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15 July 2012, Volume 31 Issue 4
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Roles of the Advanced Glycation End Products （AGEs） and Its Receptors in Women's Reproductive Health YANG Dong-zi;GUO Jing 2012, 31 (4):  253-256.  Abstract ( 2271 )   PDF (361KB) ( 7290 )   The advanced glycation end products （AGEs） are a group of reactive cross-linked molecules formed by the non-enzymatic glycation of proteins，lipids，and nucleic acids. AGEs product and accumulate quickly in condition of aging，hyperglycemia，insulin resistance，oxidative stress，inflammation，diabetes，atherosclerosis and other diseases. AGEs cause harmful effect on tissues and cells by binding to their receptor （RAGE）. A soluble isoform of RAGE （sRAGE） palys a protective role as a decoy receptor，which could be a new way to interfere with AGEs. In the past years，the roles of AGEs and RAGE in female reproductive health were studied with concern. The high level of AGEs was found to be related to polycystic ovary syndrome，endometriosis and poor outcome of ART. And the high level of AGEs may lead to high rates of preeclampsia，preterm birth and gestational diabetes. High level of AGEs can be lowered though life style modification and drug targeting to improve female reproductive function and ART outcomes in sterility women. Related Articles | Metrics

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Current Opinion on ADAM12S as a First- and Second-Trimester Screening Marker of Aneuploid ZHANG Ying 2012, 31 (4):  257-260.  Abstract ( 2075 )   PDF (449KB) ( 7355 )   A disintegrin and metalloprotease 12 （ADAM12） with proteolytic activity is a placenta- derived glycoprotein，which is involved in growth and differentiation. ADAM12-S can hydrolyze the insulin-like growth factor binding protein （IGFBP）. There is the secretory or soluble type of ADAM12 （ADAM12-S） in serum of pregnancy women，but there is not this type in non-pregnancy women. ADAM12-S levels tend to increase with the advanced gestational age in normal pregnancies. ADAM12 levels are correlated with maternal weight and ethnicity，but neither with maternal age. Smokers have lower ADAM12 levels than non-smokers. Serum ADAM12 level is highly stable. ADAM12 level is markedly decreased in the first trimester in pregnancies with foetal downs syndrome，but it is markedly elevated in the second trimester. ADAM12 levels are markedly decreased in the first trimester in pregnancies with trisomy 18，trisomy 13，Turner syndrome and triploidy. It is necessary to evaluate further the possibility that ADAM12 may be used as a additional or alternative marker in the first-trimester and second-trimester of pregnancy. Related Articles | Metrics

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Construction and Idenfication of Recombinant Adenovirus Vectors for Mouse Calb2 Expression WANG Jing;LUO Jian;LIU Shan;DAI Xiao-nan;GAO Li;GAO Chao;LIU Jia-yin;CUI Yu-gui 2012, 31 (4):  261-264.  Abstract ( 2271 )   PDF (717KB) ( 7322 )   Objective： To construct the recombinant adenovirus vector of Calretinin （Calb2） gene for over-expression of Calb2 gene，as useful tools to study the effects of Calb2 on the regulation of reproductive endocrinology，central nerve system，and visual conduction. Methods：The cDNA sequence of Calb2 was cloned by the reverse transcriptive polymerase chain reaction （RT-PCR）. A Calb2 gene fragment was sub-cloned into adenovirus shuttle plasmid pAdTrack-CMV to construct the shuttle plasmid pAdTrack-Calb2. Then it was transformed into BJ5183 cells with the adenoviral backbone pAdEasy-1 to obtain the homologous recombinant AdCMV-Calb2. The recombinant AdCMV-Calb2 was further packaged and amplificated in AD293 cells. The expression of Calb2 protein in AD293 cells was detected by Western blotting. Results：The Calb2 gene recombinant adenovirus vectors，AdCMV-Calb2，were constructed successfully by endonulease digestion and sequencing. The AD293 cells infected with AdCMV-Calb2 significantly expressed GFP protein. The expression of CALB2 protein was significantly up-regulated in AD293 cells infected with AdCMV-Calb2 plasmids. Conclusions： The recombinant adenovirus vectors of AdCMV-Calb2 were successfully constructed and their expression was identified in AD293，which has provided a laboratory basis to study the function of Calb2 gene. Related Articles | Metrics

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Analysis on the Aneuploidy Incidence of Chromosome X/Y and 18 in Later Cleavaged Embryos SHI Jie;YANG Qing-xiu;LUO Hai-ning;ZHANG Yun-shan 2012, 31 (4):  265-267.  Abstract ( 2314 )   PDF (577KB) ( 7437 )   Objective： To analyze the aneuploidy incidence of Chromosome X，Y and 18 in later cleaved embryos. Methods：The aneuploidy of Chromosome X，Y and 18 in later cleaved embryos from MⅡoocytes and two pronuclei （2PN） zygotes was detected by the method of fluorescence in situ hybridization （FISH）. Results：There were 45 later cleaved embryos from MⅡoocytes and 40 poor scored embryos from 2PN zygotes among 85 obtained embryos. Fluorescent signals were successfully catched in 512 nuclei. The abnormality rates of X，Y and 18 chromosomes were 34.5% and 38% in later cleaved embryos，and 32% and 39% in poor scored embryos from 2PN zygotes. The differences of aneuploidy incidences of chromosome X，Y and 18 were statistically insignificant between two groups. Conclusions：There are high incidences of Chromosome X，Y and 18 in later cleaved embryos and poor scored embryos from 2PN zygotes， showing that those embryos are not suitable for embryo transfer. Related Articles | Metrics

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Effect of hCG at Different Dosages on the Pregnancy Outcomes of IVF-ET XU Feng-qin;ZHANG Yun-shan;LUO Hai-ning;MA Jun-fang;SONG Cui 2012, 31 (4):  268-270.  Abstract ( 2021 )   PDF (502KB) ( 7286 )   Objective： To investigate the effects of hCG at different dosages on embryo quality and IVF-ET outcomes，so as to discuss the feasibility and safety of the lowered dosage of hCG in inducing ovulation to prevent OHSS. Methods：327 patients who had high risks of OHSS were divided into two groups as follows，group A：204 patients with hCG dosage of 2 000-4 000 IU；group B：123 patients with hCG dosage of 10 000 IU. Age，initial Gn dosage，total dosage of Gn，No. of egg retrieval，clinical pregnancy rate and the OHSS rate，were compared between two groups. Results：There were no significant differences in age，BMI，initial and total dosage of Gn，days for COH between group A and B. The differences of the E2 levels on hCG injection day，No. of growth follicles，No. of egg retrieval，fertilization rates，2PN embryos，gradeⅠembryos，No. of ET and frozen embryo between two groups were statistically insignificant. The rate of severe OHSS in group A was lower than that in group B. The clinical pregnancy rate per egg retrieval cycle in group A was significantly lower than that in group B，while the differences of the pregnancy rates per transfer cycle between two groups were statistically insignificant. Ｃｏｎｃｌｕｓｉｏｎs： The decreasing dosage of hCG for ovulation induction in high risk OHSS patients during IVF-ET has no negative influence for egg maturation，insermination and embryo quality，but can effectively prevent the severe OHSS. Related Articles | Metrics

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Application of the High-risk HPV Testing and Colposcopy in Diagnosing Atypical Squamous Cells of Undetermined Significance YANG Yun 2012, 31 (4):  271-272.  Abstract ( 2036 )   PDF (567KB) ( 7289 )   Objective： To evaluate the application value of HR-HPV and colposcopy in CIN and invasive cervical cancer diagnosis，when ASCUS was diagnosed by the cervical cytology，and to build the clinical diagnose pathway. Methods：320 patients who were diagnosed as ASCUS underwent the colposcopy and HR-HPV test. The relationship between ASCUS and patients' age was also analysed. Results：In ASCUS patients，49.38% patients were aged from 30 to 49 years. The histo-pathological results of 320 ASCUS were as follows：inflammation 73.13% （234/320），condyloma 5.32% （17/320），CIN （included CINⅠ，CINⅡ，CINⅢ） 20.61% （66/320），high grade CIN（included CINⅡ，CINⅢ） and invasive cancer 7.5%（24/320）. 144 patients were HR-HPV positive，and the positive rate was 45%（144/320）. In HR-HPV positive group，43.75% patients （63/144） were CIN. In HR-HPV negative group，only 3.41% patients（6/176）were CIN. Ｃｏｎｃｌｕｓｉｏｎs： Those ASCUS patients with HR-HPV positive，especially between 30-year to 49-year，should undergo colposcopy. Those patients with HR-HPV negative might not undergo colposcopy，but they should receive the TCT and HR-HPV test regularly. Related Articles | Metrics

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Clinical Application of Three Steps Screening for Cervical Cancer CHEN Jie-qing;ZHANG Ying-hui 2012, 31 (4):  273-275.  Abstract ( 1756 )   PDF (651KB) ( 7353 )   Objective： To evaluate the clinical application of three steps screening for cervical cancer, being thinprep cytology test （TCT），high-risk human papilloma virus （HR-HPV） DNA，and colposcopy biopsy for pathological examination. Methods：The screening results of 8 199 women who received cervical cancer screening at Chanchcheng Central Hospital of Foshan，from January 2009 to December 2011，with the three steps screening program，were analyzed retrospectively. Results：The positive rate of TCT was 6.6%，and the positive rate of ≥HSIL was 1.56%，in 8 199 participants. The infection rate of HR-HPV was 55.96% in 1 258 participants. 783 participants received colposcopy，and the positive rate was 56.32%. 441 patients underwent cervical biopsy，the biopsy rate was 5.38%. In pathological examination，the positive rate of precancer was 51.93%，the detection rate of high-grade cervical intraepithelial neoplasia was 25.4%. According to pathological grades，the detection rates were：CINⅠ54.70%，CINⅡ86.49%， CINⅢ96.43%，cervical cancer 97.87%. The detection rates of CINⅠand cervical cancer were higher than that of CINⅢ，while the double positive rate of TCT and HR-HPV DNA of cervical cancer was statistically higher than those of CINⅠ，CINⅡ and CINⅢ （P＜0.01）. Conclusions： Three steps screening，TCT combining with HR-HPV DNA detection and colposcopy in cervical biopsy for pathology，can effectively detect cervical lesions and improve screening rate of cervical cancer. Related Articles | Metrics

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Diagnostic Value of the Cervical Precancerous Lesions by Liquid-based Cytology Technique Combined with High-risk HPV-DNA Detection WANG Yu-qin;WANG Jin-hua 2012, 31 (4):  276-277.  Abstract ( 1847 )   PDF (615KB) ( 7344 )   Objective： To evaluate the diagnostic application of the high-risk human papilloma virus DNA （HPV-DNA） detection combined with liquid-based cytology technique （LCT） in cervical precancerous lesion. Methods：365 women with cervical precancerous lesion from Department of obstetrics and gynecology，Jiangsu Cancer Hospital，January 2008 to March 2010，were selected. The Screening of cervical cancer was performed by LCT and HPV-DNA detection. All women underwent colposcopic cervical biopsies and pathological examination. Pathological examination was regard as the gold standard to diagnosis cervical precancerous lesions. Results：The HPV positive results were observed in 106 cases and the LCT positive results （≥ASCUS） in 178 cases，the positive results of pathological examination were 84 and 121 cases，respectively. In 143 women with negative results of LCT and HPV detection，only two cases had the posotive results of pathological examination. The diagnostic sensitivity and specificity of LCT for cervical precancerous lesions were 80.1% and 84.9%. The diagnostic sensitivity and specificity of HPV were 55.6% and 74.1%. The sensitivity and specificity increased to 98.7% and 98.6% when combined two methods. Conclusions：Liquid-based cytology technique combined with high-risk HPV-DNA detection is better than any single technique for screening precancerous lesion of cervical carcinoma. Related Articles | Metrics

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Non-simultaneous Bilateral Tubal Ectopic Pregnancy：Two Case Reports and Literature Review TU Jiong-jiong;GONG Fei 2012, 31 (4):  278-280.  Abstract ( 1775 )   PDF (595KB) ( 7240 )   Objectives：To discuss the early diagnosis of non-simultaneous ectopic pregnancy and current treatment methods. Methods：Two cases with non-simultaneous bilateral tubal ectopic pregnancy in our reproductive medical center and three cases previously reported have been reviewed. Results：The contralateral delayed ectopic pregnancy might be easily ingnored while unilateral pregnancy has been confirmed，which often needs secondary surgery. Conclusions：For the infertile women in ART with tubal factors，removal of both follopian tubes might be a solution to exclude the potential non-simultaneous bilateral tubal ectopic pregnancy while unilateral salpingectomy is performed. Otherwise，carefully examination of contralateral tube in surgery and strictly follow up of serum β-HCG after surgery facilitate to discover the potential non-simultaneous pregnancy for those people want to save another tube. Related Articles | Metrics

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Analysis of the Association Between Preoperation Vaginal Ecology and Pelvic Celiac Disease in Sterilized Women CHEN Xiao;CHEN Ya-qiong;HOU Hai-yan 2012, 31 (4):  281-283.  Abstract ( 2151 )   PDF (578KB) ( 7230 )   Objective： To analyze the vaginal secretion pathogen and ecology correlative factors in infertile patients. Methods：We did the retrospective survey included 850 infertile women who accepted the hysteroscopy and laparoscopy examination from Jan 2008 to Dec 2009. Vaginal secretion was collected before operation. The Nugent grade was used to evaluate the vaginal bacteria. The patients were then divided into two groups，normal bacteria group （307 cases，36.12%） and abnormal group （543 cases，63.88%）. The abnormal group was further divided into five subgoups as follows, lactobacillus decreased group （325 cases），Gram positive bacillus small group （173 cases），bacterial vaginal disease group （26 cases），flora inhibit group （11 cases） and vulvovaginal candidiasis group （8 cases）. Results：The dysmenorrheal rate of abnormal bacteria group was higher than that of normal bacteria group （P＜0.05），OR （95%CI ） was 1.38 （1.02-1.88），while the incidence rate of pelvic endometriosis was higher than that of normal bacteria group （OR=1.82，95%CI：1.09~3.04，P=0.021）. The tubal distortion rate of the BV positive group was higher than that of normal group （OR=5.02，95%CI：2.11~11.94，P=0.000）. Conclusions：It is important to treat actively endometriosis for protecting the vaginal microenvironment. It would play some roles in the fertility protection to reconstruct the normal vaginal ecology. Related Articles | Metrics

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Analysis of Risk Factors of Ectopic IUD ZHANG Min;ZHOU Jian;LI Ying 2012, 31 (4):  284-287.  Abstract ( 2028 )   PDF (635KB) ( 7298 )   Objective： To evaluate the risk factors of ectopic intrauterine device （IUD），so as to prevent the adverse events of ectopic IUD，and to conduct the safest use of IUDs. Methods： By analyzing the top six adverse events of IUDs which submitted to the database of National Population and Family Planning Commission （NPFPC） contraceptive adverse reaction monitoring center，we explored the incidences of IUDs adverse events，patient's characteristics such as age，parity and breastfeeding status，to analyze the risk factors of ectopic IUDs. Results： The top six IUDs were MCu IUD，TCu220C，medicated stainless steel ring-165 （containing copper），YuanGong IUD，stainless steel ring，copper uterine cavity-shaped intrauterine devices （UCD200）. Totally，there were 236 ectopic IUDs. 210 IUDs （88.98%） were partial embedded into the endometrial and muscular layer，6 IUDs （2.54%） were complete into the endometrial and muscular layer，20 IUDs （38.98%） were migrated outside the uterus. Abdominal pain was the main events detected in the clinical symptoms. The close-model IUDs got higher risk of translocation following the transfer time of IUDs （P<0.000 1）. Conclusionｓ： IUDs type and the time after transfer might be associated with the ectopic IUDs. Abdominal pain was trigger for detection of ectopic IUDs. Women with IUDs should have regular follow-up visits. Related Articles | Metrics

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Retrospective Investigation of Clinical Application of Four Different Drugs Combination in Painless Induced Abortion DENG Ya-li;DENG Ji-guang;REN Hui-min;LI Ling;TIAN Ping 2012, 31 (4):  288-290.  Abstract ( 1816 )   PDF (691KB) ( 7310 )   Objective： To evaluate the effectiveness and safety of the combined application of drugs in painless abortion. Methods：816 patients receiving painless abortion were classified randomly into four groups as follows，group A：ketamine 50 mg and diclofenac sodium suppositories 50 mg，group B：propofol and diclofenac sodium suppositories 50 mg，group C：propofol and fentanyl 0.05 mg，and group D：propofol and flurbiprofen axetil 50 mg. Results：①The body reactions of group B，C and D were superior to group A （P<0.01）. ②The analgesic effects of group C，D were superior to group B （P<0.01）. ③The recovery time and orientation time of group D were less than those of group C （P<0.05）. ④The dosage of propofol in group D was less than that of group B and C （P<0.05）. Conclusions：Combination of propofol and flurbiprofen is one of the safest and effective way for painless induced abortion，which is worth in clinical practice. Related Articles | Metrics

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Application of DHEA in Obstetrics and Gynecology ZHANG Yang-yang;XU Yang 2012, 31 (4):  291-294.  Abstract ( 1770 )   PDF (741KB) ( 7375 )   The mechanism of action of dehydroepiandrosterone （DHEA） and its sulphate DHEAS，the most abundant sex steroids in human，are not well understood. Low levels of DHEA are associated not only with the ageing process but also with diabetes mellitus，cardiovascular diseases and some neurological or immunological diseases. Clinical application and practice of DHEA have been a topic，especially in women. Although its effectiveness has been universally acknowledged，there is scant evidence to support the safety of DHEA in clinical therapy. It is necessary to conduct the adequately powered，well-designed and randomized，and placebo-controlled trials to evaluate the clinical application of DHEA. Related Articles | Metrics

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Cryopreservation of Human Ovarian Tissue and It's Evaluation 2012, 31 (4):  295-298.  Abstract ( 2049 )   PDF (738KB) ( 7311 )   Related Articles | Metrics

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Cryopreservation of Human Ovarian Tissue and It's Evaluation PAN Yong-miao;XU Xiang-rong;PAN Yuan-yuan;HUANG He-feng 2012, 31 (4):  295-298.  Abstract ( 1111 )   PDF (738KB) ( 6930 )   Malignancy itself and its radiotherapy or chemotherapy result in premature ovarian failure. The cryopreservation of ovarian tissue may restore fertility and endocrine function for those patients，which is an important clinical technique. Laboratory methods of ovarian cryopreservation include slow-rate freezing，ultra-rapid cooling and vitrification. The histological morphology of oocytes and granular cells was observed by optical microscope after freezing and thawing ovarian tissue. Effect of freezing and thawing procedures on the ultrastructure of oocytes and interstitial cells，including mitochondria，endoplasmic reticulum，karyotheca，chromatin and so on，was evaluated by electron microscope. The potentiality of growth and development of ovarian tissue after culture was evaluated by oocyte diameter，shape and amount of granular cells，formation of follicular cavity and zona pellucida，hormonal levels in culture medium. It is the major index and goal to detect endocrinal function and reproductive recovery after tissue transplantation with the cryopreservated ovarian tissue. Related Articles | Metrics

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Recent Advances in Study of Microinsemination with Haploid Spermatid SONG Xiao-min;JIANG Hong 2012, 31 (4):  299-302.  Abstract ( 1783 )   PDF (691KB) ( 7267 )   Men with non-obstructive azoospermia might get their offspring with paternal genetic material by micro-injecting haploid spermatid into oocytes （round spermatid injection，ROSI；elongated spermatid injection，ELSI）. The haploid spermatid could be obtained from semen，testis biopsy specimens or in vitro culture of spermatogenic cells. But the fertilization rate and pregancy rate after micro-injecting with haploid spermatids were not satisfactory. In this paper，we discussed the ROSI/ELSI technique and its progress，the spermatid injection and activation，and its clinic application，as well as clinical and technical problems. Related Articles | Metrics

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Clinical Application of Assessment Methods for Embryo Quality in Assisted Reproductive Technology WANG Cai-zhu;ZHANG Bo;FENG Gui-xue 2012, 31 (4):  303-307.  Abstract ( 1744 )   PDF (799KB) ( 7354 )   Embryo viability assessment is critical when selecting single embryo to transfer. The first and the most extensive application is morphology scoring，including the scoring of oocyte，pronucleus，cleavage embryo and blastocyst. Though，recent years，targeted-metabolic analysis have been proposed as a useful tool for assessment of embryo，involving pyruvate acid，glycometabolism，amino acid turnover，soluble HLA-G and so on. Furthermore，metabolomic-profiling，by analyzing the metabolome of different embryo development stage，has showed the great application promising. But，the assessment only by morphology or metabolism can not ascertain the chromosome abnormality. So，the chromosome abnormality screeing have been a strategy to select viable embryo for transfernation. In brief，we still depend on morphology assessment as our first line approachs to embryo selection，other potential approaches need further investigation before using clinical trials. Related Articles | Metrics

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Non-invasive Prenatal Diagnosis by Fetal Nucleic Acid Analysis in Maternal Plasma YU Jun;GU Fang 2012, 31 (4):  308-311.  Abstract ( 1908 )   PDF (703KB) ( 7331 )   In the current prenatal programmes，definitive diagnosis of fetal genetic or chromosomal conditions is conducted through fetal sampling by amniocentesis or chorionic villus sampling. To obviate the risks of fetal miscarriage，non-invasive prenatal diagnostic tests based on cell-free fetal DNA analysis has been developed fastly. To date，fetal sex and rhesus D status determination by circulating fetal DNA analysis is performed clinically in many centres. Strategies for the non-invasive diagnosis of monogenic diseases and fetal aneuploidy have been achieved. We believe that many of the non-invasive prenatal tests could be introduced to the clinics extensively. Related Articles | Metrics

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Current Review on DNA Methylation in Ovarian Cancer WANG Wen-wen;QIU Li-hua 2012, 31 (4):  312-315.  Abstract ( 1837 )   PDF (713KB) ( 7309 )   Ovarian cancer is one of the common gynecologic neoplasms，which is ranked the most lethal among gynecological cancers in women. Since lacking of obvious clinical symptoms and effective early diagnostic methods for screening，more than 70% of patients are diagnosed at the advanced stage always accompanied with ascites and abdominal widespread metastasis. The prognosis in those patients is poor. Therefore，it is particularly important to improve the survival rate of ovarian cancer by early detection and early diagnosis. In recent years，rapid progresses in epigenetics make a great significance for early diagnosis，new treatment and better prognosis of ovarian cancer. DNA methylation，the most common form of epigenetic modification，can lead to many changes，such as chromatin structure，DNA conformation，DNA stability and interaction between DNA and protein. The epigenetic modification could change gene expression，which plays an important role in the formation and progression of ovarian cancer. Related Articles | Metrics

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Analysis of Obesity and Polycystic Ovary Syndrome ZHANG Zheng;ZHANG Xue-hong 2012, 31 (4):  316-318.  Abstract ( 1897 )   PDF (704KB) ( 7307 )   Polycystic ovary syndrome （PCOS） is the most common endocrine and metabolic disorder in fertile-aged women. PCOS，a highly heterogeneous disease in clinical feature，is one of the main causes of infertility due to anovulation，which affects 5% to 10% of fertile-aged women. Obesity is strongly associated with the PCOS. There are about 50% of PCOS women with overweight or obesity，most of them being abdominal obesity. Obesity is related to a series of metabolic disorders，especially hyperinsulinemia with insulin resistance and hyperandrogenism，which play a pivotal role in the pathophysiological mechanisms of PCOS. Obesity can independently exacerbate insulin resistance and hyperandrogenism，which lead to the high risk of type 2 diabetes and cardiovascular disease in obese PCOS women. In addition，hirsutism，acne and infertility，the typical clinical manifestations，could cause the increasing depression and anxiety in PCOS women. Related Articles | Metrics

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Influence of Postnatal Maternal Depression on Child Developmen ZHAO Pei;LI Su 2012, 31 (4):  319-323.  Abstract ( 1895 )   PDF (775KB) ( 7240 )   Postnatal depression, a common psychiatric disorder in postpartum women, affects their life and the relationship with others in family. The important thing to realize about that is postnatal depression increases risk of children’s mental disorders. Based on the summary on the adverse effects from depressed mothers on their offspring, four mechanisms were reviewed, including heritability, innate dysfunctional neuroregulatory mechanisms, parenting and stressors. These mechanisms could lead to children’s problems in cognition, emotion, behavior and social interaction. And factors mediating the effects of postnatal depression on child development, such as depression severity, children’s age and gender and family environment, were further proposed. We hoped that this discussion be helpful to lower the effect of postnatal depression on children development. Related Articles | Metrics