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The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.
ABSTRACT
The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.
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Objective To investigate the expression of vitronectin (VN) in placental basal plate and its relationship with the pathogenesis of severe preeclampsia.Methods From March 2010 to December 2011,17 patients with early-onset severe preeclampsia who delivered in the Second Hospital of Jilin University were recruited as the early-onset severe preeclampsia group; and 16 women were recruited as the late-onset severe preeclampsia group.Meanwhile,15 healthy pregnant women who delivered before 34 weeks were defined as the early control group (termination of pregnancy was carried out because of fetal heart malformations),and 15 healthy pregnant women delivered after 34 weeks were defined as the late control group.Imnunohistochemistry and semi-quantitative reverse transcription (RT)-PCR were used to investigate the expression of VN protein and mRNA in the placental infarct center and its surrounding tissue of placental basal plate.The levels of serum prothrombin time (PT),part thromboplastin time (APTT) and fibrinogen (FIb) were detected and the international normalized ratio (INR) was calculated.The correlation of abnormal coagulation markers and VN expression levels in the early-onset severe preeclampsia group and the early control group was studied.Results (l) VN protein was detected in all placental basal plate of the four groups.It was highly expressed in the necrotic tissue of placental infarct center and weakly expressed in the tissue far from the infarcted area.(2) The mean levels of VN protein expression in placental basal plate of the early-onset severe preeclampsia group,the late-onset severe preeclampsia group,the late control group and the early control group were 0.152 ± 0.019,0.113 ± 0.023,0.095 ± 0.014 and 0.055 ± 0.010,respectively.And the differences between the groups were statistically significant (P ＜ 0.01).The VN protein expression in placental infarct center,infarct edge,peri-infarct tissue and tissue far from the infarcted area gradually reduced,and the differences were statistically significant (P ＜ 0.01).Compared with the same areas of each group,the differences were not statistically significant (P ＞ 0.05).(3) VN mRNA were detectable in infarct center,infarct edge,per-infarct tissue and tissue far from the infarcted area of placental basal plate.In the early-onset severe preeclampsia group and the early control group,it was statistically higher in infarct center than in tissue far from the infarcted area (P ＜ 0.05).(4) PT of the early-onset severe preeclampsia group was (9.45 ± 0.63) s,significantly shorter than that of the early control group [(9.88 ± 0.17) s,P ＜ 0.05].While there was no statistically significant difference in APTT,FIB and INR among the four groups (P ＞ 0.05).(5) In the early-onset severe preeclampsia group,VN expression level and PT were significantly negative correlated (r =-0.612,P ＜0.05) ; while in the early control group there was no correlation (r =0.489,P ＞ 0.05).Conclusion VN was highly expressed in placental basal plate of the early-onset severe preeclampsia group,which caused the imbalance of coagulation and fibrinolysis system and the pathogenesis of severe preeclampsia.
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Objective To observe safety and efficacy of intrauterine device MYCu IUD that releases indomethacin. Methods In total, 2000 women requiring IUD for contraception were chosen from domestic multiple clinical centers according to an unified standard. MYCu IUD and TCu380A IUD were randomly inserted for 1000 women each, respectively. All women were regularly followed-up one, three, six and 12 months after insertion. Results All the women were followed-up for 11 985.9 and 11 753.6 person-months in MYCu IUD and TCu380A IUD groups, respectively, with cumulative IUD application rates of 97. 80% and 94. 70%, and cumulative pregnancy rates with IUD of 0. 10% and 0. 31%, respectively. Cumulative expulsion (or partial expulsion) rate in MYCu IUD group was 0. 10%, significantly lower than that in TCu380A IUD one (1.73%), P ＜0. 01, and cumulative removal rate due to medical reasons (bleeding or pain) was 1.51 % and 2. 94%, respectively, P ＜ 0. 05. Rate of IUD-associated termination and overall rate of termination differed significantly between the two groups, P ＜0. 01. Adverse reactions one, three, six and twelve months after IUD insertion included irregular bleeding, prolonged menstruation, increased menstrual blood volume and pain, less in indomethacin-containing MYCu IUD group than those in TCu380A IUD without containing it, P ＜ 0. 01. Conclusions MYCu IUD is a comparatively ideal IUD that should be promoted for extensive use, with extremely low expulsion rate, good contraceptive effect, convenience and safety in insertion and removal, and less adverse effects.
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Objective To investigate genes involved in the mechanisms underlying the progression of severe preeclampsia.Methods We conducted a muhiregional gene expression analysis using peripheral leucocytes from patients with preeclampsia and normal controls.Total RNA was extracted from peripheral blood of six severe preeclampsia and five normotensive pregnancies.We performed genome-wide expression profiling using Affymetrix HG_U133 plus 2.0 chips to screen out differentially expressed genes of 2 fold or more and q_value ＜ 5.4%.Using Gene Ontology we identified the function of differentially expressed genes after cluster analysis.Results Among the 47 000 genes that were screened in the microarray,140 genes were found to be differentially expressed between normal and preeclamptic pregnancies. Eighty six up-regulated candidate genes were mainly involved in cysteine metabolism urea cycle and metabolism of amiogroups,proteasome,TGF-beta signaling pathway, and the ratio of calponin2 (CNN2), matrix metallopeptidase 8 (MMP8),V-set and immunoglobulin domain containing 4 (VSIG4),proteasome 26S subunit ATPase 5 (PSMC5) was evidently increased in preeclampsia patients.Among 54 down-regulatedcandidates,natural killer cell mediated cytotoxicity,antigen processing and presentation,metabolism of xenobiotics by cytochrome P450 were the main pathways.KIR3DL2,AKR1C3,CHURC1 and SLC25A13 were obviously decreased in preeclampsia patients. Conclusions The gene expression of peripheral leucocytes in preeclampsia patients is significantly different from that of uncomplicated pregnancies.CNN2,MMP8,VSIG4,PSMC5,KIR3DL2,AKR1C3,CHURC1 and SLC25A13 may be involved in the molecular mechanisms underlying the progression of severe preeclampsia.
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Objective To discuss the role of platelet-actived factors and hepatic and renal function in the development of pre-eclampsia and eclampsia by detecting the levels of the GP Ⅱb/Ⅲa in the blood, Pt and hepatic and renal function of the patients with pre-eclampsia and eclampsia. Method GP Ⅱb/Ⅲa, Pt and hepatic and renal function were measured in the normal non-pregnancy women, normal late-pregnancy women and pre-eclampsia and eclampsia women. Results The level of GP Ⅱb/Ⅲa in patients with severe pre-eclampsia and eclampsia was higher than that in non-pregnancy, normal late-pregnancy and mild pre-eclampsia (P<0.01). The count of Pt in patients with severe pre-eclampsia and eclampsia was lower than that in non-pregnancy, normal late-pregnancy and mild pre-eclampsia (P<0.01). Except ALB, the hepatic and renal function had significant difference among severe pre-eclampsia and eclampsia, normal late-pregnancy and mild pre-eclampsia. Conclusion Detecting the GP Ⅱb/Ⅲa, Pt and hepatic and renal function have clinical significance in severe pre-eclampsia and eclampsia.
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objective To analyze the killer cell immunoglobulin-like receptors(KIR)gene polymorphism of pre-eclampsia patients and approach the correlation between KIR genes and pre-eclampsia.Methods The KIR gene polymorphisms of 71 pre-eclampsia patients and 100 healthy pregnant women were detected by PCR-SSP.The KIR2DL4 mRNA level in placentas from pre-eclampsia and gestational normal pregnancies were quantified by real time RT-PCR.Forty pre-eclampsia patients and 38 healthy pregnant women were detected for single nucleotide polymorphisms(SNP)in the gene coding and joint areas between introns and extrons by directly sequencing techniques of KIR2DL4 genomic DNA.Finally,all alleles and genotypes of KIR2DL4 gene were case-control studied.Result Distributions of some relatively activating KIR genotypes shewed a significant association with pre-eclampsia.Real-time RT-PCR showed that KIR2DL4 mRNA can be measured both in placenta of women with pre-eclampsia being of pre-eclampsia waft significantly lower than that of normal pregnancy.only as much as 0.276 times that of controls.We identified 18 polymorphisms,of which,7 were first reported.But no significant differences in genotype distributions or allele frequencies were observed in these SNPs between cases and controls.Conclusion The distributions of some relatively activating KIR genotypes showed a significant association with pre-eclampsia,which indicates that the polymorphism of KIR genes may be associated with the genetic predisposition to pre-eclampsia.And because the expression of KIR2DL4 mRNA in the placentas of cases wag significantly lower than control group,it is speculated that the decrease of KIR2DL4 expression in placenta may participate in the pathogenesis of pre-eclampsia.
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Objective To investigate the effect of pyrrolidine dithiocarbamate (PDTC) on the proliferation and expression of IL-8 of SKOV3 cells in acid environment,and the role of nuclear factor ?B (NF-?B) in the process.Methods SKOV3 cell lines were divided into 5 groups: normal culture group,acid environment group,acid environment plus PDTC groups (25,50 and 100 mol?L-1 PDTC).All the SKOV3 cells were cultivated for 12 h.The effect of PDTC on the proliferation of SKOV3 in the acid environment was determined by MTT,the content of IL-8 protein in the culture supernatant was detected by ELISA and the expression of NF-?B protein was measured by Western blotting.Results The IL-8 expression level in the acid environment was(1 384.211?42.320) ng?L-1.there was significant difference compared with normal group(617.505 ng?L-1?47.850 ng?L-1)(P
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Objective To explore the expressions of IgA,IgM,IgD,IgE in ovarian epithelial carcinoma and their correlations with pathological grades of ovarian epithelial carcinoma.Methods The expressions of IgA,IgM,IgD,IgE in ovarian epithelial carcinoma tissue microarrays (including 177 cases of ovarian epithelial carcinoma)and 50 cases of ovarian benign tumor tissues were detected by immunohistochemistry. Results The expressions of IgA,IgM,IgD,IgE in ovarian epithelial carcinoma tissues were significant higher than those in ovarian benign tumor epithelial tissues (P
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Objective:To explore the effects of wild type p53 gene on biologic behavior of human ovarian cancer cell line SKOV 3 and the efficacy of cisplatin against the cancer cells when combined with p53 gene therapy.Methods:A human wild type p53 gene recombinant eukaryotic expression vector was introduced by lipofectin mediated gene transfection into SKOV 3 cells which does not express endogenous p53.The clones obtained were observed for their biological behavior and the colony formation when exposed to cisplatin.Results:The exogenous wild type p53 gene expressed stably in the cells.The growth rate and colony formation of these transfected cells were suppressed significantly by exogenous p53 gene and the percentage of phase G 1 cells increased.There was an increasement in the sensitivity to cisplatin of the transfected cells.Conclusion:Exogenous wild type p53 gene can suppress the growth of human ovarian cancer cells and increase the efficacy of cisplatin against the cells.