Improving P-gp expression in human mononuclear cells in vitro transfected by multidrug resistance-1 mRNA / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the expression and function activity of P-glycoprotein (P-gp) in human mononuclear cells (MNCs) in vitro transfected by multidrug resistance-1 (MDR1) mRNA.</p><p><b>METHODS</b>Two MDR1 cDNA vectors, pT7TS_MDR1 and pGEM5Zf(+)_MDR1, were constructed and transcripted in vitro. Vector pGEM5Zf(+)_MDR1 only contained the coding region of mdr1 cDNA, and pT7TS_MDR1 also included Xeponus beta-globin 5' and 3' untranslated region. MNCs were prepared from peripheral blood of parvicellular lung cancer patient. The two human mdrl mRNAs were then transferred into human MNCs in vitro by DOTAP. And the expression efficiency and pump function of P-gp were measured with flow cytometry.</p><p><b>RESULTS</b>Expression of P-gp significantly elevated in both transferred cells compared with untransferred cells (P < 0.01). And pT7TS_MDR1 showed higher capability in elevating the expression of P-gp than pGEM5Zf(+)_MDR1 (P < 0.01). The P-gp function was elevated in both pT7TS_MDR1 and pGEM5Zf(+) MDR1 groups. The survival ratio of MNCs in erythrocyte-lysis-solution (ELS, 86.07%) and lymphocyte-isolation-solution (LIS, 83.67%) had no significant difference. The CD34+ cells content of the MNCs used for transfection was 2.65% and 1.01% in ELS and LIS group, respectively (P < 0.01).</p><p><b>CONCLUSIONS</b>It is a feasible approach to improve P-gp expression in human MNCs by transfection of MDR-1 mRNA. And the ELS may be more suitable for purifing MNCs for mRNA transfection than LIS.</p>

Evaluation of surgical resection of pulmonary metastasis of trophoblastic tumour / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the role of lung lobectomy in the patients of tumor with lung metastases.</p><p><b>METHODS</b>A total of 45 cases of trophoblastic tumor with pulmonary metastases treated by lung lobectomy from 1985-2002 at PUMC hospital was retrospectively analyzed. Seven cases were diagnosed as invasive mole and thirty-eight as choriocarcinoma.</p><p><b>RESULTS</b>Lung lobectomy was performed in all of these patients after several courses of chemotherapy. Seven cases of invasive mole reached complete remission. Eleven cases of choriocarcinoma with stage IIIa had received average 13 courses of chemotherapy, 10 of them reached complete remission. Seventeen cases of choriocarcinoma with stage IIIb had received average 14.3 courses of chemotherapy, 11 of them reached complete remission. Ten cases of choriocarcinoma with stage IV had received average 15 courses of chemotherapy, six of them reached complete remission. In the 45 patients, histologic examination disclosed haemorrhagic necrotic tissue in 27 patients, 17 of them reached complete remission (63%). Histologic examination also revealed fibrosis around the focus in 16 patients, 14 of them reached complete remission (88%). Tuberculosis was found in 2 patients.</p><p><b>CONCLUSIONS</b>Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, lung lobectomy remains an important adjunct treatment in a selected subset of patients. Pathological examinations can help to estimate the prognosis.</p>

Floxuridine-containing regime in the treatment of gestational trophoblastic tumor / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyse the efficacy of the floxuridine (FUDR)-containing regime (single agent or in combination) in the treatment of gestational trophoblastic tumor.</p><p><b>METHODS</b>Seventy-four patients with gestational trophoblastic tumors (GTT), 47 invasive mole and 27 choriocarcinoma, were treated with FUDR-containing regime. The clinical staging of the disease were: 33 cases of stage I, 3 cases of stage II, 31 cases of stage IIIa, 6 cases of stage IIIb, and 1 case of stage IV.</p><p><b>RESULTS</b>The cure rate of FUDR-containing regime in the treatment of GTT was 91.9% (68 out of 74 cases). Twenty-one out of these 74 patients showed drug resistant to 5-FU-containing or MTX-containing regime and were cured after they changed to the FUDR-containing regime. All 7 patients of advanced stage (> or = III b) got cured. The major adverse event of FUDR-containing regime was myelodepression and gastrointestinal toxicity: III-IV degree granulopenia 26%, III-IV thrombopenia 6.2%, III degree vomiting 57.1%, and III degree diarrhea 4.3%.</p><p><b>CONCLUSION</b>FUDR-containing regime is efficient for the treatment of GTT, even for those with advanced stage or drug-resistant disease.</p>

Diagnosis and therapeutics of placental site trophoblastic tumor / 中国医学科学院学报

<p><b>OBJECTIVE</b>In order to get better understanding of placental site trophoblastic tumor (PSTT), we have investigated 4 PSTT cases that diagnosed in our hospital and with literature reviews.</p><p><b>METHODS</b>We identified 4 patients of PSTT in our choriocarcinoma ward from Jan, 1985 to Dec, 2000 by retrospective analysis.</p><p><b>RESULTS</b>PSTT accounted for 3.1@1000 of all trophoblastic diseases, the ratio of PSTT to choriocarcinoma was 1:138. The average age was 31. Two cases were secondary to hydatidiform mole with paremetrial or pulmonary metastasis respectively. All cases received hysterectomy and multiple chemotherapy. With a follow-up of 29 to 84 months, all patients are survived up to now.</p><p><b>CONCLUSIONS</b>PSTT is a rare gestational trophoblastic tumor. Accurate pathological diagnosis is critical for proper treatment. The diagnosis and monitor are rather difficult because the beta-hCG are non-parallel to the growth and disappearance of the tumor. Operation plays an important role in its treatment, and multiple chemotherapy is helpful.</p>

Mutations in the D-loop region of mitochondrial DNA in ovarian tumors / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate mutations in the D-loop region of mitochondrial DNA in ovarian tumors.</p><p><b>METHODS</b>The D-loop region of 25 epithelial ovarian tumors together with the adjacent normal tissues were amplified by PCR and sequenced.</p><p><b>RESULTS</b>Among the 25 ovarian tumors, 26 mutations were identified with the mutation rate of 32%. 19 mutations were detected in two cases of borderline carcinoma which was a special type of epithelial ovarian carcinoma. There were 6 microsatellite instabilities among the mutations and 11 new polymorphisms which were not reported previously in the GenBank.</p><p><b>CONCLUSIONS</b>The D-loop region of mitochondrial DNA is a highly polymorphoric and mutable region and the mutation rate is relatively high in patients with ovarian tumors.</p>

Outcome of gestational trophoblastic neoplasia patients with residual lung tumor after completion of treatment / 中华妇产科杂志

0.05)between the recurrent rate[2.2%(10/463)]of the CR patients with lung metastasis and the progression rate of the 152 patients.Conclusions After normalization of ?-hCG titer,patients whose lung tumors remained unchanged even after several additional courses of chemotherapy should be considered as CR patients.Follow-ups should be strictly carried out on these patients,especially at around 6 months after the completion of treatment,and particularly for high-risk and drug-resistant choriocarcinoma patients.

Value of hysteroscopy and laparoscopy in differential diagnosis of gestational trophoblastic neoplasia / 中华妇产科杂志

Objective To determine the efficacy of hysteroscopy and laparoscopy in differential diagnosis of pregnancy-related diseases,including gestational trophoblastic neoplasia(GTN),incomplete abortion and ectopic pregnancy.Methods Twenty-seven patients with a suspected diagnosis of GTN were transferred to Peking Union Medical College Hospital from September 2003 to March 2006,and underwent hysteroscopy and laparoseopy.Clinical data of patients were reviewed retrospectively.Most patients had abnormal vaginal bleeding and persistently elevated plasma beta human chorionic gonadotropin(?-hCG) level for a median(53?37)days(range,15-125 days)after evacuation.Ultrasound revealed a lesion with affluent blood flow in intrauterine,unilateral horn of uterus,or myometrium.No positive findings were revealed by computerized tomography or X-ray of the chest in all patients.Eleven patients underwent evacuation under hysteroscope,10 patients were diagnosed and treated by laparoscopy,and 6 by hysteruscopy and laparoseopy.Results Choriocarcinoma was diagnosed in 4 patients,who achieved complete remission by chemotherapy later.The diagnosis of GTN was ruled out in the other 23 patients, including cornual pregnancy in 12,pregnancy in rudimentary horn in 1,and incomplete abortion in 10,who were cured by hysteroscopic and laparoscopic surgery and postoperative adjuvant single dose methotrexate.Conclusions The major causes of pregnancy-related abnormal bleeding include incomplete abortion,eetopic pregnancy,and GTN.Hysteroscopy and laparoseopy are effective alternative of diagnosis for differentiation of GTN from non-GTN and can also offer therapeutic treatment.

Clinical analysis of patients with lung metastasis of invasive mole before evacuation of hydatidiform mole / 中华妇产科杂志

0.05).Compared with control group,significant decrease in positive group was found in the interval from first evacuation of HM to resolution of serum ?-hCG level,(83?18) days versus(126?31)days(P0.05).Conclusions Once HM is diagnosed,evacuation should be performed as soon as possible,the later the evacuation begins,the higher the risks of lung metastasis and chemotherapy are.It is not necessary to worry about lung metastasis before evacuation of HM,the outcome of post- chemotherapy is very good.