2017年 · 第52卷第05期

stress urinary incontinence (SUI) refers to the involuntary leakage of urine from the urethral opening when abdominal pressure increases such as sneezing, coughing, laughing or exercising; Urodynamic examination showed involuntary urinary leakage with increased abdominal pressure without detrusor contraction during filling cystomanometry. The prevalence rate of SUI in Chinese adult women is as high as 18.9%, and the prevalence rate of SUI is the highest in the age group of 50-59 years old, which is 28.0%. At present, the treatment of urinary incontinence is increasingly standardized internationally. The Gynecology Pelvic Floor Group of Obstetrics and Gynecology Branch of Chinese Medical Association formulated the "Guidelines for the Diagnosis and Treatment of Female Stress Urinary Incontinence (Trial)" in 2011 with reference to the relevant international guidelines for the diagnosis and treatment of urinary incontinence and the national conditions of China^[1]。 After thorough discussion, at the end of 2016, according to the clinical application and research progress, the 2011 guidelines^[1]Based on the revision and improvement, the "Guidelines for the Diagnosis and Treatment of Stress Urinary Incontinence in Women (2017)" was formed.

pre-eclampsia (PE) is a disease unique to pregnancy. Its incidence is 3% ~8% and mortality is 10% ~15%^[1]。 To date, the pathogenic mechanism of PE is unclear. Studies have shown that PE is caused by the interaction between environmental factors and genetic factors, and PE has obvious family hereditary tendency, but the specific pathogenic genes are still unclear^[2,3]。 IFN-γ encoded by interferon-γ (IFN-γ) gene is an important inflammatory cytokine and plays an important role in cellular immune regulation^[4]。 The study found that the mutation of IFN-γ gene rs2430561 (i.e. +874 A→T) can lead to an increased risk of PE in Brazilian pregnant women^[5]。 Therefore, the single nucleotide polymorphism (SNP) sites of IFN-γ gene intron rs2430561 and adjacent regions rs2069705, rs1861493, rs2069718, rs2193050 were selected as the research sites in this study to explore the correlation between SNP sites in IFN-γ gene intron region and PE occurrence.

There are 1 umbilical vein and 2 umbilical arteries in the normal umbilical cord, and the umbilical blood vessels are surrounded by Wharton jelly to protect the blood vessels. The umbilical cord is an important channel for maternal-fetal gas exchange, nutrient supply and fetal metabolite excretion. Umbilical vascular embolism can obstruct umbilical blood flow, lead to fetal hypoxia, and even endanger fetal life. Clinically, umbilical vascular embolism is rare, and the incidence rate in pregnant people is about 0.08%; The incidence of umbilical vascular embolism in postpartum dead infants after autopsy is about 0.1%; The incidence of umbilical vascular embolism in high-risk pregnancy population is about 0.4%^[1]。 Therefore, there are few large sample size studies or authoritative books at home and abroad to provide clinical diagnosis and treatment of umbilical vascular embolism. This study conducted a retrospective analysis of 2 pregnant women with umbilical embolism who delivered at Ningde Hospital affiliated to Fujian Medical University from March 2013 to November 2016, with the aim of exploring the clinical diagnosis and treatment plan of umbilical embolism.

thalassemia is a hereditary hemolytic anemia due to the congenital defect of globin gene, which leads to the reduction or deletion of the corresponding globin chain synthesis and the imbalance of the ratio of alpha chain/non-alpha chain of hemoglobin (Hb)^[1,2,3]。 Thalassemia was first found to be distributed in Mediterranean countries and Southeast Asia, hence its name. There are about 200 million carriers of thalassemia worldwide. China's southern provinces such as Guangxi Zhuang Autonomous Region, Guangdong Province, Hainan Province and Fujian Province are the high incidence areas of thalassemia^[4,5,6]。 Because of the current lack of effective treatment for thalassemia, genetic screening of both couples for thalassemia before pregnancy is necessary in high-incidence areas. Prenatal diagnosis in the first and second trimester of pregnancy for people at high risk of thalassemia to prevent the birth of children with thalassemia is currently internationally recognized as the first choice preventive measure. In this study, prenatal diagnosis was performed in pregnant women whose couples were both carriers of thalassemia during prenatal screening in the First Affiliated Hospital of Zhengzhou University, and their pregnancy outcomes were followed up. The results are reported below.

The 34-year-old pregnant woman, 4-year-old and 3-year-old, was seen in the First Affiliated Hospital of Suzhou University on December 26, 2015 because she was "13 weeks pregnant and had a past history of adverse pregnancy". The pregnant woman had three previous adverse pregnancies: the first pregnancy was a natural delivery of a boy at 39 weeks of gestation in 2007. The birth weight of the newborn was 3 200 g. The placenta and amniotic fluid were unknown at birth, and she died of "congenital nephritic syndrome (CNS) and hypoalbuminemia" 3 months after birth; The second pregnancy occurred in 2009 when the fetus died suddenly in utero at 38 weeks of gestation, and then a dead girl was delivered naturally with a birth weight of 3 000 g; In the third pregnancy, a boy was delivered naturally at 39 weeks of gestation in 2011. The birth weight of the newborn was 2 950 g. The placenta and amniotic fluid were unknown at birth. He died of "CNS, hypoalbuminemia and atrial septal defect" 3 months after birth. Prenatal examination in this pregnancy and serological screening of chromosomal aneuploidy mothers at 17 weeks of pregnancy were all low risk.

The 71-year-old patient was admitted to the hospital on August 9, 2016 due to "vulvar swelling and pain after posterior vaginal wall repair for 4 months". In April 2016, the patient underwent rectovaginal hernia repair in the surgical department of a foreign hospital due to "rectal hernia". Postoperatively, he developed vulvar redness, swelling and pain, accompanied by increased vaginal discharge and peculiar smell, and denied stool-like discharge. Boric acid diluent sitz bath and antibiotic treatment were given in other hospitals, but the effect was not good. In July 2016, pelvic MRI examination in another hospital showed nodular changes in the vaginal wall. The patient's pain was aggravated and he could not sit or lie, so he was transferred to our hospital. In 2012, the patient underwent cystectomy + bilateral adnexectomy of the uterus + partial urethrovaginectomy + ileocystostomy in an external hospital due to bladder cancer. After admission, empirical anti-infective treatment was continued, and vaginal swabs were taken for culture to improve imaging examination. Pelvic MRI examination showed irregular thickening of the vaginal wall, multiple round and irregular flaky long T on the vulva and around the vagina₂Equal length T₁Signals; No significant thickening of the rectal wall was observed. Two days after admission, the patient had vaginal food residue, and immediately underwent a rectovaginal methylene blue test, which was negative. Vaginal swab culture results reported as Escherichia coli.

Prematurity has become one of the leading causes of infant mortality, with the WHO estimating that 15 million premature babies are born and 1 million newborns die from premature birth every year^[1]。 According to the monitoring data of child mortality in China, although the child mortality rate in China decreased significantly from 1993 to 2003, the proportion of premature or low birth weight deaths in infant deaths showed an upward trend, with an average annual increase of 1.52%. In 2013, this proportion rose to 22.6%; Premature birth has become the first cause of death of children under 5 years old in China, and it is one of the main factors that threaten children's health^[2,3]。 The prevalence of mortality and other diseases in premature infants was significantly higher than that in full-term infants, and the incidence of developmental disorders and adult diseases in premature infants through adolescence was also higher than that in full-term infants^[4,5]。 The literature shows that preterm birth is associated with neurodevelopmental abnormalities in 50% of children^[5]。 Preterm birth has been increasingly valued by obstetricians worldwide, and has become the main area of perinatal care worldwide. In this paper, the influencing factors of premature birth and the epidemiological research progress were reviewed to provide some reference for the prevention of premature birth.

polycystic ovary syndrome (PCOS) is a common gynecological endocrine disease, with an incidence rate of 4% ~8%^[1]It is the main cause of anovulatory infertility in women of childbearing age. It is characterized by chronic anovulation, excessive androgen, polycystic ovarian changes, irregular menstrual cycle, infertility, hirsutism, acne, obesity and other heterogeneous phenotypes^[2]。 At present, the exact cause of the disease has not been elucidated. Both candidate gene association studies and genome-wide association analysis suggest that genetic factors play a crucial role in the pathogenesis of PCOS^[3]。 The incidence of PCOS in identical twins was significantly higher than that in fraternal twins, and the phenotype of PCOS was familial aggregation^[4]All validate the above views. However, given that the diagnostic phenotype of PCOS focuses on the female reproductive system, and the lack of definition of the male phenotype of PCOS, this also limits the genetic research of PCOS to some extent. Many studies suggest that male relatives of female patients with PCOS develop different degrees of endocrine and metabolic dysfunction, the male phenotype of PCOS (the phenotype of male relatives of patients with PCOS). This article will review the male phenotypic changes of PCOS.

Cervical cancer is one of the common malignant tumors of female reproductive system. In recent years, its incidence has been younger, and due to the delay of marriage and childbearing age, the proportion of non-childbearing patients has gradually increased. With the development of society, the requirements for the quality of life are further improved, and more and more cervical cancer patients in childbearing age want to preserve their fertility function. Therefore, cervical cancer surgery that preserves fertility function has gradually been paid attention to and applied in clinical practice.

In September 2015, the American Congress of Obstetricians and Gynecologists (ACOG) issued a committee opinion on HPV vaccination^[1](i.e. ACOG Committee Opinion No. 641, replacing Committee Opinion No. 588) to provide clinical reference on the background, timing, safety and effectiveness of HPV vaccination. The following is the main content and interpretation of the committee opinion.

In August 2016, the 41st Annual Meeting of the International Urogynecological Association (IUGA) was held in Cape Town, South Africa. Thousands of experts, scholars and related doctors in the field of gynecological urology from all over the world attended this conference. In this conference, scholars from all over the world discussed the hot spots in the field of gynecological urology. The relevant contents are reported as follows for colleagues to understand the international frontier academic development trends.

The "self-sampling HPV testing model" was selected by Cleveland Medical Center in the United States as the "Top Ten Global Medical Innovation Achievements Affecting the Future in 2017". (Translated from Cleveland Medical Center website http: / /innovations.cleve-landclinic.org/Summit/Top-10-Medical-Innovations.aspx)