Comparison of the efficacy and safety of total laparoscopic hysterectomy without and with uterine manipulator combined with pelvic lymphadenectomy for early cervical cancer.

OBJECTIVE: Some studies have reported that the prognosis of total laparoscopic hysterectomy (TLH) for early-stage cervical cancer (CC) is worse than that of open surgery. And this was associated with the use of uterine manipulator or not. Therefore, this study retrospectively analyzes the efficacy and safety of TLH without uterine manipulator combined with pelvic lymphadenectomy for early-stage CC. METHODS: Fifty-eight patients with CC (stage IB1-IIA1) who received radical hysterectomy from September 2019 to January 2020 were divided into no uterine manipulator (n = 26) and uterine manipulator group (n = 32). Then, clinical characteristics were collected and intraoperative/postoperative related indicators were compared. RESULTS: Patients in the no uterine manipulator group had significantly higher operation time and blood loss than in the uterine manipulator group. Notably, there was no significant difference in hemoglobin change, blood transfusion rate, number of pelvic nodules, anal exhaust time, complications and recurrence rate between the two groups. Additionally, patients in the uterine manipulator group were prone to urinary retention (15.6%) and lymphocyst (12.5%), while the no uterine manipulator group exhibited high probability of bladder dysfunction (23.1%) and urinary retention (15.4%). Furthermore, the 1-year disease-free survival rate and the 1-year overall survival rate were not significantly different between the two groups. CONCLUSION: There was no significant difference in the efficacy and safety of TLH with or without uterine manipulator combined with pelvic lymphadenectomy in the treatment of patients with early-stage CC. However, the latter requires consideration of the negative effects of high operation time and blood loss.

Vaginal microecological changes of different degrees of cervical lesions in Hakka women in Meizhou City.

Research shows an association between vaginal microbiota and the development of cervical cancer, but the role of altered microbiota in cancer development remains controversial. In this study, we attempted to reveal the vaginal microecological changes in cervical lesions by 16S rRNA gene sequencing. Vaginal secretions were collected from Hakka women in Meizhou City, Guangdong Province, China. The diversity, composition and the correlations among species of the vaginal microbiota were determined by sequencing the bacterial 16S rRNA gene. The microbial functional abundance was detected via KEGG and COG (Clusters of Orthologous Groups). The results showed that the Cancer group was characterised by evident changes in the composition of the vaginal microbiota, increased alpha diversity, and altered community structure distribution and microbial interaction network. Linear discriminant analysis (LDA) effect size showed that 21 bacterial species were abundant in the Cancer group. In addition, the loss of Lactobacillus stimulated other flora proliferation, resulting in a microecological disturbance. KEGG and COG analysis indicated the cancer group is mainly concentrated in energy metabolism. In short, the vaginal microecology of Hakka women in Meizhou City presents with different degrees of cervical lesions, and the flora imbalance is an important factor in the development of cervical cancer.IMPACT STATEMENTWhat is already known on this subject? Cervical cancer is one of the most common gynecological malignancies worldwide and has become a prominent public health problem.What the results of this study add? Our study showed that the type of vaginal community status of Hakka women in Meizhou area was characterised by L. Iners predominates, and the gradual loss of Lactobacillus dominance in vaginal bacteria is key to microecological imbalance.What the implications are of these findings for clinical practice and/or further research? Disturbances in vaginal microecology can stimulate energy metabolism and lipid metabolism to induce cervical cancer development.

[Pollution Characteristics of PM2.5 Chemical Composition in Zhejiang Province].

To investigate the seasonal and regional pollution characteristics of PM2.5 chemical composition in Zhejiang province, this study was based on manual sampling monitoring data from 11 sampling sites of four regions in Zhejiang province from October 1, 2019 to September 30, 2020. The results showed that during the observation period, the average ρ(PM2.5) of the four regions ranged from 34.3 µg·m-3 to 46.4 µg·m-3. The PM2.5 mass concentrations in the hinterland areas of western Zhejiang and northern Zhejiang were relatively high, 15.1% and 13.2% higher than the mean value, respectively. The PM2.5 mass concentrations in the coastal areas of eastern Zhejiang and southern Zhejiang were relatively low, 8.4% and 14.9% lower than the average, respectively. The seasonal characteristics showed a higher concentration in autumn and winter and lowest concentration in summer. The seasonal variation in PM2.5 mass concentration from autumn to spring was not obvious in southern Zhejiang, whereas in western Zhejiang, the PM2.5 mass concentration followed a descending sequence of autumn>winter>spring>summer. In northern Zhejiang and eastern Zhejiang, the trend was winter>autumn>spring>summer. During the observation period in the inland area, the ρ(PM2.5) of the scenic area, administrative area, residential area, and mixed area of commercial traffic and residents were (40.2±10.2), (46.3±9.6), (50.1±10.6), and (46.7±10.2) µg·m-3, respectively. The highest value of ρ(PM2.5) was in the residential area. During the sampling period in coastal areas, the ρ(PM2.5) of the cultural and entertainment area and mixed area of commercial traffic and residents were (27.4±5.8) µg·m-3and (37.2±5.6) µg·m-3, respectively. The contribution rates of organic matter (OM), NO3-, SO42-, NH4+, trace elements, and crustal matter in PM2.5were 26.4%, 15.4%, 12.4%, 9.0%, 7.1%, and 5.7%, respectively. The SNA, including SO42-, NO3-, and NH4+, contributed 36.8% in PM2.5. In terms of seasons, the contribution of OM to PM2.5 in autumn, spring, and summer was higher than that of other compositions, which accounted for 28.3%, 27.7%, and 26.3%, respectively. The contribution rate of NO3- in PM2.5 was the largest in winter, reaching 24.3%. In terms of spatial distribution, SNA contributed the most to PM2.5 in all regions, ranging from 32.8% to 39.7%, with the highest in northern Zhejiang and the lowest in southern Zhejiang. The SNA of all regions presented NO3->SO42->NH4+. Based on the backward trajectory clustering analysis, the main air sources of northern Zhejiang were the Yellow Sea-southern Jiangsu (autumn), northern Anhui (winter), East China Sea (spring), and western Jiangsu (summer) areas, with contribution rates of 38.11%, 35.28%, 37.46%, and 27.87%, respectively. The main air sources of western Zhejiang were the Yellow Sea-southern Jiangsu (autumn), southern Anhui (winter), eastern Zhejiang (spring), and northern Zhejiang (summer), with contribution rates of 38.11%, 37.50%, 46.55%, and 32.58%, respectively. The air of autumn, winter, spring, and summer in eastern Zhejiang were influenced by air masses from northern Hebei (36.07%), eastern Shandong (38.06%), East China Sea (30.17%), and southern Guangdong (34.43%), respectively. In autumn, winter, spring, and summer, southern Zhejiang was affected by air masses from the Yellow Sea (35.66%), northeast Anhui (34.44%), East China Sea (26.72%), and southern Fujian coast (35.00%), respectively. The regions in Zhejiang province showed large seasonal differences. The difference value between the maximum value of ρ(PM2.5) in the northwest and the lowest value in the southeast was 21.0 µg·m-3 and 20.5 µg·m-3 in autumn and winter, respectively; the difference values in spring and summer were 10.4 µg·m-3 and 6.1 µg·m-3. Thus, the northern air mass had a certain exogenous contribution to PM2.5 in autumn and winter in Zhejiang province. However, with the weakening of the northern air mass trajectory in spring and summer and the increasing contribution of the southern and east China Sea air mass to the air flow in Zhejiang province, PM2.5 pollution showed a trend of improvement.

Distributions and sources of traditional and emerging per- and polyfluoroalkyl substances among multiple environmental media in the Qiantang River watershed, China.

The presence of per- and polyfluoroalkyl substances (PFASs) in the food chain poses a threat to human health. Water and the atmosphere are the major transport pathways for PFASs in the environment, while water, soil and sediment are sinks. Herein, the concentrations and distributions of traditional and emerging PFASs in multi-environmental media samples in the Qiantang River watershed were comprehensively investigated. Twenty-five PFASs, including seven emerging PFASs, were identified. The concentrations in water, soil, sediment and PM2.5 ranged from 3.58 to 786 ng L-1, 0.72 to 12.3 ng g-1, 0.73 to 6.60 ng g-1, and 93.9 to 255 pg m-3, respectively, with mean concentrations of 149 ng L-1, 4.70 ng g-1, 4.31 ng g-1, and 156 pg m-3. Perfluorooctanoic acid (PFOA) was the dominant contaminant in water, soil, and sediment, and perfluoropentanoic acid (PFPeA) was the dominant contaminant in PM2.5. Hexafluoropropylene oxide-dimer acid (HFPO-DA) and 6 : 2 chlorinated polyfluorinated ether sulfonate (6 : 2 Cl-PFESA), as substitutes for PFOA and perfluorooctane sulfonate (PFOS), were detected, indicating the gradual replacement of traditional PFOA and PFOS in this area. Perfluoro-3,6-dioxaheptanoic acid (NFDHA), as a component of the aqueous film-forming foam FN-3, was first detected in this area. Short-chain PFASs were mainly distributed in water and PM2.5, while long-chain PFASs were distributed in the solid phase, such as soil, sediment, and PM2.5. Based on principal component analysis (PCA), the major PFAS sources were emulsifiers from fluorine polymerization and surface-active agents from the textile, papermaking, leather, and other industries. In addition, correlation analysis showed that water was the main source and transport pathway of short-chain perfluoroalkyl carboxylic acid (PFCA), HFPO-DA, and NFDHA in this area, while the atmosphere combined with PM2.5 was the main transport pathway for both short- and long-chain PFCAs, PFOS, and 6 : 2 Cl-PFESA.

A DPSIR model for ecological security assessment through indicator screening: a case study at Dianchi Lake in China.

Given the important role of lake ecosystems in social and economic development, and the current severe environmental degradation in China, a systematic diagnosis of the ecological security of lakes is essential for sustainable development. A Driving-force, Pressure, Status, Impact, and Risk (DPSIR) model, combined with data screening for lake ecological security assessment was developed to overcome the disadvantages of data selection in existing assessment methods. Correlation and principal component analysis were used to select independent and representative data. The DPSIR model was then applied to evaluate the ecological security of Dianchi Lake in China during 1988-2007 using an ecological security index. The results revealed a V-shaped trend. The application of the DPSIR model with data screening provided useful information regarding the status of the lake's ecosystem, while ensuring information efficiency and eliminating multicollinearity. The modeling approach described here is practical and operationally efficient, and provides an attractive alternative approach to assess the ecological security of lakes.