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15 March 2023, Volume 42 Issue 2
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Expert Forum

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Clinical Practice of Oocyte Mitochondrial Transplantation and Ethical Issue CUI Yu-gui, JIA Hong-yan, SHI Chen-nan, YAN Zheng-jie, LIU Jia-yin, MA Xiang 2023, 42 (2):  89-94.  doi: 10.12280/gjszjk.20220498 Abstract ( 1908 )   HTML ( 499 )   PDF (804KB) ( 2764 )   Oocyte development depends on the mitochondrial energy metabolism, while the decline of oocyte quality in advanced women is closely related to mitochondrial dysfunction. Oocyte mitochondria also provide the sufficient energy accumulation for early embryonic development. Oocyte mitochondrial transplantation has been used in the clinical practice of mitochondrial dysfunction diseases caused by the mutations or microdeletions of mitochondrial DNA (mtDNA). In recent years, many clinical trials have been reported that oocyte mitochondrial transplantation was used in the advanced women with poor oocyte quality, poor ovarian response and repeated failure of in vitro fertilization and embryo transfer that were related to the mitochondrial function impairment. Mitochondrial transplantation can be divided into the allogeneic mitochondrial transplantation and the autologous mitochondrial transplantation. The autologous mitochondrial transplantation can reduce the risk of mtDNA heterogeneity and mtDNA mutation and avoid ethical problems. However, mitochondrial transplantation still has great challenges in technology, which requires further basic experiment, technological development and safety verification with animal models. References | Related Articles | Metrics

Original Article

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Effect of Atosiban on the Outcomes of Frozen-Thawed Embryo Transfer in Patients with Repeated Implantation Failure ZHANG Yuan, JIANG Chao, JIANG Chun-yan, QIAN Yi, YUAN Chun, SHU Li, MAO Yun-dong, LIU Jia-yin, DIAO Fei-yang, MA Xiang 2023, 42 (2):  95-101.  doi: 10.12280/gjszjk.20220515 Abstract ( 2061 )   HTML ( 372 )   PDF (909KB) ( 2838 )   Objective: To investigate the effects of atosiban on the pregnancy outcome of frozen-thawed embryo transfer in patients with repeated implantation failure with different etiologies. Methods: From January 2019 to January 2021, the patients diagnosed with repeated implantation failure in their frozen-thawed embryo transfer cycles were selected, and the clinical data of 230 patients were included by the propensity score matching method. Patients were divided into the atosiban group and the control group, according to whether atosiban was used on the day of embryo transfer. A small dose of 6.75 mg (0.9 mL) of atosiban was injected intravenously 30 minutes before embryo transfer in the atosiban group (n=115), while the control group (n=115) did not use. The implantation rate, clinical pregnancy rate, ectopic pregnancy rate, miscarriage rate, preterm birth rate and live birth rate were compared between the two groups. The different causes of repeated implantation failure (endometriosis, immunological or coagulation abnormalities, unknown causes, complex factors and other factors) were analyzed in subgroups, and the differences of clinical outcomes between the two groups were compared. Results: No significant differences were found in the implantation rate, clinical pregnancy rate, ectopic pregnancy rate, miscarriage rate, preterm birth rate and live birth rate between the two groups (both P>0.05). Multivariate analysis showed that there was a significant correlation between the type of transferred embryos and the live birth rate（P=0.001）. The subgroup analysis of the different causes of repeated implantation failure showed that in the subgroup of endometriosis, the use of atosiban could significantly reduce the miscarriage rate (P=0.036), but does not increase the live birth rate (P=0.757). Conclusions: The use of atosiban cannot improve the clinical outcome of frozen-thawed embryo transfer cycle in patients with repeated implantation failure, and does not improve the live birth rate. It is not recommended to use atosiban without clinical indications. Figures and Tables | References | Related Articles | Metrics

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The Safety and Clinical Pregnancy Outcome of Preimplantation Genetic Testing in Frozen-Thawed Embryos ZHANG Xiao-lan, WU Xun, CAO Shan-ren, ZHANG Jun-qiang, LING Xiu-feng, LI Xiu-ling 2023, 42 (2):  102-106.  doi: 10.12280/gjszjk.20220221 Abstract ( 1979 )   HTML ( 200 )   PDF (887KB) ( 2748 )   Objective: To explore the safety of preimplantation genetic testing (PGT) in frozen-thawed embryos and its effects on the clinical pregnancy outcome. Methods: From August 2016 to December 2021, a total of 95 clinical cases of PGT in frozen-thawed embryos were collected from the Center of Reproductive Medicine, Women’s Hospital of Nanjing Medical University (referred to as the frozen-thawed embryos PGT group, 37 cases had been transplanted up to December 31，2021) and 145 clinical cases of PGT in fresh embryos during the same period (referred to as the fresh-embryos PGT group, 95 cases had been transplanted). The differences in PGT results and the clinical pregnancy outcome of transplanted cases were analyzed between the two groups. Results: ① In 145 cases of the fresh-embryos PGT group, 742 blastocysts were biopsied and 283 euploid embryos were obtained; In 95 cases of the frozen-thawed embryos PGT group, 279 blastocysts were biopsied and 90 euploid embryos were obtained. There was no significant difference in the euploid embryos rates between the two groups (38.14% vs. 32.26%, P=0.082). ② There were no significant differences in the embryo implantation rate(56.84% vs. 54.05%), clinical pregnancy rate (56.84% vs. 54.05%), miscarriage rate (9.26% vs. 15.00%), live birth rate (51.58% vs. 45.95%) and the early birth rate (8.16% vs. 11.76%) between the two groups (all P>0.05). Conclusions: PGT in the frozen-thawed embryos is consistent with PGT in the fresh embryos about diagnostic result and pregnancy outcome. Therefore, PGT in the frozen-thawed embryos can be used as a relatively safe treatment under some special circumstances. Figures and Tables | References | Related Articles | Metrics

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The Relationship between BMI, Serum Albumin and Iron Metabolism in Pregnant Women with Mild Thalassemia PENG Jing, LAO Shao-xing, SONG Peng-shu, WEI Hong-wei, YANG Juan-juan, YANG Qin-ling 2023, 42 (2):  107-110.  doi: 10.12280/gjszjk.20220272 Abstract ( 1993 )   HTML ( 53 )   PDF (830KB) ( 2707 )   Objective: To observe the changes of the nutritional status calibrated by BMI and serum albumin in early-pregnant women with mild thalassemia, and iron metabolism levels, and to explore the relationship between nutritional status and iron metabolism in these pregnant women. Methods: The levels of serum iron (SI), serum ferritin (SF) and hemoglobin (Hb) in 634 pregnant women with mild thalassemia, from October 2018 to October 2020, were retrospectively analyzed. According to the nutritional status, the pregnant women were divided into the low weight-malnutrition group (group A), the low weight-good nutrition group (group B), the high weight-malnutrition group (group C) and the high weight-good nutrition group (group D). Results: With the increase of gestational age, the levels of SI, SF and Hb of pregnant women in the four groups showed a downward trend. The levels of SF and SI in group D were lower than those in other three groups at different gestational periods (all P<0.05). The levels of SF in group A were higher than those in the other three groups in the middle and late pregnancy, the levels of SI were higher than those in the other three groups at different gestational periods, while the levels of Hb were lower than those in the other three groups at different gestational periods (all P<0.05). Conclusions: Pregnant women with mild thalassemia, especially those with low weight- malnutrition and high weight-good nutrition, may have iron deficiency anemia. Therefore, it is necessary to dynamically monitor the level of iron metabolism during the pregnancy of mild thalassemia, and those with high iron load or good nutritional status in the early pregnancy should not be ignored. Nutrition or iron supplementation should be given to different individuals to reduce the risk of iron deficiency anemia. Figures and Tables | References | Related Articles | Metrics

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Analysis of Prevalence of 3-Methylcrotonyl-CoA Carboxylase Deficiency and Mutations of MCCC1 and MCCC2 Genes in Shijiazhuang Area JIA Li-yun, WANG Xi, MA Cui-xia, YANG Hui-xin, GONG Miao, FENG Ji-zhen 2023, 42 (2):  111-114.  doi: 10.12280/gjszjk.20220495 Abstract ( 1799 )   HTML ( 55 )   PDF (811KB) ( 2706 )   Objective: To determine the prevalence of 3-methylcrotonyl-CoA carboxylase deficiency (MCCD) in neonates in Shijiazhuang City, and to test the mutations of the related genes.Methods: 185 683 neonates born in Shijiazhuang City were screened for MCCD by tandem mass spectrometry from January 2014 to December 2021, and the gene mutations of MCCC1 and MCCC2 were analyzed in those screened positive neonates. The growth and development of positive neonates were followed up. Results: Two children were diagnosed, with a prevalence of 1.08/100 000. Among them, one case was MCCD2 type with a complex heterozygous variation, which were c.592C>T and c.1144_1147delAAAAinsTTTT. The mutation of c.592C>T was a pathogenic variation while the c.1144_1147delAAAAinsTTTT was an unreported mutation, so its pathogenicity was classified as a suspected pathogenicity. The results of tandem mass spectrometry screening showed that the level of serum C5OH in the child with gene mutaion was increased. The initial screening level of C5OH was 12.26 μmol/L (normal value range is 0.07-0.61 μmol/L). The growth and development was normal during 1 year and 3 months of following up. The another child with the maternal MCCD 1 type was also tested. The primary screening level of C5OH increased to 6.28 μmol/L, and reduced to 0.75 μmol/L within the normal range after 6 months. The MCCC1 heterozygous variation was c.1679_1680insA, which was an unreported gene mutation, and the pathogenicity is classified as suspected pathogenicity. The development of this child was normal during 4 years and 3 months of following up. Conclusions: The prevalence of MCCD in neonates in Shijiazhuang area is 1.08/100 000. Three gene variation sites were found, two of which were unreported gene variations. These results enrich the variation spectrum of MCCC1 and MCCC2 genes, and provid a basis for genetic counseling. Figures and Tables | References | Related Articles | Metrics

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Prenatal Diagnosis of 22q11 Microdeletion Syndrome in 11 Fetuses LI Yan-qing, FU Wan-yu, CHEN Geng-bo, WANG Yuan-bai, JIANG Yu-ying, XIAO Shan-shan, ZHUANG Jian-long 2023, 42 (2):  115-118.  doi: 10.12280/gjszjk.20220328 Abstract ( 2145 )   HTML ( 65 )   PDF (783KB) ( 2736 )   Objective: To improve the understanding of prenatal diagnosis of fetuses with 22q11 microdeletion syndrome (22q11DS). Methods: A retrospective analysis was conducted on the cases of amniotic fluid/umbilical cord blood chromosome karyotype and SNP-array detection in the Prenatal Diagnosis Center of Quanzhou Women’s and Children’s Hospital from January 2017 to July, 2021. The ultrasonic clinical features, genetic etiology and follow-up results of fetuses with 22q11DS were analyzed. Results: A total of 11 cases of 22q11DS were detected by SNP-array analysis, with a detection rate being 0.37%(11/2 958). Five cases performed the parental SNP-array verification, among them, 1 case inherited from the normal father and the other 4 cases were de novo. There were 9 cases with different ultrasound abnormalities including 4 cases of abnormal cardiovascular system, 3 cases of NT thickening, 1 case of bipedal varus and 1 case of duodenal atresia. The other 2 cases showed no obvious abnormality on prenatal ultrasound. Six cases were induced labor; 1 case was lost to follow-up. Four cases chose to continue pregnancy, of which 2 cases were followed up without obvious abnormality, and 2 cases were missed. Conclusions: Fetal with 22q11DS mainly manifest ultrasound structural abnormalities. Further SNP array detection of ultrasound abnormal fetus can improve the detection rate of chromosome microdeletion. Figures and Tables | References | Related Articles | Metrics

Case Report

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A Case Report of Cellular Vulvar Leiomyoma ZENG Yu-hua, OU Xiao-yu, CHEN Yan-fen, XIE Lin-ling, ZENG Lei, LU Ru-ling 2023, 42 (2):  119-121.  doi: 10.12280/gjszjk.20220419 Abstract ( 1896 )   HTML ( 53 )   PDF (4013KB) ( 2729 )   Cellular leiomyoma is a rare borderline tumor that occurs in the uterus, while cellular leiomyoma that occur in the vulva (cellular vulva leiomyoma) is more rare in the clinic. The location and clinical manifestations of leiomyomas located in the vestibular glands are very similar to those of Bartholin′s gland cysts, so these leiomyomas are often misdiagnosed as Bartholin′s gland cysts in clinical practice. Pathological examination is the main method for definite diagnosis. Compared with ordinary leiomyoma, cellular leiomyomas in histopathologic examination show the braided arrangement phenomenon and abundant cytoplasm. However, there is no significant difference in the cell size and morphology. Recently, a patient with a cellular vulvar leiomyoma was diagnosed and treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The patient was first diagnosed as the Bartholin′s gland cyst according to the history, symptoms and signs. The "cyst" was surgically excised, and for the histological examination and immunohistochemical examination confirmed the diagnosis of a cellular vulvar leiomyoma. MRI and colour ultrasound may help the clinician to make a differential diagnosis, while the definite diagnosis mostly requires pathological examination. Figures and Tables | References | Related Articles | Metrics

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A Case of Diffuse Large B-Cell Lymphoma Originating from Uterus and Bilateral Ovaries SONG Xiao-ping, XI Qiu-ping, ZHU Xiao-yan 2023, 42 (2):  122-126.  doi: 10.12280/gjszjk.20220356 Abstract ( 1831 )   HTML ( 54 )   PDF (3546KB) ( 2757 )   Diffuse large B-cell lymphoma (DLBCL) of the uterus and ovary is rare in clinic. The clinical and auxiliary examination usually have no special manifestations. The postoperative pathology and immunohistochemistry can confirm the diagnosis. The clinical data of one case of DLBCL in uterus and bilateral ovaries were retrospectively analyzed. The patient was a perimenopausal female who underwent abdominal hysterectomy, bilateral adnexectomy and greater omentectomy due to pelvic mass. The definite diagnosis of DLBCL was made by the pathology after surgery. The chemotherapy with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone was given for 6 cycles after surgery, and no recurrence was observed within 6 months after chemotherapy. Figures and Tables | References | Related Articles | Metrics

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Ovarian Borderline Brenner Tumor： A Case Report and Literature Review YU Ping-yuan, WAN Tao, CHEN Xi, ZHANG Ting-ting, YANG Yong-xiu 2023, 42 (2):  127-129.  doi: 10.12280/gjszjk.20220463 Abstract ( 1772 )   HTML ( 61 )   PDF (1459KB) ( 2701 )   Ovarian borderline Brenner tumor is a rare tumor of the ovary. The clinical symptoms and auxiliary examination usually have no special manifestation. Postoperative histopathology combined with immunohistochemistry is needed to confirm the diagnosis. A 46-year-old female patient was diagnosed as ovarian borderline Brenner tumor by postoperative pathological examination after surgery due to a 1-week left adnexal mass found in physical examination. The clinical features, diagnosis, differential diagnosis, treatment and prognosis were analyzed. The data of this case, combined with literature review, can help us to increase the understanding and to reduce the misdiagnosis rate of ovarian borderline Brenner tumor. Figures and Tables | References | Related Articles | Metrics

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Mechanisms and Clinical Relevance of Sperm DNA Damage CHEN Ruo-lin, ZHANG Yun-shan 2023, 42 (2):  130-134.  doi: 10.12280/gjszjk.20220473 Abstract ( 1846 )   HTML ( 59 )   PDF (782KB) ( 2781 )   Spermatogenesis is an important process for maintaining and promoting male fertility, involving a variety of cell types, regulatory molecules, repair mechanisms and epigenetic regulators. In the later stage of spermatogenesis, the dysfunction of the sperm DNA repair system and the excessive production of reactive oxygen species may damage the nucleus and mitochondrial DNA, causing abnormal spermatogenesis and apoptosis and reducing the probability of natural conception. The sources of sperm DNA damage mainly include replication errors and sperm DNA fragmentation (SDF), which may be related to male infertility, assisted reproduction outcomes, and the growth and development of offspring. The sperm DNA damage can be evaluated by measuring SDF level. Studying the occurrence and mechanisms of sperm DNA damage can help to improve the clinical outcomes in infertile patients. This article reviews the processes of spermatogenesis, spermatogonia regulation and sperm differentiation, and introduces the DNA damage and its impact on the assisted reproduction outcomes. References | Related Articles | Metrics

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Application of Deep Learning in Optimal Embryo Selection of In Vitro Fertilization HUO Wen-jie, WANG Xiao-cong, PENG Fei, QUAN Song 2023, 42 (2):  135-139.  doi: 10.12280/gjszjk.20220553 Abstract ( 1836 )   HTML ( 55 )   PDF (769KB) ( 2693 )   The selection of transferred embryo is one of the most important factors in achieving successful pregnancy of in vitro fertilization-embryo transfer. At present, the most common method of embryo selection is visual evaluation of embryo morphology, which is highly dependent on subjective vision and personal experience of lab technicians. This method may affect the accuracy and consistency of optimal embryo selection. Recently, some studies have tried to introduce the deep learning algorithm into embryo selection. The deep learning model is developed to assess quality, and to predict outcome based on a large number of manually labeled embryo images and vedios. It has been found that the deep learning algorithm was objective, accurate, efficient and stable. This paper reviews the application of deep learning, as well as its research progress, in embryo selection, and compares deep learning with manual evaluation or classic machine learning algorithms, so as to provide a glimpse into the application value of deep learning in assisted reproduction. References | Related Articles | Metrics

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Research Progress of Brain-Derived Neurotrophic Factor and Female Reproduction ZHU Wen-bin, XU Jing-yu, MA Rui-hong, XIA Tian, LUAN Zu-qian 2023, 42 (2):  140-144.  doi: 10.12280/gjszjk.20220501 Abstract ( 1880 )   HTML ( 59 )   PDF (773KB) ( 2744 )   Brain-derived neurotrophic factor (BDNF) is a member of the family of neurotrophic factors. When combined with its receptors, BDNF plays an important role in the development and differentiation of neurons. Recent studies have found that BDNF is also expressed in the female reproductive system and plays an important role in female reproductive endocrine. In the ovary, BDNF can promote follicle development, oocyte growth and maturation, ovulation and so on. In the utero, BDNF can regulate the endometrial receptivity by promoting endometrial proliferation, making it easier to adapt to embryo implantation, and promoting embryo and placenta development. The abnormal expression of BDNF is closely related to the occurrence of polycystic ovary syndrome, diminished ovarian reserve, endometriosis and other diseases. Therefore, it is of great significance to study the expression of BDNF in the reproductive system, its influence on reproductive function and the correlation with the reproduction-related diseases. In this paper, we summarize the reports on BDNF and female reproductive function and the related diseases, so as to provide a certain reference for improving female reproductive function and treating the related diseases. References | Related Articles | Metrics

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The Role of Telomere and Telomerase in Female Reproductive Health ZHANG An-ni, WEI Lin-fei, LI Ning, ZHOU Xin-yue, ZHANG Xue-hong 2023, 42 (2):  145-149.  doi: 10.12280/gjszjk.20220507 Abstract ( 1789 )   HTML ( 66 )   PDF (803KB) ( 2728 )   Telomeres are the DNA-protein complexes that maintain chromosomal length by forming a protective cap at the end of chromosome, which means that the length of telomere determines the cell life. Telomerase plays an important role in resisting cell replicative senescence as a ribonucleoprotein complex that maintains telomere length and integrity. Many studies have shown that the dysfunction of telomere and telomerase affects the biological behavior of cells, including cell cycle stability, cell proliferation, apoptosis and senescence. In recent years, researchers have paid attention to the relationship between telomere, telomerase and female reproduction. It has been found that the telomere lengths in granulosa cells and leukocytes were often be shorten and the telomerase activities were often decreased in different pathological conditions such as polycystic ovary syndrome, endometriosis, recurrent abortion and cervical cancer. This article reviews the functional characteristics of telomere and telomerase, and the research progress in the field of reproduction, which may provide guidance for the treatment of some female reproductive system diseases. References | Related Articles | Metrics

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The Relationship between PIWI-Interacting RNA and Reproductive Function TIAN Hui, ZHANG Yu, ZHAO Xiao-xi 2023, 42 (2):  150-155.  doi: 10.12280/gjszjk.20220479 Abstract ( 1683 )   HTML ( 41 )   PDF (852KB) ( 2710 )   PIWI-interacting RNA (piRNA), a kind of non-coding RNAs with a length of about 24-31 nucleotides, is specifically expressed in animal germ cells. The production process of piRNA can be divided into two parts: transcription in the nucleus and post-processing in the cytoplasm. piRNA can silence transcriptional genes, and regulates mRNA with the help of PIWI family proteins, and further regulates reproductive function. In male reproductive function, piRNA can control spermatogenesis by RNF8, glutathione peroxidase 5 and other proteins with the help of PIWI family proteins, resulting in azoospermia, oligozoospermia, asthenospermia and other diseases affecting male reproductive function. In the initial study of piRNA, researcher generally believed that piRNA had little effect on female reproduction. However, recent studies on golden hamsters found that piRNA/PIWI also played an important role in the regulation of female reproductive function. The production of piRNA and its correlation with reproductive function were reviewed. References | Related Articles | Metrics

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Application of Placenta-Derived Exosomes in the Diagnosis of Fetal Growth Restriction LI Meng, WU Ya-mei, LI Jia-wen, ZHENG Xiao-min, YING Hao, HUANG Lu 2023, 42 (2):  156-160.  doi: 10.12280/gjszjk.20220470 Abstract ( 1768 )   HTML ( 52 )   PDF (1488KB) ( 2715 )   The specific placenta-derived exosomes are important mediums for the communication between cells at the mother-to-fetus interface. During pregnancy, the placenta releases a large number of exosomes that promote the growth and development of embryos. These exosomes contain proteins, lipids, microRNAs, etc. As a kind of bioactive substances in exosomes, microRNAs participate in the occurrence and development of fetal growth restriction (FGR). Therefore, microRNAs may play an important role in the early diagnosis, clinical treatment and prognosis of diseases. In addition, the placental alkaline phosphatase (PLAP) and cell-free DNA (cfDNA) derived from exosome can also be used as specific markers in the clinical diagnosis of FGR. FGR is one of the common complications in obstetrics, which is the second leading cause of perinatal death. Therefore, early etiological diagnosis is extremely important. This article introduces the function of placenta-derived exosome and reviews its application in clinical diagnosis of FGR. Figures and Tables | References | Related Articles | Metrics

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The Relationship between Interleukin-1β and Pregnancy and Related Diseases CHEN Cheng, FENG Xiao-ling 2023, 42 (2):  161-166.  doi: 10.12280/gjszjk.20220458 Abstract ( 2341 )   HTML ( 51 )   PDF (813KB) ( 2748 )   Interleukin-1β (IL-1β) is expressable in a variety of tissues and cells. Bioactive signal of IL-1β is conducted by combining with IL-1RⅠ. It plays an important role in the initiation and regulation of inflammation and immune responses. IL-1β participates in maintaining maternal-fetal interface homeostasis throughout pregnancy. The expression level of IL-1β was changed in some pathological pregnancy. Recent studies have shown that IL-1β plays an important role in the regulation of physiological pregnancy processes such as degeneration, embryo implantation, trophoblastic invasion and placental formation, and that the abnormal expression of IL-1β is related to the occurrence and development of pregnancy-related diseases such as recurrent abortion, pre-eclampsia and preterm birth. What′s more, the abnormal expression of IL-1β is also involved in the mechanisms of destroying T cell mediated immune balance, inducing trophoblast dysfunction, promoting the degradation of collagen in amniotic membrane, and inducing apoptosis of endoplasmic reticulum stress related cells. In this paper, the role of IL-1β in maintaining physiological pregnancy and its relationship with pregnancy-related diseases are reviewed in order to provide a reference for further research on the pathological mechanism, prediction and clinical treatment of pregnancy related diseases. References | Related Articles | Metrics

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The Correlation between Reproductive Tract Microbiome and Chronic Endometritis ZHANG Lu, GAO Cai-hong, BAO Hong-chu 2023, 42 (2):  167-171.  doi: 10.12280/gjszjk.20220415 Abstract ( 1655 )   HTML ( 47 )   PDF (776KB) ( 2706 )   The chronic endometritis (CE), a subtle lesion and persistent inflammation without clinical symptom or only accompanied by mild disturbances, is easily overlooked. Studies have revealed a strong link between CE and unfavorable reproductive outcomes such as infertility, recurring implant failure and recurrent abortion. Since endometrial infections are the main cause of CE, pinpointing these pathogenic microorganisms and their propensity for endometrial infection will aid in improving CE diagnosis and therapy. Microbiome can more comprehensively evaluate the endometrial microbial composition of patients with CE, which will provide more possibilities for the individualized treatment of CE in the future. Hence, this paper summarize the research progress of female reproductive tract microbiome in patients with CE, in order to provide new ideas for the diagnosis and treatment of CE. References | Related Articles | Metrics

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Research Progress in Treatment of Primary Vaginal Cancer YUAN Yu-qin, LI Hong-ying 2023, 42 (2):  172-176.  doi: 10.12280/gjszjk.20220518 Abstract ( 1465 )   HTML ( 52 )   PDF (786KB) ( 2694 )   Primary vaginal cancer is a rare gynecologic malignancy, which is the only female reproductive system cancer without clinical practice guidelines in the National Comprehensive Cancer Network. For the treatment of primary vaginal cancer, the best treatment plan has not been proposed yet. The individualized radiotherapy and chemotherapy are still the main treatment methods for vaginal cancer, which may improve the local control rate and overall survival rate. The primary vaginal cancer at early stage usually adopts surgery or radiotherapy, while the vaginal cancer at the advanced stage may adopt the concurrent chemoradiotherapy as an effective alternative treatment. As with the other malignancies, the clinical stage at diagnosis of primary vaginal cancer is the most important prognostic factor, while age, lesion size and histologic type can also affect survival outcomes. Interestingly, the immunotherapy may be a new strategy to improve the prognosis of vaginal cancer. This paper review the treatment methods of primary vaginal cancer, including surgical approaches, radiotherapy, radiochemotherapy and immunotherapy, as well as the respective prognoses. References | Related Articles | Metrics