Effect of ECT2 Gene on Proliferation of Cervical Cancer Cells and Its Mechanism / 肿瘤防治研究

Objective To study the effect of epithelial cell transformation sequence 2 (ECT2) on the proliferation of cervical cancer cells and its mechanism. Methods We transfected cervical cancer cells HeLa (HeLa-ECT2) with the lentivirus overexpressing ECT2 and the cells SiHa (SiHa-siRNA) and C33a (C33a-siRNA) with the interfering plasmid. MTT assay was performed to detect cell proliferation ability. Flow cytometry was conducted to detect the cell cycle of each group. The IPA database was searched for the interacting proteins of ETC2, and immunofluorescence subcellular localization verified the effect between the two. qPCR and Western blot were carried out to detect the expression of Rac1, Cdc42, CDK1, and Cyclin B1 mRNA and protein in each group of cells. Results ECT2 may interact with CDK1. After ECT2 expression was upregulated, the G2/M phase of HeLa-ECT2 cells accelerated the transformation to G1 phase, cell proliferation ability was enhanced, and the expression levels of Rac1, Cdc42, CDK1, and cyclin B1 mRNA and protein all increased (P < 0.001); the knockdown of ECT2 expression would reverse the effect (P < 0.05). Conclusion ECT2 accelerates G2 phase of cervical cancer cells to G1 phase and promotes cell proliferation by co-localizing with CDK1 through the downstream Cdc42/Rac1 signaling pathway.

Countermeasures and Mechanisms of Drug Resistance in Immunotherapy for Cervical Cancer / 肿瘤防治研究

Cervical cancer has become a serious threat to women's health worldwide, advanced cervical cancer has limited treatment options. 5-year survival rate is less than 20%, which is a huge challenge for the gynecologic oncology community. Immunotherapy is one of the important treatment for patients with advanced cervical cancer. including immune checkpoint inhibitors, therapeutic vaccines, and periprocedural T-cell immunotherapy, etc. However, immunotherapy resistance makes some patients non-responsive and ineffective. Therefore, there is an urgent need to study and explore the mechanism of immune resistance to improve drug resistance. The present review summarizes the relevant studies on the mechanism of immune resistance in cervical cancer in recent years, mainly divided into factors such as intrinsic tumor and altered external immune environment, and introduces the countermeasures and progresses proposed for immune resistance.

Application evaluation and analysis of clinical case discussion in CPPT course / 中华医学教育探索杂志

Objective:To explore and optimize the teaching content of clinical case discussion course based on clinical pathophysiology and therapy (CPPT), and to improve the teaching quality of this course.Methods:Self-compiled evaluation form was sent to all the students who participated in this course in 2016-2017 school year, and the teaching satisfaction and teaching characteristics were evaluated. The differences of evaluation results from students with different educational programs or teachers with different seniority were compared, and the correlation between evaluation results and teachers' seniority was analyzed.Results:The students had a high evaluation on the course, but students from different programs had significant different comments on thinking inspiring, speech encouraging, questions guiding, process holding and effective feedback, as well as the self-evaluation of mastery degree. For teachers with different seniority, there were significant differences in scores in all aspects except speech encouraging, but no differences in mastery degree. Spearman analysis showed that there was a certain correlation between scores and teachers' seniority.Conclusion:The overall situation of the CPPT case discussion course in our school is worthy of recognition, but it needs to be improved in many aspects.

Burden of cervical neoplasia in mid-western rural Nepal: a population-based study / 부인종양

OBJECTIVE: To assess the burden of cervical neoplasia in mid-western rural, Nepal using cytology, visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI). METHOD: A cross-sectional, population-based study was conducted. Total of 2,279 married, non-pregnant women aged 20–65 years participated in a screening clinic from May 2016 to January 2017. All eligible women completed self-report of socio-demographic and reproductive health data followed by screening tests. Biopsies were obtained from areas on the cervix assessed by VIA and or VILI to be abnormal. Final disease was confirmed by biopsy report. RESULTS: A total of 96.09% (n=2,190) women were eligible for this study with mean age 32.78±9.33 years. The overall rate of positive cytology, VIA, and VILI were 3.69%, 12.45%, and 16.89%, respectively. Sixty-two cases were biopsy proven cervical neoplasia. Altogether 78 (3.69%) cases were cytologically abnormal: 25 (1.18%) were atypical squamous cells of undetermined significance, 33 (1.56%) were low-grade squamous intraepithelial lesion, 11 (0.52%) were high-grade squamous intraepithelial lesion, and 9 (0.42%) were squamous cell carcinoma. Illiterate women appeared to be at higher risk for cervical neoplasia (p < 0.001). Similarly, age ≥ 46 years (p < 0.013), participant's multiple marriages or sexual partners (p < 0.005), and positive human immunodeficiency virus status (p < 0.001) were significantly associated with abnormal cytology. CONCLUSION: Based on cytology report, there is 3.69% prevalence of cervical neoplasia among women in a rural region of mid-western, Nepal. A “screen and treat” approach would be more attractive in low resource settings.

Knowledge, attitude, practice and barriers of cervical cancer screening among women living in mid-western rural, Nepal / 부인종양

OBJECTIVE: To find out the knowledge, attitude, practice, and barriers of cervical cancer screening in mid-western rural, Nepal. METHODS: A hospital-based cross-sectional study was conducted. Women aged 20 or more were interviewed using a structured questionnaire regarding the socio-demographic information, knowledge, attitude, practice, and barriers to the cervical cancer screening. RESULTS: Total of 360 participants were recruited for this study, mean age was 30.13±10.4 years. More than 87% of participants had inadequate knowledge, but around 72% had a favorable attitude towards cervical cancer screening. There was a significant portion of women (86.4%) had never done any cervical cancer screening test. Despite being higher literacy rate of Brahmin and Chhetri ethnic group, they were less likely to attend the cervical cancer screening than Dalit and Janajati (p < 0.001); and those who had a positive family history of cancer were more likely to attend the cervical cancer screening (p < 0.001). Similarly, married women, who had adequate knowledge and or favorable attitude, were more likely to practice cervical cancer screening, though statistically not significant. Factors such as “No symptoms,”“Lack of awareness,”“Embarrassment,” etc. were the most common barriers for the cervical cancer screening. CONCLUSION: The adequate knowledge and practice of cervical cancer screening were meager among rural Nepalese women, but most of them had a favorable attitude. There is an imperative need for related awareness programs to promote the uptake of cervical cancer screening tests.

The Innovation Payment Mode of American Medical Insurance: Analysis on the Implementation Effectiveness and Experience of Bundled Payment / 中国卫生经济

Based on the patient,bundled payment was known as episode-based payment,which pay the overall treatment cost on a or multiple medical service providers.In the current,there were 3 main bundled payment model in the United States,including confirm service,Prometheus and service improvement payment.The series of research showed that,bundled payment could decrease the cost of medical service based on keeping even improving medical service quality.Based on diagnosis related groups (DRGs),bundled payment increased total prepayment control and introduced the calculation method on cost prepayment ratio and potential avoidable allowance and reward for complication.The cost control based on the evidence and the incentive mechanism based on the encourage were all worth for references.

Methuosis: a novel type of cell death / 南方医科大学学报

Cell death is a major physiological or pathological phenomenon in life activities. The classic forms of cell death include apoptosis, necrosis, and autophagy. Recently, a novel type of cell death has been observed and termed as methuosis, in which excessive stimuli can induce cytoplasmic uptake and accumulation of small bubbles that gradually merge into giant vacuoles, eventually leading to decreased cellular metabolic activity, cell membrane rupture and cell death. In this article, we describe the nomenclature, morphological characteristics and underlying mechanisms of methuosis, compare methuosis with autophagy, oncosis and paraptosis, and review the related researches.

Analvsis of cervical HPV infection in HIV positive Chinese women / 中华妇产科杂志

Objective To investigate prevalence HPV infections in cervix among HIV-infected Chinese women.Methods From September 2009 to May 2011,293 women with positive HIV underwent cervical cancer screening as study group matched with 200 women with negative HIV as control group.Questionnaires including demographic information and HIV associated information were collected,Pap smear and 23 subtype of HPV were performed in those women.The women with positive HPV were followed up per 6 months,and the period of following up were more than 12 months.Binary logistic analysis was used for high risk factors of HPV persistent infection.Results Prevalent HPV infection was 44.4％ (130/293) in study group and 20.0％ (40/200) in control group,respectively,which reached statistical difference( P ＜0.05).The most common genotype of HPV was HPV 16,which prevalence was 13.7％ (40/293)in study group and 7.0％ (14/200) in control group.The other HPV subtype prevalence was HPV-58,HPV-52,HPV- 43 and HPV-18,which was 9.2％ (27/293),8.2％ (24/293),8.2％ (24/293),6.8％ (20/293) in study group and 3.0％ (6/200),2.5％ (5/200),1.5％ (3/200),2.5％ (5/200) in control group.At time point of 12 months following up,the persistent prevalence of HPV was 47.5％ (48/101) in study group and 21.1％ (8/38) in control group,which reached statistical difference (P＜0.05).Multiple HPV infections ( OR =6.4,95 ％ CI:1.6 - 25.6),abnormal cytology ( OR =18.1,95 ％ CI:4.5 - 76.9 ) and lower CD4 T cell count (compaed with CD4 ＞3.5 × 108/L,if 2.0 × 108 ≤CD4 ≤3.5 × 108,OR =8.1,95％ CI:1.3 -56.3 ; if CD ＜ 2.0 × 108/L,OR =9.1,95％ CI:1.8 - 46.9 ) were independently associated with HPV persistence among HIV-positive subjects.Conclusions Prevalence and persistence of HPV infections were more common among HIV-positive Chinese women than those in HIV-negative Chinese women.Improving immune function,decreasing multiple HPV infections,treating abnormal cervical cytology could decrease prevalence of HPV infection.

Prevalence and risk factors of human papillomavirus infectious in HIV-positive women / 中华临床感染病杂志

Objective To evaluate the prevalence and risk factors of human papillomaviruses (HPV)infection among human immunodeficiency virus(HIV)-positive women.Methods Totally 178HIV-positive and 122 HIV-negative women were enrolled.Structured interviews,peripheral CD4 + T cells counts and cervical specimens were obtained.Polymerase chain reaction(PCR)assay was used to identify HPV types. SPSS 16.0 was used for statistical analysis,and logistic regression was used to identify independent prognostic factors for high-risk HPV infection. Results HPV positive rate,high-risk and multiple HPV infection rates were 38.2% vs.12.3% ,35.4% vs.8.2% ,and 13.5% vs.3.3% in HIVpositive women and HIV-negative women,respectively,and the differences were of statistical significance (x2 =24.77,29.08 and 8.91,P ＜0.05).The common types of high-risk HPV were similar between HIV-positive and HIV-negative women(HPV16,52,58 and 18).CD4 + T count ＜ 350/pL,HIV-positive in husband,and HIV infection through sexual contact were risk factors for high-risk HPV infection in HIV-positive women.Conclusion sThe prevalence of HPV infection in HIV-infected women is high,especially for high-risk HPV infection and multiple infection.High-risk HPV infection usually occurs in HIV-positive women with low immune status,HIV infection through sexual contact and HIV-positive husband.

Clinical report of the modified Piver class Ⅲ hysterectomy on invasive cervical cancer / 中华妇产科杂志

Objective To explore the surgical extent and to improve the surgical techniques of the Piver class Ⅲ hysterectomy on invasivc cervical cancer,so as to reduce the urinary tract complications,shorten the surgical duration,decrease the hemorrhage and blood transfusion.Methods The study group,196 cases with stages Ⅰ b and Ⅱ a carcinoma of the cervix underwent the modified Piver class Ⅲ hysterectomy from June 2000 to May 2005.The control group,176 cases of the same stages underwent the Pivet class Ⅲ hysterectomy between June 1994 and May 1999.The modified Piver class Ⅲ hysterectomy mainly include the surgical extent and some surgical techniques as follows.The cervicovesical and vesicovaginal space are separated with assistance of electrotome.Half of the uterosacral ligaments are removed with electrotome.The tunnel of the ureters is separated and penetrated or not. The anterior leaf of the cervicovesical ligaments is removed and the uterine artery are removed at the same time.while the ureter branch from the uterine artery are preserved.When the ureters aIe drawn to the lateral side of the body with an "S" hook and the urocyst lateral recessus are expanded.the cardinal ligaments can be exposed and be removed of 3/4.But part of the inferior of these ligaments should be preserved.The paracolpium are resected about 2 cm.2-3 cm tissue of the vagina is removed.Results Compare with the control group,the urinary tract complications of the study group were significantly reduced(51.1%versus 23.0%,P<0.01).There were a shorter surgical duration[(132±20)min],less of the hemorrhage[(322±100) ml]and blood transfusion[(154±79)ml] in the study group than those in the control group(all P<0.05).While,there was no significant difference at the survival rates of 5 years between the two groups (87.8% versus 88.6%.P=0.793).Conclusion The modified Piver class Ⅲ hysterectomy is effective and applicable for patients with cervical cancer.

Clinicopathological features and prognosis of small cell carcinoma of the cervix / 华中科技大学学报（医学）（英德文版）

Small cell carcinoma of cervix (SCCC) is a rare disease with highly aggressive behaviour and is pathologically hard to diagnose. In this study, the clinicopathological features, diagnosis, treatment and prognosis of the condition were examined. Clinical records and follow-up data of 7 cases of SCCC were retrospectively studied. Our results showed that five non-recurrent cases initially presented irregular vaginal bleeding or increased apocenosis of varying degrees. Pathological examination revealed that the stroma was diffusely infiltrated with small monomorphous cells ranging from round to oval shape. Three cases were immunohistochemically confirmed. One case was accompanied with squamous cell cancer. Of the 7 cases, one case was classified as stage I b1, two stage I b2, one stage IIa, one stage IIb, and one stage IIIb. On the basis of their stages of condition, one subject with stage III b underwent chemotherapy, and one with stage Ib2 received extensive hysterectomy plus pelvic lymphadenectomy, while the other 5 cases were treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre- and/or post-operative adjuvant chemotherapy and radiotherapy. Of the 7 patients, 4 had relapse-free survival of 14, 14, 16 and 28 months respectively. It is concluded that SCCC is an aggressive tumor with propensity for early pelvis lymph node metastases. Early-stage patients should be treated by extensive hysterectomy and pelvic lymphadenectomy in combination with pre- and/or post-operative adjuvant chemotherapy and radiotherapy.

Inhibiting effects of root of Mallotus apelta on duck hepatitis B virus / 中西医结合学报

OBJECTIVE: To evaluate the inhibiting effects of the root of Mallotus apelta (Lour.) Muell.-Arg. on duck hepatitis B virus (D-HBV) in vivo. METHODS: Forty nestling ducks with congenitally infection of D-HBV detected by PCR were randomly divided into five groups: untreated group, lamivudine-treated group, and high-, medium- and low-dose root of Mallotus apelta-treated groups. The ducks in the lamivudine-treated group were fed lamivudine with a dose of 50 mg/kg once. Ducks in the three-dose Mallotus apelta-treated groups were treated with different doses of decoction of this herbal medicine for 21 days respectively. The serum content of D-HBV DNA was determined by quantitative real-time PCR technique before and 7 days after the treatment, and on the 7th, 14th and 21st day of the treatment. Liver biopsy was also executed before and after the treatment to observe the histopathological changes. RESULTS: Lamivudine showed a rapid inhibiting effect on D-HBV DNA, but this effect didn't last long, and the serum level of D-HBV DNA increased again after treatment. The serum level of D-HBV DNA dropped markedly in the high- and medium-dose Mallotus apelta-treated groups on the 14th and 21st day. Low-dose Mallotus apelta revealed no obvious inhibiting effect on D-HBV. After treatment, the inhibiting effect in the root of Mallotus apelta-treated group continued as compared with that in the untreated group. The histopathological changes of liver tissues showed that the inflammation in the high-dose root of Mallotus apelta-treated group was weakened as compared with that in the lamivudine-treated group. CONCLUSION: The root of Mallotus apelta has therapeutic effect on D-HBV. It can restrain the duplication of D-HBV in vivo. Although this effect is weaker than that of lamivudine, it continues longer. Thus this herbal medicine is an effective, safe and economical drug for hepatitis B.

Establishment of rat model of syndrome of stagnation of liver qi and primary study using metabonomics / 中华中医药杂志

Objective:To establish and validate the rat model of syndrome of stagnation of liver qi,followed by a primary study on this model with 1H NMR based on metabonomics to explore the essence of syndrome of stagnation of liver qi. Methods:Twelve Wistar male rats were randomly divided into two groups(model group and control group).The rats of model group were restrained by special equipment for 21 days to get into stagnation of liver qi.The behavior,fluid consumption test and plasma CORT of rats were recorded.At 22th day,animals were sacrificed and biopsies of gastric mucosa and adrenal gland were collected for pathological check,and serum samples for 1H NMR spectroscopy.The NMR data were analyzed using principal component analysis.Results:There were abnormal behaviors,such as decrease of elusion,slackness,looser stools,and matte fur were observed among model group rats.After one week the body weight of model group was significantly lower than that of control group(P

CLINICAL TRIALS OF PARTIAL RADIOIMMUNITY TARGETING THERAPY WITH ~(131)I MONOCLONAL ANTIBODY FOR HEPATOCELLULAR CARCINOMA (HCC) / 解放军医学杂志

To explore the therapeutic effects and toxic side-effect of 131I-McAb (S102, T9, CL-3) in the treatment of hepatocellular carcinoma (HCC). 131I-McAb, which was labelled by IODO-GEN method, with 50-70mCi of 131I, was percutaneously injected into the tumor under B-ultrasonic guidance in 116 patients. The results showed that the effective rate (CR+PR) was 29.3% (34/116), the overall effective rate (CR+PR+MR) was 53.4% (62/116), the one-year survival rate was 38.2% (39/102), the mean survival time was 34.7 weeks, and the mean tumor developing phase was 12 weeks. The results suggested that the use of 131I-McAb in the treatment of HCC is a low toxic, effective and minimal invasive operation.