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Objective:To analyze the efficacy of the enhanced recovery after surgery(ERAS)approach in endometrial cancer patients treated with surgical staging and its beneficial effects on the oxidative stress response.Methods:Eight-two endometrial cancer patients treated with surgical staging at our hospital between March 2020 and March 2022 were recruited and divided into different groups using a computer-generated random number table, with 41 in the control group who were given routine intervention and 41 in the observation group receiving ERAS.Results:About perioperative performances, the oxidative stress response, inflammatory factor levels and complications were compared between the two groups.Results in the observation group, the intraoperative body surface temperature was higher than in the control group[(36.71±0.22)℃ vs.(36.20±0.21)℃, t=10.737, P=0.000], and the time from the end of surgery to first water intake[(4.41±1.30)h vs.(6.79±1.28)h, t=8.353, P=0.000], to first food intake[(7.86±1.35)h vs.(12.88±2.57)h, t=11.073, P=0.000], to first ambulation[(12.92±3.11)h vs.(24.24±5.06)h, t=12.204, P=0.000], to first flatus[(24.11±4.96)h vs.(35.13±6.20)h, t=8.887, P=0.000], to first bowel movement[(2.67±0.63)d vs.(4.03±1.15)d, t=6.641, P=0.000]and the length of hospitalization[(3.31±1.25)d vs.(5.77±1.59)d, t=7.788, P=0.000]were shorter than in the control group.On the third day after surgery, the levels of malondialdehyde[(77.96±7.62)μmol/L vs.(90.16±7.88)μmol/L, t=7.126, P=0.000], advanced oxidation protein products[(33.16±4.75)μmol/L vs.(43.55±5.37)μmol/L, t=9.280, P=0.000], CAT[(22.59±3.01)U/ml vs.(25.12±3.3)U/ml, t=3.609, P=0.000]and reactive oxygen species[(74.13±5.02)pmol/L vs.(90.33±5.89)pmol/L, t=13.404, P=0.000]in the two groups were higher than those on the day before surgery, but were lower in the observation group than in the control group at the same time points after surgery.On the 3rd day after surgery, the levels of Tumor Necrosis Factor-α, C-reactive protein and interleukin 6 in the two groups were higher than those on the day before surgery, but were lower in the observation group than in the control group at the same points after surgery(all P<0.05). In the observation group, the incidence of complications was 14.63%, lower than 39.02% in the control group( χ2=6.212, P=0.013). Conclusions:The ERAS approach can achieve significant results in endometrial cancer patients treated with surgical staging.It can not only improve perioperative performance, relieve oxidative stress and lower inflammatory factor levels, but also effectively prevent complications.
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Objective:To investigate the role of kinesin family proteins(KIF)2C in chemoresistance of epithelial ovarian cancer and its potential molecular mechanism.Methods:The differential expression of KIF2C in cisplatin-sensitive cell line A2780 and cisplatin-resistant cell line A2780DDP was detected.Different concentrations and time of cisplatin were added to A2780 cell line to detect the differential expression of KIF2C.The ovarian cancer cell line KIF2C-OV with stable overexpression of KIF2C was constructed by lentivirus infection of A2780DDP cell line.The same concentration of cisplatin was added to KIF2C-OV and its control group(Ctrl-OV)cell lines.The effect of KIF2C overexpression on the proliferation of drug-resistant cell line A2780DDP was detected by Cell Counting Kit-8(CCK-8). Finally, the molecular mechanism of KIF2C resistance in ovarian cancer cell lines was preliminarily explored.Results:KIF2C was significantly down-regulated in A2780DDP cells.After cisplatin was added to A2780 cell line, the expression of KIF2C decreased with the increase of cisplatin concentration and action time.The ovarian cancer cell line KIF2C-OV with stable overexpression of KIF2C was constructed by lentivirus infection of A2780DDP cell line.After adding cisplatin, the proliferation ability of KIF2C-OV cell line was significantly lower than that of Ctrl-OV cell line.The expression of p-Erk was increased in A2780DDP cell line.The expression of p-Erk in A2780 cell line was increased with the increase of cisplatin concentration and time.After overexpression of KIF2C in A2780DDP ovarian cancer cell line, the expression level of p-Erk decreased.Conclusions:KIF2C may be a potential target gene of chemotherapy resistance in ovarian cancer, which may play its role through MAPK/ERK pathway.
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Objective:To investigate whether Losartan can inhibit the formation of ascites in a nude mouse model of ovarian cancer by improving lymphatic drainage.Methods:Eight-week-old nude mice were randomly divided into 3 groups with 24 mice in each group.The blank control group received no treatment.Mice in the other two groups were given orthotopic transplantation of SKOV3 IP1-Gluc human ovarian cancer cells.Peritoneal tumor growth was monitored by peripheral blood Gluc levels, and mice were enrolled when the blood Gluc level reached 1×10 6 relative light units.Twenty-two nude mice were in the control group and 23 in the Losartan treatment group.Mice were sacrificed on the 28 th day after cancer cell implantation.Tumor tissues and diaphragm were removed, and the volume of ascites was measured after suction.Sirius Red, αSMA and Collagen 1 staining were used to detect the contents of extracellular matrix collagen and fibroblasts.Lymphangiography was used to examine the diaphragmatic lymphatic morphology, and intraperitoneal injection of fluorescent microspheres was used to visualize the distribution of fluorescent microspheres in diaphragmatic and mediastinal lymph nodes to estimate the function of diaphragmatic lymphatic drainage. Results:Losartan treatment significantly reduced the formation of ascites in the nude mouse model of ovarian cancer( P<0.05). Intratumoral contents of collagen(sirius red positive area, Collagen 1 content)and fibroblasts(αSMA positive area)were significantly reduced in the Losartan treatment group(all P<0.05). Compared with normal nude mice, the diaphragm lymphatic vessels were dilated and the structure was disordered in the control group.In the Losartan treatment group, the morphology and distribution of lymphatic vessels in the diaphragm improved and tended to normalize, as did the drainage function of lymphatic vessels. Conclusions:Losartan can inhibit the formation of extracellular matrix, reduce the extracellular matrix content of ovarian cancer cells, reduce solid pressure, relieve the oppressive effect on lymphatic vessels, improve lymphatic drainage and reduce ascites formation.
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Objective The objective of this study was to investigate the clinicopathological features and rational treatment of primary fallopian tube cancer(PFTC).Methods The clinical and pathological data of 39 patients with primary fallopian tube cancer from January 2006 to July 2016 in Beijing Tongren Hospital of Capital University were retrospectively analyzed.Results There were 39 cases of undifferentiated carcinoma,including 1 case of undifferentiated and transitional cell carcinoma,37 cases of undifferentiated adenocarcinoma,or 29 cases of simple adenocarcinoma and 10 cases of mixed type.Among them,7 cases were treated with clear cell carcinoma,endometriosis in 2 cases,combined with transitional cell carcinoma in 1 case.Extra-pelvic metastases were the most common site of the omentum with 17 cases.The preoperative test CA125 was increased in 13 cases and 38 patients received postoperative chemotherapy.The 5-year overall survival rate of 39 patients was 51.3%.Univariate analysis showed that postoperative pathologic stage(Ⅰ~Ⅱ vs.Ⅲ,P<0.001),intraoperative residual lesion size(P<0.001),omentum metastasis(P<0.001),ovarian metastasis(P=0.034),retroperitoneal lymph node metastasis(P=0.018)and preoperative CA125 elevation(P=0.002)were associated with prognosis,while age(P=0.310)and pathological grade(P=0.663)were not associated with prognosis.Multivariate analysis showed that the number of patients with postoperative lymph node metastasis(P=0.018)and preoperative CA125 elevation(P=0.002)were correlated with prognosis(HR=1.202,95% CI:2.354~63.290,P=0.003) and pathological stage(HR=3.810,95% CI:1.202~12.079,P=0.023).They were associated with prognosis as independent prognostic factors.Conclusion Tumor pathologic staging and omentum metastasis are important prognostic factors influencing the prognosis of patients with primary fallopian tube cancer.Early diagnosis and complete operation can improve the prognosis of patients.
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Objective To investigate the clinical effect of maternal pat with Chinese medicine in episiotomy wound care. Methods One thousand one hundred cases of maternal with full-term,vaginal delivery, episiotomy in the Beijing Tongren Hospital Affiliated to Capital Medical University from Jun. 2013 to Jun. 2014 were randomly divided into test group and control group. Patients in test group were given routine nursing care combined with Chinese medicine maternal pat to nurse perineal wound,while in the control group were given routine nursing combined with common maternal pat. The data of perineal wound swelling,pain and healing were recorded and compared in two groups. Results The incidences of mild,moderated swelling within 24 h,48 h in test group were 35. 5%( 195/550 )and 6. 0%( 33/550 ),13. 4%( 74/550 )and 1. 6%( 9/550 ),significantly lower than that of the control group( 24 h:51. 5%( 283/550 ),24. 5%( 135/550 );48 h:34. 2%( 188/550 ), 2. 7%(15/550);Z=12. 555,8. 144;P﹤0. 01). The incidences of moderate,severe pain within 24 h,48 h in test group were 12. 5%(69/550)and 2. 9%(16/550),8. 4%(46/550)and 1. 3%(7/550),significantly lower than that of the control group( 24 h:37. 3%( 205/550 ),7. 5%( 41/550 );48 h:20. 6%( 113/550 ),3. 5%(19/550);Z=10. 429,11. 886;P ﹤0. 01). The wound healing rate in test group was 92. 36%,significantly higher than that of control group( 80. 73%,P ﹤0. 01 ). The wound infection rate in test group was 1. 82%, significant lower than that of control group(3. 82%,P﹤0. 01). The incidence of comfort and satisfaction in test group was 90. 18%,significantly higher than that of control group(73. 09%;Z= -5. 614,-7. 345;P ﹤0. 05). Conclusion Nursing lateral episiotomy wound using Chinese medicine maternal pat can reduce the swelling, pain and promote wound healing with convenient and comfortable. Therefore,it is worth of the clinical popularization and application.
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Objective To explore the reproductive outcomes of different management strategies of ectopic pregnancy .Methods A retrospective cohort study was performed for 648 consecutive patients with a diagnosis of ectopic pregnaney between June 2011 and september 2013.The follow-ups were conducted telephone interviews of pregnancy outcomes after various treatments .Results The subsequent intrauterine pregnancy rates after surgical , medical and expectant managements were 89(65.0%), 35(79.6%) and 6 (54.5%) the intrauterine pregnancy was higher for medical treatment than that for surgical treatment (P<0.05).The subsequent infertility rate after surgical , medical and expectant management were 4.5%, 36.4%, 19.0%.The subsequent infertility rate after medical treatment was lower than that for surgical and expectant managament ( P<0.05) .The re-ectopic pregnancy rates of laproscopic versus abdominal operation were [11 (11.7%), 13(30.2%)] with significant difference (P<0.05).And abdominal operation was higher than laproscopic operation .Conclusion For younger ectopic pregnancy patients , medical treatment shold be as possible as we can .If operation is necessary , laproscopic operation is preferred .
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Objective To compare the effect of four-in-one teaching method and traditional teaching method in clinical clerkship teaching in the department of obstetrics and gynecology. Methods Totally 70 clinical probationer were enrolled(35 from 2007 grade were taken as control group and 35 from 2008 grade were taken as experiment group ). Four-in-one teaching method and traditional teaching method were respectively in experiment group and control group. Examination score and clinical skill re-sults were analyzed by t test and satisfaction degree was analyzed byX2 test. P<0.05 signifies statistical sig-nificances . Results Examination score of experiment group and control group were 86 . 9 ± 7 . 7 and 76.5 ±8.7 respectively with statistically significant differences(P=0.000). Clinical skill score of experi-ment group and control group were 87.6±6.9 and 75.9±7.5 respectively with statistically significant dif-ferences(P=0.000). Each questionnaire index was significantly higher in experiment group than in con-trol group with statistically significant differences(P=0.000). Conclusions Four-in-one teaching method can make students understand theoretical knowledge and master obstetrics and gynecology basic clinical skills,enhance interests in learning,build up self-confidence and establish preliminary clinical thinking ability and innovation ability which will lay a solid foundation for future clinical and research practice.
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Objective To investigate the risk of heart failure to the mother and the neonate.Methods The clinical data of 30 pregnant womem with heart failure from January 1993 to December 2010 from Capital Medical University Tongren Hospital was retrospectively analyzed.Results Of the 30 patients,there were 12 affected with congenital heart disease (40％) ; 9 with rheumatic heart disease 30％,7 with heart failure in pregnancy-induced hypertension 23％.Heart failure appeared at the average of (34.20 ± 4.25) weeks in pregnancy.The average terminal time of pregnancy was (34.84 ± 2.17) weeks.The rate of early birth was 73.33％.The average birth weight was (2011 ±568) g,with 7 babies less than 2000 g.No death occurred in both new the mother and the neonate.Condusion The main causes of heart failure in pregnancy are congenital and rheumatic heart disease and pregnancy-induced hypertension.For those heart failure occurs before 30 weeks,it is the first selection that pregnancy shoud be terminated; For those occur after 30 weeks,active treatment should be performed to improve maternal heart function and promote fetal maturity.Apropriate threatment during per-cesarean section may decrease the case fatality of the mother and neonate.
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Objective To evaluate the clinical value of liquid-based thinprep cytology test (TCT) and human papillomavirus (HPV) in cervical lesions diagnosis.Methods 525 patients with TCT was inflammation and abnormalities had HPV testing and colposcopy with biopsy analysis.Results Histopathological diagnosis as CIN Ⅰ or CIN Ⅰ above cases percentage of TCT of ASCUS,LSIL,HSIL,and cancer cases were 55 ％ (160/290),88 ％ (99/113),92 ％ (24/26) and 100 ％ (4/4),Pathological diagnosis as inflammation and glandular phosphate in 441 cases of this TCT-positive patients were 148 patients,false positive 34 ％.TCT-negative patients,pathologically confirmed of CIN in 84 cases patients with moderate to severe cervical erosion or cervical polyps were 22 cases,26 ％ TCT false negative.They had statistically significance (x2 =815.4,P =0.000).74 ％ HPV positive patients diagnosed as CIN Ⅰ or CIN Ⅰ above (x2 =104.94,P =0.000).Diagnosed as CIN Ⅰ cases in less than 30 years old accounted for 62 ％ (61/98),CIN Ⅱ and above for only 38 ％ (37/98) and without cancer.But the CIN Ⅰ in above 30 age group was significantly reduced to only 37 ％ (81/217),CIN Ⅱ and above was significantly increased to 63 ％ (136/217),and cancer rate increased (x2 =63.71,P =0.012).Histopathological diagnosed as CIN Ⅰ case were 26 ％ (83/315) of cervical smooth,74 ％ (232/315) of cervical erosion; 14 cases of cancer occurred in patients with cervical erosion.It was statistically significant (x2 =39.9,P =0.014).Conclusion TCT and HPV for screening of cervical lesions play an important role in cervical lesions screening.
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Objective To explore the value of hysteroscopy in diagnostic curettage, the incidence of complications and preventive measures in senile women. Methods One hundred and thirteen senile patients who underwent hysteroscopy from January 2002 to December 2007 were recruited in the study, and one hundred and fifty-seven non senile patients were selected as control group. All the patients were operated with diagnostic curettage and hysteroseopy. The success rate of hysteroscopy operation, the incidence of complications and control effect were recorded and compared between two groups. Results The success rate of hysteroscopy operation was 88. 5% (100/113) in the senile group and 100% (157/157) in the non senile group, and there was significant differenee(P <0. 01). The incidence of complications was higher in the senile women group than that in the non senile women group (P< 0. 01). In senile group, the accuracy of diagnostic curettage and hysteroscopy was higher than diagnostic curettage alone, and the success rate was 95.5% (64/67)in estrogen group and 69.6%(32/46) in blank control group (P<0. 01) ,which indicated that estrogen was positively related with the success rate of operation. Compared with misoprostol, estradiol-pretreatment operation was safer and had higher success rate. Conclusions It is safe and feasible to perform hysteroscopy and diagnostic curettage for older women, though it has higher incidence of complications and lower success rate compared with non senile women. Hysteroscopy and diagnostic curettage are more accurate than diagnostic curettage alone, and it is a good choice to apply estradiol before operation.
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@#Objective To study laparoscopic pelvic lymphyectomy combined with vaginal hystectomy in the treatment of patients with stage Ⅰ endometrial carcinoma.Methods The data of 77 patients with stage Ⅰ endometrial carcinoma were reviewed retrospectively. These patients divided into the laparoscopic group and abdominal group according to the operation style. The operation time, blood loss, postoperation complication, rehabilition of the digestion tract, satisfaction degree to the operation of two groups were compared.Results There was no serious complications in the both groups. In the laparoscopic group, the operation time was longer than the abdominal group ( P<0.01), but so far as to the blood loss, the time of rehabilition of the digestion tract, the number of lymphyectomy, the postoperation pain alleviation and the degree of postoperation depression were superior to the abdominal group ( P<0.01).Conclusion Though the Laparoscopic operation takes longer time than the abdominal operation, it has much more advantage: mimimal blood loss, minimal abdominal scar, rapid postoperation rehabilition, much better pain alleviate, less urine retention.