Objective:To investigate the differences between patients with small cell carcinoma of the cervix and other type of cervical cancer on clinicopathological characteristics,treatment,prognosis through the retrospective analysis,also study the prognostic factors in patients with SCCC.Methods:The patients with SCCC(63 cases,research group) and patients with Non-SCCC(60 cases,control group) such as squamous cell carcinoma and adenocarcinoma of cervix were chosen during May 2003 and June 2015 in department of obstetrics and gynecology,west China second university hospital.The clinical pathological and survival data were collected,sort out,checked and analyzed.Chi-square test or Fisher's exact probability method was used to compare the differences of clinical features between the two groups.The 5-year disease-free survival(DFS) rate and 5-year overall survival(OS) rate were generated using the Kaplan-Meier method.Univariate and multivariate analysis were applied to research the prognostic factors.Results:①The median age of the patients in research group was 40 years old,younger than control group whose median age was 44 years old (P =0.001).The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in research group were significantly higher than those of control group (P ＜ 0.05).There were no significantly differences between two groups in clinical symptoms,FIGO stage,therapeutic schedule.②In the survival analysis,the research group estimated 5-year overall survival (OS) rate (29.2％) and estimated 5-year disease-free survival rate (DFS)(26.6％) was significantly lower than those of the control group(82.6％,and 76.7％,respectively) P ＜ 0.05.③In the COX multivariate regression analysis,the results showed that the lymph node metastasis was the independent factor influencing overall survival rate and disease-free survival rate(HR =4.784、3.067,P ＜ 0.05).In addition,the tumor size was the independent factor influencing overall survival rate (HR =3.610,P ＜ 0.05),and advanced FIGO staging was the independent factor influencing disease-free survival rate (HR =2.793,P ＜ 0.05).Conclusions:The patients with SCCC were younger than other cervical cancer,and the clinical symptoms,cervical appearance,treatment between the two types are almost the same.However,The rate of lymph node metastasis,parametrial infiltration,vascular involvement and positive surgical margins in patients with SCCC were significantly higher than other cervical cancer,and the prognosis of the patients with SCCC was very poor.The main prognostic factors were lymph node metastasis,advanced FIGO stage and tumor size.

Objective:To investigate the clinical value of emergency cervical cerclage combined mesh patch suture in the treatment of cervical incompetence.Methods:From January 2011 to August 2016 in our hospital 65 cases of pregnant women with inevitable abortion,32 cases of they had carried out emergency cervical cerclage combined mesh patch suture(group A),33 cases of they had carried out cervical cerclage only(group B),The prolongation of gestation time,delivery gestational age,neonatal outcome,delivery mode and postoperative complications were compared between the two groups.Results:The operation time of A group was higher than that of group B,surgical complications of cervical laceration in group A was less than B group,the difference was statistically significant(P ＜ 0.05);there was no significant difference in the incidence of chorioamnionitis between the two groups(P＞0.05);the gestational age of group A was extended to 84.45 ±35.77 days,and the gestational age of B group was extended to 51.86 ±29.93 days,there was statistically significant difference between the two groups(P＜0.05);there was more than 28 weeks delivery in 23 cases(71.88％) in group A,and 17 cases (51.52％) in group B,the difference was statistically significant(P ＜ 0.05);there were no statistically significant differences in the delivery mode between the two groups(P ＞ 0.05);neonatal birth weight,birth Apgar 1 minutes score of group B were significantly lower than those of group A,the difference was statistically significant (P ＜0.05).Conclusions:Emergency cervical cerclage combined mesh patch suture can effectively prolong the gestational age,improve neonatal outcome,no obvious complication and has certain clinical applicative value.

Objective:To evaluate the efficacy of loop electrosurgical excision procedure(LEEP) in the treatment of different grade of cervical intraepithelial neoplasia(CIN). Methods:898 cases with CIN treated by LEEP were retrospectively analyzed. Operation time, blood loss during the operation, changes of histopathologic results and high-rick HPV before and after the operation were studied. The diagnosis and treatment results by LEEP were evaluated. Results: The average operation time was 5.1 minutes. The average blood loss during the operation was 5.6 ml. The concordance rate of pathologic results under colposcope before operation and after LEEP was 77.73% (698/898) .96 cases had increased CIN grade after LEEP(10.69%). The HPV-DNA loading dose after operation declined significantly (P< 0.01). Conclusions: The detection rate of invasive cervical cancer by LEEP is higher than multiple punch biopsy under electronic colposcope. LEEP is an effective method for the diagnosis and treatment of CIN, and it can eliminate high-rick HPV at the same time of ablating the cervical lesion.

Objective:To explore the effect and mechanism of Xinfuning( recombinant human α-2b interferon capsule for vaginal foams) on the clearance of human papilloma virus (HPV). Methods: The patients with HPV infection were divided into experimental group (Xinfuning group) and control group (Shurunshuan group, a common recombinant human interferon α-2b in suppository form) .The HPV negative conversion rate was compared between the two groups after action on vaginal posterior fomix. The content of cytokines IL-4, IL-10, IFN-γ, TNF-a in the cervical region before or after the application was detected by ELISA. Results:The negative conversion rate in the experimental group was higher than that in the control group ( P<0.05). The content of IL-4, IL-10 was decreased and the cont ent of IFN-γ,TNF-α was increased apparently( P < 0.05). Conclusions: Interferon has the effect on clearance of HPV infection by regulating Th1/Th2 balanced state to boost immunization and the unique preparation of Xinfuning can strengthen such function.

Objective:To investigate the pathogen flora of recurrent vulvovaginal candidiasis(RWC),and to discuss its treatment. Methods: Fungal culture and susceptibility tests of vaginal discharge from 108 RWC patients were performed. Sensitive drugs were selected for effective consolidating treatment for half year. Fungal smears were examined at the 3rd and 6th months after the treatment respectively. Results:①Among RWC patients,there were 81 cas es of Candida albicans(75.0%), 19 cases of C. Glabrata(17.6%), 4 cases of C. Parapsilosis(3.7%) ,2 cases of C.tropicalis (1.9%) and 2 cases of M. Krusei (1.9%). The drug susceptibility test showed that 80.6% of these 108 patients were sensitive to nystatin; 66.7% were sensitive to clotrimazole; 65.7% were sensitive to miconazole; 57.4% were sensitive to fluconazole;8.3% were sensitive to ketoconazole;6.5% were sensitive to itraconazole; 7.4% were resistant to all of the above drugs.②The score of symptom and sign was significantly improved compared with the first visit at the 3rd and 6th month after the treatment( P<0.0001). The negative rate was 76.2%(80/105) at the 3rd month after the treatment and 64.8%(68/105)at the 6th month after the treatment. Conclusions:①The rate of non Candida albicans is increased to 25% in RWC patients, and 17.60% is Candida glabrata.②During the treatment of RWC, the drugs should be selected according to fungal culture, results of susceptibility test, medication experience of patients,and attack character. The research of immune abnormality of the local vagina will be helpful to improve the cure rate of RWC.

Objective:To investigate the clinical effects of levonorgestrel-releasing intrauterine device(LNG-IUD) in the treatment of adenomyosis in perimenopausal period. Methods: A total of 92 patients with adenomyosis in perim enopausal period were treated with LNG-IUD and followed up at the 3rd,6th, 12th,24th month. Change of menses, uterine volume,visual analogue scale (VAS) of dysmenorrhea,the serum CA_(125) level and degree of satisfaction with the treatment were observed. Results:The dysmenorrhea was alleviated along with the follow-up time in all of the pa tients after insertion of the LNG-IUD ( P<0.05). The menstrual volume, uterine volume and serum CA_(125) level were decreased significantly(P<0.05) .Conclusions:LNG-IUD is a safe, effective and simple treatment of adenomyosis in perimenopausal period.

Objective: To study the relation of bile acid levels and fetal hypoxia and brain injury in Intrahepatic Cholestasis of Pregnancy (ICP). Methods: From May. 2006 to Sep. 2006, we selected 30 cases of ICP as the study group, and randomly selected 30 cases of normal pregnant women for delivery during the same period as the control group in our hospital. Color Doppler ultrasound was used to measure the peak systolic velocity to end-diastolic velocity (S/D) and the resistive index (RI) of fetal middle cerebral artery, and the automatic biochemical analyzer be used to detect the total bile acid (BA) in maternal blood, and BA, pH as well as lactate in umbilical arterial serum; neuron-specific enolase (NSE) in umbilical artery serum was detected by ELISA. The results were analyzed and compared. Results:①The BA concentration in maternal blood and newborn umbilical artery blood of the study group was significantly higher than that of the control group ( P<0.01). In the study group, the BA in maternal and newborn blood were positively correlated ( r=0.937, P< 0.01) ;②Lactate and the NSE Concentration in newborn umbilical artery of the study group was significantly higher than that of the control group ( P< 0.01). The pH value innewbom umbilical artery and The S/D, RI value of fetal middle cerebral artery in the study group was significantly lower than those of control group ( P< 0.01); ③ In the study group, the NSE concentration was positively correlated with BA and lactate concentration in newborn umbilical artery, while negatively correlated with the S/D and RI values of fetal middle cerebral artery and the pH value in newborn umbilical artery ( P<0.01). Conclusions: There is the existence of hypoxia and brain injury in fetus of ICP. By measuring the blood flow changes of fetal cerebral artery with Color Doppler and detecting pH, lactate as well as NSE levels in umbilical arterial blood, we could early predict the fetal hypoxia and diagnose the fetal brain injury in ICP.

Objective:To detect the expression of ALDH1 and ABCG2 in the specimens from different levels of cervical lesions.Methods:Use SP immunohistochemistry to detect the expression of ALDH1 and ABCG2 in 76 cases of cervical squamous cancers,52 cases of HSIL,and 37 cases of chronic cervicitis tissues,and analyze the results.Results:①The positive expression rates of ALDH1 and ABCG2 in chronic cervicitis tissues were 5.41％ (2/37) and 8.11％ (3/37),in HSIL tissues were 23.08％ (12/52) and 28.85％ (15/52),and in cervical cancers tissues were 53.95％ (41/76) and 61.84％ (47/76),respectively.The positive expression rates in cervical cancers tissues were significantly higher than in HSIL and Cc hronic cervicitis tissues,(P ＜ 0.05).②The positive expression of ALDH1 in cervical cancer tissues had correlation with tumor grade and lymphnode metastasis (P ＜0.05),while the positive expression of ABCG2 in cervical cancer tissues had correlation with tumor grade,clinical stage and lymph-node metastasis(P ＜0.05).③The expressions of ALDH1 and ARCG2 in cervical cancer were positive relative(r =0.535,P ＜ 0.05).Conclusions:The increased expressions of ALDH1 and ABCG2 in cervical squamous cancer may play a role in the occurrence,development and metastasis of cervical squamous cell carcinoma.ALDH1 and ABCG2 may have synergistic effect in occurrence of cervical cancer.

Objective:To evaluate the consistency of colposcopy diagnosis performed by a single examiner with pathologic diagnosis and to analyze the factors related with colposcopy over-and under diagnosis.Methods:A retrospective study was performed.The initial 200 cases diagnosed by a single colposcopy beginner at Peking University first Hospital out-patient clinic from March 2015 to October 2015 were included in this study.The consistency rate and bias rate of colposcopy diagnosis versus pathologic diagnosis as well as the causes of such differences were analyzed.Results:Of 174 cases with pathologic diagnosis,the consistency rate was 59.2％.The underdiagnosis rate and overdiagnosis rate were 18.4％ and 22.4％ separately.Of HSIL underdiagnosis group,the rate of TCT NILM was 78.6％ which was higher than 18.1％ in HSIL consistency group,P ＜ 0.05.Re-evaluation of the colposcopy pictures revealed that acetowhite epithelium were present in all 14 cased of HSIL underdiagnosis group.The rate of post-menopausal women was higher in HSIL underdiagnosis group than in HSIL consistency group(21.4％ vs 0％),P ＜0.05.The medium numbers of biopsy were higher in HSIL consistency group when compared with HSIL underdiagnosis group,P ＜0.05.The medium numbers of biopsy was higher in overdiagnosis group when compared with consistency group,P ＜ 0.05.Conclusions:Underdiagnosis of colposcopy was related with TCT-overdependent,insufficient understanding of acetowhite epithelium and post-menopausal women.Increasing biopsy numbers may improve the consistency rate of colposcopy and pathologic diagnosis.However,the increasing numbers of biopsy often results from overdiagnosis.

Objective:To evaluate the association between weight gain in late gestation and glycated albumin (GA),visfatin level and neonatal body composition in gestational diabetes mellitus (GDM) patients who are non-obese.Methods:200 pregnant women were enrolled.The preconception body mass index(BMI) of all the research object was less than 25 kg/m2.According to the speed of body mass growth from 28th week of gestation to delivery,the subjects were divided into two groups:excessive weight gain group (n =77) and appropriate weight gain group(n=123).Variance of serum GA,visfatin levels and neonatal birth weight(BW),the percent of body fat in newborn(F％) between two groups were compared,and the relationship between weight gain in late pregnant GDM patients and above values was analyzed.Results:①Serum GA,HbA1 c,visfatin and total cholesterol,triglyceride,low density lipoprotein,very low density lipoprotein levels in excessive weight gain group were higher than those in appropriate weight gain group(P ＜ 0.05).②Mean gestational age,newborn Apgar score immediately,the ratio of baby boys and vaginal delivery rate in two group had no significant difference(P＞0.05).Compared with the appropriate weight gain group,the excessive weight gain group had higher average birth weight and lower blood glucose levels.The proportion of large for gestational ages(LGA) was increased in appropriate weight gain group,and the ratio of abdomen circumference (AC) and head circumference (HC) and the percent of body fat in newborn(F％) were significantly increased in this group(P ＜0.01).③The speed of body mass growth in late pregnancy in GDM patients was positively related with serum GA,visfatin,HbA1c levels and newborn birth weight and the percent of body fat in newborn(r=0.524,0.470,0.456,0.329,0.473,P＜0.001).Conclusions:The monitoring of the serum GA and visfatin levels may have certain clinical value to evaluate the weight gain in late pregnancy of GDM patients.The rapid body mass growth in those patients may accelerate the visceral fat accumulation and worsen existing glucolipid metabolic disorders,and is also closely related to the increase of neonatal BW and F％.