2015年 · 第50卷第07期

intrahepatic cholestasis of pregnancy (ICP) is an important complication of pregnancy that mainly leads to increased perinatal mortality. There are obvious regional and ethnic differences in the incidence of ICP. So far, there is no unified international opinion on the diagnosis and treatment of ICP. In 2011, the Obstetrics Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association organized relevant domestic experts to formulate the first edition of the "Guidelines for the Diagnosis and Treatment of Intrahepatic Cholestasis in Pregnancy", the publication of which played an important guiding role in the standardization of ICP diagnosis and treatment in China. In recent years, new understanding has been gained in the diagnosis and treatment of ICP, so it has been revised. ICP has had many names, which also caused confusion in diagnosis and treatment. Since the publication of the 1st edition of ICP Diagnosis and Treatment Guidelines, domestic textbooks and literature have basically adopted the names in the 1st edition of ICP Diagnosis and Treatment Guidelines.

intrahepatic cholestasis of pregnancy (ICP) is an idiopathic disease of pregnancy, which often occurs in the middle and third trimester of pregnancy. Its clinical characteristics are unexplained skin pruritus, abnormal liver function, and rapid disappearance or return to normal after delivery. The prognosis of pregnant women suffering from this disease is good, and its main harm is the increase of perinatal morbidity and mortality, including premature birth, fetal distress, intrauterine fetal death, stillbirth and contamination of amniotic fluid and meconium^[1]。 The pathogenesis of ICP is characterized by recurrence, family clustering, racial and regional differences^[1]。 Because the etiology of ICP is still unclear, early diagnosis, close monitoring, rational treatment and timely termination of pregnancy are still the most effective treatment measures at present.

In order to accelerate the achievement of the Millennium Development Goals, reduce maternal, infant and under-5 mortality rates and achieve "universal access to reproductive health", many countries and regions have asked WHO to develop a global strategy to strengthen postpartum contraception as soon as possible. Family planning is well known as an effective intervention to reduce maternal and infant mortality, with postpartum contraception being a top priority. Postpartum contraception refers to preventing unwanted pregnancy and avoiding too short birth intervals in women within 1 year after delivery^[1]。 The WHO recommends that another pregnancy be carried out at least after 24 months postpartum in order to reduce adverse outcomes for the mother, perinatal fetus and newborn^[2]。

idiopathic infantile arterial calcification (IIAC) is a rare genetic disease characterized by extensive calcification of the elastic layer in the heart valve and middle and large arteries. Due to heart failure, 85% of the children died in utero or within 6 months of life^[1,2]。 Less than 200 cases were reported in domestic and foreign literature^[3]Of which only 15 cases were diagnosed prenatally^{[1,4,5,6,7,8,9,10,11,12,13,14]}。 First reported domestically in 1994^[15]Only 5 cases have been reported so far^{[15,16,17,18,19]}All were found by postpartum necropsy or by pediatric diagnosis after birth. Recently, a case of IIAC diagnosed prenatally was admitted to Shenzhen People's Hospital, which is reported as follows.

recurrent spontaneous abortion (RSA) refers to two or more spontaneous abortions in a couple. Its etiology is complex, and chromosome abnormalities are one of the important causes of repeated abortion in pregnant women^[1]。 Because there is no effective treatment for diseases caused by chromosome abnormalities, it is particularly important to perform karyotyping on RSA couples. In this study, RSA couples were observed. Five cases of human chromosome abnormal karyotypes were found by cytogenetic examination. The relationship between chromosome abnormalities and RSA was discussed by analyzing the pregnancy and childbirth history of these five patients and their families, and combined with the analysis of chromosome karyotypes.

premature ovarian failure (POF) refers to the state of ovarian failure in women before the age of 40, which is manifested by primary or secondary amenorrhea (at least 6 months) accompanied by increased gonadotropin levels (FSH>40 U/L) and decreased estrogen levels; The incidence rate in women of childbearing age is 1% ~3%, and there is an increasing trend^[1]。 Because POF is the terminal state of ovarian function decline, it brings heavy mental burden and psychological pressure to patients and their families. In recent years, the name POF has been replaced by primary ovarian insufficient (POI)^[2]。 How to solve the fertility problem of POI patients has always been the focus of clinical treatment, and egg donation combined with assisted reproduction technology is one of the important treatment methods. 1984, Lutjen et al.^[3]It was reported for the first time that POF patients successfully obtained normal newborns with hormone supplementation therapy (HRT) combined with egg donor therapy; In January 1994, the first neonate obtained by HRT combined with egg donor therapy was born in the First Affiliated Hospital of Sun Yat-sen University^[4]。 Donating eggs has become the preferred option for patients with POI to get pregnant. Different from abroad, there are large sample sizes of reports on the outcome of assisted reproductive technology treatment in donor women^[5]At present, only small sample size has been reported in China. The First Affiliated Hospital of Anhui Medical University has been conducting egg donation therapy since 2000. This study analyzed the clinical results of POI patients who received egg donation therapy in our hospital in recent years to explore the factors that may affect their pregnancy outcome.

Recent statistics show that in 2014 alone, there were 12,360 new cases of cervical cancer in the United States, and 4,020 patients died of cervical cancer, which ranks third in the incidence of malignant tumors among women^[1]。 With the in-depth research on the pathogenesis of tumor molecules, gene targeted therapy for cervical cancer is expected to become a new model for the treatment of cervical cancer. forkhead box protein (Fox) M1 is a transcription factor belonging to the evolutionarily conserved Fox family^[2]。 Previous studies of our research group confirmed that FoxM1 was highly expressed in cervical cancer tissues, and the expression level of FoxM1 gene in cancer tissues was positively correlated with pathological grade and clinical stage^[3]； In vitro, downregulation of FoxM1 gene expression could inhibit the proliferation and clonogenic ability of cervical cancer cells^[4]。 In this study, we investigated the effect of downregulation of FoxM1 protein on the growth of transplanted tumors in nude mice, and further investigated its effect on tumor invasion ability, which provided a new basis for the treatment of cervical cancer targeting FoxM1 gene.

polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disease in women of childbearing age. Its clinical manifestations often include abnormal menstruation, infertility, hyperandrogenicity, polycystic ovarian manifestations, etc. At the same time, it can be accompanied by abnormal metabolic function such as obesity, insulin resistance, abnormal blood lipid level, etc. It is a high risk factor for type 2 diabetes, cardiovascular and cerebrovascular diseases and endometrial cancer, which seriously affects the quality of life of patients^[1]。 According to the Rotterdam diagnostic criteria for PCOS recommended by the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) in 2003^[2]Recent epidemiological surveys abroad show that the incidence of PCOS is as high as 18%^[3]。 Li et al.^[4]A large-scale epidemiological survey of 15 924 women of childbearing age in China showed that the incidence of PCOS among women aged 19-45 years in China was 6.5%.

In China, the incidence of malignant tumors among young people is increasing year by year. 10% of malignancies occur in<Among females aged 45^[1]。 Among women of childbearing age, the most common malignant tumors were breast cancer, melanoma, cervical cancer, non-Hodgkin's lymphoma and leukemia. The 5-year survival rates were 90%, 91%, 71%, 69% and 55%, respectively^[2]。 Ovary is the most important gonadal organ in women, with two major functions: reproductive and endocrine. The hormones secreted by the ovary are mainly estrogen, progesterone and androgen, which not only play an important role in maintaining female sexual characteristics, physical development and sexual desire, but also participate in the regulation of vascular nerve function and water and sodium balance of the body, and regulate lipid metabolism and bone metabolism. Therefore, it is particularly important for female patients with malignant tumors to preserve the reproductive and endocrine functions of ovaries while radically curing the disease.

Uterine sarcoma is a heterogeneous tumor of unknown etiology consisting mainly of tumors originating from mixed components of uterine smooth muscle, endometrial stroma (or epithelium) and non-epithelium. Uterine sarcomas of different origins have different biological characteristics and different responses to treatment. At present, the treatment of uterine sarcoma advocates comprehensive treatment based on surgery, emphasizing the individualized selection of appropriate treatment methods according to the characteristics of the patient's tumor. In recent years, with the rapid progress of molecular biology research, more and more scholars have turned their attention to the field of molecular targeted therapy. A large number of studies have discovered molecular biological mechanisms such as genetic changes, chromosome abnormalities and uncontrolled cell cycle of uterine sarcoma. These studies have gradually made people understand the inherent laws of the occurrence and development of uterine sarcoma, and revealed potential key therapeutic targets. Although there are no effective drugs for targeted therapy of uterine sarcoma at present, with the deepening of research, the possibility of targeted therapy of uterine sarcoma is increasing day by day. In addition, in the treatment of some other soft tissue sarcomas, the success achieved by targeted therapy also holds promise for the treatment of uterine sarcomas.