Objective To investigate selective pregnancy reduction in second-trimester and its notices. Methods Selective pregnancy reduction in 19 cases of multiple pregnancy during 12～25 gestational age was performed,including 6 cases of twins,1 cases of triplets,1 case of quadruplet and 1 case of sextuplet. Ultrasonographically guided transabdominal intracardiac injection of high concentrate potassium chloride (KCl) solution was used. Results Performances of selective feticide in all twins were successful,except one monochorionic twins. In 11 cases of triplets,one case was aborted,one case was monozygotic triplet. Selective feticide was performed successfully in 7 of the rest 9 cases and the quadruplet Two cases were aborted after the procedure. The sextuplet was aborted after feticide. Conclusion Multifetal pregnancy reduction can be successfully performed in the second trimester without severe maternal complications. But abortion might occur afterwards. It is possible to reduce the abortion rate if monozygotic twin or triplet can be excluded before feticide,choosing the gestational sac which near the fundus,reducing the amniotic fluid volume of the target fetus or postponing feticide.

Objective To study the interphase FISH of cells from aminotic fluid in the third trimester prospectively. Methods Amniotic fluid (5ml) was obtained in 32 pregnant women in the third trimester who underwent cordocentesis for karyotyping. FISH was performed on uncultured am niocytes and the results were compared with karyotypes. Results Abnormal aneuploid were identified in 6 cases among the 32 women. The FISH results were consistent with the karyotypes. Conclusions Interphase FISH in third-trimester amniocentesis can provide an accurate clinical diagnosis on common aneupoidies.

【Objective】 To explore the complication and engra ftment of human cord blood hematopoietic stem cells in utero transplantation thr o ugh abdominal cavity of fetal rats , and to establish an animal model for clini cal application. 【Methods】　Human cord blood (MNC) cells were transplanted into th e abdominal cavity of fetal rats, the complications and the outcome of pregn ancy were observed. The condition of engraftment was detected by flow cytometr y and immunohistochemistry methods after the fetus were born. 【Results】 Huma n CD3 cells were detected in rats and the engraftment rate was 64%. At 1 and 2 months of age, the mean value of human CD3 cells were 0.28%±0.05% and 0.41 %± 0.05% respectively （P＜0.05）.Human CD3 、CD20及 CD+34 ce lls were also detected in liver、spleen and thymus of rats at 2 months of age. The i ncidence of complication was significantly different between transplanted grou p and non-transplanted group. 【Conclusion】　Human cord blood cells transfused into the abdominal cavity of fetal rats were engrafted . There were some complication s occurred during operations which affected the outcome of pregnancy.

Objective To investigate the effect of cervical knife conization (CKC) or loop electrical excision procedure (LEEP)on the outcome of subsequent pregnancies and mode of deliveries. Methods A retrospective case-control study including 228 women after treatment with LEEP or CKC for cervical intraepithelial neoplasia (CIN) Ⅱ -Ⅲ who gave birth in the First Affiliated Hospital of Sun Yat-sen University and He-xian Memorial Hospital of Pangyu from January 2004 to January 2010 was performed.Patients (n = 228) without cervical surgical history were randomly extracted from the respective hospitals birth registries as controls and were matched by age, gestation,parity and income.The information including gestational age, premature rupture of membranes (PROM), type of deliveries and birth weight of the two groups were collected.Results The gestational age of women treated with conization was (268.3±26.2) d, longer than that of the women without surgery (279.4±25.3) d (t=4.60, P＜0.01). The incidence of preterm birth was 18.0％(41/228) and 4.4％ (10/228) (x2 = 21.22, P＜ 0. 05). The incidence of PROM was higher in conizationgroup (10.1％, 23/228) than that (1.3％, 3/228) in control group (x2=16.32, P＜0. 05). Risk for PROM was almost eight fold (OR=8. 42, 95％CI: 2.49-28.44) higher in conization group. Cesarean section rate was higher in conization group (69.3 ％ ) than in control group (39.0 ％ )(x2=42.06, P＜0. 01). The gestational age of women treated with LEEP was longer than those treated with CKC[(269.8±24.6) d vs (260.2± 26.5) d, t= 4. 01, P＜0.01]. The incidence of preterm birth was 13. 1％ (22/168) and 31.6％ (19/60) (x2 = 10. 34, P＜0. 05). The mean birth weight of women with LEEP was heavier than that with CKC[(3358.5 ±812.2) g vs (3295.9 ±832.6) g, t=3.08, P＜0. 01]. The incidence of PROM (7.1％, 12/168) of woman with CKC was higher than that (1.3％, 11/60) of women with LEEP (x2 =6.10, P＜0.05). Conclusions Conization might increase the incidence of preterm delivery and preterm PROM. LEEP showed less adverse effect onthe outcome of subsequentpregnanciesthan CKC,and waspreferredfor primigravida, and the risk of treatment should be informed in advance.

AIM: To study the mRNA and protein expression of Kang ai1 (KAI1) tumor suppressor gene and to determine the relationship between KAI1 and invasiveness and metastasis of cervical cancer. METHODS: The expression of KAI1 metastasis suppressor was detected by immunohistochemistry in paraffin slides and by real-time quantitative polymerase chain reaction (RT-PCR) in fresh tissue. The samples included 20 cases of normal cervical tissues, 20 cases of cervical intraepithelial neoplasia (CIN) and 40 cases of cervical carcinoma. The results of the gene expression combined with the pathological and clinical data were also analyzed. RESULTS: The expression of KAI1 protein and mRNA was related to the tissue differentiation of cervix. The positive rates of KAI1 expression were the highest in the normal cervical tissue, the middle in CIN and the lowest in cervical carcinoma with significant difference among three groups (P<0.01). The expression of KAI1 protein was not related with the grade of CIN (P>0.05). However, both mRNA and protein expression of KAI1 were related to the differentiation and the clinical stages of cervical cancer (P<0.01) and also related to the metastasis of the cancer. The positive rates between the non-lymphatic metastasis and lymphatic metastasis (P<0.05) were significant different. Cox regression and logistic regression showed that the tissue differentiation, clinical stages, lymphatic metastasis and expression of KAI1 were all related factors with recurrence and prognosis of cervical cancer. CONCLUSION: The down-regulation of KAI1 tumor suppressor gene at both mRNA and protein levels is related to the differentiation, clinical stages and metastasis of cervical cancer, indicating that the expression of KAI1 is a prognostic factor for cervical cancer.

[Objective] To investigate the relationship of different types of gestational diabetes mellitus (GDM) and thyroid function.[Methods] A Total of 3846 cases,which received prenatal examination,delivered in the Eastern Hospital of the First Affiliated Hospital,Sun Yat-sen University and performed a 75 g oral glucose tolerance test (75 g 0GTT) at 24-28 gestational weeks,from Jan 1st,2014 to Dec 31st,2015,were divided into 2 groups.Normal blood glucose group:the result of OGTT (fasting plasma glucose,1 hour glucose and 2 hour glucose) was normal;Gestational diabetes mellitus group (GDM group):the result of 0GTT was abnormal.GDM group were divided into Ⅰ,Ⅱ,and lⅢ.GDM Ⅰ defined as one abnormal blood glucose of result.GDM Ⅱ:two abnormal blood glucose.GDM Ⅲ:three abnormal blood glucose.1868 cases of healthy pregnant women were reselected as the control group.TSH,FT4 and TPO Ab were detected in two groups.Analysis of Variance,Mann-Whitney U test,Kruskal Wallis rank test or Fisher's test was used for statistical analysis.[Result] There were statistically significant difference in TSH,FT4 between GDM subgroup and control group (P =0.012,P =0.002).TSH median trend to increase in GDM Ⅱ,and FT4 median trend to decrease in GDM Ⅱ.The Prevalence of hypothyroidism in GDM Ⅱ and GDM Ⅲ were higher than those in control group.[Conclusion] The GDM group with two or three abnormal blood glucose had a higher incidence thyroid gland dysfunction,especial with subclinical hypothyroidism.We should fully test the thyroid function,treat diabetes as early as possible and improve the pregnancy outcome as we could.

[Objective] To investigate associations between the functional polymorphisms of signal transducer and activator of transcription 4 (STAT4) gene and unexplained recurrent spontaneous abortion (URSA) and between STAT4 protein expression and the genotypes of rs 10181656 locus.[Methods] PCR-restriction fragment length polymorphism was used to genotype rs 1 0181656 locus polymorphism in 332 URSA cases and 260 normal controls,in 86 URSA cases and 77 normal controls of which immunohistochemical technique was used to detect STAT4 protein expression.[Results] The frequencies of rs10181656 C/G were 36.45 ％,46.54％ in genotype C/C,46.99％,45.38％ in genotype C/G and 16.57％,8.08％ in genotype G/G between URSA patients and normal controls.They reached statistical difference (P ＜ 0.05).The carriers of rs 10181656 G allele increased the risk of URSA (OR =1.50,P ＜ 0.05).STAT4 protein expression in decidual tissues:①There was statistical difference in the STAT4 protein expression in decidual tissues between cases and controls (P ＜ 0.05).In URSA patients there was statistical difference in the STAT4 protein expression among genotype CC,CG and GG of rs10181656 locus (P ＜ 0.05).So was in normal controls (P ＜ 0.05).In genotype CC there was no difference in the STAT4 protein expression between cases and controls (P ＞ 0.05).Neither was In genotype CG and GG respectively (P all ＞ 0.05).[Conclusion] Functional polymorphisms of the rs10181656 locus could probably associate with the susceptibility of URSA via STAT4 protein expression increased by genotype G/G in maternal decidual tissue.

[Objective]Dysregulated long noncoding RNAs(lncRNAs)have been found involved in human diseases,including cancers. Long non-coding RNA growth arrest-specific 5(GAS5)was reported to be dysregulated in different types of cancers. Howev-er,the role of GAS5 in ovarian cancer remains elusive.[Methods]In the present study,the expression of GAS5 was detected in 108 ovarian cancer tissues and compared adjacent normal tissues by quantitative real-time PCR(qRT-PCR).[Results]The results showed that the expression levels of lncRNA GAS5 were significantly decreased in cancer tissues(P=0.0004),and it was negatively correlated with tumor size(<5 cm vs.>5 cm,P<0.0001),invasion depth(T1-T2 vs. T3-T4,P=0.0021),and tumor grade(Ⅰ~Ⅱgrades vsⅢ~Ⅳgrades,P=0.0086)in ovarian cancer patients. Kaplan-Meier analysis demonstrated that decreased lncRNA GAS5 expression contributed to poor disease-free survival and overall survival.[Conclusion]In conclusion ,our study suggested that decreased lncRNA GAS5 expression may beidentified as a potential poor prognostic biomarker in ovarian cancer.

[Objective]To investigate associations between the functional polymorphisms of signal transducer and activator of transcription 4 (STAT4) gene and preeclampsia.[Methods]PCR-restriction fragment length polymorphism was used to genotype rs10181656 and rs16833431 local polymorphism in 228 preeclampsia cases and 179 normal controls.[Results](1)The frequencies of rs10181656C/G were 35.96%,46.37%in genotype C/C,47.81%,44.69%in genotype C/G and 16.23%,8.94%in genotype G/G between preeclampsia patients and normal controls. They reached statistical difference (P = 0.031). There was different distribution in two alleles(C and G)between preeclampsia patients and normal controls(P=0.009).(2)There was no different distribution in 3 genotypes(C/C,C/T,T/T)and 2 alleles(C and T)of rs16833431 C/T between preeclampsia patients and normal controls(P =0.508,0.461).[Conclusions]Functional polymorphisms of the rs10181656 locus could associate with the preeclampsia. The polymor-phisms of the rs16833431 locus could not associate with the preeclampsia.

Objective To investigate the association between the functional polymorphisms of Foxp3 gene and unexplained recurrent spontaneous abortion (URSA).Methods PCR-restriction fragment length polymorphism (rs3761548,rs2294021 ) and PCR with sequence-specific primers (rs2232365,rs5902434) were used to detect four polymorphisms of Foxp3 in 146 URSA cases and 112 normal controls.Results ( 1 ) The frequencies of rs3761548A/C were 10.3％,22.3％ in genotype C/C,38.4％,40.2％ in genotype A/C and 51.4％,37.5％ in genotype A/A between URSA patients and normal controls; the frequencies of rs2232365A/G were 5.5％,15.2％ in genotype A/A,47.9％,50.0％ in genotype A/G,46.6％,34.8％ in genotype G/G between URSA patients and normal controls; they all reached statistical difference ( P＜0.05 ).The carriers of rs3761548A allele and rs2232365G allele increased the risk of URSA (OR=1.73,1.61 ; all P ＜ 0.05 ).(2) There was no difference in the genotypic distribution of rs5902434del/ArTTpolymorphism between cases and controls ( P =0.10),but the frequency of del allele in URSA was statistically increased than that of controls (71.2％,62.5％ ; OR =1.49,P =0.04 ).(3) There was no different distribution in 3 genotypes (C/C,T/C,T/T) and 2 alleles (T and C) of rs2294021T/C between URSA patients and normal controls (P =0.18 and 0.08 ).(4) Estimated haplotype frequency distribution of rs5902434del/ATT,rs3761548A/C and rs22323565A/G showed haplotype del-A-G conferring the susceptibility to URSA ( OR =2.51,P ＜ 0.01 ) but haplotype del-C-G and ATT-A-A could provide protection on URSA ( OR =0.18,0.22 ; all P ＜ 0.01 ).Conclusion Functional polymorphisms of Foxp3 gene could probably confer the susceptibility to URSA,by altering Foxp3 function and (or) its expression.