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Objective:To explore the status of microsatellite instability (MSI) and its relationship with clinicopathological characteristics of patients with endometrial carcinoma.Methods:The clinical data of 365 patients with endometrial carcinoma who received surgery in Shanxi Province Cancer Hospital between January 2020 and December 2021 were retrospectively analyzed. Immunohistochemistry was used to detect the expressions of 4 DNA mismatch repair (MMR) proteins (MLH1, MSH2, MHS6, and PMS2), estrogen receptor (ER), progesterone receptor (PR), and p53 mutant protein in postoperative cancer tissue samples from 365 patients with endometrial carcinoma. All patients were divided into MSI group (1 or more non-expression of MMR protein) and microsatellite stability (MSS) group (4 proteins were all expressed), and the clinicopathological characteristics of patients in both groups were compared. φ efficient was used to analyze the correlation of MSI with ER, PR, p53 mutant protein expressions. Results:There were 72 cases (19.7%) in MSI group and 293 cases (80.3%) in MSS group; and the age of all patients was (53±19) years (21-83 years). There were statistically significant differences in the proportion of MSI patients in endometrial carcinoma patients with different age [>50 years vs. ≤50 years: 22.1% (61/276) vs. 12.4% (11/89)], tumor diameter [≤2 cm vs. > 2 cm: 25.9% (30/116) vs. 16.8% (42/249)], International Federation of Gynecology and Obstetrics (FIGO) staging [stage Ⅲ-Ⅳ vs. stage Ⅰ-Ⅱ: 31.1% (14/45) vs. 18.1% (58/320)], histological type [type Ⅰ vs. type Ⅱ: 21.7% (71/327) vs. 2.6% (1/38)] (all P < 0.05). There were no statistically significant differences in the proportion of MSI patients with different depth of invasion, degree of differentiation, lymph node metastasis, vascular involvement, and lesion location (all P > 0.05). Among 327 cases of type Ⅰendometrial carcinoma, 1 case was mucinous adenocarcinoma (MSS status), and the other 326 cases were endometrioid adenocarcinoma. Of the 72 patients with MSI, 71 cases were endometrioid carcinoma and the other was 1 of 3 mixed carcinomas in type Ⅱ endometrial carcinoma. There was a negative correlation between MSI and mutant p53 ( φ coefficient was -0.11, P = 0.031), and φ coefficient of the correlation of MSI with ER and PR was -0.03 and -0.06, while there were no statistically significant differences ( P value was 0.578 and 0.255, respectively). Conclusions:Endometrioid adenocarcinoma is the main type of endometrial cancer patients with MSI. MSI in endometrial cancer is correlated with age, FIGO staging, tumor diameter and histological type of patients, while negatively correlated with mutant p53.
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Objective:To investigate the expression levels of peripheral blood lymphocytes in patients with high-grade squamous intraepithelial lesions (HSIL) of the cervix and early cervical cancer, and to analyze their correlation with the clinicopathological characteristics of cervical cancer.Methods:The clinical data of 65 patients with HSIL and 78 patients with early cervical cancer (2018 International Federation of Gynecology and Obstetrics stage ≤ stage Ⅱ A) treated in Shanxi Province Cancer Hospital from October 2020 to November 2021 were retrospectively analyzed, and 31 healthy people undergoing physical examination during the same period were treated as the healthy control group. The expressions of CD3 + T cells, CD4 + T cells, CD8 + T cells, NK cells, NK/T cells and other immune cells in fasting peripheral blood of the patients were detected by using flow cytometry. Results:The expression levels of CD3 + T cells, CD4 + T cells, CD4 +/CD8 + and NK cells were 71±8, 39±7, 1.5±0.5, 16±7, respectively in HSIL group, and 73±9, 41±9, 1.5±0.6, 16±9, respectively in early cervical cancer group, which were lower than those in the healthy control group (76±9, 45±10, 2.0±1.3, 20±7) (all P < 0.05). The expression levels of CD8 + T cells was 28±7, 29±8, respectively in HSIL group and early cervical cancer group, which were higher than those in the healthy control group (24±7) (all P < 0.05). The expression level of total B cells in early cervical cancer group was lower than that in healthy control group (10±4 vs.12±3, P < 0.05). The expression level of CD3 + T cells in peripheral blood of early cervical cancer patients with tumor diameter >4 cm and nerve/vascular invasion was 71±10 and 72±8, which was lower than that of patients with tumor diameter 2-4 cm, ≤2 cm and without nerve/vascular invasion (72±8, 75±8, 78±7); the expression level of CD8 + T cell was 32±8 and 35±4, which was higher than that of patients with tumor diameter 2-4 cm, ≤2 cm, and without nerve/vascular invasion (28±8, 28±7, 29±8) (all P < 0.05). The levels of CD3 + T cells and total B cells were negatively correlated with the tumor diameter (all P < 0.05), while the level of CD8 + T cells was positively correlated with tumor diameter ( P < 0.05); the levels of CD3 + T cells and NK cells were negatively correlated with nerve/vascular invasion (all P < 0.05). Conclusions:The immune function of the body starts to change in the early progression of cervical cancer, and is related to the tumor diameter and nerve/vascular invasion of cervical cancer.
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ObjectiveTo evaluate the efficacy and influencing factors of Biejiajianwan in the treatment of primary liver cancer based on real-world data of traditional Chinese medicine （TCM）. MethodClinical diagnosis and treatment data of patients with primary liver cancer admitted to five Grade-A tertiary hospitals in Henan Province from January 2015 to December 2020 were collected from the medical electronic database. The patients treated with Biejiajianwan for ≥30 days were assigned to the exposure group and those without treatment with Biejiajianwan or treated with Biejiajianwan for <30 days to the non-exposure group. The propensity score matching model was used to balance confounding factors between the two groups according to the 1∶1 genetic matching method. Kaplan-Meier method was used for survival analysis and survival curve plotting. Log-rank was used to test the difference in survival rate between the two groups. Univariate analysis of Biejiajianwan in the treatment of primary liver cancer was performed by Log-rank test combined with the Kaplan-Meier method. The factors with statistical significance （P<0.05） were combined with unbalanced factors by the propensity score matching model， and at the same time， clinical common sense and relevant prognostic factors by literature search were considered， which were subjected to multivariate analysis by Cox proportional hazards regression model. ResultA total of 2 207 electronic cases were collected，including 174 cases in the exposure group （Biejiajianwan group） and 2 033 cases in the non-exposure group. After propensity score matching， there were 174 cases in the exposure group and 174 cases in the non-exposure group. The Kaplan-Meier method was used for survival analysis on the matched data， and the Log-rank test results showed that the survival rate of patients with primary liver cancer in the Biejiajianwan group was higher than that in the control group （χ2=12.193， P<0.01）. Cox proportional hazards regression model analysis showed that the regression coefficient of Biejiajianwan was -0.916 4 with the hazard ratio （HR） ［95% confidence interval （CI）］=0.4 （0.239 5-0.668 0）， P<0.01， and the regression coefficient of radiofrequency ablation treatment was -0.976 5 with HR （95% CI）=0.376 6 （0.172 8-0.821 1， P<0.05）. Fibrinogen （FIB） abnormal regression coefficient was 0.481 4 with HR （95% CI）=1.618 4（1.022 0-2.562 9），P<0.05. ConclusionBiejiajianwan can prolong the survival period of patients with primary liver cancer. Radiofrequency ablation is an independent protective factor for Biejiajianwan in the treatment of primary liver cancer，while abnormal FIB are independent risk factors for Biejiajianwan in the treatment of primary liver cancer.
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Objective:To investigate the apoptosis-inducing effect of baohuoside I (BI) on endometrial cancer Ishikawa cells and its related molecular mechanism.Methods:With 0 μ M and 0 h treatment were used as blank control group, and BI treatment was used as experimental group. The inhibitory effect of BI on the proliferation of Ishikawa cells was detected by CCK-8 assay. The apoptosis-inducing effect of BI on Ishikawa cells and the changes of mitochondrial membrane potential were detected by flow cytometry. The expressions of apoptosis-related proteins and signaling pathway-related proteins were detected by Western blot.Results:CCK-8 experiment showed that BI could be expressed in concentration gradient (3, 10, 20, 30, 40 μM). It could effectively inhibit the proliferation of Ishikawa cells (the survival rates were 89.56±0.96, 74.69±1.21, 60.28±1.09 and 43.51±2.17 respectively). Its toxic and side effects on normal cells were lower than that of 5-FU. The results of flow cytometry showed that BI could effectively induce the apoptosis of Ishikawa cells by reducing the level of mitochondrial membrane potential. The proportion of apoptotic cells in each group was (9.92±0.77) %, (14.01±0.83) %, (17.05±1.41) %, (28.21±1.73) % and (44.55±3.11) %. Western blot showed that BI could up-regulate the level of p-p38 and reduce the level of p-STAT3.Conclusions:BI can effectively inhibit the proliferation of Ishikawa cells, and induce apoptosis by reducing the mitochondrial membrane potential and activating the mitochondria-dependent pathway. Its regulatory mechanism is achieved by activating the p38 signaling pathway and inhibiting the STAT3 pathway.
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Objective@#To explore determinants of childhood trauma among college students with left-behind experience, and to provide a reference for effective intervention among students with left-behind experience.@*Methods@#A total of 2 468 students selected from 5 universities and 2 higher vocational colleges in tianjin by stratified cluster sampling method were investigated by self-compiled questionnaire and childhood trauma questionnaire.@*Results@#The scores in emotional abuse, sexual abuse, emotional neglect, physical neglect and childhood trauma of students with left-behind experience were significantly higher than those without left-behind experience(t=3.01，3.13，3.24，2.27，3.60，P<0.05)；parental separation times and the frequency of parental return had significant interaction effect on the total score of childhood trauma of students with left-behind experience (F=2.37, P<0.05)；the gender had a significant major effect on the total score of childhood trauma of students with left-behind experience under the interaction with the place of origin, age at first separation,the cumulative time of leftbehind experiences and the frequency of parents contacting (F=4.49，5.23，5.93，5.11，P<0.05)；the age of subjects when parents going out under the interaction with the place of origin, the gender, if only-child,parental separation times and the frequency of parental return；as well as the frequency of parents contacting under the interaction with the place of origin，the household registration, the gender, if only-child and the cumulative time of left-behind experiences also had significantly main effect(F=3.88，4.25，3.32，2.86，3.45；3.82，4.02，2.64，3.29，P<0.05).@*Conclusion@#It is necessary to attach great importance to demographic and context information regarding left-behind experiences,which lead to more specific and effective prevention and intervention strategy for individual with left-behind experiences.
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Objective To evaluate the clinical significance of expression of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase kinase 3 (MEKK3) in the early-stage cervical cancer. Methods Seventy-one patients with cervical intraepithelial neoplasia (CIN) and 92 patients with early-stage cervical cancer who underwent surgery in Shanxi Provincial Cancer Hospital from March to October 2010 were enrolled. In the same period, 30 normal cervical specimens from hysterectomy due to uterine fibroids were collected as normal controls. The expression of MEKK3 in all specimens was detected by immunohistochemistry and its clinical significance was analyzed. Theχ2 test was performed on the comparison of count data. Results The positive expression rate of MEKK3 was 13.33％ (4/30) in the normal control group, 28.57％(6/21) in the CINⅠgroup, 38.89％(7/18) in the CINⅡgroup, 56.25％(18/32) in the CIN Ⅲgroup and 70.65％(65/92) in the early-stage cervical cancer group. The differences of positive expression rates of MEKK3 in the normal control group, CIN group and early-stage cervical cancer group had statistical significance (χ2=36.870, P<0.05). Compared with the normal control group, the positive rates of MEKK3 in the CINⅢ group and early-stage cervical cancer group increased significantly (χ2 values were 12.458 and 30.251, both P<0.005). The positive rate of MEKK3 in the early-stage cervical cancer group was higher than that in the CIN Ⅰ group (χ2=12.964, P<0.005). The expression of MEKK3 in early-stage cervical cancer were related to histopathological differentiation and lymphatic metastasis (χ2 values were 6.832 and 4.404, both P< 0.05) rather than age, International Federation of Gynecology and Obstetrics (FIGO) stage, histopathological type, tumor diameter and infiltration depth (all P>0.05). Conclusion MEKK3 plays a role in the occurrence, development and prognosis of early-stage cervical cancer, and the detection of MEKK3 may help to assess the degree of early-stage cervical cancer.
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Objective To analyze the application of the HR -HPV,TCT combined with digital colposcopy cervical biopsy in diagnosis of CIN and cervical carcinoma.Methods From 2014 to 2016,250 cases diagnosed as ASCUS and above the level of disease were selected in Shanxi Cancer Hospital ,including 148 cases of ASCUS,68 cases of LSIL,27 cases of HSIL and 7 cases of SCC.The HR-HPV copy number was detected by using PCR fluorescence measurement,the Reid colposcopy scores were measured by using digital colposcopy ,and the cervical histopathological diagnosis was regarded as a measurement rule.Results The diagnostic rate of simple use of TCT for the diagnosis of CIN and above lesions was 41.20%(103/250), HR -HPV & TCT in diagnosis of CIN and above lesions was 58.78%(77/131),TCT & digital colposcopy for the diagnosis of CIN and above lesions was 67.42%(89/132), which were significantly increased (χ2＝35.87,P＝0.00;χ2＝59.01,P＝0.00).The diagnostic rate of HR-HPV&TCT combined with electronic colposcopy in diagnosis of lesions above CIN was 79.82%( 91/114 ), which was significantly higher than that of HR -HPV & TCT[58.78%(77/131)],and the diagnostic rate of TCT & digital colposcopy was 67.42%(89/132)(χ2＝15.54,P＝0.01;χ2＝8.05,P＝0.02).The incidence of CIN and cervical cancer were closely related with HR -HPV infection and the rate of HR-HPV infection showed an increasing trend with the aggravating degree of disease (the HR-HPV infection rate of ASCUS was 39.86%,the HR-HPV infection rate of LSIL was 61.76%,the HR-HPV infection rate of HSIL was 88.89%,while the HR-HPV infection rate of SCC was 100.00%).Conclusion HR-HPV,TCT combined with digital colposcopy can effectively improve the diagnosis rate of CIN and above the level of disease.At the same time,with the deterioration of the disease ,HR-HPV infection rate increases significantly ,which can provide diagnostic information and significance in the clinical diagnosis of CIN and cervical cancer.
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Nine female patients underwent resection of the middle and distal urethra and the urethra was reconstructed with labia majora fasciocutaneous flap.During the operation the bilateral inner side partial flap of labia majora was taken,and penetrated through the tunnel under the labia minora to the urethral incision,then the flap was sutured as tube-shaped and anastomosed with the urethral incision to reconstruct the urethra.Patients were followed-up for up to 11 years,all patients had normal urination,except 1 patient with adenocarcinoma who developed urinary incontinence 1 month after operation and recovered by pelvic floor muscle training.The application of labia majora fasciocutaneous flap is a safe and effective procedure with less trauma and fewer complications in reconstruction of female middle and distal urethra.
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Objective To investigate the variance and significance of Th1/Th2 type cytokines in plasma of ovarian cancer patients. Methods The levels of IL-2, IFN-?, TNF-?, IL-4, IL-6, IL-10 in 34 plasma samples of ovarian cancer patients and 14 normal women were detected by cytometric bead array. Results The levels of IL-2, IFN-?, TNF-? in ovarian cancer patients were obviously lower than those in normal womens but the levels of IL-4, IL-6, IL-10 were obviously higher. Furthermore, the variance changed along with clinic stage. Conclusion It is suggested that the imbalance of Th1/Th2 type cytokines in ovarian cancer patients may provide clinical index for the evaluation of progression and prognosis.
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@#目的探讨轮椅技能训练的简单化、实用化和规范化。方法将 216例脊髓损伤住院患者按性别、年龄和损伤平面分为4组进行轮椅技能训练,项目包括绕障碍物行走计时、100m竞速、400m竞速、2柱×10折返跑、上下台和上下坡道,将各项目按成绩分为10个级别,制定出不同组别患者应该达到的水平,评定患者的训练效果。结果训练后,患者的100m、400m竞速、2柱×10跑折返、绕障碍计时成绩和上台(坡)的能力明显提高(P<0.01);训练效果明显75人、有效141人。结论轮椅技能训练可使脊髓损伤患者真正达到生活自理、自立,但应根据患者的损伤平面制定规范化的训练方案。
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Objective To evaluate the relationship between the expressions CyclinD1 and nm23H1 and the response to neoadjuvant chemotherapy (NACT) in cervical carcinoma. Methods 100 patients with cervical cancer were enrolled in this study. These patient were randomly divided into two groups. The observed group were treated by neoadjuvant chemotherapy followed by radical hyterectomy and lymphonectomy. The other 50 cases were treated by operation as control group. The expression of CyclinD1 and nm23H1 were examined by immunohistochemistry using post-operation specimens. Results The total response rate of neoadjuvant chemotherapy was 75 %( CR+PR). The expression rate of CyclinD1 was 76 % in experimental group, and 54 % in control group(P 0.05). Conclusion The neoadjuvant chemotherapy was helpful for the patients with local advanced stage of cervical carcinoma. CyclinD1 may be one of the path of NACT, but nm23H1 may not related to NACT.