Table of Content

15 July 2013, Volume 32 Issue 4
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述评
专家论坛
热点问题
论著
综述
讲座
标准与指南
论著
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述评

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Translational Medicine Research on Reproduction Safety—Challenges & Prospectives WANG Yi-fei 2013, 32 (4):  225-228.  Abstract ( 1860 )   PDF (512KB) ( 7369 )   Reproduction safety implies that people are able to have safe and satisfied sexual life with no worry about suffering sexual associated diseases，as well as a complete safe and healthy state related to all functions and processes of human reproduction，including pregnancy，embryo development，neonatal and child development. One of the reproduction safety research priority areas is the potential risks of assistded reproductive technology （ART）. It is suggested：①National and global ART surveillance programmes should be developed，and ART statistics need to emphasize the birth rate of healthy infants，as well as rates of malformations，neonatal morbidity and mortality，abnormalities of pregnancy and child development. ②An interdisciplinary research team is of strategic importance to successful translational medicine research on Reproduction Safety. ③Clear distinction should be made to evaluate and monitor ART preclinical research，small-scale clinic trial and randomized，controlled clinical studies. Related Articles | Metrics

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The International Attention on the Long-acting Reversible Contraceptives WU Shang-chun;CHU Guang-hua 2013, 32 (4):  229-232.  Abstract ( 1811 )   PDF (523KB) ( 7376 )   This article reviewed the UN Millennium Development Goals（MDG）5 to improve the status of women′s health，and introduced the recommendations provided by international community for choices of contraceptives. WHO carried out some recommendations on policies，programs and researches for promoting the use of long-acting reversible contraceptives（LARC） among the parous and young nuliparus women. LARC provided immediately after delivery or after abortion（no opportunities missed） can improve the utilization rate of the effective contraceptives to avoid unintended pregnancy and pregnancy occurred within short term after induced abortion and delivery，so as to reduce induce abortion and repeated abortion. This article also introduced the experiences of developed countries to promote LARC. Related Articles | Metrics

专家论坛

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Current Status of Long-acting Reversible Contraceptives LIU Ju-hong;LI Jian 2013, 32 (4):  233-235.  Abstract ( 1812 )   PDF (610KB) ( 7352 )   The unintended pregnancy resulting in abortion is a worldwide problem，with multiple adverse effects on women. There was good evidence that the use of long-acting reversible contraception （LARC），including intra-uterine device，subdermal implant and injectable contraceptive，was associated with the lowered risk of unintended pregnancy. LARC is efficient，long-acting，fertility-reversible，safe and easy to use. Its effect is not dependent on the user′s compliance. Therefore，LARC methods are recommended to fertile women in the world. Related Articles | Metrics

热点问题

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Management of Irregular Vaginal Bleeding Induced by the Progestin only Contraceptives JIN Li 2013, 32 (4):  236-239.  Abstract ( 1829 )   PDF (807KB) ( 7448 )   There are three kinds of progesterone only contraceptives（POCs）， intramuscular injection， implants and levonorgestrel-intrauterine system（LNG-IUS）. POCs offer the safe，effective and reversible contraceptive options，particulary for women with the risk of venous thromboembolism. Breakthrough or irregular bleeding （BTB） and amenorrhea are the main side-effects，which often lead to discontinuation. The exact pathophysiological mechanisms of BTB remain unclear，but they are likely to relate to the chronic endometritis，thin and dilated wall of vessels in subendometrium，high expression of COX-2 and MMP-9. Many effective methods are tried to stop bleeding. The most important thing is to consult the women carefully before their utilization of POCs. Related Articles | Metrics

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The Feasibility of Long-acting Reversible Contraception for Nulliparous Person LIU Xiao-ai 2013, 32 (4):  240-243.  Abstract ( 1898 )   PDF (606KB) ( 7335 )   Nulliparous women are usually careless of contraception. They are a group of women with the high risk of unintended pregnancy. Their compliance to the short effect contraceptives is rather poor. They prefer those simple contraceptive methods with nothing to do by themselves and their partner. The long acting reversible contraceptions（LARCs） are very simple and highly effective. It is suitable for nulliparous women because the contraceptive effects are not associated with users. The feasibility and good satisfactory of LARC has been demonstrated by the clinical practice. The existing problems on the consulting and insertion skills from the providers should be enabled urgently. Related Articles | Metrics

论著

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Application of the Levonorgestrel-releasing Intrauterine System and the Transcervical Endometrium Resection in Treating Menorrhagia: A Clinical Control Study WANG Yu;BI Fang-fang;YANG Qing;ZHANG Shu-lan 2013, 32 (4):  244-246.  Abstract ( 1926 )   PDF (781KB) ( 7381 )   Objective：To compare the effectiveness，side effects and clinical outcomes of the levonorgestrel-releasing intrauterine system and the transcervical resection of endometrium in treating menorrhagia without organic uterine disease. Methods：In this prospective study，96 patients with menorrhagia were divided into two groups after the informed consent，LNG-IUS group with 46 cases and TCRE group with 50 cases. The bleeding volume，hemoglobin and side-effects of two groups were compared. Results：The bleeding amounts of both groups were reduced effectively after treatment，while the effect of TCRE was better than that of LNG-IUS （P＜0.05）. There was not significant difference between two groups in hemoglobin（P＜0.05），and there were not severe complications in two groups. The rat of side effects in the LNG-IUS group （69.6%） was more than that in the TCRE group （14%）. Conclusions：Both LNG-IUS and TCRE can reverse the menorrhagia without organic uterine disease. LNG-IUS is suitable for the young patients who require the reserving of eugenesis and TCRE for the patients who do not want prengancy any more. Related Articles | Metrics

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Clinical Application and Evaluation of Levonorgestrel-releasing Intrauterine System TIAN Ying;LANG Yu-ping;WEI Zhen-he;DONG Yan;YANG Hua 2013, 32 (4):  247-249.  Abstract ( 1906 )   PDF (783KB) ( 7357 )   Objective： To observe the clinical application of levonorgestrel-releasing intrauterine system （LNG-IUS），and to evaluate the effeciency of resetting the downward shifted LNG-IUS. Methods：Total 152 patients with LNG-IUS were follow-up visited，to assess the degree of dysmenorrheal，the extent of menstrual bleeding and the position of LNG-IUS in uterine. The reposition under the guidance of B ultrasound were performed in 45 cases with ectopic LNG-IUS. Results：Both VAS grade and PBAC grade after inserting the LNG-IUS were significantly lowered when compared with their pre-deposited grades （t＝2.15，P＜0.05；t＝142.63，P＜0.01）. Of the 45 cases undergoing reposition （29.6%），42 cases were still using the device. Conclusions：LNG-IUS is one of the effective treatments for dysfunctional uterine bleeding and adenomyosis of uterus. The reposition of the downward shifted LNG-IUS under the guidance of B ultrasound is safe and feasible. Related Articles | Metrics

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The Clinical Performance of Single Rod Etonogestrel Implant LI Jin-jin;LIU Xin-yan 2013, 32 (4):  250-253.  Abstract ( 1821 )   PDF (619KB) ( 7513 )   The single rod etonogestrel implant is a new implantable，highly effective，long-acting，reversible，progestin-only contraceptive. More advantages include its strong receptability，high safety，convenient insertion and remove，and long validity of 3 years. Compared with Norplant system of 6 roots，this single root implanont is inserted only one root，with significantly shortened times for insertion and remove. As a progestin-only contraceptive，this implant has a main side effect of menstrual disorder that users more likely discontinue，especially if the bleeding is prolonged. The other common adverse events includ acne，weight gain，and changes of bone density. In clinical practice，its contraindications should be cared，and more follow-up studies should be conducted. Related Articles | Metrics

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Application and Progress of Estrogen Oral Contraceptives WANG Xiao;XIONG Cheng-liang 2013, 32 (4):  254-257.  Abstract ( 1941 )   PDF (652KB) ( 7478 )   The combined oral contraceptives（COCs） are the main methods with steroidal hormones for birth control at present. For half a century，the more safe，reliable and effective COCs were continuously developed. The chemical composition of estrogen in COCs have also been improved. This article summarized the early process of modern COCs and the development of estrogen，as well as the contraceptive mechanism of ethinylestradiol and mestranol. The two developing areas of estrogen in COCs are as follows：to reduce its dose to achieve an optimal concentration for the body′s sensitivity and compliance，to find some better estrogens than ethinyl estradiol. Related Articles | Metrics

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Research Progress on Antifertility of Chinese Herbal Medicine HUANG Shi-xing;XIONG Cheng-liang 2013, 32 (4):  258-260.  Abstract ( 1923 )   PDF (647KB) ( 7369 )   It is a long history that traditional Chinese medicines （TCM） as some natural herbs were used in clinical practice and contraception. With the development of modern medicine，hormonal contraceptives gradually become mainstay. Actually，TCM was not replaced in clinical practice，especially in reproductive medicine. In recent years，many experiments confirmed that some TCMs have antifertility effects，meanwile have more important antibacterial effects. We reviewed the research progress of TCM antifertility，and TCM active compositions，so as to provide theoretical basis for the further research and clinical application of Chinese herbal medicine. Related Articles | Metrics

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Research Progress of the Antimicrobial Peptides with Dualfunctionality of Spermicide and Microbicide ZHANG Wei;HOU Li;YU He-ming 2013, 32 (4):  261-263.  Abstract ( 1872 )   PDF (863KB) ( 7326 )   Antimicrobial peptides are of important components of low-molecular weight peptides to defense organisms invasion. Antimicrobial peptides have many characteristics，such as the big antibacterial potential，broad antibacterial spectrum，safety，and non-toxic. Some of them also have powerful spermicidal and contraceptive potential. This review introduced the difunctionality of spermicide and microbicide of four antimicrobial peptides，including Magainin，Dermaseptins，Nisin and Subtilosin，which could provide us new ideas to develop the biological products with the difunctionality of spermicide and microbicide. Related Articles | Metrics

讲座

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Immediate Post-abortal Insertion of the Intrauterine Devices WANG Cai-yan;HUANG Zi-rong 2013, 32 (4):  264-266.  Abstract ( 1799 )   PDF (618KB) ( 7361 )   Women generally have strong desire for contraception when they are suffering from artificial abortion. The immediate insertion of an intrauterine device （IUD） after an artificial abortion can induce higher rate of effective contraception and lower rate of repeated abortion，while the cost of public health was finally saved. The immediate insertion of IUD after an artificial abortion is safe and high-effective without increased risks of adverse outcomes，such as pain，bleeding，perforation and pelvic inflammatory disease （PID）. Although the rate of IUD expulsion of the immediate post-abortal insertion is low，the follow-up examination is still very important. It's not clear whether the removal of IUD in those women after menopause is difficult. There are two types of IUD for the immediate post-abortal insertion，the copper IUD and the progesterone-releasing IUD. Related Articles | Metrics

标准与指南

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The Technical Guide of Long-acting Reversible Contraceptives for those Post-abortion and Postpartum Women HOU Zi-hong;WU Shang-chun;GU Xiang-ying 2013, 32 (4):  267-268.  Abstract ( 1937 )   PDF (990KB) ( 7456 )   The post-abortion and postpartum are of two key times to initiate contraception timely or as early as possible，by which the unwanted pregnancy can be effectively prevented. So abortion and its complications are prevented，and health of mind and body，and reproductive health，are protected for women of childbearing age. Based on the guideline of post-abortion and postpartum contraception，this review introduced the long-acting reversible contraceptives （LARCs），such as the IUDs and Implanons，which were given priority to those women. This review will help clinicians and consultants to provide safe and appropriate contraceptives under the informed consent for those post-abortion and postpartum women. Related Articles | Metrics

论著

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The Correlation between IVF Methods and Monozygotic Twins Gestation FAN Wen-qian;SUN Ying-pu;SU Ying-chun;GUO Yi-hong 2013, 32 (4):  275-277.  Abstract ( 1758 )   PDF (1018KB) ( 7484 )   Objective： To investigate the correlation between those risk-factors of in vitro fertilization-embryo transfer （IVF-ET） and monozygotic twins （MZT） gestation. Methods：3 966 clinical pregnancy cycles，including 36 MZT cycles，were analyzed by Logistic regression. According to fertilization methods and with or without laser-assisted hatching （LAH），total of 11 423 IVF/intracytoplasmic sperm injection （ICSI） cycles were divided into nonAH-IVF group （4 624 cases），nonAH-ICSI group （1 571 cases），LAH-IVF group （3 807 cases） and LAH-ICSI group （1 421 cases）. The incidences of MZT were compared. Results：LAH-ISCI （OR=1.039，95%CI:1.013～1.065） may be a risk factor of MZT pregnancy in IVF-ET. There were no significant differences in general condition between nonAH groups and LAH groups，and no significant differences in clinical pregnancy rate （40.72% vs. 42.76%） and MZT rate （0.69% vs. 0.75%） between nonAH-IVF group and nonAH-ICSI group （P＞0.05）. MZT rate was significantly higher in LAH-ICSI group than that in LAH-IVF group （2.31% vs. 0.66%，P＜0.05），while there was no significant difference in the pregnancy rate between the two groups （27.97% vs. 29.77%，P＞0.05）. Conclusions：LAH-ICSI might increase the occurrence of MZT. Related Articles | Metrics

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Application of Cordocentesis Guided by Transabdominal Ultrasound in Prenatal Diagnosis LI Xiao-feng;GONG Fei;XIAO Hong-mei;TAN Yue-qiu;LIN Ge 2013, 32 (4):  278-280.  Abstract ( 2105 )   PDF (1003KB) ( 7405 )   Objective： To evaluate the efficacy and safety of cordocentesis guided by transabdominal ultrasound during pregnancy for prenatal diagnosis. Methods：The cordocenteses under transabdominal ultrasound guidance were performed in 158 cases with proper indications for fetal chromosome analysis at Reproductive & Genetic Hospital of CITIC-XIANGYA during 2004 to 2012（21 cases of chromosomal anomaly of gravida or her husband，58 cases of hinting abnormal by ultrasound，38 cases of bad pregnancies history，41 cases of serology screening is positive of gravid）. The abnormal karyotypes rate，operational indications，complications and pregnancy outcomes were analyzed. Results: The success rate of cordocentesis was 100%. There were 11 abnormal karyotypes in those 158 cases （6.96%） detected by cordocentesis. The difference in the abnormal karyotypes rate among four groups was not significant （χ2=7.377，P=0.061）. There were 97 cases with the blood leakage from placentas or umbilical cords （６１．４％），and 17 cases with transient fetal bradycardia （10.8%） after cordocentesis. There was not a preterm delivery，intrauterine infection or placental abruption. In those 11 cases treated by the induced labour，and 3 birth defects were diagnosed. Conclusions：Cordocentesis guided by transabdominal ultrasound is a useful，relatively safe and effective procedure for prenatal diagnosis. Birth defects can not be completely diagnosed by the cordocentesis and genetic analysis at present，so it is necessary to use ultrasonography as the further follow-up diagnosis for reducing the rate of birth defect. Related Articles | Metrics

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Exposure of Phthalic Acid Esters and Spontaneous Abortion GAO Fu-mei;CAI Xiao-hui;SHEN Huan 2013, 32 (4):  281-283.  Abstract ( 1826 )   PDF (950KB) ( 7427 )   Objective： To investigate the relationship between phthalic acid esters （PAEs） exposure and sponstaneous abortion. Methods：In this retrospective study，107 spontaneous abortion cases and 152 induced abortion cases of early pregnancy were included，from January 2009 to December 2012. All the patients enrolled were required to complete a survey questionnaire about PAEs exposure. Results：By statistical analysis of logistic regression，it was showed that the shorter after the house decoration （OR=0.88，95%CI：0.81-0.96，P=0.00），the less office ventilation in summer （OR=0.95，95%CI：0.90-1.00，P=0.04） and the more utilization of preservative film（OR=1.14，95%CI：1.00-1.29，P=0.047），the higher relative risk of spontaneous abortion. In contrast，it was also observed that the more frequent of housecleaning （OR=3.50，95%CI：1.60-7.64，P=0.00），the lower relative risk of spontaneous abortion. Conclusions：The environmental pollutant of PAEs may be one of risk-factors of spontaneous abortion. Related Articles | Metrics

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Clinical Application of the Laparoscopy Combined with Hysteroscopy or Laparoscopy only in Treating Cornual Pregnancy and Interstitial Tubal Pregnancy WU Ji-rong;PENG Xiao-mei;LI Jia-qi 2013, 32 (4):  284-285.  Abstract ( 1759 )   PDF (961KB) ( 7426 )   Objective：To compare the efficacy of the laparoscopy combined with hysteroscopy or the laparoscopy only in treating tubal interstitial pregnancy and cornual pregnancy. Methods：From August 2007 to August 2012，there were 59 patients with tubal interstitial pregnancy or cornual pregnancy in our hospital. They were divided into two groups，group A treated with the laparoscopy combined with hysteroscopy，group B treated with the laparoscopy only. The clinical data were retrospectively analyzed. Results：The diagnostic accordance rate，operating time，blood loss，and the success rate of retaining fallopian tube，were significantly different in two groups （P＜0.05）. The average hospital stays after operation，and the tiem of hCG changing negative，were insignificantly different in two groups（P＞0.05）. Conclusions：The combination of laparoscopy and hysteroscopy can make definite diagnosis of tubal interstitial pregnancy and cornual pregnancy. It is a safe and effective way to protect the integrity of uterine and fallopian tube. Related Articles | Metrics

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Short-term Efficacy and Quality of Life Evaluation for Adenomyosis after High Intensity Focused Ultrasound Treatment LU Bai-yu;HU Kui;YAN Li-mei;HE Min;HUANG Guo-hua;LI Ke-quan;HE Jia 2013, 32 (4):  286-289.  Abstract ( 1982 )   PDF (1111KB) ( 7411 )   Objective： To evaluate the efficacy of the ultrasound ablation with real-time ultrasonic monitoring in adenomyosis treatment and the effect on life quality. Methods：35 patients with adenomyosis were treated with the high intensity focused ultrasound（HIFU）. The effecacy of ablation was evaluate by the enhanced MRI. The lesions were monitored by the color Doppler ultrasound. Clinical symptoms，life quality，the side effects after treatment，as well as prognosis，were recorded by the standard UFS-QOL measuring scale. Results：The ablation ratio of adenomyosis lesion detected by the enhanced dynamic MRI was （68.9±18.9）% on the 2nd day after treatment. All side effects after treatment were under the B-level of the standard classification of International Association of Interventional Radiology （SIR）. The size of adenomyosis lesion before treatment [approximately 36.9（20.5，44.8） cm3] was significantly bigger than that after one month of treatment [19.1（12.1，31.1） cm3]（Z=2.801，P=0.005）. The UFS score before treatment [22.5（17.5，32.5）] was higher than that after one month of treatment [15.0（7.5，25.0）]（Z=3.695，P=0.000）. However，the QOL before treatment was （77.9±10.5） while the QOL after one month of treatment was（81.4±13.3），respectively （t=1.230，P=0.223）. Dysmenorrheal was significantly relieved（Zc=7.280，P=0.000）. Conclusions：The ultrasound-guided high intensity focused ultrasound ablation is effective in treatment of adenomyosis，the associated clinical symptoms can be significantly relieved and the size of lesions be significantly reduced. It is a longer follow-up time to improve the quality of life. Related Articles | Metrics

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Efficacy of Letrozole in Clomiphene-resistant Infertile Women with Polycystic Ovarian Syndrome YANG Zheng-li;LIU Rong-xia;HAO Guo-rong 2013, 32 (4):  290-292.  Abstract ( 1725 )   PDF (1031KB) ( 7570 )   Objective： To evaluate the clinical efficacy of letrozole in treatment of clomiphene-resistant women with polycystic ovarian syndrome （PCOS）. Methods：Eighty-eight clomiphene-resistant women with PCOS were enrolled in this prospective，randomized，open-labeled study between Jan. 2010 and Jan. 2011. All subjects were divided into three groups andomly：the Letrozole group received Letrozole （LE） 2.5 mg/d per os for 5 days during days 3-7 of menstrual circle，the control group was administered HMG progressive increasing from 75 IU/d intramuscular. for ovulation induction on day 5 of menstrual circle；the LE+HMG group was treated with LE 2.5 mg/d for 5 days during days 3-7 of menstrual circle，from day 8，then treated with HMG 75 IU/d intramuscular. The transvaginal ultrasonography was applied to observe follicle growth and ovulation. When the follicular diameter was ≥18 mm in length，hCG （5000 IU） was injected to induce ovalution. Ovulation rate，pregnancy rate and the endometrial thickness were observed. Results：Ovulation rate and pregnacy rate were similar in three groups. The incidences of single dominant follicle in LE group and LE+HMG group were significantly higher than that in HMG group （P＜0.05），while the numbers of mature follicles in the LE group and LE+HMG group were lower than that in the HMG group. There was insignificant difference in endometrial thickness at the day of hCG injection among three groups. Conclusions：Letrozole can get good ovulation rate and pregnancy rate in those clomiphene-resistant women with PCOS. Compared with HMG alone，LE combined with HMG on the controlled ovarian stimulation can get higher ovulation rate with the lowered dose of HMG. Related Articles | Metrics

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Status of Reproductive Health Knowledge among Undergraduates and its Influential Factors LI Guo-ju;LI Xiao-mei;LIU Song;HOU Yun-rong;LI Xiang-yun 2013, 32 (4):  293-296.  Abstract ( 1806 )   PDF (1051KB) ( 7372 )   Objective： To survey the knowledge status of reproductive health among students in a medical college，and to analyze its influential factors，so as to provide evidences for education of reproductive health in university. Methods：The stratified random sampling study was based on the data collected from a medical college. The self-designed questionnaire was used to collect data after consulting several specialists. Results：A total of 2 500 individuals were interviewed，and 2 421 undergraduates actually completed the questionare. The proportion of effective questionaire was 96.84%. The average scores of the sexually transmitted disease （STD） knowledge and reproductive knowledge were 53.422 and 72.678，respectively. Multi-factor analysis showed that gender （the score in male was higher than that in female），grades （the scores in senior and junior were higher than that in fresh），specialties （the score in medical students was higher than those in non-medical students），and consumption levels （the score in those high-consumption students was higher than that in those low-consumption students） could be main influential factors. Conclusions：This study showed that the knowledges of reproductive health in undergraduates were different in different groups of gender，grades and specialties. The education of reproductive health in college （university） should be carried out in accordance with the different conditions of students. Related Articles | Metrics

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The Empty Spiracles Homeobox 2 in Reproductive Medicine: A Review LIU Na;CAI Xia 2013, 32 (4):  301-304.  Abstract ( 1718 )   PDF (763KB) ( 7384 )   The empty spiracles homeobox 2 （EMX2） is homolog of the Drosophila head gap gene empty spiracles（ems） homeobox gene. The normal developments of human urogenital system and pelvis are dependent on the regulation of EMX2. EMX2 expressed in adult reproductive tract with cyclical changes，which regulated normal endometrial remodeling and blastocyst implantation. The upstream genes of EMX2 are HOXA10，Spastin and Ghrelin，while the downstream genes of EMX2 were reported less. EMX2 is related to the occurrence of endometriosis. With continuous study in future，we believe that the effect of EMX2 gene，as well as its clinical application in infertility and ART，will be revealed. Related Articles | Metrics

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Effect of Apigenin on Reproduction and Reproductive Endocrinology KOU Yong-mei;GUO Xiao-xia 2013, 32 (4):  305-307.  Abstract ( 1779 )   PDF (826KB) ( 7464 )   Apigenin，a common flavonoid，has extensive pharmacological activities. Apigenin inhibits growth and invasion of tumor cells of urogenital system through a variety of mechanisms and multiple pathways. Apigenin can also induce apoptosis of tumor cells. Meanwile，apigenin has a harmful effect on testis because of its estrogenic activity. Apigenin regulates the endocrine system by the hypothalamus-pituitary-gonadal axis. However，studies on the biological activity of apigenin are mostly in vitro or at animal model stage，and many mechanisms are still unclear. Therefore，it is necessary to study further the pharmacological effects and mechanisms for the further development of apigenin and its clinical application. Related Articles | Metrics

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Common Morbid Genes of Hereditary Deafness and Screening Methods WANG Yan-li;ZHANG Ying 2013, 32 (4):  309-312.  Abstract ( 1953 )   PDF (852KB) ( 7444 )   Deafness，a common disability affected human health，was mostly hereditary. There were more than one hundred deafness genes identified. In our country，the most common genes involved in deafness are GJB2，SLC26A4，12SrRNA. With the development of molecular biology，the methods to detect deafness genes，including restriction enzyme mapping，denaturing high performance liquid chromatography，high-resolution melt, and gene chip，were developed. Gene chip technology is a rapid method for screening deafness genes. The accurate and rapid diagnosis of hereditary deafness is helpful to further treatment，so as to improve the quality of life. This article reviewed the morbific genes and screening methods. Related Articles | Metrics

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Early Screening and Prevention Strategies for Biliary Atresia LOU Xi-rong;GUAN Zhi-wei;ZHAN Jiang-hua 2013, 32 (4):  313-316.  Abstract ( 1928 )   PDF (1061KB) ( 7370 )   Biliary atresia （BA） is one of the most significant life-threatening hepatobiliary disorders in infant. Those patients with BA could die in the first year of life if not treated timely. The etiology of BA is unclear. It may be related to genetic factors，viral infections，immune dysregulations，etc. Reasonable application of noninvasive techniques，such as B-ultrasound for prenatal screening，can effectively prevent BA and really reduce the incidence of BA. The preferred treatment for BA is hepatoportoenterostomy which was proposed by Kasai in 1959. Early diagnosis and early treatment are critical to increase the rate of successful operation and to improve the quality of life. So，it is important to promote the early screening of BA. Related Articles | Metrics

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Evaluation of Laparoscopic Myomectomy HU You-bin;HAN Wen-jun;ZHAO Min 2013, 32 (4):  317-318.  Abstract ( 1818 )   PDF (828KB) ( 7321 )   Uterine fibroids are the most common benign tumors of the genital tracts in women aged 30 to 50 years. In recent years，laparoscopic myomectomy is widely used with the development of minimally invasive surgical techniques. Laparoscopic myomectomy has been widely recognized as the merits of small wound，clear operative horizion，safe and early recovery，etc. There are still controversies about surgery indications and the prevention of postoperative complications. We reviewed papers pbulished in recent years. It depends on not only the fibroids' number，size，location，but also the surgeon′s operating proficiency，the patient's marriage and wishes，whether laparoscopic myomectomy is preferred. Complications of laparoscopic myomectomy include bleeding，infection，fibroids recurrence，regnancy uterine rupture，etc. In this article，we also raised up some prevention measures. Related Articles | Metrics