Objective To clone the genes related to pregnancy induced hypertension (PIH) for the study of PIH pathogenesis. Methods The differential expressed cDNA of PIH and normal pregnant placenta were cloned using modified polymerase chain reaction based subtractive hybridization. The differential cDNA were sequenced. Results Ammong 86 clones from subtractive hybridization, 14 clones containing differential expressed gene fragments in PIH and normal placenta were identified, and these might be the genes associated with PIH. Compared with the expressed sequence tags (EST) in dbEST of National Center for Biotechnology Information, it showed that 11 of them were known gene fragments, and three were unknown. The three unknown gene fragments were registered in GenBank, the accession number is AF 232216, AF 232217, AF 233648 respectively. Conclusions Fourteen PIH related genes were cloned with subtractive hybridization. A new approach to study on the pathogenesis of PIH is presented.

Objective To unmask clues for the investigation of PIH pathogenesis by detecting the altered gene expression profile of placentas from PIH patients. Methods Clinical data and placentas were collected from 42 PIH patients and 22 normotensive pregnancies in seclective cesarean section to construct PIH database from Mar. 2001 to Sep. 2002 in Xi’an district. Suppression subtractive hybridization (SSH) was performed to set the subtractive cDNA library and differential screening was used to identify the positive clones;insertion of positive clones were sequenced by T7 primer method. RT-PCR and immunohistochemistry were employed to confirm the putative gene inhibin A expression. Results A database was set up that consists of pre- and postpartum clinical data and placenta samples of 42 preeclamptic pregnancies and 22 normotensive ones From which,150 features of placental tissue microarray were made. One hundred and three positive clones were isolated by SSH and differential screening. Sequencing and BLAST analysis showed that 90 insertion shared more than 95% homology with sequences in the GenBank/EMBL database. We identified 36 putative genes including pregnancy-specific glycoproteins gene (BC005924),serine protease inhibitor gene (BC012868),VEGFR-1 gene (AF063657),cytokeratine 7 gene(CK7) (AF509887),etc. Inhibin beta A gene was highly expressed in placentas in PIH patients. Conclusion The gene expression profile in PIH placenta was greatly changed;it might be necessary to investigate the role of VEGFR1,serine protease inhibitor,inhibin and CK7 in the pathogenesis of PIH.

Objective To investigate the effect of hypoxia on the expression of vascular endothelial growth factor (VEGF) in villous explants, and the effect of hypoxia-inducible factor 2? (HIF-2?) on the VEGF expression. Methods The villous were obtained from women who underwent suction and curettage for termination at 6-8 gestational weeks. Four groups were divided: normoxia group; hypoxia group; sense HIF-2? oligonucleotide group and anti-sense HIF-2? oligonucleotide group. All villous were cultured in vitro. In anti-sense and sense group, villous were incubated under hypoxia with HIF-2? oligonucleotide. The villous explants were collected after 48 h of cultivation. The protein level of HIF-2? was detected by Western blot and the mRNA of HIF-2? and VEGF were examined by real-time PCR. Results The expression of HIF-2? mRNA and VEGF mRNA as well as the protein level of HIF-2? were increased in hypoxic group comparing with the normoxia group. Compared with the sense group, the expression of HIF-2? protein and HIF-2?, VEGF mRNA showed significant decrease in anti-sense group. Conclusions Hypoxia may result in the increased expression of VEGF in villous explants during the early trimester, which might be mediated by HIF-2?.

HLA-G belongs to non-classical HLA-class Ⅰ genes.It is expressed in the fetal-maternal interface on the extravillous cytotrophoblast and in such immune privilege tissues as the cornea and pancreas.However, under pathological conditions, such as tumor, inflammatory diseases and post transplantation, HLA-G is expressed abnormally.HLA-G can interact with its acceptors or immune cells and suppress the function of immune cells, which facilitates the escape of the surveillance of the human immune system and the consequent damage.In clinical studies,HLA-G is related to some clinical parameters.This review will focus on the expression, function and regulatory mechanisms of HLA-G in cancer immunology.

Objective To study the clinical efficacy of robotic sacral hysteropexy in treatment of uterine prolapse.Methods From January 2012 to December 2013,3 patients undergoing robotic sacral hysteropexy in treatment of uterine prolapse in General Hospital of People's Liberation Army were studied retrospectively.Operation time,blood loss and postoperative recovery exhaust time and pelvic organ prolapse quantification (POP-Q) staging were evaluated.Results Three patients were treated by robotic sacral hysteropexy successfully.The mean operation time was 221 minutes (210-240 minutes),mean blood loss was 45 ml.One case with Ⅱ degree perineal laceration patients simultaneously perineal repair,neither intranor post-operative complications occurred.The mean postoperative recovery exhaust time was 16 hours.At three months of follow-up,all 3 patients got satisfaction.Although one patient at the first six months of postoperation had leakage of urine when coughing,instruct exercise pelvic floor muscle function and acupuncture one month their symptoms disappear.Conclusion Robotic sacral hysteropexy pave the way for an effective option in the management of uterine prolapse.

Objective To evaluate the role and efficacy of preventing bone mineral loss in patients with endometriosis treated by gonadotrophin-releasing hormone analogues (GnRH-a) combined with addback therapy.Methods Prospective,randomized controlled studies of the use of GnRHa with add-back therapy in treatment of endometriosis were enrolled in this study from Medline,Embase,Cochrane library,China National Knowledge Internet (CNKI),Chinese Biological Medicine Disk (CBM) and Data Base of Wanfang.After quality assessment and data extraction,meta-analysis were conducted in the change of BMD,reproductive hormone (E2) and visual pain score (VAS) by Stata 11.0 software.Results A total of 785patients from 13 randomized controlled trail (RCT) studies enrolled in this study after exclude no following up,poor quality and repeat published studies.377 patients were in group of GnRH-a with add-back treatment and 408 patients were in group of GnRna alone.The findinds were showed in meta-analysis:(1) there was a significant difference in percentage change of bone mineral density (BMD) between two groups,the addback therapy was more effective in prevention of bone loss which was (SMD =0.223,95％ CI:0.003 to 0.443,P =0.047).(2) There was no significant difference in the level of reproductive hormone between two groups (SMD =-0.053,95％ CI:-0.479 to 0.373,P =0.807).(3) There was also no significant difference in the visual pain score between the two groups (SMD =-0.157,95％ CI:-0.474 to 0.160,P=0.332).Conclusions GnRH-a with add-back therapy have been shown to be more effective in preventing loss of BMD than GnRH-a treatment alone.However,the long term effect of preventing BMD should be studied.

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

Objective To apply robotic surgery of early ovarian malignancy tumors clinically and evaluate its feasibility in management for early ovarian cancer. Methods Using the da Vinci robotic surgical system, seven patients with early ovarian malignancy tumors (stage Ⅰ) underwent robotic surgery from April 2012 to September 2013. The average age was 45.7 years. Robotic surgeries approaches contained salpingo-oophorectomy,para-aortic lymphadenectomy, pelvic lymphadenectomy, omentectomy and appendectomy. Perioperative and follow-up clinical data were recorded. Results All robotic surgeries were successfully completed without the conversion to laparotomy. The mean operative time was 225 minutes (100-330 minutes). The average estimated blood loss was 171 ml (20-600 ml). No patients received blood transfusions. No intraoperative and postoperative complications were observed. The average number of pelvic lymph node dissected were 18.3 (11-34). The average number of para-aortic lymph node dissected were 3.7 (3-4). The mean follow-up time was 26.0 months after surgery (20-36 months). Currently, all patients had no tumor recurrence and survived. Conclusion Robotic surgery is feasible as a novel alternative approach in the treatment of early ovarian malignancy tumors.

Objective To investigate the expression levels of tumor necrosis factor alpha (TNF-α),interleukin-6(IL-6) and the change of serum ferritin in patients with intracranial aneurysm and its clinical significance.Methods 22 patients with intracranial aneurysm and 16 cases of traumatic brain injury who recevied operation in Department of Neurosurgery in Quzhou People's Hospital from Jan.2014 to Jan.2015 were enrolled as observation group and control group.The intracranial aneurysm tissues and normal cerebral vascular tissues were collected respectively to detect the situation of inflammatory cell infiltration,and the expression of TNF-α and IL-6 was detected by HE staining and immunohistochemical staining.The serum was collected on hospitalized,postoperative 3 days and postoperative 7 days to detect serum ferritin.Results The positive cells were observed in the observation group after immunohistochemical staining,in which the expression levels of TNF-α [(0.194 ± 0.074) vs.(0.135 ± 0.047),t =2.799] and IL-6 [(0.152 ± 0.057) vs.(0.103 ± 0.028),t =3.494] were significantly higher than those in the control group(P =0.008,0.001).The serum ferritin level in the observation group was significantly higher than that in the control group at postoperative 3d [(232.25 ± 105.26) ng/mL vs.(169.51 ± 66.24) ng/mL,t =2.097] and postoperative 7d[(263.39 ± 114.73) ng/mL vs.(166.57 ± 73.71) ng/mL,t =2.955] (P =0.043,0.005).The difference of serum ferritin on different day in the observation group also was statistically significant(F =8.625,P =0.003).Conclusion The expression levels of TNF-α and IL-6 in intracranial aneurysms were high,which may be one of the important factors in the formation of intracranial aneurysms,and it provides an important reference of early prevention and drug treatment for patients with intracranial aneurysm.The serum ferritin is related to the rupture and hemorrhage of intracranial aneurysm,which can be used to judge prognosis and guide rational treatment,and worth further study to confirm.

OBJECTIVETo determine the optimal fertilization method for primary infertility patients without definite causes undergoing in vitro fertilization and embryos transfer (IVF-ET).

METHODSA total of 321 IVF-ET cycles for primary infertility without definite causes were divided into two groups, namely group A with infertility period ≥ 5 years (165 cycles) and group B with infertility period <5 years (156 cycles). Each group was further divided into IVF, ICSI, and partial ICSI subgroups. The fertilization rate, incidence of low fertilization rate and clinical pregnancy rate were analyzed.

RESULTSThe fertilization rate of IVF in group A was 67.5%, significantly lower than that of ICSI and partial ICSI in the same group (82.0% and 77.7% respectively) and that in IVF control group (76.3%, P<0.05). The incidence of low fertilization rate of IVF in group A was 33.3%, significantly lower than that of ICSI and partial ICSI (8.3% and 15.8%, P<0.05); in group B, the incidence of low fertilization rate of IVF was 12.3%, significantly lower than that of IVF in group A but showed no significant differences from that of ICSI and partial ICSI in group B (P>0.05). In group A, IVF resulted in a significantly lower clinical pregnancy rate (21.1%) than ICSI (43.3%, P<0.05), half ICSI (40.0%, P<0.05), IVF in the control group (48%, P<0.05), and IVF in group B (50.0%, P<0.05).

CONCLUSIONICSI treatment can increase the fertilization rate in IVF-ET cycles in patients with primary infertility for unknown causes, and may improve the clinical outcome of patients with long infertility period.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Humans ; Infertility ; therapy ; Male ; Ovulation Induction ; Sperm Injections, Intracytoplasmic ; Young Adult