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15 March 2018, Volume 37 Issue 2
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Effects of Hepatitis B Virus Infection on Outcomes after Frozen-Thawed Embryo Transfer   WANG Li-si，HU Li-na，ZHANG Chan-yu，LI Sang-lin，HE Fan 2018, 37 (2):  93-96.  Abstract ( 1554 )   PDF (828KB) ( 9094 )   Objective：To investigate the effects of female hepatitis B virus (HBV) infection on outcomes after frozen-thawed embryo transfer (FET). Methods: The baseline characteristics and data of FET cycles in both the HBV group (couples with an HBsAg-positive female partner and an HBsAg-negative male partner) and the control group (couples with both HBsAg-negative partner) were retrospectively analyzed. Multivariate logistic regression was used to test for the association between clinical pregnancy and maternal HBV infection. P＜0.05 was considered statistically significant. Results: A total of 93 FET cycles were included in this study, including 31 cycles in the HBV group and 62 cycles in the control group. There were no significant differences in those baseline characteristics between the two groups (P＞0.05). The HBV group had mildly higher clinical pregnancy rate (45.2% vs. 40.3%, P=0.656) and embryo implantation rate (31.3% vs. 25.0%, P=0.361) when compared with the control group. Multivariate logistic regression analysis showed that maternal HBV infection was not associated with clinical pregnancy in FET cycles (OR=1.219, 95%CI=0.510-2.911, P=0.656). Conclusions: Maternal HBV infection had not adverse effect on clinical pregnancy rate after FET. Related Articles | Metrics

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Effects of Anxiety Disorder on the Outcome of In-Vitro Fertilization-Embryo Transfer  ZHOU Xiao-jing，WANG Fang，LIU Ge-lin，LU Ya-qiong 2018, 37 (2):  97-98.  Abstract ( 1767 )   PDF (763KB) ( 9102 )   Objective：To explore the effects of anxiety disorder on the clinical outcomes of in-vitro fertilization-embryo transfer (IVF-ET). Methods: The anxiety level was assessed and analyzed by the Hamilton anxiety scale (HAMA) for 210 patients undergoing IVF-ET treatment. They were then divided into three groups: the A group (mild anxiety, n=55), the B group (moderate anxiety, n=105) , and the C group (severe anxiety, n=50). Several parameters of the three groups, including the number of retrieved oocyte, 2PN rate, the rate of high-qualified embryo, clinical pregnant rate and early abortion rate, were compared. Results: The retrieved oocyte number, 2PN rate, the rate of high-qualified embryos and clinical pregnant rate in the A group were significantly higher than those in the B group and the C group (P＜0.05). The clinical pregnancy rate in the B group was significantly higher than that in the C group (P＜0.05). Conclusions: The heavier the anxiety, the worse the effect on the outcome of IVF-ET. The anxiety level should be evaluated in IVF patients if possible, and treated with appropriate psychological intervention in those patients with moderate and severe anxiety, so as to improve their outcomes of IVF-ET. Related Articles | Metrics

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Reproductive Outcome of Metroplasty by Laparoscopy Combined with Hysteroscopy for Complete Bicornuate Uterus LIU Lin-lin，HUANG Xiao-wu，XIA En-lan 2018, 37 (2):  99-102.  Abstract ( 2309 )   PDF (810KB) ( 10839 )   Objective：To explore the improvement of reproductive outcome in those women with a complete bicornuate uterus who underwent metroplasty by the laparoscopy combined with hysteroscopy. Methods: 19 women with complete bicornuate uteri who underwent metroplasty by the laparoscopy combined with hysteroscopy in our hospital from October 2006 to November 2015 were retrospectively analyzed. The pregnancy outcome was followed-up. Results: 19 women were followed up for 2 to 11 years, and 4 of them dropped. In 15 women, 9 cases of pregnancy and 6 cases of non-pregnancy were recorded after their one-year effective postoperative contraception. The first postoperative pregnancy time after metroplasty ranges from 14 to 46 months. For the 9 women who had conception, the rates of spontaneous abortion (90.5% vs. 10.0%), term delivery (0 vs. 50.0%) and "take-home-baby" (0 vs. 80.0%) were recorded before and after the operation (all P＜0.05). Of the 19 patients, a total of 4 patients with complete bicornuate uteri combined with cervical insufficiency underwent laparoscopic abdominal cerclage before pregnancy, and 2 of them achieved successful pregnancy and delivered live babies. Conclusions: The metroplasty by the laparoscopy combined with hysteroscopy can significantly improve the reproductive prognosis for those women with adverse pregnancy outcomes owing to complete bicornuate uterus. Related Articles | Metrics

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5 756 Cases Analysis of Non-Invasive Prenatal Fetal Free-DNA Testing in Peripheral Serum of Pregnant Women LUO Li-shuang，MENG Fan-jie，ZHANG Ning，YU Yue-xin，HAO Dong-mei 2018, 37 (2):  103-106.  Abstract ( 2106 )   PDF (796KB) ( 9216 )   Objective：To evaluate the clinical application of non-invasive prenatal testing (NIPT) in screening of fetal chromosomal aneuploidy. Methods：Totally 5 756 pregnant women receiving NIPT in People′s Liberation Army No.202 Hospital from December 2014 to December 2016 were retrospectively analyzed. Amniocentesis and fetal karyotyping were recommended in those women with the high-risk results of NIPT. Results：Among 5 756 pregnant women, 62 cases were found the high-risk by NIPT, with a positive rate of 1.08%. 48 cases underwent chromosome karyotype analysis, including 24 cases with trisomy 21, 2 cases with trisomy 18, 1 case with trisomy 13, and 8 cases with sex chromosome abnormality. The positive predictive values of trisomy 21, trisomy 18, trisomy 13 and sex chromosome number abnormality were 86%, 40%, 25% and 73%, respectively. Among those pregnant women receiving NIPT, the three proportions of pregnant women with advanced age, low-risk but asking for NIPT and critical risk in their serum screening were 37.70%, 32.35% and 16.09%, respectively. The positive rate of NIPT in those women with abnormal ultrasonic soft index was statistically higher than that in others (P＜0.01). Conclusions：NIPT has high detection rates of trisomy 21, trisomy 13, trisomy 18 and sex chromosome abnormalities. It has high positive predictive values of trisomy 21 and sex chromosome number abnormality. NIPT has been widely accepted by those pregnant women with advanced age, low-risk but asking for NIPT and critical risk in serum screening. NIPT has a good clinical prospect because NIPT can greatly reduce the invasive prenatal diagnosis. Related Articles | Metrics

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Effect of Hemabate on Hemostatic Results and Oxidative Stress in Patients with Placenta Previa WANG Yu-feng，GUO Hong，HU Yi-wen，E Luo-ji 2018, 37 (2):  107-109.  Abstract ( 1426 )   PDF (804KB) ( 8977 )   Objective：To investigate the effect of hemabate on the hemostasis and oxidative stress in patients with placenta previa who undergoing cesarean delivery. Methods: Ninety-eight patients with placenta previa who undergoing cesarean delivery and postpartum hemorrhage in our hospital from January 2015 to February 2017 were retrospectively analyzed. According to the treatment methods, they were divided into the control group (51 cases) and the observation group (47 cases). The control group received the intrauterine packing hemostasis, and the observation group received a hemabate injection (250 μg) in corpus uteri besides the packing hemostasis. The bleeding volume, oxidative stress level and stress hormone were tested. Results: The blood loss in operation, 2 h postpartum and 24 h postpartum in the observation group were significantly lower than those in the control group (P＜0.05). The postoperative levels of serum ROS and MDA in both groups were significantly higher than the preoperative levels, and the postoperative levels of SOD and CAT were lower than the preoperative levels (P＜0.05). The postoperative levels of ROS and MDA in the observation group were significantly lower than those in the control group, and the postoperative levels of SOD and CAT were higher in the observation group than in the control group (all P＜0.05).  The postoperative levels of NE, E and Cor in both groups were significantly higher than those preoperative levels, while the postoperative levels of NE, E and Cor in the observation group were lower than those in the control group (all P＜0.05). Conclusions: Hemabate injection in corpus uteri as the adjuvant therapy of pre-placental hemorrhage can effectively reduce the blood loss and oxidative stress, suggesting the potential application of hemabate. Related Articles | Metrics

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Application of Doula Delivery Apparatus Combined with Whole Process Painless Delivery in Elderly Parturient Women CHEN Li，XU Heng 2018, 37 (2):  110-112.  Abstract ( 1577 )   PDF (748KB) ( 9045 )   Objective：To evaluate the effictiveness of the doula delivery analgesia apparatus combined with the whole process painless delivery in those elderly parturient women. Methods: A total of 160 cases of elderly primipara in maternal and child health hospital of shenzhen city from January 2016 to January 2017 were randomly divided into two groups. Cases in the observation group (n=80) were treated with the doula delivery analgesia apparatus combined with the whole process painless delivery, while cases in the control group (n=80) with the traditional delivery way in the conventional labour room. The duration of labor and the outcomes of mother and infant were compared. Results: The first and second stages of labor, and total labor stage, in the observation group were significantly shorter than those in the control group (P＜0.05). However, there was no significant difference in the third stage of labor between the two groups (P＞0.05). The rate of vaginal delivery in the observation group was significantly higher than that in the control group (P＜0.05). There was no significant difference in the rate of neonatal asphyxia between the two groups (P＞0.05). The observation group had better security sense, and lower rate anxiety and fear when compared with the control group (P＜0.05). The VAS score of labor pain in the observation group was significantly better than that in the control group [(3.53±1.22) vs. (8.15±1.48)，t=9.576，P=0.000]. Conclusions: The doula delivery analgesia apparatus combined with the whole process painless delivery can be recommended to use in those elderly parturient women, with the advantages of the alleviated pain, the shorten delivery time and the improved mental state. The rate of vaginal delivery in those women with this method can also be increased. Related Articles | Metrics

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Temporary Ovarian Suspension Reduced Postoperative Adhesions in Endometriosis: A Meta-Analysis LI Chao，LI Zhi-ru，WANG Ling 2018, 37 (2):  113-118.  Abstract ( 1627 )   PDF (1334KB) ( 8988 )   Objective：To evaluate the effectiveness of temporary ovarian suspension in reducing the postoperative adhesions of laparoscopy in those patients with endometriosis. Methods：We searched PUBMED, MEDLINE, EMBASE, the ISI Web of Science，Ovid，Cochrane Library，CNKI，Wanfang Data, VIP database and CBM and so on，using the keywords "ovarian suspension", "laparoscopy", "endometriosis" and "pelvic adhesions", to identify studies involving human subjects published in English between January 1950 and December 2017. No restrictions on language or time were applied. The selection criteria included the randomized controlled trials （RCTs） that compared the effectiveness of temporary ovarian suspension in reducing the postoperative adhesions of laparoscopy in patients with endometriosis. Meta-analysis was performed by two investigators using data from the cochrane systematic review. Results：We included four RCTs involving 302 patients in the meta-analysis. Temporary ovarian suspension significantly lowered the incidence rate of laparoscopy postoperative adhesions in severe endometriosis （RR＝0.75，95%CI：0.64～0.87）. The dyschezia was more effectively alleviated (RR=－0.30, 95%CI: －0.58～－0.02). However, dysmenorrhea (RR=－0.75, 95%CI: －1.92～0.41), chronic pelvic pain (RR=－0.77, 95%CI: －1.88～0.35), dyspareunia (RR=1.25, 95%CI: －0.86～3.37) and dysuria (RR=－1.51, 95%CI: －4.22～1.20) were not significantly relieved. Conclusions：Temporary ovarian suspension is an effective technique in preventing the postoperative adhesion in endometriosis women, with the reduced dyschezia, in which the life quality of patients was improved. Related Articles | Metrics

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Advantage of Hysteroscopy in Taking out the Incarcerated Intrauterine Device QIU Xue-yan，REN Ya-juan，CHEN Shu-tao，MOU Jing，LIN Qing 2018, 37 (2):  119-121.  Abstract ( 1459 )   PDF (2540KB) ( 8974 )   Objective：To compare the efficiency and safety of two methods taking out the incarcerated intrauterine device (IUD): hysteroscopy and B-mode ultrasound. Methods: A total of 87 patients underwent unsuccessfully the conventional removal of IUD were diagnosed as the incarcerated IUD from January 2013 to March 2017. Based on a random table, the 45 cases were treated with hysteroscopy to take out their IUD as the observation group, and 42 cases with B-mode ultrasound to take out IUD as the control group. The operation time, intraoperative blood loss, the success rate of taking out IUD at once, hospital stays and expense were compared between the two groups. The incidences of lumbar pain and low-abdominal pain and vaginal bleeding in 1 month of following up were also compared. Results: The success rate of IUD removal at once in the observation group was significantly higher than that in the control group ( χ2=7.112, P=0.000). The operation time and the bleeding amount in the observation group were significantly less than those in the control group ( χ2=4.322 and 6.083, all P＜0.05). There were no complications such as uterine perforation, intrauterine adhesions and infection in one month of following up in the two groups. The incidences of 0～Ⅰ grade of lumbar pain and low-abdominal pain, and ≤1 day of vaginal bleeding or no bleeding, in observation group were significantly higher than those in the control group (all P＜0.05). There was no significant difference in hospital stays between the two groups [(2.24±0.63) d vs. (2.08±0.54) d, t=0.003, P=0.976]. However, the treatment cost in the observation group was significantly higher than that in the control group [(2 231.28±256.90) Yuan vs. (1 712.14±156.82) Yuan, t=6.117, P=0.007]. Conclusions: Taking out the incarcerated IUD under hysteroscopy can be recommended due to the shorter operation time, less blood loss, higher success rate and higher safety, although the relatively higher treatment cost, when compared with the method under B ultrasound. Related Articles | Metrics

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Clinical Application of GnRH Antagonist in Assisted Reproductive Technology WANG Han-han，LI Meng，LU Mei-song 2018, 37 (2):  122-127.  Abstract ( 1337 )   PDF (901KB) ( 9109 )   Three main purposes of the controlled ovarian stimulation (COS) in assisted reproductive technology (ART) were: to inhibit pituitary activity, to stimulate follicular growth and to induce ovulation. gonadotropin-releasing hormone antagonist (GnRHA) as a competitor of traditional GnRH agonist (GnRHa) inhibits the luteinizing hormone (LH) peak more rapidly, and GnRHA has no GnRHa-related "sudden action" and long-term effect of pituitary down-regulation. In the cycles with GnRHA, the dosage of gonadotropin (Gn) is reduced, the treatment time shorten, and the occurrence of ovarian hyperstimulation syndrome (OHSS) reduced more effectively. In recent years, GnRHA has been widely used in the controlled superovulation (COH) for various types of infertility patients, especially for those specific infertile patients (ovarian low responders, high responders). However, it is necessary to explore whether the new GnRHA protocol can replace the traditional GnRHa long-term protocol, or whether GnRHA protocol can be used as a routine COH protocol. Meanwhile, GnRHA protocol itself should be optimized in future. Related Articles | Metrics

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Effect of Vitamin D on Outcomes of Frozen-Thawed Embryo Transfer LAN Ting，ZHAO Jun-li 2018, 37 (2):  128-132.  Abstract ( 1407 )   PDF (868KB) ( 9109 )   Frozen-thawed embryo transfer (FET) has been widely used in ART, with the benefits of the improved cumulative pregnancy rate, the prevention of ovarian hyperstimulation, the decreased rate of multiplets. How to improve the success rate of FET is currently one of the hotspots in reproductive medicine. With the research progress of vitamin D in recent years, it is found that vitamin D participates in the regulation of human reproductive function in addition to calcium and phosphorus metabolism. Vitamin D as a salutary factor participates in follicular development, production of steroid hormones and embryo implantation. The vitamin D deficiency is also associated with a variety of gynecological diseases, such as endometriosis and polycystic ovary syndrome. However, there is few research on the effect of vitamin D on the outcomes of FET. We reviewed the application of vitamin D and its clinical effect in FET and ART. Related Articles | Metrics

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Assisted Reproductive Technology Outcomes of Uterine Abnormalities YUAN Yue, YANG Yuan, HE Xiao-xia, ZHANG Xue-hong 2018, 37 (2):  132-136.  Abstract ( 1256 )   PDF (816KB) ( 9062 )   Assisted reproductive technology (ART) is one of the most important therapeutic measures for infertile couples, and embryonic implantation is one of the pivotal taches for the successful pregnancy of ART. Embryonic implantation is defined as the procedure of embryonic adhering and intruding into endometrium, so the uterine cavity and endometrium are very important for successful embryonic implantation and pregnancy. Abnormalities of uterus, including those congenital abnormalities and posteriority pathological states, could result in the failing embryonic implantation and pregnancy. In this review, those uterine factors related to the outcomes of ART were summarized, including thin endometrium, endometrial polyps, intrauterine adhesion, uterine fibroids, adenomyosis, endometrial peristalsis wave, uterine malformations and endometrial blood flow perfusion, so as to investigate the embryonic implantation and to improve the clinical outcomes of ART. Related Articles | Metrics

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Research Progress of Biomarkers Associated with Air Pollution Exposure in Pregnant Women LIU Jin-long，HOU Hai-yan，CHEN Xiao 2018, 37 (2):  137-140.  Abstract ( 1276 )   PDF (781KB) ( 9073 )   Air pollution can lead to respiratory diseases and cardiovascular and cerebrovascular diseases. Pregnant women in a high metabolic state are more sensitive to air pollutants, while the fetuses in a critical period of physiological development are also more sensitive to pollutants. Studies in recent years have shown that the exposure to air pollution is associated with several adverse perinatal outcomes, including spontaneous abortions, intrauterine growth retardation, preterm births, and low birth weight (LBW). However, the underlying mechanism is unclear. At present, many biomarkers of the exposure to air pollution, such as DNA adducts, were screened out by the applications of exposomics and metabonomics. Biomarkers can be used to reflect the level of internal exposure in an individual. It is thought that those biomarkers are more accurate than the monitoring of exposed contaminants. It is important that those biomarkers can be used to explore the potential mechanism of adverse pregnant outcomes related with the exposure to air pollution. Related Articles | Metrics

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Autophagy and Pregnancy XIAO Wen-xia，WANG Hui-zhi 2018, 37 (2):  141-144.  Abstract ( 1877 )   PDF (757KB) ( 9242 )   Autophagy is an important life phenomenon with extensive physiological functions. The fundamental function of autophagy is the adaption to starvation, in which cells can survive in the condition of starvation. Therefore, autophagy is a promotion mechanism of cell survival. Autophagy can also contribute to maintaining the homeostasis of cells. Recently, it is revealed that autophagy is related to pregnancy. The autophagy in normal early pregnancy can protect the trophoblast survival, and participate in the regulation of trophoblast differentiation, development, invasion and remodeling  of  maternal spiral arteries. Autophagy also exists in the second and third trimester of pregnancy, which can promote placental development and sustain pregnancy. Additionally, autophagy is implicated in abnormal pregnancies, such as the preeclampsia related to aberrant autophagy, the fetal growth retardation involved in the enhanced autophagy, and the preterm birth related to the decreased autophagy. Related Articles | Metrics

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Treatment of the Recurrent Spontaneous Abortion Caused by Dysimmunity and Prethrombotic State GUAN Gui-xue，YAN Lei 2018, 37 (2):  145-149.  Abstract ( 2304 )   PDF (812KB) ( 10827 )   Many etiologies attribute to the recurrent spontaneous abortion (RSA). Nowadays, the prethrombotic state and immunological factors have aroused more and more attention. However, it is difficult for us to treat the RSA related to dysimmunity or prethrombotic state. Usually, prednison, ciclosporin, immune globulin and lipid emulsion can be used in those women with abnormal lymphocyte, autoantibody and abnormal complement system. Prednison, hydroxychioroquine and immune globulin are used in those woman with the positive lupus screening test, and abnormal anti-SSA, anti-SSB and anti-dsDNA. Ciclosporin and immune globulin can be used when the blocking antibody is negative, while aspirin and low molecular heparin used when the coagulation indicator is abnormal and the antiphospholipid antibody is positive. Most of these drugs are out of their scopes when they are used in RSA. However, a great deal of clinical trials have proved that RSA women can authentically benefit from these drugs. We discussed the advantages and disadvantages of these drugs when used in RSA women, including the mechanism and clinical effects. Related Articles | Metrics

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Prethrombotic State of Recurrent Spontaneous Abortion and Its Treatment: A Mini Review CHEN Can-ming，REN Wei-juan，WANG Yi-fang，WEI Gui-lan，LIU Li-li 2018, 37 (2):  150-153.  Abstract ( 1669 )   PDF (796KB) ( 9113 )   The etiology of recurrent spontaneous abortion(RSA) is very complicated. The prethrombotic state related to RSA is hotspot research in recent years. More and more research indicated that the pathogenic factor of RSA could include the coagulation factor V mutation, prothrombin gene polymorphism, MTFHR gene mutation, protein C deficiency, protein S defect, fibrinogen gene mutation, anti-phospholipid syndrome antibody, angiotensin converting enzyme gene insertion and deletion, and PAI-1 gene polymorphism. There is no sufficient evidence that low-molecular-weight heparin can improve pregnancy outcome in RSA the patients with prethrombotic state. Medical researchers still actively explore the therapeutic regimen of RSA the prethrombotic state related to RSA, and put forward some useful treatment suggestions based on their experience in treatment of RSA and in assisted reproductive technology. Related Articles | Metrics

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Research Progress of Triglyceride Metabolism During Pregnancy CHEN Meng-fan，CHEN Dan-qing 2018, 37 (2):  154-158.  Abstract ( 1589 )   PDF (866KB) ( 8978 )   Triglyceride as a main component of lipids in human body  can be hydrolyzed by lipoprotein lipase into free fatty acids and glycerins. Triglyceride also participates in energy supply for mother and fetus, and fetal development during pregnancy. Recently, increasing studies have shown that the level of triglyceride in pregnant women was remarkably higher than in non-pregnant women, and  that the level of triglyceride was increased with the progress of pregnancy. Interestingly, the level of triglyceride was changed in those women with gestational complications such as gestational diabetes mellitus, pre-eclampsia, intrahepatic cholestasis of pregnancy, premature delivery and gestational acute pancreatitis. This article discussed the relationships between the altered triglyceride level and gestational complications such as gestational diabetes mellitus, pre-eclampsia and intrahepatic cholestasis of pregnancy. The related mechanism and follow-up visit were also included. It is important to develop the internationally-recognized range of triglyceride with regional differences and the individualized monitoring and treatment guidelines. The management of triglyceride level during pregnancy is of great importance. Related Articles | Metrics

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Research Progress of NGAL and Pregnancy-Related Diseases YIN Xiao-qian，ZHANG Yan-hong，HUO Yan 2018, 37 (2):  158-161.  Abstract ( 1453 )   PDF (767KB) ( 8994 )   Neutrophil gelatinase-associated lipocalin (NGAL), a new member of lipocalin family, is a fatty cytokine or an inflammatory factor. NGAL participates in various physiological and pathological processes, such as embryonic development, cell differentiation, apoptosis, tumor occurrence and development, inflammatory immune response, glucose and lipid metabolism, and insulin resistance. Hypertensive disorders complicating pregnancy, gestational diabetes mellitus (GDM) and premature birth, three kinds of common pregnancy-related diseases, are closely related to the inflammatory reaction, glucose and lipid metabolism, and insulin resistance. These diseases seriously affect the outcome of pregnancy and the prognosis of mothers and infants. It was reported that NGAL also played an important role in pregnancy-related diseases such as hypertensive disorders complicating pregnancy, GDM and premature birth. This article will review the research progress of NGAL and pregnancy related diseases. Related Articles | Metrics

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Research Progress on the Delivery Mode of Cicatricial Uterus QI Zi-dan，ZHANG Yu 2018, 37 (2):  162-166.  Abstract ( 1567 )   PDF (830KB) ( 9069 )   Cicatricial uterus refers to the uterus after cesarean section or myomectomy, repair of perforation or rupture, hysteroplasty and other gynecologic operations, in which cesarean section is the main reason of the cicatricial uterus. In recent years, because of the high rate of cesarean section and changes in the policy of family planning, the number of pregnant women with a prior cesarean delivery has increased year by year. However, the management of the pregnancy in cicatricial uterus is always a challenge subject of obstetrics because of the high risk of the serious maternal and perinatal complications. It is one of the most urgent and complicated problems for an obstetrist how to treat correctly the delivery model of the pregnancy in cicatricial uterus. We review the obstetrical strategy in the treatment of the second pregnancy of cicatricial uterus, including the delivery model, the dications of vaginal delivery, and labor management, to provide practical guidelines of delivery model and improve the quality of obstetrics. Related Articles | Metrics

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Research Progress in the Mechanism of Insulin Resistance in Polycystic Ovary Syndrome ZHANG Fei-xiang，LI Xue-lian 2018, 37 (2):  167-171.  Abstract ( 2170 )   PDF (841KB) ( 10751 )   Polycystic ovary syndrome (PCOS), a gynecological endocrine disease with high heterogeneity, is characterized by hyperandrogenemia, hyperinsulinemia and/or abnormal ovulation. Insulin resistance (IR) is considered as a part of the pathogenesis of PCOS, and PCOS patients often show hyperinsulinemia. It is helpful for understanding the pathogenesis and prognosis of PCOS to explore the mechanism of IR, and for preventing the complications, especially cardiovascular disease. The molecular biological basis of IR in PCOS women is related to the gene of insulin receptor(INSR), the regulation of gene expression and the intracellular insulin signaling pathway. We will mainly discuss the polymorphism of related genes, mitochondrial transport RNA (mt-tRNA), microRNA, INSR and its downstream signals such as PI3K and MAPK, and some post-receptor substances which can regulate the insulin sensibility. Related Articles | Metrics

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Long-Term Complications of Polycystic Ovary Syndrome and Treatment LIU Jia，YU Chu-yi，MA Hong-xia，LI Juan 2018, 37 (2):  172-176.  Abstract ( 1678 )   PDF (833KB) ( 9138 )   Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age. With the development of age, the metabolism disorders of PCOS become worse and worse. Many long-term complications of PCOS would be induced by insulin resistance and hyperandrogenism, including diabetes, metabolism syndrome, non-alcoholic fatty liver disease, cardiovascular disease, pregnancy complication, endometrial cancer and mental problem. The prevention and treatment of those long-term complications of PCOS are principally included as follows, the improvement of life style and insulin resistance, anti-inflammatory, the down-regulation of androgen, and recover of menstrual regularity. Acupuncture, a method of Chinese traditional medicine, has been tried to treat the long-term complications of PCOS in recent years, as a replacement or supplement of therapic drugs including oral contraceptives and down-androgen drugs. Related Articles | Metrics