Table of Content

15 July 2014, Volume 33 Issue 4
Previous Issue    Next Issue
---
专家论坛
论著
综述


For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

专家论坛

Select

Fertility Preservation for Women with Ovarian Cancer: a Minireview WANG Zhong-min;JIANG Ji-yong 2014, 33 (4):  257-260.  Abstract ( 1579 )   PDF (638KB) ( 7682 )   The fertility preservation for those patients with malignant ovarian tumors are often an important problem for clinical doctors, due to more and more late marriage and fewer births, and increasing rate of ovarian cancer. The indications of preserving fertility include Ⅰa borderline ovarian tumor and Ⅰa of G1 malignant epithelial ovarian cancer except for the clear cell carcinoma. Resection of the affected uterine adnexa, and contralateral ovarian biopsy, ascites cytology and peritoneal lymph nodes （pelvic and/or abdominal） dissection or biopsy are basic surgical technique. It is difficult to carry out the randomized controlled study to get conclusive data due to medical ethics. So, there is inconsistency in indications and surgical methods of preserving fertility for those patients with ovarian cancer. On the other hand, with the increasing patients with malignant ovarian tumors, the indication of preserving fertility might be expanded. This paper reviewed these hot issues. Related Articles | Metrics

论著

Select

Inducing Apoptosis of Norcantharidin in Combination with ABT-737 on Cervical Cancer Cells WANG Na;ZHANG Ju-xin;LIU Guang-zhi 2014, 33 (4):  261-264.  Abstract ( 1519 )   PDF (650KB) ( 7578 )   Objective：Norcantharidin （NCTD） is a new small molecule with anticarcinogen activity, which was extracted from Chinese cantharides. ABT-737 is another small molecule with anticarcinogen activity in lower dose by inhibiting BCL-2. This study was designed to explore the effect of NCTD combined with ABT-737 on the in vitro proliferation and apoptosis of cervical cancer cells. Methods：HeLa and SiHa cell lines were cultured in vitro. NCTD alone or in combination with ABT-737 was used to treat cells. MTT assay was used to determine the viability of cells. The flow cytometry was used to detect apoptosis. Results：NCTD alone could significantly inhibit the proliferation of HeLa and SiHa in a dose-dependent manner. NCTD combined with ABT-737 could significantly enhance the effect of NCTD. The apoptosis rates of HeLa in the ABT-737 （1 μmol/L） group and the NCTD （60 μmol/L） group were （31.65±7.75）% and （40.34±14.52）%, while this rate was （63.03±10.90）% in the NCTD combined ABT-737 group. The apoptosis rates of SiHa in the ABT-737 group and the NCTD group were （9.76±0.04）% and （22.04±3.03）%, respectively; while the rate in the NCTD combined ABT-737 group was （58.36±2.31）%. Effect of the combined two drugs on apoptosis was significantly stronger than that of any single drug （P＜0.05）. Conclusions：NCTD shows the in vitro anti-proliferation effect on the HeLa and SiHa cell lines and the effects of both inhibiting proliferation and inducing apoptosis when combined with ABT-737. Related Articles | Metrics

Select

Analysis of Clinical/Pathological Factors on Clinical Outcomes in Patients with Advanced Cervical Cancer Experiencing Radiotherapy Combined with Chemotherapy WANG Qian;YANG Wei;CHENG Wen-lan;CHENG Kun 2014, 33 (4):  265-267.  Abstract ( 1596 )   PDF (437KB) ( 7600 )   Objective：To investigate the effect of clinical and pathological factors on the clinical outcomes in those patients with the advanced cervical cancer who were experiencing the combined therapy with radiotherapy and chemotherapy. Methods：A total of 126 patients with the advanced cervical cancer who were receiving the radiotherapy combined with cisplatin were followed up for five years. Effect of those factors, such as FIGO stage, histological type, tumor grade and tumor size, on the survival rate was analyzed. Results：At of the end of the follow-up, 79 patients survived, and the five-year survival rate was 62.7%. 77 patients were in progression-free survival, the progression-free survival rate was 57.1%. The median follow-up was 45 months（Range＝8-69）. There were significant differences in the progression-free survival and the overall survival after the stratification analysis by age, level of tumor grade and FIGO classification. The Cox regression analysis showed that the tumor grade was significant related to the progression-free survival（P＜0.05）; and that the tumor grade and FIGO grade had a significant impact on overall survival（P＜0.05）. Adverse event included bone marrow suppression（21.4%）, gastrointestinal reaction（16.7%） and kidney dysfunction（6.3%）. Conclusions：Those patients with the advanced cervical cancer who have higher tumor grade and FIGO stage could have poor clinical outcomes of the combined therapy with radiotherapy and chemotherapy. The lower survival rate in those patients should be attended in clinical practice. Related Articles | Metrics

Select

Investigation and Analysis on AIDS Prevention in a College of China PANG Yan-lei;LI Xiao-mei;LI Xiang-yun 2014, 33 (4):  268-270.  Abstract ( 1647 )   PDF (691KB) ( 7617 )   Objective：To investigate and analyze the status of AIDS prevention knowledge in Chinese university, and to explore those possible factors, so as to provide the reference for improving AIDS prevention and health education in university. Methods：A total of 2 500 undergraduates were selected by using the stratified random sampling method, and epidemiologically surveyed using the questionnaires designed by ourselves. Results：The average score of AIDS prevention knowledge was 74.19±14.88, boys had higher mean score than girls （χ2=16.516, P=0.000） while seniors had higher mean score than those lower grades （Z=7.765, P=0.000）. Interestingly, the group of only-child had higher score than the group of non-only-child（χ2=7.639, P=0.006）, and students from different majors had different scores（χ2=17.718, P=0.013）. After corrected by the unconditional Logistic regression, girls had lower score than boys（OR=0.686, 95%CI: 0.548-0.860）. Those students from the first grade had lower scores than those from the second grade （OR=1.865, 95%CI: 1.455-2.390）, the third grade （OR=2.671, 95%CI: 2.033-3.509）and the fourth grade （OR=2.618, 95%CI: 1.918-3.573）. Conclusions： Female students, low-grade students and non-only-child students should be important groups of the AIDS education in Chinese universities, to improve their knowledge on the AIDS prevention and self-care. Related Articles | Metrics

Select

Identification of Aneuploidy with Fluorescence C-banding Staining in Mouse Oocytes ZHANG Jin-wen;DU Chun-hai 2014, 33 (4):  271-273.  Abstract ( 1638 )   PDF (589KB) ( 7607 )   Objective：To investigate the oocyte aneuploid in mice with the method of chromosome C-banding staining. Methods：The standard Giemsa C-banding staining and the modified Giemsa C-banding staining were used to show mouse chromosomes, respectively. The DAPI （4′, 6-diamidino-2-phenylindole） staining, so-called fluorescence C-banding staining, was used to show oocytes. Subsequently, the morphology and number of chromosomes were analyzed with fluorescence microscope. Results：Chromosomes were weakly stained by the standard Giemsa C-banding staining, while chromosomes were easily dissolved by the modified Giemsa C-banding staining. The fluorescence C-banding staining showed superiorities, such as the increased contrast degree between the brilliant white centromeres and the strong blue arms of chromosomes, and the shorten dyeing time. Conclusions：The study suggested that the fluorescence C-banding staining was a simple and rapid method to identify aneuploidy of mouse oocytes. Related Articles | Metrics

Select

Impact of Embryo Blastomere Number and D2 or D3 Cryopreservation after in Vitro Fertilization on the Clinical Outcomes of the Frozen-thawed Embryo Transfer JIAO Jie-hua;ZHU Gui-jie;TAN Li 2014, 33 (4):  274-276.  Abstract ( 1747 )   PDF (486KB) ( 7645 )   Objective: To explore the impact of embryo blastomere number at cryopreservation, and different cryopreservation time on day 2 （D2） or day 3 （D3） after in vitro fertilization，on the clinical outcomes of the frozen-thawed embryo transfer（FET）. Methods：This is a retrospective analysis on 417 FET cycles. The patients were respectively divided into different groups according to cryopreservation time after in vitro fertilization，embryo blastomere number and good-quality embryo number. The clinical outcomes of the embryo-transfer were compared. Results：The embryo survival rate and total blastomere survival rate in the group of the blastomere number exceeded 4-cells on D2 after frozen-thawed were significantly higher than those in the group of the blastomere number less than 4-cells（89.35% vs. 79.11%，42.01% vs. 30.22% respectively，P＜0.05）. Compared with the group of blastomere less than 6-cells on D3，the group of blastomere exceeded 6-cells on D3 had higher embryo survival rate and total blastomere survival rate（86.52% vs. 72.43%，41.13% vs. 31.07%，P＜0.01）. The good-quality embryo rate on D2（56.84%） was significantly higher than that on D3 （48.82%），while the clinical pregnancy rate on D3（38.52%） was significantly higher than that of D2 （27.61%）. There was no significant difference in the embryo survival rate and abortion rate between D2 and D3 （83.50% vs. 79.44%，10.81% vs. 10.09%，P＞0.05） after frozen-thawed embryo-transfer. More good-quality embryos were transferred，higher the clinical pregnancy rate and multiple pregnancy rate obtained（P＜0.05）. Conclusions：Cryopreservation of more than 4 blastomeres on D2 and more than 6 blastomeres on D3 could get better frozen-thawed effect. The clinical outcomes of D3 cryopreservation embryo after FET were superior to D2 embryo. Related Articles | Metrics

Select

IUI Outcomes in Patients with Endometriosis in Half Year after Laparoscopic Treatment HE Qian-dong;TANG Yan;ZHANG Ting-ting;SU Yuan-yuan;YAO Shu-zhong;ZHENG Yan 2014, 33 (4):  277-279.  Abstract ( 1722 )   PDF (515KB) ( 7618 )   Objective: To investigate the clinical outcomes of intrauterine insemination （IUI） in infertility women with endometriosis in half year after laparoscopic treatment. Methods：Ninety-eight patients with endometriosis （stage Ⅰ-Ⅲ） treated by laparoscopy, from January 2010 to December 2012 at Zhongshan People′s Hospital, were divided into three groups: nature cycle plus IUI（NC+IUI）, controlled ovarian hyperstimulation plus IUI（ＣＯＳ＋ＩＵＩ）， and expectant treatment without IUI（ET control）, with the informed consent. The pregnancy rates of three groups in half year after operation were compared. Results：The pregnancy rate per cycle, and the cumulative pregnancy rate in half a year were 6.1%（12/197） and 28.6%（12/42） in the ET control group, 6.6%（4/61） and 10.5%（4/38） in the NC+IUI group, and 14.8%（4/27） and 22.2%（4/18） in the COS+IUI group. Interestingly, there were no significant differences in those rates among three groups（P＞0.05）. Conclusions：There is not significant difference in the pregnancy rate in those infertility patients with endometriosis （stage I-III） in half year after the laparoscopic treatment combined with IUI and without IUI （expectant treatment）. Of course, it is necessary to study further with more samples. Related Articles | Metrics

Select

Incidence of Gestational Diabetes Mellitus and Factors Related to Glycometabolic Disorders in Mobile Population in Shenzhen CHEN Ji-ying;HUANG Li-lan;ZOU Qing-ru 2014, 33 (4):  280-282.  Abstract ( 1429 )   PDF (507KB) ( 7592 )   Objective：To investigate the incidence of gestational diabetes mellitus （GDM） in mobile population in Shenzhen, and to analyze those factors related to glucose metabolism. Methods：From January 2012 to June 2013, there were 850 pregnant women receiving prenatal check-up in our Department of obstetrics. The oral 75 g glucose tolerance test （OGTT） was conducted. Results：The incidence of GDM diagnosed by OGTT was 9.65% in Shenzhen area. Those pregnant women with risk factors, such as ageing over 35 years, abnormal labor history, repeated positive glycosuria, body weight＞75 kg before pregnancy, BMI≥25 kg/m2, macrosomia, positive HBsAg, three or more times of pregnancy, had higher rate of positive OGTT （P＜0.01）. Conclusions：All pregnant women should be asked OGTT test. The new diagnostic criteria of GDM is great benefit to diagnosis of GDM. Those pregnant women with high risk factors should be carefully follow-up visited. Related Articles | Metrics

Select

Experience of Comprehensive Intervention in Reducing Caesarean Rate in Haimen City MA Han-jun;CHEN He-xin;SHI Jian 2014, 33 (4):  283-285.  Abstract ( 1466 )   PDF (566KB) ( 7602 )   Objective：To explore the effective intervention in reducing the caesarean rate in Haimen City. Methods：Comprehensive intervention measures entitled ′encouraging natural birth, reducing the caesarean rate′ were implemented, including strengthening health education, improving service agency management in relation to midwifery skills, implementing free maternal care policy, following strictly caesarean indication, as well as establishing and implementing routinely the rewards and punishment rules by the health administrative department. Results：The caesarean rate in Haimen City was reduced from 73.39% between October 2010 and May 2011 （pre-intervention period） to 55.48% in 2012 and 54.86% in 2013, indicating a remarkable achievement. Conclusions：Comprehensive intervention measures, especially establishing and implementing routinely the rewards and punishment rules by the health administrative department played a key role in controlling the rising caesarean rate in Haimen City. Related Articles | Metrics

Select

Efficiency of Health Education on Vaccination among Pregnant Women HUA Rui-jue;ZHANG Xiao-juan;XU Min-gang;HUANG Jin 2014, 33 (4):  286-288.  Abstract ( 1755 )   PDF (498KB) ( 7624 )   Objective：To assess the efficiency of health education on vaccination among pregnant women in Zhabei District of Shanghai. Methods：The strategy of health education was based on the Delphi Expert Consultation Method. Total 110 pregnant women were given the health education on vaccination in two hospitals of Zhabei District in 2013. The questionnaire is used before and after health education to evaluate the efficiency of education. Results：After health education, pregnant women achieved the high rates of understanding basic knowledge （more than 95.0%） and classification knowledge of vaccine （92.3%）. The rate of understanding immunization program of vaccine, and the rate of understanding that the class-Ⅱvaccines can be used to replace immunization program, were significantly increased （P＜0.01）. Conclusions：The health education on vaccine can significantly improve the knowledge of vaccination among pregnant women. Related Articles | Metrics

Select

Factors Related to Postpartum Contraception in 102 Cases WEI Feng-ling;SONG Zhen;DONG Sheng-wen 2014, 33 (4):  289-292.  Abstract ( 1607 )   PDF (758KB) ( 7632 )   Objective：To investigate the contraceptives used in those postpartum women, and to analyze the factors related to postpartum contraception. Methods：A self-designed questionnaire was conducted in 102 postpartum women within one year after childbirth. Results：88.2% of women took contraceptives in the post-natal life, the contraception rate of the resuming firstly sexual activity after childbirth was 52.6%. The demand on getting contraceptive knowledge in those women without the re-birth wishes was 8.918 times higher than that in women with the re-birth wishes （OR=8.918）. Effects of those factors, such as educational background and times of pregnancy, were significantly on the contraception rate. Conclusions：Most women had misunderstanding on the postpartum contraception. Doctors and family planning workers should pay more attention to education of the contraceptive knowledge in those postpartum women, so as to improve their contraception rate. Related Articles | Metrics

Select

Analysis of Factors Related to Recurrence of Endometriosis after Conservative Operation WANG Qing 2014, 33 (4):  293-294.  Abstract ( 1504 )   PDF (363KB) ( 7566 )   Objective：To explore those factors of endometriosis （EMs） recurrence after conservative surgery. Methods：126 cases of EMs after conservative surgery from June 2008 to June 2012 were analyzed. They were divided into two groups: the non-recurrence group （89 cases） and the recurrent group （37 cases）. Clinical data was Analyzed, those risk factors related to recurrence were evaluated. Results：In 126 cases, there were 19 cases with recurrence in the first year （15.08%）, 14 cases with recurrence in the second year （11.11%） [totally, 33 cases （26.19%）], and 4 cases with recurrence in the third year （3.17%） after conservative surgery [total 37 cases （29.37%） in three years]. The number of recurrence cases increased with years after surgery （χ2=8.375, P=0.015）. There is no significant difference in the previous surgical history between two groups （P＜0.05）. Those risk factors related to recurrence included the surgery history of conservative EMs surgery, pelvic diseases, postoperative r-AFS score, painful nodules in posterior vaginal fornix. Those protective factors included the time of pregnancy and treatment with mifepristone. Conclusions：Those risk factors and protective factors related to EMs recurrence after conservative surgery should be noticed, so as to predict prognosis and to guide clinical treatment. Related Articles | Metrics

综述

Select

MicroRNA and Cervical Cancer LI Pu;LIU Jun-yan;KONG Fan-ming;YIN Li-rong 2014, 33 (4):  297-300.  Abstract ( 1688 )   PDF (524KB) ( 7637 )   MicroRNA （miRNA）, a class of endogenous small non-coding regulatory RNAs, regulate the expression of target genes by pairing with its 3′untranslated regions （3′UTR） to induce the inhibited translation or mRNA degression. Mature miRNA may interfere with multiple biological processes involved in tumorigenesis such as cell proliferation, cell cycle, apoptosis, angiogenesis, invasion and metastasis. Multiple studies showed that the aberrant expression of miRNA, as novel potential makers, could provide numerous promising merits in diagnostic, pathological and therapeutic targets in cervical cancer. Related Articles | Metrics

Select

Progress in Oocyte Quality Assessment HUANG Ying;YU Yang;QIAO Jie 2014, 33 (4):  301-305.  Abstract ( 1501 )   PDF (682KB) ( 7681 )   Oocyte quality is one of the key factors that affect the efficiency of human assisted reproductive technology（ART）. Current clinical data and basic research results showed that a part of oocytes from ART were abnormal in spindle assembly, gene expression, organelle morphology and function, etc. Those abnormalities could lead to lower rate of embryo development and some long-term health risks of offspring. Thus, the identification of the most competent oocyte can optimize translation process and improve the outcome of ART. However, the lack of reliable and objective predictive marker for oocyte/embryo selection during IVF-ET greatly hindered the clinical application of this technology. This article reviewed the existing methods to evaluate the oocyte quality, providing us some basis and guidance for clinical practice. Related Articles | Metrics

Select

Research Progress on Regulation of the Activation of Primordial Follicles NIE Ming-yue;YANG Xiao-kui 2014, 33 (4):  306-309.  Abstract ( 1518 )   PDF (556KB) ( 7659 )   Primordial follicles are of the most abundant stage in the ovary, which serve as a source of all developing follicles. The pool of primordial follicles is essential for female fertility. Most primordial follicles remain quiescent, while few of them are initiated to grow, mature, and ovulate at last. The activation of primordial follicles is defined as a transition from primordial to primary follicle, which is regulated by multiple factors. The mechanisms underlying this activation are not completely stated. Recent studies showed that the growth differentiation factor 9 （GDF-9） and other factors promoted the activation of primordial follicles, while many factors, such as PTEN, inhibited the growth of primordial follicles to maintain the size of the primordial follicle pool. The regulation disorders may cause reproductive endocrine diseases. It is helpful for us to understand the physiology and pathology of human ovary and to provide theory of the fertility preservation, to explore the mechanisms regulating the activation of primordial follicles. Related Articles | Metrics

Select

Effect of Elevated Progesterone on the Day of hCG Administration during Ovarian Stimulation on IVF-ET QU Juan;WU Xia-di;MAO Yun-dong 2014, 33 (4):  310-313.  Abstract ( 1750 )   PDF (569KB) ( 7679 )   There is a debate regarding the impact of the raised level of progesterone on the day of chorionic gonadotrophin （hCG） administration during late follicular phase on the outcomes of in vitro fertilization （IVF）. Based on hypothesis that the raised level of progesterone on the day of hCG injection affect IVF outcome, it was found that progesterone was produced by follicular granulosa cells, and that a variety of factors increased the progesterone production during ovarian stimulation. The effects of the raised level of progesterone on IVF outcomes were reviewed, including hormone, oocyte quality and endometrial receptivity. We can conclude that the raised progesterone could reduce the pregnant rate by the lowered endometrial receptivity. This review will be helpful for doctors to optimize their protocols of ovarian stimulation and/or embryonic transplantation, so as to improve IVF outcomes and to explore new protocol of ovarian mini-stimulation/natural cycle. Related Articles | Metrics

Select

Effects of Placental Shape on Perinatal Outcome WANG Fei;ZHENG Kai-yan;CHEN Dan-qing 2014, 33 (4):  314-317.  Abstract ( 1655 )   PDF (621KB) ( 7595 )   Placenta, serve as a mediation of nutrition and information exchange between mother and fetus, plays a vital role in maintaining the intrauterine growth and development of fetus. Placental function is based on its normal shape. Placental shape is often influenced by many factors, such as mother′s nutritional status, lifestyle, complications of pregnancy and operation history of uterine cavity. Those factors may directly or indirectly affect the growth of villous angiogenesis, leading to abnormally changes in placental shape, such as circumvallate and multi-lobate placenta. Abnormally shaped placenta has low efficiency in nutrients transporting and metabolism function, which to some extent, affects fetal growth and development with clinical manifestations including fetal intrauterine growth restriction, small for gestation age, fetal distress and even stillbirth, and other adverse pregnancy outcomes. Therefore, to understand those factors and their mechanisms that affect placental shape, and to evaluate and prevent those negative influence in many aspects, can reduce the adverse outcomes of pregnancy and fetal development to a certain extent. Related Articles | Metrics

Select

Strategies of in Vitro Culture and Embryo Transfer in Human Assisted Reproductive Technology GAO Ge;ZHANG Yun-shan 2014, 33 (4):  318-320.  Abstract ( 1607 )   PDF (439KB) ( 7574 )   Human assisted reproductive technology（ART） is one of the most effective therapies for human infertility. In vitro culture condition and the strategy of embryo transfer are important factors of ART outcomes such as the live birth rate and the singleton pregnancies rate. Those conditions of in vitro culture include temperature, pH, oxygen concentration, medium and sequential or continuous culture. The strategy of embryo transfer involves the elective single or double embryo transfer, transfer in cleavage or blastocyst stage, and the index for selecting the best blastocyst. Based on recent studies, this review discussed above controversial problems. Related Articles | Metrics

Select

Treatment of Hydrosalpinx before IVF-ET AN Jin-xia;GAO Xi-hong 2014, 33 (4):  321-324.  Abstract ( 1601 )   PDF (633KB) ( 7679 )   Hydrosalpinx can reduce the pregnancy rate and implantation rate of in vitro fertilization and embryo transfer （IVF-ET）, and increase the rate of spontaneous abortion. Hydrosalpinx may affect the IVF-ET clinical outcome by embryo toxicity, impairment of endometrial receptivity, mechanical hindrance to implantation. At present, the treatment options of hydrosalpinx are multifarious, including salpingectomy, salpingostomy, tubal ligation, tubal occlusion by hysteroscopy, transvaginal aspiration of fluid, and combination of Chinese and Western Medicine. Salpingectomy may affect ovarion response in IVF hyperstimulation. As for transvaginal aspiration of fluid, although there are smiple and less invasive advantages, the recurrence rate is high. The Essure?誖and Adiana?誖microimplant by hysteroscopy for tubal occlusion are trying to treat hydrosalpinx in clinical practice in recent years. The efficiency, advantage and disadvantage of different treatment schemes of hydrosalpinx were compared in this review, which is helpful for clinical doctors to select better individualized strategies before assisted reproductive technology（ART） treatment for those patients with hydrosalpinx. Related Articles | Metrics

Select

Obesity and Spontaneous Abortion YUAN Hai-lin;WU Qing-l 2014, 33 (4):  325-328.  Abstract ( 1529 )   PDF (665KB) ( 7648 )   Gestational obesity and correlative abortion are becoming the focus. In those infertile women, obese women have higher risk of abortion. So, obese women are suggested to control well their weight before pregnancy. In those women with natural pregnancy, obese women have also increased risk of abortion. Most studies showed that the endocrine disorders related with obesity were the main mechanism of abortion. Most obese patients are accompanied with hyperinsulinism and insulin resistance, while the plasminogen activator inhibitor-1 （PAI-1）, androgen and insulin-like growth factor play different roles in the pathophysiology. In addition, the decreased uterine receptivity, the reduced endometrial blood flow and abnormal karyotype are reasons of abortion in obese women. In this paper, the mechanism of abortion in obese women was reviewed. Related Articles | Metrics