[Clinical and prognostic features of ovarian endometrioid carcinoma with synchronous endometrial lesions].

Objective: To compare the clinical and prognostic characteristics of ovarian endometrioid carcinoma (OEC) patients with synchronous endometrial lesions and patients with pure OEC. Methods: A retrospective review of the medical records of patients received initial treatment and a postoperative pathological diagnosis of OEC at Peking University People's Hospital between August 1998 and December 2017 were performed. According to the inclusion criteria, a total of 56 patients with OEC were included in the study, including 13 patients concurrent with simultaneous endometrial lesions (Group A) and 43 patients with pure OEC (Group B). Results: Patients with synchronous endometrial lesions accounted for 23% (13/56). Mean age of Group A at diagnosis was (44.9±8.3) years old, 2/13 of patients were postmenopausal, and no one had a history of hypertension, the first symptom of 5/13 people was irregular vaginal bleeding. Mean age of Group B patients at diagnosis was (52.7±10.2) years old, 53% (23/43) of patients were postmenopausal, and 28% (12/43) patients had the history of hypertension, the first symptom of 4 (9%, 4/43) people was irregular vaginal bleeding. The differences of age, menopause status, history of hypertension and initial symptoms between the two groups were statistically significant (all P<0.05). There were no significant differences in fertility history, dysmenorrhea history, age of menarche, history of endometriosis, preoperative and postoperative CA125 level, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor grade, metastatic site and platinum-based chemotherapy drug resistance between the two groups (all P>0.05). The overall 5-year survival rate of OEC patients was 91.6%, and the overall 5-year progression-free survival rate was 76.6%. Among them, the 5-year survival rate of the OEC concurrent with simultaneous endometrial lesions group was 80.2%, and the pure OEC group was 93.4%; the 5-year progression-free survival rate of the OEC concurrent with simultaneous endometrial lesions group was 74.1%, and the 5-year progression-free survival rate of the pure OEC group was 77.3%. There were no significant differences between the two groups (all P>0.05). Multivariate analysis showed that the independent factors for the prognosis of OEC patients were FIGO stage (P=0.006) and residual lesion size (P=0.020). Conclusions: OEC patients have a high proportion of simultaneous endometrial lesions. OEC with simultaneous endometrial lesions are younger than patients with pure OEC. Synchronous endometrial lesions do not affect the prognosis of patients with OEC.

[A single-center clinical analysis of 65 cases of pseudomyxoma peritonei from appendiceal origin in the early stage].

Objective: To analyze the efficacy and safety of cytoreduction surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP) in the early stage. Methods: The clinical data, including pathological features, recurrence and survival of 65 PMP patients in the early stage underwent CRS combined with HIPEC in Aerospace Center Hospital from January, 2011 to December, 2018 were retrospectively analyzed. Results: 65 patients with early stage PMP underwent CRS+ HIPEC. Among these patients, 25 were males and 40 were females, and the mean age was 52.5 years. The median peritoneal cancer index was 3 (0-16). The score of completeness of cytoreduction (CC) of 63 patients (96.9%) was 0, and 2 patients (3.1%) was 1. No perioperative death occurred, the incidence of surgical complications above grade 3 was 3.1%. Three patients relapsed during the follow-up period, including 1 patient with low-grade PMP, 1 patient with high-grade PMP, and 1 patient with high-grade PMP accompanied by signet ring cell. The 5-year disease-free survival rate of the whole group was 92.4%. Conclusions: PMP patients in the early stage treated by CRS combined with HIPEC can achieve benefit and safety. A close long-term follow-up is necessary.

[Experiment research of natural killer cells amplification in vitro and the killing effect on ovarian cancer cells].

Objective: To amplify natural killer (NK) cells in vitro and explore its killing effect on ovarian cancer cells. Methods: (1) The separation of NK cells and identification. A total of 20 ml peripheral blood of one healthy volunteer was collected in Nov. 2015, Peking University People's Hospital. The peripheral blood mononuclear cells of normal volunteers were isolated, cultured in vitro and amplificated cultivation for 14 days with K562 cells transfected and expressing interleukin 21 (IL-21-K562) as nourish cells. The number and dynamic state of the growth cells were monitored during the cultured process. Cells were harvested and counted after 14 days cultured. The NK cells phenotypes were detected by flow cytometry. (2) The killing effect of NK cells on ovarian cancer cells: the ratio of effector cells (NK cells) and target cells (ovarian cancer cells and its control) was 50∶1, 20∶1, 10∶1, 5∶1 or 1∶1, NK cells killing effect on ovarian cancer cells was detected by the lactate dehydrogenase (LDH) release experiments. Results: (1) The results of NK cells establishment and phenotypic characterization: the cells were induced in vitro for 14 days by amplification culture. With the extension of incubation time, the number of NK cells increased constantly, from 2.0×10(7) on day 0 to 5.1×10(9) on day 14. Obvious amplification of the total number of cells were detected for 255 times. Living cells unstained by trypan blue eventually reached 95% above. Before and after the induction and amplification in vitro, the percentage of NK cells(CD(3)(-)CD(5)(6+)cells) in CD(3)- cells were 2.33% and 85.32%, respectively (P<0.01), which covered the whole lymphocytes 1.06% and 69.42%, respectively (P<0.01), which showed that NK was the main cell type in the amplificated lymphocytes. (2) The killing rate of NK cells on ovarian cancer cells in vitro: the results detected by LDH release experiments showed that NK cells could performed strong nonspecific killing effect on ovarian cancer cell lines SKOV3, HOC1A, 3AO and CAOV3, as well the normal ovarian cell line T29 and NK sensitive cell line K562, and the killing effect increased significantly along with the increase of effector cells and target cells ratio (P<0.01). When the ratio was 1∶1, the killing rate was 37% for K562, while the rate of killing of other cells was around 10% (P<0.05). When the effect-target ratio was 20∶1 and 50∶1, in addition to CAOV3 cells (more than 70%), NK cells had a kill rate of more than 80% for other ovarian cancer cells lines and their control cell K562 and T29 cells (P>0.05). Conclusion: NK cells could be established in vitro and have a good non-specific killing effect on ovarian cancer cells.

[Three-dimensional vector analysis after decompression surgery in thyroid-associated ophthalmopathy].

Objective: To analyze the change of globe position after different orbital decompression in thyroid-associated ophthalmopathy (TAO). Methods: It was a retrosective case series study. Twenty-nine TAO patients (33 eyes) underwent orbital decompression were collected between October 2014 and December 2016 at Eye & ENT Hospital of Fudan University. There were 17 males and 12 females, and the average age was 46 years (ranging from 21 to 66 years). Fifteen patients (17 eyes) underwent balanced decompression, 11 patients (11 eyes) underwent deep lateral decompression, and 4 patients (5 eyes) underwent medial decompression. CT scan was performed pre and postoperatively for each patient and a reference coordinate system was established on the three-dimensional reconstructed image. The eyeball vector EC from the eyeball center to the corneal apex was defined and the coordinates (X(E), Y(E), Z(E))(X(C), Y(C), Z(C)) were calculated. The angle M between EC and the midsagittal plane and the angle F between EC and the Frankfort plane were also calculated. Paired t test and one way ANOVA were used for statistical analysis. Results: The average value of X(C) before and after deep lateral decompression was 19.53 mm and 17.25 mm (t=10.87, P<0.05) and average value of X(E) was 7.73 mm and 5.69 mm (t=12.22, P<0.05). The average value of X(C) before and after medial decompression was 20.24 mm and 18.17 mm (t=7.93, P<0.05) and average value of X(E) was 7.14 mm and 5.52 mm (t=9.24, P<0.05). The average value of X(C) before and after balanced decompression was 22.16 mm and 18.83 mm (t=12.71 , P<0.05) and average value of X(E) was 10.20 mm and 6.67 mm (t=11.91, P<0.05). The average value of horizontal deviation angle M before and after medial decompression was 6.48° and 13.34° (t=- 8.41, P<0.05). The average value of angle M before and after balanced decompression was 1.42° and 6.76° (t=- 2.86, P<0.05). The average value of angle M before and after deep lateral decompression was 5.18° and 1.39° (t=2.57, P<0.05). Conclusions: The proptosis reduction was significant after deep lateral decompression, balanced decompression and medial decompression. Additionally, the horizontal deviation tended to increase after medial and balanced decompression, whereas the horizaontal deviation tended to decrease after deep lateral decompression. (Chin J Ophthalmol, 2017, 53: 424-429).

Misdiagnosed paranasal gossypiboma: a 10-year experience with 21 cases at a tertiary center.

BACKGROUND: Different from rhinoliths, the paranasal gossypiboma is a foreign body, such as a surgical sponge, left in the nasal cavity. It is a rare, frequently misdiagnosed disease that has rarely been reported. We summarize its clinical characteristics, management, and possible risk factors. METHODOLOGY: We reviewed medical records of confirmed paranasal gossypibomas at a tertiary medical center between 2005 and 2015. Clinical symptoms, age, sex, anatomic sites, endoscopic photography, computed tomography, intraoperative findings, and past medical history were reviewed. RESULTS: The study included 21 patients, each of whom had ultimately undergone two operations. Among them, 20 underwent endoscopic nasal surgery in primary hospitals, and 15 had been misdiagnosed during the second surgery. The average interval to discovery of a retained foreign body was 200 days. Predominant occurrence sites were the maxillary and ethmoid sinuses. Computed tomography showed paranasal gossypiboma as a heterogeneous cystic lesion with a thin calcified shell. CONCLUSIONS: A history of endoscopic nasal surgery, especially performed at a primary hospital, is a warning sign for clinicians. Computed tomography can add to the warning by showing a heterogeneous cystic lesion with a thin calcified shell. Clinicians should be aware of these characteristics to avoid misdiagnosing paranasal gossypiboma.

Cloning and expression analysis of the cytochrome P450c17s enzymes during the reproductive cycle in ovoviviparous Korean rockfish (Sebastes schlegeli).

Cytochrome P450c17 (CYP17, 17α-hydroxylase/17, 20-lyase) plays a critical role in the production of androgens and estrogens in vertebrates. We isolated the full length cDNAs of P450c17-I and P450c17-II from Sebastes schlegeli. The cDNA sequences of P450c17-I and P450c17-II encoded 515 and 533 amino acid residues respectively. The putative P450c17-I and P450c17-II enzymes of Korean rockfish share high sequence identity with that of Japanese flounder (92% and 81%) respectively. Our current study describes that P450c17s of Korean rockfish are mainly expressed in gonads, head kidney and kidney by RT-PCR. Quantitative real-time PCR showed that the expression patterns of Korean rockfish P450c17s were developmental stage-dependency. In addition, the testosterone (T) and gonadosomatic index (GSI) levels further support the important role of P450c17-I during shift in steroidogenesis. Taken together, this study provides information about the Korean rockfish P450c17s characterization and mRNA expression as such helps in further understanding of its function in gonadal development.

Polymorphysims of CYP17-I Gene in the Exons Were Associated with the Reproductive Endocrine of Japanese Flounder (Paralichthys olivaceus).

The cytochrome P450c17-I (CYP17-I) is one of the enzymes critical to gonadal development and the synthesis of androgens. Two single nucleotide polymorphisms (SNPs) were detected within the coding region of the CYP17-I gene in a population of 75 male Japanese flounder (Paralichthys olivaceus). They were SNP1 (c.C445T) located in exon2 and SNP2 (c.T980C (p.Phe307Leu)) located in exon5. Four physiological indices, which were serum testosterone (T), serum 17ß-estradiol (E2), Hepatosomatic index (HSI), and Gonadosomatic index (GSI), were studied to examine the effect of the two SNPs on the reproductive endocrines of Japanese flounder. Multiple comparisons revealed that CT genotype of SNP1 had a much lower T level than CC genotype (p<0.05) and the GSI of individuals with CC genotype of SNP2 was higher than those with TT genotype (p<0.05). Four diplotypes were constructed based on the two SNPs and the diplotype D3 had a significantly lower T level and GSI. In conclusion, the two SNPs were significantly associated with reproductive traits of Japanese flounder.

The role of HE4 in ovarian cancer: inhibiting tumour cell proliferation and metastasis.

As a promising biomarker, human epididymis protein 4 (HE4) has been widely used for the early detection and differential diagnosis of ovarian cancer. This study evaluated the function of HE4 in the carcinogenesis and progression of ovarian cancer. An enzyme immunometric assay, used to detect HE4 in the serum of ovarian cancer patients, showed that the protein could discriminate between malignant and benign ovarian tumours with high specificity. An exogenous HE4 gene was transfected into ovarian cancer cell lines and an immortalized ovarian epithelial cell line. Compared with the controls, HE4 overexpression significantly promoted cell apoptosis and adhesion. Overexpression of HE4 also led to significant inhibition of cell proliferation, migration and invasiveness in vitro, as well as xenograft tumour formation in vivo. This is the first report to demonstrate the functional importance of HE4 in multiple cellular processes and indicates that HE4 may play a protective role in the progression of ovarian cancer.

[Study on the relationship between allergic rhinitis and airway hyperresponsiveness].

OBJECTIVE: In order to study the relationship between allergic rhinitis and airway hyperresponsiveness. METHOD: Each of them were separately engaged skin test with antigen. All 50 patients had intense positive reaction to artemisia pollen (++-+++), but all controls were negative. We conducted bronchial provocation test (BPT) with 1:100 (w/v) artemisia pollen. Before and after BPT, we separately tested the forced expiratory volume in first second (FEV1) which represented ventilative function and eosinophil cationic protein (ECP) in their serum. RESULT: Before BPT, 50 patients and 20 normal controls had no trachea symptoms. FEV1 of 50 patients is (70 +/- 20)%, that normal controls is (85.6 +/- 8.9)% (P < 0.001). After BPT, in 50 patients, 23 cases felt constriction in the chest, 10 cases had wheezes, 5 cases had asthma, 12 cases had no symptoms. At the same time, all of normal controls had no symptoms. After BPT, FEV1 of 50 patients is (60 +/- 20)%, that of normal controls was (85.6 +/- 8.9)% (P < 0.05), ECP of patients was (30.37 +/- 18.92) micrograms/L, that of controls was (5.245 +/- 3.228) micrograms/L (P < 0.05). CONCLUSION: Patients with allergic rhinitis not only have chronic inflammation in their nose mucosa that results from allergic react, but also have chronic inflammation in bronchus which leads to AHR. The results reveal that most patients with allergic rhinitis have AHR (76%).