Clinical value of P16 and Ki-67 expressions in cervical biopsy for predicting early cervical cancer in patients with high-risk HPV infection / 中国基层医药

Objective To explore the positive expressions of P 16 and Ki -67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid -based thin-layer cytology test (TCT),and the clinical value in predicting occurrence of early cervical cancer .Methods A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive) and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis ,immunohistochemical staining was used to detect P 16 and Ki-67 proteins. Results There were up to 66 patients with HPV-16 positive,34 cases with HPV-18 positive,other 20 cases with 16 and 18 positive;6 cases of atypical squamous epithelial cells (ASC),46 cases of low-grade squamous intraepithelial lesions (LSIL),60 cases of high-grade SIL(HSIL),other 8 cases of cervical squamous cell carcinoma (SCC) were diagnosed by TCT;5 cases of inflammation,105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation ,CIN and SCC[0(0／5),36.2%(38／105),70.0%(7／10),χ2 ＝4.382,P＝0.036;0 (0／5),40.0%(42／105),80.0%(8／10),χ2 ＝5.945,P＝0.015].The patients with CIN were followed up for 21～36 months,median time 29.5 months.Twenty-six patients progressed to SCC ,at the end of follow-up,the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress [61.5%(16／26) vs.39.2%(31／79), χ2 ＝3.934,P＝0.047;69.2%(18／26) vs.41.8%(33／79),χ2 ＝5.905,P＝0.015].Conclusion The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high -risk HPV infection and abnormal TCT ,which in patients with pathologically diagnosis of SCC are higher than CIN patients,the same results in CIN patients with SCC progression than non -progressing patients,suggesting that P16 and Ki-67 proteins are of great value in predicting occurrence of early cervical cancer .

Clinical value of P16 and Ki-67 expressions in cervical biopsy for predicting early cervical cancer in patients with high-risk HPV infection / 中国基层医药

Objective@#To explore the positive expressions of P16 and Ki-67 proteins in cervical biopsy lesions of patients with high-risk HPV infection and abnormal detection of liquid-based thin-layer cytology test(TCT), and the clinical value in predicting occurrence of early cervical cancer.@*Methods@#A total of 120 patients with high-risk HPV infection(16 and 18 subtypes positive) and abnormal TCT in the Traditional Chinese Medicine Hospital of Linhai from January 2016 to July 2017 were enrolled in the study.The colposcopy was used to get cervical biopsy lesions for pathological diagnosis, immunohistochemical staining was used to detect P16 and Ki-67 proteins.@*Results@#There were up to 66 patients with HPV-16 positive, 34 cases with HPV-18 positive, other 20 cases with 16 and 18 positive; 6 cases of atypical squamous epithelial cells(ASC), 46 cases of low-grade squamous intraepithelial lesions (LSIL), 60 cases of high-grade SIL(HSIL), other 8 cases of cervical squamous cell carcinoma(SCC) were diagnosed by TCT; 5 cases of inflammation, 105 cases of CIN and 10 cases of SCC by pathologically diagnosis.The positive rates of P16 and Ki-67 proteins were gradually increased in patients with inflammation, CIN and SCC[0(0/5), 36.2%(38/105), 70.0%(7/10), χ2=4.382, P=0.036; 0(0/5), 40.0%(42/105), 80.0%(8/10), χ2=5.945, P=0.015]. The patients with CIN were followed up for 21~36 months, median time 29.5 months.Twenty-six patients progressed to SCC, at the end of follow-up, the positive rates of P16 and Ki-67 proteins in patients with SCC were significantly higher than those in the CIN patients without progress[61.5%(16/26) vs.39.2%(31/79), χ2=3.934, P=0.047; 69.2%(18/26) vs.41.8%(33/79), χ2=5.905, P=0.015].@*Conclusion@#The positive expression rates of P16 and Ki-67 proteins in cervical biopsy tissues are significantly higher in patients with high-risk HPV infection and abnormal TCT, which in patients with pathologically diagnosis of SCC are higher than CIN patients, the same results in CIN patients with SCC progression than non-progressing patients, suggesting that P16 and Ki-67 proteins are of great value in predicting occurrence of early cervical cancer.

Conducta Sexual Diurna de la Vaca Lechera Tropical Carora (Bos taurus taurus) / Diurnal Sexual Behavior of Carora (Bos taurus taurus) Tropical Dairy Cow

A pesar de la importancia de la conducta sexual (CS) para el manejo de programas reproductivos bajo inseminación artificial (PRBIA), los estudios en ganado Carora son escasos. En ese sentido, se estudió la CS en vacas ordeñadas dos veces al día, sin apoyo del becerro e inseminación artificial (IA) siguiendo la regla am-pm, semiestabuladas, alimentadas con forrajes locales y suplementación alimenticia, sales, agua y melaza ad libitum. Se realizó la observación visual diurna durante una hora, a intervalos de tres horas, considerándose en celo aquella hembra que aceptó quieta la monta (AQM) por una de sus compañeras. Se detectaron 134 AQM y otros signos conductuales secundarios (SCS) relacionados. Se determinó la frecuencia, proporción, horario y relación cronológica de SCS con la AQM (período periAQM). La proporción de los SCS fue: cuello uterino tónico 60,45%; presencia de moco cervical o limo 59,70%; seguida por otras vacas 52,99%; olfateada y/o lamida en zona perineal por otra vaca 52,24%; topeteos cabeza con cabeza 42,54%; grupos sexuales activos 40,30%; aceptación quieta de mentón en la grupa 36,57%; rechazo de monta 31,34%; depilaciones-excoriaciones en parte trasera 29,85%; caminar en círculos con husmeos mutuos 23,88%; entrecruzamiento de cuellos (21,64%); aceptación quieta de la monta desorientada (20,15%); apoyar mentón en grupa de otra vaca (19,40%); apoyar o aceptar apoyo del mentón en otras partes del cuerpo (16,42%); caminar nerviosa (12,69%); signo de Flehmen (8,96%); orejas erectas (8,21%); cola en bandera (6,72%); mucosa de vulva enrojecida (2,24%); bramidos (0,75%); tumefacción de vulva, micción frecuente y sangramiento visible en el metaestro no fueron detectados. El 59,70% de las AQM se detectaron en horario pm, 64,9% de los SCS se detectaron en un periodo PeriAQM de dos horas. La vaca Carora presentó una expresiva conducta sexual ventajosa para los PRBIA. Se requieren mayores estudios sobre la duración del estro y su asociación con la endocrinología reproductiva y bienestar animal.

Despite the importance of sexual behavior (SB) for managing animal breeding programs under artificial insemination (ABPAI), studies in Carora cattle are scarce. In that respect, the objective was to study the SB of cows milked twice without calf support and artificial insemination (AI) with am-pm rule, halfway stabled, fed with local forages and nutritional supplementation, salt, water and molasses ad libitum. By diurnal visual observation were observed five times/day, for one hour in intervals of three, considering in heat the quiet acceptance (standing) of the mount (QAM) by one of his herd mates, were detected 134 QAM and other secondary behavioral signs (SBS) related. It was recorded the frequency, time, proportion and chronological relationship between QAM with SBS (PeriQAM period). The SBS proportion were: tonic uterine cervix 60.45%, cervical mucus presence 59.70%) followed by other cows 52.99%, sniffing and/or licking the perineal zone by another cow 52.24%, head to head butting 42.54%, sexually active groups (40.30%), accepted chin resting on rump 36.57%, rejection to mount 31.34%, alopecia by scraping or excoriation on tail head or rump 29.85%, walking in circles with mutual sniffing of the genitalia 23.88%, crosslinking necks 21.64%, standing to disoriented mounts 20.15%, supporting chin on rump of other cows (19.40%), support or accept the chin on other body parts (16.42%), agitated or nervous walking, (restlessness) (12.69%), Flehmen sign (8.96%), erect ears (8.21%), flag tail (6.72%), reddening of vulvar mucus membrane (2.24%), bellowing (0.75%); swelling of the vulva, frequent urination and visible mataestrus bleeding were not detected. The 59.70% of the QAM were detected during PM hours, 64.9% of SBS were detected on a period of two hours PeriQAM. Carora cows showed an expressive advantageous sexual behavior for ABPAI. Further studies on the duration of estrus and its association with reproductive endocrinology and animal welfare are required.

Insights into the role of cervical mucus and vaginal pH in unexplained infertility / Sobre o papel do muco cervical e do PH vaginal na gênese da infertilidade inexplicada

Unexplained infertility diagnosis is made in the presence of a normal semen analysis when tubal patency and normal ovulatory function are established. Among several potential causes, unexplained infertility could be attributed to vaginal pH and cervical mucus abnormalities. Although the vaginal canal and the cervix generally function as effective barriers to sperm, and although the production of mucus is essential to transport them from the vagina to the uterine cavity, these factors receive little attention in the investigation of couples with unexplained infertility. A substantial reduction in sperm number occurs as they transverse the cervix. From an average of 200 to 300 million sperm deposited in the vagina, only a few hundred achieve proximity to the oocyte. Given this expected high spermatozoa loss, a slight modification in cervical mucus may rapidly transform the cervix into a "hostile" environment, which, together with changes in vaginal environment and cervix structure, may prevent natural conception and be a cause of infertility. In this review, we discuss the physiological role of the vaginal pH and cervical mucus in fertility, and describe several conditions that can render the cervical mucus hostile to sperm and therefore be implicated in the pathophysiology of unexplained infertility.

RESUMO O diagnóstico de infertilidade inexplicada baseia-se na presença de espermograma normal, constatadas também permeabilidade tubária e função ovulatória normais. Entre as várias causas potenciais de infertilidade inexplicada, a presença de muco cervical e pH vaginal anormais devem ser consideradas. Embora a produção adequada de muco cervical seja essencial para o transporte dos espermatozóides da vagina para a cavidade uterina, e tanto o canal vaginal quanto o colo do útero desempenham função importante como barreira à passagem dos espermatozóides, estes fatores recebem pouca atenção na investigação de casais com infertilidade inexplicada. Uma redução substancial do número de espermatozoides ocorre à medida que estes percorrem o trato reprodutivo feminino. Partindo de cerca de 200 a 300 milhões de espermatozoides depositados na vagina, apenas algumas centenas alcançam a proximidade do oócito. Alteracões do muco cervical podem rapidamente transformar o colo do útero num ambiente hostil, que em conjunto com alterações no ambiente vaginal e da estrutura de colo do útero, podem apresentar-se condicões impedientes para a concepção natural; desse modo, convertem-se em causa de infertilidade. Nesta revisão, discutimos o papel fisiológico do pH vaginal e do muco cervical na fertilidade, descrever várias condicões que podem tornar o muco cervical hostil aos espermatozoides e, por fim analisamos como estes fatores interferem na fisiopatologia da infertilidade inexplicada.

Aspiração do muco cervical e infusão de jato com meio de cultivo no canal cervical antes da transferência embrionária e resultados de fertilização in vitro / Cervical mucus aspiration and flushing with culture medium cervical canal prior to embryo transfer and in vitro fertilization outcomes

A transferência de embriões é considerada uma etapa fundamental nos ciclos de fertilização in vitro. Os resultados reprodutivos do tratamento são diretamente relacionados à técnica da transferência embrionária. Alguns trabalhos mostraram que o muco cervical poderia afetar os resultados da fertilização in vitro. A aspiração do muco cervical e a limpeza do canal cervical com jato de meio de cultivo foram incorporadas à prática dos serviços de reprodução assistida em todo o mundo. A presente revisão tem como objetivo esclarecer a verdadeira eficácia desses procedimentos no incremento das taxas de gravidez em ciclos de fertilização in vitro.

Embryo transfer is considered an essential stage for in-vitro fertilization cycles. Reproductive outcomes of treatment are directly related to embryo transfer technique. Some papers showed that cervical mucus could affect in-vitro fertilization outcomes. Aspiration of cervical mucus and flushing cervical canal with culture media were incorporated to practice in assisted reproduction technologies centers all over the world. This review aimed to make clear the true efficacy of these procedures with respect to the increase in pregnancy rates of in-vitro fertilization cycles.