Application of transumbilical single-port laparoscopy with self-made approach in common gynecological operations / 中国医师杂志

Objective:To explore the clinical application of transumbilical single-port laparoscopy with self-made approach in common gynecological operations.Methods:105 cases of transumbilical single-port laparoscopic surgery with self-made approach successfully (single-port laparoscopic group) carried out in Karamay Central Hospital from January 2018 to September 2020 were retrospectively collected, and 105 cases of multi-port laparoscopic surgery (multi-port laparoscopic group) with matching conditions were selected. The operation time, intraoperative blood loss, postoperative first exhaust time, postoperative first out of bed activity time, postoperative 24-h pain score, postoperative satisfaction score of patients 3 months after operation, incision cosmetic score of doctors 3 months after operation, postoperative hospital stay, intraoperative surgeon′s feeling score and intraoperative and postoperative complications were compared between the two groups.Results:All operations were successfully completed under laparoscopy, without conversion to laparotomy, without auxiliary holes, and no obvious complications occurred during the operation. The operation time and intraoperative blood loss in the single-port laparoscopic group were greater than those in the multi-port laparoscopic group (all P<0.05). The incision cosmetic score of single-port laparoscopic group was significantly better than that of multi-port laparoscopic group ( P<0.05). The intraoperative surgeon′s feeling score in multi-port laparoscopic group was better than that in single-port laparoscopic group ( P<0.05). There was no significant difference between the two groups in the first postoperative exhaust time, the first postoperative out of bed activity time, 24-hour postoperative pain score, surgical satisfaction score and postoperative hospital stay (all P>0.05). The operation time and intraoperative blood loss of ovarian cyst stripping, hysteromyomectomy and total hysterectomy in the multi-port laparoscopic group were less than those in the single-port laparoscopic group (all P<0.05). There was no significant difference between the two groups in the operation time and intraoperative blood loss of salpingectomy and adnexectomy (all P<0.05). The feeling of doctors in multi-port laparoscopic group was better than that in single-port laparoscopic group (all P<0.05). Conclusions:Under the condition of appropriate case selection, laparoendosopic single-port surgery with self-made approach is feasible in common gynecological operations. The prominent advantage of laparoendosopic single-port surgery is postoperative cosmetic effect.

The value of colposcopy in referral of cervical high-risk HPV positive women / 中国医师杂志

Objective:To investigate the clinical value of referral colposcopy in cervical high-risk human papillomavirus (HR-HPV) positive women in cervical cancer screening.Methods:Totally 2 445 cases, which were referred for colposcopic cervical biopsy for cervical HR-HPV positive in Karamay Central Hospital from January 2018 to November 2021 were collected. The status of cervical HR-HPV positive transferred colposcopy in different situations to identify high-grade squamous intraepithelial lesions (HSIL) and above (HISL+ ) was analyzed. The value of referral colposcopy in cervical HR-HPV positive women under different conditions was evaluated.Results:2 445 HR-HPV positive women were referred for colposcopic cervical biopsy, which confirmed 1 447 cases of negative for intraepithelial lesion or malignancy (NILM), 362 cases of low grade squamous intraepithelia lesion (LSIL), 510 cases of HSIL and 126 cases of squamous cell carcinoma (SCC); The complete coincidence rate between colposcopy diagnosis and pathological diagnosis was 67.08%(1 640/2 445), and the Kappa value of consistency test was 0.489. The sensitivity and specificity of colposcopy in the diagnosis of LSIL+ were 91.28% and 69.38%, and HSIL+ were 74.52% and 93.15%. The detection rates of HSIL+ in HPV16/18 positive and other 12 HPV positive patients with abnormal cervical liquid based cytology (TCT) were 64.78%(103/159) and 78.79%(364/462), respectively. The positive rates of HPV16/18 and 12 other HPV positive HSIL+ with normal TCT were 16.46%(82/498) and 6.56%(87/1 326), respectively. The rate of detecting HSIL+ in abnormal areas under colposcopy was 44.69%(534/1 195), and that in routine biopsy was 8.16%(102/1 250).Conclusions:Among the referred for colposcopic cases, the detection rate of HSIL+ was higher in cases with cervical HR-HPV positive and TCT abnormalities. Colposcopy has obvious value in identifying cervical lesions. The accurate diagnosis of cervical lesions is based on cervical biopsy under colposcopy.

Piperine inhibits Ang Ⅱ-induced cellproliferation and migration of rat airway smooth muscle cells / 基础医学与临床

Objective To explore the effects of piperine on cell proliferation and migration in angiotensin Ⅱ (Ang Ⅱ)-treated rat airway smooth muscle cells (ASMCs).Methods The primary ASMCs of rats were cultured by improved tissue-piece digestion inoculation and trypsin digestion.MTT assay was used to detect the effects of Ang Ⅱ and Ang Ⅱ receptor antagonist losartan on cell proliferation activity.After treatment with Ang Ⅱ and piperine, the cell proliferation activity, the cell cycle distribution and the cell migration were detected by MTT, flow cytometry and Transwell assay respectively.ERK1/2 inhibitor PD98059 and losartan were then applied to determine the expression of cyclin D1, MMP-9, p-ERK1/2, ERK1/2, and β-actin proteins by Western blot assay.Results After 24 h culture, Ang Ⅱ treatment promoted the cell proliferative activity in rat ASMCs (P<0.05), and the promotive effect of 10-7 mol/L Ang Ⅱ was the most significant.Additionally, losartan blocked the Ang Ⅱ-induced cell proliferative activity in rat ASMCs (P<0.05).10-7 mol/L Ang Ⅱ treatment resulted in the elevated cell proliferative activity, higher S phase fraction, increased migrated cell number, and enhanced expression of cyclin D1, MMP-9and p-ERK1/2 proteins (P<0.05);these effects were dose-dependently reversed by piperine.Both PD98059 and losartan blocked Ang Ⅱ-induced expression of p-ERK1/2, cyclin D1 and MMP-9 proteins in rat ASMCs.Conclusions Piperine may inhibit Ang Ⅱ-induced cell proliferation and cell migration via ERK1/2 signaling pathway in rat ASMCs.

The expression and clinical significance of miR-146a/133b in Xinjiang women with cervical lesion / 重庆医学

Objective To explore the different expression and clinical significance of miR-146a/133b in cervical tissue in uy-ghur and Han women in Xinjiang.Methods The relative expression of miR-146a/133b in paraffin embedding tissues of cervicitis, CIN and cervical cancer was detected by the RT-qPCR.And analyzed the clinical significance in the development of cervical cancer. Results Compared with cervicitis,the expression of miR-146a/133b increased significantly in CIN and cervical cancer(P <0.05). With the cervical lesion was aggravating,the expression level increased.In cervical cancer tissue,the expression of miR-146a were different between Uyghur and Han women(P <0.05).Marriage age<20 years old,tumor diameter≥4 cm,with HPV infection in cervical cancer tissue,miR-146a/133b had high expression (P <0.05).Conclusion MiR-146a/133b are involved in incidence and development of cervical cancer,they may become new prognostic and evaluating molecular markers in cervical cancer.

Correlation of ER with Bcl-2 in cervical cancer and pre-cancerous lesion / 中国肿瘤临床

Objective:This study aimed to investigate the relationship between estrogen receptor (ER) and Bcl-2 in cervical can-cer and precancerous lesions. Methods:ER and Bcl-2 were evaluated by immunohistochemistry in 20 non-tumor tissues, 30 low-grade cervical intraepithelial neoplasias, 70 high-grade cervical intraepithelial neoplasias, and 80 cervical cancers. Results:The positive rate of ER was 75%in non-tumor tissues;this rate decreased with disease severity (χ2=24.266, P<0.01). The overexpression of ER protein was remarkably lower in cervical intraepithelial neoplasias (CIN) Ⅱ-Ⅲ and carcinomas than in non-tumorous cervices. Differences were not significant between CINⅠand non-tumorous cervices (χ2=0.751, P=0.386). Furthermore, ER expression was not correlated with histological type and tumor grade. The positive rate of Bcl-2 was 75.38%in squamous cell carcinoma. This rate increased with dis-ease severity (χ2=27.715, P<0.01). The Bcl-2 protein overexpression was remarkably higher in CINⅠ, CINⅡ-Ⅲ, and carcinomas than in non-tumorous cervices. Bcl-2 expression was also not correlated with histological type (P=0.500);by comparison, Bcl-2 expression was correlated with tumor pathological grade (χ2=4.862, P=0.027). The co-expression of ER and Bcl-2 was 38.57%and 15.38%in CINⅡ-Ⅲand squamous cell carcinoma, respectively;the differences between these two values were significant (χ2=9.108, P=0.003). A cor-relation between ER and Bcl-2 was observed in CINⅡ-Ⅲ(r=0.506, P<0.01);no correlation was observed between other groups. Con-clusion: ER expression was inversely correlated with Bcl-2 in cervical cancer progression. The co-expression of these markers may have an important function in the course of high-grade cervical intraepithelial neoplasia.