Could fertility-sparing surgery be considered for stage I ovarian sex cord-stromal tumors? A comparison of the Fine-Gray model with Cox model.

Objective: To evaluate the oncologic outcomes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I ovarian sex cord-stromal tumors (SCSTs) who underwent fertility-sparing surgery (FSS) and the independent risk factors affecting overall survival (OS) and cancer-specific survival (CSS). Methods: Data were acquired from the Surveillance, Epidemiology, and End Results (SEER) database between 1973 and 2018. A total of 240 patients diagnosed with stage I ovarian SCSTs were divided into the definitive surgery group (N=116) and FSS group (N=124). The Kaplan-Meier analysis and Cox model were used to evaluate the overall survival (OS) and cancer-specific survival (CSS) of the two groups and assess the independent risk factors respectively. The Fine-Gray model evaluated cancer-specific mortality (CSM) and the independent risk factors that affected CSM. Results: Kaplan-Meier survival analysis showed no statistically significant differences in OS and CSS between the two groups (P>0.05). Univariate analysis of the Fine-Gray model also showed that there was no difference in the CSS between the two groups (P>0.05). However, from the 15th year postoperatively, the CSS of the FSS group decreased by 13.21% compared with that of the control group and by 17.49% in the 20th and 25th years postoperatively. The Cox proportional hazards model found that surgical methods ("defined surgery" vs "FSS"; HR=0.03259, P=0.0196) and FIGO stage ("stage IA" vs "stage IC"; HR=0.03073, P=0.0300) were independent risk factors for OS. The multivariate analysis of Fine-Gray model showed that the cancer-specific mortality of patients receiving definitive surgery was 40.1% lower than that of patients receiving FSS ("definitive surgery" vs "FSS"; HR=0.599, P=0.005), indicating that FSS might lead to higher tumor-specific mortality and lower CSS. However, age, race, laterality, history, FIGO stage, and tumor size had no significant influence on the tumor-specific mortality (P>0.05). Conclusions: FSS is considered for patients with stage I SCSTs with reproductive needs, but the follow-up period should not be less than 15 years. For patients with stage IC disease, FSS should be selected carefully, and close follow-up is necessary. Perhaps, definitive surgery after birth is a means to improve long-term survival rates.

Long noncoding RNA SNHG12 promotes the progression of cervical cancer via modulating miR-125b/STAT3 axis.

Increasing evidence showed that long noncoding RNAs (lncRNAs) played an important role in the occurrence and development of tumors. To date, lncRNA small nucleolar RNA host gene 12 (SNHG12) has revealed an oncogenic role in various tumors. However, the role of SNHG12 in cervical cancer is still unclear. Therefore, we focused on the biological function and molecular mechanism of SNHG12 in the tumorigenesis of cervical cancer. In this study, the expression of miR-125b was observably downregulated in cervical cancer cells. Meanwhile, the expression of SNHG12 was obviously upregulated in cervical cancer cell lines (HeLa, SiHa, Caski, C4-1, and C33A) compared with the immortalized cervical epithelial cells. The further assay showed that miR-125b was a target of SNHG12 in cervical cancer. Moreover, a negative relationship between miR-125b and SNHG12 was found in cervical cancer. In addition, SNHG12 inhibition restrained the proliferation, migration, and invasion of cervical cancer cells. Meanwhile, miR-125b mimics repressed the expression of signal transducer and activator of transcription 3 (STAT3). The further assay showed that STAT3 was a target of miR-125b in cervical cancer. In addition, sh-STAT3 repressed the migration and invasion of cervical cancer cells. Furthermore, it showed that miR-125b inhibitors reversed STAT3 expression restrained by the reduction of SNHG12 expression. In general, SNHG12 modulated STAT3 by sponging miR-125b in cervical cancer and played an important role in the development of cervical cancer.

MiR-128 promotes the apoptosis of glioma cells via binding to NEK2.

OBJECTIVE: The aim of this study was to explore whether miR-128 could promote the apoptosis of glioma cells by targeting NIMA related kinase-2 (NEK2), thus participating in the occurrence and progression of glioma. PATIENTS AND METHODS: Expression levels of miR-128 and NEK2 in glioma tissues and normal brain tissues were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The relationship between miR-128 expression, tumor size and stage of glioma was analyzed. The effect of miR-128 on the apoptosis of glioma cells was detected by flow cytometry and Western blot, respectively. Dual-luciferase reporter gene assay was applied to verify the binding condition of miR-128 and NEK2. Meanwhile, rescue experiments were conducted to determine whether miR-128 could promote the apoptosis of glioma cells by targeting NEK2. RESULTS: The expression level of miR-128 in glioma tissues was significantly lower than that of normal brain tissues. However, NEK2 was highly expressed in glioma tissues. MiR-128 expression was correlated to tumor size and malignant level of glioma, whereas not related to age and gender of glioma patients. Meanwhile, overexpression of miR-128 promoted the apoptosis of U87 cells, upregulated protein levels of cleaved Caspase-3 and BCL2-associated X (Bax), and downregulated B-cell lymphoma-2 (Bcl-2). Dual-luciferase reporter gene assay indicated that miR-128 directly bound to NEK2. Further rescue experiments suggested that NEK2 overexpression partially reversed the effect of miR-128 on the apoptosis of glioma cells. CONCLUSIONS: Downregulated miR-128 inhibited the apoptosis of glioma cells via targeting NEK2.

The effects of interventional therapy on serum HTATIP2/TIP30, B7-H4 and short-term curative effect in primary hepatocellular carcinoma.

OBJECTIVE: To explore the effects of interventional therapy on human immunodeficiency virus (HIV)-1 Tat interactive protein 2/Tat interactive protein 30 (HTATIP2/TIP30), B7-H4 and short-term curative effect in primary hepatocellular carcinoma. PATIENTS AND METHODS: 62 patients with primary hepatocellular carcinoma admitted in our hospital from June 2015 to June 2016 were enrolled in this study and divided into observation group (n = 31) and control group (n = 31) according to the random number table. The patients in the control group were treated with radiofrequency ablation, and the patients in the observation group were treated with transcatheter arterial chemoembolization (TACE). The patients in both groups received liver protection therapy, hydration, antiemetic and stomach protection. The curative effects, the serum HTATIP2/TIP30, B7-H4, alanine aminotransferase (ALT) and total bilirubin in serum (TBIL), life quality before and after treatment, and survival during the 1-year follow-up, were compared. RESULTS: The total short-term effective rate (70.97%) was higher than the control group (38.71%) (p < 0.05). The serum levels of HTATIP2/TIP30 and B7-H4 were decreased after treatment in both groups (observation group: t = 17.1838, 18.9795, control group: t = 8.3787, 10.6393, p < 0.05). The serum levels of HTATIP2/TIP30 and B7-H4 after treatment in the observation group were lower than the control group (t = 12.2975, 10.5361, p < 0.05). The levels of ALT and TBIL were decreased after treatment (observation group: t = 15.1716, 34.5771, control group: t = 8.3374, 17.3015, p < 0.05). The levels of ALT and TBIL were lower in the observation groups than the control group (t = 15.2697, 16.8592, p < 0.05). The improvement rate of life quality in the observation group (80.65%) was higher than the control group (54.84%) (p < 0.05). The survival rates of the two groups after 1-year follow-up were not statistically different (p > 0.05). CONCLUSIONS: The short-term curative effect of interventional therapy of primary hepatocellular carcinoma is good. It can decrease serum HTATIP2/TIP30 and B7-H4, improves the liver function and the life quality of patients, prolonging the survival time. It has a high research value and it is worthy of further application.

The expression of Ldh-c in the skeletal muscle of plateau pika (Ochotona curzoniae) enhances adaptation to a hypoxic environment.

The plateau pika (Ochotona curzoniae) is a species of sprint-running alpine animals in the Qinghai-Tibet Plateau, which is a harsh highland hypoxic environment. Ldh-c is expressed in the testis, sperm and somatic tissues of plateau pika. To reveal the role and physiological mechanisms of sperm-specific lactate dehydrogenase (LDH-C4), in plateau pika to adapt to hypoxic environment, an adenoviral line of pMultiRNAi-Ldhc was constructed and injected into the bilateral biceps femoris of the hind legs. The swimming times of the pikas, and the Ldh-c expression levels, total LDH activities and ATP levels in skeletal muscle, were measured after the pikas were raised in the trapped site for 5 days. Our results showed that after Ldh-c was silenced, the sprint-running ability (swimming time) of the plateau pikas was significant decreased, and the total LDH activities and ATP levels were reduced by 28.21% and 27.88%, respectively. Our results indicated that expression of Ldh-c in the skeletal muscle of plateau pika increased anaerobic glycolysis and enhanced adaptation to highland hypoxic environments.

Alignment of the lower extremity mechanical axis by computer-aided design and application in total knee arthroplasty.

PURPOSE: The success of total knee arthroplasty (TKA) depends on many factors. The position of a prosthesis is vitally important. The purpose of the present study was to evaluate the value of a computer-aided establishing lower extremity mechanical axis in TKA using digital technology. METHODS: A total of 36 cases of patients with TKA were randomly divided into the computer-aided design of navigation template group (NT) and conventional intramedullary positioning group (CIP). Three-dimensional (3D) CT scanning images of the hip, knee, and ankle were obtained in NT group. X-ray images and CT scans were transferred into the 3D reconstruction software. A 3D bone model of the hip, knee, ankle, as well as the modified loading, was reconstructed and saved in a stereolithographic format. In the 3D reconstruction model, the mechanical axis of the lower limb was determined, and the navigational templates produced an accurate model using a rapid prototyping technique. The THA in CIP group was performed according to a routine operation. CT scans were performed postoperatively to evaluate the accuracy of the two TKA methods. RESULTS: The averaged operative time of the NT group procedures was [Formula: see text] min shorter than those of the conventional procedures ([Formula: see text]  min). The coronal femoral angle, coronal tibial angle, posterior tibial slope were [Formula: see text], [Formula: see text], [Formula: see text] in NT group and [Formula: see text], [Formula: see text], [Formula: see text] in CIP group, respectively. Statistically significant group differences were found. CONCLUSIONS: The navigation template produced through mechanical axis of lower extremity may provide a relative accurate and simple method for TKA.

Preliminary experience of endoscopic submucosal tunnel dissection for upper gastrointestinal submucosal tumors.

BACKGROUND AND STUDY AIM: Although the majority of submucosal tumors (SMTs) are benign, some do have a malignant potential. Resection of SMTs would aid in establishing the diagnosis and may be curative. Our aim was to examine the feasibility and safety of a novel method for endoscopic resection of upper gastrointestinal SMTs. PATIENTS AND METHODS: In 12 patients who presented with an upper gastrointestinal SMT of ≤40 mm located in the esophagus or cardia, a submucosal tunnel was endoscopically created starting approximately 5 cm proximal to the lesion. After careful submucosal dissection with carbon dioxide or air insufflation, the SMTs were completely removed, and the entrance of the tunnel closed using endoclips. RESULTS: SMTs had a mean size of 19.5 mm (range 10-40 mm); eight were located in the esophagus and four in the cardia. SMT resection was successful in all patients with en bloc resection in 10 patients (83.3%) and resection in two pieces in the remaining two patients. The mean time required for the procedure was 48.3 minutes (range 30-60 minutes). Two patients had both pneumothorax and subcutaneous emphysema. All the complications resolved with conservative management. CONCLUSIONS: In this pilot study, endoscopic submucosal tunnel dissection (ESTD) of esophageal and cardia SMTs was effective and appeared to be safe. Larger studies that also examine its application for gastric SMTs are warranted.

Huashan Hospital affiliated to Fudan University: spanning a century of history.

Established in 1907, Huashan Hospital affiliated to Fudan University represents in microcosm the growth of modern Chinese medical science and shows its course of development. Over the past 103 years, the hospital has grown from a staff of a dozen to 3103 staff members, covering an area of 37,396 m(2) with 1216 hospital beds. Huashan Hospital has grown into one of the best-known hospitals in China with multiple world-renowned disciplines, including neurosurgery, hand surgery, dermatology, and infectious disease.

Long-term results of intratumorous bleomycin-A5 injection for head and neck lymphangioma.

From June 1987 to June 1995, 200 patients with various types of head and neck lymphangioma were treated by intratumorous injection of bleomycin-A5. All 200 cases were followed from 2 to 10 years; 95 cases were followed for more than 5 years. The effective rate was 97%, and the curative rate was 86.5%. No pulmofibrosis or other serious complications were found. The relationships between the curative effect and tumor type, size, and side effect of bleomycin are discussed.