Endometrial cancer is one of the common malignant tumors in female genital tract.The incidence of endometrial cancer is increasing,even the top one in the developed country and bigger cities in China.The screening of endometrial cancer should be performed in the high risk population.In the recent years,the popular screening methods for endometrial cancer include ultrasound,endometrial biopsy,and endometrial cytology (ECT),etc.This review introduces briefly above methods.

Objective:To study the mechanism on extracellular signal-regulate kinases ( ERK) signal transduction by calcium influx initiated by combination of estrogen with calcium channels or estrogen re-ceptor in endometrial cancer cell Ishikawa. Methods: Confocal test was used to determine the relative calcium mobilization by stimulation of estrodiol together with and without the inhibition of ICI182780 and nifedipine. Western-blotting was used to detect the protein expression of phosphorylated ERK1/2 (P-ERK1/2) in the same condition. Results:The transient calcium flux initiated by 17β-estrodiol (E2) and a membrane-impermeable conjugate of estrogen and bovine serum albumin ( E2-BSA ) , and the calcium mobilization could be inhibited by ICI182780 and nifedipine in 1 min. In Ishikawa cells, phosphorylation of ERK1/2 was stimulated by E2 , and the phosphorylation could not be inhibited by E2 after the combination with ICI182780 in 5 min and in 30 min. The phosphorylation also could not be in-hibited by E2-BSA after the combination with nifedipine in 5 min, but in 30 min the phosphorylation was decreased. The phosphorylation of ERK by E2-BSA was decreased by the combination with nifedipine in 30 min. Conclusion:The transient calcium flux initiated by estrogen has an effect on the activation of ERK signal pathway in endometrial carcinoma cells.

Objective To compare patients' quality of life followed by Prolift operation and the revised total pelvic floor reconstruction with Gynemesh.Methods Thirty one patients underwent total pelvic floor reconstruction surgery were divided into two groups,including 14 cases treated by Prolift surgery and 17 cases treated by the revised total pelvic floor construction with Gynemesh.The body weight index(BWI),menopausal age and gravidity history did not show significant difference between two groups(P ＞0.05).The patients' age with 63±9 in Prolift group was significantly lower than 69±5 in Gynemesh group (P ＜0.05).Questionnair score of quality of life were collected and evaluated pre-and post-operation.Result (1) Preoperative scores:there was no significantly different scores of the following index between two groups (P ＞0.05),which were 91±42 in pelvic floor impact query,100±59 in pelvic floor distress query and 77±26 in sexual life query in Prolift group,65±56 in pelvic floor impact query,89±73 in pelvic floor distress query and 75±18 in sexual life query in Gynemesh group.(2) Postoperative scores:similarly,there was also no significantly different scores in the following index between two groups (P ＞ 0.05),which were 7±15 in pelvic floor impact query,27±24 in pelvic floor distress query and 79±43 in sexual life query in Prolift group,13±24 in pelvic floor impact query,24±21 in pelvic floor distress query and 74±15 in sexual life query in Gynemesh group.Conclusions The patients' quality of life were improved after Prelift operation and the revised total pelvic floor construction with Gynemesh.However,about quality of sexual life,Prolift operation did much better than revised pelvic surgery with Gynemesh.

0 05) The radiotherapy and chemotherapy ratio of them was significantly higher than the control ( P 0 05). Multivariate analysis showed that the prognosis were related to the stage and tumor cell differentiation affected the prognosis remarkable But the prognosis was independent of age and associated medical disorders Conclusions The endometrial carcinoma often associates with hypertension, diabetes mellitus, coronary heart disease, and so on The incidence rate of medical disorders increases with the aging of the patients The medical disorders might affect the therapy to a certain extent But they do not affect the prognosis remarkably

Objective To investigate clinical treatment and outcome of mesh-related pain after pelvic floor reconstruction. Methods Twelve patients were referred to Peking University People′s Hospital for post-operation pain related to polypropylene mesh or tape used in pelvic floor reconstruction and received reoperation from January 2007 to December 2014. The demographic characteristics, clinical manifestation, operation method and follow-up outcome were retrospectively analyzed, and current literature was also reviewed. Results (1)General information:the median age was 54 years old(range 43-74 years old). The median vaginal delivery times was 2 (range 1-5). Initial pelvic floor operation procedures included 4 cases vaginal mesh, 5 cases vaginal mesh plus tension-free vaginal tape (TVT), 1 case rectal surface mesh implantation, and 2 cases sacrocolpopexy. (2) Related complications:all 12 patients had pain-related post-operation symptoms including dyspareunia, perineal pain, urination and defecation difficulty. Seven patients also complicated with other symptoms including discharge and bleeding. Mean time from first operation to medical consultation was 30 months (range 1-72 months). (3) Reoperation results:all 12 patients received reoperation on mesh revision or tape, 10 cases of them reoperated by vaginal approach, while the other 2 cases by laparoscopy. The range of the mesh or tape depended on tender or firm tissue and scar by palpation. The visual analogue scale (VAS) was significantly improved, which was 7.1 ± 2.2 pre-operation, and 0.9 ± 1.9 post-operation (95%CI: 4.48-7.86, P<0.01). Conclusions Pain is one of the reason why patients was removal of the mesh or tape after pelvic floor reconstruction operation. The surgery procedure may be considered as partial or entire mesh or tape excision by vaginal or abdominal way. Mesh or tape removal surgery could relieve related pain and other complications, and the VAS score was significantly improved after surgical management.

Objective To study the urodynamic characteristics of women with pelvic organ prolapse in prolapse and reset condition. Methods From Jan. 2010 to Apr. 2010, 30 patients with pelvic organ prolapse (POP), including 1 case in grade Ⅰ , 6 cases in grade Ⅱ , 21 cases in grade Ⅲ and 2 cases in grade Ⅳ, treated in Peking University People's Hospital were analyzed their urodynamical changes at status of prolapse and reset with pessary. Results (1)The symptoms: in the prolapse condition, there were 11 patients with bladder outlet obstruction( BOO), 7 patients with residual volume more than 100 ml, and 4 patients with stress urinary incontinence(SUI). In the reset condition, there were 5 patients with BOO,5 patients with residual volume more than 100 ml, and 4 SUI patients. (2) Characteristics of urodynamic:there were significant difference in first desire to void ( FD, P = 0. 047), normal desire to void ( ND, P =0. 007), strong desire to void ( SD, P = 0. 001 ), maximum cystometric capacity ( MCC, P = 0. 001 ),maximum flow rate ( Q=max, P = 0. 001 ), average flow rate ( Q P = 0. 001 ), and residual volume ( RV,P = 0. 025 ) between prolapse and reset condition among all patients. In patients with grade Ⅰ to Ⅱprolapse, Qmax were (11 ±6) ml/s in prolapse condition and (15 ±4) ml/s in reset condition (P =0. 014), Qave were ( 6 ± 4 ) ml/s in prolapse condition and ( 7 ± 3 ) ml/s in reset condition ( P = 0. 237 ),RV were (29 ±46) ml in prolapse condition and (15 ±25) ml in reset condition (P =0. 157). Among patients with grade Ⅲ to Ⅳ prolapse, Qmax were ( 11 ± 8 ) ml/s in prolapse condition and ( 17 ± 10) ml/s in reset condition (P=0.001), Qave were (5 ±4) ml/s in prolapse condition and (7 ±4) ml/s in reset condition ( P = 0. 002 ), RV were ( 105 ± 169 ) ml in prolapse condition and (47 ± 92) ml in reset condition (P = 0. 037 ). Conclusions Patients with pelvic organ prolapse Ⅲ - Ⅳ may present pseudo BOO,recessive stress urinary incontinence and residual volume more than 100 ml. There were significant improvement in cystometric sensation, capacity, flow rate, and residual volume after reset. The urodynamic test for patients with pelvic organ prolapse in the reset condition might be much better in evaluating lower urinary tract function.

Objective To investigate the role of two isoforms of human progesterone receptor A (hPR-A) and B(hPR-B) in the development of uterine leiomyoma, their distribution and expression in leiomyoma were detected. Methods The tissues of leiomyoma and normal myometrium from 30 uteri, which were excised for leiomyoma, were used for the localization and quantification of protein of the two isoforms. Immunohistochemistry and Western blot were applied respectively. Results Both hPR-A and hPR-B were nuclear receptors. Concentrations of hPR-(A+B) and hPR-A in leiomyoma were higher than those in normal myometrium (295 796? 90 856,256 275?98 560; P =0 042, P =0 000 563). Both isoforms were presented in leiomyoma and normal myometrium, with a consistent dominance of hPR-B over hPR-A. More expression of hPR-A was found during secretive phase than proliferative phase, not only in leiomyoma but also in normal myometrium ( P =0 037, P =0 024). Conclusions The development of uterine leiomyoma seems to be related with the progesterone receptor isoforms, especially hPR-A.

Objective To compare the expressions of p16~(ink4a) and Ki-67 in human cervical lesions. Methods The expressions of p16~ink4a and Ki-67 protein were measured with immunhistochemical staining in 42 human normal uterine cervical tissues,21 with human cervical intraepitheial neoplasia(CIN) Ⅰ,21 with CINⅡ,and 36 with CINⅢ.The relevance of the expressions of the two proteins to CIN grades was analyzed by Spearman Correlation.The sensitivity,specificity,positive/negative predictive values,and youden's index of p16~(ink4a) and Ki-67 were also studied. Results For p16~(ink4a),the sensitivity and specificity were 83.3% and 90.5%;the positive and negative predictive values were 94.2% and 74.5%;Youden's index was 0.738.For ki-67,the sensitivity and specificity were 98.7% and 16.7%;the positive and negative predictive values were 68.75% and 87.5%;Youden's index was 0.154.Both the sensitivity and specificity for the combined Ki-67 and p16~(ink4a) are 83.3%.Conclusion p16~(ink4a) has higher specificity and positive predictive value,and is a good diagnostic marker for cervical lesion.By contrast,Ki-67 has higher sensitivity and negative predictive value.Even with its poor specificity,it can still be regarded as a supplementary test for early diagnostic cervical lesion.The overall performance of p16~(ink4a) is better than that of Ki-67.

Atlas Human cDNA expression array technique was employed to study the differences in gene expression in normal and endometrial cancer tissues. In this technique, dATP? 32 P labeled cDNA from normal and tumor tissues was hybridized to identical human cDNA expression array membranes (containing 588 known genes). The results showed that the expression of endometrial cancer associated genes including IRP, Wnt 5, 5T4 oncofetal antigen precusor , and CD147, were higher compared with controls. It suggested that the differential hybridization technique of Atlas Human cDNA expression array can be a useful method to identify genes differentially expressed either in normal or endometrial cancer tissue.

Objective To investigate the etiology and clinical characteristics of pregnancy-emerged thrombocytopenia.Methods A retrospective analysis was conducted on clinical data of 159 pregnancies with thrombocytopenia,who were admitted to Peking University People's Hospital from January 2000 to January 2010.All the patients recruited in this study had no history of blood or immune system disease before pregnancy,and thrombocytopenia was the predominate clinical manifestation during pregnancy,with platelet counts less than 100 × 109/L at least twice during pregnancy.The thrombocytopenia should not be induced by drugs,viral infections,preeclampsia or hemolysis,elevated liver enzymes,and low platelets syndrome (HELLP).All cases were followed up.The general condition,the onset time of thrombocytopenia,platelet changes,accompany symptoms,maternal and perinatal outcomes as well as follow-up conditions were compared based on the etiology.Results ( 1 ) Etiology:among the 159 cases,101 (63.5％) were diagnosed gestational thrombocytopenia (GT) ;43 ( 27.0％ ) were idiopathic thrombocytopenic purpura(ITP) ;9 ( 5.7％ ) were blood system diseases,including 4 cases of megaloblastic anemia( MA ),2 cases of aplastic anaemia (AA),and 3 cases of myelodysplastic syndrome(MDS).Six cases (3.8％)were diagnosed immune system diseases,including 3 cases of systemic lupus erythematosus ( SLE),2 cases of antiphospholipid syndrome (APS),and 1 case of Evans syndrome.(2)Maternal and perinatal outcomes:pregnancy induced hypertension was diagnosed in 21 cases ( 13.2％ ),abnormal glucose metabolism in 13 cases ( 8.2％ ),anemia in 44 cases ( 27.7％ ) and preterm delivery in 18 cases ( 11.3％ ).Twenty-nine cases ( 18.2％ ) were treated with corticosteroids or gamma globulin during pregnancy.The average gestational week was 38 weeks.Fifty-five cases ( 34.6％ ) underwent vaginal delivery,104 cases ( 65.4％ ) received cesarean section.Postpartum hemorrhage was observed in 34 cases (21.4％),and puerperal infection happened in 2 eases ( 1.3％ ).No maternal death was found.In a total of 160 fetuses (including twins),there were 157 live births.Three cases of fetal death and 2 cases of early neonatal deaths were observed.Fetal growth restriction was observed in 4 cases,and neonatal thrombocytopenia was seen in 6 cases.No intracranial hemorrhage was detected.(3)The onset time of thrombocytopenia:among the 159 cases,29 cases ( 18.2％ ),67 cases (42.1％ ),63 cases (43.6％) of thrombocytopenia were detected in the first,second and third trimester,respectively.There was a significant difference of the onset time of thrombocytopenia between GT and ITP groups( P ＜ 0.05 ).Patients with GT tended to have a later onset of thrombocytopenia,which mainly happened in the second and third trimester,while patients with ITP tended to happen in the first and second trimester.(4)The degree of thrombocytopenia:the cases with the minimum platelets level of (51 - 100) × 109/L,(31 - 50) × 109/L,( 10 - 30) × 109/L,＜ 10 × 109/L during pregnancy were 75 (47.2％ ),39 (24.5％ ),31 ( 19.5％ ),14( 8.8％ ) respectively.There was a significant difference between GT and ITP groups in the lowest platelets level (P ＜ 0.01 ).(5)Thrombocytopenia accompany with anemia:among the 159 cases,there were 44 cases (27.7％ ) accompanied with anemia.The proportion was 9.9％ ( 10/101 ) in GT group,58.1％ (25/43) in ITP group,with significant difference(P ＜0.01 ).Anemia was also found in 5 cases in blood system disease group (5/9),and 1 case in immune system disease group (Evans syndrome,1/6).Pancytopenia was observed in 2 cases with ITP (4.7％,2/43 ) and 3 cases with blood system disease ( AA:1 cases,MA:2 cases,3/9).(6) The recovery of the platelets counts postpartum:the postpartum follow-up periods were 7 months to 10 years.Patients recovered within 1 week,6 weeks,6 months postpartum were 66 cases ( 41.5％ ),43 cases ( 27.0％ ),17 cases ( 10.7％ ) respectively.The platelets counts did not recover within 6 months postpartum in 33 cases(45.7％ ).Conclusions GT is the leading cause of pregnancy-emerged thrombocytopenia followed by ITP.There are significant differences between GT and ITP in the onset time of thrombocytopenia,the lowest platelets level,the proportion of anemia accompanied and the postpartum recovery.Other etiologies including immune and blood system diseases are rare.The relevant examinations should be taken for etiology and differential diagnosis.