2017年 · 第52卷第03期

The reason why patients with endometriosis (endometriosis) need long-term management is, first of all, that the cause of endometriosis is unknown and difficult to remove. Among them, menstrual blood reflux is very common, which is an inevitable problem for women of reproductive age; Secondly, endometriosis can infiltrate and grow around like a malignant tumor, and even invade the intestines, vagina, ureter and bladder, etc. It is difficult to complete surgery^[1]； In addition, endometriosis is a chronic disease, which is easy to relapse after surgery and difficult to cure, and needs long-term drug control; Finally, endometriosis can become cancerous and endanger the patient's life.

mirror syndrome refers to a rare clinical syndrome with symptoms such as maternal edema accompanied by fetal and/or placental edema, also known as Ballantyne syndrome. Ballantyne first described a case of maternal edema associated with fetal edema due to maternal and infant Rh blood group incompatibility in 1892^[1]。 In 1956, O'Dricoll DT first named this clinical syndrome in which maternal edema mirrors fetal edema as mirror syndrome^[2]。 For many years, mirror syndrome has also been known as "pseudotoxemia", "triple edema", etc^[3,4]。 At present, there are few cases of mirror image syndrome reported, and its pathogenesis is still unclear. In this study, the clinical data of 6 pregnant women with mirror image syndrome admitted to Fujian Maternal and Child Health Hospital affiliated to Fujian Medical University were analyzed to explore their etiology, clinical characteristics, treatment plan and pregnancy outcome.

Van Wyk-Grumbach syndrome (VWG syndrome) can occur at different ages and is more common in adolescent women. It is mainly manifested as primary hypothyroidism in adolescence, short stature, delayed development of bone age, pseudoprecocious puberty in adolescence, breast development, vaginal bleeding, abnormal development and enlargement of ovaries and testicles, ovarian cysts, which may be secondary to pituitary tumor-like hyperplasia. Patients are easily misdiagnosed as ovarian cysts because of ovarian cysts and pituitary tumor-like hyperplasia, and then take inappropriate surgery or drug treatment^[1]。 This article reports the diagnosis and treatment process of a patient recently admitted to Hubei Maternal and Child Health Hospital who planned to be treated by surgery due to giant ovarian cyst, and later was found to be VWG syndrome. Combined with relevant literatures, the clinical and imaging manifestations, pathogenesis, treatment and prognosis of VWG syndrome are expounded, with the aim of deepening the understanding of VWG syndrome and accumulating experience in diagnosis and treatment.

Pelvic organ prolapse often seriously affects the quality of life of patients. Severe pelvic organ prolapse often pulls adjacent pelvic organs, causing their position to move downward and tissue structure to change, which can make the ureter twist and/or angle when entering the bladder, resulting in mechanical obstruction caused by lumen stenosis, resulting in dysuria and urinary retention. Long-term urinary retention weakens or loses bladder detrusor function, and urine reflux, resulting in hydronephrosis. A patient with IV degree pelvic organ prolapse combined with bilateral hydronephrosis was admitted to the Second Hospital of Hebei Medical University. After pessary treatment, the symptoms were relieved and the effect was good. The following is reported in combination with the literature review.

autophagy is a process in which intracellular components degrade themselves and maintain intracellular balance. The disturbance of autophagy activity leads to a variety of diseases, including the occurrence of pregnancy complications^[1]。 pre-eclampsia (PE) is a common complication during pregnancy, and its exact pathogenesis is still unknown. microtubule associated protein 1 light chain 3 (LC3) is an autophagy-related protein, including LC3Ⅱ and LC3Ⅰ. The ratio of LC3Ⅱ to LC3Ⅰ protein (LC3Ⅱ/Ⅰ) reflects the autophagy activity of cells. It was found that the expression level of LC3Ⅱ/Ⅰ in placental tissue of PE patients was higher than that of normal pregnant women^[2], indicating that elevated autophagy activity in placental tissue is associated with PE; The expression level of other common autophagy-related factors, such as the autophagy gene Beclin1, can also reflect the autophagy activity of cells.

Epithelial ovarian cancer (ovarian cancer) is a gynecological malignant tumor with the highest mortality rate. According to statistics, there are about 239,000 new cases worldwide every year, of which 152,000 patients die due to this disease^[1]； In China, there are about 52,000 new cases and about 23,000 deaths every year^[2]。 Ovarian cancer accounts for about 90% of ovarian malignant tumors, and its pathological types include ovarian serous carcinoma, mucinous carcinoma, endometrioid carcinoma, clear cell carcinoma, transitional cell carcinoma, mixed carcinoma and undifferentiated carcinoma. More than 70% of patients with ovarian cancer were found to be advanced, and 78% of them had lymph node metastasis. There was a significant correlation between systematic lymph node resection and 5-year survival rate^[3,4]。 Therefore, it is particularly important to select the appropriate patient for lymph node resection.

Adenomyosis is a diffuse or localized lesion formed by endometrial glands and interstitial invasion of the myometrium layer. It is a common benign disease in gynecology, and its main clinical manifestations are excessive menstrual flow, prolonged menstrual period and secondary progressive dysmenorrhea. According to incomplete statistics, the incidence of adenomyosis dysmenorrhea is 15% ~30%, which seriously endangers the physical and mental health of patients. Pain is an unpleasant subjective sensory and emotional experience associated with tissue damage or potential damage, and its production requires nociceptive stimuli to excite pain receptors, afferent nerve fibers, and pain conduction pathways. The nociceptors of the pelvic organs, in a state of tissue damage or inflammation, conduct pain sensation by very small amounts of myelinated A delta and unmyelinated C sensory nerve fibers. The pelvic organs are co-innervated by somatic and autonomic nerves, among which the uterus, vagina, bladder and rectum are mainly controlled by sympathetic and parasympathetic nerves. Although the mechanism of dysmenorrhea is uncertain, it is closely related to inflammatory response, increased nerve fiber density, abnormal contraction of myometrium, etc. Based on pain sensation, this paper reviews the research progress of neurological factors related to dysmenorrhea in adenomyosis through four aspects: pain causing substances, nerve fibers, electrical activity, hyperalgesia and neurological factors.

Nowadays, more and more women of childbearing age are diagnosed with malignant tumor. With the continuous improvement of science, technology and medical level, the continuous research and development of chemotherapy drugs, and the continuous progress of medical concept, the disease-free survival rate and overall survival rate of young patients after chemotherapy are significantly improved, and some malignant tumors are even cured^[1]。 However, with the increase of the cure rate of malignant tumors, the long-term adverse effects caused by the cytotoxic effects of chemotherapy drugs have attracted more and more attention from clinicians, especially premature ovarian failure (POF) and infertility after chemotherapy^[2,3]POF can also cause other women's health-related problems, including osteoporosis, hot flashes, sleep disorders, sexual dysfunction, etc., which have a negative impact on the short-term and long-term quality of life of patients.

Things are often not as desired, and different pregnant women will have different pregnancy outcomes, some go smoothly, and others will encounter unpleasant events, such as spontaneous abortion, fetal malformation, or other events that lead to pregnancy termination. However, in the face of this part of bereavement couples, there is still a lack of medical professional support (support) in the country, and there is no widely accepted means of mourning in the society, which leads to the dilemma of "a silent sorrow"^[1]。 As a medical staff, it is necessary to grasp the psychological and emotional changes and needs of pregnant women, and give appropriate care and support in time.

At present, there are three main screening methods for cervical cancer, namely, cytology [including traditional Pap smear and liquid-based cytology (LBC)], high-risk HPV test, and cytology combined with high-risk HPV test. The purpose of cervical cancer screening is to detect precancerous lesions (especially high-grade lesions) and early cervical cancer, so as to achieve early diagnosis and treatment, and reduce the incidence and mortality of cervical cancer. However, the current situation of cervical cytology examination in China is: lack of technicians, uneven examination level, weak quality control (quality control), low cell sensitivity, and false negative rate as high as 50%. Therefore, in 2014, China set up a cervical cancer screening project for rural women, and took the lead in adopting high-risk HPV detection and cytology as the primary screening methods in 28 provinces and 130 pilot areas, respectively, to explore the screening effect of these two methods. Fortunately, the Colposcopy and Cervical Pathology Branch (CSCCP) of Chinese Eugenics Science Association and the Cytology Group of Cervical College of Obstetrics and Gynecology Branch of Chinese Medical Doctors Association have provided professional training on cervical cytopathology and other examinations, in order to train cytology technicians for China and improve the level of cytology diagnosis^[1,2,3]。 The key to improving the level of cytology diagnosis is quality control, including material collection, fixation, film making, staining, film reading and other links. At the rural cervical cancer screening site, it was found that the following problems existed in the cell sampling process: including the use of lubricants such as soapy water or physiological saline, very clean wiping of cervical surface secretions, unclear sampling site, irregular operation, etc., which led to the decrease of the satisfaction rate of cytology samples, which directly affected the diagnosis rate of cytology examination. Therefore, this article shares the experience and experience of cervical cytology sampling with colleagues, aiming at standardizing cytology sampling and improving the detection rate and screening effect of cervical lesions.

On October 28-30, 2016, the 12th National Obstetrics and Gynecology Academic Conference of Obstetrics and Gynecology Branch of Chinese Medical Association was held in Xiamen, Fujian Province. A total of 1,894 conference submissions were received, and the number of registered participants reached 3,281. There were 226 special speeches and 340 conference speeches. Academician Fan Daiming, Academician Rao Zihe and Academician Chen Guoqiang respectively made wonderful and macroscopic reports on today's integrated medicine, precision medicine and integration with clinical and basic research, which broadened the horizons of the participants. Academician Lang Jinghe, chairman of the Obstetrics and Gynecology Branch of Chinese Medical Association, gave a special speech on "Medicine and Philosophy", explaining the relationship between modern medicine and philosophy. The conference is divided into 7 sub-venues: obstetrics and hypertensive disorders during pregnancy, gynecological endoscopy, gynecological oncology and pathology, menopause, gynecological endocrinology, family planning, and gynecological pelvic floor and infection. The contents are introduced as follows.