2018年 · 第53卷第08期

Cervical cancer has always been a common gynecological malignant tumor that seriously threatens women's health worldwide. Radical surgery, as the main treatment for cervical cancer, has been developed for more than 100 years. This kind of operation was first established by Austrian gynecologist Wertheim, and then Schauta, Ganglin, Meigs and other scholars reported a variety of operative methods^[1,2,3,4]。 These initially proposed surgical methods have unclear anatomical landmarks, inconsistent excision range, and lack of individualized surgical concept for different stages of tumors.

pre-eclampsia (PE) is one of the main causes of morbidity and death in pregnant women and perinatal infants. Its incidence is increasing year by year, but the etiology is still unclear. Placental trophoblast dysfunction is one of the more recognized pathogenesis. Previous studies of our research group showed that high mobility group box 1 (HMGB1), receptor for advanced glycation end products (RAGE), The expression of nuclear factor-κ B (NF-κ B) was significantly enhanced, and HMGB1 as a nuclear protein showed obvious cytoplasmic transfer phenomenon, suggesting that the signaling pathway mediated by the binding of HMGB1 to its receptor RAGE was involved in the pathogenesis of PE^[1]。 The purpose of this study was to further explore the mechanism of RAGE regulation by HMGB1 on the inflammatory response of placental trophoblasts, and to provide experimental evidence for the study of the pathogenesis of PE.

Assisted reproductive technology has undergone more than 30 years of development, benefiting many infertile couples. With the development of assisted reproductive technology, the current clinical pregnancy rate is constantly increasing. However, there are many reports in the literature that the rate of early abortion after assisted reproductive technology is 18% ~30%^[1,2,3]； In addition, with the implementation of the "two-child policy", the number of elderly infertility patients has increased significantly, and the early abortion rate after assisted reproductive technology treatment will continue to increase. Missed abortion, also known as overdue abortion, is a special type of early abortion. Most of them occur within 20 weeks of pregnancy, and the embryo or fetus has died, remaining in the uterine cavity and failing to discharge in time. Current data suggest that the missed abortion rate of singleton pregnant women between 10 and 14 weeks of gestation is about 2%^[4]Its pathogenic factors are complex, involving embryonic chromosome abnormalities, endocrine abnormalities, abnormal apoptosis, uteroplacental circulation disorders, environmental factors and other aspects^[5,6]。 During pregnancy, every stage from fertilized egg implantation to placenta formation is closely related to the formation of new blood vessels and abundant blood supply. There are many factors involved in the regulation of angiogenesis, among which vascular endothelial growth factor (VEGF) -vascular endothelial growth factor receptor (VEGFR), angiopoietin (Ang), and tyrosine kinase receptor 2 (Tie-2) containing epidermal growth factor homologous domain play an important role in regulating angiogenesis^[7,8]。 In this study, the expression of Ang-1, Ang-2 and VEGF in decidua tissues of missed abortion after in vitro fertilization (IVF), missed abortion after spontaneous pregnancy and normal pregnant women were examined, and the relationship between these angiogenic factors and missed abortion was preliminarily investigated, and the cause of missed abortion after IVF was explained from the angle of angiogenesis.

Polypoid endometriosis was first elaborated and named by Mostoufizadeh and Scully in 1980^[1]Different from traditional peritoneal, ovarian and deep infiltrating endometriosis, the appearance of polypoid endometriosis is generally manifested as a single or multiple polypoid mass, which is easily misdiagnosed as a malignant tumor in clinical and imaging. In this paper, 3 cases of polypoid endometriosis were reported, and related literatures were reviewed, and the clinicopathological characteristics, pathogenesis and imaging characteristics of this rare type of endometriosis were expounded, so as to deepen the understanding and accumulate clinical experience.

There are about 500,000 new cases of cervical cancer in the world every year, while about 130,000 new cases in China every year, accounting for about 28% of new cases of cervical cancer in the world^[1]。 Clinically, surgery is the first choice for patients with stage IA ~ Ⅱa cervical cancer. However, due to the wide range of surgery, the nerves of pelvic organs, pelvic floor muscles, and fascia and ligaments around bladder and rectum are damaged, which often causes a series of symptoms such as abnormal pelvic floor myoelectric reflex and bladder and rectal dysfunction, which affect the quality of life of patients. The modern treatment concept of cervical cancer pays more attention to improving the quality of life of patients while treating tumors^[2]Therefore, in order to understand the postoperative pelvic floor function of patients with cervical cancer and explore the early warning method of postoperative bladder dysfunction, 150 patients with PIVER type III extensive hysterectomy for cervical cancer admitted to Peking University People's Hospital from February 2015 to April 2017 were selected to investigate the urinary incontinence, and analyze the correlation between pelvic floor muscle fatigue and abnormal urinary control function and urinary incontinence. The results are reported as follows.

Placental implantation refers to the invasion of placental villi into the myometrium, reaching or penetrating the serosa layer of the uterus, and even involving the bladder and rectum in severe cases. The incidence of placental implantation has been increasing in recent years, approximately 1:533^[1]。 The incidence of complications due to placental implantation is as high as 60%, so pregnant women who underwent hysterectomy accounted for 73.3% of the total perinatal hysterectomy^[2]。 Placenta implantation has attracted much attention because it seriously endangers the health of mother and child and the quality of life of pregnant women.

Preterm birth is one of the main causes of perinatal death and neonatal near-term and long-term complications. Statistics at home and abroad show that the incidence of twins is increasing year by year, which may be related to the increase of older mothers and the use of assisted reproductive technology^[1]。 The risk of premature birth in twin pregnancies is much higher than in single pregnancies. The incidence of premature birth in single pregnancies in the United States in 2013 was 9.7%, while the incidence of premature birth in twin pregnancies was as high as 56.6%^[2]； From 1990 to 2014, the proportion of the total number of fetuses in twin pregnancies to perinatal infants in Peking Union Medical College Hospital increased from 2.0% to 5.0%, and the incidence of premature birth in single and twin pregnancies was 6.1% and 55.0%, respectively, all of which were mainly spontaneous premature birth^[3]。

Menstruation is the result of the periodic shedding of the endometrium with hormonal changes, which is a normal uterine bleeding. Due to functional or organic problems, some women's menstrual frequency and regularity will be abnormal, and obesity is an important factor leading to menstrual abnormalities. Studies have shown that the rate of obesity among women with abnormal menstrual cycles is significantly higher than that of the general population, and weight loss can help obese women return to normal menstrual cycles^[1]。 There are four clinical indicators to evaluate whether menstruation is abnormal: (1) Menstrual cycle frequency: frequent menstruation (<21 d), menstrual thinness (>35 d); (2) Menstrual cycle regularity (i.e., changes between cycles in the past 1 year): irregular menstruation (≥7 days); (3) Length of menstruation: amenorrhea (≥6 months without menstruation), prolonged menstruation (>7 d), short menstruation (<3d); (4) Menstrual bleeding: menorrhagia (>80 ml), oligomenorrhagia (<5 ml). If any of the above items are met, it is considered that there is menstrual abnormality^[2]。 According to the 2000 WHO "New definitions of obesity and its treatment in the Asia-Pacific region"^[3]Asian adults are classified according to body mass index (BMI) as: (1) Hypomass: BMI<18.5 kg/m²； (2) Normal: BMI 18.5~22.9 kg/m²； (3) Overweight: BMI ≥23.0 kg/m²； (4) Pre-obesity: BMI 23.0~24.9 kg/m²； (5) Degree I obesity: BMI 25.0~29.9 kg/m²； (6) Degree II obesity: BMI ≥30.0 kg/m²。