ABSTRACT
We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Subject(s)
Female , Humans , Uterine Cervical Neoplasms/drug therapy , Prospective Studies , Quality of Life , Neoplasm Staging , Chemoradiotherapy , Chemotherapy, Adjuvant/adverse effects , Adjuvants, Immunologic , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Retrospective StudiesABSTRACT
This study was performed to evaluate the oncological and reproductive outcomes of childbearing-age women treated with fertility-sparing surgery (FSS) for non-epithelial ovarian tumors in China. One hundred and forty eight non-epithelial ovarian tumor women treated with FSS between January 1, 2000 and August 31, 2015 from two medical centers in China were identified. Progression-free survival (PFS) was 88.5%, whereas overall survival (OS) was 93.9%. Univariate analysis suggested that delivery after treatment is related to PFS (P = 0.023), whereas histology significantly influenced OS. Cox regression analysis suggested that only histology was associated with PFS and OS (P < 0.05). Among the 129 women who completed adjuvant chemotherapy (ACT), none developed amenorrhea. Among the 44 women who desired pregnancy, 35 (79.5%) successfully had 51 gestations including 35 live births without birth defects. Non-epithelial ovarian tumors can achieve fulfilling prognosis after FSS and chemotherapy. Histology might be the only independent prognostic factor for PFS and OS. FSS followed by ACT appeared to have little or no effect on fertility. Meanwhile, postoperative pregnancy did not increase the PFS or OS. Use of gonadotropin-releasing hormone agonist was not beneficial for fertility.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Pregnancy , Young Adult , Chemotherapy, Adjuvant , China , Infertility, Female , Neoplasm Staging , Organ Sparing Treatments , Ovarian Neoplasms , Drug Therapy , General Surgery , Pregnancy Rate , Prognosis , Retrospective Studies , Survival AnalysisABSTRACT
Objective To explore the effect of different dosages of progynova in preventing intrauterine adhesions after transcervical resection of septum ( TCRS) under laparoscope. Methods Clinical data of 213 TCRS patients under laparoscope were retrospectively analyzed, and these cases were divided into four groups according to the dosages of progynova. Except for group A (n=26), group B, C, D were given 4,6,8 mg.d-1 of progynova.Endometrial thickness, menstrual blood volume, incidence rates of residual septal and intrauterine adhesions, rate of adverse effect, pregnancy rate after operation and rate of spontaneous abortion were compared among the four groups. Results The incidence rate of residual septal in group A, B, C, D was 11.5%, 6.9%, 6.0% and 6.3%, respectively.Incidence rate of intrauterine adhesions after operation was 46.2%, 12.5%, 9.0% and 4.2%, respectively.The pregnancy rate in group A, B, C and D was 30.8%, 59.7%, 58.2% and 60.4%, respectively. There were significant differences between group A and the other groups(all P<0.05).The high dose of progynova(8 mg.d-1) significantly increased endometrial thickness ( P<0. 05 ) and menstrual blood volume ( P<0. 05 ) . But the incidence rates of gastrointestinal tract reaction, hepatic damage and vaginal spotting in the high dose group of progynova increased obviously( P<0.05) . Conclusion Progynova is a safe and effective drug in preventing intrauterine adhesions after TCRS. It can effectively prevent intrauterine adhesions, increase pregnancy rate and improve pregnant outcome.
ABSTRACT
Objective To observe the effect of irbesartan on the expression of angiopoietinlike protein 2 (ANGPTL2) in the diabetic rats kidney and explore the underlying mechanism.Methods A total of sixty male SD rats were divided into normal control group (NC group,n=15) and experimental group (n=45) randomly.The experimental group was fed with high sugar-fat diet and given a low dose streptozocin (STZ 30 mg/kg)to establish type 2 diabetic model.Rats successfully induced diabetes were randomly divided into 2 groups:diabetes group (DM) and irbesartan group (DI).Weight,blood pressure,blood glucose,serum creatinine (Scr),blood urea nitrogen(BUN),24 hour urinary albumin(UAL) and renal histomorphology were observed after drug intervention at the 4th,8th and 12thweeks.The expression of ANGPTL2 in renal tissue were detected by immunohistochemistry,real-time PCR and Western blotting.Results The levels of Scr,BUN,TG,TC and UAL in group DM were higher than in group NC at the 4th,8th and 12th week (all P ＜ 0.05).Compared with that in group DM,above indexes were lower in group DI at the 4th,8th and 12th week (all P ＜ 0.05).The pathological changes of the kidney in group DM were more serious than that in group DI.The expression of ANGPTL2 in group DM was much higher than that in group NC at the 4th,8th and 12th week (all P ＜0.05),and irbesartan treatment inhibited the up-regulation of ANGPTL2 in group DI(all P ＜ 0.05).Conclusion The expression of ANGPTL2 increases in T2DM rats kidney tissue with time and irbesartan can inhibit the up-regulation of ANGPTL2 in T2DM rats.
ABSTRACT
Objective Type around the HRCT manifestations of pulmonary hamartoma , in order to improve the level of diag-nosis of the disease .Methods Last 14 years retrospective analysis confirmed by surgery and biopsy of peripheral pulmonary hamar -toma 23 cases of CT performance.Results Nine cases of right lung (for 3 cases of the upper lobe of right lung middle in 2 cases, 4 cases were characterized by lower lobe ), 14 cases had left lung (6 cases left upper lobe, left lower lobe 8 cases), 12 cases round, round 8 cases, shallow points Ye Zheng 3 cases, border and clear, no deep lobulated, burr and satellite lesions.1.0~5.4 cm in di-ameter, the average is about 2.6 cm in diameter, less than 3 cm17 cases.5 cases of lesions containing fat , 7 cases there are both fat and calcification;8 cases of lesions with calcification , typical popcorn calcification in 3 cases;All 11 cases in 15 cases of calcified lesions located in the middle and lower lobe basal segment .3 cases of homogeneous soft tissue density with increase in mild to moderate strengthening , soft tissue density partial reinforcement degree about 5~16 HU.Conclusions HRCT can show pulmonary hamartoma characteristic calcification and fat density with help in the diagnosis of peripheral hamartoma lungs .Fat or there are both fat and calcifi-cation isolated pulmonary nodules or masses , can consider hamartoma;Instead of n/med tuberculosis good hair part containing calcium isolated pulmonary nodules , should think of hamartoma diagnosis .
ABSTRACT
Huazhong University of Science and Technology is one of the five schools that trial implementing eight-year program medical education of first batch.Eight-year program medical students in Tongji college came into obstetrics and gynecology clinical contact in 2010.According to the characteristics of students and discipline,obstetrics and gynecology department used multiple teaching methods and means as PBL teaching,integrated case management,typical clinical case conference,clinical diagnosis and treatment,academic lecture,research report,experimental design,scientific research and experi-ment,etc.Available practice mode was reformed.Those students accomplished clinical practice,and achieved expected effect.
ABSTRACT
The prevalence of human papilloma virus (HPV)-16 in patients with cervical cancer, the physical status of HPV-16 in patients with cervical lesions, and the role of HPV-16 integration in cervical carcinogenesis were investigated. HPV genotyping was performed by using PCR approach with the primer GP5+/GP6+ and type-specific primer on biopsy specimens taken operatively from 198 women. Multiple PCR was done to detect physical status of HPV-16 in a series of cervical liquid-based cytology samples and biopsy specimens obtained from different cervical lesions with HPV-16 infection, including 112 specimens with cervical cancer, 151 specimens with CIN I, 246 specimens with CIN and 120 specimens with CINIII. The results showed that there were 112 cervical cancer samples (56.57% of total cervical cancer patients) with HPV-16 infection. The frequency of HPV-16 pure integration was 65.18% (73/112), 56.57% (47/120), 23.58% (58/246) and 7.95% (12/151) in cervical cancer, CINIII, CINII and CINI patients respectively. In situ hybridization was performed on some paraffin-embedded sections of CINII, CINIII and cervical cancer to verify the physical status of HPV-16 infection. Significant difference was observed between cervical cancer and CIN I, CINII, CINIII in the frequency of HPV-16 integration (P<0.01). It is suggested that HPV-16 is the most prevalent type and is associated with cervical cancer. In the case of HPV-16 infection there are close associations between the severity of cervical lesions and the frequency of HPV-16 integration. The application of testing HPV genotyping and physical status based on detection of HC-II HPV DNA would be in favor of predicting the prognosis of cervical precancerosis and enhancing the screening accuracy of cervical cancer.
ABSTRACT
The aim of the present study was to examine the effects of suppression of EphB4 and/or mTOR on the biological behaviors of ovarian cancer cells, and the potential regulatory pathways. Antisense EphB4 vectors and shRNA vectors targeting mammalian target of rapamycin (mTOR) were constructed and transfected into A2780 and SKOV3 cells (two ovarian cancer cell lines). The effects of the antisense EphB4 vectors and the shRNA vectors on the proliferation, apoptosis and invasion of ovarian cancer cells were measured, and the expression of EphB4, mTOR and Akt detected. The results showed that transfection with mTOR shRNA could inhibit growth, induce apoptosis, and reduce invasive ability of ovarian cancer cells, which was accompanied by downregulation of EphB4, mTOR and Akt. The inhibitory effects on cell growth caused by mTOR shRNA alone were weaker than those by antisense pEGFP-C1-EphB4. In the antisense pEGFP-C1-EphB4-transfected cells, it was found that EphB4 knockdown could decrease the mTOR expression and slightly reduce the Akt phosphorylation. Significant suppressive effects on cell growth were observed in cells co-transfected with antisense pEGFP-C1-EphB4 and mTOR shRNA. In co-transfection group, the expression levels of EphB4, mTOR and Akt were distinctly lower than those in other groups. It was concluded that suppression of EphB4 may inhibit the growth of ovarian cancer cells by downregulation of the PI3K/Akt/mTOR pathway, and reverse Akt phosphorylation induced by mTOR shRNA. Inhibition of EphB4 and mTOR combined may cooperatively suppress the biological behaviors of ovarian cancer cells.
ABSTRACT
The aim of the present study was to examine the effects of suppression of EphB4 and/or mTOR on the biological behaviors of ovarian cancer cells, and the potential regulatory pathways. Antisense EphB4 vectors and shRNA vectors targeting mammalian target of rapamycin (mTOR) were constructed and transfected into A2780 and SKOV3 cells (two ovarian cancer cell lines). The effects of the antisense EphB4 vectors and the shRNA vectors on the proliferation, apoptosis and invasion of ovarian cancer cells were measured, and the expression of EphB4, mTOR and Akt detected. The results showed that transfection with mTOR shRNA could inhibit growth, induce apoptosis, and reduce invasive ability of ovarian cancer cells, which was accompanied by downregulation of EphB4, mTOR and Akt. The inhibitory effects on cell growth caused by mTOR shRNA alone were weaker than those by antisense pEGFP-C1-EphB4. In the antisense pEGFP-C1-EphB4-transfected cells, it was found that EphB4 knockdown could decrease the mTOR expression and slightly reduce the Akt phosphorylation. Significant suppressive effects on cell growth were observed in cells co-transfected with antisense pEGFP-C1-EphB4 and mTOR shRNA. In co-transfection group, the expression levels of EphB4, mTOR and Akt were distinctly lower than those in other groups. It was concluded that suppression of EphB4 may inhibit the growth of ovarian cancer cells by downregulation of the PI3K/Akt/mTOR pathway, and reverse Akt phosphorylation induced by mTOR shRNA. Inhibition of EphB4 and mTOR combined may cooperatively suppress the biological behaviors of ovarian cancer cells.