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Objective:To screen and diagnose cervical lesions in middle-aged and elderly postmenopausal women and analyze the characteristics of cervical lesions in middle-aged and elderly women.Methods:A retrospective analysis was conducted on the screening data of 1 337 postmenopausal women aged between 50 and 86 years who visited the outpatient clinics of the gynecology department of Beijing Hospital between January, 2015 and December, 2019.Participants were divided into groups based on age, with 787 in the 50-59 years old group, 483 in the 60-69 years old group, 60 in the 70-79 years old group, and 7 in the 80-89 years old group.Exfoliated cervical cells were collected, and high-risk human papillomavirus(HPV)detection and liquid-based cervical cytology examination were performed to confirm the diagnosis based on the pathological results of cervical biopsy.Cervical lesions were analyzed.Results:53.0%(708)of the 1 337 enrolled patients made their hospital visits because of symptoms.There were 666 patients(49.8%)with cervical lesions, including 357 with low-grade squamous intraepithelial lesions(LSIL), 252 with high-grade squamous intraepithelial lesions(HSIL)and 57(4.3%)with cervical cancer.The 70-79 group showed the highest incidence of HSIL at 30.0%(18/60), while the 50~59 group had the highest incidence of LSIL at 30.6%(241/787), and there were significant differences in different types of cervical lesions between different age groups( χ2=28.919, P<0.01). Liquid-based cervical cytology examination revealed a positive rate of 51.6%(166/322)for LSIL, a positive rate of 70.8%(143/202)for HSIL, and a rate of 71.4%(25/35)for cervical cancer.There were significant differences in LSIL, HSIL and other above-mentioned positive rates of lesions( P<0.05). In the cervical malignancy group, cytological high-grade squamous epithelial lesions made up 51.4%(18/35). Intraepithelial lesions or cancerous lesions represented 29.2%(59/202)in the HSIL group.The rate of intraepithelial lesions or cancerous lesions in the LSIL group was 48.4%(156/322), with statistically significance in these differences( χ2=118.806, P<0.01). Chronic cervicitis was found in 52.9%(109)of 206 patients with atypical squamous cells and positive HPV, and in 76.2%(16)of 21 patients without HPV.HPV examination was completed in 1 301 patients, with 69.4%(903)having infections by one HPV strain and 30.6%(398)having infections by mixed HPV strains.Biopsy results showed that the rates of HPV infections in LSIL, HSIL and cancer patients were 84.6%(302/357), 95.9(185/193)and 100%(54/54), respectively, and the differences in these pathological results were statistically significant( P<0.01). HPV16 was the most common subtype in single HPV strain infections.The most common subtypes of HPV infections in cervical lesions with HSIL and above were HPV16 and HPV18.The agreement rate was 52.4%(187/357)for LSIL, 60.7%(153/252)for HSIL, and 64.9%(37/57)for cervical cancer between diagnoses based on cervical biopsy and those based on colposcopy.As the severity of lesions increased, the accuracy of colposcopy also increased.Differences between colposcopic diagnosis and pathological diagnosis on different types of cervical lesions were statistically significant( χ2=550.382, P<0.01).1 310 patients underwent endocervical curettage, identifying 120 cases of HSIL and 39 cases of cervical cancer, with a detection rate of 55.8%(159/285). Conclusions:The incidence of cervical cancer is high in elderly women.The incidences of high-grade lesions and cervical cancer in patients with atypical squamous cells plus HPV infections in the cervix are also high.Postmenopausal patients with cervical lesions are mainly infected by a single HPV subtype, with subtype 16 being the most common one.With increasing severity of lesions, the accuracy of colposcopy-based diagnosis increases and the rate of missed diagnosis decreases.Cervical curettage is an important means to reduce missed diagnosis with colposcopy.
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Aim To study the synergism of silymarin and CH11 on A375-S2 cell apoptosis.Methods Inhibitory effects on A375-S2 cell lines were measured by crystal violet test.Photomicroscopical observation and LDH activity test were used to assess apoptosis.SIRT1,Bcl-2 and Bcl-xL were detected by western blot analysis.Results Treatment with silymarin and CH11 significantly induced apoptosis in A375-S2 cells in a time-dependent manner.A375-S2 cells incubated with silymarin and CH11 for 12 h showed marked apoptotic changes including condensed chromatin,nuclear fragmentation and apoptotic bodies.Expressions of anti-apoptotic Bcl-2 and Bcl-xL(Bcl-2 family member) were decreased simultaneously.Expressions of apoptotic Bax and cytochrom C were increased.Consequently,Caspase-3,downstream of mitochondria signal pathway, more significantly expressed after A375-S2 cells treatment with silymarin and CH11 for 12 h.Conclusion Silymarin and CH11 synergistically induced A375-S2 cells apoptosis.
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Objective: To study the antitumor activity and immune modulation of extract from Chlorella pyrenoidosa Chick. (CE). Methods:Cyclophosphamide is positive control and saline is negative control. S180-bearing and HCA-bearing mice were used as animal model. The changes of the growth of S180 and HCA tumor cells in vitro, the changes of tumor weight in vivo and the effect on immune system such as phagocytosis of macrophages,proliferation of lymphocytes were investigated when CE were used. Results: The tumor cells were killed by CE in vitro. CE inhibited tumor growth markedly in S180 and HCA bearing mice and the effect was enhaced if CE and cyclophosphamide were used simultaneously. CE also enhanced the immune function. Conclusion: CE has the antitumor effect and the effect of immune modulation.