Distribution of human papillomavirus types in cervical cancer population / 中国医师杂志

Objective:To investigate the distribution of human papillomavirus (HPV) subtypes in patients with cervical invasive cancer.Methods:Retrospective selection was conducted on hospitalized patients diagnosed with cervical invasive cancer by pathology at the Third Affiliated Hospital of Sun Yat-sen University from January 2016 to December 2020, with complete relevant information. The age, histological classification, specific HPV infection types at the time of diagnosis of cervical cancer were recorded, and differences in HPV types and single and multiple infections in the squamous cell carcinoma and adenocarcinoma populations were analyzed. The coverage rate of bivalent, tetravalent, and ninvalent HPV vaccines in the cervical cancer population was analyzed.Results:A total of 231 cases of cervical invasive cancer that met the criteria were included, including 183 cases of squamous cell carcinoma, 43 cases of adenocarcinoma, and 5 cases of other histological types. The positive rates of HPV infection in cervical cancer, squamous cell carcinoma, and adenocarcinoma populations were 89.18%(206/231), 92.35%(169/183), and 74.42%(32/43), respectively. The top five types of HPV infection in cervical cancer patients were 16, 18, 58, 52, 31, and 33, respectively; The top five types of infection rate in squamous cell carcinoma patients were HPV16, 18, 58, 52, 31, and 33, respectively; Adenocarcinoma patients only detected 5 types of HPV, with the main types being HPV16 and 18. The infection rates of single HPV type in patients with cervical cancer, squamous cell carcinoma, and adenocarcinoma were 77.49%(179/231), 79.23%(145/183), and 67.44%(29/43), respectively. The multiple infection rates were 11.69%(27/231), 13.11%(24/183), and 6.98%(3/43), respectively. The positive rate of HPV was higher in all age groups of cervical cancer. The coverage rates of bivalent, tetravalent, and ninvalent HPV vaccines covering different types of infections in cervical cancer populations were 66.67% to 74.03%, 67.53% to 74.89%, and 81.39% to 87.44%, respectively.Conclusions:The cervical cancer population is mainly affected by high-risk HPV single infection, mainly including HPV16, 18, 58, 52, 31, 33; The HPV infection rate in the squamous cell carcinoma population is higher than that in the adenocarcinoma group, with the main type being HPV16, while in the adenocarcinoma population, the main types are HPV16 and 18.

Research on the average age of onset of endometrial cancer based on data mining / 中国医师杂志

Objective:To explore the average age at onset of endometrial cancer (EC) and the differences between domestic and international factors.Methods:Pubmed, Wanfang Database, VIP Information Resource System, and China National Knowledge Infrastructure (CNKI) were selected to extract clinical research data related to EC. Through data mining methods such as frequency analysis and cluster analysis, we compared the differences in the average age of onset of EC between domestic and foreign countries.Results:A total of 280 articles that met the inclusion criteria were selected, and frequency analysis found that the average age of onset of EC in the Chinese population was mostly concentrated under 57 years old, while in European and American countries, it was mainly concentrated above 57 years old. Through cluster analysis, it was found that the average age of onset in China was clustered in one category with most Asian countries, while European and American countries and Australian countries were clustered in another category. Through analysis of domestic and foreign articles, it was found that the average age of onset of EC did not show a significant upward or downward trend with years.Conclusions:There are differences in the average onset age of EC among different countries and regions. The onset age of EC in Asian populations is significantly earlier than that in European and American populations. The average onset age of EC in Chinese populations is 54 years old, and there is no trend towards a younger onset of EC.

The value of inflammatory markers combined with tumor markers in the diagnosis of torsion of mature ovarian teratoma / 中国医师杂志

Objective:To investigate the diagnostic efficacy of inflammatory biomarkers [neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR)] combined with tumor markers [carbohydrate antigen (CA)125, CA199] in mature cystic teratoma (MCT) patients possess torsion.Methods:The clinical data of patients with MCT diagnosed by surgery and pathology in the third Affiliated Hospital of Sun Yat-Sen University from March 2013 to October 2019 were retrospectively analyzed. A total of 31 MCT patients with torsion were included in observation group , another 101 MCT patients without torsion were assigned to the control group.Clinical characteristics and the levels of NLR, MLR, PLR, CA125, CA199 were assessed and analyzed.Results:The inflammatory biomarkers (NLR, MLR, PLR) and tumor markers (CA125) in the observation group were higher than those in the control group ( P<0.05). Univariate regression analysis was used to screen variables with statistical significance, including NLR, PLR, CA125 and CA199 ( P<0.05), and multivariate logistic regression was used to construct a prediction model for diagnose MCT patients with torsion , which combined NLR and CA199 ( P<0.05). The area under curve (AUC) of NLR, PLR, CA125, CA199 and the combined prediction models of NLR and CA199 were 0.83, 0.72, 0.69, 0.60 and 0.86, respectively. Among them, the joint prediction model of NLR and CA199 had the highest diagnostic efficiency, with a sensitivity of 77.42% and a specificity of 82.18% ( P<0.05). In the observation group, the accuracy of combined prediction model of NLR and CA199 in the diagnosis of MCT pedicle torsion was higher than that of ultrasound (87.10% vs 61.29%), but according to the clinical symptoms and ultrasonic examination, 90.32% of the patients were diagnosed as MCT pedicle torsion. Conclusions:The inflammatory biomarkers and tumor markers have useful clinical significance in the diagnosis of MCT with torsion, especially the combine measurement of NLR and CA199. Associated with the patient's symptoms, signs, examination included doppler ultrasound may assist in improving the diagnostic accuracy .

Prognostic value of metabolic tumor volume and total lesion glycolysis from ¹⁸F-FDG PET/CT in lymph node metastases and risk stratification of endometrial carcinoma / 부인종양

OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.

Ovarian tumor associated with anti-N-methyl-D-aspartate receptor encephalitis: A report of 110 cases / 中国医师杂志

Objective To summarize the clinical features of patients with ovarian tumor associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis,and to explore the influence of operation patterns on the prognosis.Methods The clinical data of ovarian tumors with anti-NMDAR encephalitis in the Third Affiliated Hospital of Sun Yat-sen University from January 2009 to December 2018 were collected,and the clinical characteristics,treatment and prognosis were analyzed.Results A total of 110 patients with ovarian tumors and anti-NMDAR encephalitis were collected.All patients were positive for anti-NMDAR antibodies in serum and/or cerebrospinal fluid.The age of onset ranged from 10 to 35 years (24.6 ±5.7).About 60.9％ patients'initial symptom was psychosis.The main clinical features were psychosis (97.3％),seizures (83.6％),conscious disturbance (72.7％),autonomic dysfunction (64.5％),dyskinesia (64.5％),central hypoventilation (54.5％) and impaired memory (31.8％).Most patients'symptoms were relieved after surgery and immunotherapy.Postoperative pathological results revealed that ovarian teratoma accounted for 97.8％ of the ovarian tumor.The prognosis of patients with surgery was better than the patients without surgery,with statistically significant difference (P ＜ 0.05).The prognosis of patients with adnexectomy was better than the patients with ovarian tumor excision,with statistically significant difference (P ＜ 0.05).Conclusions Anti-NMDAR encephalitis,with psycho-neurological symptoms as dominant manifestation,is usually associated with ovarian tumor.For young female patients with psychosis,clinicians should be alert to the possibility of anti-NMDAR encephalitis and screen for tumor.Patients with adnexectomy and immunotherapy can get a better prognosis.

Regard on the diagnosis and treatment of lethal Anti-NMDAR encephalitis initiated by teratoma / 中国医师杂志

Teratoma is the most common germ cell tumor,which accounts for 20％ to 40％ of ovarian tumor.Recently,teratoma has been found to be able to initiate anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis,which belongs to autoimmune encephalitis with the possibilities of lethality and disability.The main clinical features are psychosis,impaired memory,dyskinesia,autonomic dysfunction,seizures,conscious disturbance and central hypoventilation.Most patients can get a good prognosis after immunotherapy and surgery.This article reviews the progresses of anti-NMDAR encephalitis to improve the cognition of clinicians.It is recommended that all anti-NMDAR encephalitis patients should receive tumor screening.And gynecologist should pay more attention to the diagnosis and treatment of benign ovarian tumor.

The significance of 18F fluorodeoxyglucose-positron emission tomography/computed tomography in detection of pelvic nodal metastases in endometrial cancer / 中国医师杂志

Objective This study was conducted to assess the accuracy of [18F] fiuorodeoxyglucose-positron emission tomography/computed tomography (18FDG PET-CT) in detection of pelvic nodal metastases in endometrial cancer.Methods Patients with endometrial cancer from January 2015 to June 2017 confirmed by the postoperative pathology were retrospectively analyzed.30 patients finished PET-CT before operation.The findings on histopathology were compared with 18FDG-PET/CT findings to calculate the sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),and accuracy of 18FDG-PET/CT.To analyze the efficacy of maximum standardized uptake (SUVmax) and lymph node maximum standardized uptake (LN-SUVmax) of PET-CT in the diagnosis of pelvic lymph node metastasis.Resuits For detection of pelvic nodes,based on patient analysis,18FDG-PET/CT had a sensitivity of 75.0％,specificity of 88.5％,PPV of 50.0％,NPV of 95.8％ and accuracy of 86.7％.Based on a nodal region analysis,18FDG-PET/CT had a sensitivity of 83.3％,specificity of 98.3％,PPV of 55.0％,NPV of 99.6％,and accuracy of 98.3％.When maximum standardized uptake values (SUVmax) ＞ 8,area under curve (AUC) =0.64,Yonden Index =0.42.When maximum standardized uptake values of lymphonodus (LN-SUVmax) ＞ 3 (AUC =0.79,Yonden Index =0.63),the sensitivity and specificity of diagnosis of lymph node metastasis were 100％,42.31％,and 75.0％,88.5％,but without statistically significant difference.Although AUC of LN-SUVmax was higher than SUVmax of primary lesion,but the difference was not statistically significant (P ＞ 0.05).Conclusions 18 FDG-PET/CT has high specificity,NPV for detection of pelvic LN metastasis area in endometrial cancer,which can provide preoperative basis for patients with endometrial cancer to avoid lymph node resection,thereby reducing the risk of early endometrial cancer surgery and improving the quality of life after surgery.We concluded that,there were no exact cutoffs of SUVmax for the prediction of lymph node metastases,neither primary lesion,nor lymph node.There is clearly a need for multicenter,large-scale trials to find out better parameters in judging metastasis of lymphnodes.

Epidemiological features and trends of endometrial cancer: 10 081 cases analysis of 62 hospitals in Guangdong province / 中国医师杂志

Objective To explore the epidemiology characteristics of endometrial cancer (EC).Methods We retrospectively analyzed 10081 patients diagnosed with EC from 62 hospitals between 2000 and 2010 in Guangdong province.Results The mean age at diagnosis was 52.8 ± 9.3.The proportion were 19.3％,64.2％,16.6％ in patients with ages ≤45,＞ 45-60,＞ 60 respectively.From 2000 to 2010,the mean ages at each year were no statistic significance.The number of cases of EC were positively correlated with years(r =0.964,P ＜ 0.001).The number of cases of patients with ≤ 30 years old (r =0.857,P =0.001),≤35 years old (r =0.866,P =0.001),≤40 years old (r =0.952,P ＜ 0.001),≤ 45 years old (r =0.952,P ＜0.001) were positively correlated with years.The ratios of patients with ≤30 years old (x2 =10.390,P =0.407),≤35 years old (x2 =11.651,P =0.309),≤ 40 years old (x2 =17.329,P =0.067),≤45 years old (x2 =5.154,P =0.881) during these eleven years were no statistic significance.The ratios of type Ⅰ EC at 2000-2010 were no statistic significance.Conclusions EC often present in patients aged from ＞ 45-60 years old.The case number of EC showed an increasing trend.However,the proportion of young patients was stable.The endometroid adenocarcinoma was the main histological type of EC.

The application value of DNA hybridization probe test in the diagnosis of bacterial vaginosis and vulvovagi-nal candidiasis / 实用医学杂志

Objective To investigate the sensitivity and specificity of DNA hybridization probe test(Af-firm VPIII) in the identification related microorganisms of bacterial vaginosis(BV),vulvovaginal candidiasis (VVC). Methods Vaginal secretion were detected in 103 patients with symptom and sign of vaginitis in the out patient department. According to Nungent score,the fungal culture as the gold standard. BV blue reagent assay and wet mount microscopy as a common detection method,evaluated the sensitivity and specificity of Affirm VPIII. Results Compared with the Nungent score,the sensitivity and specificity of Affirm VPIII were 98% and 96.2%. Compared with the fungi culture,the sensitivity and specificity of Affirm VPIII were 89.4% and 98.3%. Conclusion Affirm VPIII has high sensitivity and specificity which can identify pathogenic microorganisms of BV,VVC,especially in BV diagnosis.

Comparison of robotic surgery with laparoscopy for surgical staging of endometrial cancer:a meta-analysis / 中华妇产科杂志

Objective To evaluate the safety and effectiveness of robotic surgery in surgical staging of endometrial cancer. Methods Searched English and Chinese databases, including Cochrane library, PubMed, Embase, Web of Science, China National Knowledge Internet, data base of Wanfang, China Science and Technology Journal(CSTJ), and relevant journals and magazines by hand from Jan. 2000 to Oct. 2016.(1)In accordance with the inclusion criteria,two independent investigators screened databases and extracted the relevant data respectively, then evaluated the quality of including studies in Newcastle-Ottawa Scale(NOS).(2)Meta-analysis was performed with RevMan 5.3 software. Heterogeneity inspection was done for each study and different effect model included the random effect model and fixed effect model was chose according to the results of the inspection. At last, the related parameters of the robotic surgery and laparoscopic surgery was analysed. Results (1) Thirteen articles were ultimately included. All of them were written in English and included a total of 1554 patients, included 739 cases of robotic surgery and 815 cases of laparoscopic surgery. Thirteen articles were all cohort study, four of them were prospective cohort study, while others were retrospective cohort study. After quality assessment, all studies had more than 5 stars and illustrated the higher quality.(2)Meta-analysis results showed:compared with laparoscopic surgery in surgical staging of endometrial cancer, robotic surgery had less estimated blood loss [standard deviation (SD)=-72.31 ml,95%CI:-107.29 to-37.33,P<0.01], less time for hospital stay (SD=-0.29 days,95%CI:-0.46 to-0.13,P=0.001), less need for blood transfusion [risk ratio (RR)=0.57,95%CI:0.33 to 0.97,P=0.040], and conversion to open surgery (RR=0.41,95%CI: 0.26 to 0.65,P=0.000),less intraoperative complications (RR=0.43,95%CI: 0.24 to 0.76,P=0.004) in surgical staging of endometrial cancer. There was no statistically significant difference in aspects of operative time (SD=10.26 minutes, 95%CI:-13.62 to 34.13,P=0.400), postoperative complications (RR=0.87, 95%CI: 0.67 to 1.12,P=0.280), the total number of lymph nodes removed (SD=-0.04,95%CI:-3.99 to 3.91,P=0.980), the number of pelvic lymph node dissection (SD=0.48,95%CI:-1.76 to 2.71,P=0.680) and the number of para-aortic lymph node dissection (SD=0.46,95%CI:-1.42 to 2.34,P=0.630). Conclusions Compared the robotic surgery with laparoscopic surgery in surgical staging of endometrial cancer, robotic surgery has less estimated blood loss, less need for blood transfusion and conversion to open surgery,less intraoperative complications and other advantages. While its cost is so expensive that restrict clinical application.

The Expression and Significance of LGR5 in Endometrial Cancer / 实用妇产科杂志

Objective:To investigate the expression of Leucine-rich repeat-containing G protein-coupled receptor 5(LGR5) in endometrial cancer(EC) and their relationship with clinicopathological characteristics.Methods:Immunohistochemistry were performed to measure the LGR5 expression in EC(n =90) and normal endometrium tissue(n =30).The expression of LGR5 and its relationship with clinicopathological characteristics were analyzed.Results:The expression of LGR5 was significantly higher in EC than that in normal tissue (63.3％ vs 23.3％,P＜0.001).The expression of LGR5 in ＜ 1/2 myometrium infiltration group was higher than in ≥1/2 myometrium infiltration group(72.5％ vs 33.3％,P =0.001).There was no significant difference between the expression of LGR5 in different group of age,histological type,histological differentiation,cervical stroma invasion,lymph node metastasis,FIGO stage(P ＞ 0.05).Multivariate analysis showed that LGR5 was an independent influential factor of myometrium infiltration (OR =0.163,95％ CI 0.034 ～ 0.772,P =0.022).Conclusions:LGR5 is up-regulated in EC,and is correlated to myometrium infiltration.LGR5 may play an important role in EC tumorigenesis.

Meta-analysis of prognosis of ovarian preserving in young patients with early endometrial cancer / 中华妇产科杂志

Objective To discuss the effect of preserving ovaries on the prognosis of young early endometrial cancer patients. Methods Searched English and Chinese databases by computors, including Cochrane library, Embase, PubMed, Web of Science, China National Knowledge Internet (CNKI), data base of Wanfang, China Science and Technology Journal(CSTJ), and also relevant journals and magazines by hand. Retrieval time from January 1996 to March 2016. In accordance with the inclusion criteria, two independent investigators screened the studies and extracted the relevant data respectively. Then evaluated the quality of included studies. Finally, conducted the meta-analysis with RevMan 5.3 software from cochrane collaboration network, in which heterogeneity test of enrolled studies firstly was completed and combined analysis with effect models according to the heterogeneity secondary. In the light of the result, effect of remaining ovaries on the prognosis (5-year recurrence rate and 5-year overall survival rate) of young early endometrial cancer patients was determined. Results Ten trials were included. All of them were cohort studies, a total of 5 299 patients, in which 916 patients′ ovaries were remained. Quality assessment of all 10 studies were based on Newcastle-Ottawa Scale (NOS) scale. All of the studies enrolled were of high quality with a score of ≥7. After quality assessment,all studies illustrated the higher the quality. Meta-analysis showed that there was no statistically significant difference between who had ovarian preservation and without preservation in terms of 5-year overall survival rate [96.00%(863/899) vs 96.51%(3 736/3 871);RR=1.00,95%CI:0.99-1.02,P=0.792] and the 5-year recurrence rate [2.58%(7/271) vs 4.43%(51/1 150);RR=1.01, 95%CI:0.46-2.22, P=0.986]. Conclusion Ovarian preservation in young early stage patients of endometrial cancer could not effect the 5-year overall survival rateand the 5-year recurrence rate.

Comparative analyses of clinical and pathological characteristics between types 1 and 2 endometrial uterine cancers / 中国医师杂志

Objective To investigate the clinical and pathological characteristics between types 1 and 2 endometrial uterine cancers.Methods The clinical materials of 9 437 patients with uterine cancer were collected with retrospective analysis from 62 hospitals during 2000 to 2010.Results The mean age of type 1 endometrial cancers was less than type 2.There were more young patients in type 1 endometrial cancers.The mean menopause age of type 2 endometrial cancers was greater than type 1.The mean age of menarche,obesity,diabetes,hypertension,infertility,and nulliparous were not significant differences between types 1 and 2 endometrial cancers.There were more patients with advanced tumor,deep myometrium invasion,estrogen receptor (ERs) negative,progesterone receptor (PR) negative,P53 positive,lymph vascular space involvement,cervical stromal invasion,adnexal metastasis,and lymph node metastasis in type 2 endometrial cancers.Conclusions Type 2 endometrial uterine cancers occurred in elder people with more pathological risk factors and more malignant biological activities.

Endometrial carcinoma diagnosed after hysterectomy / 中国医师杂志

The clinical manifestation of endometrial uterine cancers is similar to other gynecological diseases like endometrial hyperplasia,polyps,uterine myoma,and adenomyosis.This similarity may result in missed diagnosis of endometrial cancer,which should be paid wide attention.In these cases,pathological examination reports malignancy of uterine specimen after simple hysterectomy.Personalized treatment,such as observation and reoperation,should be supplemented for these patients,according to the pathological characteristics of the tumor,risk factors of lymphatic and ovarian metastasis and the willingness of patient.

Value of hysteroscopy and dilatation and curettage in diagnosis of endometrial cancer / 中华妇产科杂志

Objective To evaluated the value of hysteroscopy and dilatation and curettage (DC) in diagnosis of endometrial cancer. Methods This retrospective analysis included clinical pathologic data of 3 676 patients with endometrial cancer from Jan. 1, 2000 to Dec. 31, 2010 in hospitals of endometrial cancer prevention projects in Guangdong Province. Results A total of 3 676 patients with endometrial cancer were divided into DC group (3 211 patients) and hysteroscopy group (465 patients). Compared to the results of pathological diagnosis, the accuracy rate between DC group and in hysteroscopy group were no statistically difference was 91.00%(2 922/3 211) vs 90.75%(422/465;χ2=0.030, P=0.862). The accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of cervical involvement between DC group and hysteroscopy group were 81.28%vs 86.45%(P0.05), 93.76%vs 98.71%(P0.05), respectively. Rate of positive peritoneal cytology in DC group was 4.76%(153/3 211), and the rate was 3.23%(15/465) in hysteroscopy group, which were no statistically difference (χ2=2.206, P=0.137). There were no statistically difference in 5-year overall survival (91.02% vs 92.03%;χ2=0.033, P=0.856) and 5-year progression-free survival (89.81%vs 91.83%;χ2=1.508, P=0.219) between DC group and hysteroscopy group. Conclusions Hysteroscopy and dilatation and curettage is an effective method in diagnosis of endometrial cancer, especially hysteroscopy is better in diagnosis of cervical involvement. Hysteroscopy don′t improve risks of positive peritoneal cytology and don′t affect the prognosis of patients with endometrial cancer.

Follow-up study on hepatitis B virus mother-to-child transmission in 1355 HBsAg-positive pregnant women / 中华传染病杂志

Objective To investigate hepatitis B virus (HBV) mother-to-child transmission rate in hepatitis B virus surface antigen (HBsAg)-positive pregnant women.MethodsA total of 1355 HBsAg-positive pregnant women and their 1360 newborns (included 5 twins)were collected prospectively.All newborns received hepatitis B immunoglobulin (HBIG) 200 U intramuscularly within 6 hours of birth as early as possible,and were administered with routine 10 μg recombinant hepatitis B vaccine (at 0,1,6 months of birth).The venous blood HBV markers and HBV DNA levels were detected in all newborns at 0,7,12 months of age.The measurement data were analyzed by t test.Qualitative data were analyzed by chi square test,rank sum test or Fisher exact test.Results The intrauterine HBV infection rate of 1360 infants were 1.54％ (21/1360) during 12 months of follow-up.The rate of intrauterine infection in HBeAg positive mothers was significant higher than that of HBeAg negative mothers (4.44％ vs 0,χ2 =35.99; P＜0.05); the rate of intrauterine infection in HBV DNA positive mothers was significant higher than that of HBV DNA negativemothers (3.13％ vs 0,χ2 =21.84; P＜0.05).When maternal serum HBV DNA≥1 × 107 IU/mL,the rate of intrauterine infection was 6.01 ％,which was significantly higher than that of maternal serum HBV DNA＜ 1 × 107 IU/mL (χ2 =39.43,P＜0.05).ConclusionsAfter strict combined active-passive immunization,the rate of HBV intrauterine infection is 1.54％.When mothers are HBeAg positive or with high level of HBV DNA,the rate of HBV intrauterine infection increases significantly.Intrauterine infection is the main cause of failure in immunoblockade of HBV mother-to-child transmission.

Study of G1 phase synchronization in endometrial carcinoma HEC-1-A cells / 肿瘤研究与临床

Objective To investigate the effects of lovastatin on inducing G1 phase synchromzation in HEC-1-A cells and examine the cell cycle progression after desynchronization.Methods The doubling time of HEC-1-A cells was detected by cell counting Kit-8 assay.To determine the best lovastatin concentration of G1 synchronization,HEC-1-A cells were treated with lovastatin at concentration of 10,20,30 and 40 μmol/L respectively for 1 × doubling time,and the cell cycle was detected by flow cytometry (FCM).To determine the best period of lovastatin treatment to achieve G1 synchronization,HEC-1-A cells were treated with lovastatin at the best concentration for 0.5 × to 2 × doubling time,and the cell cycle was detected every 4 h using FCM.Furthermore,the cell cycle progress of HEC-1-A cells after desynchronization was also observed.Results The doubling time of HEC-1-A cells was 24 h.Treated with lovastatin at concentration of 40 μmol/L for 28 h achieved maximum G1 arrest (87.87±0.70) ％ in HEC-1-A cells.Minimum G1 phase (58.42±0.54) ％ and maximum S phase (33.58±0.62) ％ were observed after desynchronizing for 20 h.Conclusion Maximum G1 synchronization of HEC-1-A cells is induced by lovastatin at concentration of 40 μmol/L for 28 h.The HEC-1-A cells show minimum G1 phase and maximum S phase after desynchronizing for 20 h.

Causes and management for pelvic mass in adolescents / 中国综合临床

Objective To explore the clinical characteristics,causes,diagnosis and treatment of pelvic mass in adolescents caused by gynecologic diseases. Methods One hundred and twenty-six adolescents with gynecologic diseases presented as pelvic mass were retrospectively reviewed. Results The average age of all patients was 17. 6 years,ranging from 10. 0 to 19. 0 years. Ectopic pregnancy was found in 38 patients(30. 2%) ,the average age of the patients was 18.6 ±0.5 years, ranging from 17.0 to 19.0 years. Ovarian neoplasm was found in 35 patients (27. 8%) ,the average age of the patients was 17. 1 ± 2. 1 years, ranging from 10. 0 to 19. 0 years. Twenty cases (57. l%)had germ cell tumor, eighteen with mature teratomas, one with endodermal sinus tumor and one with immature teratoma. Thirteen cases(37. 2%)had epithelial ovarian tumors;eight with serous cystadenomas,three with mucinous cystadenoma, one with mucinous cystadenoma complicated with serous cystadenoma and one with borderline mucinous cystadenoma. Two cases had simple cyst of the ovary (5. 7%) . Congenital abnormality of reproductive tract was found in 14 patients (11. 1%), the average age was 14. 7 ±2. 2 years, ranging from 13.0 to 19. 0 years. Seven had imperforate hymens, two had rudimentary horn of uterus,four had atresia of vagina,one had atresia of vagina complicated with rudimentary horn of uterus,and one had oblique septum of vagina. Corpus luteum rupture was found in 11 patients (8. 7%) , the average age was 18. 1 ± 1. 9 years, ranging from 13. 0 to 19. 0 years. 116 patients underwent operative treatment and 10 patients underwent conservative therapy. Conclusions According to the stage of adolescents, main causes of pelvic mass in adolescents are different Main causes of pelvic mass in early adolescents are tumorous disease. Congenital abnormalities of reproductive tract are usually in middle adolescents. The gonads develop closely mature in late adolescent period; main causes of pelvic mass are ectopic pregnancy, ovarian neoplasm and physiologic ovarian cyst Surgery is the main therapy of pelvic mass in adolescents.

Change of serum nitric oxide in infectious premature rupture of membrane and its clinical significance / 中国医师进修杂志

Objective To investigate the change of serum nitric oxide ( NO ) in premature rupture of membrane (PROM) and its clinical significance, so as to assess the role of NO in the mechanism of PROM . Method The serum NO in 40 advanced stage pregnant women,28 premature delivery PROM,40 unknown reason term pregnancy PROM ,40 term pregnancy ,40 term labor were detected and compared. Results The serum NO was higher in unknown reason term pregnancy PROM [(95.364±3.562) (u)ol/L] than that in term pregnancy [(75.020±3.416)(u)ol/L] and term labor [(31.457±3.859)(u)ol/L](P<0.01). The serum NO was higher in premature delivery PROM [(101.256±3.124)(u)ol/L] than that in advanced stage pregnant women [(80.363±5.112)(u)ol/L] (P<0.0l),but similar with unknown reason term pregnancy PROM (P = 0.086). Conclusions The serum NO in PROM of term pregnancy significantly is higher than that of advanced stage and term labor women,indicates PROM relating to the increase of NO level. Because the increase of NO links to infection,it suggests that PROM relate closely to the amniotic infection.

Clinical value of neoadjuvant chemotherapy in the treatment of local advanced cervical cancer / 中国医师杂志

Objectives To evaluate the clinical value of neoadjuvant chemotherapy (NACT) in the treatment of local advanced cervical cancer. Methods We searched the clinical trials on the treatment of local advanced cervical cancer with NACT followed by surgery versus initial surgery on English and Chinese published literatures from the main medical data resources (MEDLINE, PUBMED, ELSEVIER ScienceDirect, CNKI). The data about positive pelvic nodes, interstitial infiltration, vascular invasion, positive surgical margin, 3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year OS, 5-year DFS were extracted from these papers, and a meta-analysis was applied. Result The hazard ratio (HR) of positive pelvic nodes on NACT group versus control group was 0. 54(95% CI 0. 33 ～0. 86), HR of interstitial infiltration was 0. 45(95% CI 0. 24 ～0. 86), HR of vascular invasion was 0. 25(95% CI 0. 16 ～0. 38), all differences were statistically significant. And HR of positive surgical margin was 0. 45 ( 95% CI 0. 21 ～0. 99), P = 0. 05, which indicated the difference was not statistically significant. And there were also no significant difference on the HR of 3-year OS, 3-year DFS, 5-year OS and 5-year DFS, and their RR were 1.18(95% CI 0. 84 ～ 1.66) ,1.31 (95% CI 0. 96 ～ 1.78) ,0. 89(95% CI 0. 68 ～ 1.15) ,and 0. 99(95% CI 0. 71 ～ 1.93) respectively. Conclusion For local advanced cervical cancer, NACT could reduce pathological risk factors but it did not improve the survival.