Maternal Serum Angiogenic Factor sFlt-1 to PlGF Ratio in Preeclampsia: A Useful Marker for Differential Diagnosis and Prognosis Evaluation in Chinese Women.

The ratio of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) is elevated and proved to be useful in preeclampsia (PE) diagnosis. Its value in differential diagnosis with other pregnancy complications and prediction of pregnancy duration has yet to be clarified in Chinese population. We retrospectively analyzed 118 singleton pregnancies with suspected or diagnosed PE at the Peking Union Medical College Hospital (PUMCH) in China. Among these, 62 pregnancies were diagnosed as PE (48 early onsets and 14 late onsets, with 39 and 5 severe PE, respectively), 12 gestational hypertension (GH), 15 chronic hypertension (chrHTN), 16 autoimmune diseases, and 13 pregnancies with uncomplicated proteinuria. And 76 normal pregnancies were included as control. The results showed (1) the sFlt-1/PlGF ratio in early onset PE subgroup was significantly higher than that in GH, chrHTN, and control groups; the sFlt-1/PlGF ratio in late onset PE subgroup was significantly higher than that in chrHTN and control groups, but similar as GH group; the sFlt-1/PlGF ratio was similar among GH, chrHTN, and control groups. (2) The sFlt-1/PlGF ratio was significantly increased in the PE group compared with autoimmune disease and uncomplicated proteinuria pregnancies. (3) By ROC curve analysis, the cutoff value of the sFlt-1/PlGF ratio was less than 21.5 to rule out PE and higher than 97.2 to confirm the diagnosis of PE. (4) The sFlt-1/PlGF ratio was higher in PE pregnancies delivering within 7 days than those more than 7 days, either in early onset PE or severe PE. In conclusion, we show that maternal sFlt-1/PlGF ratio is an efficient biomarker in the diagnosis and differential diagnosis of PE. This ratio can be used to predict the timing of delivery for PE pregnancies.

[Clinical features of recurrence of vulvar squamous cell carcinoma: analysis of 18 cases].

OBJECTIVE: To analyze the clinical characteristics of recurrence of vulvar squamous cell cancer and to explore the treatment thereof. METHODS: The clinical data of 18 patients vulvar squamous cell cancer, confirmed at the age 28-76, who developed recurrence were retrospectively analyzed. RESULTS: The overall recurrence rate was 21.3%. The time range between the primary operation and the discovery of primary recurrence was 2 months - 16 years. Local recurrence occurred in 11 of the 18 patients (61.1%). Recurrence in groin alone occurred in 4 of the 10 patients (22.2%) and recurrence in both the vulva and groin occurred in 3 of the 18 patients (16.7%). Local recurrence occurred more than 1 year after the primary treatment and inguinal recurrence occurred mostly within 1 year after the primary treatment. The survival time of the patients with vulvar recurrence was (63.2 +/- 8.1) months, significantly longer than that of the patients with groin recurrence [(10.7 +/- 1.6) months, P < 0.01]. CONCLUSION: The clinical characteristics and the prognosis of recurrent vulvar squamous cell cancer depend on the site of recurrence. The best treatment option for recurrence is surgery.

[Recurrent mature ovarian teratomas: retrospective analysis of 20 cases].

OBJECTIVE: To investigate the clinical characteristics and the rule of recurrence of mature ovarian teratoma. METHODS: The clinical data of 20 patients with recurrent mature ovarian teratoma treated 1965 approximately 2002 was analyzed retrospectively and compared with the data of 40 patients without recurrence who were randomly selected at the ratio of 1 patient with recurrence to 2 patients without recurrence and who underwent surgical treatment in the same operation dates as the corresponding patients with recurrence. RESULTS: The overall recurrence rate after The patients with recurrence was (26 +/- 7) years old on average at the onset of recurrence, significantly younger than those without recurrence [(30 +/- 6 yearly old, P < 0.05). There were no significant differences in gravidity, parity, and the cyst size, manner of surgery, and rupture during operation between the 2 groups (all P > 0.05). The incidence rates of bilateral or multilocular cysts in the patients with recurrence were significantly higher than those of the patients without recurrence (P < 0.05 or P < 0.01). The overall recurrence rate after conservative treatment was 2.5%. The mean period of recurrence was 8 +/- 7 years. CONCLUSION: Younger patients and patients bilateral or multiple dermoid cysts should be followed up closely. Laparoscopy is the best treatment choice for mature ovarian teratoma. Biopsy of the contralateral ovary is not recommended regularly in surgery.

[Study on posterior intra-vaginal slingplasty for pelvic floor reconstruction].

OBJECTIVE: To study the efficacy and safety of posterior intra-vaginal slingplasty (IVS) in the re-construction surgery of pelvic floor. METHODS: Eleven patients with vault prolapse and severe prolapse of uterus undergoing posterior IVS were prospectively studied. RESULTS: Average operation time was 55 min. Average blood loss was 86 ml. Average hospitalization time was 5.6 d. No severe complications occurred. According to subjective assessment of the outcome, all patients were cured. CONCLUSION: Posterior IVS is a minimally invasive, effective and safety surgery for re-construction of pelvic floor.