[Diagnostic value of human papillomavirus E6/E7 mRNA for residue and recurrence after cervical conization].

OBJECTIVE: To explore the diagnostic value of human papillomavirus E6/E7 mRNA for residue and recurrence of cervical intraepithelial neoplasia (CIN) patients after cervical conization.
 METHODS: A total of 154 patients, who underwent cervical conization and possessed complete follow-up data of high-grade cervical intraepithelial neoplasia (CINII, III), were subjected to thin-prep cytology test (TCT), HPV-DNA typing and HPV E6/E7 mRNA test in 3-6 months and 12 months after cervical conization. Abnormal cytology (≥ASC-US) or high-risk HPV-DNA (+) or HPV E6/E7 mRNA (+) cases were found by colposcopy and cervical biopsy pathological diagnosis.
 RESULTS: Nine patients had residue and 22 recurred. HPV-DNA detections after cervical conization in 57 patients were positive. Among them, 30 patients had residual/recurrent lesions. HPV E6/E7 mRNA detections in 26 patients were positive. Among them, 24 patients had residual/recurrent lesions. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis in the detection of HPV-DNA were 96.8%, 78%, 52.6%, 99%, and 81.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis in the detection of HPV E6/E7 mRNA were 77.4%, 98.4%, 92.3%, 94.5%, and 94.2%, respectively. The specificity and positive predictive value of HPV E6/E7 mRNA test were greater than those of HPV-DNA typing test. There was a significant difference between the two groups (P<0.05).
 CONCLUSION: Detection of HPV E6/E7 mRNA during the follow-up period could timely and effectively forecast the risk of residue and recurrence of CIN after cervical conization, and reduce excessive examination and treatment.

[Progress in studies on the relationship between Dicer and ovarian tumor].

MiRNAs are short, noncoding RNAs that modulate gene expression at the posttranscriptional level and induce the degradation of the mRNA transcript or the inhibition of protein translation. Dicer is an endoribonuclease in the RNase III family that is essential for the production of miRNAs. The abnormal expression of Dicer is frequently found in the occurrence and development process of many kinds of tumors, which is closely related to the treatment and prognosis of tumor.

Asbestos textile production linked to malignant peritoneal and pleural mesothelioma in women: Analysis of 28 cases in Southeast China.

BACKGROUND: Chrysotile had been used in asbestos textile workshops in Southeast China but a clear relation to mesothelioma is lacking. METHODS: All patients diagnosed with mesothelioma from 2003 to 2010 at Yuyao People's Hospital were re-evaluated by multiple expert pathologists with immunohistochemistry and asbestos exposure data were collected. RESULTS: Of 43 patients with a mesothelioma diagnosis, 19 peritoneal and nine pleural cases were finally diagnosed as mesothelioma. All were females, and the mean age of the patients with peritoneal or pleural mesothelioma was 52.4 and 58.2 years, respectively. All these cases had a history of domestic or occupational exposure to chrysotile. Two-thirds of the patients were from two adjoining towns with multiple small asbestos textile workshops. Contamination of tremolite was estimated to be less than 0.3%. CONCLUSIONS: This is a report of mesothelioma in women exposed to chrysotile asbestos at home and at work, with an over-representation of peritoneal mesothelioma.

[Comprehensive analysis of therapeutic methods and effect on cesarean scar pregnancy].

OBJECTIVE: To evaluate the efficacies and medic economic efficiency of therapeutic method for cesarean scar pregnancy (CSP). METHODS: The pertinent literatures on the treatment of CSP were collected and screened by retrieving some Chinese and English databases, such as PubMed, VIP and Wanfang Data. The weighting means and polled standard deviations of operative duration, operative hemorrhage volume, hysterectomy rate, length of stay, medical fees and the time of serum level of beta-human chorionic gonadotropin (ß-HCG) returning to normal were reckoned. RESULTS: Among different therapeutic methods of CSP, curettage duration was shortest in the patients with methotrexate (MTX) injection; operative hemorrhage volume, hysterectomy rate and length of stay were smallest in those with uterine artery embolization; medical fees was least in those with local MTX injection; the time of serum ß-HCG level returning to normal was shortest in those with hysteroscopic and/or laparoscopic operation after MTX injection or uterine artery embolization. CONCLUSION: Curettage after uterine artery embolization offers multiple advantages over therapeutic methods in the treatment of CSP.

Safety and efficacy of airbag midwifery in promoting normal vaginal delivery and reducing caesarean section.

BACKGROUND: Balloon bionic midwifery has been applied in clinical obstetrics in China for 10 years, although played a certain role in controlling and improving the quality of obstetrics and caesarean section rate, but some questions have not been resolved. OBJECTIVE: The aim of this study was to investigate the efficacy and safety of airbag midwifery. MATERIALS AND METHODS: Primiparas (2410 cases) with various medical conditions were randomly divided into airbag and control groups undergoing the same obstetrical treatments, but airbag midwifery as a birthing option was chosen twice when the cervix was dilated to 2-4 cm during labor. RESULTS: The duration of the first and second stages, as well as the total delivery process, of the airbag group was shorter than that for the controls. The natural delivery rate of the airbag group was higher than that of the control group. The forcep delivery rate, cesarean section rate, amount of vaginal bleeding within 2 h after delivery, rate of postpartum hemorrhage, fetal distress, and pitocin use in the airbag group were all lower than those in the control group. No significant difference in the rate of maternal and fetal complications was observed in the two groups. The bionic airbag midwifery approach did not contribute to the incidence rate of urine retention, leukocyte count, neutrophil proportion, and level of creactive protein and IL-6 24 h after delivery. CONCLUSION: Airbag midwifery skill is a simple, effective, and safe procedure.

[Diagnostic and therapeutic analyses for peritoneal malignant mesothelioma: a report of 26 women].

OBJECTIVE: To investigate the etiology, clinicopathologic features and prognosis of peritoneal malignant mesothelioma (PMM). METHODS: The diagnostic and therapeutic data for PMM from March 2000 to December 2010 were retrospectively analyzed for 26 women. They had an age range of 41 - 78 years old. Among them, 21 patients (81%) had a history of exposure to asbestos. Their major symptoms were abdominal distension, abdominal pain, ascites and abdominopelvic mass. Some had cachexia. Intestinal obstruction occurred in all cases during a late stage. RESULTS: Among them, the tumor marker of CA125 increased markedly in serum and ascitic samples. The positive rate of ascitic cytology was 31%. Type B ultrasound and CT (computed tomography) examinations showed ascites, peritoneal thickening and abdominopelvic mass and pie-shaped omentum. Their general pathological classifications were as follows: diffuse type (n = 23), localized type (n = 3), epithelial (n = 14), sarcoma (n = 3) and mixed type (n = 9). Cytoreductive surgery was performed in 16 cases. Ten patients underwent only laparoscopy while 23 patients received chemotherapy. The comparison of life span was not statistically significant between cytoreductive surgery and laparoscopy (P > 0.05); the difference of life span between ≤ 6 courses of chemotherapy and < 6 courses was not statistically significant (P > 0.05). CONCLUSION: The history of exposure to asbestos is a risk factor for PMM. PMM with no specific clinical features should be combined with laboratory and imaging studies to make a timely clinical diagnosis. Final diagnosis should be based upon histopathological and immunohistochemical examinations. Surgery and chemotherapy do not prolong the life span of patients. And the patients have a very poor prognosis.

[Diagnosis and treatment of cesarean scar pregnancy].

OBJECTIVE: To investigate the suitable measures of diagnosis and treatment of cesarean scar pregnancy (CSP). METHODS: From May 2003 to February 2010, 52 cases were diagnosed as CSP on the basis of the history of cesarean section and the manifestations of pregnancy by transvaginal ultrasound and magnetic resonance imaging (MRI) examination. According to the blood level of ß-HCG, 32 patients underwent uterine artery methotrexate perfusion and uterine artery embolization (UAE), 20 cases received a protocol of methotrexate and leucovorin (CF) while UAE or Foley catheter balloon hemostasis was performed for massive vaginal bleeding cases. When ß-HCG decreased 80% - 90% and mass blood flow reduced or disappeared, focal resection was administered. RESULTS: Forty-six cases were diagnosed by transvaginal ultrasound and 6 cases by MRI. On admission, 11 patients with severe vaginal bleeding underwent UAE or Foley catheter hemostasis. Forty patients undergoing curettage had no uterine perforation or rupture with hysteroscopic guidance and laparoscopic monitoring if necessary. Among them, 39 (97.5%) cases were successful. Six cases were directly treated by laparotomy or laparoscopic focal resection and uterine repair. And 6 cases underwent conservative treatment without focal resection. 52 patients were cured successfully without any case of hysterectomy. CONCLUSION: Transvaginal ultrasound is the preferred diagnostic method of CSP while MRI is an auxiliary method for diagnosis. The treatment of CSP should be based on blood ß-HCG levels and lesion location, size, muscle thickness of surface, the condition of blood supply and vaginal bleeding. Different measures may be selected to kill embryos, stop hemorrhage and resect lesions.