[Relationship between vitamin D receptor gene polymorphism and preterm birth].

OBJECTIVE: To explore the relationship between vitamin D receptor (VDR) gene pol-ymorphisms at Fok I site and the risk of preterm birth for potential intervention of of preterm birth or threatened premature delivery. METHODS: Fifty-seven women with preterm birth and 84 with full-term birth were included in this analysis. Polymerase chain reaction-restriction frag-ment length polymorphism (PCR-RFLP) was performed to identify VDR gene Fok I geno-types. RESULTS: No significant difference was found in age, D-dimer (DDI), fibrinogen (Fg), serum calcium (Ca2+), leukocyte count or glycosylated hemoglobin (HbA1c) level between the women in the preterm and full-term birth groups (P>0.05). The two groups differed signifi-cantly in the distribution of VDR gene Fok I site genotypes and allele frequency of F/F (P<0.05).The frequency of FF genotype was significantly higher in the preterm group than in the full-term group. Compared with Ff and ff genotypes, FF genotype was associated with an in-creased risk of preterm delivery (χ2=9.701, P=9.701, OR=3.320, 95% CI [1.560, 7.066]). In the preterm group, the maternal age, DDI, Fg, serum Ca2+, leukocyte count or HbA1c did not differ significantly between the genotypes (P>0.05). CONCLUSION: VDR gene Fok I site geno-types are related with preterm birth, and the FF genotype may serve as a potential risk factor for preterm birth.

Risk factors for adverse fetal outcomes among women with early- versus late-onset intrahepatic cholestasis of pregnancy.

OBJECTIVE: To determine risk factors for adverse fetal outcomes (AFOs) among women with intrahepatic cholestasis of pregnancy (ICP) on the basis of time of onset. METHODS: In a retrospective analysis, data were obtained for all women with ICP admitted to two centers in Guangzhou, China, between February 1, 1993, and January 31, 2014. Patients were divided into group A (early-onset ICP) and group B (late-onset ICP), and were further divided on the basis of severity. The frequency of AFOs was assessed. RESULTS: Among 371 eligible women, 57 (15.4%) were in group A and 314 (84.6%) in group B. AFOs affected 20 (35.1%) women in group A and 67 (21.3%) in group B (P=0.024), and 12 (54.5%) of 22 women in group A and 21 (29.6%) of 71 in group B with severe ICP (P=0.032). Independent risk factors for AFO in group A were increased levels of serum bile acid (P=0.016) and alkaline phosphatase (P=0.004). Independent risk factors in group B were increased levels of alkaline phosphatase (P<0.001) and gamma-glutamyl transpeptidase (P=0.001). CONCLUSION: Early-onset ICP is associated with a higher frequency of AFO than is late-onset ICP, especially in severe disease. The risk factors differ between early-onset and late-onset ICP.

[Expression of hypoxia-inducible factor-1alpha in endometriosis].

OBJECTIVE: To detect the expression of hypoxia-inducible factor-1alpha(HIF-1alpha) in endometriosis and explore the possible role of HIF-1alpha in the pathogenesis of endometriosis. METHODS: Immunohistochemistry was performed to examine the expression of HIF-1alpha in 20 normal endometrium, 20 ectopic endometrium and 68 eutopic endometrium specimens from 68 endometriosis patients, and the results were analyzed statistically. RESULTS: The expression of HIF-1alpha was significantly increased in ectopic endometrium than in normal endometrium (P<0.01), and the expression did not undergo changes with the normal menstrual cycle in the three types of endometrium. CONCLUSION: HIF-1alpha expression increases in ectopic endometrium, suggesting that HIF-1alpha plays an important role in the pathogenesis of endometriosis.

[Clinical analysis of radical hysterectomy plus pelvic lymphadenectomy for patients with malignant uterine tumors: laparoscopy versus laparotomy].

OBJECTIVE: To compare clinical efficacy of laparoscopy with laparotomy in radical hysterectomy plus pelvic lymphadenectomy for patients with malignant uterine tumors. METHODS: This retrospective study population included two groups: (1) 26 patients underwent laparoscopy-assisted radical hysterectomy plus pelvic lymphadenectomy (group laparoscopy) and (2) 27 patients were treated with radical hysterectomy plus pelvic lymphadenectomy through laparotomy (group laparotomy). The tumor stage in these two groups of patients was matched. Multiple clinical parameters were observed and analyzed statistically. RESULTS: Compared to the patients in group laparotomy, the patients in group laparoscopy had a longer operative time (310 vs 238 min), more pelvic lymph nodes removed (22 vs 16), lower volume of blood loss (756 vs 1129 ml), and transfusion (321 vs 746 ml), a shorter postoperative gastrointestinal function recovery time (37 vs 62 h), a quicker return to normal temperature (5 vs 8 d), and a shorter period to use antibiotics (6 vs 8 d) (P < 0.01) However, there were no significant differences in the volume of pelvic drainage (321 vs 216 ml), urination recovery time (13 vs 10 d), number of WBC found (11 x 10(9)/L vs 10 x 10(9)/L), hospital stay (26 vs 28 d) and cost (25 986 vs 22 672 Yuan) between the two groups (P > 0.05). CONCLUSION: The clinical efficacy of radical hysterectomy plus pelvic lymphadenectomy by laparoscopy for patients with malignant uterine tumor is equal to that through laparotomy.

[Laparoscopic radical hysterectomy and pelvic lymphadenectomy: analysis of 14 cases].

OBJECTIVE: To evaluate the feasibility and safety of surgical removal of the tumors through laparoscopy in patients with early-stage uterine cancer. METHODS: A retrospective analysis of the clinical data of 10 cervical cancer and 4 endometrial cancer cases, in which laparoscopic radical hysterectomy and pelvic lymphadenectomy were performed following the same surgical procedures as in laparotomy. RESULTS: The mean operating time was 302 min, and mean estimated blood loss was 760 ml, with the mean postoperative gastrointestinal recovery time of 30 h and average number of removed lymph nodes of 22. CONCLUSION: Laparoscopic surgery has equivalent curative effect to laparotomy, and laparoscopic radical hysterectomy and pelvic lymphadenectomy in the patients with early-stage uterine cancer is both feasible and efficient.

[Establishment of a new rat model of intrauterine growth retardation].

OBJECTIVE: To establish intrauterine growth retardation (IUGR) models in rats for study of the etiology, pathology and therapy of this disease. METHOD: Partial ligation of the medial segment of the uterine artery and vein was performed in 10 Sprague-Dawley rats with pregnancy (17 d) to establish IUGR models, and another 9 rats with pregnancy of the same length which did not receive the operation were used as control. On day 21 of pregnancy, the fetuses and placentas in both groups were surgically taken and weighted, and the incidence of IUGR and mortality in the fetus were observed. RESULTS: Significant decrease in the average weight of the fetuses (3.32+/-0.54 g) and placentas (0.38+/-0.05 g) occurred in the ligated group as compared with those of the control group (4.55+/-0.76 g and 0.44+/-0.11 g, P<0.005). An incidence of IUGR as high as 33.33% was resulted in the fetus of ligation group, significantly higher than that in the control group (1.14%, P<0.005), but no significant difference was observed in the mortality between the 2 groups (4.94% vs 3.41%, P>0.05). CONCLUSION: IUGR models can be successfully established in SD rats by partial ligation of the medial segment of the uterine artery and vein.