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To compare clinicopathological features and survival outcomes in patients with endometrial cancer, with and without associated adenomyosis. PubMed, Embase and Scopus databases were systematically searched for relevant observational studies. The pooled effect sizes were reported as either hazards ratio (HR) for survival-related outcomes or as odds ratio (OR) for other categorical outcomes. Weighted mean difference (WMD) was reported for continuous outcomes. All the analyses used the random effects model. A total of 21 studies (N = 46,420) were included. Compared to endometrial cancer patients without adenomyosis, patients with associated adenomyosis had improved overall 5-year survival (OS) (HR 0.62, 95% CI: 0.50, 0.79) and disease-free survival (DFS) (HR 0.60, 95% CI: 0.44, 0.82). Disease-specific survival was statistically similar in patients with and without adenomyosis (HR 0.60, 95% CI: 0.35, 1.05). Among patients with adenomyosis, the risk of having an advanced tumour grade (Grade 2 or 3) was lower (OR 0.51, 95% CI: 0.42, 0.62) and a risk of having International Federation of Gynaecology and Obstetrics (FIGO) stage I or II was higher (OR 2.23, 95% CI: 1.65, 3.01). Patients with adenomyosis had lower risk of tumour invasion of adnexa, cervical stromal invasion, deep myometrial involvement (DMI), lympho-vascular space invasion (LVSI) and peritoneal invasion. Presence of adenomyosis in patients with endometrial cancer is associated with favourable tumour characteristics and may improve the survival.
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Adenomiosis , Neoplasias Endometriales , Femenino , Embarazo , Humanos , Adenomiosis/complicaciones , Neoplasias Endometriales/complicaciones , Pronóstico , Bases de Datos Factuales , Supervivencia sin EnfermedadRESUMEN
INTRODUCTION: The implantation of a gestational sac within the scar of a previous caesarean delivery is defined as caesarean scar pregnancy (CSP), which is classified into two types: CSP I and CSP II. CSP II is life threatening, and no clear consensus for CSP II management exists. PATIENT CONCERNS: A 31-year-old woman, gravida 1, para 1, with a previous caesarean delivery due to macrosomia, presented with an estimated 45 days of amenorrhea. The patient presented to the emergency department with vaginal bleeding for 1 day and no abdominal pain. DIAGNOSES: An ultrasound examination was performed demonstrating a viable fetus that was embedded in the caesarean scar area and was bulging through the wall of the uterus into the bladder without contact with the uterine cavity or cervical canal. A diagnosis of type II caesarean scar pregnancy was made. INTERVENTIONS: Local lauromacrogol was used to reduce the gestational sac blood supply. Suction curettage was performed under the guidance of abdominal ultrasound 24âh later, and the amount of bleeding was 20âmL. The response to the treatment was monitored by serial beta-human chorionic gonadotropin (ß-hCG). OUTCOMES: Patient was followed up with ß-hCG weekly levels which became <10âmIU/mL after 4 weeks of treatment. CONCLUSION: Ultrasound-guided local lauromacrogol injection combined with suction curettage may be a safer and novel therapeutic method.
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Cesárea/efectos adversos , Cicatriz/complicaciones , Legrado por Aspiración/métodos , Adulto , Cesárea/métodos , Femenino , Humanos , Polidocanol/uso terapéutico , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Complicaciones del Embarazo/cirugía , Ultrasonografía/métodosRESUMEN
Both the increasing prevalence and growing burden of diabetes mellitus have caused global public health concerns. With the development of bio-psycho-social medical model, the impact of psychosocial factors on diabetes has attracted more attentions among the researchers. This paper summarizes findings from epidemiological studies that focusing on the association between diabetes and related psychosocial risk factors. Foreign studies have shown that psychological factors are closely related to diabetes, but the conclusions on social factors are inconsistent. Domestic studies have only targeted on small-sample-sized and cross-sectional studies. More longitudinal research is needed to confirm the impact of psychosocial factors on the risk of diabetes.
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Humanos , China/epidemiología , Estudios Transversales , Diabetes Mellitus/psicología , Incidencia , Prevalencia , Factores de Riesgo , Medio Social , Apoyo SocialRESUMEN
Both the increasing prevalence and growing burden of diabetes mellitus have caused global public health concerns.With the development of bio-psycho-social medical model,the impact of psychosocial factors on diabetes has attracted more attentions among the researchers.This paper summarizes findings from epidemiological studies that focusing on the association between diabetes and related psychosocial risk factors.Foreign studies have shown that psychological factors are closely related to diabetes,but the conclusions on social factors are inconsistent.Domestic studies have only targeted on small-sample-sized and cross-sectional studies.More longitudinal research is needed to confirm the impact of psychosocial factors on the risk of diabetes.
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This study was aimed to establish an optimized method to observe the synchronous changes of vascular tension and intracellular Casignal in the third-order branches of mesenteric arteries (sMA, diameter: 100-300 μm). The vascular tension and intracellular Casignal changes in response to potassium chloride (KCl), endothelin-1 (ET-1) and Gdwere detected using confocal wire myograph system and confocal laser scanning microscopy imaging technique, respectively. The experimental results were analyzed to explore the optimal experimental conditions. The results showed that KCl caused contraction in sMA significantly, and the intracellular Calevel of vascular smooth muscle cells (VSMCs) was also increased under 20× and 40× objective lens. Compared with those under the 40× objective lens, the Casignal change was larger and the fluorescence value was more stable under the 20× objective lens, whereas the Casignal change was not obvious under the 10× objective lens. ET-1 (1-10 nmol/L) caused concentration dependent contraction in sMA significantly, and the intracellular Casignal of VSMCs was also enhanced in a concentration dependent manner. Additionally, Gdsignificantly reduced the contraction of sMA and the intracellular Casignal of VSMCs caused by ET-1. The results suggest that the intracellular Casignal of VSMCs changes with vascular contraction or relaxation caused by the agonists or antagonists of Cachannels. We successfully recorded both changes synchronously using confocal wire myograph system and confocal laser scanning microscopy imaging technique at the same time. Based on the analysis of the experimental results, we concluded that 20× objective lens provides the best experimental condition. Compared to combination of vascular tone detection method and real-time cellular fluorescence imaging technique, the present synchronous method is convenient and helpful to reduce experimental error.
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The cytokine-induced killer cells (CIK) have been reported to have potent cytotoxicity against a variety of tumor cells including multiple myleoma (MM) cells. The mechanisms that CIK cell recognizing MM cells remain unknown. Recent studies indicated that the interaction between NKG2D receptor and NKG2D ligands plays an important role in inducing cytotoxicity against various target cells by natural killer cells (NK). We suspect whether NKG2D receptor and NKG2D ligands interaction is also responsible for the killing of MM cells by CIK as the same way did NK cells. We expanded CIK cells from healthy controls with interferon (IFN)-γ, CD3 monoclonal antibodies (mAb) and interleukin-2 (IL-2), and checked expression of NK cell receptors on CIK cells by flow cytometry. About 86% bulk CIK cells expressed NKG2D receptor but not other NK receptors, such as CD158a, CD158b and NCRs. We analyzed NKG2D ligands expression in MM patients by flow cytometry, primary plasma cells from 8 out of 13 (62%) MM patients expressed different levels of ULBPs or MICA/B on the cell surface. Interestingly, when stimulated with MM cell line U266 that expressed some levels of MICA/B, only NKG2D expressing CIK cells released IFN-γ. CIK cells showed cytotoxicity against NKG2D ligands expressing U266 and primary MM cells, and the cytotoxicity was partially blocked by treating CIK with anti-NKG2D antibody. We conclude that NKG2D-NKG2D ligand interaction may be one of the mechanisms by which CIK cells kill MM cells.
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Células Asesinas Inducidas por Citocinas/inmunología , Células Asesinas Inducidas por Citocinas/metabolismo , Mieloma Múltiple/inmunología , Mieloma Múltiple/metabolismo , Subfamilia K de Receptores Similares a Lectina de Células NK/metabolismo , Línea Celular Tumoral , Citotoxicidad Inmunológica/inmunología , Antígenos de Histocompatibilidad Clase I/metabolismo , Humanos , Inmunofenotipificación , Interferón gamma/metabolismoRESUMEN
We extend the study on a four-wave mixing (FWM) scheme of contiuous-wave lasers in a hot rubidium vapor when the probe and coupling fields work in the electromagnetically induced transparency (EIT) regime while the pump and signal fields work in the two-photon Raman regime. Our experimental results show that the generated signal field is well contained in an EIT dip of the incident probe field as a result of efficient FWM. We find, in particular, that an optimal FWM process can only be attained when the coupling and pump fields are well matched in intensity. If the probe intensity is far beyond the EIT condition, however, the nonlinear efficiency of energy transfer from the probe field to the signal field will be greatly reduced.