Transvaginal natural orifice transluminal endoscopic surgery in gynecological procedure: Experience of a Women's and Children's Medical Center from China.

OBJECTIVE: To review of our hospital's experiences in transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and challenges we encountered in performance of the procedure, so as to provide help to medical institutions who are preparing to carry out vNOTES. METHODS: We retrospectively analyzed the data of all patients receiving vNOTES in our hospital from April 2018 to May 2021. Data we collected cover the general characteristics, perioperative outcomes, and complications of the patients. RESULTS: A total of 1147 patients underwent vNOTES in the past 3 years at our hospital. The total numbers of adnexal surgery, myomectomy, hysterectomy, pelvic floor reconstruction surgery, and malignant tumor surgery performed via vNOTES were 902, 98, 82, 51, and 14, respectively. Eighteen patients were converted to transabdominal laparoscopic surgery. A total of 38 patients had complications according to Clavien-Dindo classification, and the total complication rate was 3.31%. Among these cases of complications, 27 were Grade I, 4 were Grade II, and 7 were Grade III. No complications of Grade IV or V were reported. CONCLUSION: The application of vNOTES is safe and feasible for most gynecological surgeries. Moreover, hospitals with traditional laparoscopic equipment are advised to try this technique as there is no need to purchase additional expensive equipment. However, since vNOTES represents a novel approach, the long-term complications and efficacy associated with this technique are pending to be verified through large-scale prospective multicenter randomized controlled studies.

Immune Negative Regulator TIPE2 Inhibits Cervical Squamous Cancer Progression Through Erk1/2 Signaling.

Tumor necrosis factor (TNF)-α-induced protein-8-like 2, or TIPE2, is a newly found immune negative regulatory molecule. This study further investigated the role of TIPE2 on proliferation and invasion of cervical squamous cancer cells. Expression of TIPE2 was compared in cervical squamous cancer tissues and adjacent normal tissues by Western blot and immunohistochemistry (IHC). Cervical squamous cancer cell lines, SiHa and C33A, were transfected with recombinant plasmid encoding TIPE2 and tested for cytologic characteristics. The impact of TIPE2 on phosphorylation of extracellular signal-regulated kinase (Erk) signaling pathway was also tested by Western blot analysis of key factors. TIPE2 expression was higher in cervical cancer tissues than that in normal tissue. IHC score of tumor tissue was negatively associated with lymphatic metastasis. Over expression of TIPE2 effectively inhibited the proliferation of cervical cancer cells. Wound healing and transwell assay showed that over expression of TIPE2 suppressed cell migration and invasion in vitro. Meanwhile, phosphorylation of Erk1/2 and upstream mitogen-activated protein kinase kinase (MEK) 1/2 was reduced by TIPE2. TIPE2 is negatively related with development of cervical squamous cancer. TIPE2 is an inhibitory factor of proliferation and invasion of cervical squamous cancer cells, probably through inhibiting Erk signaling pathway.

[Effects and its mechanism of quercetin on cervical cancer HeLa cells].

OBJECTIVE: To evaluate the effects of quercetin on HeLa cells proliferation and study the mechanism of apoptosis. METHODS: The proliferation of HeLa cells treated with quercetin at different concentrations (6.25, 12.5, 25, 50 micromol/L) for 24 hours was assessed by methyl thiazolyl tetrazolium (MTT) method, and also observe the inhibitory effect of quercetin on the transplanted carcinoma in BALB/ C nude mice. Cell apoptosis rate was detected by flow cytometry with annexin V- fluorescein isothiocyannate (FITC)/propidium iodide (PI) technology. The changes of intracellular calcium ion concentration ([Ca2+]i) and mitochondrial membrane potential in HeLa cells induced by quercetin were studied by laser confocal fluorescence microscope and specificity fluorescent probes of Fluo-3/AM and JC-1. Colorimetric method was used to measure the activity of caspase-3. RESULTS: After treated by different concentrations of quercetin (6.25, 12.5, 25, 50 micromol/L), the proliferation was inhibited and the apoptosis was induced in HeLa cells with the inhibition rate of (13.4 +/- 2.2)%, (26.2 +/- 6.8)%, (39.8 +/- 11.4)% and (48.5 +/- 9.1)% respectively, and with the apoptosis rate of (9.0 +/- 1.4)%, (13.3 +/- 1.1)%, (22.5 +/- 2.3)% and (44.7 +/- 4.2)% respectively, and which effects were dose-dependent (P < 0.01). Treated by different concentrations of quercetin (25, 50, 100 mg kg(-1) d(-1)), the growth of transplanted tumor in nude mice was inhibited with the inhibition rate of 13.4%, 30.4%, 45.8%. The apoptosis of HeLa cells was induced by quercetin, which markedly reduced mitochondrial membrance potential, effectively enhance [Ca2+]i, and the caspase-3 was activated in a dose-dependent manner (P < 0.01). CONCLUSION: Quercetin can significantly inhibit the proliferation of HeLa cells, which may be induced apoptosis of cervical cancer cells via the Ca2+ -dependent mitochondrial apoptosis pathway.