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15 May 2019, Volume 38 Issue 3
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Application of ICSI Combined with IVM in Ageing Women with Poor Ovarian Response SONG Wen-yan，TIAN Cheng-cheng，JIN Hai-xia，SHI Sen-lin，MA Fu-hui 2019, 38 (3):  181-184.  Abstract ( 1230 )   PDF (785KB) ( 8953 )   Objective：To investigate the application of intracytoplasmic sperm injection (ICSI) combined with immature oocyte in vitro maturation (IVM) in those ageing women with poor ovarian response(POR) who underwent different ovarian stimulation. Methods: A total of 81 cycles of ICSI were evaluated retrospectively from January 2016 to September 2018 at the First Affiliated Hospital of Zhengzhou University. The inclusion criteria were age ≥35 years, the number of oocytes≤3, and the oocytes immature. These cycles were grouped according to the protocols of ovulation stimulation: the micro-stimulation group (n=37) and the antagonist group (n=44). The basal levels of reproductive hormones and the pregnancy outcome were compared between the two gruops. Results: There were no significant differences in age, infertility years, basal levels of hormones (including AMH) and basal antral follicles between the two groups (P＞0.05). The amount of Gn in the antagonist group was significantly higher than that in the micro-stimulation group (P＜0.05). There were no significant differences in the in vitro culture maturation rate, 2PN rate, cleavage rate, embryonic rate and excellent embryo rate between the two groups (P＜0.05). Meanwhile, there were no significant differences in the implantation rate and the clinical pregnancy rate (P＞0.05). Conclusions: The ICSI combined with IVM in ageing women with POR is beneficial to improve the oocyte maturation rate and embryo utilization, and to increase the pregnancy chance. The micro-stimulation protocol is a cost-effective option for those women with POR. Related Articles | Metrics

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Embryodynamic Parameters and Pregnancy Outcomes Using Time-Lapse System ZHANG Can, HU Yan-qiu, SHE Hong, CHEN Fang 2019, 38 (3):  185-190.  Abstract ( 1215 )   PDF (975KB) ( 9003 )   Objective：To explore the relationship between the embryodynamic parameters using time-lapse system and the pregnancy outcomes, so as to establish a model of the optimal embryo selection. Methods: A total of 137 cycles with the time-lapse system (IVF/ICSI-ET cycle) were retrospectively analyzed from December 2016 to December 2017. The clinical data including basic information and pregnancy outcomes were collected. The morphokinetic parameters using the time-lapse system (t2、t3、t4、t5、t6、t7、t8、cc2、s2、cc3、s3) were compared between the implanted embryos and the unimplanted embryos. Based on those parameters related with embryo implantation, a multivariate classification model was developed. This model was then primarily verified. Results: ①Totally 171 embryos had one or more early abnormal division event，in which 16 were considered to be implantable, and then transplanted. There were 4 embryos implantated succesfully. ②There were no significant differences in all of 11 morphokinetic parameters between the implanted embryos and the unimplanted embryos (P>0.05). ③The t6 (OR=1.462, 95%CI: 1.093-1.954, P=0.010) and t7 (OR=0.803, 95%CI: 0.653-0.989, P=0.039) could be the best predictors of implantation. A classification model was developed with these two parameters combined with the exclusion standard of abnormal division event. The implantation rate was declined as the embryonic grade dropped. The area under the receiver operating characteristic curve (AUC) was 0.649 (95%CI: 0.528-0.770). Conclusions: Two of morphokinetic parameters (t6, t7) could be closely related to the implantation potential. We tried to develop an embryo selecting model with these two parameters combined with exclusion standard of abnormal division events. It is true that this model should be furtherly validated in our centers. Related Articles | Metrics

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Application of Ooplasm Optimization in IVM Medium Containing Autologous Serum in Patients Undergoing Their First ICSI Cycles JI Dong-mei，ZHANG Zhi-guo，ZOU Wei-wei，DENG Xiao-hong，CHEN Bei-li，ZHOU Ping，WEI Zhao-lian，CAO Yun-xia 2019, 38 (3):  190-193.  Abstract ( 1253 )   PDF (789KB) ( 9064 )   Objective：To evaluate the role of short time incubation with in vitro maturation (IVM) medium containing 20% autologous serum in patients undergoing their first intracytoplasmic sperm injection (ICSI) cycles. Methods：Between January 2017 and July 2018, a total of 1 074 patients undergoing their first ICSI cycles were evaluated retrospectively. Patients were divided into the serum incubation group (n=819) and the non-serum incubation group (n=255), according to whether oocytes were in vitro cultured with the IVM medium containing 20% autologous serum or the routine fertilization medium for 2-4 h prior to sperm injection on the day of oocyte collection. General data, embryonic development and clinical outcomes of the two groups were compared. Results：There was no significant difference between the two groups in age, duration of infertility, body mass index, basal levels of FSH and LH (P＞0.05). The average number of oocytes collected, oocytes maturation rate, fertilization rate and blastocyst formation rate in the serum incubation group were slightly higher than those in non-IVM group, the high-quality blastocyst rate was slightly lower in the serum culture group, however there were no significant differences between the two groups (all P＞0.05). Fresh embryo transfer was performed in 47 cases in the serum culture group and 22 cases in the non-serum culture group. There was no significant difference in the age, basal level of FSH, endometrial thickness, number of embryos transferred, clinical pregnancy rate, cycle cancellation rate and implantation rate between the two groups for patients undergoing fresh embryo transfer (all P＞0.05). Interestingly, the abortion rate was significantly reduced (6.25% vs. 36.36%), and the live birth/continued pregnancy rate increased (93.75% vs. 63.64%) in the serum incubation group (both P＜0.05). Conclusions：The short time incubation of oocytes in the IVM medium containing 20% autologous serum for 2-4 h before ICSI can significantly reduce the abortion rate, in those patients undergoing ICSI treatment for the first time. Related Articles | Metrics

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Clinical Outcome of the Frozen-Thawed Embryo Transfer Following GnRHa Down-Regulation Protocols in Infertile Women with Endometriosis ZHOU Xue-yuan，WEN Ji，KONG Wei，FANG Zhou，LI Yan 2019, 38 (3):  194-196.  Abstract ( 1386 )   PDF (741KB) ( 8960 )   Objective：To investigate the effects of different GnRHa down-regulation protocols on the clinical outcomes of frozen-thawed embryo transfer (FET) in infertile women with endometriosis (EMs). Methods：A total of 320 FET cycles of EMs infertile patients were collected in our hospital from January 2016 to January 2018. The patients were randomly grouped into two groups: 160 cases in the group A were treated with the artificial cycle combined with GnRHa down-regulation，and 160 cases in the group B were treated with artificial cycle. Demographic data, cycle characteristics and clinical outcome were compared between the two groups. Results：There were no significant differences in demographic data, serum CA125 level, progesterone level, the number of embryos transferred and miscarriage rate between the two groups (P＜0.05). Compared with the Group B, the Group A had significantly lower estradiol level (P＜0.05), and higher endometrium thickness, proportion of type A endometrium, clinical pregnancy rate, implantation rate and live birth rate (all P＜0.05). Conclusions: The artificial cycle combined with GnRHa down-regulation protocols is helpful to improve the clinical outcome of FET in those infertile women with EMs. Related Articles | Metrics

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Pregnancy Outcomes of Fresh Cycle and FET Cycle in Patients with Different Ovarian Response on Antagonist Protocol FENG Li-zhen，LIU Yan，LI Ya，SONG Xue-ru，BAI Xiao-hong 2019, 38 (3):  197-200.  Abstract ( 1258 )   PDF (785KB) ( 8991 )   Objective：To compare the pregnancy outcomes bewteen the fresh embryo transfer (ET) and the first frozen thawed embryo transfer (FET) after embryo vitrification in patients with different ovarian response on the antagonist protocol. Methods：A total of 251 cycles of infertile patients undergoing IVF/ICSI-ET and the antagonist protocol of ovarian stimulation were retrospectively studied from May 2016 to September 2018 in our Reproductive Center. According to the ovarian response, those patients were divided into three groups, the group A including 33 cycles (the number of oocytes retrieved ≤3), the group B including 157 cycles (the number of oocytes retrieved 4 to 15) and the group C including 47 cycles (the number of oocytes retrieved ＞15). Further, each group was divided into the fresh embryo transfer sub-group (A1 of 18 cycles, B1 of 99 cycles, C1 of 15 cycles) and the first frozen thawed embryo transfer after embryo vitrification sub-group (A2 of 15 cycles, B2 of 58 cyles, C2 of 46 cycles). Basic parameters, the embryo implantation rate and the clinical pregnancy rate were compared. Results：There were no significant differences in age, body mass index (BMI), bFSH/bLH, sterility type, total Gn, days of Gn, insemination mode and insemination rate in A1/A2 group, B1/B2 group and C1/C2 group (all P＞0.05). The number of oocytes retrieved in the C2 sub-group was higher than that in C1 sub-group (t=-2.963, P=0.000). As for the outcomes, the clinical pregnancy rate in B2 sub-group was significantly higher than that in B1 sub-group ( χ2=5.502, P=0.019). The embryo number and embryo quality score in C2 sub-group were significantly higher than those in C1 sub-group (P＜0.05). However, there were no significant differences in the implantation rate, clinical pregnancy rate and abortion rate (all P＞0.05). Conclusions：Patients with low ovarian response should be recommended the fresh transplantation as priority selection. Patients with normal ovarian response should give priority to the whole-embryo freezing and then transfer the frozen-thawed embryo. In order to avoid the ovarian hyperstimulation to the greatest extent, patients with ovarian hyperresponsiveness should be directly recommended to give priority to the whole-embryo freezing and then transfer the frozen-thawed embryo. Related Articles | Metrics

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Study on Fertility Stress and Life Quality in Couples Undergoing Artificial Insemination by Donor LUO Li-yan，SHI Li，ZHAO Yang 2019, 38 (3):  201-205.  Abstract ( 1181 )   PDF (850KB) ( 8937 )   Objective：To investigate the fertility stress and life quality in those couples undergoing artificial insemination by donor (AID), and to provide a theoretical reference for the psychological intervention. Methods：The cross-sectional survey was carried out in 129 infertile couples using the Fertility Question Inventory (FPI) scale and the Fertility Quality of Life (FertiQoL) scale who were undergoing AID in our hospital from May 2018 to September 2018. The fertility stress and life quality in husband and wife, and the relationship between the fertility stress and life quality were analyzed. Results：The total FPI score in female patients undergoing AID was 159.00±17.52, and the total FertiQoL score 62.27±9.26. The total FPI score in those husbands was 153.91±19.96, and the total FertiQoL score 65.12±11.62. The total score of fertility stress (t=2.436, P=0.016) and the childless stress dimension score (t=3.145, P=0.002) in wives were higher than those in husbands. The total FertiQoL score (t=-2.881, P=0.005) and the body-mind dimension score (t=-11.401, P=0.000) in husbands were higher than those in wives, while the affective response dimension score (t=3.681, P=0.000) in wives was higher than that in husbands. Pearson analysis showed that there were negative correlations between the total FertiQoL score and the total fertility stress score, or sexual concern score, relationship concern score, or the need for parenthood score in FPIin wives (P＜0.05), and that there were negative correlations between the FertiQoL and the fertility stress score, or other dimension score except need for parenthood score in FPI in husbands (P＜0.05). Multiple linear regression analysis showed that the fertility stress, culture degree and residence place were three main factors of the life quality in wives (F=3.485, R2=0.168, P＜0.05), and that the fertility stress, education degree and family monthly income were three main factors of the life quality in husbands (F=4.390, R2=0.203, P＜0.01). Conclusions：The fertility stress of female patients undergoing AID was higher than that of male spouses, and the life quality of female patients is also lower than that of male spouses. The fertility stress is often an important factor of the life quality. The greater fertility stress, the lower life quality. Related Articles | Metrics

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Effect of Age on Clinical Outcomes of In Vitro Fertilization-Embryo Transfer XU Li-shuang, CHEN Jie, XIONG Fang, WEI Wei 2019, 38 (3):  206-208.  Abstract ( 1162 )   PDF (722KB) ( 9076 )   Objective：To investigate the effect of age on the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET). Methods: The clinical data of 4 512 infertile women who received IVF-ET in our Reproductive Medicine Center from January 2013 to July 2017 was analyzed retrospectively. All subjects were divided into six groups: younger than 35 years (3 619 cases, 11 patients were lost in follow-up), aged 35-37 years (479 cases), aged 38-40 years (262 cases), aged 41-42 years (90 cases), aged 43-44 years (39 cases), and older than 44 years (23 cases). The clinical pregnancy rate, first-trimester abortion rate, late abortion rate, ectopic pregnancy rate and live birth rate were compared among six groups. Results: There were decreases with age in the clinical pregnancy rate (P＜0.000 1), while the clinical pregnancy rate was best in the group of ＜35 years(54.42%). Meanwhile，the early abortion rate was increased significantly with age, especially in the women over 35 years (P＜0.01), and almost reached to 40% in the women more than 40 years. The live birth rate was decreased with age (P＜0.000 1), and this rate was 0 in those women aged more than 44 years. Conclusions: Age is a key factor related to the clinical outcomes of IVF-ET. The early intervention treatment should be advocated in those infertile women aged over 38 years because of the poor clinical outcomes. Related Articles | Metrics

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Expressions of Folate Receptor Alpha and CA125 in Endometrial Carcinoma Tissues ZHOU Yang, SUN Hao, JIN Zhi-jun, WU Yu-xian, WANG Cheng-cai 2019, 38 (3):  209-213.  Abstract ( 1292 )   PDF (869KB) ( 8911 )   Objective：To investigate the expressions of folate receptor alpha (FRα) and carbohydrate antigen 125 (CA125) in the endometrial cancer (EC) tissues, and to analyze their possible roles in the occurrence，progression and prognosis of EC. Methods: The 62 patients with EC who were admitted to our hospital from July 2015 to December 2018 were selected as the EC group. 42 patients with atypical hyperplasia of the endometrium were selected as the atypical hyperplasia group and 42 patients with normal endometrium as the normal group. The expressions of FRα and CA125 in the endometrial tissues were tested by immunohistochemistry. The tumor size, differentiation degree, clinical stage, lymph node metastasis and the myometrial invasion depth were compared in those patients with EC. The relationship between FRα and CA125 expression, and the one-year recurrence rate of EC patients, was analyzed. Results: The positive rates of FRα and CA125 expression in the endometrial tissues of the EC group were higher than those in the atypical hyperplasia group and the normal control group (all P＜0.05). There were no significant differences in the expressions of FRα and CA125 between EC patients with different tumor size and lymph node metastasis (P＞0.05). The expressions of FRα and CA125 in the EC patients with the degree of tumor differentiation from G2 to G3, clinical stage Ⅲ to Ⅳ, and the myometrial invasion depth ≥ 1/2 were higher than those in those EC patients with tumor differentiation G1, clinical stage Ⅰto Ⅱ, and the myometrial invasion depth ＜1/2 (P＜0.05). The Spearman correlation analysis confirmed that there was a positive correlation between FRα and CA125 expression in the endometrial tissues of the EC group（rs=0.328，P=0.009）. The one-year recurrence rate in the patients with higher expressions of FRα and CA125 was higher than that in other patients with lower expressions, but the difference was not significant (P＞0.05). Conclusions: The expressions of both FRα and CA125 in the EC tissues are increased. Both FRα and CA125 can be used as the possible indicators for the pathological diagnosis and malignant degree evaluation of EC. Related Articles | Metrics

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The Function of Noncoding RNAs in Spermatogenesis HE Chen，LIU Qiang 2019, 38 (3):  213-216.  Abstract ( 1177 )   PDF (721KB) ( 9213 )   There are about 1%-2% genomic DNAs encoding proteins in the human genome, and the coding products of the remaining 98% genomic DNAs are called noncoding RNAs (ncRNAs). NcRNAs play roles in many life activities including spermatogenesis. NcRNAs can regulate the gene expression at the transcriptional and post-transcriptional levels, in which ncRNAs participate in physiological and pathological processes such as gene imprinting, apoptosis, tumorigenesis and epigenetic modification. Spermatogenesis undergoes a long and complex change, from spermatogonial stem cells(SSC) to spermatozoa, which is regulated by multiple hormones and transcription factors. It has been found that ncRNAs also play some roles in spermatogenesis. NcRNAs can regulate the self-renewal and differentiation of SSC and participate in meiosis and other processes. NcRNAs are also expressed in spermatozoa. In this review, three kinds of ncRNAs and their effects in different stages of spermatogenesis were summarized. Related Articles | Metrics

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Application of Single-Cell Transcriptional Sequence in Study of Reproductive Development LI Tong，XU Jia-wei，SUN Ying-pu 2019, 38 (3):  217-221.  Abstract ( 1207 )   PDF (763KB) ( 9132 )   Cell is the fundamental unit of the structure and function of lives. The cell fate is a process that decided at the single-cell level. Due to genomic and epigenetic reprogramming, as well as errors in cell division and differentiation, cells from the same lineage or individual varies in genomes, transcriptomes and epigenomes, which is the so-called heterogeneity. Single cell sequencing allows the high-throughput molecular detection of individual cell, which not only has a powerful function in solving biological heterogeneity, but also has many advantages in rare cells problems. The single-cell transcriptome sequencing (scRNA-seq) plays an important role in the observation of mammalian gamete development and early embryo development, and is of great significance for the reproductive development. In this review, we discuss recent progress in methodology and applications of the scRNA-seq. Related Articles | Metrics

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Research Progress of Germline Stem Cells JIA Tian-yu，LIU Long-hui，SHEN Hao-fei，ZHANG Xue-hong 2019, 38 (3):  222-225.  Abstract ( 1245 )   PDF (713KB) ( 9043 )   The primordial follicle as the basic reproductive unit of women is the only form of oocyte reserve. The traditional view is that the number of oocytes no longer increases after birth. With the development, maturation and atresia of follicles, the oocytes are continuously depleted. Women with the declined ovarian function will go through the menopause. With the research progress of human stem cells, the application of stem cells in clinical treatment has become a reality. For example, the bone marrow hematopoietic stem cell transplantation has become an important treatment for those patients with blood system diseases such as leukemia. Recently, researchers have discovered mitotic germ cells in the ovary of adult mice. This kind of mitotic germ cell may be involved in oocyte regeneration, which is likely to be germline stem cells (GSCs). GSCs brings the hope of fertility preservation for those women with primary ovarian insufficiency (POI), premature ovarian failure (POF) and malignant tumors, and the hope of health maintenance for postmenopausal women. The research progress of GSCs and potential clinical application were reviewed in this paper. Related Articles | Metrics

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lncRNAs as Members of ceRNA Network and Ovarian Cancer ZHANG Li, LIU Shi-yi, WANG Yan-qing, YANG Xiao, CHENG Yan-xiang 2019, 38 (3):  226-229.  Abstract ( 1148 )   PDF (771KB) ( 9075 )   Most parts of the human genome are non-coding regions which produce non-coding RNA (ncRNA). Although ncRNAs cannot be translated into protein, it can affect human physiological and pathological processes through direct and indirect regulation of mRNA. Long non-coding RNA (lncRNA) is important branch of ncRNAs. LncRNA is involved in cancer cell proliferation, migration, invasion, apoptosis and drug resistance, etc. Therefore, lncRNA could be used as a marker of early diagnosis and prognosis, and therapeutic target of tumors. The hypothesis of the competitive endogenous RNAs (ceRNA) network has led to a further understanding of the mechanism of tumorigenesis. LncRNA is indispensable in the formation of the ceRNA network. In recent years, there have been more and more research on the lncRNA in ovarian cancer (OC). In this paper, we review the advance of lncRNA as a member of ceRNA network in the pathogenesis of OC. Related Articles | Metrics

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Evaluation of Ovarian Reserve Function by AMH in Patients with PCOS and Its Diagnostic Value XU Yuan-fang，HUANG Yuan-hua 2019, 38 (3):  230-235.  Abstract ( 1211 )   PDF (806KB) ( 9006 )   The level of serum AMH has been used as an indicator of ovarian reserve and ART outcome. The relationship between AMH and polycystic ovary syndrome (PCOS) has also attracted more and more attention. The ovarian reserve of PCOS patients is different from that of non-PCOS patients of the same age, and the actual age is not the same as the ovarian fertility age in PCOS patients. The mean fertility age of PCOS patients is actually postponed, and the ovarian reserve is better than that of non-PCOS patients of the same age. PCOS patients have their own characteristics of the expression and change of AMH. AMH is abnormally increased in PCOS patients, and the decline of AMH with age is faster than that in non-PCOS patients. There is a strong positive correlation between AMH level and AFC or the follicle number of controlled ovarian stimulation (COS) in PCOS patients. However, there is a controversy correlation between AMH level and IVF-ET pregnancy outcome in PCOS patients. The diagnostic efficacy of AMH for PCOS is good. Because the increase of AMH is related to the specific phenotype and ethnic difference of PCOS patients, the cutoff value of AMH fluctuates widely. Understandably, there is not a unified conclusion on this cutoff value at present. Related Articles | Metrics

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Epithelial-Mesenchymal Transition and the Development, Function and Diseases of Female Reproductive System WEN Si-xi, SONG Ya-li, LIU Jing, QUAN Song 2019, 38 (3):  236-239.  Abstract ( 1401 )   PDF (739KB) ( 8951 )   Epithelial-mesenchymal transition (EMT) is the process by which epithelial cells undergo morphological transformation into fibroblasts or mesenchymal cells. EMT plays an important role in embryonic development, tissue regeneration, tumor metastasis, and organ fibrosis. With the continuous discovery of EMT in the field of reproduction, EMT has received attention as an important regulatory mechanism for the female reproductive system. In this review, we discusse the importance of EMT in the formation, development and normal function of female reproductive system, and expound the role of EMT in pathological conditions such as endometriosis, intrauterine adhesions and reproductive system malignancies in order to provide new ideas for the research and treatment of female reproductive system. Related Articles | Metrics

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Research Progress on the Relationship between Vitamin D Deficiency and Female Reproduction CHU Qi, ZHENG Lian-wen, MA Ya-lan, LI Dan, XU Ying 2019, 38 (3):  240-243.  Abstract ( 1516 )   PDF (740KB) ( 9115 )   Vitamin D acts not only as a vitamin but also as a hormone. It is a sterol derivative that regulates calcium and phosphorus metabolism. Vitamin D can play some biological roles in cardiovascular diseases, immune regulation, anti-inflammatory, cancer and reproduction. The biological effects of vitamin D are usually mediated by the soluble protein, vitamin D receptor (VDR). VDR is a transcription factor located in the nucleus of target cells distributed in various human systems and tissues, including the female reproductive system. Recently, the relationship between vitamin D and the female reproduction attracted more and more attention. Vitamin D affects ovarian physiological function and female fertility to a certain extent, and is associated with some female reproductive diseases, such as polycystic ovary syndrome, pre-eclampsia, endometriosis, and gestational diabetes. The relationship between vitamin D deficiency and female reproductive system is briefly discussed in this review. Related Articles | Metrics

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Female Genital Tract Diseases Related with HPV Infection and Current Status of HPV Vaccine LUO Ya-juan, WANG Dan-dan, YANG Qing 2019, 38 (3):  244-248.  Abstract ( 1454 )   PDF (764KB) ( 9158 )   Human papillomavirus (HPV) is one of the most common sexually transmitted viruses. HPV causes a variety of pathological changes after infection in female genital tract. The high infection rate and high pathogenicity of HPV seriously endanger female reproductive health. The common clinical manifestations mainly include transient infection, genital warts, vulvar intraepithelial neoplasia, vulvar cancer, cervical intraepithelial neoplasia and cervical cancer. In recent years, with the introduction of HPV preventive vaccines, the incidences of HPV infection and related diseases have been greatly reduced. For the cervical lesions caused by HPV16/18, the prevention rate of 2- and 4-valent vaccines can reach 100%. Only a small number of people have dizziness, headache, nausea and adverse reactions at the inoculation site after vaccination. The safety and effectiveness of HPV vaccines have been confirmed. We briefly review the pathological changes related with HPV infection in female genital tract, the significance of HPV screening and the application status of HPV vaccines. Related Articles | Metrics

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Application of Preterm Placenta in Evaluating the Adverse Outcomes of Brain Injury: A Mini Review DU Qiu-yue, SHEN Yan 2019, 38 (3):  249-252.  Abstract ( 1345 )   PDF (716KB) ( 8942 )   With the rapid development of obstetrics and neonatal intensive care technology, the survival rate of preterm infants with extreme survival has increased year by year. However, due to immature development of the nervous system, those infants are easily affected by various high-risk factors, which result in the increased incidence of brain damages. The multiple brain damages will seriously threaten the growth and development of premature infants and their physical and mental health. As the bond between mother and fetus, placenta has become an important organ in the study of neurodevelopmental dysplasia in preterm infants. It has been found that the placental histopathology associated with brain injury in preterm infants is often accompanied by the changes in acute chorionic amnionitis, placental perfusion disorder, chorionic angiopathy, et al. Molecular pathology showed the increased inflammatory factors, the excessive expressions of hypoxic induction factors and the decreased placental exosome protection. The miRNAs can be changed with the intrauterine environment, reflecting the role of epigenetic regulation in protecting the fetal nervous system from external factors. The article reviews the characteristics of placenta changes in preterm infants, including the changes of histopathology, molecular pathology and epigenetics, and the potential mechanism. It is of worth to test those placenta factors in preterm infants to assess the adverse outcomes of brain injury. Related Articles | Metrics

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Genetic Factors and Hypospadias WANG Xin，WU Yong，MENG Qing-ya，GUAN Yong 2019, 38 (3):  253-256.  Abstract ( 1396 )   PDF (725KB) ( 9033 )   Hypospadias, one of the most common congenital malformations in male neonates, is due to abnormal penis and urethral development. It is a highly heterogeneous disorder that is related to multiple factors including genetic factor, hormonal insufficient, maternal and placental factor and environment factor. During the last decade, a tremendous work has been devoted to the molecular genetics of isolated hypospadias including the study of BMP, FGF, HOXA and so on. The related genes covered gender, steroidogenesis and signaling genes. It is necessary to study the biological functions of those genes and potential application in diagnosis by the case-control study with large samples. With the development of sequencing technique, the interaction of gene-gene or gene-environment will be decoded through new exome sequencing and whole genome sequencing, which is helpful for us to understand better the molecular mechanism of hypospadias and to explore the diagnosis markers and therapy targets. In this paper, we review the genetic factors of hypospadias and the research progress. Related Articles | Metrics

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Preoperative Diagnosis of Uterine Sarcoma CHEN Si-lei，WANG Guang-wei，ZHAO Wan-cheng，YANG Qing 2019, 38 (3):  257-260.  Abstract ( 1671 )   PDF (743KB) ( 9096 )   Uterine sarcoma (US) is a rare malignant tumor with the characteristics of difficulty in diagnosis, high malignant degree, early metastasis, early recurrence and poor prognosis. Early diagnosis and surgical treatment are two key factors in improving prognosis, the preoperative diagnosis of uterine sarcoma, and staging, is of great clinical significance. There is no specific clinical manifestation of uterine sarcoma. Preoperative examinations such as the elevated levels of serum CA125 and lactate dehydrogenase (LDH) are suggestive, however they cannot be used as diagnostic indicators. When uterine sarcoma protruded into the uterine cavity, the cytological examination of endometrium could make a positive diagnosis. Imaging studies such as the magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) can be helpful to distinguish uterine sarcoma and benign uterine tumors. However, the clinical value of this combined imaging should be furtherly validated. Ultrasound-guided biopsy can obtain reliable pathological results, which cannot be used as a routine preoperative examination due to the related risks and complications. The comprehensive preoperative predictive systems of uterine sarcoma is constructed by the clinical signs, biomarkers and imaging. Related Articles | Metrics

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Transverse Facial Cleft in Newborn: A Case Report and Literature Review FANG Qian-yu 2019, 38 (3):  261-262.  Abstract ( 2202 )   Transverse facial cleft is a congenital facial malformation that seriously affects the beauty and survival of newborns, and unilateral cleft is common. The incidence of transverse facial cleft is very low, and the etiology remains unknown. At present, there is no clear and effective means to screen the disease before or during pregnancy. However, it is very easy to diagnose according to its clinical manifestations after delivery. Surgery is main therapeutic method of transverse facial cleft to correct facial deformity, but the best surgical method is still uncertain. In this paper, a case of transverse facial cleft was reported, and the related literatures were reviewed, so as to improve our understanding of the disease. Related Articles | Metrics

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A Case Report of Uterine Rupture and Intestine Fistula Caused by Non-Standardized Medication Abortion LIU Xue-li，ZHAO Liu-bi-qi，XU Zi-li，WANYAN-Wen-ya，LI Hui-qin，FAN Li-mei 2019, 38 (3):  263-264.  Abstract ( 1493 )   PDF (641KB) ( 9029 )   Medical abortion should be performed in a qualified medical institution. Although serious complications of medical abortion are rare, they could be emerged due to non-standard medical abortion. We reported a case of the uterine rupture and small intestine fistula with abdominal infection due to herself medication abortion in this paper. This case told us that medical staff should pay attention to the standard of medical abortion, and that the public should improve their knowledge on the complications of medical abortion. The non-standard medical abortion could lead to serious complications which even endanger the life safety. We concluded that medical staff should strictly follow the indications and contraindications of medical abortion, and that medical abortion should be done in those medical institutions with rescue condition, so as to avoid the serious complications like this case. Related Articles | Metrics