2015年 · 第50卷第03期

Endometriosis (endometriosis) refers to the appearance, growth, infiltration and repeated bleeding of endometrial tissue (glands and interstitial) in the endometrial cavity covering the endometrium and the part outside the uterus, which then causes pain, infertility and nodules or masses. Endometriosis is a frequent and common disease in women of reproductive age. Endometriosis has extensive lesions, diverse morphologies, extremely aggressive and recurrent, and is characterized by sex hormone dependence.

Pregnancy-induced Cushing's syndrome is less common and is often accompanied by miscarriage, preterm birth, gestational diabetes or abnormal glucose tolerance, heart failure, pulmonary edema, hypertension, preeclampsia, increased probability of incision difficulty healing, and higher maternal and infant mortality^[1]。 While pregnancy-induced Cushing's syndrome is more rare, in 1971, Wieland et al.^[2]The first cases of pregnancy-induced Cushing's syndrome have been reported so far, a total of 11 cases worldwide^{[3,4,5,6,7,8,9,10,11,12]}。 Recently, a patient with recurrent pregnancy-induced Cushing's syndrome was admitted to the Department of Endocrinology of the Second Affiliated Hospital of Zhejiang University School of Medicine, which is now reported in combination with the literature review as follows.

chorioamniotic membrane separation refers to the disappearance of the extraembryonic body cavity after 14 weeks of pregnancy, the amniotic membrane and the chorionic membrane are not attached together but are in a separated state, and there is a space between the two after ultrasound examination^[1]。 According to the etiology, it can be divided into spontaneous and iatrogenic, and the etiology of spontaneous chorioamnionic separation is mostly unclear; Iatrogenic chorioamniotic separation mainly occurs after interventional intrauterine diagnosis and intrauterine intervention surgery. With the increasing clinical application of fetoscopy, this problem is particularly prominent. Chorioamnionic separation is clinically rare and can lead to adverse pregnancy outcomes. Currently, there are no clinical management norms and guidelines to follow. The Hospital of Obstetrics and Gynecology affiliated to Zhejiang University School of Medicine recently treated two patients with chorioamniotic membrane separation after uterine cavity surgery, which are reported below in combination with literature review.

Since 1982 Mulliken and Glowacki^[1]Since the pathological classification of congenital vascular lesions was put forward, the understanding and treatment level of congenital vascular lesions have developed rapidly. According to the characteristics of vascular endothelial cells in the lesion, congenital vascular lesions can be divided into two categories: hemangioma and vascular malformation. Hemangioma is characterized by the increase of the number and layer of vascular endothelial cells, and the typical clinical manifestation is a rapid growth period within 1 year after birth and a slow spontaneous regression period thereafter; However, the number of vascular endothelial cell layers of vascular malformation is normal, and it develops slowly throughout its life and will not resolve. Venous malformation is the most common type of vascular malformation, accounting for 2/3 of all vascular malformations^[2]Can occur in any part with normal blood vessel growth, resulting in disfigurement and loss of function, affecting coagulation function or even life-threatening in severe cases^[3,4]。 Cavernous hemangioma located in female vulva is a venous malformation. Because of its atypical initial clinical manifestations, it is easy to be misdiagnosed as varicose veins, Barr gland cyst, hernia and other soft tissue tumors. For the treatment of this disease, there are no unified standards and guidelines at home and abroad, and the treatment methods are diverse, the effects are different, and the prognosis is quite different. Simple surgical resection has the problems of excessive intraoperative bleeding, unclear visual field and residual tumor tissue. Intratumoral urea injection has been used for the treatment of vascular malformations for nearly 30 years^[5]Intrafocal urea injection of venous malformation can make the boundary of the lesion clear and thrombosis in the lesion^[6,7]To make up for the shortcomings of simple surgical treatment. This study retrospectively analyzed the clinical data of 32 female patients with vulvar cavernous hemangioma treated with intratumoral urea injection combined with surgery admitted to the Hemangioma Department of Henan Provincial People's Hospital from January 2009 to March 2014, which are now reported below.

Cervical cancer is the third most common tumor in women worldwide^[1]The treatment of patients with recurrent and metastatic cervical cancer is difficult, and the main treatment methods are radiotherapy and chemotherapy, but the curative effect is often unsatisfactory. At present, the research on bevacizumab is increasing day by day, and it has also shown good efficacy in patients with recurrent and metastatic cervical cancer^[2]。 From January 2013 to February 2014, the Department of Gynecology, Affiliated Cancer Hospital of Zhengzhou University used bevacizumab combined with chemotherapy to treat 15 cases of recurrent and metastatic cervical cancer. Now, the short-term efficacy and safety are retrospectively analyzed.

Conic trunk malformation accounts for about 70% of cyanotic congenital heart disease, and the prognosis of children is poor. Nearly half of them die in infancy^[1,2,3]。 Therefore, accurate prenatal diagnosis of trunk conus malformation can provide prenatal consultation information, so that parents of children can make a choice about whether to terminate pregnancy with full understanding of prognosis; At the same time, it can also provide scientific perinatal management basis for continuing pregnancy, which is conducive to improving perinatal survival rate and reducing birth defect rate. In this study, the angle between fetal ascending aorta and pulmonary aortic trunk was measured by using color Doppler ultrasound diagnostic apparatus, using spatiotemporal image correlation (STIC) technique combined with dynamic orthogonal three-planar (MP) analysis, and the normal reference values of different gestational weeks were established. In addition, the angle between ascending aorta and pulmonary aortic trunk was observed at the corresponding gestational weeks of fetuses with congenital heart disease. The purpose was to explore the application value of STIC combined with MP analysis to measure this angle in prenatal screening of fetal arterial trunk conus malformation.

The perineal body, also known as the central perineal tendon, is a fibromuscular tissue located between the anus and the vestibule of the vagina. It is wedge-shaped on the sagittal plane, with the tip facing down, the bottom facing up, and a depth of 3 to 4 cm. The front of the perineal body is fixed to the mucosal layer of the vagina, and it ends at the pubic bone forward through the puborectal muscle and the puborectal muscle, and the perineal body is also continuous with the posterior edge of the perineal membrane; On both sides, the perineal body is fixed to the ischiopubic branch through the superficial transverse perineal muscle, and the upper parts of both sides of the perineal body are attached to the pubococcygeal muscle, the pubovaginal muscle and the puborectal muscle; Posteriorly, the perineal body is connected to the longitudinal fibrous sheath of the internal anal sphincter and protrudes forward towards the posterior wall of the vagina at the anorectal junction^[1,2]。 The perineal body is vulnerable to damage during childbirth. After childbirth, the mobility of the perineal body will increase significantly^[3]。 The perineal body has the function of fixing the pelvic floor and supporting the organs in the pelvic cavity. Most studies have shown that the injury of the perineal body is closely related to urinary incontinence, fecal incontinence and pelvic organ prolapse^[4,5]。 However, there are few reports on the anatomy of the perineal body and its role in pelvic floor dysfunction (PFD) in China. This article aims to review the anatomy of the perineal body and its role.

leiomyomatosis peritonealis disseminata (LPD) is a non-metastatic, homologous and multicentric benign tumor disease characterized by small leiomyomas scattered on the peritoneum and omentum surface. This disease is very rare, and there are only more than 100 cases of this disease reported in the literature worldwide. LPD usually occurs in women of childbearing age^[1,2]Occasionally, LPD has been reported in menopausal women, men and young children. Because most patients are asymptomatic, the disease is discovered accidentally, so the actual incidence of the disease may be higher than the incidence reported in the literature^[3]。 This article summarizes the recent research progress on the etiology, pathological features, clinical manifestations and imaging features, diagnosis and differential diagnosis, treatment and prognosis of LPD in recent years as follows.

Positron emission tomography (PET) is a functional imaging that lacks the ability to anatomically locate the lesion; CT, on the other hand, can perform accurate anatomical localization, and can well distinguish benign and malignant lesions and find small lesions. In 1998, Townsend and Beyer, U.S.^[1]Combining PET and CT, the first PET-CT all-in-one machine in the world was successfully developed. In 2000, Charron et al.^[2]Firstly, the clinical application of PET-CT examination was reported; In the same year, Beyer et al.^[3]Scholars performed PET-CT scans on 110 patients with different types of tumors, which confirmed that whole-body PET-CT examination is of great value in the diagnosis, staging and evaluation of treatment effect of tumors. At present, PET-CT examination has been widely used in the clinic of various tumors. This article summarizes the application of PET-CT in the diagnosis, staging, monitoring of tumor recurrence and guiding the adjustment of clinical treatment plan of common gynecological malignant tumors as follows.

From April 30 to May 3, 2014, the 12th World Congress On Endometriosis (WCE) was held in Sao Paulo, Brazil. 1,300 scholars and 30 academic groups from 68 countries around the World attended the conference. More representatives from China attended the conference and gave speeches and displayed posters. This conference embodies the worldwide update of the concept of diagnosis and treatment of endometriosis (endometriosis) in the past three years, the technological progress and the prospect of future research.