Abstract:Advances in reproductive medicine have significantly increased the success of fertility treatments. Nevertheless，a new challenge has emerged：recurrent implantation failure（RIF）. RIF brings mental stress and heavy economic burden to patients. There is no uniform definition of RIF，and it is a complex problem with several variables. The exact prevalence rate of RIF was difficult to de－termine because of the varied definitions used to describe the disease. This paper aims to present the history of RIF and focuses on the application.

Abstract:Objective：To investigate the expression of histidine triad nucleotide binding protein 1（Hint1） gene in the endometrium during early pregnancy in mice and its role in decidualization of endometrial stromal cells. Methods：Immunohistochemistry，in situ hybridization，Western blot，and RT-qPCR were used to measure the expression of Hint1 in the uterus in mouse models of early preg－nancy，pseudopregnancy，and artificially-induced decidualization，and siRNA was used to knockdown the expression of Hint1 in pri－mary endometrial stromal cells. LC-MS was used to analyze the effect of Hint1 on lipidomic profile in stromal cells during decidualiza－tion. Results：The expression of Hint1 gradually increased from day 1 to day 8 of pregnancy，and the expression at implantation sites was significantly higher than that at non-implantation sites. The mice with artificially induced decidualization had significantly higher expression of Hint1 in the endometrium than the control mice without decidualization. The siRNA interference with Hint1 expression significantly affected decidualization and lipid metabolism in endometrial stromal cells. Conclusion：There is an increase in the expression of Hint1 in endometrial stromal cells during decidualization，which may be associated with lipid metabolism in endometrial stromal cells during decidualization.

Abstract:Objective：To investigate the effect of progranulin（PGRN） on placental angiogenesis in mice. Methods：Placenta tissue samples were collected from 10 patients with preeclampsia（PE） who underwent caesarean section in The First Affiliated Hospital of Chongqing Medical University from January to April，2017（PE group） and 12 normal controls（NC group）. PCR and Western blot were used to compare the expression of PGRN in the placenta between the PE group and the NC group. Immunofluorescence assay and immunohistochemistry were used to compare angiogenesis in the embryo on day 6.5 of pregnancy and in the placenta on day 17.5 of pregnancy between PGRN-/- mice and normal mice. HE staining was used to compare the diameter and wall thickness of the uterine artery on day 6.5 of pregnancy between groups. Results：The PE group had significantly higher PGRN expression in placenta than the NC group（1.420±0.255 vs. 0.726±0.192，t=4.118，P=0.001）. On day 6.5 of pregnancy，the PGRN-/- mice had a significantly lower number of embryos than the normal mice（5.333±1.154 vs. 9.333±1.527，t=3.618，P=0.022）. The PGRN-/- mice had significantly lower expression of the vascular marker SMA protein than the normal mice in early pregnancy（25 396.600±2 413.606 vs. 17 484.980±1 606.019，t=4.727，P=0.009）. Compared with the normal mice，the PGRN-/- mice had significant reductions in the diameter of the uterine artery（675.844±147.635 vs. 1 022.234±133.902，t=3.010，P=0.039） and muscular thickness of the uterine artery（10.136±1.634 vs. 18.214±2.899，t=4.204，P=0.013）. On day 17.5 of pregnancy，the PGRN-/- mice had significantly lower expression of the vascular markers SMA，COX2，and Tie2 than the normal mice（SMA：626.467±114.744 vs. 5 288.375±871.319，t=9.188，P=0.001；COX2：828.298±29.192 vs. 1169.734±43.490，t=11.290，P=0.000；Tie2：335.766±125.570 vs. 2 415.752±579.038，t=6.080，P=0.003）. Conclusion：PGRN may play a role in the development of pregnancy-related complications by participating in angio－genesis of the embryo and the placenta.

Abstract:Objective：To investigate the effect and mechanism of action of 2，3，7，8-tetrachlorodibenzo-p-dioxin（TCDD） intrauterine exposure on the reproductive function of male offspring rats. Methods：After mating，pregnant rats were randomly divided into high-dose TCDD group（0.5 μg/kg），low-dose TCDD group（0.1 μg/kg），and solvent control group，with 6 rats in each group. The TCDD groups and the control group were treated with TCDD and corn oil，respectively，by intragastric administration on gestation days 8-14 （GD8-14）. After being delivered naturally，male offspring were measured for anogenital distance（AGD），and testicular organ coeffi－cient was also calculated. Then the quality and quantity of sperm were analyzed by a sperm quality analyzer. In addition，the level of testosterone（T） in the serum of male offspring was determined by enzyme-linked immunosorbent assay，and the expression levels of the apoptosis-related proteins Bax，Bcl2，and caspase-3 were also measured. Results：Compared with the control group，both the low-dose group and high-dose group had a significantly shortened AGD[（1.32±0.01） cm and （1.21±0.02） cm vs. （1.49±0.04） cm，P=0.000]，and these two groups showed significant reductions in sperm count[（63.67±3.44）×106/mL and （45.33±5.47）×106/mL vs. （72.33±4.46）×106/mL] and sperm motility rate[（64.40±3.14）% and （53.87±3.65）% vs. （78.53±1.26）%]. Furthermore，a signifi－cantly increased rate of sperm deformity[（4.83±0.75）% and （8.00±1.10）% vs. （2.17±0.75）%，P=0.000] and a significantly decreased level of testosterone in serum[（2.38±0.08） ng/mL and （2.10±0.09） ng/mL vs. （2.68±0.06） ng/mL，P=0.000] were also observed in these two groups. The testicular weight and testicular organ coefficient in the high-dose group decreased significantly compared with those in the low-dose group（P=0.001 and 0.004，respectively）. With an increase in TCDD dose，the relative expression level of Bax protein increased significantly in testic－ular tissue cells（0.836±0.004 vs. 1.185±0.004 vs. 1.414±0.001，P=0.000），whereas the expression level of Bcl-2 demonstrated an opposite trend（1.368±0.053 vs. 1.108±0.040 vs. 0.751±0.022，P=0.001）. Meanwhile，the high-dose group had a significant reduc－tion in the expression level of pro-caspase-3 and a significant increase in the expression level of cleaved-caspase-3（P=0.000）. Conclusion：Intrauterine exposure to TCDD can induce feminization of male offspring，affect their fertility，and cause reproductive toxicity. The mechanism may be related to cell proliferation-apoptosis imbalance and activation of the mitochondrial pathway of apop－tosis in the testicular tissue cells of these offsprings.

Abstract:Objective：To explore the effects of dihydrotestosterone（DHT） and flutamide（Flu） on the gene expression of Mafb. Methods：Primarily cultured normal foreskin fibroblasts from children were treated with different concentrations of DHT and Flu，and then were tested for the transcription and expression of Mafb using RT-PCR，cellular immunofluorescence，and Western blot. Results：After treatment with DHT at concentrations of 3.0×10-8 mol/L and 3.0×10-6 mol/L，the mRNA expression of Mafb was significantly up-regulated in the DHT 3.0×10-6 mol/L group（0.594±0.045 vs. 0.444±0.007，P=0.005），but not significantly up-regulated in the DHT 3.0×10-8 mol/L group（0.372±0.003 vs. 0.444±0.007，P=0.145），as compared with that in the normal group. After treatment with 15 μmol/L Flu，the mRNA expression of Mafb was significantly reduced compared with that in the normal group（0.221±0.013，P=0.000）. Cellular immunofluorescence assay showed that the expression of Mafb was significantly up-regulated in the DHT 3.0×10-8 mol/L group and the DHT 3.0×10-6 mol/L group（0.046±0.004 and 0.076±0.003，respectively，P=0.010 and 0.000，respectively），but significantly down-regulated in the Flu group（0.006±0.002，P=0.009），as compared with that in the normal control group（0.027±0.006）. Similarly，Western blot results showed that the protein expression of Mafb was not significantly up-regulated in the DHT 3.0×10-8 mol/L group（0.146±0.001，P=0.960），but was significantly up-regulated in the DHT 3.0×10-6 mol/L group（0.598±0.087，P=0.000），while the expression was significantly down-regulated in the Flu group（0.066±0.002，P=0.040），as compared with that in the control group（0.163±0.001）. Conclusion：In the foreskin fibroblasts cultured in vitro，the gene expression of Mafb is regulated by DHT and Flu. Mafb，as a downstream regulatory protein of androgen receptor，may be an important mechanism in the androgen receptor signaling pathway to promote urinary tract development.

Abstract:Objective：To investigate the role of Chemerin in the pathogenesis of polycystic ovarian syndrome（PCOS）. Methods：Hu－man ovarian granulosa cells（COV434） were cultured in vitro. Down-regulation and overexpression of Chemerin were performed in the COV434 cells. Enzyme-linked immunosorbent assay was used to determine the concentrations of inflammatory factors such as interleukin-6（IL-6），interleukin-8（IL-8），and interleukin-10（IL-10），and tumor necrosis factor-α（TNF-α） in the culture medium. The EdU method and flow cytometry were used to measure cell proliferation ability and apoptosis，respectively. Results：Compared with the negative control group（LV3-NC），the down-regulation groups（LV3-shChemerin-1，LV3-shChemerin-2） had significantly lower concentrations of IL-6，IL-8，and TNF-α and a significantly higher concentration of IL-10 in the culture medium（PIL-6=0.006，PIL-8=0.001，PTNF-α=0.012，PIL-10=0.002），significantly lower proliferative capacity of COV434 cells（P=0.004），and signifi－cantly enhanced apoptosis（P=0.000）. Compared with the negative control group（LV5-NC），the overexpression group（LV5-Chemerin） had significantly higher concentrations of IL-6，IL-8，and TNF-α and a significantly lower concentration of IL-10 in the culture medium（PIL-6=0.044，PIL-8=0.008，PTNF-α=0.015，PIL-10=0.004），significantly higher proliferative capacity of COV434 cells（P=0.013），and significantly reduced apoptosis（P=0.030）. Conclusion：Chemerin plays a role in the development and progression of PCOS by promoting inflammatory response，inducing proliferation，and inhibiting apoptosis of ovarian granulosa cells.

Abstract:Objective：To investigate polyethylene glycol citrate-co-N -isopropylacrylamide gelatin（PPCNg）-mediated feasibility and effectiveness of human amniotic mesenchymal stem cells（hAMSCs） in the treatment of intrauterine adhesion（IUA）. Methods：The PKH26-labeled hAMSCs were cultured in different concentrations of PPCNg and were observed for cell status with a fluorescence microscope after 48 hours. CCK-8 assay was used to evaluate the cytotoxicity and material toxicity of PPCNg. The female Sprague-Dawley rats were randomly divided into sham operation group，IUA group（model group），PPCNg-treated IUA group（PPCNg group），hAMSCs-treated IUA group（hAMSCs group），and PPCNg+hAMSCs-treated IUA group（PPCNg+hAMSCs group）；two weeks after IUA modeling，the above five groups except the sham operation group（left untreated） were injected with PBS，PBS-suspended PPCNg，PBS-suspended hAMSCs，and PBS-suspended hAMSCs and PPCNg solution，respectively，in the uterine cavity. Two weeks after the intrauterine injection，paraffin sections of the uterine tissue were treated with HE staining and Masson staining to measure the number of endometrial glands and fibrosis status. Immunohisto－chemistry was used to determine the expression of transforming growth factor-β1（TGF-β1），vascular endothelial growth factor （VEGF），vimentin（VIM），α-smooth muscle actin（α-SMA），cytokeratin 19（CK19），and E-cadherin（E-Ca） in the endometrium. The distribution of hAMSCs in the endometrium was evaluated with a fluorescence microscope using frozen sections. Results：In different concentrations of PPCNg，hAMSCs adherently grew well，and PPCNg was not cytotoxic with its material toxicity classified as grade 1（qualified）. Compared with the sham operation group，the model group had a significantly reduced number of glands and a significantly increased fibrosis area ratio（both P=0.000）. Compared with the model group，the PPCNg group，the hAMSCs group，and the PPCNg+hAMSCs group had different degrees of increase in the number of glands（P=0.000） and different degrees of decrease in the fibrosis area ratio；meanwhile，the three groups had different degrees of decrease in the expression of TGF-β1，VEGF，VIM，and α-SMA（with a significant decrease observed in the PPCNg+hAMSCs group[P=0.000]） and different degrees of increase in the expression of CK19 and E-Ca（with a significant increase observed in the PPCNg+hAMSCs group[P=0.000]）. The PPCNg+hAMSCs group had more PKH26-labeled hAMSCs than the hAMSCs group. Conclusion：PPCNg has no cytotoxicity and can significantly improve the effectiveness of hAMSCs in the treatment of IUA.

Abstract:Objective：To investigate the effect of palmitic acid（PA） on actin cytoskeleton and slit diaphragm injury in podocytes. Methods：Conditioned immortalized mouse glomerular podocyte strains stimulated with PA in vitro were divided into control group （1% BSA） and PA（150 ?滋mol/L） group. Alexa 549-phalloidin staining was used to observe the change of the actin cytoskeleton of the podocyte. Immunofluorescence staining was used to detect the expression of Nephrin and Podocin. The oil red “O”，transmission electron microscope and BODIPY staining were used to detect intracellular lipid accumulation with PA stimulation. The podocytes were stimulated with different concentrations of PA and divided into control group（1% BSA），50 ?滋mol/L PA group，150 ?滋mol/L PA group，and 300 ?滋mol/L PA group. The expression of Nephrin and Podocin was measured by Western blot. The podocytes were further treated with oxygen free radical scavenger N-acetylcysteine（NAC） and divided into control group（1% BSA），PA（150 ?滋mol/L） group，NAC group，PA（150 ?滋mol/L） + NAC group. DCFH-DA staining was used to detect the generation of reactive oxygen species（ROS） in the cells. Alexa 549-phalloidin staining was used to observe the changes of the actin cytoskeleton of the podocyte. Western blot was used to detect the expression of Nephrin and Podocin. Results：Western blot results showed that the expression of Nephrin and Podocin in the podocyte of the 300 ?滋mol/L PA group（0.360±0.030，0.900±0.040），was significantly decreased（P=0.000，P=0.000；P=0.000，P=0.003） compared with those of control group（1.000±0.030，1.000±0.030） and the 50 ?滋mol/L PA group（0.912±0.020，0.900±0.040）. Immunofluores－cence revealed a decrease in the expression of Nephrin（t=6.014，P=0.010） and Podocin（t=6.171，P=0.010） protein in the podocyte of the PA group compared with those of control group. With the pretreatment of podocytes with NAC to clear ROS，expression of Nephrin（2.87±0.05） and Podocin（2.69±0.06） decreased in PA+NAC group（P=0.000，P=0.000），when compared with that of PA group（1.21±0.04，1.30±0.03）. Conclusion：ROS mediated palmitic acid induces cytoskeletal structure injury in podocytes.

Abstract:Objective：To investigate the changes in serum levels of procollagen type Ⅲ（PCⅢ） and N-terminal peptide of PCIII （PII－INP） and their association with renal fibrosis in patients with obstructive nephropathy. Methods：A total of 78 patients with obstruc－tive nephropathy who were treated in our hospital from January 2012 to December 2017 and 30 individuals who underwent physical examination were enrolled. Radioimmunoassay was used to measure the serum levels of PCⅢ and PⅢNP. Renal tissue samples were collected for HE and Masson staining. The degrees of renal fibrosis were observed under a light microscope. The Spearman analysis was used to investigate the association of PCⅢ and PⅢNP with renal fibrosis. A logistic regression model was used to analyze the risk factors for renal fibrosis based on the levels of PCⅢ and PⅢNP. The receiver operating characteristic（ROC） curve was used to predict the sensitivity and specificity of PCⅢ and PⅢNP in the diagnosis of degree Ⅱ renal fibrosis. Results：The levels of PCⅢ and PⅢNP gradually increased with the increase in the degree of renal fibrosis（P<0.01）. The levels of PCⅢ and PⅢNP were positively correlated with the degree of renal fibrosis（rs=0.820 and 0.806，P=0.000 and 0.000）. PCⅢ had a sensitivity of 95.45%，a specificity of 83.93%，and an area under the ROC curve（AUC） of 0.96（95%CI=0.890 to 0.991） in predicting degreeⅡ renal fibrosis；PⅢNP had a sensitivity of 86.36%，a specificity of 92.86%，and an area under the ROC curve（AUC） of 0.93（95%CI=0.849 to 0.976） in pre－dicting degreeⅡ renal fibrosis；both of them had a high predictive value. PCⅢ（OR=1.151，95%CI=1.035 to 1.280，P=0.009） and PⅢNP（OR=1.198，95%CI＝1.039 to 1.380，P=0.013） were risk factors for renal fibrosis. Conclusion：The serum levels of PCⅢ and PⅢNP are positively correlated with the degree of renal fibrosis，and both of them have a good value in predicting severe renal fibrosis and thus hold promise for clinical application.

Abstract:Objective：To investigate the differentially expressed proteins between mouse testicular tissue with ionizing radiation injury and normal testicular tissue using bioinformatics methods and the functions and biological processes of these proteins. Methods：A mouse model of ionizing radiation injury was established. Comparative proteomic methods，isobaric tags for relative and absolute quantitation，and liquid chromatography-tandem mass spectrometry were used to screen out differentially expressed proteins，and then David and Uniport databases were used for gene ontology（GO） and Kyoto Encyclopedia of Genes and Genome（KEGG） enrichment analyses of differentially expressed proteins. Results：A total of 1633 proteins were identified in mouse testicular tissue with ionizing radiation injury and normal testicular tissue，with 128 differentially expressed proteins in total，among which 28 were upregulated and 100 were downregulated. GO analysis showed that the differentially expressed proteins were mainly involved in biological processes such as oxidation-reduction process，spermatogenesis，and ATP metabolism. KEGG analysis showed that these proteins were mainly distributed in 21 signaling pathways including Parkinson’s disease，oxidative phosphorylation，and metabolic pathways，etc. Conclusion：The bioinformatics method is used for data mining of proteins in mouse testicular tissue with ionizing radiation injury and normal testicular tissue，which provides a reference for further research on the mechanism of ionizing radiation in inducing testicular tissue injury and new biomarkers.

Abstract:Objective：To investigate the screening and preliminary validation of potential key genes for the regulation of BeWo cell fusion based on bioinformatics，since syncytiotrophoblasts（STBs） are a type of multinucleated epithelial cells located at the outermost layer of the placenta and are generated by the differentiation and fusion of cytotrophoblasts（CTBs）. STBs play an important role in the secretion of key hormones for pregnancy maintenance and nutrition exchange between mother and fetus during pregnancy. However，the regulatory mechanism of placenta trophoblast cell fusion remains unclear. Methods：The microarray datasets of BeWo cells before and after cell fusion were searched and downloaded from GEO database. A bioinformatics analysis was performed for a comprehensive analysis of all datasets to screen out the differentially expressed genes（DEGs），and then a cluster analysis was performed based on GO and KEGG. The PPI network was used to screen out node genes，and qRT-PCR was used to verify the differential expression of can－didate genes before and after cell fusion. Results：A total of 137 differentially expressed genes were screened out from two datasets，among which 25 were shared by the two datasets and were involved in cell migration，cell adhesion，hormone metabolism，and the MAPK signaling pathway. Three candidate genes were screened out by the PPI network and validated by qRT-PCR，and the results were consistent with the information analysis. Conclusion：This study provides some potential target genes for the research on trophoblast fusion and gives a clue to molecular regulation mechanism.

Abstract:Objective：To examine the relationship between N5，10-methylenetetrahydrofolate reductase（MTHFR） C677T gene poly－morphism and nonneoplastic epithelial disorders of vulva（NNEDV），and its possible mechanism of action. Methods：The clinical data of 60 patients NNEDV confirmed by biopsy（study group） and 46 healthy women（control group） in our hospital between August 2016 to June 2018 were reviewed. MTHFRC677T gene polymorphism was compared between the two groups. In addition，MTHFRC677T gene polymorphism and serum folic acid and serum homocysteine levels were also compared between patients with different histopathologic types of NNEDV. The study group included 21 cases of vulvar lichen simplex chronicus（LSC） and 39 cases of vulvar lichen sclerosus（LS）. Results：The frequencies of the MTHFR 677TT genotype and T allele were significantly increased in the study group（13.3% and 38.3%，respectively） than in the control group（4.3% and 21.7%，respectively）（ χ2=6.851，P=0.033； χ2=6.688，P= 0.010，respectively）. Compared with the control group，LSC patients had significantly increased frequencies of MTHFR 677TT genotype（23.8%） and T allele（45.2%）（ χ2=7.572，P=0.023； χ2=7.717，P=0.005，respectively）. In contrast，there no significant differences in the frequencies of the MTHFR 677TT genotype（7.7%） and T allele（34.6%） between LS patients and controls（both P>0.05）. Com－pared with the CC genotype，the CT（OR=2.386，95%CI=1.046 to 5.443） and TT（OR=5.091，95%CI=0.981 to 26.430） genotypes might increase the risk of NNEDV. In patients with the MTH－FR677CC，CT，and TT genotypes，serum folic acid level signifi－cantly decreased（F=4.386，P=0.018） and serum homocys－teine level significantly increased（F=4.978，P=0.012） as the number of T mutations increased. However，there were no sig－nificant differences in serum folic acid and homocysteine levels between LSC and LS patients（both P>0.05）. Conclusion：Serum folic acid and homocysteine dysmetabolism induced by MTHFRC677T gene mutation may be associated with the development of LSC.

Abstract:Objective：To examine the expression of zinc finger protein Snail and nuclear factor kappa B（NF-κB） in the endometrium of patients with intrauterine adhesions（IUAs）. Methods：Endometrial tissues were collected by hysteroscopy from 34 IUA patients（IUA group） and 19 non-IUA patients（control group）. The mRNA and protein expression levels of NF-κB，Snail，E-cadherin，and Vimentin were determined using real-time quantitative PCR，immunohistochemistry，and Western blot. Results：The IUA group had significantly increased expression of NF-κB（2.478±0.279 vs. 1.459±0.323，P=0.013），Snail（2.801±0.502 vs. 1.218±0.313，P= 0.005），and Vimentin（3.581±0.650 vs. 1.756±0.260，P=0.006），but significantly reduced expression of E-cadherin（1.324±0.617 vs. 2.784±0.647，P=0.023），as compared with the control group. Conclusion：NF-κB and Snail may be involved in the development and progression of IUA.

Abstract:Objective：To investigate the clinical characteristics of asymptomatic hypercholanaemia of pregnancy（AHP），and to compare them with those of intrahepatic cholestasis of pregnancy（ICP）. Methods：The clinical data were collected from 94 women with AHP，257 women with ICP，and 284 normal pregnant women admitted to the First Affiliated Hospital of Chongqing Medical University from July 2015 to April 2018；then the clinical data were analyzed retrospectively. Results：The proportion of women with early-onset（<28 weeks） AHP was significantly higher than that of women with early-onset ICP （44.7% vs. 13.2%，P<0.05）. The incidence rate of ad－verse pregnancy outcome in the AHP group was significantly higher than that in the control group，but was significantly lower than that in the ICP group（28.7%，10.9%，and 50.2%，respectively，P<0.017）. The ICP group with high serum total bile acid（TBA）（≥40 μmol/L） had significantly higher incidence rates of iatrogenic preterm labor，spontaneous preterm birth，amniotic fluid turbidity，fetal distress，and transfer to neonatal intensive care unit（NICU） compared with the ICP group with low TBA（<40 μmol/L）（P<0.05）. There were no significant differences in the incidence rates of adverse pregnancy outcomes between the AHP groups with high and low TBA（P>0.05）. The incidence rates of iatrogenic preterm labor and transfer to NICU were significantly lower in the AHP group with high TBA than in the ICP group with high TBA（P<0.05）；the incidence rate of amniotic fluid turbidity was significantly lower in the AHP group with low TBA than in the ICP group with low TBA（P<0.05）. Conclusion：The clinical characteristics of wom－en with AHP are different from those of women with ICP，which may increase the risk of adverse pregnancy outcome.

Abstract:Objective：To investigate the effect of fast thawing and slow thawing methods on the sperm quality. Methods：A total of 50 semen samples were screened out from the Reproductive Center of Fujian Provincial Maternal and Children’s Hospital，and each sample was aliquoted into two parts and then cryopreserved by the liquid nitrogen vapor method. The two parts of the same semen were divided into two groups based on the methods used for thawing，i.e.，fast thawing or slow thawing，and were observed for the difference in the thawing effect. The thawing effect included sperm kinetic parameters，morphological parameters，sperm DNA fragmentation index（DFI），sperm motility at 1 h，3 h，6 h，and 24 h after thawing when kept at room temperature，and kinetic parameters of sperms after a discontinuous density gradient centrifugation. Results：There were no significant differences between the two groups in the sperm kinetic parameters and percentage of sperms with normal morphology after thawing（P>0.01）. Compared with the slow thaw－ing group，the fasting thawing group had significantly reduced values of the following：sperm DFI，deformity rate of sperm head，body，and tail，teratozoospermia index（ＴＺＩ），and sperm deformity index（SDI）（P<0.01）. There were no significant differences between the two groups in the sperm kinetic parameters at 1 h and 3 h after thawing when kept at room temperature（P>0.01），but the fasting thawing group had significantly improved sperm kinetic parameters at 6 h and 24 h after thawing（P<0.01）. There were no significant differences between the two groups in the sperm density，total motile sperm count，forward sperm motility，and sperm recovery after a discontinuous density gradient centrifugation（P>0.01）. Conclusion：Fast thawing is better than slow thawing for semen cryopreserved by liquid nitrogen vapor due to less damage produced to sperms by the former.

Abstract:Objective：To investigate the features of clinical phenotype and genotype in children with Alport syndrome（AS）. Methods：The clinical and laboratory data，renal biopsy results，and gene detection results of 28 children with AS who were treated in our de－partment from May 2013 to May 2017 were collected，and a retrospective analysis was performed to investigate the features of clinical phenotype and genotype. Results：Of all 28 children，21 had X-linked Alport syndrome（XLAS），1 had autosomal recessive Alport syndrome，4 had autosomal dominant Alport syndrome（ADAS），and 2 had XLAS and ADAS. All 28 children had hematuria as the initial manifestation；2 had hearing impairment，3 had ocular lesions，and 5 had renal dysfunction. Of all children，23 had a positive family history. Renal biopsy was performed for 17 children，among whom only 4 had typical pathological manifestations of AS under an electron microscope；immunofluorescence assay was performed for 16 children，among whom only 5 had absent expression of α3 and α5 chains. A total of 34 mutation sites were found，with 25 missense mutations，4 frameshift mutations，3 shear mutations，2 stop mutations，and 1 large fragment deletion，and 24 mutation sites had not been reported before. Conclusion：XLAS is the most common type of AS and missense mutation is the main type of pathogenic mutation. Hematuria is the most common clinical manifestation，with or without proteinuria，and extrarenal manifestations are rare. Renal biopsy shows minimal change disease in most children with AS，with atypical findings under an electron microscope，which leads to a high rate of missed diagnosis. Gene detection is an important method for the diagnosis of AS.

Abstract:Objective：To investigate the clinical efficacy and safety of holmium laser enucleation of the prostate（HoLEP） in the treat－ment of benign prostatic hyperplasia（BPH） with acute urinary retention（AUR）. Methods：A retrospective analysis was performed in 128 patients with BPH who underwent HoLEP in our hospital from February 2016 to February 2018，including 40（31.25%） patients with AUR（AUR group） and 88（68.75%） patients without AUR（non-AUR group）. According to the number of urinary retention episodes，the AUR group was divided into two subgroups：subgroup A（≤1 time，n=25） and subgroup B（>1 time，n=15）. The basic information，perioperative data，and postoperative follow-up parameters were compared between the AUR group and the non-AUR group and between the subgroup A and the subgroup B. Results：Compared with the non-AUR group，the AUR group had significant－ly higher urinary white blood cell positive rate，urine culture positive rate，prostate-specific antigen level，and International Prostate Symptom Score（IPSS）（P<0.05），a significantly longer operation time（P<0.05），and a significantly lower hemoglobin level（P<0.05）. There were no significant differences in change in hemoglobin level，catheter indwelling time，length of hospital stay，and incidence rate of perioperative complications between the two groups（P>0.05）. After surgery，both groups had significantly decreased post-void－ing residual（PVR），IPSS，and quality of life（QoL） score（P<0.05） and a significantly increased maximum urinary flow rate（Qmax）（P<0.05）. There were no significant differences in perioperative data and IPSS，QoL score，PVR，and Qmax at 6-month follow-up after surgery between the subgroup A and the subgroup B（P>0.05）. Conclusion：HoLEP is safe and effective in the treatment of BPH with AUR. The number of urinary retention episodes has no effect on the surgical outcome.

Abstract:Objective：To investigate the surgical approaches for complete duplex kidney with ureterocele in children and their clinical effect. Methods：A retrospective analysis was performed for the clinical data of 60 children with complete duplex kidney and ureterocele who underwent surgical treatment from January 2012 to July 2018. Among these children，34 underwent duplex kidney removal and ureterectomy due to dysplasia of the upper renal segment；among the 26 children without dysplasia of the upper renal segment，5 had severe vesicoureteral reflux（VUR） or stenosis at the end of the ureter without ureterocele and underwent ureteral reimplantation，and 21 underwent transurethral cystoscopic incision and drainage. Surgical outcome was evaluated by clinical manifestations，degree of hydronephrosis，degree of ureterectasia，ureterocele size，VUR，and reoperation rate. Results：All children were followed up after surgery，with a follow-up time of 1-55 months（mean 11.6 months）. Among the 34 children who underwent duplex kidney removal and ureterectomy，5 experienced postoperative urinary tract infection；2 children underwent cystoscopic incision and drainage again，and among the remaining 32 children，6 still had ureterocele on ultrasound，with a significant reduction in ureterocele diameter after surgery（13.2±4.4 mm vs. 26.3±3.9 mm，P=0.004）. Among the 21 children who underwent transurethral cystoscopic incision and drainage，6 experienced postoperative urinary tract infection；3 children underwent duplex kidney removal and ureterectomy again，1 underwent ureterovesical reimplantation，and the remaining 17 children had a significant reduction in the degree of hy－dronephrosis in the upper renal segment（9.9±8.2 mm vs. 24.9±10.8 mm，P=0.000），among whom 8 children still had ureterec－tasia，with a significant reduction in the degree of ureterectasia after surgery（7.0±2.5 mm vs. 10.0±3.3 mm，P=0.007）. Among the 5 children who underwent ureterovesical reimplantation，1 experi－enced urinary tract infection after surgery，no children underwent surgery again，and there was a significant reduction in the degree of hydronephrosis in the upper renal segment after surgery（10.0±2.9 mm vs. 24.2±6.9 mm，P=0.004）. Conclusion：Transurethral cystoscopic incision，duplex kidney removal and ureterectomy，and ureteral reimplantation can be used as an effective treatment for complete duplex kidney with ureterocele. For patients with dysplasia of the upper renal segment，resection of the upper renal segment and ureterectomy are recommended. For patients with well-developed upper renal segment，ureteral reimplantation is recommended for patients with severe VUR or deformity at the end of ureter，and transurethral cystoscopic incision with little trauma is recom－mended for those without other deformities.

Abstract:Objective：To investigate the clinical features and treatment of ectopic kidney with other urinary malformations in children，and to assess the safety and effectiveness of laparoscopic treatment. Methods：The clinical data of 9 children with ectopic kidney and other urinary malformations treated with laparoscopy from October 2009 to July 2018 in Department of Urology，Children’s Hospital of Chongqing Medical University were retrospectively analyzed. Results：Ectopic kidney often occurred with other urinary malformations in children，including ipsilateral renal dysplasia（6/9），ipsilateral ureteropelvic junction stenosis（3/9），ipsilateral ectopic ureteral orifice（5/9），and urethrovaginal fistula（2/9）. Six children underwent heminephrectomy and nephroureterectomy and 3 children under－went dismembered pyeloplasty by laparoscopy. The operations were successful without conversion to open surgery. All children showed a postoperative improvement in preoperative symptoms and follow-up showed no recurrence of hydronephrosis. Conclusion：Ectopic kidney often occurs with other urinary malformations in children and it is minimally invasive，safe，and effective to treat this disease with laparoscopy.

Abstract:Objective：To investigate the clinical value of international prostatic symptom score-voiding/storage subscore ratio（IPSS-V/S） in assessing lower urinary tract symptoms（LUTS） after transurethral electrovaporization prostatectomy（TUVP）. Methods：A retro－spective analysis was performed for international prostatic symptom score（IPSS） and other clinical data of 234 patients with benign prostatic hyperplasia（BPH） who underwent TUVP from January 2015 to December 2016. According IPSS-V/S，these patients were divided into group A（80 patients with an IPSS-V/S≤1） and group B（154 patients with an IPSS-V/S>1）. IPSS，international prostatic symptom score-voiding（IPSS-V） score，international prostatic symptom score-storage（IPSS-S） score，and quality of life（QOL） score were reassessed at 6 months after surgery. Results：All 234 patients had significant reductions in IPSS and QOL score at 6 months after surgery（t=33.0 and 34.3，both P=0.000）. At 6 months after surgery，group B had a significantly greater improvement in IPSS than group A[（12.36±3.67） points vs. （8.20±3.21） points，t=8.96，P=0.000]. At 6 months after surgery，group A had a significantly higher IPSS-S score than group B[（9.61±2.88） points vs. （5.55±2.63） points，t=10.8，P=0.000]，while there was no significant difference in IPSS-V score between the two groups（t=1.56，P=0.120）. Although group A had a significant improvement in QOL score at 6 months after surgery[（3.59±0.91） points vs. （5.19±0.55） points，t=14.8，P=0.000]，group A had a significantly lower satisfaction rate than group B（13.75% vs. 70.78%）. At 6 months after surgery，group A had varying degrees of improvement in IPSS-S symptom scores，among which the score of urgency of urination showed the highest degree of improvement，followed by the scores of frequency of urination and nocturia；the score of nocturia had the lowest improvement rate of 36.3%（29/80），which was an important reason for the low degree of improvement in IPSS and QOL. Conclusion：Compared with IPSS，IPSS-V/S can reflect the outcome after TUVP more accurately，and voiding symptoms have sig－nificantly greater improvements than storage symptoms in LUTS. BPH/LUTS patients with nocturia as the main complaint have limited improvement in QOL after TUVP，which should be taken seriously by clinicians.

Abstract:Objective：To investigate the effect of GnRHa on intrauterine adhesions and pregnancy outcomes in women of childbearing age with type Ⅱ submucous uterine myoma after electrotomy. Methods：Fifty-eight patients were enrolled in the study who were di－agnosed with type Ⅱ submucosal uterine myoma and underwent hysteroscopic resection in our hospital from May 2015 to May 2017. According to whether GnRHa was used or not before the operation，these patients were divided into GnRHa group（A group） and non-GnRHa group（B group）. In the A group，all 30 cases received hysteroscopic resection after three cycles of GnRHa treatment，while in the B group，all 28 cases received the same surgery without GnRHa treatment. The operation time，intraoperative blood loss，and dis－tention volume were recorded in both groups. Hysteroscopy was performed again one month later to evaluate the condition of uterine cavity and record the occurrence of intrauterine adhesions. Some endometrial tissues were then collected，and immunohistochemistry was used to determine the expression of collagen typeⅠ（Col-Ⅰ），connective tissue growth factor（CTGF），and transforming growth factor-β1（TGF-β1）. The pregnancy outcome was followed up for 6 to 12 months after attempted pregnancy. Results：The mean time of operation in the A group and B group was （40.90±15.09） min and 52.9±13.5 min，respectively，and the mean intraoperative blood loss in both groups was （27.0±14.4） mL and （52.3±17.5） mL，respectively. There were significant differences between these two groups regarding the time of operation and intraoperative blood loss（P<0.05）. The incidence rate of intrauterine adhesions was 6.7%（2/30） in the A group and 7.7%（2/26） in the B group af－ter hysteroscopic resection，showing no significant difference be－tween these two groups（P>0.05）. There were no significant dif－ferences in the expression of Col-Ⅰ，CTGF，and TGF-β1 be－tween the two groups（P>0.05）. All cases were followed up for 6 to 12 months after attempted pregnancy，and the postoperative pregnancy rate was 72% in the A group and 68.2% in the B group，giving no significant difference（P>0.05）. Conclusion：GnRHa pretreatment significantly shortens the time of operation and reduces intraoperative blood loss，but fails to alleviate postoperative in－trauterine adhesions and improve the pregnancy of the patients.

Abstract:Objective：To investigate the risk factors for failure in transvaginal debridement of pregnancy tissue at cesarean scar with or without uterus repair in the treatment of type Ⅱ cesarean scar pregnancy（CSP） using a retrospective analysis，and to provide a refer－ence for clinical treatment. Methods：A total of 98 patients who were diagnosed with type Ⅱ CSP and underwent vaginal surgery in our hospital from April 2016 to March 2018 were enrolled. Among these patients，82 underwent successful transvaginal debridement of pregnancy tissue at cesarean scar and uterus repair，14 underwent transvaginal debridement alone，and 2 were converted to laparoscopy due to surgical difficulties. The former 82 patients were enrolled as successful vaginal surgery group，and the remaining 16 patients were enrolled as treatment failure group. The chi-square test，the t-test，and the rank sum test were used for comparison of the gener－al status between the two groups，and univariate and multivariate logistic regression analyses were used to screen out the high-risk factors for vaginal surgery in the treatment of type Ⅱ CSP. The receiver operating characteristic（ROC） curve was plotted to determine cut-off values. Results：There were no significant differences between the two groups in age，number of days of menopause，number of times of cesarean section，time from the last cesarean section to this pregnancy，diameter of pregnancy sac，preopera－tive HCG，scar thickness，whether methotrexate pretreatment was performed before surgery，and intraoperative bleeding（P>0.05）. There were significant differences between the two groups in the distance from scar to external cervical orifice（3.364±0.802 vs. 4.050±0.701，P<0.05） and length of hospital stay（5.560±1.813 days vs 6.560±1.711 days，P<0.05）. The univariate and multivariate logistic regression analyses showed that distance from scar to external cervical orifice was a high-risk factor for failure in vaginal surgery for the treatment of type Ⅱ CSP（univariate：odds ratio[OR]=0.289，95% confidence interval[CI]：0.126-0.659，P=0.003；multivariate：OR=0.177，95%CI＝0.051 to 0.611，P=0.006）. The ROC curve showed that distance from scar to external cervical orifice had a sensitivity of 87.3%，a specificity of 50.0%，and an accuracy of 73.7% at the optimal cut-off value of 4.25 cm. Conclusion：Vaginal surgery is a relatively safe method for the treatment of type Ⅱ CSP，and patients suitable for this method should be selected. When the distance from scar to external cervical orifice is greater than 4.25 cm，patients should be fully informed of risks before surgery，and preparations for laparoscopy or interventional therapy should be made，or other treatment methods should be adopted.

Abstract:Objective：To investigate the clinical features，diagnosis，and treatment of patients with severe pelvic infection referred to our hospital from other hospitals. Methods：A retrospective analysis was performed for the clinical data of 9 patients with severe pelvic infection during the postpartum period who were admitted to the First Affiliated Hospital of Army Medical University from January 2010 to October 2017. Results：Of all patients，6 gave birth in a secondary hospital and 3 gave birth in a local health center；3 adopted vaginal delivery，and 6 underwent cesarean section. Among the 6 patients who underwent cesarean section，2 underwent elective cesarean section（among whom 1 had scarred uterus and 1 underwent cesarean section due to social factors） and 4 were converted to cesarean section due to failed vaginal delivery. All 9 patients had severe fever after delivery，with a body temperature of 38.9 ℃-41 ℃；of all patients，7 had lower abdominal pain and 2 had no obvious abdominal pain；4 patients had intestinal obstruction after cesarean section. One patient died of the rupture of infectious thoracic aortic aneurysm on day 11 after cesarean section，and the other 8 patients were cured and discharged after intravenous anti-infective therapy，drainage，or removal of the foci of infection. Conclusions：Induction of labor in midtrimester pregnancy and cesarean section without indications are not recommended. The role of drainage during and after surgery should be taken seriously in patients who undergo cesarean section and are suspected of infection. Increased body temperature after delivery，lower abdominal pain，and intestinal obstruction symptoms may be early symptoms of severe pelvic infection，and surgical treatment should be given if conservative treatment with antibiotics achieves no response.

Abstract:Objective：To evaluate the value of magnetic resonance imaging（MRI） in the diagnosis of occult cervical cancer. Methods：Six menopausal patients with advanced cervical cancer were enrolled；they had a history of bleeding after sexual intercourse or vagi－nal bleeding and were highly suspected of having invasive cervical cancer，but no pathological evidence of invasive cancer was found in multiple conventional three-step examinations（i.e.，cytology，colposcopy，and cervical biopsy） of cervical cancer. Abdominopelvic MRI revealed definitive lesions of invasive cervical cancer，which was pathologically confirmed after the operation. Results：Definitive cervical cancer was recognized in the MRI results of all these six patients，with clear contrast observed between cancer and cervical stroma，endometrium，and parametrial fat tissue. The coincidence rate of tumor size between MRI results and postoperative measure－ments was 88.5%[（2.370±1.109） cm vs. （2.250±1.084） cm，P>0.05]. Conclusion：Given the price of the examination，MRI has not been included as a routine examination in the diagnosis of cervical cancer. Nevertheless，for those with highly suspected cervical cancer who have experienced known symptoms such as postmenopausal vaginal bleeding and have no pathological evidence in con－ventional three-step examinations，auxiliary MRI can visually and accurately reveal the size and invasion range of cervical cancer，which will contribute to making a definitive diagnosis and formulating an appropriate treatment strategy.