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Objective To evaluated the value of hysteroscopy and dilatation and curettage (DC) in diagnosis of endometrial cancer. Methods This retrospective analysis included clinical pathologic data of 3 676 patients with endometrial cancer from Jan. 1, 2000 to Dec. 31, 2010 in hospitals of endometrial cancer prevention projects in Guangdong Province. Results A total of 3 676 patients with endometrial cancer were divided into DC group (3 211 patients) and hysteroscopy group (465 patients). Compared to the results of pathological diagnosis, the accuracy rate between DC group and in hysteroscopy group were no statistically difference was 91.00%(2 922/3 211) vs 90.75%(422/465;χ2=0.030, P=0.862). The accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of cervical involvement between DC group and hysteroscopy group were 81.28%vs 86.45%(P0.05), 93.76%vs 98.71%(P0.05), respectively. Rate of positive peritoneal cytology in DC group was 4.76%(153/3 211), and the rate was 3.23%(15/465) in hysteroscopy group, which were no statistically difference (χ2=2.206, P=0.137). There were no statistically difference in 5-year overall survival (91.02% vs 92.03%;χ2=0.033, P=0.856) and 5-year progression-free survival (89.81%vs 91.83%;χ2=1.508, P=0.219) between DC group and hysteroscopy group. Conclusions Hysteroscopy and dilatation and curettage is an effective method in diagnosis of endometrial cancer, especially hysteroscopy is better in diagnosis of cervical involvement. Hysteroscopy don′t improve risks of positive peritoneal cytology and don′t affect the prognosis of patients with endometrial cancer.
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Objective: To investigate the relationship between human papilloma virus (HPV) gene types and cervical diseases. Methods:The subjects included women with HPV who were diagnosed in the Outpatient Department of the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) from March 1, 2010 to January 31, 2011. A total of 21 HPV DNA types were found in the women using DNA flow-though hybridization genotyping technique, and a questionnaire-type survey was conducted on these pa-tients. In this study, 256 cases of normal or inflamed cervix, 34 cases of cervical intraepithelial neoplasia I (CINⅠ), 61 cases of CINⅡor CINⅢ, and 9 cases of cervical cancer were analyzed. Results:The HPV infection rates were 18.4%in the normal cervical or inflam-mation group, 67.6%in the CINⅠgroup, 96.7%in the CINⅡor CINⅢgroup, and 100%in the cervical cancer group. The HPV in-fection rate was higher in the CIN I group than in the normal HPV infection or inflammation group (P<0.001) and was higher in the CIN Ⅱ or CIN Ⅲ groups than in the CIN I group (P<0.001). The main types of infection were HPV16 (44.2%), HPV58 (24.2%), HPV52 (11.6%), and HPV33 (8.4%) in the CIN groups. The main type of infection was HPV16 in the cervical cancer group (88.9%). Conclusion: Cases of cervical lesions are increasing. With this prevalence of HPV, considerable attention should be focused on HPV16-, 58-, 52-, and 33-related infections and cervical lesions. Among them, HPV16 infection is the primary cause of disease progres-sion and carcinogenesis.
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Objectives To evaluate the clinical value of neoadjuvant chemotherapy (NACT) in the treatment of local advanced cervical cancer. Methods We searched the clinical trials on the treatment of local advanced cervical cancer with NACT followed by surgery versus initial surgery on English and Chinese published literatures from the main medical data resources (MEDLINE, PUBMED, ELSEVIER ScienceDirect, CNKI). The data about positive pelvic nodes, interstitial infiltration, vascular invasion, positive surgical margin, 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, 5-year DFS were extracted from these papers, and a meta-analysis was applied. Result The hazard ratio (HR) of positive pelvic nodes on NACT group versus control group was 0. 54(95% CI 0. 33 ～0. 86), HR of interstitial infiltration was 0. 45(95% CI 0. 24 ～0. 86), HR of vascular invasion was 0. 25(95% CI 0. 16 ～0. 38), all differences were statistically significant. And HR of positive surgical margin was 0. 45 ( 95% CI 0. 21 ～0. 99), P = 0. 05, which indicated the difference was not statistically significant. And there were also no significant difference on the HR of 3-year OS, 3-year DFS, 5-year OS and 5-year DFS, and their RR were 1.18(95% CI 0. 84 ～ 1.66) ,1.31 (95% CI 0. 96 ～ 1.78) ,0. 89(95% CI 0. 68 ～ 1.15) ,and 0. 99(95% CI 0. 71 ～ 1.93) respectively. Conclusion For local advanced cervical cancer, NACT could reduce pathological risk factors but it did not improve the survival.
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AIM:To investigate the inhibitory effects of recombinant human Mullerian inhibiting substance on cell proliferation in human ovarian carcinoma cells (OVCAR8 and SKOV3 cell lines). METHODS:The expression of MISIIR protein and the localization of MISIIR protein were analyzed by Western blotting and confocal spectral microscopy,respectively. Cell apoptosis and cell cycle were detected by flow cytometry (FCM). Cell viability was determined via MTT method. Clone formation test was used to detect oncogenicity in vitro.RESULTS:The MISIIR protein expression in OVCAR8 cells but not in SKOV3 cells was observed. MISIIR expression was seen on the OVCAR8 cell surface and in the cytoplasm with both antibodies. After treated with rhMIS for 48 h,the cell viability was significantly decreased in OVCAR8 cells. rhMIS inhibited the oncogenicity of OVCAR8 cells greatly. The cell apoptosis of OVCAR8 cell exposed to 10 mg/L rhMIS was (31.3±2.1)%,and OVCAR8 cells in the G_1 phase were increased by (70.4±3.0)%. Compared to SKOV3 cells the differences were significant (P<0.01). CONCLUSION:Recombinant human Mullerian inhibiting substance suppresses the growth of MISIIR-positive ovarian cancer cells by inducing apoptosis and cell cycle arrest. We predict that rhMIS might be a new target to treat human ovarian malignancies.
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Objective To retrospectivly analyze the value of Pap smear,liquid-based cells, colposcopy and colposcopic cervical biopsy in the diagnosis of cervical cancer. Methods 116 cases of cervical cancer were retrospectively analyzed, and the value of Pap smear,liquid-based cells ,colposcopy,and colposcopic cervical biopsy in the diagnosis of cervical cancer were investigated. Result 116 patients were pathologically diagnosed with cervical cancer before and after surgery. Pap smear was performed for 30 patients (25.9%) ,and 10 patients (33.3%) were detected with HSIL. Liquid-based cells was performed for47 patients (40.5%) ,and 25 patients (53.1%) were detected with HSIL. Colposcopy was performed for 99 patients (85.3%), and 75 patients (75.8 % ) were detected with HSIL or invasive cancer. Preoperative colposcopic biopsy was performed for 99 patients, and the pathological coincidence rate was 94.9%. There was no significant difference statistically between two cytology screening ( P ＞ 0.05 ). There was significant difference statistically between liquid-based cells and colposcopy ( P ＜ 0.01 ). There were significant differences statistically among liquid-based cells,colposcopy ,and colposcopic cervical biopsy ( P ＜0.01 ). Conclusion Cytology, colposcopy, colposcopic cervical biopsy could not be individually more complete and accurate detection of cervical cancer. Colposcopy,colposcopic biopsy than cytology had higher accurate rate of diagnosis of cervical cancer. A reasonable combination of multiple detection methods could improve the diagnostic accuracy of cervical cancer.
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Objective To investigate the apoptotic and proliferation effects of signal transduction inhibitors on human endometrial carcinoma cells with different PTEN gene expression. Methods FTEN antisense oligonucleotide and pcDNA3.1/PTEN vector contained PTEN gene were transfected into endometrial carcinoma cells (HEC-1A and Ishikawa). The expression of PTEN protein was detected by confocal spectral microscopy. The endometrial carcinoma cells (HEC-1A, HEC-1A-PTEN-null, Ishikawa, Ishikawa-PTEN) were treated with signal transduction inhibitors, RG-14620, SB203580 (SB) and rapamycin, respectively. Cell apoptosis morphology, cell apoptosis and cell cycle were detected by Hoechst 33258 staining and flow cytometry. Cell viability was determined by methyl thiazolyl tetrazolium assay. Results The PTEN protein expression in two endometrial carcinoma cells (Ishikawa, HEC-1A) was exchanged by PTEN antisense oligonucleotide blocked and pcDNA3. 1/PTEN stable transfected. After treated with RG-14620, SB and rapamycin, marked morphological changes of apoptosis were observed in HEC-1A-PTEN-null and Ishikawa cells. The cell apoptosis of HEC-1A-PTEN-null and Ishikawa cells exposed to SB were significantly increase [(31.6±0.8)% and (37.8±0.8)%, respectively], the G1 phase cells were increased to (84.1±3.2)% and (87.5±1.9)%. While cell viability was significantly decreased in HEC-1A-PTEN-null and Ishikawa cells, the cell viability of HEC-1A-PTEN-null and Ishikawa cells exposed to SB were (54.0±2.1) % and (49.0±1.7) %. Conclusion Loss of PTEN in endometrial carcinoma cells may improve the G_1 phase cells and apoptotic effects, inhibit the cell proliferation, which due to the sensitivity of cells to related signal transduction inhibitors.
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Objective To understand the influence of HBsAg+ pregnant woman on the persistence of hepatitis B surface antibody(HBsAb)of neonates in three years after the first"0,1,6"immunization,and the influences of regular examination every half-year and revaceination in time on maintaining the immune effect. Methods Twenty neonates born from HBsAg-mothers and 24 from HBsAg+ mothers were followed up for 3 years.And children whose HBsAb's titer faded or disappeared(unstable)received recombinate yeast-derived hepatitis B gene vaccine.The proportion of children with unstable HBsAb and the positive rate of HBsAb on 7 month-old and 3 year-old were compared. Results The unstable rate of HBsAb in HBsAg- and HBsAg+ groups were 20.0%(4/20)and 79.2%(19/24),respectively(P<0.05).The rate of revaccination in these two groups were significantly different.The positive rate of HBsAb in 7 month-old children of HBsAg-mothers was 100.0%(20/20)and 62.5%(15/24)in those of the HBsAg+ group(P<0.05).No statistically difference was detected between the two groups when followed up at 3 years of age[85.0%(17/20)vs 91.7%(22/24),P>0.05]. Conclusions HBsAg+ mothers would reduce the stability of HBsAb in their neonates within three years after the first"0,1,6"immunization,but the immune effect of vaccination against hepatitis B can be maintained through regular examination every half or one year and revaccination.
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Objective To explore the high-risk factors of the abdominal wound undesirable healing in gynecologic operations and its prevention and treatment.Methods A retrospective clinical study reviewed 58 cases in gynecologic operations.To investigate and analyze its frequent clinical risk factors.Results The risk factors in these wound healing defect such as the fat liquefied:3 cases(48.3%),the anaemia and/or hypoproteinemia:13 cases(22.4%);combined with diabetes:3 cases(5.2%),hypertension:6 cases(10.3%),wound infection:2 cases(3.5%)and wound hematoma:1 case(1.7%);two high risk factors coexisted:22 cases(37.9%),three or more risk factors coexisted:11 cases(19.0%).The complication of such wound healing defect such as effusion:26 cases(44.8%),flare and induration:28 cases(48.3%),low-grade fever:5 cases(8.6%).Conclusion The fat liquefaction is the important reason of the wound dehiscence in gynecology operations;the effusion,flare or induration is the precipitation of the wound healing defect.If we can treat these high-risk groups positively,we will improve the clinical prognosis.
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Objective To study the rules of lochia rubra and draw normal pattern chart of post-partum lochia prospectively. Methods Samples were collected from parturients who had given birth in our hospital from July to December in 2002 consecutively including 191 women with cesarean section (CS) ,and 187 with spontaneous delivery. The amount of blood loss was measured and recorded everyday from 24 hours postpartumly to the day that lochia rubra was over by checking the special sanitary pads with squares on. All subjects were followed up on the 42nd day after delivery and the charts collected. Results The mean duration of lochia rubra in spontaneous delivery and CS group were (33. 9?12. 0) days and (39. 6?13. 1) days, respectively; and the 95% CI were 10-57 days and 14 -65 days, respectively (P = 0. 006). More recurrent lochia cases were seen in the CS group than that in spontaneous delivery group (103 vs 28, 66. 5% vs 19. 9%). Conclusions The duration of lochia rubra of CS group is longer than that of spontaneous delivery group. The 95% CI of the duration of lochia rubra is: 10- 57 days in spontaneous delivery group while 14- 65 days in CS group. Lochia rubra will recurred several times during puerperium, especially in CS group.
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0.05). There were no adverse events or severe adverse events in all these 72 cases. Conclusion Ozone is effective and safe in the treatment of bacterial vaginosis.