Highlights of human uterus transplantation / 器官移植

As a novel solid organ transplantation, uterus transplantation has become an important approach for women with uterine infertility to obtain biological offspring. Multiple technological challenges exist in uterus transplantation, such as acquisition of vascular pedicle, organ perfusion and vascular suture, etc. However, with the development and application of uterus transplantation in animal model and transplantation in human cadavers, a lot of problems have become new hot topics of discussion, such as the selection of uterus transplantation donors and recipients, selection of uterine vessels, prevention and treatment of complications after uterus transplantation, evaluation of graft vitality, timing of pregnancy and delivery, timing of hysterectomy, mental health of donors and recipients and offspring health, etc. According to current data and outcomes of human uterus transplantation worldwide, these hot topics were reviewed in this article, aiming to provide reference for promoting the development and progress of human uterus transplantation research in China.

Oncologic outcomes of early stage cervical cancer performed operation by different laparoscopic surgical procedures: analysis of clinical data from mutiple centers / 中华妇产科杂志

Objective:To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy.Methods:From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study.Results:There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （ P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （ P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （ P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （ P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively ( P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions:The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.

Drug therapy and mechanism of pain in mice with induced adenomyosis / 中国实验动物学报

Objective To investigate the effects of different drugs and to explore the mechanism of pain in mice with adenomyosis ( ADM) .Methods The mouse model of adenomyosis was induced by oral administration of tamoxifen. The vaginal smear was examined by cytology, and serum levels of 5-HT, GnRH-R, NGF and NF were determined.Results Higher level of 5-HT was detected in the controls compared with the models.The expression of GnRH-R and NGF in nor-mal endometrium and eutopic endometrium were significantly lower than those in ectopic endometrium.The expression on NF in normal endometrium was significantly lower than that in the eutopic and ectopic endometria.Conclusions Similar with regular dose of GnRH-a, half dose of GnRH-a can slow down the progress of ADM as well as reducing pain.Combina-tion of regular dose of GnRH-a and Diane-35 could consolidate the therapeutic effect and even achieve pathological cure.5-HT may take an active part in the mechanism of pain in ADM.