Effects of colpotomic approaches on prognosis and recurrence sites of stage Ⅰa2-Ⅱa2 cervical cancer after laparoscopic radical hysterectomy / 中华妇产科杂志

Objective:To investigate the factors affecting the prognosis of stage Ⅰa2-Ⅱa2 cervical cancer after laparoscopic radical hysterectomy (LRH), and to compare the prognosis and recurrence sites of patients with different colpotomy paths.Methods:The clinical data of 965 patients with stage Ⅰa2-Ⅱa2 cervical cancer who underwent LRH in the First Affiliated Hospital of Army Medical University from January 2015 to December 2018 were collected. The median age was 47.0 years of all patients with a median follow-up of 62 months (48-74 months). Cox regression was used to perform the univariate and multivariate analysis of the clinicopathological factors associated with the prognosis that included disease-free survival (DFS) and overall survival (OS). Patients were categorized into LRH through vaginal colpotomy (VC group, n=475) and LRH through intracorporeal colpotomy (IC group, n=490) according to the colpotomic approaches. The prognosis and recurrence sites of patients in each group were compared. Results:(1) During the follow-up period, 137 cases recurred (14.2%, 137/965) and 98 cases died (10.2%, 98/965). The 5-year DFS and OS were 85.8% and 89.9%, respectively. In univariate analysis, positive vaginal margin (PVM) was significantly affected the 5-year OS of patients with cervical cancer ( P=0.023), while clinical stage, maximum diameter of tumor, degree of pathological differentiation, lymph node metastasis (LNM), depth of cervical stromal invasion, parametrium involvement, and uterine corpus invasion (UCI) were significantly associated with 5-year DFS and OS in patients with cervical cancer (all P<0.05). In multivariate analysis, clinical stage ( HR=1.882, 95% CI: 1.305-2.716), LNM ( HR=2.178, 95% CI: 1.483-3.200) and UCI ( HR=3.650, 95% CI: 1.906-6.988) were independent risk factors of 5-year DFS (all P<0.001). Clinical stage ( HR=2.500, 95% CI: 1.580-3.956), LNM ( HR=2.053, 95% CI: 1.309-3.218), UCI ( HR=3.984, 95%C I: 1.917-8.280), PVM ( HR=3.235, 95% CI: 1.021-10.244) were independent risk factors of 5-year OS (all P<0.05). (2) Different colpotomy paths did not significantly affect the 5-year DFS and OS of patients with stage Ⅰa2-Ⅱa2 cervical cancer. The 5-year DFS in VC group and IC group were 85.9% and 85.6% ( P=0.794), and the 5-year OS were 90.8% and 89.3% ( P=0.966), respectively. Recurrence patterns consisted of intraperitoneal recurrence, pelvic recurrence, vaginal stump recurrence, and lymph node and distant metastasis. The intraperitoneal recurrence rate of VC group was significantly lower than that of IC group [0.6%(3/468) vs 2.3% (11/485), P=0.037], while the rates of pelvic recurrence, vaginal stump recurrence, lymph node and distant metastasis and overall recurrence were not significantly different between two groups (all P>0.05). Subgroup analysis of patients with different clinical stages, LNM and UCI showed that statistical differences of the intraperitoneal recurrence rates between two groups were only in patients without LNM (0.5% vs 2.3%, P=0.030) or without UCI (0.7% vs 2.3%, P=0.037). Conclusions:Clinical stage, LNM, PVM and UCI are independent risk factors for the prognosis of patients with stage Ⅰa2-Ⅱa2 cervical cancer. For patients without LNM or UCI, LRH through VC could reduce the intraperitoneal recurrence rate, while it is not enough to improve 5-year DFS and OS of patients. Low proportion of intraperitoneal recurrence, intra-operative tumor cells spillage to vagina stump and pelvic cavity might be the explanation.

Establishment and application of a nomogram model for prognostic risk prediction in patients with epithelial ovarian cancer / 中华妇产科杂志

Objective:To explore the prognostic factors of epithelial ovarian carcinoma (EOC), construct a nomogram model, and evaluate the prognosis of EOC patients.Methods:A retrospective analysis was performed on clinicopathological data of 208 cases of EOC patients who received initial treatment in the First Affiliated Hospital of Army Medical University from August 11, 2016 to July 11, 2018, including age, preoperative ascites, preoperative neoadjuvant chemotherapy, surgical method, pathological type, pathological differentiation degree, surgical pathology stage, preoperative and post-chemotherapy serum cancer antigen 125 (CA 125) level, human epididymal protein 4 (HE4) level, platelet count and platelet/lymphocyte number ratio (PLR). The univariate and multivariate Cox risk ratio models were used to analyze the related factors affecting progression free survival (PFS) in EOC patients, and the prediction nomogram of PFS in EOC patients was established to evaluate its efficacy in predicting PFS. Results:Univariate analysis showed that preoperative neoadjuvant chemotherapy, pathological type, pathological differentiation degree, surgical pathology stage, serum CA 125 and HE4 level before operation and after chemotherapy, platelet count and PLR before operation and after chemotherapy were significantly correlated with PFS in EOC patients (all P<0.05). Multivariate analysis showed that surgical pathology stage, preoperative PLR, serum CA 125 and HE4 level after chemotherapy were independent prognostic factors affecting PFS of EOC patients (all P<0.01). The index coefficient of the prediction model for the prognosis of EOC patients established by this method was 0.749 (95% CI: 0.699-0.798), which had good prediction ability, and could help clinicians to more accurately evaluate the prognosis of EOC patients. Conclusion:The nomogram model constructed based on surgical pathology stage, preoperative PLR, serum CA 125 and HE4 level after chemotherapy could effectively predict the PFS of EOC patients after initial treatment, could help clinicians to screen high-risk patients, provide individualized treatment, and improve the prognosis of EOC patients.

Oncologic outcomes of early stage cervical cancer performed operation by different laparoscopic surgical procedures: analysis of clinical data from mutiple centers / 中华妇产科杂志

Objective:To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy.Methods:From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study.Results:There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （ P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （ P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （ P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （ P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively ( P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions:The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.

Clinical comparative analysis of comprehensive laparoscopic and laparotomic staging of early-stage epithelial ovarian cancer / 中华妇产科杂志

Objective To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups. Results (1)LPS group had less intra-operative blood loss [(288±239) vs (631±463) ml], lower rate of blood transfusion(14%vs 58%), larger number of pelvic dissected lymph nodes (18.1±5.6 vs 15.5± 4.6), lower vasual analogue scalescore(VAS) pain score (2.1 ± 1.6 vs 3.0 ± 1.1), shorter gastrointestinal recovery time [(2.6 ± 0.8) vs (3.5 ± 0.9) days] and shorter hospital stay [(9.9 ± 2.9) vs (11.3 ± 5.0) days] when compared with LPT group (all P0.05). (2) No significant difference was found in postoperative rate of complications [11%(8/71) vs 19%(6/31),χ2=1.192, P=0.275]. (3) No significant difference was found in recurrence rate [17%(11/66) vs 14%(4/29), χ2=0.125, P=0.724] and 5-year overall survival (86.7% vs 86.8%, P=0.874). Conclusion Compared with LPT group, there are no significance differences in recurrence rate and mortality between two groups, laparoscopic staging, which could be recommended as a choice of surgical treatment of early ovarian cancer, shows more favorable operative outcomes including minimally invasive, less intra-operative blood loss, less postoperative pain and quicker recovery.

Study on isolation and culture modes of mouse primordial germ cell and its biological characteristics / 重庆医学

Objective To explore a simple and efficient method for isolating and culturing mouse primordial germ cells (mPGCs) in vitro in order to provide the sufficient mPGCs sources of mouse model .Methods The 12 .5 dpc mouse embryonic gen-ital ridge were isolated in vitro and cut into pieces ,then the organization to adherent culture was performed in a-MEM medium con-taining fetal calf serum and insulin-transferrin-selenium (ITS) and follicle stimulating hormone(FSH) and recombinant endothelial growth factor(rEGF) .The inverted microscope was used to observe the cellular morphology .Flow cytometry was used to identify the stage specific embryonic antigens of cultured cells .Reverse transcription-polymerase chain reaction(RT-PCR) and immunofluo-rescence were used to identify the pluripotency gene Oct4 expressions of stem cells and specific genes in the meiosis phaseⅠ .Results The in vitro isolated and cultured mPGCs showed good cell morphology ,extremely strong proliferation capacity and the positive expression of SSEA-1 and negative expression of SSEA-4 ,Oct4 ,meanwhile the expressions of Stra8 ,Vasa ,Scp3 ,Zp3 were detected to be positive .Conclusion Using this culture method can culture the high purity of mPGCs with the excellent stem cell properties and extremely strong proliferative ability ,moreover which makes the cells entering the meiosis stage .

Laparoscopic-assisted vaginoplasty by using sigmoid colon and peritoneum for congenital complete colpatresia / 局解手术学杂志

Objective To study the desired therapeutic effect of vaginoplasty using sigmoid colon or peritoneum for entire vaginal atre-sia.Methods From May 2015 to October 2015,8 patients with complete vaginal atresia in our hospital performed vaginoplasty using sigmoid colon or peritoneum successfully.The operation methods,prognosis and therapeutic effect and quality of sexual life of two groups were com-pared and analyzed to investigate a perfect operative method and ideal nursing.Results Laparoscopic vaginoplasty using the peritoneum compared with that using sigmoid colon has advantages of shorter time of operation,less bleeding,less trauma and quicker recovery.However, artificial vagina using sigmoid colon was much more similar to a natural vagina in morphological and physiological characteristics,merely ac-companied by excessive mucus discharge during the postoperative period.At lower risk of vaginal adhesion and stenosis,laparoscopically as-sisted vaginoplasty using sigmoid colon graft also puts high technical requirements.Two patients normally developed uterus menstruate regular-ly.Four patients without uterus and 2 patients with rudimentary uterus experienced good sexual intercourse after vaginoplasty.Conclusion Patients with complete colpatresia who have normal womb should creat a patent and functional vagina until adolescence to restore its physio-logical and reproductive function.Anatomical reconstructive treatment of vaginal agenesis for patients with absent or hypoplastic uterus can be postponed till the late teens or in the adult.Both laparoscopic sigmoid vaginoplasty and peritoneal vaginoplasty achieve a minimal-invasive, cosmetic,natural lubricous, smooth artificial vagina for patient’ s sex life satisfactory.

Clinical analysis of relapse in vaginal stump after treatment of cervical cancer and endometrial cancer in 28 cases / 局解手术学杂志

Objective To summarise the clinical characteristics, treatment and prognostic analysis of relapse in vaginal stump after treatment of cervical cancer and endometrial cancer, and to offer assistance to clinical diagnosis and treatment. Methods Clinical data of 28 patients (admitted in our hospital from Sepetember 2002 to July 2014) with cervical cancer and endometrial cancer after a simple hysterecto-my were retrospectively analyzed. According to the illness, the 28 cases were given partial vagina resection, total vaginal resection and ex-panded vaginal resection. Observe whether the prognostic is in correlation with lymph node metastasis, adjacent organs involvement, interval of recurrence and tissue differentiation degree. Results Median survival time of patients with well or poor differentiation were 40 and 15 months respectively(P<0. 05);and the 3 year survival rates were 66. 1% and 30. 7% respectively (P=0. 03). Median survival time of pa-tients with or without lymph node metastasis were 18 and 40 months respectively (P< 0. 05);and the 3 year survival rates were 0 and 24%respectively(P<0. 05). Median survival time for interval of recurrence of more than 24 months and less than or equal to 24 months were 28 and 16 months respectively (P<0. 05). Conclusion The surgical treatment of vaginal stump carcinoma is safe and effective, and the prog-nostic is in correlation with lymph node metastasis, adjacent organs involvement, interval of recurrence and tissue differentiation degree.

Randomized, blind, parallel-controlled and multiple-centre clinical trial on the effectiveness and safety of leuprolide acetate in the treatment of endometriosis / 中华妇产科杂志

Objective To evaluate the effectiveness and safety of leuprolide acetate in the treatment of endometriosis. Methods From Nov. 2007 to Oct. 2012, the patients who confirmed to be endometriosis were randomly divided into test group of 113 cases and control group of 116 cases. The test drug was the sustained-release agent of leuprolide acetate. The control drug was Enantone. The drugs were used for 3 times in total. After treatment, the ovarian mass volumes measured with type-B ultrasound, the scores of the patient′s subjective symptoms during non-menstrual and menstruation days, the pelvic signs during non-menstrual days, the changes of hormones [estradiol (E2), FSH, LH], and adverse events were observed. Results After the treatment, the rate of changes of ovarian mass volume (among them, at 12 weeks after the first injection, the median was -55.83% in the test group, -68.22% in the control group, P=0.336), the distinct improvement rate of symptom scores and pelvic signs during non-menstrual days [among them, at 12 weeks after the first injection, the rate of lower abdomen pain was 47.5%(48/101) in the test group, 44.0%(44/100) in the control group, P=0.881], the hormone (E2, FSH, LH) levels [among them, at 12 weeks after the first injection, the serum level of E2, was (33±38) pmol/L in the test group, (38± 40) pmol/L in the control group, P=0.414;the serum level of FSH, was (5.1±2.8) U/L in the test group, (5.3± 2.3) U/L in the control group, P=0.666;the serum level of LH, was (0.6±0.8) U/L in the test group, (0.6±0.9) U/L in the control group, P=0.907], had no statistically significant difference between the two groups (all P>0.05). The distinct improvement rate and improvement rate of symptom (lower abdomen pain, low back pain) scores during menstruation days at 12 weeks after the first injection, the rates of lower abdomen pain were 73.9%(34/46), 15.2%(7/46) respectively in the test group, 72.3%(34/47), 2.1%(1/47) respectively in the control group, had statistically significant difference between the two groups (P=0.026). There was no serious adverse event occurred in both two groups. The incidence rate of adverse event was 33.6%(38/113) in test group, 23.2% (27/116) in control group, there was no significant difference between the two groups (P=0.082). Conclusion Leuprolide acetate is effective and safe in the treatment of endometriosis.

Effects of ginkgo flavone on the expression of TLR4 and NF-κB in the liver of mice with nonalcoholic fatty liver disease / 实用医学杂志

Objective To investigate the effects of ginkgo flavone on the expression of NF-κB and TLR4 in the liver of mice with nonalcoholic fatty liver disease (NAFLD). Methods 120 KM mice were randomly divided into the control group, model group, as well as high, medium and low dosage of ginkgo flavone groups. The animal model of NAFLD in mice was constructed with high fat diet. The pathological changes of liver, liver index , the serum TNF-α, IL-6 , TG , NF-κB and TLR4 in hepatic tissue was observed after 8 weeks of administration. Results Compared with the model group, the level of liver index, serum TG, TNF-α, IL-6 and the expression of NF-κBp65 in the ginkgo flavone groups dramatically decreased 8 weeks after the administration. And the hepatic steatosis was milder. There was no statistical differences in the expression of TLR4 between the ginkgo flavone groups and the control group (P > 0.05). Conclusions These results suggested the closely relationship between TLR4/NF-κB inflammatory pathway and NAFLD. Ginkgo flavone had the therapeutical effects on NAFLD by anti-inflammatory and lipid-lowering action, but no effect was observed on the expression of TLR4 in hepatic tissue.

Effects of gingko flavonoid on expression of NF-κBp65 and TNF-αin mice with non-alcoholic fatty liver disease / 重庆医学

Objective To investigate the effects of different doses of gingko flavonoid on the expression of nuclear factor-κBp65 (NF-κBp65) and tumor necrosis factor-α(TNF-α) in mice with non-alcoholic fatty liver disease(NAFLD) .Methods The mice mod-el of NAFLD was constructed by the high fat diet for 4 weeks .The mice were randomly divided into the control group ,high fat model group ,high ,middle and low doses of gingko flavonoid groups .High ,middle and low doses of gingko flavonoid groups were respectively gavaged with the different doses of gingko flavonoid .The normal control group and the high fat model group were ga-vaged with normal saline .After 12 weeks ,the mice were killed for taking liver tissue and detecting NF-κBp65 expressions ,and ser-um TNF-αand triacylglycerol(TG) levels were detected .Results Compared with the normal control group ,the levels of NF-κBp65 ,TNF-αand TG in the high fat model group were increased(P<0 .05) .Compared with the high fat model group ,the levels of NF-κBp65 ,TNF-αand TG in the high ,middle and low doses of gingko flavonoid groups were decreased (P<0 .05) ,moreover the higher the dose ,the more obvious the decrease .Conclusion Gingko flavonoid may play certain role in the treatment of NAFLD by reducing the generation of NF-κBp65 ,TNF-αand TG .

The application of the OSCE evaluation system on the medical skills examination and the evaluation on its intrinsic influencing factors / 中华医学教育探索杂志

Objective To investigate the application of OSCE evaluation system on the medical skills examination of clinical medical students and the significance of this system on the training of their medical skills.Methods 20 teachers examed 150 students by the OSCE evaluation system with 4 test stations,by comparing the score of the students of different test stations by one-way ANOVA and evaluating the system by questionnaire survey with Likert 5 on the degree of satisfaction and Likert 3 on effects and intrinsic influencing factors of the system.Results The score of the first and forth test stations was lower than that in the other stations(P＜0.05).8/5.48％ students and 1/5％ teachers were not satisfied with the system.The OSCE evaluation system could exam the psychological diathesis,ability of communication,cooperation,and clinical thinking,practical skill of the students and its effects are moderate (the score was more than 2.0).Evaluation on the intrinsic influencing factors:Students considered the questions were more difficulty in the 2nd,3rd,1st,4th test stations order.4/20％ teachers considered the questions of the second test station was easy.8/40％ teachers considered the duration of the second test station was too long.More than 70％ students and teachers considered the other indexes were rational.Conclusion The OSCE evaluation system can play an effective role in directing the teaching and learning.It can also help to culture the comprehensive capacity of the students.We should gradually improve the design of the system by considering the intrinsic influencing factors.

"Prospective multi-center study in ""Xiehe"" pelvic floor reconstruction surgery for severe pelvic organ prolapse" / 中华妇产科杂志

Objective To evaluate clinical efficiency and quality-of-life outcomes in treatment of severe pelvic organ prolapse by the Xiehe pelvic floor reconstruction surgery. Methods From Jun. 2006 to Dec. 2008, 277 severe pelvic organ prolapse patients with stage Ⅲ to Ⅳ from 8 hospitals in China were enrolled in this prospective study. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed in this interim study. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic floor distress inventory-short form 20 (PFDI-20) in these patients before and after surgery was used to evaluate quality of life. Comparison of pelvic organ prolapse-urinary incontinence sexual questionnaire (PISQ) in these patients before and after surgery was used to evaluate quality of sexual life. Results With a median follow-up of 14. 0 months (6 -28 months),twenty-three patients showed recurrent prolapse (8. 3%, 23/277), and anatomical success ( ＜ stage 2 in the treated compartment) was 91.7% (254/277). In this series, mesh exposure or erosion rate was 6. 9% (19/277). The postoperative de novo stress incontinence rate was 6. 5% (18/277). The scores for PFIQ-7 and PFDI-20, and its subscales were significantly improved, the scores of before treatment were lower than those after treatment (P ＜0. 01 ). And there was no significant difference in the average score of PISQ before and after the surgery (76. 6 ± 15.4 versus 75.5 ± 14. 5 versus 73.6 ± 12. 6, P ＞0. 05 ), but the rate of de novo dyspareunia was 11% (9/80). Conclusions Xiehe pelvic floor reconstruction surgery was safe and efficacy in treatment of pelvic organ prolapse. It could improve quality of life remarkably with less cost when compared with the traditional total pelvic floor reconstruction surgery.

Innovating the teaching model of internal medicine / 中华医学教育探索杂志

With the change of medical model and the transfer of health to communities and rural towns,the expanding enrollment of colleges and universities makes collegiate internship progrms more and more difficult Clinical College of Guilin Medical University explores the new methodology of teaching practice,constructs and practises the new molde of internal madichine teaching,Combines the coummunity internship programs with hospital internship programs.and was improved the quality of practice teaching

Isolation, Culture and Characterization of Endothelial Cells from Capillary Lymphantic Vessels of Human Skin / 实用妇产科杂志

Objective:Human capillary lymphatic endothelial cells (LECs) were isolated and cultured to assist further investigation of the function of lymphatic vessels generation during cancer metastasis. Methods:Human skin was digested by type I collagenase. Cells were isolated using magnetic beads which were marked by monoclonal antibodies against the extracellular domain of VEGFR-3, and purified by cloning col-umn. The morphology and structure of cells were observed by microscopy. Immunophenotype was identified by immunofluorescence. Cell growth curve was recorded to measure the effect of VEGF-C protein. Results:LECs exhibited the typical cobblestone morphology as monolayer growth pattem under microscopy. Enlarged nucleus and rich cytoplasm with bubbles were found under electromicroscopy. LECs specific markers inclu-ding VEGFR-3, LYVE-1, Podoplaninand D2-40 all were positive. VIII factor as specific marker of blood ves-sel endothelium cells (BVECs) was negative. VEGF-C induced a marked increase of cell proliferation. Con-clusions:Human dermal LECs could be harvested successfully using collagenase digestion, immunomagnet-ic beads sorting and clonic column purification.

In vitro female germline potential of human umbilical cord-derived matrix stem cells / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cells(BM-MSCs)have been shown to possess the potential to differentiate into oocytes.However,immune rejection and a limited number of donors of BM-MSCs constrain the applications of BM-MSCs.Several studies have demonstrated that human umbilical cord matrix stem cells(UC-MSCs)also have an intrinsic ability to differentiate into oocyte-like cells in vitro.OBJECTIVE:To establish the method for UC-MSCs culture and to investigate the in vitro differentiation potential of UC-MSCs towards germ cells.METHODS:Umbilical cord from full-term normal deliveries was obtained in sterile condition.Collagenase I-digested cells were cultured in DMEM.The immunophenotype of cells was determined by flow cytometry.Lipoblasts,osteoblasts and chondroblasts were induced in different condition cultures.The expression of germ cells specific marker in UC-MSCs was determined by reverse transcdption-polymerase chain reaction.Follicular fluid was employed to induce UC-MSCs differentiation into germ cells.RESULTS AND CONCLUSION:Spindle-like umbilical cord cells were shown and cells in culture were extended to more than 10passages.BM-MSCs-like immunophenotypes were shown:CD29,CD44,CD73(SH3),CD90 and CD105(SH2)were positive;SSEA-4 was weakly positive;CD31,CD34,CD45 and HLA-DR were negative.After UC-MSCs were induced in different condition cultures,lipid droplet-,bone tubercle-,and cartilage tubercle-like structures emerged and the mRNA expressions of specific gene of fat,bone and cartilage were observed.Germ cells markers,OCT4,Stella,Ifitm3,were expressed in UC-MSCs.After induced by 5%,10% or 20% follicular fluid,cells aggregated and oocyte-like structures were observed.Human UC-MSCs could be cultured and amplificated in vitro.UC-MSCs showed immunophenotypes similar to BM-MSCs.UC-MSCs had the potential to differentiate into lipoblasts,osteoblasts,and chondroblasts.Oocyte-like structure was induced in vitro from UC-MSCs with germ cells specific marker.These findings suggest that UC-NSCs have the potential to differentiate into germ cells.

Effects of muscular traumatic fluid on biological properties of muscle-derived stem cells in rats / 中华创伤杂志

Objective To study the effects of muscular trumatic fluid on the biological properties of muscle-derived stem cells (MDSCs) in rats.Methods MDSCs were isolated and purified by the preplate technique,muscle injury was made for the extraction of muscular traumatic fluid.Bradford colorimetric was used to detect the protein content in the muscular traumatic fluid,and the fluid with the highest protein was used to co-culture with MDSCs.Methyl thiazolyl tetrazolium (MTT) assay and wound model of monolayer of cells were used to observe the effects of wound fluids on the proliferation and mobility of MDSCs.The expressions of α-SMA and Vimentin were tested by immunohistochemistry and Western blot technique.Results MTT assay showed that wound fluid with concentration of 10% could most significantly increase the proliferation of MDSCs.The increased expressions of α-SMA and Vimentin were found in MDSCs after cultrue with muscular traumatic fluid in vitro,and the time-dependent relation exists.Conclusions Wound environment can directly participate in the muscle regeneration by inducing the proliferation,mobility of MDSCs;on the other hand,MDSCs can differentiate into fibrotic cells under stimulation of muscular traumatic fluid.

Laparoscopic anatomical nerve sparing radical hysterectomy for cervical cancer: a clinical analysis of 37 cases / 中华妇产科杂志

Objective To investigate feasibility of laparoscopic anatomical nerve sparing radical hysterectomy (LANSRH) used for locally advanced cervical cancer treatment and evaluate early recovery of bladder function postoperatively. Methods From October 2006 to September 2007, 37 cervical cancer patients with stage Ⅰb1 to Ⅱ a underwent LANSRH(LANSRH group) with pelvic lymphadenectomy matched 25 patients with cervical cancer treated by general laparoscopic radical hysterectomy (LRH,LRH group) with pelvic lymphadenectomy. The data of operating time, blood loss, numbers of lymph node, the length of resected vaginal and paracervix tissue were collected and compared. In the mean time, postoperative recovery of bladder function was evaluated. Results The laparoscopic anatomic nerve-sparing procedure was performed successfully and safely among all patients. (1) There was no remarkable difference in the following clinical parameters between LANSRH and LRH group: median operating time [(175±41) min vs. (178±30) min, P=0.72 ], blood loss [(233±104)ml vs. (218±77) ml, P=0.06], numbers of lymph nodes (13±4 vs. 15±6, P=0.16), resected length of paracervix tissue [(3.6±0.5)cm vs. (3.7±0.6) cm, P=0.43], resected length of vaginal tissue [(3.5±1.0)cm vs. (3.5±0.8) cm, P=0.80]. (2) The mean time of the Foley catheter removed was (10.6±2.7)days(7-17 days)in LANSRH group and (17.2±4.2)days(9-25 days)in LRH group (P=0.02). After Foley catheter removed, 95% (35/37) presented bladder fulfilling sense, 86% (32/37) presented automatic micturition and urination emptying in LANSRH group. However, In LRH group, 88% (22/25) presented bladder fulfilling sense, 76% (19/25) presented automatic micturition and urination emptying. The bladder void function recovery were 68% (25/37) in class 0 and 3% (1/37) in class Ⅱ in LANSRH group, when compared with 40% (10/25) in class 0 and 12% (3/25) in class Ⅱ in LRH group, it reached statistical difference (P<0.05). In the mean time, there was no significant difference in Class Ⅰ bladder void function recovery, which were 24% (9/37) and 48% (12/25). (3) No surgery complications and blood transfusion were observed in LANSRH and LRH group. Postoperative pathology suggested that no tumor cell invasion occurred in paracervix tissue and lymph nodes. During the range of 11 to 19 months follow-up, all patients were alive without tumor recurrence and metastasis. Conclusion LANSRH is safe and feasible surgical management for cervical cancer at early stage and would improve the recovery of bladder voiding function postoperatively by sparing anatomical nerve.

Effect of selection techniques on chromosome and ultrastructure of human spermatozoa / 中华男科学杂志

<p><b>OBJECTIVE</b>To know the effect of different selection techniques on chromosome abnormality rate and the percentage of spermatozoa with relatively intact head ultrastructure in human sperm.</p><p><b>METHODS</b>The selection techniques of swim-up, Percoll density gradient centrifugation and doule-flection tube were used to observe sperm chromosome abnormality rate, sex chromosomal ratio and the percentage of spermatozoa with relatively intact head ultrastructure.</p><p><b>RESULTS</b>The sperm chromosome abnormality rate, sex chromosomal ratio and the percentage of spermatozoa with relatively intact head ultrastructure remained unchanged after the application of the three selection techniques(P > 0.05).</p><p><b>CONCLUSION</b>The three selection techniques used in this study neither increase the damage to sperm ultrastructure nor exert effects on human chromosome.</p>

Correlation between the VEGF-C and VEGF-D expressions and the retroperitoneal and inguinal lymph node metastasis in human epithelial ovarian carcinoma / 第三军医大学学报

Objective To investigate the correlation between the expressions of vascular endothelial growth factor C (VEGF C) and vascular endothelial growth factor D (VEGF D) and the lymph node metastasis of groin and retroperitoneum in human epithelial ovarian carcinoma. Methods The expressions of VEGF C and VEGF D in benign, borderline, and malignant epithelial ovarian tumors were detected by immunohistochemistry and light microscopy. Results The expressions of VEGF C and VEGF D were found in benign, borderline, and malignant epithelial ovarian tumors. The expressions of VEGF C and VEGF D in ovarian carcinomas were significantly higher than those in benign and borderline ovarian tumors. The expression levels of VEGF C and VEGF D were correlated with peritoneal metastasis, lymph node metastasis of groin and retroperitoneum, and clinical stage, but not with distant metastasis, histology type, histological grade, and age. Conclusion Up regulation of VEGF C and VEGF D in epithelial ovarian carcinoma is advantageous to lymph node metastasis. This process may probably be correlated with lymphangiogenesis in tumors.

Changes of ANF mRNA expression in the myocardial tissue of rat embryo and suckling induced by 2,3,7,8-tetrachlorodibenzo-p-dioxin / 第三军医大学学报

Objective To investigate the changes of ANF mRNA expression in the myocardial tissues of rat embryo and neonate induced by 2,3,7,8-TCDD so as to determine if TCDD can cause injuries of cardiac functions. Methods SD rat embryos were divided into 4 groups respectively exposed to TCDD at the dose of 0.05,0.5,5,10 ?g/kg. The mRNA expression of ANF/ANP in the myocardial tissues of rat embryos of day 15,19 and suckling rats aged 5 days were detected by semiquantitative RTPCR analysis. Results TCDD could upregulate ANF mRNA expression in the myocardial tissues of rat embryos and suckling rats,as compared with control group. Conclusion TCDD can upregulate ANF mRNA expression in myocardial tissues,suggesting that TCDD may cause injuries of cardiac functions of rat embryos and suckling rats.