Risk factor assessment and adverse outcome prediction of placenta accreta in pregnant women after cesarean section complicated with placenta previa: a national multicenter retrospective study / 中华妇产科杂志

Objective:To study the risk factors of adverse pregnancy outcomes for the diagnosis and treatment of pregnancy after cesarean section complicated with placenta previa.Methods:A national multicenter retrospective study was conducted to select a total of 747 pregnant women with the third trimester singleton pregnancy after cesarean section complicated with placenta previa from 12 tertiary hospitals in January 1st to December 31st, 2018. The risk factors of severe adverse outcomes [hysterectomy, intraoperative blood loss ≥1 000 ml, intraoperative diagnosis of placenta accreta spectrum disorders (PAS)] in pregnant women with second pregnancy complicated with placenta previa after cesarean section were investigated by logistic regression analysis. The roles of prenatal ultrasonography and magnetic resonance imaging (MRI) in the prediction of PAS and severe adverse outcomes were observed. According to whether vascular intervention was performed (uterine artery embolization or abdominal aortic balloon occlusion), the pregnant women were divided into the blocked group and the unblocked group, and the maternal and infant perinatal outcomes between the two groups were compared.Results:(1) General information: the hysterectomy rate of 747 pregnant women with second pregnancy complicated with placenta previa after cesarean section was 10.4% (78/747), the intraoperative blood loss ≥1 000 ml in 55.8% (417/747), and PAS was confirmed in 47.5% (355/747). The incidence of uterine rupture was 0.8% (6/747). (2) Analysis of risk factors for severe adverse outcomes: based on binary unconditioned logistic regression univariate and multivariate analysis, the risk factors for hysterectomy were the mode of vascular embolization and intraoperative blood loss. The probability of hysterectomy with uterine artery embolization was 5.319 times higher than that with abdominal aortic balloon occlusion (95% CI: 1.346-21.018). The risk factors of intraoperative blood loss ≥1 000 ml were the number of cesarean section delivery, ultrasonography indicated PAS and suspected PAS, intraoperative PAS and complete placenta previa. The risk factors for intraoperative PAS were uterine scar thickness, ultrasonography indicated PAS and suspected PAS, MRI indicated PAS and suspected PAS, and complete placenta previa. (3) The roles of ultrasonography and MRI in predicting PAS: the sensitivity and specificity of ultrasonography in predicting PAS were 47.5% and 88.4%; the kappa value was 0.279 ( P<0.001), with fair agreement. The sensitivity and specificity of MRI to predict PAS were 79.2% and 97.8%, respectively. The kappa value was 0.702 ( P<0.001), indicating a good agreement. The intraoperative blood loss and hysterectomy rate of pregnant women with PAS indicated by ultrasonography and MRI were significantly higher than those with PAS only by ultrasonography or MRI. (4) Influence of vascular occlusion on pregnancy outcome: there were no significant differences in intraoperative blood loss and incidence of intraoperative bleeding ≥1 000 ml between the blocked group and the unblocked group (all P>0.05). There was no significant difference in intraoperative blood loss between the pregnant women with abdominal aortic balloon occlusion, uterine artery embolization and those without occlusion ( P=0.409). The hysterectomy rate of pregnant women with uterine artery embolization was significantly higher than those with abdominal aortic balloon occlusion [39.3% (22/56) vs 10.0% (5/50), P=0.001]. Conclusions:In the third trimester of pregnancy with placenta previa after cesarean section, MRI examination has better consistency in predicting PAS than ultrasonography examination. Ultrasonography examination combined with MRI examination could effectively predict the hysterectomy rate and intraoperative blood loss. Vascular occlusion could not reduce the amount of intraoperative blood loss. The hysterectomy rate of pregnant women with uterine artery embolization is higher than those with abdominal aortic balloon occlusion.

Pregnancy outcomes in patients with adenomyosis with fertility requirements: retrospective analysis of clinical data from real world / 中华妇产科杂志

Objective:To retrospectively analyze the pregnancy outcomes of patients with adenomyosis requiring fertility in a single center under real world condition.Methods:From June 2015 to May 2020, 231 cases of pregnancy complicated with adenomyosis diagnosed by ultrasound with fertility requirements were treated in the Women′s and Children′s Hospital Affiliated to Qingdao University with complete clinical data. And they were divided into three groups according to the treatment of adenomyosis before pregnancy: expectation group, drug group and operation group. The relevant data before pregnancy of the three groups were analyzed, and the pregnancy outcomes of the patients were summarized. According to whether the early pregnancy was treated with medication, the patients who were naturally conceived without symptoms of threatened abortion were divided into observation group and fetus protection group, and the pregnancy outcomes of the two groups were compared.Results:(1) Compared with the expectation group, the ages of patients in the drug group and the operation group were larger [(31.5±1.8) vs (34.1±3.7) vs (36.9±3.6) years old], and the difference was statistically significant ( P<0.05). Only 9 patients (11.5%, 9/78) had clinical symptoms in the expectation group, while the patients in the drug group and the operation group had a higher proportion of dysmenorrhea and increased menstrual volume. The uterine volume of the drug group and the operation group were larger than that of the expectation group [(151±46) vs (166±27) vs (97±18) cm 3], the difference was statistically significant ( P<0.05). 78.6% (33/42) of the operation group were focal adenomyosis. The proportion of natural pregnancy in the expectation group was 97.4% (76/78), and in vitro fertilization and embryo transfer was mainly used in the drug group and the operation group. (2) The abortion rates of the three groups were 48.7% (26/111), 4/17, 67.5% (27/78) respectively. Compared with the drug group and the operation group, the preterm birth rate was lower [55.9% (33/111) vs 11/17 vs 12.5% (5/78)] and the natural delivery rate was higher [44.1% (26/111) vs 4/17 vs 67.5% (27/78)] in the expectation group. (3) There were 89 cases of spontaneous pregnancy without threatened abortion symptoms, including 31 cases in the observation group and 58 cases in the fetus protection group. Compared with the observation group, the abortion rate of patients in the fetus protection group was lower [41.9% (13/31) vs 34.5% (20/58)], and the difference was statistically significant ( P<0.05). Conclusions:Patients with adenomyosis who have fertility requirements should be comprehensively evaluated and individualized treatment plans should be given. Pregnancy patients with adenomyosis have a high rate of miscarriage, and they should be included in the management of high-risk pregnant women. Active fetal protection treatment during early pregnancy might improve pregnancy outcomes.

Awareness of risk factors for gastric cancer among residents / 中华全科医师杂志

Objective:To survey the awareness status of risk factors for gastric cancer and related factors among residents in Shijiazhuang city.Methods:From October to November 2020, residents aged>18 years were selected through convenience sampling from Xinhua District and Yuhua District in Shijiazhuang for a face-to-face questionnaire survey. The demographic characteristics and awareness levels of risk factors for gastric cancer among 1 490 subjects were analyzed. The multivariate linear regression model was applied to analyze the related factors.Results:There were 522 male participants (35.0%) and 968 female participants (65.0%). The mean knowledge score of risk factors of gastric carcinoma in the respondents was 5.0 (1.0, 11.0). There were 57.0% (849/1 490) of the participants who had a low knowledge level about risk factors of gastric cancer. The more highly recognized risk factors were irregular diet (47.4%, 706/1 490), consumption of pickled foods (45.2%, 674/1 490), consumption of smoked foods (45.0%, 671/1 490); the less-recognized risk factors included physical inactivity (14.8%, 221/1 490), male sex (17.3%, 258/1 490) and older age (19.5%, 291/1 490). Only 26.8% (400/1490) of the participants regarded H. pylori infection as a risk factor of gastric cancer. Univariate analysis showed that educational level ( Z=39.34), marital status ( Z=53.31), monthly income ( Z=11.82), family member or friend ever having stomach problem ( H=-2.98), and family history of gastric cancer ( H=-2.34) were significantly associated with the knowledge score of risk factors for gastric cancer ( P<0.05). Multivariate analysis showed that compared to participants with educational levels of primary school or below, those with educational level of junior high school ( β=0.27, P<0.001), high school ( β=0.23, P<0.001), or college ( β=0.16, P<0.001) had a higher levels of knowledge of risk factors for gastric cancer; compared to unmarried participants, awareness of risk factors was significantly better in those who were married ( β=0.16, P<0.001), divorced ( β=0.05, P=0.039), or widowed ( β=0.06, P=0.027); compared to participants with monthly income<3 000 yuan, the subjects with monthly income from 5 000 to 10 000 yuan ( β=0.07, P=0.020) had a higher knowledge score; compared to participants with no family history of gastric cancer, subjects with family history had higher knowledge level of risk factors for gastric cancer ( β=0.06, P=0.029). Conclusion:The knowledge levels of risk factors for gastric cancer are generally low among residents in Shijiazhuang city. Educational initiatives are required to improve the awareness of risk factors for gastric cancer, and interventions need to be implemented concurrently to change unhealthy behaviors among residents in Shijiazhuang city.

Evaluation of the diagnosis and treatment of cesarean scar pregnancy induced in the second trimester: a national multicenter retrospective study / 中华妇产科杂志

Objective:To study the risk factors of adverse pregnancy outcomes for induced abortion of cesarean scar pregnancy in midtrimester.Methods:A national multicenter retrospective study was conducted. A total of 154 singletons pregnant women with cesarean scar pregnancy during the second trimester induced abortion by various reasons in 12 tertiary A hospitals were selected, their pregnant outcomes were observed and the risk factors of serious adverse outcomes were analyzed with univariate and multivariate logstic regression; the role of ultrasound and MRI in predicting placenta accreta and severe adverse outcomes was evaluated, the effectiveness of uterine artery embolization (UAE) in preventing hemorrhage in pregnant women with and without placenta accreta was compared.Results:Among 154 subjects, the rate of placenta accreta was 42.2% (65/154), the rate of postpartum hemorrhage≥1 000 ml was 39.0% (60/154), the rate of hysterectomy was 14.9% (23/154), the rate of uterine rupture was 0.6% (1/154). The risk factor of postpartum hemorrhage≥1 000 ml and hysterectomy was placenta accreta ( P<0.01). For each increase in the number of parity, the risk of placenta accreta increased 2.385 times (95% CI: 1.046-5.439; P=0.039); and the risk of placenta accreta decreased with increasing ultrasound measurement of scar myometrium thickness ( OR=0.033, 95% CI: 0.001-0.762; P=0.033). The amount of postpartum hemorrhage and hysterectomy rate in the group with placenta accreta diagnosed by ultrasound combined with MRI were not significantly different from those in the group with placenta accreta diagnosed by ultrasound only or MRI only (all P>0.05). For pregnant women with placenta accreta, there were no significant difference in the amount of bleeding and hysterectomy rate between the UAE group [median: 1 300 ml; 34% (16/47)] and the non-embolization group (all P>0.05); in pregnant women without placenta accreta, the amount of bleeding in the UAE group was lower than that in the non-embolization group (median: 100 vs 600 ml; P<0.01), but there was no significant difference in hysterectomy rate [2% (1/56) vs 9% (3/33); P>0.05]. Conclusions:(1) Placenta accreta is the only risk factor of postpartum hemorrhage≥1 000 ml with hysterectomy for induced abortion of cesarean scar pregnancy in midtrimester; multi-parity and ultrasound measurement of scar myometrium thickness are risk factors for placenta accreta. (2) The technique of using ultrasound and MRI in predicting placenta accreta of cesarean scar pregnancy needs to be improved. (3) It is necessary to discuss of UAE in preventing postpartum hemorrhage for induced abortion of cesarean scar pregnancy in midtrimester.

Electrical stimulation combined with manual massage can relieve myofascial pelvic pain / 中华物理医学与康复杂志

Objective:To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS).Methods:A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group ( n=30), an electrical stimulation group ( n=31) and a combination group ( n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment. Results:The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%).Conclusion:Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Electrical stimulation combined with manual massage can relieve myofascial pelvic pain / 中华物理医学与康复杂志

Objective@#To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS).@*Methods@#A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group (n=30), an electrical stimulation group (n=31) and a combination group (n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment.@*Results@#The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%).@*Conclusion@#Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Ultrasound and serological diagnosis of TORCH infection in pregnant women / 国际检验医学杂志

Objective To study the use of ultrasound and serological diagnosis of TORCH infection in pregnant women .Methods Enzyme linked immunosorbent assay of serum IgM antibodies specific for TORCH were performed .Biweekly ultrasonic inspec‐tion were also performed to detect fetal development .Results Among 656 cases of pregnant women ,the TORCH infection rate was 19 .36% ,and the positive rates of IgM specific for toxoplasma ,Rubella virus ,cytomegalovirus ,herpes simplex virus were 3 .50% , 2 .13% ,4 .27% and 4 .72% .Among TORCH antibody positive pregnant women ,ultrasound abnormality included 37 cases of omphalocele ,12 cases of cervical lymph hydrocyst ,4 cases of growth‐stopping ,6 cases of hydrocephalus ,9 cases of fetal death ,16 cases of single umbilical artery hydronephrosis ,12 cases of gastroschisis ,24 cases of intrauterine fetal growth retardation ,and the total abnormal rate was 18 .29% .Among 656 cases of pregnant women ,there are 574 cases of normal deliveries ,including 56 cases of TORCH infection ,accounting for 9 .76% ,and 82 cases with adverse pregnancy outcome ,including 43 cases of TORCH infection , accounting for 52 .44% ,which was higher than that in pregnant women with normal deliveries(P<0 .05) .Conclusion Ultrasound and serological diagnosis of TORCH infection could be reliable and effectively improve the quality of the population .

Analysis of imaging findings in jaw bone islands / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To provide reference data on frequency and distribution of bone islands (BIs) and investigate their relationship with age, gender, and localization.</p><p><b>METHODS</b>A population who received a pretreatment and at least one follow-up panoramic radiograph in the Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, were selected for this retrospective study. A sample population of 29,556 patients (12,824 males and 16,732 females) with different dental complaints and ages ranging from 8 to 80 years (mean age: 23.95 years) were included.</p><p><b>RESULTS</b>In the radiographic evaluation, BIs appeared as localized, well-defined, non-expansile, radiopaque masses which were round, elliptic, or irregular in shape. Their sizes varied from a few millimeters to about 2 cm in diameter. A total of 598 radiopacities were detected, and 545 patients of 29,556 patients (1.84%) had BIs. Among subjects with multiple lesions, 49 patients had 2 BIs and 2 patients had 3 BIs. The BIs had immense mandibular predilection, with presentation primarily in the premolar/molar region. The condition appeared to have no tendencies based on sex.</p><p><b>CONCLUSION</b>Recognition of BIs variation is significant in dental examinations.</p>

Relationship of development between third molar and second molar, canine in aged 11 / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the imaging manifestations of third molar (M3) in aged 11, and to explore the relationship of development between M3 and second molar (M2), canine (C).</p><p><b>METHODS</b>A total of 399 cases, aged 11, of West China School of Stomatology in June-August 2010 were selected as the imaging database. The M3, M2, C on the panoramic images were observed and the development degree in 399 was divided. And then the correlation analysis was done.</p><p><b>RESULTS</b>45.5% of M3 in aged 11 was in stage C. 30.8% of M2 was in stage F. 36.1% of C was in stage G. The development of M3 appeared earlier in girls than in boys, and earlier in the mandible than in the maxillary. There was no significant difference between the left and right side. The correlation coefficient between M3 and M2 was 0.437, and the correlation coefficient between M3 and C was 0.132.</p><p><b>CONCLUSION</b>The general trends of the developments of M3 and M2, C were the same. The development of M3 can be used to describe the development of M2 and C, according to the close relationship in radiograph.</p>

Expression of Syk gene and the methylation of its promoter in cervical carcinoma / 中华全科医师杂志

Reverse transcription-PCR and methylation-specific PCR (MSP) were used to determine the expression levels of Syk gene and the methylation status of its promoter in tissue samples from 60 patients with cervical cancer, 50 patients with cervical intraepithelial neoplasia (CIN), and 20 normal controls. We also analyzed the association of the methylation status and expression levels of Syk gene with linicopathological features of patients. The expression rates of Syk gene in 20 normal cervical tissue samples and 18 CIN Ⅰ samples were both 100% ; those of CIN Ⅱ- Ⅲ and cervical carcinoma were 56% (18/32)and 35% (21/60) respectively. Among cervical carcinoma patients, the expression of Syk mRNA was detected in one out of 13 cases with lymph node metastasis (1/13) and in 20 out of 47 cases with no lymph node metastasis (43%). The methylation of Syk gene in promoter region was detected in 34 out of 60 cases of cervical carcinoma (57%) ; while there was no methylation in CIN cases. In 13 cases with lymph node metastasis, 11 were found to have the methylation of Syk gene. The methylation rate of Syk promoter in cervical carcinoma was higher than that of CIN tissue( x~2 = 7. 13, P ＜0. 01 ). The methylation status of Syk gene was correlated with the lymph node metastasis ( P＜ 0. 05 ), but not with other clinicopathological parameters ( P ＞ 0. 05). There was a significant correlation between methylation status and expression level of Syk gene ( P ＜ 0. 05 ). The hypermethylation leads to silencing of the Syk gene in human cervicalcarcinoma. Syk hypermethylation may be associated with oncngenesis, metastasis of cervical carcinoma.

Aminoglycosides Modification Enzymes Genes in Pseudomonas aeruginosa Isolated from NICU Patients / 中华医院感染学杂志

OBJECTIVE To investigate genes associated with aminoglycosides modification enzymes(AMEs)in Pseudomonas aeruginosa(PAE)isolated from NICU patients.METHODS Drug-resistant genes encoding AMEs such as aac(3)-Ⅰ,aac(3)-Ⅱ,aac(3)-Ⅲ、aac(3)-Ⅳ,aac(6')-Ⅰ,aac(6')-Ⅱ,aph(3')-Ⅵ,ant(3″)-Ⅰand ant(2″)-Ⅰwere detected bypoly merase chain reaction(PCR)amplification in 36 PAE isolates.The bacteria were identified by ATB.RESULTS The positive rates of aac(6')-Ⅱ,aac(3)-Ⅱ,aac(6')-Ⅰ and aph(3')-Ⅵ genes were 52.8%,47.2%,11.1% and 2.8% of 36 isolates,respectively.Drug-resistant genes encoding AMEs were detected positively in 77.8% of 36 isolates.CONCLUSIONS AMEs genes are present in high percentage of PAE isolated from NICU patients.

Drug Resistance and Genotype of Extended Spectrum ?-Lactamases and Plasmid AmpC Enzyme-producing Klebsiella pneumoniae / 中华医院感染学杂志

OBJECTIVE To explore the drug-resistance,the existing forms,genotype,and transfer ways of extended spectrum ?-lactamases(ESBLs) and plasmid AmpC enzyme in Klebsiella pneumoniae.METHODS The drug sensitivity of K.pneumoniae to 17 antibiotics was done by slip-diffusion and microdilution methods.The genotype of two enzymes was assessed by PCR and sequencing.The transfer ways of K.pneumoniae drug-resistant gene were identified by transconjugants-test.RESULTS The ESBLs were mainly produced in 55 cefoxitin resistant K.pneumonia strains.The major genotypes of ESBLs and plasmid AmpC nzyme were CTX-M,MIR and DHA.These genes could be transferred from clinical isolates to recipient bacteria.CONCLUSIONS ESBLs as well as AmpC enzymes are the most important resistance mechanism in K.pneumoniae.The resistance could be transferred through the bacterial conjugation.

Use of Antimicrobials in Operating Departments of Hospital / 中华医院感染学杂志

OBJECTIVE To investigate and analyze the application of prophylactic antibiotics in perioperation period in our hospital.METHODS According to the designed table with unified contents and standards,a retrospective investigation was made in 325 patients who had been discharged from our hospital.RESULTS Of the 325 patients in our study,antimicrobials use in 281 patients was rational,44 patients had irrational antimicrobials use.CONCLUSIONS The results show that it is very important to strengthen and improve the management of the antimicrobials use in a normal and standard way in our hospital.

Genotypes of ?-Lactamases Multi-drug Resistant Genes of Pseudomonas aeruginosa and Type Ⅰ Integrating Enzyme Genes / 中华医院感染学杂志

OBJECTIVE To investigate genes associated with the drug-resistance of ?-lactamases antibiotics in Pseudomonas aeruginosa(PAE) and type Ⅰ integrating enzyme gene isolated from clinical patients.METHODS The drug-sensitivity for 16 antibiotics were detected by the disc agar diffusion(DAD) and microdilution.To ditect the related drug-resistence genes TEM,SHV,OXA-10,PER,VEB,GES,CARB,IMP,VIM,SPM,GIM,DHA,F-OX,MOX,CTX-M9,CTX-M1 and outer membrane protein gene oprD2 and 18 main drug resistance genes of typeⅠ integrating enzyme gene and others with PCR method.RESULTS Resistant rates of 34 multidrug resistant P.aeruginosa(MRPA)strains for amikacin,ceftazidime,ciprofloxacin,cefoperazone/sulbactam,cefepime,imipenem,levofloxacin,piperacillin/tazobactam,aztreonam,piperacillin and tobramicin were 14.7%,29.4%,61.8%,67.6%,70.6%,73.5%,76.5%,76.5%,79.4%,91.2% and 94.1%,respectively,with 100.0% for others antibiotics.The positive diagnosis rates of gene encoding extended-spectrum ?-lactamases FOX,IMP,DHA,and VIM were 23.5%,11.8%,11.8% and 5.9%,24(70.6%) were deleted in outer membrane protein gene oprD2,other ?-lactamase genes were absent in all isolates,the type Ⅰ integrating enzyme gene intⅠ1 was positive in 34 strains.CONCLUSIONS P.aeruginosa carries various ?-lactamases genes in clinical PAE patients,and the deletion ratio of oprD2 gene is high,type Ⅰ integrating enzyme exists largely in MRPA.

Drug Resistance Genes in Imipenem-resistant Pseudomonas aeruginosa / 中华医院感染学杂志

OBJECTIVE To study the drug resistance genes in imipenem-resistant Pseudomonas aeruginosa.METHODS Five main drug resistance genes:IMP,VIM,SPM and GIM which are pertinent with metal ?-lactamase and outer membrane protein oprD2 gene were analyzed using PCR method.RESULTS The oprD2 genes in 48 strains of imipenem-resistant P.aeruginosa were negative,and in 14 strains were positive from all 62 strains tested.There were 16 strains with positive IMP type and 5 strains with positive VIM type metal enzyme genes positive,7 metal enzymes producing strains were with negative oprD2 gene.The SPM and GIM metal enzyme genes detected were all negative.CONCLUSIONS The loss of outer membrane protein oprD2 gene is the main mechanism of imipenem resistance in P.aeruginosa in Tai′an area.

The therapeutic value of preoperative neoadjuvent chemotherapy in patients with stage Ⅰ_(B2)~Ⅱ_b bulky cervical cancer / 中国癌症杂志

Background and Purpose:Cervical cancer is one of the most common malignant neoplasms among women.The 5-year survival for patients with early stage disease is over 70%.While it is generally accepted that either radical surgery or radiotherapy can achieve cure for the majority of patients with early-stage cervical cancer,there is no standard approach to the patients with bulky disease,whose prognosis remains very poor in spite of the therapeutic advances achieved in recent years.Neoadjuvant chemotherapy has been used as part of the multidisciplinary treatment before either operation or radiation therapy.Although the approach still had many controversies,numerous studies have supported its effectiveness in bulky cervical cancer.The present study was conducted to explore whether neoadjuvant chemotherapy with the combination of vincristine,bleomycin and cisplatin could improve the operability and pathological response rate in Ⅰb_(2)~Ⅱb bulky cervical cancer patients.Methods:A total of fifty-six patients with bulky cervical cancer were histologically diagnosed and staged into Ⅰb_(2)~Ⅱb according to the standards of International Federation of Gynecology and Obstetrics(FIGO) and randomly selected,including 15 cases with Ⅰb_(2),15 with Ⅱa,26 with Ⅱb.They were treated by a regimen of PVB chemotherapy for 2 cycles and followed by operation.The immediate response and adverse effects were analyzed.Results:The overall response rate was 78.6%.The resectability rate for surgery after chemotherapy was 100%.No intolerable toxic and adverse effects were recorded during neoadjuvant chemotherapy.Preoperative neoadjuvant chemotherapy can apparently increase the possibility of resection by operation and enhance the remission rate.The primary tumor sizes were significantly decreased after chemotherapy before surgery(P

Clinicopathological significance of vascular endothelial growth factor C and its receptors in cervical carcinoma / 中国癌症杂志

Background and purpose:Vascular endothelial growth factor-C(VEGF-C) is ranked first as a lymphoangiogenic factor, which induces lymphatic proliferation and spread of solid tumors. Lymph node status remains the strongest prognostic factor in a variety of human malignant tumors including uterine cervical carcinomas and lymphnode metastasis is stimulated by tumor cell aggressiveness, such as abilities of growth and metastases.We examined the correlation between VEGF-C expression and tumor aggressiveness in cervical carcinomas with respect to clinicopathologic features and patient outcome and to see whether the expression of VEGF-C and its receptor in cervical carcinoma tissue and their paratumour tissue had a role in tumor metastasis and other clinical significance. Methods:48 fresh cervical cancer tissues and their paratumour tissue were examined by RT-PCR to detect the VEGF-C/KDR/Flt-4mRNA expression.Results:There was a significant difference of VEGF-C/KDR/Flt-4mRNA expression between the tumor , paratumour tissue and the normal controls. And there was no significant relationship between VEGF-C mRNA, KDR mRNA or flt-4mRNA expression with the pathological types and clinical stage of invasive carcinoma of cervix. However,expression was significantly associated with the grade of tumor pathology, lymph node metastasis, tumor size and the invasion of deep muscular layer(P

Real-time quantitative PCR in determination of VEGF expression in endometrial carcinoma and peripheral blood and its clinical relevance / 中国肿瘤生物治疗杂志

Objective:To examine the expression of VEGF gene in the endometrial carcinoma tissues,para-tumor tissues,normal endometria and peripheral blood,and analyze the role of VEGF in tumor growth and tumor metastasis.Methods:Real-time fluorescence quantitative PCR was used to detect the expression of VEGF gene in 51 endometrial carcinoma samples and the corresponding para-tumor tissues,40 normal endometria samples and their corresponding peripheral blood samples.The relation between the VEGF expression and clinical pathological parameters was analyzed.Results:The expression of VEGF gene was higher in the endometrial carcinoma tissues than in the corresponding para-tumour tissues and normal endometrial tissues(P0.05).The expression of VEGF in peripheral blood was higher in patients with endometrial carcinoma than that in the normal controls;and the expression was significantly correlated with the clinical stage,histological grades,pathological types and the presence of lymph node metastasis(P0.05).Conclusion:Real-time fluorescent quantitative PCR can sensitively,specifically detect the expression of VEGF in the endometrial carcinoma tissues and peripheral blood samples.VEGF might play an important role in the development,invasion,and metastasis of endometrial carcinoma.

Multi-drug Resistant Genes of Pseudomonas aeruginosa Clinical Strains / 中华医院感染学杂志

OBJECTIVE To analyze the multi-drug resistant genes(genes encoding extended-spectrum ?-lactamases,outer membrane protein gene oprD2,aminoglycoside-modifying enzyme genes,sulfonamides and disinfectant-resistance gene and plasmid-mediated quinolone resistance gene) of Pseudomonas aeruginosa clinical strains.METHODS The drug-resistance to 15 antibiotics was detected by the disc agar diffusion(DAD) and microdilution broth method in 32 P.aeruginosa strains isolated from Jun to Dec 2006.Twenty-eight related drug-resistant genes and outer membrane protein gene oprD2 were examined by PCR method.RESULTS The resistance rate of 32 P.aeruginosa strains to amikacin,ceftazidime,ciprofloxacin,cefepime,cefoperazone/sulbactam,imipenem,meropenem,levofloxacin,piperacillin/tazobactam,aztreonam and piperacillin were 9.4%,25%,59.4%,68.7%,68.8%,78.1%,81.1%,81.3%,84.4% and 94.4%,respectively,and that to others antibiotics were 100%.The detective rate of aminoglycoside-modifying enzyme genes(aac(6′)-Ⅱ,aac(3)-Ⅱ,aac(6′)-Ⅰ,aph(3′)-Ⅵ,ant(3″)-Ⅰ and aac(3)-Ⅰ) were 68.8%,62.5%,21.9%,9.4%,9.4% and 6.3%,and the genes encoding extended-spectrum ?-lactamases(blaFOX,blaIMP,blaVIM and blaDHA) were 37.5% 15.6% 6.3% and 9.3%,respectively.Twenty-two(68.8%) of them were detected in oprD2 and 9(28.1%),but positive in qacE?-sul1 gene.CONCLUSIONS The detective rate of aminoglycoside-modifying enzyme genes,extended-spectrum ?-lactamases genes and the loss rate of outer membrane protein gene oprD2 are high in these 32 multi-drug resistant P.aeruginosa clinical strains.