiang-lian, ZHU Shu, XU Wei, WANG Xiu-li
    2023, 50 (2):  165-169.  doi: 10.12280/gjfckx.20220689
    Abstract ( 1217 )   HTML ( 30 )   PDF (713KB) ( 1987 )  

    Endometriosis (EMs) is a common and frequent disease in women of reproductive age. The main clinical manifestations are dysmenorrhea and infertility, and there is a high recurrence rate and a potential risk of malignant transformation. EMs is an estrogen-dependent disease, with progesterone-resistant properties. The local synthesis of estrogen and progesterone in the ectopic lesions and the interactions with the receptors play an essential role in the development and progression of EMs. The local high estrogen environment favors the proliferation, migration, adhesion and invasion of ectopic endometrial cells, promoting the development of EMs and even malignancy. Progesterone resistance can affect endometrium tolerance and is closely associated with endometriosis-associated infertility. Recent studies have identified DNA methylation plays an important regulatory process in the synthesis of estrogen and progesterone and the expression of their receptors in eutopic endometrium and ectopic lesions of EMs. Understanding the role of gene methylation related to estrogen and progesterone and their receptors in the development of EMs, endometriosis-associated infertility and endometriosis-associated malignancy can provide a basis for diagnosis and drug-targeted therapy studies for EMs.

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    Research Progress of Non-Surgical Treatment of Postpartum Sexual Dysfunction
    YAN Hong-liang, JIN Cui-ping, MA Fu-ling, SHANG Yu-min
    2023, 50 (2):  170-175.  doi: 10.12280/gjfckx.20220582
    Abstract ( 1148 )   HTML ( 32 )   PDF (793KB) ( 2038 )  

    Postpartum sexual dysfunction (PSD) is a disease with a high incidence rate in women with complex etiology and various treatment methods, including psychotherapy, drug therapy, behavioral therapy, physical rehabilitation therapy, surgical treatment, etc. The main treatment measures for PSD are still non-surgical treatment. The pelvic floor doctors should give professional guidance to postpartum women in the process of resuming sexual life. Drug treatment can effectively relieve vaginal dryness and burning sensation. Both electrical stimulation and biofeedback can reduce sexual intercourse pain, and biofeedback has more advantages than electrical stimulation in increasing libido and vaginal lubrication. Magnetic stimulation can not only improves pelvic floor muscle strength, but also has a certain effect on postpartum sexual intercourse pain. Manual treatment of pelvic floor myofascial pain needs to be combined with other treatments. Radiofrequency therapy should be used to improve vaginal laxity and dryness. To provide reliable clinical basis for searching for the best non-surgical treatment method, we reviewed the intervention measures and indications in the non-surgical treatment of PSD and evaluated its therapeutic effects.

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    Research Advances in Temperature Controlled Radiofrequency Treatment for Pelvic Floor Dysfunction
    SONG Wen-jing, WANG Jing, LIU Mei-hua, WANG Xiao-hui
    2023, 50 (2):  176-180.  doi: 10.12280/gjfckx.20220878
    Abstract ( 1327 )   HTML ( 25 )   PDF (702KB) ( 2465 )  

    Pelvic floor dysfunction (PFD) is a group of diseases involving pelvic organ dysfunction caused by multiple factors, including vaginal laxity, vaginal atrophy, sexual dysfunction, stress urinary incontinence, etc. At present, PFD is most common in middle-aged and elderly women with increasing incidence year by year. The onset of PFD is insidious and easy to be prolonged and not recovered, which persist seriously affects the quality of life of patients. In recent years, compared with traditional surgical treatment, the temperature controlled radiofrequency technology has greatly promoted the treatment to a minimally invasive, accurate and safe direction, which has met the needs of female patients for the treatment of PFD, and has gradually been recognized by physicians and patients. And with the gradual increase of clinical application of temperature controlled radiofrequency technology, its treatment of the applicable population, advantages and safety have been widely emphasized and considered. This paper reviews the principles, effects and safety of temperature controlled radiofrequency technology applied in PFD, in order to provide some reference for clinical application.

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    Research Progress of Risk Factors Related to Urinary Incontinence
    CHEN Lu-lu, WU Zhen-zhen, MAO Bao-hong, LIU Qing
    2023, 50 (2):  181-184.  doi: 10.12280/gjfckx.20220641
    Abstract ( 1006 )   HTML ( 35 )   PDF (685KB) ( 2047 )  

    The incidence rate of urinary incontinence is increasing year by year, and the main incidence group is the elderly, which leads to adverse events such as falls, tumbles and fractures, and psychological problems such as anxiety and depression. More and more patients with urinary incontinence have suffered physiological, psychological and social stress, which seriously affects the quality of life and life safety. By identifying the high-risk factors that can be intervened and taking targeted measures, it is of great significance to the occurrence and development of urinary incontinence and to reduce the probability of adverse events related to urinary incontinence. Studies have shown that the occurrence and development of urinary incontinence are affected by a variety of factors. It is generally accepted that metabolic syndrome includes advanced age, obesity, mode of delivery, neurological dysfunction, etc. At the same time, more and more studies have proved that insulin resistance, physical activity, atherosclerosis, endothelial dysfunction, lifestyle habits are closely related to the development of urinary incontinence. The research progress of high-risk factors of urinary incontinence is briefly summarized, in order to prevent the occurrence and development of urinary incontinence and reduce the probability of adverse events related to urinary incontinence by identifying high-risk factors.

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    Application of Photodynamic Therapy in Female Reproductive Tract Diseases
    MEI Shi-hao, WANG Yue
    2023, 50 (2):  185-189.  doi: 10.12280/gjfckx.20220798
    Abstract ( 1387 )   HTML ( 30 )   PDF (722KB) ( 2414 )  

    Photodynamic therapy (PDT) is a novel, non-invasive treatment modality based on topical or systemic application of photosensitizer, which concentrates photosensitizer specifically at the lesion site. When the lesion site is irradiated with the appropriate wavelength of light, photosensitizer is initiate the activation process by the absorption of light energy, thus plays a role in the selective destruction of diseased cells. PDT is mainly used to treat skin and mucosal lesions or tumors. It has the characteristics of small trauma, good selectivity, repeatable treatment, and protection of organ structure and function. As the incidence of female genital tract diseases tends to be younger, people′s requirements for preserving the original organ structure and reproductive function protection after treatment are increasing. In order to avoid the side effects of scar, ulceration, organ structure or function injury caused by traditional treatment methods, in recent years, the application of PDT in female condyloma acuminatum, cervical/vaginal squamous intraepithelial lesions, and vulvar lesions has gradually expanded and played its advantages.

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    The Effect of Insulin Resistance on Reproductive Endocrine and Metabolism of Polycystic Ovary Syndrome
    LIU Yin, LU Di, SONG Dian-rong
    2023, 50 (2):  190-195.  doi: 10.12280/gjfckx.20230032
    Abstract ( 1135 )   HTML ( 27 )   PDF (762KB) ( 2033 )  

    Polycystic ovary syndrome (PCOS) represents the most common disease with endocrine dysfunctional in women of reproductive age with multiple reproductive and metabolic phenotypes. About 50%-70% of the PCOS patients have combined insulin resistance (IR). IR plays a significant role in the occurrence and development of PCOS. Not only does IR affect the reproductive endocrine function of PCOS patients, but also increases the risk of metabolic disorders in PCOS patients. IR and hyperandrogenism interact with each other to promote the development of PCOS. IR is associated with the degree of menstrual disorder. IR in partial endometrium of PCOS patients decreases endometrial receptivity. IR aggravates PCOS patients′ disorder of lipid metabolism,promoting the occurrence and development of non-alcoholic fatty liver disease. IR affects the development and function of adipose tissue. Obesity also affects insulin sensitivity. IR can reduce bone formation, hinder bone resorption, and aggravate the risk of osteoporosis, and adversely affects bone metabolism in patients with PCOS. This article elaborating from the above aspects, is expected to provide reference for improving the metabolic disorder and reproductive function of PCOS patients with IR.

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    Research on Gynecological Malignancies: Review
    Research Progress of Near-Infrared Photoimmunotherapy in Ovarian Cancer
    ZHAO Tiao-hong, LU Tao-feng, CHEN Yuan-yuan, LU Ru-xia, ZHAO Yuan-xu, PEI Ya-ping, LIU Hui-ling
    2023, 50 (2):  196-200.  doi: 10.12280/gjfckx.20220637
    Abstract ( 1338 )   HTML ( 28 )   PDF (4434KB) ( 2089 )  

    Ovarian cancer is one of the most lethal gynecological malignancies, which is characterized by difficulties in early diagnosis, high recurrence rate and mortality. Although most patients achieve clinical remission after aggressive treatment, more than 80% of patients may experience drug-resistant recurrence, usually accompanied by lymph node and extensive abdominal metastasis. There is an urgent need to find new therapeutic strategies for ovarian cancer to prolong survival and reduce recurrence. Near-infrared photoimmunotherapy (NIR-PIT) is a novel molecular targeted therapy that combines the specificity of antibody targeting tumor and light-absorbing dye exposure to near-infrared. NIR-PIT is an emerging targeted therapy for cancer, which plays an important role in the early diagnosis, treatment and drug resistance of tumors. This paper reviews the mechanism of anti-tumor effect of NIR-PIT and the current research progress of NIR-PIT in ovarian cancer.

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    Application of 3D Printing Technique Combined with Brachytherapy in Cervical Cancer
    QIN Yao, LI Jie-hui
    2023, 50 (2):  201-205.  doi: 10.12280/gjfckx.20220751
    Abstract ( 1370 )   HTML ( 24 )   PDF (3356KB) ( 2074 )  

    Brachytherapy is an essential part of radical radiotherapy of cervical cancer. However, traditional brachytherapy applicators are difficult to be placed, cannot be adapted to individualized local lesions, and have unsatisfactory dose distribution for some patients with recurrent postoperative stumps or eccentric or large cervical cancer, which then affects the efficacy and prognosis. Personalized radiotherapy products can be designed for each patient by utilizing 3D printing technology. Combination of 3D printing technology and brachytherapy can effectively improve accuracy of radiotherapy. The application of 3D printing technology in cervical cancer brachytherapy mainly includes the construction of cervical cancer model to preoperative planning and display tumor shape as well as anatomic relationship between tumor and surrounding tissues. It also includes the production of personalized applicator to reduce the occurrence of air gaps to achieve precise dose distribution. In addition, the design of parallel/oblique needle channel applicator and the optimization of needle channel and target dose distribution are also included. Applications of 3D printing technology in brachytherapy of cervical cancer have been summarized in the afore-mentioned areas. At the same time, the challenges in the development of 3D printing materials, system establishment and image guidance have been discussed.

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    Research Progress of Ferroptosis in Ovarian Cancer
    QI Qi, ZHANG Jing, WANG Min, LIN Zhi-ming, XU Fei-xue
    2023, 50 (2):  206-210.  doi: 10.12280/gjfckx.20220884
    Abstract ( 1522 )   HTML ( 47 )   PDF (720KB) ( 2105 )  

    Ferroptosis is a novel cell death mode different from autophagy, apoptosis and necrosis, which is initiated by cellluar iron overload and lipid peroxidation. In recent years, an increasing number studies have explored the role of ferroptosis related mechanisms in ovarian cancer, and found that altered the metabolism of iron and lipid in ovarian cancer cells, as well as the expression of P53, Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) can regulate the ferroptosis of cancer cells, thereby delaying the progression of ovarian cancer. Studies also confirmed that ferroptosis can not only improve the sensitivity of ovarian cancer cells to platinum drugs, enhance the effect of chemotherapy, but also improve the resistance of ovarian cancer cells to poly (ADP-ribose) polymerase (PARP) inhibitors, and improve the clinical benefits of PARP inhibitor treatment in ovarian cancer patients, PARP inhibitor and immunotherapy can promote the ferroptosis of ovarian cancer cells in the treatment of ovarian cancer. This shows that ferroptosis and chemotherapy, PARP inhibitors and immunotherapy have synergistic effects in inhibiting the growth of ovarian cancer cells. Therefore, ferroptosis may become a new target for the treatment of ovarian cancer in the future.

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    Research Advances in the Application of siRNA Therapy in Gynecologic Tumors
    LUO Yan, SUN Ge-ge, HAN Li-ting, LI Xin
    2023, 50 (2):  211-215.  doi: 10.12280/gjfckx.20220961
    Abstract ( 1236 )   HTML ( 35 )   PDF (717KB) ( 2225 )  

    Gynecologic tumors are among the leading diseases in women in terms of morbidity and mortality, and patients with recurrence and drug resistance after conventional treatment have poor prognosis. Small interfering RNA (siRNA) is a promising tool for the treatment of gene-related diseases because of its high efficiency in gene silencing, ease of synthesis and wide range of targets. However, the clinical application of siRNA drugs still needs to face the problems of bare sequence instability, low in vivo delivery efficiency, and uncontrollable adverse effects. In recent years, the choice of vectors for in vivo delivery of siRNA drugs and the selection of suitable targets for their application have been the focus of research on siRNA therapeutics. This paper mainly reviews the recent research progress about the application of vector-modified siRNA drugs in gynecologic tumor therapy and the important potential application targets of siRNA in various gynecologic tumors.

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    Research on Gynecological Malignancies: Original Article
    Bioinformatics Based Effect of ZNF492 Mutation on Transcriptome of Ovarian Cancer and Its Clinical Value
    LU Yuan-yuan, LI Li
    2023, 50 (2):  216-222.  doi: 10.12280/gjfckx.20220662
    Abstract ( 1379 )   HTML ( 37 )   PDF (4114KB) ( 2055 )  

    Objective: To investigate the mechanism and clinical value of zinc finger protein 492 (ZNF492) gene mutation in ovarian cancer, and to provide a theoretical basis for the diagnosis and treatment of ovarian cancer. Methods: The transcriptome data of ZNF492 mutant samples were downloaded by TCGA, and the samples were divided into two groups: ZNF492 mutant and non-mutant groups. The R package DESeq2 was used to analyze the differential genes between the two groups. The differentially expressed genes were analyzed by kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis and gene set enrichment analysis (GSEA). The age, tumor stage and differentiation of ovarian cancer patients were obtained, and the Nomogram model was constructed and evaluated by multivariate COX regression prediction model of ZNF492 expression and clinical characteristics of ovarian cancer patients. Results: There were 100 up-regulated genes and 971 down-regulated genes in the differential genes between the ZNF492 mutant group (n=377) and the non-mutant group (n=2). The pathway enrichment analysis of differential genes between the two groups and 100 up-regulated genes in the ZNF492 mutant group showed that they were enriched transforming growth factor-β (TGF-β) signal path. The results of multivariate COX regression prediction model showed that higher age (≥65 years old), the higher tumor stage (Ⅲ-Ⅳ stage) and differentiation (G3) might be related to the poor overall survival (HR>1), while high expression of ZNF492 (≥0.672) was related to the better prognosis (HR<1), among which the higher age patients (≥65 years old) had a poor prognosis (P<0.01). Based on the above four factors, further construct the Nomogram prediction model. The model validation results showed that the C index was 0.593, the area under the curve (AUC) (0.610 and 0.566) of three-year and five-year ROC curves, and the clinical decision curve analysis (DCA) suggested that patients can take bold measures when the 3-year or 5-year survival rate was greater than 18% and less than 82%. Conclusions: Mutated ZNF492 may affect the occurrence and development of ovarian cancer by regulating TGF-β pathway and anti-apoptosis potential mechanism, and has strong clinical practical value in predicting prognosis. ZNF492 mutation is expected to be a marker of circulating tumour DNA and therapeutic target for ovarian cancer.

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    The Predictive Value of Naples Prognostic Score in FIGO Stage Ⅰ-Ⅱ Cervical Cancer Patients with Postoperative Recurrence and Metastasis
    LIU Zhi-chao, LIU Guo-yan, DOU Xian-feng, HE Qian, ZHAO Hai-ling
    2023, 50 (2):  223-227,233.  doi: 10.12280/gjfckx.20220908
    Abstract ( 2346 )   HTML ( 44 )   PDF (871KB) ( 2096 )  

    Objective: To investigate the prognostic value of Naples prognostic score (NPS) in predicting postoperative recurrence and metastasis of cervical cancer in patients with stage Ⅰ-Ⅱcervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO). Methods: The clinical data of 186 patients with FIGOⅠ-Ⅱ cervical cancer were collected retrospectively. The patients were divided into low-risk group (0), medium-risk group (1-2) and high-risk group (3-4) according to NPS. Patients were divided into non-recurrence or metastasis group (n=147) and recurrence or metastasis group (n=39) according to whether they had relapsed or not, and the differences in clinical characteristics between the two groups were compared. COX proportional hazards regression was used to analyze the factors influencing patients′ recurrence or metastasis. Kaplan-Meier method was used to compare the difference of disease-free survival (DFS) among patients with different NPS patients. Results: There were statistically significant differences in albumin, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), degree of differentiation and proportion of parametrial infiltration in low-risk, medium-risk and high-risk NPS groups (all P<0.05). COX regression analysis showed that NPS was an independent prognostic factor for recurrence or metastasis in patients with cervical cancer (HRhigh-risk vs. low-risk=14.304, 95%CI: 3.214-63.656, P<0.001). Subgroup analysis showed that DFS in NPS high-risk group was significantly lower than that in medium-risk group and low-risk group (Log-rank χ2=23.267, P<0.001). Patients with FIGO stage Ⅰ and Ⅱ had significantly lower DFS in the NPS high-risk group than in the medium-risk and low-risk groups (Log-rank χ2=15.760 and 8.294, respectively, P<0.05). Conclusions: NPS is an independent influencing factor of postoperative progress of patients with FIGOⅠ-Ⅱ cervical cancer, and patients with higher NPS have relatively shorter DFS.

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    Research on Gynecological Malignancies: Case Report
    Glassy Cell Cervical Carcinoma:A Case Report and Literature Review
    WANG Yao, YANG Jia-xin
    2023, 50 (2):  228-233.  doi: 10.12280/gjfckx.20220423
    Abstract ( 1324 )   HTML ( 35 )   PDF (4611KB) ( 2048 )  

    Glassy cell cervical carcinoma (GCCC) is a very rare form of cervical carcinoma, which belongs to the low-differentiated subtype of adenosquamous carcinoma, and the related reports at home and abroad are few. Due to its rarity and particularity, there are currently no relevant guidelines for diagnosis and treatment of this disease. This article reports the diagnosis and treatment process of a 43-year-old patient with stage ⅡB GCCC who underwent laparoscopic total hysterectomy combined with bilateral adnexectomy after concurrent chemoradiotherapy, and was also given 3 courses of adjuvant chemotherapy with paclitaxel and cisplatin. However, in a short period of time, there have been multiple metastases throughout the body. The patient responded poorly to multiple chemotherapy regimens and was eventually lost. This article reviews the relevant literature both domestic and abroad, aiming to improve the understanding, diagnosis and treatment of the disease, and provide more reference for diagnosis and treatment for follow-up study of this disease.

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    Rhabdomyolysis after Laparoscopic Surgery for Cervical Cancer: A Case Report and Literature Review
    LI Juan, XU Xiao-ying, SHENG Yan-nan, MA Fu-tang, ZHAO Ya-qin, WANG Fang, WU Zhen-zhen
    2023, 50 (2):  234-236.  doi: 10.12280/gjfckx.20220374
    Abstract ( 1300 )   HTML ( 32 )   PDF (653KB) ( 1954 )  

    Rhabdomyolysis (RM) is a well-known clinical syndrome caused by the breakdown and necrosis of muscle tissue. It can lead to electrolyte abnormalities and acute kidney injury. A case of RM is analyzed retrospectively during laparoscopic surgery for cervical cancer. It is related to the state of general anesthesia, surgical position and long time immobilization. It is characterized by muscle pain, weakness, and dark pigmentation of the urine. The diagnosis is confirmed by elevated creatine kinase and myoglobin levels. The management of RM is prompt intravenous volume expansion, maintainous urine output, and continuous renal replacement therapy (CRRT). Doctors need to pay attention to the intro-operative RM. Prolonged duration and passive position of surgery is a well-recognized risk factor in the development of RM. It emphasize the importance of placing the patient in the surgical position in the awake state.

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    Cervical High-Grade Squamous Intraepithelial Lesions Involving the Endometrium and Ovary: A Case Report and Literature Review
    CHEN Zhi-rou, WANG Xin-tao, HU Qun-chao, ZHU Hai-yan
    2023, 50 (2):  237-240.  doi: 10.12280/gjfckx.20220515
    Abstract ( 1297 )   HTML ( 41 )   PDF (3544KB) ( 1997 )  

    Cervical squamous cell carcinoma that spreads superficially to the inner surface of the endometrium has been rarely reported. There is still lack of clinical guidance for this disease entity. In this paper, we report a case of a 60-year-old woman who presented to our hospital with "abnormal postmenopausal vaginal discharge" and was positive for human papillomavirus 16, followed by laparoscopic total hysterectomy and bilateral salpingo-oophorectomy. Postoperative pathological findings showed that the high-grade squamous intraepithelial lesions of the cervix involved the glands and spread widely superficially to the endometrium and involved the plasma surface of the right ovary. All the lesions showed consistent high expression of p16 and Ki-67. We summarize the previous reports and the characteristics of this case in order to provide evidence for early diagnosis and treatment of the disease and improve clinical prognosis.

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