Laparoendoscopic single-site surgery using a homemade glove port in the treatment of 60 benign gynecologic cases / 中国实用妇科与产科杂志

OBJECTIVE:To investigate the safety and clinical value of laparoendoscopic single-site surgery(LESS)using a homemade glove port in benign gynecologic diseases.METHODS:From December 2017 to May 2018,60 LESSs were performed in the First Affiliated Hospital of Chongqing Medical University,including hysterectomy,myomectomy,etc.The operations were performed using a patented homemade glove port with conventional laparoscopic instruments.The clinical data were recorded and analyzed retrospectively.RESULTS:All surgeries were successfully completed,including1 case of conversion to laparotomy and 4 cases of an additional site.The mean operation time was 104.4 min.The mean blood loss was 57.8 mL.The average hemoglobin decrease was 16.3 g/L 24 h after surgery.The pain score was 2.8 24 h af⁃ter surgery.No fever happened postoperatively.The average hospital stay was 2.9 days after surgery.One case of navel wound was poorly healed.No poor wound healing or umbilical hernia occurred at the 1-month follow-up. The main medi⁃cal cost of LESS was from the wound retractor,which cost around 700 RMB.CONCLUSION:LESS using a homemade glove port has the advantage of high safety and low cost in gynecological benign diseases,which is suitable for wide application.

Ca(2+) is an important mediator of nanosecond steep pulse-induced apoptosis in human ovarian cancer SKOV3 cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of Ca(2+) in nanosecond steep pulse (NSP)-induced apoptosis of human ovarian carcinoma cell line SKOV3 in vitro.</p><p><b>METHODS</b>The early apoptotic rate of SKOV3 cells treated with NSP was detected by Annexin V/PI double staining and flow cytometry. MTT assay was used to detect the viability of the cells pretreated with BAPTA-AM (0, 25, 50 and 100 µmol/L) chelation for 1 h to increase the intracellular free Ca(2+) prior to NSP exposure, and the cell morphological changes and caspase 12 expression were detected using Hoechst 33342 staining and Western blotting, respectively.</p><p><b>RESULTS</b>Flow cytometry showed that NSP induced early apoptosis of SKOV3 cells, and the optimal effect was achieved with the treatment parameter configuration of field strength of 90 kV/cm, pulse width of 100 ns, frequency of 1 Hz, and exposure time of 30 s. The highest early apoptotic rate and necrosis rate was (60.31∓5.67)% and (1.35∓0.39)%, respectively. Pretreatment with BAPTA-AM chelation prior to NSP exposure significantly increased the cell viability (P<0.05), and resulted also in lowered apoptosis rate and decreased expression of caspase 12 (P<0.05).</p><p><b>CONCLUSION</b>NSP can induce apoptosis in SKOV3 cells. Increased intracellular free Ca(2+) functions as an important mediator in NSP-induced cell apoptosis, which may also involve Ca(2+)-mediated endo- plasmic reticulum pathway.</p>

Response of early stage bulky cervical squamous carcinoma to preoperative adjuvant chemotherapy / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the potential role of preoperative adjuvant chemotherapy on early stage cervical squamous carcinoma with bulky tumor.</p><p><b>METHODS</b>One hundred and forty-five patients with cervical squamous cancer stages Ib-IIa were investigated, among which 17 patients with bulky tumors (> or = 4 cm) were managed by cisplatin-based chemotherapy for 1-2 courses followed by radical hysterectomy and pelvic lymphadenectomy (BC group). The change of tumor size, pelvic lymph nodes metastasis, cervical wall invasion, the involvement of surgical specimen margin, and the blood loss during operation were assessed after operation and compared with those in 51 patients with bulky tumors (BN group) and 77 patients with small local tumors (S group) who underwent surgery directly.</p><p><b>RESULTS</b>(1) The tumor size of 17 patients in BC group were decreased in various degrees after chemotherapy, with 13 patients of clinical effectiveness (76.47%). And the responsiveness pertained to neither histological differentiation nor size of local tumors. (2) Post-operative histology has showed that patients in BC and BN group have higher incidence of lymph node metastasis and deep cervical infiltration (5/68 and 3/68, respectively) than in S group (1/77 and 1/77, respectively) while with no statistical significance. (3) Blood loss during operation in BC group was less than BN and S group. (4) Seventeen patients, including those underwent surgeries of vaginal prolongation and/or ovarian transposition, appeared disease-free survival within the follow-up time.</p><p><b>CONCLUSIONS</b>Most of patients with bulky early stage cervical squamous carcinoma are sensitive to cisplatin-based chemotherapy, which could greatly reduce local tumor size and in turn facilitate the following operation by well controlling blood loss.</p>