2016年 · 第51卷第05期

Since 2002, prenatal screening and prenatal diagnosis of common chromosome abnormalities such as Down syndrome have been launched in China, and karyotype analysis technology is the "gold standard" for diagnosis. Chromosome karyotype analysis technology is accurate and reliable, but it is mainly manual operation and requires cell culture. There are many problems such as long time consumption, low detection throughput, need to train professionals and long laboratory construction period, etc. It is difficult to meet the increasing demand of clinical prenatal diagnosis.

Uterine rupture refers to the rupture of the uterine body or lower uterine segment during delivery or late pregnancy, which is a serious obstetric complication and can endanger the life safety of mother and child. According to the time of occurrence, it is divided into prenatal and intrapartum rupture, and according to the cause, it is divided into spontaneous and traumatic rupture. This paper reports a case of spontaneous uterine rupture in the third trimester of pregnancy after laparoscopic cervical cerclage.

Turner syndrome (TS) is the most common disease caused by sex chromosome abnormalities, with an incidence rate of about 1/2 500 live births in female babies^[1]。 2% ~8% of TS patients were able to conceive spontaneously, and most of them were 45, X/46, XX chimeras, and the spontaneous abortion rate was higher after pregnancy (45%)^[2,3]Therefore, in recent years, more and more TS patients have chosen to assist pregnancy through egg donation in vitro fertilization-embryo transfer technology (IVF-ET)^[4,5,6]But the maternal and child risks associated with it are also gradually being recognized. The First Affiliated Hospital of Zhengzhou University admitted a TS patient with primary amenorrhea and infertility in 2014. She pregnant twins through egg donation IVF-ET and achieved a good pregnancy outcome. Now, the pregnancy diagnosis and treatment process and maternal and infant outcomes are analyzed, and the perinatal risks and countermeasures of egg donation IVF-ET twin pregnancy in TS patients are discussed in combination with the literature.

metastasis-associated in colon cancer 1 (MACC1) is abnormally expressed in colon cancer, gastric cancer, liver cancer, ovarian epithelial cancer (ovarian cancer) and other malignant tumors, which may be closely related to the occurrence and development of the above malignant tumors^[1,2,3,4,5]。 Studies have shown that the use of small molecule interfering RNA (siRNA) to inhibit the expression of MACC1 gene in prostate cancer cells can increase the sensitivity of prostate cancer cells to gemcitabine, and its effect may be related to the inhibition of the activity of Ras/extracellular signal-regulated kinase (ERK) signaling pathway^[6]。 In this study, the expression of MACC1 gene was silenced by short hairpin RNA (shRNA), and the changes of cisplatin-resistant ovarian cancer cell lines A2780/DDP and COC1/DDP to cisplatin were observed. The relationship between MACC1 gene and cisplatin-resistant ovarian cancer cells and its possible molecular mechanism were investigated.

Endometrial cancer is one of the common malignant tumors of female reproductive system. According to statistics, there are more than 30,000 new cases in the United States every year, and the incidence rate is increasing year by year^[1]。 Endometrial carcinoma occurs in perimenopausal and postmenopausal women, and its etiology is still unclear. According to its biological behavior and pathogenesis, it is divided into estrogen-dependent and non-estrogen-dependent types. At present, the main conservative treatment of endometrial dysplasia and endometrial cancer is high-dose and long-term progesterone^[2]。 The effective rate of high-dose progesterone therapy for early endometrial cancer is only about 70%. At present, the treatment of progesterone-resistant endometrial cancer patients who require to preserve their fertility function is a hot issue for gynecologists. Recent studies suggest that the hypoglycemic drug metformin has the effect of inhibiting tumor growth. Many studies have shown that metformin has anti-tumor effects on in vitro cells and in vivo animal models, and can also reduce the incidence of malignant tumors in diabetic patients^[3,4,5]。 In this study, the effects of metformin on progesterone-resistant endometrial cancer cells were observed by interfering with progesterone-resistant endometrial cancer cells, and the expression of autophagy-related genes beclin and LC3 protein were detected. The effect of metformin on progesterone-resistant endometrial cancer cells and its mechanism were investigated.

The 39-year-old patient was admitted in August 2010 due to irregular vaginal bleeding for 4 months. Past physical health, pregnancy 2 delivery 1. Preoperative serum CA₁₂₅The level (42.88 kU/L) was slightly elevated, and MRI showed malignant tumor of uterine body and neck. Histopathological examination of uterine cavity: leiomyosarcoma, endometrial stromal tumor and poorly differentiated carcinoma may be. Then laparoscopic total hysterectomy + bilateral adnexectomy + pelvic and para-abdominal aortic lymphadenectomy was performed. Postoperative pathological examination showed that the tumor cells showed diffuse and infiltrating growth, invading the uterine wall and cervical wall (depth<1/2), see extensive intravascular tumor thrombus; Tumor cells are small in size, short fusiform or oval in shape, and have sparse cytoplasm. Immunohistochemical detection showed that synaptophysin and p16 were positive, cell proliferation-related nuclear antigen was 70% positive, ER, PR and p63 were negative. Postoperative pathological diagnosis: Endometrial small cell carcinoma (SCCE) stage IIb G₃。 Postoperatively, he was given etoposide + cisplatin chemotherapy for 6 courses (the last chemotherapy time was April 2011); The pelvic cavity was externally irradiated 25 times with a total amount of 40 Gy. The serum tumor marker CA was found at the 18th month of follow-up for 56 months₁₂₅Oncoprotein 2 (CP₂) levels (59.12 and 41.7 kU/L, respectively) were both increased; Positron emission tomography (PET) -CT findings: anterior tracheal and left clavicular area¹⁸F-deoxyglucose metabolism increased focus, considering recurrence, after 2 courses of chemotherapy in the original regimen, serum CA was re-examined₁₂₅and CP₂It was still high, and no tumor lesions were found in B-ultrasound, chest CT and PET-CT. It was decided to suspend the treatment and follow up closely. At 56 months after surgery, the patient's serum CA₁₂₅CP₂The level continued to increase for 39 months, and he still survived without tumor.

genitourinary syndrome of menopause (GSM) is a newly developed concept. Because this syndrome may have long-term adverse effects on the quality of life of postmenopausal women, it is particularly important to diagnose and treat it effectively. This paper summarizes the background of the new term GSM and its research progress in diagnosis and treatment.

overactive bladder (OAB) is defined by the International Association for Urinary Control (ICS) as "a group of syndromes with urgency, with or without urgency urinary incontinence, often combined with frequent urination and nocturia. Urinary infection and other pathological conditions should be excluded when diagnosing OAB"^[1]。 The etiology of OAB is unknown. European epidemiological data indicate that the prevalence of OAB in women over 40 years of age is 16.6% and increases with age^[2]。 The prevalence of OAB among Chinese women was 6.0% and increased to 14.8% among women over 50 years of age^[3]。 It can be seen that postmenopausal women are the main incidence population of OAB. With the aging of the population, OAB has increasingly affected the quality of life of elderly women. There are many clinical treatment methods for OAB, but the curative effect needs to be improved. Therefore, the progress of its treatment is reviewed.

Epithelial ovarian cancer (ovarian cancer) is one of the most common tumors of female reproductive system. Its incidence is third after cervical cancer and uterine body cancer, but its mortality is the first among gynecological tumors^[1]。 In recent years, the theory of cancer stem cells has attracted more and more attention. Cancer stem cells have characteristics similar to normal stem cells, that is, they have the potential of self-renewal, multidirectional differentiation and initiation of tumorigenesis. Besides, they also have the characteristics of resistance to radiotherapy and chemotherapy. This theory believes that cancer stem cells are the origin of malignant tumors and an important cause of tumor metastasis and recurrence. Therefore, this provides researchers with new ideas. Whether ovarian cancer stem cells can be specifically eliminated to achieve the effect of treating ovarian cancer, this article reviews the biological characteristics of ovarian cancer stem cells, the mechanism involved in chemotherapy resistance and targeted therapy strategies. The progress in several aspects is summarized as follows.

amniotic fluid embolism is an obstetric complication characterized by asthma, cardiopulmonary failure, coma, loss of consciousness, even cardiac arrest, and severe postpartum hemorrhage caused by DIC that suddenly appears in the parturient during labor or after the fetus is delivered. The fatality rate is as high as 20% ~60%^{[1,2,3,4,5,6]}； Worldwide is one of the leading causes of maternal mortality^{[1,2,3,4,5,6]}。 At present, the etiology and pathogenesis of amniotic fluid embolism are still unclear, and there is a lack of rapid and specific diagnostic methods. The diagnosis is mainly based on the exclusion of clinical symptoms and signs. Because amniotic fluid embolism is rare and rapidly onset, early identification and rapid and efficient team-based rescue are key to reducing adverse outcomes.