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Objective To investigate the high-risk factors of retroperitoneal lymph nodes metastasis (LNM) and the effect of lymph nodes metastasis on prognosis in patients with endometrial carcinoma (EC).Methods Retrospec-tive research was carried out from January 2005 to December 2010 to identify 289 endometrial carcinoma patients treated with retroperitoneal lymphadenectomy at Peking Union Medical College Hospital.The high-risk factors of retroperitoneal LNM and prognostic factors of this disease were studied.Results 1) The median age at diagnosis was 55 years old.Patients of stage Ⅰ, Ⅱ, Ⅲ and Ⅳ were 224 (77.5%), 13 (4.5%), 45 (15.6%) and 7 (2.4%), respectively.Two hundred and eighty-nine patients received pelvic lymphadenectomy, of that 30 (10.4%) patients were found the pelvic LNM.Ninety-six patients received periaortic lymphadenectomy, of that 11 (11.5%) patients were found the periaortic LNM.Twenty-one (7.3%) patients developed recurrent disease and 11 (3.8 %) dead.The median follow-up was 37 months and the median disease-free survival (DFS) was 34 months.2) In univariate analysis, the incidence of LNM significantly increased in patients with CA125 ≥ 35 U/mL preoperatively, non-endometrioid adenocarcinoma, low grade, deep myometrium invasion, diameter of tumor ≥ 2 cm, cervical stroma involvement, positive peritoneal cytology and vagina or parametrial involvement (P<0.05).In multivariate analysis, CA125 ≥ 35 U/mL preoperatively, low grade, deep myometrium invasion were the independent high-risk factors of LNM (P<0.05).3)The Kaplan-Meier analysis showed a significant difference between positive peritoneal cytology, vagina or parametrial involvement, appendix involvement, LNM and DFS (P<0.05).We also found a significant difference in the impact of non-endometrioid adenocarcinoma, low grade, deep myometrium invasion, positive peritoneal cytology, appendix involvement and LNM on overall survival (OS) (P<0.05).Cox regression analysis revealed retroperitoneal LNM is the independent prognostic factor of 5-year DFS (patients without LNM 92.1% vs patients with LNM 65.3%, P=0.002, 95% CI 0.078-0.552).We also found the trend that the 5-year OS was higher in patients without LNM than them with LNM, even though there was no significant difference(patients without LNM 96.1% vs patients with LNM 70.0%, P=0.086, 95% CI 0.039-1.238).Conclusions 1) there is a predictive value of low grade and deep myometrium invasion for EC patients with LNM.2)Patients with LNM have poorer prognosis than them without LNM.Therefore, patients with LNM should receive adjuvant therapy to reduce the risk of recurrence.
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Objective To investigate the clinical characteristics and treatments of endometrioid carcinoma patients with preoperative diagnosis of endometrial hyperplasia.Methods From 2005 to 2010, 404 patients were diagnosed with endometrioid carcinoma after hysterectomy.Among these patients,44 of them were diagnosed atypical endometrial hyperplasia(AEH) preoperatively.Retrospectively analysis the characteristics of these patients with SPSS13.0.Results Among the 44 cases, all of them were grade G1 disease, and 39 of them received comprehensive staging surgery.14(32%)young cases preserved bilateral ovaries.9 cases(20%) were given adjuvant radiology.No recurrence was detected during the median follow up of 52 months.Compared to the premenstrual group, although no statistical difference was detected, more patients with risk factors of deep myometrium invasion(4/22 vs 1/22) and lymph-vascular space invasion(LVSI, 3/22 vs 0/22) in the postmenstrual group.Compared to the patients who diagnosed with endometrioid cancer(EC) preoperatively, there are more patients with grade G1(P=0.000), fewer patients received adjuvant chemotherapy(P=0.003) and fewer recurrence(P=0.019) in AEH group.Conclusions The endomtrioid cancer patients who diagnosed with atypical hyperplasia preoperatively have better prognosis.Hysterectomy with bilateral ovaries preserved is acceptable in young patients.Post menopause patients have more risk factors of deep myometrium invasion and LVSI.
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Objective The aim of this study is to evaluate the safety and prognosis of ovarian preservation in young women with early-stage endometrial cancer.Methods Women≤45 years of age with stageⅠendometrial cancer recorded from Jan 2005 to Dec 2011 in Peking Union Medical College Hospital were examined.They were further divided into two groups: ovarian preservation group and oophorectomy group.Clinical and pathological recording of these patients were compared.Results A total of 72 women, including 25 patients (34.7%) who had ovarian preservation, were identified.The ovarian preservation group was younger (P=0.007) and had a lower prevalence of lymphadenectomy (P0.05).Of seventy-two cases, five patients relapsed and all survived after a median follow-up time of 89 months (rang: 7-131 months).The Kaplan-Meier curve and the log rank test showed no difference in recurrence-free survival (P=0.194).In Cox model analysis, ovarian preservation had no effect on recurrence-free survival(HR=3.08, 95% CI 0.54-18.44).Conclusions Ovarian preservation in young women with early-stage endometrial cancer is safe and has no negative effect on recurrence-free survival or overall survival.
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Objective To determine the prognostic significance of positive peritoneal cytology (PPC) among patients with endometrial cancer and to find out potential risk factors for PPC in endometrial cancer.Methods Data were extracted from Peking Union Medical College Hospital between Jan 1 2005 and Dec 31 2010.Only those patients who had undergone a staging procedure were included.A total of 486 patients were identified.Statistical analyses were performed using Fisher`s exact test, Kaplan-Meier log rank, and Cox proportional hazards models.ResultsRate of PPC was 4.8% in endometrial cancer.Non-endometrioid endometrial cancer(P=0.000), stage Ⅲ/Ⅳ(P=0.000), deep myometrial invasion(P=0.001), and cervical stromal involvement(P=0.018) appeared to be risk factors for PPC in endometrial cancer.Univariate analysis revealed statistically difference in 5-year PFS (70.9% vs 90.0%) and 5-year OS (72.2% vs 96.0%).Progression-free survival and overall survival showedstatistically difference(P=0.005,P=0.000)between PPC and NPC endometrial cancer.On multivariate analysis, PPC remained no statistically difference in progression-free survival or overall survival(RR=3.812,95% CI 0.897-16.200,P=0.070;RR=3.426,95% CI 0.800-14.673,P=0.097).Conclusions PPC is not an independent risk factor in patients with endometrial cancer.Aggressive histology, FIGO stage, deep myometrial invasion and cervical stromal involvement are presumed to be associated with PPC in endometrial cancer.
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Objective To study the biocompatibility of bone marrow mesenchymal stem cells (BMSCs) on acellular collagen matrix double-layer material.Methods BMSCs with acellular collagen matrix double-layer material were trained as experimental group,while separately cultured BMSCs as control group.The growth and proliferation of BMSCs on acellular collagen matrix double-layer material were investigated.Scanning electron microscope was used to observe the adherence of cells,and cell vitality was detected by CCK-8 method.Results The acellular collagen matrix double-layer material did not influence the growth and proliferation of BMSCs.The difference between the growth curves of experimental group and control group was not significant (P＞0.05).Conclusions The acellular collagen matrix double-layer material has acceptable biocompatibility.This research provides a scientific basis for the application of this composite material.
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Objective To study the clinical features,treatment and prognosis of struma ovarii.Methods From January 1990 to January 2012,a total of 68 patients were diagnosed struma ovarii at the Department of Obstetrics and Gynecology,Peking Union Medical College Hospital.Clinical data of these patients were studied retrospectively.Results (1) Characteristics of patients:the median age of patients was 42 years old (17-81 years).Of those patients,64 cases (94％) were diagnosed begin struma ovarii and 4(6％) were malignant struma ovarii.(2) Clinical feature:32(47％,32/68) patients were identified with pelvic mass by ultrasonic test,28 cases(41％) had clinical abdominal pain,8(12％) touched a mass from abdominal wall.Preoperative CA125 were tested in 54 patients,but only 8 cases(15％) had moderate elevation.All patients receive ultrasound examination,and 51 cases (75％) were mulitcystic lesions with many septi,3(4％) solid lesions and 14(21％) solid-cystic tumors.The mean diameter of tumors was(8 ± 3) cm.Ascites was present in 4 (6％,4/68)patients.Sixty-seven patients had unilateral lesions,and 1 patient had bilateral lesions.No patient had hyperthyroidism presentation.Nineteen cases underwent thyroid function test after operation,and the results were normal.(3) Treatment:all patients underwent surgical treatment.Among patients with begin struma ovarii,25 cases underwent cystectomy,15 cases unilateral,2 bilateral salpingo-oophorectomy,22 cases hysterectomy + unilateral or bilateral salpingo-oophorectomy.Four malignant struma ovarii,1 patient underwent fertility-sparing staging surgery,2 patients unilateral salpingo-oophorectomy,1 case hysterectomy + bilateral salpingo-oophorectomy.Two patients received chemotherapy after surgery.(4) Prognosis:all patients were followed up in Peking Union Medical College Hospital.The median follow-up time of benign struma ovarii was 5.4 years (6 months-21 years) and there were no recurrence.The median follow-up time of malignant struma ovarii was 11.5 years (9-20 years).Three cases had long-term recurrence at 2,7 and 16 years respectively after surgery.They were received surgical treatment after recurrence and all were alive.Two cases were given by thyroidectomy and 131I treatment.Conclusions Struma ovarii is a rare ovarian monodermal teratoma.Tumorectomy or salpingo-oophorectomy is the appropriate therapeutic treatment for benign struma ovarii.The incidence of malignant struma ovarii is low,and there are no standard treatments.Because of higher long-term recurrence rate,these patients need close follow-up.
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Objective To investigate the changes of regulatory T cells (Tregs) in hepatocellular carcinoma(HCC) patients with thermal ablation therapy(TAT),and to explore the mechanisms of immunity enhancement induced by TAT.Methods A total of 36 patients with HCC undergoing TAT (observation group) were enrolled in this study from December 2009 to December 2010.Another 20 healthy person were selected as control group.The percent of Tregs was detected by flow cytometry analysis.The level of serum IL-10 was measured with ELISA.Results Before treatment,the percent of Tregs in TAT group was significantly higher than that in control group [(11.44 ± 2.74)％ vs.(2.45 ± 0.67)％] (P ＜ 0.01).After treatment,the percent of Tregs in TAT group decreased significantly[(11.44 ± 2.74)％ vs.(5.07 ± 0.82)％] (P ＜ 0.01).The level of serum IL-10 in TAT group [(41.66 ± 9.24) mg/L] was significantly higher than that in control group [(14.32 ± 3.64) mg/L] (P ＜ 0.01).After treatment,the level of serum IL-10 in TAT group decreased significantly[(41.66 ± 9.24) mg/L vs.(25.47 ± 5.43) mg/L] (P ＜ 0.01).Conclusion TAT can enhance immunity in HCC patients,and which may accomplish by down regulation of Treg and IL-10.
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Microspheres made of poly-lactic-co-glycolic acid (PLGA) have been frequently proposed as drug delivery systems.A very significant challenge in the development of controlled PLGA releasing systems is the instability of drugs especially therapeutic peptides and proteins.Additional approaches,particularly the use of additives,are needed to optimize PLGA delivery of drugs.This article reviews the effects of additives,especially the effects of stabilizing protein during the preparation of PLGA microsphere and the sustained drug releasing processes.
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BACKGROUND: Eggembryosin is characterized by tonifying kidney and vital essence, invigorating qi and spleen, replenishing and activating blood, beautifying and nourishing face, and improving constitution of whole organism.OBJECTIVE: To observe the influence of eggembryosin on aging index,quantity of hemocytes and quality of immune organs of animal models, and analyze its effect on cosmetology, anti-senility and immunoloregulation.DESIGN: Randomized controlled observation.SETTING: Department of Pharmacology, Xinxiang Medical College.MATERIALS: The experiment was carried out in the Department of Pharmacology of Xinxiang Medical College between April 1998 and September 2002. A total of 80 Kunming mice of both sexes were selected in this study.METHODS: ① Effect of eggembryosin on activity of superoxide dismutase (SOD) in serum, content of malondialdehyde (MDA), lipofuscin and hydroxyproline respectively in serum, liver and tendon of tail of aging mice: Thirty mice were divided into 3 groups according to randomly lined table, including eggembryosin group, D-galactose model group and normal control group with 10 in each group. The former two groups were injected with D-galactose to copy aging models, and eggembryosin group were perfused with eggembryosin to measure activity of SOD in serum, content of MDA, lipofuscin (aging index) and hydroxyproline (elasric index of skin) respectively in serum, liver and tendon of tail. ② Effect of eggembryosin on mass of immune organs of mice with low immunological function: Thirty mice were selected and divided as the same way mentioned above. Mice in eggembryosin group were perfused with eggembryosin. In addition, those in eggembryosin group and cyclophosphamide (CAP) group were peritoneally injected with CAP to copy immunosuppression models and calculate index of thymus (spleen) (mg/g) = weight of thymus (spleen)/body. ③ Effect of eggembryosin on quantities of erythrocytes and hemoglobin of mice with blood deficiency: Twenty mice were divided into 2 groups according to randomly lined table, including eggembryosin group and normal control group with 10 in each group. Values of erythrocytes and hemoglobins of mice were measured before administration. Models in types of blood-deficiency blood-loss were copied with tail xsanguinations, and then, mice were perfused with eggembryosin and saline, respectively. Blood of mice were collected from their tails to measure values of erythrocytes and hemoglobin.MAIN OUTCOME MEASURES: Activity of superoxide dismutase (SOD) in serum, content of malondialdehyde (MDA), lipofuscin and hydroxyproline respectively in serum, liver and tendon of tail of aging mice, index of thymus, and spleen, contents of blood erythrocytes and hemoglobins.RESULTS: A total of 80 mice were involved in the final analysis without any loss. ① Activity of SOD in serum and contents of hydroxyproline in tendon of tail of mice in eggembryosin group were significantly higher than those of mice in D-galactose model group (P ＜ 0.01); content of MDA in serum and content of lipofuscin in liver of mice in eggembryosin group were significantly lower than those of mice in D-galactose model group (P＜ 0.01). ② Indexes of thymus and spleen of mice in eggembryosin group were higher than those of mice in CAP group (P ＜ 0.05-0.01). ③ Increasing values of blood erythrocytes and hemoglobin of mice in eggembryosin group were significantly higher than those of mice in normal control group (P ＜ 0.01).CONCLUSION: Eggembryosin taken orally can improveanti-oxidation of organism and elasticity of skin, increase quality of immune organs damaged by CAP and immunological function, and nourish the blood.
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BACKGROUND:Huperzine A is a reversible choline enzyme(CHE) inhibitor initially developed in China,which has favorable therapeutic effectiveness in benign memory dysfunction,and could significantly promote the learning process and memory reappearance in rodent animals. OBJECTIVE:To comprehend the impacts of Huperzine A on the enhancement of learning, memory and behavior in platform and maze experiments in D Galoctose(Gal) induced senile mouse model. DESIGN:A randomized and controlled trial. SETTING:Institute of Pharmaceuticals of Xinxiang Medical College. MATERIALS:Study was performed in the Laboratory of Physiology and the Institute of Pharmaceuticals of Xinxiang Medical College from January to December in 2002.A total of 100 healthy Kunming mice were selected for platform and electric maze experiments with 50 mice in each experiment.Huperzine A tablet was obtained from Henan Zhulin Zhongsheng Pharmaceutical Company Limited(batch number:031001).D Gal is the product of Shanghai No.2 Reagent Factory. MAIN OUTCOME MEASURES:The latency in the safe area on the platform and the times of electric shock occurred within 5 minutes were observed in mice in platform experiment;the times of the mice mistakenly escaping to the right electric attacking area were observed in mice in electric maze experiment. CONCLUSION:Huperzine A can effectively improve the learning and memory ability of D Gal induced senile mice, and there is dose effect relationship within certain range. Qiu PY,Chen ZY,Wang YX,Zhang JX,Wu ZZ.Effects of Huperzine A on the memory and behavior in D galactose induced senile mice.Zhongguo Linchuang Kangfu 2005;9(4):247- 9(China) [www.zglckf.com]
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Objective To detect the expression of inhibitor of apoptosis protein survivin and mdr1 gene protein P-gp in ovarian epithelial carcinoma,and analyze their functions of drug resistance in chemotherapy and the relationship with pathological characteristics.Methods We detected the expression of survivin and mdr1 proteins in 8 cases of normal ovarian tissues,16 cases of benign epithelial ovarian tumor tissues and 46 cases of epithelial ovarian cancerous tissues(28 cases of serous cystadenocarcinoma,12 cases of mucinous cystadenocarcinoma,and 6 cases of endometrioid carcinoma) with immunohistochemistry.Results The positive rate of survivin and mdr1 proteins in ovarian cancerous tissues was 60.9% and 34.8%,respectively,which was significantly higher than that in benign epithelial ovarian tumor tissues(31.3% and 0%) and normal ovarian tissues(negative)(P