Clinical Efficacy and Safety of Major Uterine Wall Resection and Reconstruction of the Uterus Combined with LNG-IUS for the Treatment of Severe Adenomyosis.

Objective Aim of the study was to evaluate the clinical efficacy and safety of major uterine wall resection and reconstruction of the uterus (MURU) combined with a levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of adenomyosis. Methods Ninety patients diagnosed with adenomyosis were enrolled in this study. All participants were examined by transvaginal ultrasound (TVU) or magnetic resonance imaging (MRI). Serum levels of cancer antigen 125 (CA 125) were quantitatively measured. All patients underwent MURU in combination with LNG-IUS. The therapeutic safety of MURU was assessed during surgery and the patients' stay in hospital. The clinical efficacy was evaluated by comparatively analyzing changes in dysmenorrhea, volume of menstrual blood, uterine volume and serum levels of CA 125 before, and at 3, 6 and 12 months following MURU. Results All 90 patients enrolled in the study were successfully treated with MURU combined with LNG-IUS. No significant complications were observed during surgery and hospital stay. The mean operation time, intraoperative blood loss and length of hospital stay were 82.4 ± 13.8 min, 53.3 ± 20.3 ml, and 4.3 ± 0.8 days, respectively. Dysmenorrhea completely disappeared in all patients. Uterine volume and serum levels of CA 125 were restored to normal ranges. No recurrence of adenomyosis was observed during postoperative follow-up. Conclusion MURU combined with LNG-IUS is an efficacious and safe treatment for severe adenomyosis. This combined technique is not only effective to manage severe adenomyosis but also preserves as much of the uterus as possible.

Experimental study on ablation of leiomyoma by combination high-intensity focused ultrasound and iodized oil in vitro.

AIM: The aim of the current study was to investigate whether iodized oil (IO) enhances high-intensity focused ultrasound (HIFU) ablation of uterine leiomyoma and to determine the features of hyperechoic changes in the target region. METHODS: Forty samples of uterine leiomyoma were randomly divided into an experimental group and a control group. In the experimental group, the leiomyoma was ablated by HIFU 30 min after 1 mL of iodized oil had been injected into the center of the myoma. The hyperechoic values and areas in the target region were observed by B-modal ultrasound after HIFU ablation. The samples were cut successively into slices and stained by triphenyltetrazolium chloride (TTC) solution within 1 h after HIFU ablation. The diameters of TTC-non-stained areas were measured and tissues in the borderline of the TTC-stained and -non-stained areas were observed pathologically. All procedures in the control group were the same as those in the experimental group except IO was replaced by physiological saline. RESULTS: The hyperechoic value in the target region in the experimental group was higher than that in the control group 4 min after HIFU ablation (P < 0.05). Hyperechoic areas in the target region as well as TTC-non-stained volumes in the experimental group were greater than those in the control group (P < 0.05). Routine pathologic observation showed that coagulation necrosis of leiomyoma occurred in the target region in both groups. CONCLUSION: IO causes coagulation necrosis, enlarges tissue damage, and postpones the attenuation of hyperechoic changes in the target region when HIFU ablation is carried out for leiomyoma in vitro.

MicroRNA-424 may function as a tumor suppressor in endometrial carcinoma cells by targeting E2F7.

MicroRNAs (miRNAs) are frequently dysregulated in human cancers and can act as potent oncogenes or tumor suppressor genes. Aberrant expression of miR-424 has been identified in some types of cancer, however, its expression and potential biologic role in endometrial cancer are remains to be determined. In the present study, we demonstrated that miR-424 was downregulated in human endometrial cancer and suppressed growth of the human Ishikawa and HEC-1B endometrial cancer cell lines. Bioinformatics analysis indicated that E2F7 was a putative target of miR-424. In a luciferase reporter system, we confirmed that E2F7 was a direct target gene of miR-424. Furthermore, knockdown of E2F7 inhibited Ishikawa and HEC-1B cell growth. These findings indicate that miR-424 targets the E2F7 transcript and suppresses endometrial cancer cell growth, suggesting that miR-424 has a tumor suppressive role in human endometrial cancer pathogenesis.

Ablation of leiomyomas using a combination of HIFU and iodized oil in vitro.

This study investigates the enhancement effects of iodized oil and the features of hyperechoic focus changes in a target region of high-intensity focused ultrasound (HIFU) ablated uterine fibroids. Leiomyomas in the experimental group of 20 randomly assigned patients were ablated by HIFU under certain parameters 30 min after 1 mL of iodized oil was injected into the center of the myomas. The value of the gray scale and its area were observed by B-mode ultrasound in the target region and were carefully recorded at 0, 2, 4, and 5 min, respectively, after HIFU ablation. The samples were sectioned successively in a thickness of 1∼2 mm and stained by 2,3,5-triphenyltetrazolium chloride solution within 1 h after HIFU ablation. The TTC non-staining volumes were measured afterwards. All procedures in the control group of the other 20 randomly assigned patients were the same except that iodized oil was replaced by physiologic saline. The hyperechoic areas in the target region were observed in all fibroids of both groups. Compared with the control group, the gray scale values in the target region of the experimental group were higher 4 min after HIFU ablation. The enhanced gray scale area in the target region and the 2,3,5-triphenyltetrazolium chloride non-staining volumes in the experimental group were bigger. Based on our experience, HIFU sonication of leiomyomas injected with iodized oil produces hyperechoic foci that are greater than areas injected with saline. More studies are required to understand the clinical implications of these observations.

[Therapeutic effects of focused ultrasound on chronic cervicitis and the influencing factors].

OBJECTIVE: To explore the therapeutic effect of focused ultrasound (FU) on chronic cervicitis unitarily and its influential factors. METHODS: Three hundred and thirteen patients of chronic cervicitis were treated with the device of CZF model focused ultrasound. The therapeutic effects in 300 cases with complete records, as well as the relationship between the diameter of cervical erosion and the exposure time to FU were analyzed. RESULTS: The effective rates of FU in treatment of chronic cervicitis unitarily were 100.0% (53/53), 95.2% (120/126) and 91.7% (111/121), respectively, for mild, moderate and severe cases. The overall effective rate was 94.7% (284/300). With other parameters of FU unchanged, the exposure time to FU showed an exponential relationship with the diameter of erosion, and the regression equation was D = 31.71e(0.4808t) (R(2) = 0.9966). CONCLUSIONS: The controllability and achievement ratio of FU to treat cervical erosion could be enhanced when exposure time and manners were fully considered based on the diameter and type of cervical erosion. A satisfactory therapeutic efficacy could be achieved with FU to treat cervical erosion unitarily.

[Toxicity of hydroxyapatite nanoparticles on rabbits].

OBJECTIVE: To study the toxicity of nano-hydroxyapatite on rabbits by vein. METHODS: The hydroxyapatite solution was intravenous injected into 50 New Zealand white rabbits with different concentration, then to observe the reactions and the survial rates of rabbits, and to investigate the effects of nano-HA to the liver function, renal function, enzyme and Ca, Mg, P. RESULTS: The medium lethal dosege of nano-HA administrated intravenous (iv) was determined as 200mg/kg. The level of phosphorous increased but calcium and magnesium kept stable. LDH, CPK, GOP and GDT dramatically increased in 30 minutes after injection, arriving the peak at 2 hours later, however, they all returned to normal 24h after injection. BUN and ALP got to the peak at 24 hours later, then decreased rapidly to normal level. The other indexes almost maintained at normal level. CONCLUSION: Nano-hydroxyapatite has no accumulative toxicity to rabbits, it is suggested that it is safe when the hydroxyapatite-sol was applied intravenously as a drug carrier in small dosage more less than the medium lethal dose, even as a kind of anticancer drug.