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15 July 2021, Volume 40 Issue 4
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Original Article

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Human Amnion Mesenchymal Stem Cells Improve Testicular Steroidogenesis in Aging Mice ZHANG Yue-xin, LIU Han-wen, SHI Chen-nan, NING Song, ZHOU Jing, LI Chu-yu, YANG Xiao-yu, QIN Lian-ju, LIU Jia-yin, HU Yan-qiu, CUI Yu-gui 2021, 40 (4):  265-271.  doi: 10.12280/gjszjk.20210138 Abstract ( 2439 )   HTML ( 186 )   PDF (3119KB) ( 7664 )   Objective: To explore whether human amnion mesenchymal stem cells(hAMSC) can improve testicular steroidogenesis in the aging mice. Methods: 31 male mice aged 36-weeks as the model of aging males were randomly divided into 5 groups, with 3 mice in the normal saline control group and 7 mice in the other four groups. Different doses of hAMSC (3.4×106 cells/kg, 6.7×106 cells/kg, 1.4×107 cells/kg) were injected through the tail vein, and the 1% human serum albumin group was used as the treatment control. And the normal saline was used as the blank control. Seven mice aged 10 weeks were used as the young control. The mice were injected four times and once a week. After five weeks of recovery, both testes were taken. The histopathological change was observed by HE staining. The expressions of StAR and 17β-HSD in testicular tissues were detected by immunoblotting. The expressions of STEM121 and CD105 were also detected by immunofluorescence. The epididymis was taken to evaluate sperm count, sperm motility rate and sperm morphology. The level of testosterone was tested by chemiluminescence immune assay.Results: Compared with the young control, the aged mice in the blank control and the treatment control had the increased body weight, the decreased testicular mass-to-weight ratio, the increased fat around the testes (all P<0.01), and the decreased sperm motility rate and normal morphological sperm rate (bothP<0.05). There were no significant differences in sperm density and the expressions of StAR and 17β-HSD protein in testicular tissues between the aging control and the young control (allP>0.05). After five weeks of the hAMSC treatment, the immunofluorescence images showed that there were many cells with the positive expressions of STEM121 and CD105 in the interstitial area of testis. There were no significant differences in the expression of StAR in testis among the treatment groups. The expression of 17β-HSD in the high-dose group was increased than that in the treatment-control group, and the level of testosterone was also increased (bothP<0.05). The histopathology showed that the cell layers of seminiferous tubules were increased in the medium dose group and the high dose group than those in the treatment control group (P<0.05).Conclusions: The preliminary results indicate that hAMSC has a protective effect on testicular aging and can improve testicular steroidogenesis in the aging mice. Figures and Tables | References | Related Articles | Metrics

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SOD is Associated with Schisandrin B Attenuating the PM2.5-Induced HTR Cells Damages YANG Ning-ning, DONG Qu-long, JIAO Li-yuan. 2021, 40 (4):  272-276.  doi: 10.12280/gjszjk.20200644 Abstract ( 1693 )   HTML ( 27 )   PDF (1808KB) ( 7614 )   Objective: To investigate whether superoxide dismutase (SOD) played a role in Schisandrin B (Sch B) attenuating the cell damage induced by PM2.5 in the human trophoblast HTR-8/SVneo(HTR) cells. Methods: With the in vitro cultured model of HTR cells, the expression of SOD gene was down-regulated by siRNA technology, and cells were treatment with PM2.5 at the doses from 0 to 150 μg/mL. The cell proliferation was tested by MTS, the expression of SOD mRNA was tested by real-time PCR, and the expression of SOD protein was measured by ELISA. Results: After the expression of SOD was down-regulated by siRNA, the inhibition rate in the HTR cells induced by 150 μg/mL PM2.5 was incresed to 33.97%, while the protection rates in those HTR cells induced by 0.25, 0.5, 1 and 2 μmol/L Sch B were decresed from 2.74%, 7.91%, 10.31%, 14.07% to 1.39%, 4.98%, 7.75%, 9.55% respectively. Meanwhile, the expressions of SOD mRNA in the HTR cells treated with 0.25, 0.5, 1, 2 μmol/L Sch B were decreased 1.26, 1.47, 1.86, 2.25 times than that in the cells before SOD siRNA, and decresed 1.13, 1.25, 1.43, 1.77 times than that in the cells after SOD siRNA. Analogously, the expressions of SOD protein in the HTR cells treated with 0.25, 0.5, 1, 2 μmol/L Sch B were decreased 1.19, 1.36, 1.60, 1.94 times than that in the cells before SOD siRNA, and decresed 1.09, 1.16, 1.27, 1.41 times than the cells after SOD siRNA. Conclusions: The increased expression of SOD was a protective factor in the effect of Sch B attenuating the PM2.5-induced HTR cell damages. Figures and Tables | References | Related Articles | Metrics

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Comparison of Clinical Outcomes in Women with Follicular Dysplasia Treated with Clomiphene Citrate and Letrozole NI Li-li, WANG Jing, DIAO Fei-yang, MA Xiang, LIU Jia-yin 2021, 40 (4):  277-281.  doi: 10.12280/gjszjk.20210002 Abstract ( 2514 )   HTML ( 74 )   PDF (886KB) ( 7571 )   Objective: To compare the clinical outcomes of artificial insemination with donor sperm (AID) in those women with follicular dysplasia who treated with clomiphene citrate (CC) and letrozole (LE).Methods: The data of AID cycles performed between January, 2012 and August, 2019 were retrospectively analyzed, including 320 cycles by women with small follicle ovulation and 286 cycles by women with follicle growth arrest or atresia. The cycles were respectively grouped according to ovulation induction protocol with CC or LE. Univariate and multivariate logical regression analyses were used to compare the intrauterine pregnancy rate (IPR) and live birth rate (LBR) between CC group and LE group. Results: Women with small follicle ovulation had a comparable IPR (27.68%vs. 21.68%, P=0.196), a significantly lower pregnancy loss rate (PLR) (10.20% vs. 29.03%, OR=0.278, P=0.038) and a significantly higher LBR (24.86% vs. 15.38%, OR=1.875, P=0.031) in the LE group when compared with CC group. Women with follicle growth arrest or atresia had a higher IPR (32.22% vs. 22.45%) without significant difference (OR=1.679, P=0.071), a comparable PLR (10.34% vs. 18.18%, OR=1.926, P=0.366) and a significantly higher LBR (28.89% vs. 18.37%, OR=1.886, P=0.035) in the CC group when compared with LE group. Conclusions: In AID procedure, LE protocol can lead to better clinical outcomes than CC for women with small follicle ovulation, while CC protocol can get better clinical outcomes than LE for women with follicle growth arrest or atresia. Figures and Tables | References | Related Articles | Metrics

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Screening of Neonatal G6PD Deficiency and Gene Mutation Analysis in Shijiazhuang City FENG Lu-lu, LI Li-xin, MA Cui-xia, FENG Ji-zhen, LI Yang. 2021, 40 (4):  282-285.  doi: 10.12280/gjszjk.20200696 Abstract ( 3293 )   HTML ( 92 )   PDF (1058KB) ( 7614 )   Objective: To carry out the screening of glucose-6-phosphate dehydrogenase (G6PD) deficiency in newborns in Shijiazhuang City, and to further analyze the mutations of disease genes.Methods: The heel blood of 237 312 newborns born in Shijiazhuang City, from September 2018 to November 2020, was collected and made the dried blood spots on filter paper. G6PD activity was screened by fluorescence method, and the suspected children were analyzed further by gene sequencing. Results: Among 237 312 newborns, 142 cases were positive and 114 cases were confirmed. The prevalence rate was 0.05%. Among the 114 children, 105 were males, accounting for 92.1%. The average screening result (range) was 1.8 (0.4~3.7) U/g Hb; 9 cases were female, accounting for 7.9%, the average screening result (range) was 2.9 (1.8~4.0) U/g Hb. 56 of 114 children underwent genetic diagnosis (the family members of the other 58 children refused to perform genetic diagnosis). The genetic test showed that all of 56 children had heterozygous mutations. The analysis of mutation sites revealed 19 types of mutations, of which 16 have been reported, c.1376G>T, c.1024C>T, c.1388G>A, c.871G>A, c.95 A>G, c.487 G>A, c.1478 G>A, c.406 C>T, c.577 G>A, c.925A>T, c.185 A>G, c.961 G>A, c.482 G>T, c.653 C>T, c.392 G>T, c.1466 G>T; 3 kinds have not been reported, respectively c.1316 G>A, c.575G>C, c.1400 C>T. The higher mutation frequencies were c.1376G>T (0.25), c.1024C>T (0.16) and c.1388G>A (0.14).Conclusions: The prevalence of G6PD deficiency was preliminarily clarified as 0.05% in newborns in Shijiazhuang area. The distribution of gene mutation sites was further clarified. Three unreported gene mutations were discovered, which enriched the database of gene mutations of G6PD deficiency. Figures and Tables | References | Related Articles | Metrics

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Expression of MiR-146a-5p in Decidual Tissue of Unexplained Recurrent Spontaneous Abortion FENG Yu-ting, LUO Shu-hong, LI Lan, SU Qin, CHENG Jing-qiu, YE Hong-xia 2021, 40 (4):  286-293.  doi: 10.12280/gjszjk.20200669 Abstract ( 2390 )   HTML ( 104 )   PDF (8286KB) ( 7623 )   Objective: To study the expression of miR-146a-5p in the decidual tissue of unexplained recurrent miscarriage (URSA), and analyze the possible mechanism of action. Methods: From January to December 2019, ten patients who underwent uterine evacuation due to URSA (URSA group) and ten normal pregnant patients who underwent induced abortion due to no childbirth planning (control group) in Chengdu Xi′nan Gynaecology Hospital were recruited. The decidual tissues were collected. The levels of miR-146a-5p in the decidual tissues were tested. Bioinformatics methods were used to predict the potential target genes of miR-146a-5p and the molecular mechanisms involved. The levels of key target genes of miR-146a-5p in each group were detected. The correlation between miR-146a-5p and the target genes was analyzed.Results: The level of miR-146a-5p in decidual tissue was lower in the URSA group than in the control group (P<0.001). Thirty-five target genes of miR-146a-5p were predicted in at least three databases, among whichIRAK1, CD80, and TRAF6 in the Toll-like receptor (TLR) signaling pathway; and IRAK1, SORT1, and TRAF6 in the neurotrophin (NT) signaling pathway. The levels of IRAK1, CD80, TRAF6 and SORT1, both mRNAs and proteins, in decidual tissue in the URSA group were higher than those in the control group (all P<0.05), and the level of miR-146a-5p was negatively correlated with the expressions of these four molecules (P<0.05).Conclusions: miR-146a-5p in decidual tissue may participate in the pathogenesis of URSA by regulating TLR and NT signaling pathways, which provids new ideas and potential targets for further studies on URSA prevention and therapy. Figures and Tables | References | Related Articles | Metrics

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The Application of Ultrasound Combined with MRI in Diagnosis of Fetal Diseases SHEN Yong-mei, CHEN Xu, LI Shan-shan, ZHAO Xiao-min, ZHANG Lei, LI Wen, CHANG Ying 2021, 40 (4):  294-297.  doi: 10.12280/gjszjk.20200587 Abstract ( 2295 )   HTML ( 77 )   PDF (796KB) ( 7528 )   Objective: To explore the application of ultrasound alone and ultrasound combined with magnetic resonance imaging (MRI) in the diagnosis of fetal diseases. Methods: 177 pregnant women with abnormal fetal detected by ultrasound, and further examined by MRI, were selected from January 2015 to July 2019. Those cases with lost follow-up and without reexamination were excluded. The cases were then divided into groups according to MRI diagnosis results. The accuracy rates of ultrasound and/or MRI diagnosis according to the pregnancy outcomes were analyzed.Results: The result of ultrasound and the result of MRI were consistent in diagnosing the fetal respiratory system and urinary system, and the proportions of exact match were 45.9% and 53.8%, respectively. MRI mostly supplemented the results of ultrasound when using in the diagnosis of the fetal digestive system disease and ovarian cyst, with the supplemental proportion of 57.7% and 80%, respectively. The accuracy rate of MRI in the diagnosis of digestive system diseases was significantly higher than that of ultrasound (P<0.05); there was no obvious difference between the accuracy rate of MRI and ultrasound in detecting structural abnormalities and echo enhancement (allP<0.05).Conclusions: In case of fetal respiratory and urinary system disease detected by ultrasound, MRI can be suggested when the ultrasonic diagnosis information was insufficient. When detecting fetal digestive system disease and ovarian cysts, MRI was better recommendation regardless of the structural abnormalities or echo enhancement found by ultrasound. Figures and Tables | References | Related Articles | Metrics

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Application of MRI in the Diagnosis and Treatment of Uterine Incarceration during Pregnancy ZHOU Guang-jin, ZHAO Yang-yu, WANG Xue-ju 2021, 40 (4):  298-302.  doi: 10.12280/gjszjk.20200525 Abstract ( 2239 )   HTML ( 79 )   PDF (3109KB) ( 7632 )   Objective: To investigate the application of magnetic resonance imaging (MRI) in the diagnosis and treatment of uterine incarceration during pregnancy.Methods: Four cases of uterine incarceration during pregnancy treated in the Obstetrics Department of Peking University Third Hospital from 2010 to 2020 were retrospectively analyzed. MRI and ultrasound were used in the diagnosis of these cases, and the application value of MRI in preoperative evaluation were evaluated. Results: 2 cases with placenta previa, and 2 cases with abnormal cervix and lower uterine segment, were found by the primary ultrasound. The definite diagnosis of 4 cases was made by MRI examination. The pregnancy outcomes were included 1 case with vaginal delivery at term after reset in the second trimester, 1 case with cesarean section at mid-trimester because of placenta increta, and 2 cases with deliberated cesarean section at third-trimester. Conclusions: MRI can make a definite diagnosis for those suspected cases of uterine incarceration during pregnancy, as a reference for surgical plan. For ultrasound the suspected cases of uterine incarceration, the definite diagnosis by MRI will improve the outcomes of mother and child. Figures and Tables | References | Related Articles | Metrics

Case Report

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A Case Report of Early Embryonic Arrest due to TUBB8 Mutation LI Wen-shu, LIU Xue-mei 2021, 40 (4):  303-305.  doi: 10.12280/gjszjk.20210068 Abstract ( 2866 )   HTML ( 115 )   PDF (787KB) ( 7580 )   The mutation in TUBB8 gene (c.208C>T/p.Pro70Ser) was found in a patient with early embryonic arrest after repeated IVF/ICSI. The association betweenTUBB8 mutation and early embryonic arrest was further explored. This study provides more possibilities for the diagnosis and treatment of patients with recurrent implant failure. Figures and Tables | References | Related Articles | Metrics

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N6-Methyladenosine in Reproductive System: Effect and Regulation ZHANG Meng-hui, LIU Xiao-cong, GUO Yi-hong 2021, 40 (4):  306-309.  doi: 10.12280/gjszjk.20200653 Abstract ( 2289 )   HTML ( 17 )   PDF (757KB) ( 7580 )   N6-methyladenosine (m6A) is the most common RNA modification in eukaryotic cells. Under the dynamic regulation of methylase, demethylase and binding protein, m6A modification is involved in RNA metabolism processes, such as RNA splicing, nucleation and translation and so on. In recent years, many studies have shown that the RNA m6A modification plays an indispensable role in the reproductive processes, such as oocyte maturation and spermatogenesis. During oocyte maturation, the dynamic regulation network of m6A affects the assembly of chromosomes and spindles, interferes with meiosis and impedes the development of follicles. In granulosa cells, apoptosis of granulosa cells caused by the abnormal m6A is related to POI and PCOS. In the male reproductive system, the deficiency of m6A-related enzyme could damage the motility, number and morphology of sperm in mice, while the m6A level in semen was increased in patients with asthenospermia. The combination of new technologies such as artificial intelligence and m6A sequencing technology provides a new direction for the exploration of m6A dynamic network in the future. References | Related Articles | Metrics

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Thyroid Autoimmunity and Assisted Reproduction YANG Yuan, WANG Zhi-hong 2021, 40 (4):  310-313.  doi: 10.12280/gjszjk.20200722 Abstract ( 2072 )   HTML ( 104 )   PDF (760KB) ( 7590 )   Thyroid autoantibodies may be associated with the increased risk of miscarriage, but whether there is a causal relationship and the related mechanism is not clear. The effect of thyroid autoimmunity (TAI) on the outcomes of assisted reproduction is a controversial topic for a long time. Existing studies have shown that the evidence of levothyroxine, glucocorticoid, immunoglobulin and so on, using to improve the outcomes of assisted reproduction in TAI women is insufficiency. It is needed to study further in future. The causal relationship between thyroid autoantibodies and adverse pregnancy should be further explored. In the research design, thyroid autoantibody titer, different insemination methods and fresh embryo transfer or frozen embryo transfer should be considered. It is necessary to further study whether intracytoplasmic sperm injection/frozen embryo transfer（ICSI/FET） is more beneficial to the pregnancy outcomes of TAI women undergoing assisted reproduction. References | Related Articles | Metrics

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Pathogenic Factors and Management Strategies of Treatment-Resistant Thin Endometrium WANG Li-yan, FU Xiao-qian, LI Hua, YANG Yi-hua 2021, 40 (4):  314-318.  doi: 10.12280/gjszjk.20210037 Abstract ( 2127 )   HTML ( 41 )   PDF (793KB) ( 7523 )   Endometrial receptivity is one of the main factors affecting embryo implantation rate, and endometrial thickness is an important index to evaluate endometrial receptivity. Patients with thin endometrium (TE) have poor clinical pregnancy outcome. The endometrium of most TE patients can reach a suitable thickness required for embryo implantation after estrogen treatment. However, some of TE patients cannot reach suitable thickness even though giving super-physiological dose of estrogen, which is called treatment-resistant thin endometrium (TTE). The pathogenesis of TTE is not clear. It is believed that the related factors of TTE are the insensitivity to estrogen receptor, abnormal expression of related factors and insufficient intimal blood supply. The main causes of TTE include infection, uterine cavity operation and insufficient blood flow. The causes of some patients with TTE are still unknown. At present, the clinical treatment of TTE mainly includes drug treatment, regenerative medicine and traditional Chinese medicine. Although there are a variety of treatment methods for TTE, the efficiency is still not satisfactory. This article reviews the epidemiology, high risk factors and treatment of TTE in order to provide reference for clinical treatment. References | Related Articles | Metrics

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Endometrial Stem/Progenitor Cells and the Pathogenesis of Endometriosis DAI Lei, MAO Yun-dong 2021, 40 (4):  319-322.  doi: 10.12280/gjszjk.20200720 Abstract ( 1911 )   HTML ( 18 )   PDF (778KB) ( 7616 )   The endometrial stem/progenitor cells are new targets for the study of the pathogenesis of endometriosis. According to their surface markers and functions in human body, endometrial stem/progenitor cells can be divided into four subgroups: endometrial epithelial progenitor cells, endometrial mesenchymal stem cells, side population cells, niche cells. The discovery of endometrial stem/progenitor cells has improved the Sampson′s theory of retrograde menstruation, and provided a new and reasonable explanation for the pathogenesis of adolescent endometriosis. The further study of endometrial stem/progenitor cells will provide a new possibility for the diagnosis and treatment of endometriosis. References | Related Articles | Metrics

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Research Progress of CRISP2 Protein YAO Yu-tong, QI Cong, Dina Yeernuer, WU Shi-qi, MA Jie, LIU Qiang 2021, 40 (4):  323-327.  doi: 10.12280/gjszjk.20200672 Abstract ( 1972 )   HTML ( 15 )   PDF (742KB) ( 7572 )   CRISPs (cysteine rich secretory proteins) family contains four members. CRISP2 is the only member expressed in testicles, with high tissue specificity. CRISP2 is expressed and secreted by spermatocytes. This process won′t be affected by androgen. CRISP2 scatters in the seminiferous epithelium and is located at the junction of spermatocytes and Sertoli cells, helping spermatocytes connect to Sertoli cells. Afterward, CRISP2 goes with round spermatids and elongated spermatids, combines to the tail and the acrosome in the head of spermatozoa. CRISP2 probably modulate the influx of Ca2+ by combining with RyR3. CRISP2 may also act in modulating other receptors like inhibiting K+ channels. Research indicates that CRISP2 participates in the maturation and capacitation of spermatozoon all along, and also works in sperm-oocyte fusion. In this review, we will focus on the expression and distribution of CRISP2 in testicles as well as its regulation and function. References | Related Articles | Metrics

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Research Progress of Androgen in Polycystic Ovary Syndrome with Non-Alcoholic Fatty Liver Disease PENG Yang-yang, XIE Qing-zhen 2021, 40 (4):  328-333.  doi: 10.12280/gjszjk.20210022 Abstract ( 1812 )   HTML ( 38 )   PDF (882KB) ( 7502 )   Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder in women of childbearing age, which is often accompanied by metabolic disorders such as obesity, insulin resistance, lipid metabolism disorder and so on. Non-alcoholic fatty liver disease (NAFLD) is a common chronic non-alcoholic liver disease, including non-alcoholic simple fatty liver disease, non-alcoholic steatohepatitis, liver fibrosis, liver cirrhosis and hepatocellular carcinoma. In recent years, studies have found that the incidence of NAFLD in patients with PCOS increases, and that the two often coexist. More and more studies have proposed that hyperandrogenemia (HA), one of the important pathophysiological factors of PCOS, plays an important role in the pathogenesis of PCOS-related NAFLD. References | Related Articles | Metrics

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Research Progress on the Mechanism of Gastrointestinal Microbiome in Insulin Resistance of Polycystic Ovary Syndrome CHAI Yi-hong, YANG Pan-pan, ZHANG Xue-hong 2021, 40 (4):  334-338.  doi: 10.12280/gjszjk.20200654 Abstract ( 1812 )   HTML ( 54 )   PDF (898KB) ( 7516 )   Polycystic ovary syndrome (PCOS) is a highly heterogeneous gynecological endocrine disease with clinical manifestations of ovulation disorders, menstrual disorders, hirsute, acne and even infertility. It is often accompanied by metabolic disorders such as obesity, insulin resistance (IR) and dyslipidemia. The pathogenesis of PCOS remains unclear. IR is the main pathological basis of PCOS, which is closely related to the changes of reproductive function such as abnormal level of sex hormones, abnormal follicle development and the reduced endometrial receptivity. Gut microbiome, known as the "second genome of human body", plays a variety of functions in maintaining the homeostasis of the host′s internal environment, such as preventing pathogens from invading the host, regulating absorption and metabolism of nutritional materials, and maintaining the stability of immune system and nervous system. In recent years, many studies have reported that the changes of gut microbiome composition can cause IR through endotoxemia, bile acid, chronic low-grade inflammation and other ways, thus promoting the occurrence and development of PCOS. Figures and Tables | References | Related Articles | Metrics

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Relationship between Homocysteine and Adverse Pregnancy Outcomes SHEN Lu-lu, ZHAO Zhi-mei 2021, 40 (4):  339-343.  doi: 10.12280/gjszjk.20200737 Abstract ( 2126 )   HTML ( 86 )   PDF (789KB) ( 7529 )   Homocysteine (HCY) is an intermediate product of methionine metabolism. The elevated HCY level is an independent risk factor of cardiovascular and cerebrovascular diseases. Adverse pregnancy is a type of clinical pregnancy diseases. With the change of living environment, the incidence increases year by year. However, the relevant pathogenesis of adverse pregnancy is not clear. In recent years, studies have found that the level of HCY is closely related to the occurrence of a series of adverse pregnancies. The level of HCY in pregnant women is significantly lower than that before pregnancy, and the sensitivity to HCY injury is also enhanced in pregnant women. A slight increase in the level of HCY may lead to a series of vascular damage, and then lead to the occurrence of a series of adverse pregnancies. The major causes of HCY increase are the abnormal levels of enzymes related to HCY production, lack of cofactors, excessive intake of methionine, some diseases and some drugs. The decrease in the HCY level can effectively improve adverse pregnancy, by the reasonable supplement of folic acid and B vitamins and the lifestyle intervention. In this paper, the relationship between HCY and adverse pregnancy outcomes is reviewed in order to provide useful reference for the prevention and treatment of adverse pregnancy. References | Related Articles | Metrics

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Diagnosis and Treatment of Heterotopic Pregnancy CHANG Xiao-ying, WANG Li-yan, SHEN Hao-fei, SONG Ji, XU Ling-bo, ZHANG Xue-hong 2021, 40 (4):  344-347.  doi: 10.12280/gjszjk.20200687 Abstract ( 2374 )   HTML ( 62 )   PDF (741KB) ( 7533 )   Heterotopic pregnancy (HP) is a complicated pathological pregnancy, which is rare in natural pregnancy. However, with the development of assisted reproductive technology (ART), the incidence is gradually increasing. Tubal factors and the application of ART are the main factors of HP pathogenesis. It is easy to miss diagnosis or delay diagnosis because of simultaneous intrauterine pregnancy and lack of specificity of symptoms and signs in early stage. The combined application of transvaginal ultrasound and blood hCG value can improve the sensitivity of diagnosis. Therefore, patients with high-risk factors should be in well vigilant, and be diagnosed early, so as to reduce the incidence of adverse obstetric outcomes. Laparoscopic surgery is the main treatment for HP, and other treatments include conservative treatment and drug treatment. Because of the different reproductive needs of patients, the individualized treatment should be adopted to minimize the impact on intrauterine pregnancy and strive for a better pregnancy outcome. If HP can be diagnosed early and treated actively, the prognosis is generally better. References | Related Articles | Metrics

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New Advances in Ovarian Clear Cell Carcinoma: from the Mechanism of Drug Resistance to the Selection of Targeted Drugs DU Yuan-yuan, WANG An-sheng, YANG Yang 2021, 40 (4):  348-352.  doi: 10.12280/gjszjk.20200633 Abstract ( 2725 )   HTML ( 69 )   PDF (802KB) ( 7633 )   Ovarian clear cell carcinoma (OCCC) is a relatively rare histological subtype of epithelial ovarian cancer (EOC) with high level of malignant differentiation, low sensitivity to conventional cytotoxic drugs and platinum chemotherapeutic drugs, and poor prognosis. Therefore, it is an urgent clinical problem to find new therapeutic targets for OCCC therapy. The known new molecular targets for OCCC therapy can be divided into four categories: ①AT-rich interactive domain 1A（ARID1A）-related chromatin remodeling errors; ②downstream pathways of receptor tyrosine kinases; ③antioxidant stress molecule; ④immunomodulatory dysfunction. Several inhibitors have been identified. The in vitro and/or in vivo experiments have showed the inhibitory effects on OCCC cells. However, clinical trials did not show sufficient efficacy at present. References | Related Articles | Metrics