ABSTRACT
Background: Ovarian cancer (OC) remains the deadliest gynecologic malignancy worldwide due to delayed diagnosis, recurrence, and drug resistance. This study aimed to identify key factors affecting delayed diagnosis in OC patients. Methods: A retrospective analysis was conducted on OC patients treated at Taihe Hospital, Hubei University of Medicine from June 2023 to September 2023. Patients were categorized based on a three-months cut-off point for delayed diagnosis. Collected data included demographics, tumor incidence, and disease cognition. The analysis of variance and the chi-squared test was used for comparison between groups. Results: The significant differences were found in age, residence, education level, family income, family history of tumor, histology, FIGO stage, and tumor location between groups (P<0.05). Multifactorial logistic regression analysis identified education level [odds ratio (OR) = 0.606; 95% confidence interval (CI): 0.440, 0.833; P = 0.002], family history of tumor (OR = 0.462; 95% CI: 0.214, 0.997; P = 0.049), emotional barriers (OR = 1.332; 95% CI: 1.081, 1.642; P = 0.007), and practical barriers (OR = 2.964; 95% CI: 2.195, 4.004; P < 0.001) as risk factors for delayed diagnosis of OC. Conclusion: Patient cognition is crucial in OC diagnosis delay. Enhancing public awareness and understanding of OC is essential to eliminate fear and improve early diagnosis.
ABSTRACT
Introduction: Neuropathic pain (NP) conditions arising from injuries to the nervous system due to trauma, disease, or neurotoxins are chronic, severe, debilitating, and exceedingly difficult to treat. However, the mechanisms of NP are not yet clear. Here we explored the role of Dock4, an atypical Rac1 GEF, in the development of NP. Methods: Mechanical allodynia was assessed as paw withdrawal threshold by a dynamic plantar aesthesiometer. Immunofluorescence staining was conducted to investigate the expression and localization of Dock4, Rac1 and GluN2B. Quantitative analysis of Dock4, Rac1 and GluN2B were determined by qRT-PCR and Western blot assay. Spontaneous excitatory and inhibitory postsynaptic currents in spinal cord slices were examined using whole cell patch clam. Dendritic spine remodeling and synaptogenesis were detected in cultured dorsal spinal neurons. Results and discussion: We found that SNL caused markedly mechanical allodynia accompanied by increase of Dock4, GTP-Rac1and GluN2B, which was prevented by knockdown of Dock4. Electrophysiological tests showed that SNL facilitated excitatory synaptic transmission, however, this was also inhibited by Dock RNAi-LV. Moreover, knockdown of Dock4 prevented dendritic growth and synaptogenesis. Conclusion: In summary, our data indicated that Dock4 facilitated excitatory synaptic transmission by promoting the expression of GluN2B at the synaptic site and synaptogenesis, leading to the occurrence of NP.
ABSTRACT
Objective: The objective of this study was to evaluate the efficacy of hysteroscopic electroresection in the treatment of atypical endometrial hyperplasia and to determine the prognostic factors. Methods: 226 patients with endometrial dysplasia treated in hospital from January 2021 to August 2022 were selected and divided into control group (113 cases) and study group (113 cases) according to different treatment methods selected by the patients themselves. The control group received curettage plus conventional progesterone treatment, while the study group received hysteroscopic electroresection plus conventional progesterone treatment. After 6 months of treatment, the clinical efficacy (complete response, partial response and progress) of the two groups were evaluated, complications and adverse drug reactions of the two groups were analyzed, and estrogen levels before and after treatment were compared between the two groups. After 1 year follow-up, patients were divided into relapse group and non-recurrence group according to whether they had relapse or not. Clinical data of the two groups were compared to analyze the related factors affecting the prognosis of patients. Results: (1) Chi-square test results showed that the total effective rate of the study group was higher (96.46% VS 77.88%) than that of the control group (P < .05). The complication rate and recurrence rate of the study group were lower than those of the control group (1.77% VS 7.96%, 4.42% VS 21.24%) (P < .05). (2) t test results of independent samples showed that after 6 months of treatment, the levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the study group were lower than those in the control group (P < .05); (3) The t test results of independent samples indicated that the age and body mass index of the relapsed group were higher than those of the non-relapsed group (P < .05); Chi-square test results showed that the proportion of diabetes was higher than that of the group without recurrence, and the proportion of hysteroscopic electroresection was lower than that of the group without recurrence (P < .05). (4) Logistic regression model was established, and the results showed that age (OR=1.159), body mass index (OR=1.529) and diabetes (OR=3.861) were the risk factors for prognosis of patients with endometrial dysplasia (P < .05), and hysteroscopic electroresection was the protective factor (OR < 1, P < .05). Conclusion: Hysteroscopic electroresection shows significant potential in the treatment of atypical hyperplasia of endometrial, and can improve clinical efficacy and reduce complications by effectively regulating estrogen secretion. In addition, studies have shown that the prognosis of endometrial dysplasia may be related to the age of patients, body mass index and diabetes mellitus. Therefore, for patients with the above risk factors, early consideration of hysteroscopic electrotomy therapy is recommended to reduce recurrence rates and provide important informational support for treatment protocols and clinical guidelines.