2016年 · 第51卷第11期

With the prolongation of the average life expectancy and the ageing of the population in China, the number of elderly gynecological malignant tumors is also increasing. According to the analysis of the 2012 National Malignant Tumor Registry data conducted by the National Cancer Center, the incidence of malignant tumors gradually increases with age, and the incidence of malignant tumors in both urban and rural areas is<At a lower level in the 40-year-old group, it began to rise rapidly after the age of 40 and reached a peak at the age of 80, while the mortality rate of malignant tumors across the country also increased with age, at<The 45-year-old group was at a lower level and began to rise rapidly after the age of 45, reaching a peak at the age of 80^[1]。 The elderly not only increase the incidence of malignant tumors, but also gradually decline the functions of various organs in the body. They are often complicated with a variety of medical diseases (including cardiovascular and cerebrovascular diseases, endocrine system diseases, respiratory diseases, etc.). Although these complications are not related to malignant tumors themselves, they affect the treatment process of tumors. Surgery is the main treatment of gynecological malignant tumors, but its large surgical scope, high surgical risk, slow postoperative recovery and easy surgical complications are also important factors affecting patients' treatment decision-making. Therefore, for patients with gynecological malignant tumors with other organs, especially important organ diseases such as heart and lung, their treatment puts forward higher requirements for gynecological oncologists, which often requires the multidisciplinary participation of relevant departments. Nevertheless, gynecological oncologists as the main treatment body should not only pay attention to the treatment of their tumors, but also pay attention to the treatment of their comorbidities, so as to ensure the safety of the whole tumor treatment process.

Uterine rupture during pregnancy is a serious complication of obstetrics, which can endanger the life of pregnant women and often lead to fetal death. Its incidence rate is about 0.14% reported in China. In recent years, there has been a significant increase in cases of uterine rupture during pregnancy after minimally invasive uterine surgery. These minimally invasive surgeries include myomectomy, adenomyosis lesion removal, angulotomy (for tubal interstitial pregnancy or interstitial pregnancy after salpingectomy during hydrosalpinx), uterine repair suture (uterine malformation correction surgery, uterine perforation, and uterine incision diverticulum repair after cesarean section), and even after resection of deep endometriosis lesions behind the cervix. Cases of uterine rupture during repregnancy after these surgeries have been reported. Rupture of scar uterus after cesarean section is more common after labor, and incomplete rupture is common; However, uterine rupture during re-pregnancy after minimally invasive uterine surgery is almost all seen in the third trimester, complete rupture is common, and the prognosis of mother and child is worse, which should be highly paid attention by obstetricians and gynecologists.

levonorgestrel-releasing intrauterine system (LNG-IUS) is widely used in contraception and treatment of menorrhagia. In addition, it can also be used in the treatment of adenomyosis and endometrial hyperplasia^[1,2,3]。 The main side effects of LNG-IUS are vaginal bleeding, breast distension, weight gain, acne, ovarian cysts, etc. LNG-IUS releases lower levels of levonorgestrel in the blood, which is safer and more effective than other contraceptives, with fewer side effects, and is not even contraindicated in patients with a history of pulmonary embolism and deep vein thrombosis^[4]。 Currently, in case reports of side effects of LNG-IUS, Chen et al.^[5]A case of skin allergic reaction caused by LNG-IUS was reported; Karri et al.^[6]A case of severe seborrheic dermatitis caused by LNG-IUS was reported, and the symptoms disappeared after removal; Motegi et al.^[7]Two cases of cervical canal stenosis caused by LNG-IUS placement were reported; Cohen and Rossen^[8]Severe acne has been reported in 2 patients treated with LNG-IUS, one with remission after removal and the other with improvement after local treatment. Searching the literature, there are no reports of thrombosis caused by LNG-IUS. This article reports a case of adenomyosis patient with recurrent venous thrombosis of lower extremities after LNG-IUS, and analyzes it in combination with literature review.

pre-eclampsia (PE) refers to the onset of new hypertension after 20 weeks of pregnancy, accompanied by proteinuria or other systemic damage. Severe systemic damage makes it the main cause of increased perinatal morbidity and mortality in pregnant women. Since the first pregnant woman with PE was clinically diagnosed in 1840^[1]Researchers are committed to clarifying the pathogenesis of PE in order to prevent and treat PE in a targeted manner. In fact, the effective treatment is to remove the placenta. In complicated pregnancy, the placenta may release certain factors into the maternal blood circulation, causing spasm of small blood vessels in the whole body, which in turn causes ischemia of various tissues and organs and causes system damage.

pre-eclampsia (PE) is a serious complication that occurs during pregnancy and is one of the main causes of high maternal and perinatal mortality^[1]。 The pathogenesis and mechanism of PE are still unclear. So far, scholars at home and abroad have put forward a large number of hypotheses about the etiology of PE, such as the theory of vascular endothelial damage^[2]Genetic theory^[3]Insulin resistance theory^[4]et al., the study also found that immune imbalance is one of the main factors leading to PE^[5]。

Endometrium is an important tissue and organ to maintain female menstruation and reproductive function, and has strong regenerative ability. Female reproductive period can undergo more than 400 endometrial exfoliation, regeneration and differentiation repair processes^[1]。 Intrauterine adhesion is a kind of endometrial damage disease mainly related to curettage and curettage in pregnancy. The incidence and detection rate are increasing year by year, and it has become the main cause of secondary infertility. At present, there is no effective method for repair, regeneration and functional reconstruction after extensive endometrial injury. It is speculated that the difficulty of endometrial regeneration in patients with moderate to severe intrauterine adhesion is related to the extensive reduction or functional impairment of endometrial cells. Therefore, some scholars have proposed to use autologous or allogeneic stem cell replacement therapy to solve the problem of endometrial loss with its strong self-renewal and differentiation potential. In recent years, it has been reported that mesenchymal stem cells (MSC) have been used to repair damaged endometrium and improve its function^[2]MSC has become a good source of cells for damaged tissues due to its multidirectional differentiation potential, strong migration ability, low immunogenicity, wide source, easy isolation and expansion, and no ethical restrictions, bringing new treatment strategies for diseases such as intrauterine adhesions. This article reviews the research progress of MSC in repairing damaged endometrium and its possible repair mechanisms.

Platinum drugs are an important part of chemotherapy regimens for many malignant tumors. Cisplatin and carboplatin have become the first-line drugs for chemotherapy of ovarian epithelial cancer (ovarian cancer), endometrial cancer and cervical cancer. Patients with ovarian cancer who relapsed more than 6 months after the last chemotherapy with platinum drugs (i.e., platinum-sensitive patients) still have a good prognosis after carboplatin retreatment. hypersensitivity reaction (HSR) is an unexpected reaction that cannot be explained by known toxicity of chemotherapeutic drugs^[1]It is an uncommon adverse reaction in platinum chemotherapy, and it is also one of the common problems that affect the smooth progress of platinum chemotherapy. In this paper, the research progress of platinum-based drugs HSR is summarized.