Predicting the impact of femtosecond-assisted arcuate keratotomy combined with tri-planar clear corneal incisions on astigmatism in implantable collamer lens surgery: one-year follow-up.

PURPOSE: To investigate the factors associated with and impact on the femtosecond-assisted (FS-assisted) limbal relaxing incision (LRI) combined with the steep-meridian tri-planar clear corneal incision (TCCI) to reduce astigmatism in patients undergoing Implantable Collamer Lens (ICL) surgery. METHODS: Retrospective case series. The study reviewed patients with ICL surgery combined with FS-assisted LRIs paired with steep-meridian TCCIs. Correlation analysis examined the relationship between independent variables, including preoperative characteristics (intraocular pressure, corneal thickness, axial length, et al.), TCCI, and LRI surgical parameters. The predictors of surgically induced astigmatism (SIA) were determined using individual-level analysis and accounting for inter-eye correlation with the generalized estimating equation (GEE). RESULTS: The study enrolled 69 patients, with 114 eyes (55 right and 59 left). The mean spherical equivalent (SEQ) was - 10.29 ± 2.99D and - 9.99 ± 2.72D for the right and left eye, respectively, while the mean preoperative corneal astigmatism was - 1.54 ± 0.47D and - 1.54 ± 0.46D for the right and left eyes, respectively. After 12 months of follow-up, univariate analysis revealed significant correlations between SIA and intraocular pressure (IOP), astigmatism type, TCCI position (degree), peripheral corneal thickness (PCT), LRI arc incision diameter, post depth (%), and angle, respectively (P = 0.046, 0.016, 0.039, 0.040, 0.009, 0.000, 0.000). Multivariate analysis using GEE demonstrated that axial length (AL), astigmatism type, LRI arc diameter, and angle were independent predictors of SIA (P = 0.000, 0.005, 0.029, 0.000). CONCLUSIONS: The type of astigmatism and axial length were independent factors that affected SIA when modifying the LRI arc diameter and angle through FS-assisted steep-meridian TCCI paired with LRI in ICL surgery.

Comparison of prognosis between extracorporeal CPR and conventional CPR for patients in cardiac arrest: a systematic review and meta-analysis.

AIM: Compared to the conventional cardiopulmonary resuscitation (CCPR), potential benefits of extracorporeal cardiopulmonary resuscitation (ECPR) for patients with cardiac arrest (CA) are still controversial. We aimed to determine whether ECPR can improve the prognosis of CA patients compared with CCPR. METHODS: We systematically searched PubMed, EMBASE, and Cochrane Library from database's inception to July 2023 to identify randomized controlled trials (RCTs) or cohort studies that compared ECPR with CCPR in adults (aged ≥ 16 years) with out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). This meta-analysis was performed using a random-effects model. Two researchers independently reviewed the relevance of the study, extracted data, and evaluated the quality of the included literature. The primary outcome was short-term (from hospital discharge to one month after cardiac arrest) and long-term (≥ 90 days after cardiac arrest) survival with favorable neurological status (defined as cerebral performance category scores 1 or 2). Secondary outcomes included survival at 1 months, 3-6 months, and 1 year after cardiac arrest. RESULTS: The meta-analysis included 3 RCTs and 14 cohort studies involving 167,728 patients. We found that ECPR can significantly improve good neurological prognosis (RR 1.82, 95%CI 1.42-2.34, I2 = 41%) and survival rate (RR 1.51, 95%CI 1.20-1.89, I2 = 62%). In addition, the results showed that ECPR had different effects on favorable neurological status in patients with OHCA (short-term: RR 1.50, 95%CI 0.98- 2.29, I2 = 55%; long-term: RR 1.95, 95% CI 1.06-3.59, I2 = 11%). However, ECPR had significantly better effects on neurological status than CCPR in patients with IHCA (short-term: RR 2.18, 95%CI 1.24- 3.81, I2 = 9%; long-term: RR 2.17, 95% CI 1.19-3.94, I2 = 0%). CONCLUSIONS: This meta-analysis indicated that ECPR had significantly better effects on good neurological prognosis and survival rate than CCPR, especially in patients with IHCA. However, more high-quality studies are needed to explore the role of ECPR in patients with OHCA.

Vector analysis of high astigmatism (≥ 2.0 diopters) correction after small-incision lenticule extraction with stringent head positioning and femtosecond laser-assisted laser in situ keratomileusis with compensation of cyclotorsion.

BACKGROUND: The purpose of this study was to compare the astigmatic correction by vector analysis in patients with high myopic astigmatism after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) with cyclotorsion compensation or small-incision lenticule extraction (SMILE) with stringent head positioning. SETTING: Beijing Aier-Intech Eye Hospital, Beijing, China. DESIGN: A retrospective case series. METHODS: Patients who had correction of myopic astigmatism of 2 diopters (D) or more treated with either FS-LASIK with cyclotorsion compensation or SMILE with stringent head positioning were included. The results of vision and refraction were analyzed and compared between groups with the right eye. RESULTS: The study enrolled 94 patients (41eyes in an FS-LASIK with compensation of cyclotorsion group and 53 eyes in a SMILE with stringent head positioning control group. The mean preoperative manifest cylinder was -2.65 ± 0.77D in the FS-LASIK group and 2.51 ± 0.56D in the SMILE group (P = 0.302). At 12 months, there was no significant between-group difference in uncorrected distance visual acuity (UDVA, P = 0.274) and postoperative spherical equivalent (SEQ) (P = 0.107). 46.3% and 24.5% of eyes in the FS-LASIK and SMILE groups were within 0.25 D were within 0.25D postoperative cylinder, respectively, and 78% and 66% of eyes in these two groups were within 0.5 D postoperative cylinder (P = 0.027, P = 0.202). The vector analysis showed comparable between-group target-induced astigmatism (TIA) (P = 0.114), surgically induced astigmatism (SIA) (P = 0.057), difference vector (DV, P = 0.069), and the angle of error (AE) (P = 0 .213) values. The index of success (IOS) was 0.18 in the FS-LASIK group and 0.24 in the SMILE group (P = 0.024), with a significant difference between the two groups. CONCLUSION: FS-LASIK with compensation of cyclotorsion showed a favorable correction of high myopic astigmatism (≥ 2.0 D) compared to SMILE with stringent head positioning at 12 months.

Dynamically tunable narrowband anisotropic total absorption in monolayer black phosphorus based on critical coupling.

A dynamically tunable anisotropic narrowband absorber based on monolayer black phosphorous (BP) is proposed in the terahertz (THz) band. The proposed absorber consists of a monolayer BP and a silicon (Si) grating, which is placed on a silica (SiO2) isolation layer and a gold (Au) substrate. The benefit from the critical coupling mechanism with guided resonance is the efficiency of the absorption can reach 99.9% in the armchair (AC) direction and the natural anisotropy of BP makes it only 87.2% in the zigzag (ZZ) direction. Numerical and theoretical studies show that the absorption efficiency of the structure is operatively controlled by critical coupling conditions, including the geometric parameters of the Si grating, the electron doping of BP and the angle of incident light, etc. More importantly, in the absence of plasmon response, this structure greatly enhances the interaction between light and matter in monolayer BP. In particular, there are several advantages in this structure, such as extremely high-efficiency absorption, excellent tunability, outstanding intrinsic anisotropy and easy manufacturing, which will show unusual and promising potential applications in the design of BP-based tunable high-performance devices.

Unified Synthesis of Polycyclic Alkaloids by Complementary Carbonyl Activation*.

A complementary dual carbonyl activation strategy for the synthesis of polycyclic alkaloids has been developed. Successful applications include the synthesis of tetracyclic alkaloids harmalanine and harmalacinine, pentacyclic indoloquinolizidine alkaloid nortetoyobyrine, and octacyclic ß-carboline alkaloid peganumine A. The latter synthesis features a protecting-group-free assembly and an asymmetric disulfonimide-catalyzed cyclization. Furthermore, formal syntheses of hirsutine, deplancheine, 10-desbromoarborescidine A, and oxindole alkaloids rhynchophylline and isorhynchophylline have been achieved. Finally, a concise synthesis of berberine alkaloid ilicifoline B was completed.

Synthesis of polyketide stereoarrays enabled by a traceless oxonia-Cope rearrangement.

Polyketide antibiotics bearing skipped polyols represent a synthetic challenge. A SiCl4-promoted oxonia-Cope rearrangement of syn,syn-2-vinyl-1,3-diols was developed to forge an array of 1,5-pentenediols, thus providing versatile motifs for the preparation of 1,2,3,5-stereoarrays in a highly stereoselective manner. Further exploration with Sn(OTf)2 realized the rearrangement of a cross-aldehyde which tactically warrants the utility of the current approach to access complex polyketides. The origin of high stereoselectivity is attributed to a chairlike anti-conformation of the oxonium ion intermediate.

Multiplexed manipulation of orbital angular momentum and wavelength in metasurfaces based on arbitrary complex-amplitude control.

Due to its unbounded and orthogonal modes, the orbital angular momentum (OAM) is regarded as a key optical degree of freedom (DoF) for future information processing with ultra-high capacity and speed. Although the manipulation of OAM based on metasurfaces has brought about great achievements in various fields, such manipulation currently remains at single-DoF level, which means the multiplexed manipulation of OAM with other optical DoFs is still lacking, greatly hampering the application of OAM beams and advancement of metasurfaces. In order to overcome this challenge, we propose the idea of multiplexed coherent pixel (MCP) for metasurfaces. This approach enables the manipulation of arbitrary complex-amplitude under incident lights of both plane and OAM waves, on the basis of which we have realized the multiplexed DoF control of OAM and wavelength. As a result, the MCP method expands the types of incident lights which can be simultaneously responded by metasurfaces, enriches the information processing capability of metasurfaces, and creates applications of information encryption and OAM demultiplexer. Our findings not only provide means for the design of high-security and high-capacity metasurfaces, but also raise the control and application level of OAM, offering great potential for multifunctional nanophotonic devices in the future.

Therapeutic and adverse effects of adrenaline on patients who suffer out-of-hospital cardiac arrest: a systematic review and meta-analysis.

OBJECTIVE: The efficacy and safety of epinephrine in patients with out-of-hospital cardiac arrest (OHCA) remains controversial. The meta-analysis was used to comprehensively appraise the influence of epinephrine in OHCA patients. METHODS: We searched all randomized controlled and cohort studies published by PubMed, EMBASE, and Cochrane Library from the inception to August 2022 on the prognostic impact of epinephrine on patients with OHCA. Survival to discharge was the primary outcome, while the return of spontaneous circulation (ROSC) and favorable neurological outcome were secondary outcomes. RESULTS: The meta-analysis included 18 studies involving 863,952 patients. OHCA patients with adrenaline had an observably improved chance of ROSC (RR 2.81; 95% CI 2.21-3.57; P = 0.001) in randomized controlled studies, but the difference in survival to discharge (RR 1.27; 95% CI 0.58-2.78; P = 0.55) and favorable neurological outcomes (RR 1.21; 95% CI 0.90-1.62; P = 0.21) between the two groups was not statistically significant. In cohort studies, the rate of ROSC (RR 1.62; 95% CI 1.14-2.30; P = 0.007) increased significantly with the adrenaline group, while survival to discharge (RR 0.73; 95% CI 0.55-0.98; P = 0.03) and favorable cerebral function (RR 0.42; 95% CI 0.30-0.58; P = 0.001) were lower than the non-adrenaline group. CONCLUSION: We found that both the randomized controlled trials (RCTs) and cohort studies showed that adrenaline increased ROSC in OHCA patients. However, they were unable to agree on a long-term prognosis. The cohort studies showed that adrenaline had an adverse effect on the long-term prognosis of OHCA patients (discharge survival rate and good neurological prognosis), but adrenaline had no adverse effect in the RCTs. In addition to the differences in research methods, there are also some potential confounding factors in the included studies. Therefore, more high-quality studies are needed to fully confirm the effect of adrenaline on the long-term results of OHCA.

Management of Cervical Cancer in Pregnant Women: A Multi-Center Retrospective Study in China.

Background: This retrospective multi-center study aimed to describe the epidemiological characteristics, clinical features, and management of patients with cervical cancer in pregnancy (CCIP) and evaluate maternal and infant outcomes. Methods: The data of patients with CCIP were retrospectively collected from those diagnosed and treated in 17 hospitals in 12 provinces in China between January 2009 and November 2017. The information retrieved included patients' age, clinical features of the tumor, medical management (during pregnancy or postpartum), obstetrical indicators (i.e., gestational age at diagnosis, delivery mode, and birth weight), and maternal and neonatal outcomes. Survival analyses were performed using Kaplan-Meier survival curves and log-rank tests that estimated the overall survival of patients. Results: One-hundred and five women diagnosed with CCIP (median age = 35 years) were identified from ~45,600 cervical cancer patients (0.23%) and 525,000 pregnant women (0.020%). The median gestational age at cancer diagnosis was 20.0 weeks. The clinical-stage of 93.3% of the patients with CCIP was IB1, 81.9% visited the clinic because of vaginal bleeding during pregnancy, and 72.4% had not been screened for cervical cancer in more than 5 years. To analyze cancer treatments during pregnancy, patients were grouped into two groups, termination of pregnancy (TOP, n = 67) and continuation of pregnancy (COP, n = 38). Analyses suggested that the TOP group was more likely to be diagnosed at an earlier gestational stage than the COP group (14.8 vs. 30.8 weeks, p < 0.001). The unadjusted hazard ratio for the COP group's overall survival was 1.063 times that of the TOP group (95% confidence interval = 0.24, 4.71). There were no significant differences between the TOP and COP groups in maternal survival (p = 0.964). Thirty-three of the infants of patients with CCIP were healthy at the end of the follow-up period, with a median age of 18 ± 2.8 months. Conclusions: Most patients with CCIP had not been screened for cervical cancer in over 5 years. The oncologic outcomes of the TOP and COP groups were similar. A platinum-based neoadjuvant chemotherapy regimen could be a favorable choice for the management of CCIP during the second and third trimesters of pregnancy.

[BPNN simulation of photocatalytic degradation of reactive scarlet BES by UV-Vis spectrophotometer].

The use of chemometric techniques and multivariate experimental designs for the photocatalytic reaction of reactive scarlet BES in aqueous solution under ultraviolet light irradiation is described. The efficiency of photocatalytic degradation was evaluated by the analysis of the parameter of decoloration efficiency determined by UV absorption at 540 nm using a UV-Vis spectrophotometer in different conditions. Five factors, such as the amount of titanium oxide ([TiO2]), the concentrations of reactive scarlet BES (c(0)), irradiation time (t), the pH value (pH) and temperature (T), were studied. [TiO2]. c(0), t and pH selected on the basis of the results of variance analysis by Plackett-Burman design were used as independent variables. Training sets and test sets of back propagation neural network (BPNN) were formed by Box-Behnken design and uniform design U10 (10 x 5(2) x 2) respectively. The process of photocatalytic degradation of the target object was simulated by the BPNN model. The correlation coefficient (r) of the calculation results for training set and test set by BPNN is 0.996 4 and 0.963 6 respectively, and the mean relative errors between the predictive value and experimental value of decoloration efficiency are 6.14 and 7.76, respectively. The modeled BPNN was applied to analyze the influence of four factors on decoloration efficiency. The results showed that the initial conditions of c(0) being lower, pH 5.0 and appropriate amount of [TiO2] contribute to improving the decoloration efficiency of reactive scarlet BES. Under the condition of c(0) = 40 mg x L(-1), the optimized experimental condition of the system was obtained: [TiO2] = 1.20 g x L(-1) and pH 5.0. Under the optimized experimental condition, the experimental value of decoloration efficiency is 98.20% when irradiation time is 35 minutes and the predictive value of decoloration efficiency is 99.16% under the same condition. The relative error of decoloration efficiency between the predictive value and experimental value is only -0.96%. The experimental value is very close to the model predicted value.

[Postoperative short-term complications of laparoscope-assisted transanal total mesorectal excision for rectal cancer after neoadjuvant therapy and their management: a single center report].

OBJECTIVE: To summarize and analyze the postoperative short-term complications of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer patients after neoadjuvant therapy. METHODS: A prospectively established database on taTME patients at Peking University Cancer Hospital was screened with the following conditions: data retrieval from June 2016 to August 2018, pathologically confirmed adenocarcinoma, receiving preoperative neoadjuvant chemoradiotherapy or chemotherapy. The transabdominal procedure and the transanal procedure were performed simultaneously in the taTME operation. Occurrence of complications during perioperative period (within postoperative 3 months) in these patients, especially anastomosis-related complications and their management were analyzed. The relevant complications were recorded according to the Clavien-Dindo (CD) grading criteria. The severity of anastomotic leakage and anastomotic stenosis was evaluated according to criteria developed by the International Rectal Cancer Research Group. RESULTS: A total of 29 patients were enrolled in this study. In the 29 patients, 25 (86.2%) were male and 4 (13.8%) were female, the median age was 60 (range, 30 to 72) years, the median body mass index was 25.8 (range, 19.8 to 36.4) kg/m2, the median distance from the tumor to anal verge was 4 (range, 2 to 8) cm. All the patients completed laparoscope-assisted taTME operations successfully without conversion to laparotomy, intra-operative severe complication or death. The median operation time was 300 (range, 198 to 405) minutes, and the median intra-operative blood loss was 100 (range, 50 to 200) ml. All the TME specimens were complete according to the Nagtegaal standard. All the patients underwent prophylactic ileostomy. Hartmann procedure was performed in one case due to poor blood supply in the proximal bowel without the possibility of anastomosis. Anal sphincter preservation rate was 96.6% (28/29). The median postoperative exhaust time was 2 (range, 1 to 10) days, and the median postoperative hospital stay was 9 (range, 7 to 24) days. Fifteen patients (51.7%) had postoperative complications, among which serious complication (CD grade IIIb and above) accounted for 6.9% (2/29). No perioperative death was observed. Five patients (17.2%) presented anastomosis-related complications, including 2 cases of grade C anastomotic leakage due to anastomotic rupture, who underwent abdominal perineal resection 1 month after operation; 2 cases of grade B anastomotic leakage, who improved after conservative treatment; 1 case of grade A anastomotic stenosis, who improved with anal expansion 1 month after operation. The incidence of postoperative infection was 24.1% (7/29), including 6 cases of pelvic infection and 1 case of trocar site infection, all of which were CD grade II. One case had incomplete intestinal obstruction (CD grade II); 1 case had gastroplegia; 1 case had abdominal trocar hernia. All the patients were followed up for a median of 12.0 (range, 3.9 to 29.9) months. Seven cases did not undergo ileal stoma closure. The anal sphincter preservation rate was 75.9% (22/29). CONCLUSION: Pelvic infection and anastomosis-related complications are common after laparoscope-assisted taTME surgery for rectal cancer patients following neoadjuvant chemoradiotherapy, which require active management and appropriate treatment.

[Short-term outcome of transanal total mesorectal excision for male low rectal cancer patients with "difficult pelvis" : a single center report from Peking University Cancer Hospital].

OBJECTIVE: To explore the applicable value of transanal total mesorectal excision (taTME) in male low rectal cancer patients with narrow pelvis-"difficult pelvis", which remains difficult for both open and laparoscopic sphincter-saving operations. METHODS: Clinical data of male low rectal cancer patients diagnosed by pathology undergoing taTME between June 2016 and January 2018 at Peking University Cancer Hospital were collected. A retrospective cohort study was performed. Patients were selected according to the following criteria: (1) low rectal cancer, the distance between inferior margin of tumor and anal verge ≤5 cm; (2) the distance between two sciatic tubercles <5 cm; (3) body mass index (BMI) >25 kg/m2; (4) tumor horizontal diameter ≤4 cm. Operation time, intraoperative blood loss, postoperative hospital stay, postoperative complications and anal function were analyzed. RESULTS: A total of 20 patients were included in this study. All the patients received preoperative neoadjuvant chemoradiation and hybrid transabdominal and transanal surgery. The median BMI was 27.7(26.2-36.4) kg/m2; the median distance between two sciatic tubercles was 92.5 (78-100) mm; the median distance between the inferior margin of tumor to the anal verge was 4 (2-5) cm; the median operation time was 302 (215-402) min; the median intraoperative blood loss was 100 (50-200) ml; the median postoperative hospital stay was 9 (5-15) d. Postoperative complications occurred in 5 patients (25%), including 3 pelvic infection, 1 intestinal obstruction, 1 anastomotic leakage receiving sigmoid colostomy. There was no perioperative death. Sphincter-preservation rate was 100%. Nineteen patients received anal manometry 1 month after operation with normal resting pressure (41.5±8.6) mmHg and squeeze pressure (121.0±11.6) mmHg. All the patients were followed up to March 2018, and the median follow-up time was 4.5 months. Only 1 patient had supraclavicular lymph node metastasis and no local recurrence was found. CONCLUSIONS: The safety of transanal total mesorectal excision for male patients with low rectal cancer and difficult pelvis is acceptable. TaTME is helpful to preserve the anal sphincter.

miR-140-5p inhibits ovarian cancer growth partially by repression of PDGFRA.

Dysregulation of miRNAs is a common feature in human cancers, and miR-140-5p has been found to be down-regulated in cancer. However its role in ovarian cancer remains unclear. miR-140-5p was underexpressed in HCC tissues and cell lines compared with their normal controls. Additionally, PDGFRA was predicted the target gene of miR-140-5p. PDGFRA was inversely correlated with the expression of miR-140-5p in ovarian cancer cells. Importantly, we demonstrate that the over expression of miR-140-5p significantly inhibits ovarian cancer cell proliferation and induces apoptosis. Our results suggest the existence of a novel miR-140-5p-PDGFRA pathway and indicate that miR-140-5p acts as a tumor suppressor during ovarian carcinogenesis. These results may provide a promising alterative strategy for the therapeutic treatment of ovarian cancer.

Safety assessment of ovarian cryopreservation and transplantation in nude mice bearing human epithelial ovarian cancer.

OBJECTIVE: Nude mice with orthotopic transplantation of human ovarian epithelial cancer were used to investigate screening criteria for paraneoplastic normal ovarian tissue and the security of the freezing and thawing for ovarian tissue transplantation. METHODS: Expression of CK-7, CA125, P53, survivin, MMP-2/TIMP- 2 in paraneoplastic normal ovarian tissues were detected by RT-PCR as well as immunohistochemistry. The tissues of the groups with all negative indicators of RT-PCR, all negative indicators of immunohistochemistry, negative expression of CK-7, CA125 and survivin, positive expression of CK-7, CA125 and survivin, cancer tissues and normal ovarian tissues of nude mice were used for freezing and thawing transplantation, to analyze overt and occult carcinogenesis rates after transplantation. RESULTS: When all indicators or the main indicators, CK-7, CA125 and survivin, were negative, tumorigenesis did not occur after transplantation. In addition the occult carcinogenesis rate was lower than in the group with positive expression of CK-7, CA125 and survivin (P<0.01). After subcutaneous and orthotopic transplantation of ovarian tissues, rates did not change (P>0.05). There was no statistical significance among rates after transplantation of ovarian tissues which were obtained under different severity conditions (P>0.05). CONCLUSION: Negative expression of CK-7, CA125 and survivin can be treated as screening criteria for security of ovarian tissues for transplantation. Immunohistochemical methods can be used as the primary detection approach. Both subcutaneous and orthotopic transplantation are safe. The initial severity does not affect the carcinogenesis rate after tissue transplantation. Freezing and thawing ovarian tissue transplantation in nude mice with human epithelial ovarian carcinoma is feasible and safe.

[Alteration of multiple tumor metastatic genes with correlation to metastasis in ovarian carcinoma].

OBJECTIVE: To investigate the expression and mutation of MTA1, nm23H1 and E-cadherin(E-cad) genes in ovarian carcinoma (OC) in relation to lymph node (LN) metastasis. METHODS: A panel of normal ovarian tissues, primary OC specimens and corresponding LNS was examined for mRNA expression and mutation of MTA1 and nm23H1 and protin expression of E-cad genes by using RT-PCR, RT-PCR-SSCP and immunohistochemistry. RESULTS: The frequency of MTA1 over expression was 100%(7/7) in primary OC with metastasis but only 38.5%(5/13) in those without metastasis (P = 0.0103). Overexpression of MTA1 was observed in 87.5%(6/7) of LNS with metastasis but in only 23%(3/13) of LNS without metastasis (P = 0.0118). In contrast with MTA1, low expression of nm23H1 mRNA was seen in 7 of 7 OC with metastasis but only in 4 of 13(30%) of those without metastasis (P = 0.0043). Low nm23H1 expression was also seen in 7 of 7 LNS with metastasis but only in 5 of 13 (38.5%) nonmetastatic LNS (P = 0.0102). Meantime, no expression of E-cad protein was observed in 7 of 7 OC with metastasis but in 6 of 13(46.2%) of those without metastasis (P = 0.044). In correlation analysis of the three genes, MTA1 reversely correlated with nm23H1 and E-cad respectively (r = -0.903, -0.803), and positive correlation existed between nm23H1 and E-cad (r = 0.724). No mutation of MTA1, nm23H1 and was found by SSCP analysis. CONCLUSION: The mRNA expression of MTA1, nm23H1 and E-cad is positively and negatively correlated with LN metastasis. The expression abnormalities but not the mutations of the three genes are frequent events related to LN metastasis of ovarian cancer.