Construction and evaluation of a cloud follow-up platform for gynecological patients receiving chemotherapy.

BACKGROUND: Patient follow-up is an essential component of hospital management. In the current information era, the patient follow-up scheme is expected to be replaced by Internet technology. This study constructed a cloud follow-up platform for gynecological chemotherapy patients and assessed its cost-effectiveness and patients' feedback. METHODS: A total of 2,538 patients were followed up using a cloud follow-up system between January and October 2021. Prior to this, 690 patients were followed manually via telephone calls. Patients' characteristics, follow-up rate, satisfaction, and session duration were compared between the cloud follow-up and manual follow-up groups. In addition, the read rate of health education materials in the cloud follow-up group was analyzed. RESULTS: General information, including age, education attainment, cancer stage, and disease category, and follow-up rate (cloud: 6,957/7,614, 91.4%; manual: 1,869/2,070, 90.3%; P = 0.13) did not significantly differ between the two groups. The follow-up satisfaction of the cloud follow-up patients was significantly better than that of the manual follow-up group (cloud: 7,192/7,614, 94.5%; manual: 1,532/2,070, 74.0%; P<0.001). The time spent on the follow-up was approximately 1.2 h for 100 patients in the cloud follow-up group and 10.5 h in the manual follow-up group. Multivariate analysis indicated that the cloud follow-up group had significantly greater follow-up satisfaction (odds ratio: 2.239, 95% CI: 1.237 ~ 5.219). Additionally, the average follow-up duration of the cloud follow-up group decreased by 9.287 h (coefficient: -9.287, 95% CI: -1.439~-0.165). The read rate of health education materials was 72.9% in the cloud follow-up group. CONCLUSIONS: The follow-up effect of the cloud follow-up group was not inferior to that of the manual follow-up group. The cloud follow-up was more effective for prevention and control requirements in the post-epidemic era. Cloud follow-up can save medical resources, improve cost-effectiveness, provide sufficient health education resources for patients, and improve their satisfaction.

Chemotherapy effect on myocardial fibrosis markers in patients with gynecologic cancer and low cardiovascular risk.

Background: Patients with gynecologic cancers experience side effects of chemotherapy cardiotoxicity. We aimed to quantify cardiac magnetic resonance (CMR) markers of myocardial fibrosis in patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy. Methods: This study is part of a registered clinical research. CMR T1 mapping was performed in patients with gynecologic cancer and low cardiovascular risk undergoing chemotherapy. The results were compared with those of age-matched healthy control subjects. Results: 68 patients (median age = 50 years) and 30 control subjects were included. The median number of chemotherapy cycles of patients was 9.0 (interquartile range [IQR] 3.3-17.0). Extracellular volume fraction (ECV) (27.2% ± 2.7% vs. 24.5% ± 1.7%, P < 0.001) and global longitudinal strain (-16.2% ± 2.8% vs. -17.4% ± 2.0%, P = 0.040) were higher in patients compared with controls. Patients with higher chemotherapy cycles (>6 cycles) (n=41) had significantly lower intracellular mass indexed (ICMi) compared with both patients with lower chemotherapy cycles (≤6 cycles) (n=27) (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 34.30 g/m2 [IQR 29.93-39.79 g/m2]; P = 0.002) and the control group (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 32.79 g/m2 [IQR 27.74-35.76 g/m2]; P = 0.002). Patients with two or more chemotherapy regimens had significantly lower ICMi compared with both patients with one chemotherapy regimen (27.45 ± 5.16 g/m2 vs. 33.32 ± 6.42 g/m2; P < 0.001) and the control group (27.45 ± 5.16 g/m2 vs. 33.02 ± 5.52 g/m2; P < 0.001). The number of chemotherapy cycles was associated with an increase in the ECV (Standard regression coefficient [ß] = 0.383, P = 0.014) and a decrease in the ICMi (ß = -0.349, P = 0.009). Conclusion: Patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy have diffuse extracellular volume expansion, which is obvious with the increase of chemotherapy cycles. Myocyte loss may be part of the mechanism in patients with a higher chemotherapy load. Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR-DDD-17013450.

Myocardial edema during chemotherapy for gynecologic malignancies: A cardiac magnetic resonance T2 mapping study.

Objective: Myocardial edema is an early manifestation of chemotherapy-related myocardial injury. In this study, we used cardiac magnetic resonance (CMR) T2 mapping to assess myocardial edema and its changes during chemotherapy for gynecologic malignancies. Methods: We enrolled 73 patients receiving chemotherapy for gynecologic malignancies, whose the latest cycle was within one month before the beginning of this study, and 41 healthy volunteers. All participants underwent CMR imaging. Of the 73 patients, 35 completed CMR follow-up after a median interval of 6 (3.3 to 9.6) months. The CMR sequences included cardiac cine, T2 mapping, and late gadolinium enhancement. Results: Myocardial T2 was elevated in patients who were treated with chemotherapy compared with healthy volunteers [41ms (40ms to 43ms) vs. 41ms (39ms to 41ms), P = 0.030]. During follow-up, myocardial T2 rose further [40ms (39ms to 42ms) vs. 42.70 ± 2.92ms, P < 0.001]. Multivariate analysis showed that the number of chemotherapy cycles was associated with myocardial T2 elevation (ß = 0.204, P = 0.029). After adjustment for other confounders, myocardial T2 elevation was independently associated with a decrease in left ventricular mass (ß = -0.186; P = 0.024). Conclusion: In patients with gynecologic malignancies, myocardial edema developed with chemotherapy cycles increase, and was associated with left ventricular mass decrease. T2 mapping allows the assessment of myocardial edema and monitoring of its change during chemotherapy.

Myocardial microvascular function assessed by CMR first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies.

OBJECTIVES: Cancer chemotherapy potentially increases the risk of myocardial ischemia. This study assessed myocardial microvascular function by cardiac magnetic resonance (CMR) first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies. METHODS: A total of 81 patients treated with chemotherapy for gynecologic malignancies and 39 healthy volunteers were prospectively enrolled and underwent CMR imaging. Among the patients, 32 completed CMR follow-up, with a median interval of 6 months. The CMR sequences comprised cardiac cine, rest first-pass perfusion, and late gadolinium enhancement. RESULTS: There were no significant differences in the baseline characteristics between the patients and normal controls (all p > 0.05). Compared with the normal controls, the patients had a lower myocardial perfusion index (PI) (13.62 ± 2.01% vs. 12% (11 to 14%), p = 0.001) but demonstrated no significant variation with an increase in the number of chemotherapy cycles at follow-up (11.79 ± 2.36% vs. 11.19 ± 2.19%, p = 0.234). In multivariate analysis with adjustments for clinical confounders, a decrease in the PI was independently associated with chemotherapy treatment (ß = - 0.362, p = 0.002) but had no correlation with the number of chemotherapy cycles (r = - 0.177, p = 0.053). CONCLUSION: Myocardial microvascular dysfunction was associated with chemotherapy treatment in patients with gynecologic malignancies, and can be assessed and monitored by rest CMR first-pass perfusion. KEY POINTS: • Chemotherapy was associated with but did not aggravate myocardial microvascular dysfunction in patients with gynecologic malignancies. • Rest CMR first-pass perfusion is an ideal modality for assessing and monitoring alterations in myocardial microcirculation during chemotherapy treatment.

Choriocarcinoma misdiagnosed as cerebral hemangioma: A case report.

BACKGROUND: Choriocarcinoma is a subtype of gestational trophoblastic disease, gestational trophoblastic neoplasia. Patients with brain metastasis are rare and information on the optimal treatment and patient outcome is limited. In order to improve the prognosis of this disease, accurate and timely treatments are very important for the patient of brain metastasis by choriocarcinoma. CASE SUMMARY: A 17-year-old unmarried girl was misdiagnosed with a cerebral hemangioma with intracranial hemorrhage in a local hospital after presentation with severe head pain. She underwent craniotomy three times for treatment. The pathological results of posterior intracranial hematoma showed choriocarcinoma, and the patient was diagnosed as choriocarcinoma (21 points in stage IV). After uterine artery embolization, etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy for 7 cycles, and whole brain radiotherapy, the patient achieved remission. She has been followed for 2 years with no signs of tumor recurrence. CONCLUSION: For female patients of childbearing age with an intracranial hematoma, the possibility of brain metastasis by choriocarcinoma should be considered. It is necessary to obtain a detailed history, including menstruation, beginning age of first sex, contraception, etc. The level of ß-human chorionic gonadotropin should be tested at the beginning, and a stratified treatment should be administered according to the International Federation of Gynecology and Obstetrics staging and World Health Organization prognostic scoring systems.

Safety and Efficacy of Neoadjuvant Chemotherapy Followed by Radical Surgery Versus Radical Surgery Alone in Locally Advanced Cervical Cancer Patients.

OBJECTIVES: This study aimed to evaluate the safety and efficacy of neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) among patients with locally advanced cervical cancer (LACC). METHODS: Eight hundred patients with LACC received either NACT followed by RS (NACT-RS) or RS alone. The primary outcome measures assessed the efficacy and adverse effects of NACT. Secondary outcome measures compared the preoperative clinical stage to the postoperative pathologic stage in NACT-RS and RS patients, assessed intraoperative and postoperative complications, including the adverse effects of postoperative radiotherapy and radiochemotherapy, and estimated the 5-year progression-free survival and 5-year overall survival. RESULTS: The clinical response to NACT was 89.54%. Patients in the NACT-RS group had lower preoperative hemoglobin levels (115.20 vs 122.04 g/L, P < 0.001), a longer operative time (mean, 233.66 vs 224.37 minutes, P = 0.008), more intraoperative bleeding (750.34 vs 684.41 mL, P = 0.011), a shorter duration of catheter use (mean, 29.84 vs 32.14 days, P = 0.036), and a lower incidence of postoperative complications (7.30% vs 13.62%, P = 0.002) and postoperative radiotherapeutic and radiochemotherapeutic adverse effects (3.16% vs 4.63%, P < 0.001) compared to patients in the RS group. The 5-year progression-free survival and 5-year overall survival were 80.30% and 81.10% in the NACT-RS group and 81.00% and 78.50% in the RS group (P > 0.05). Pathological poor differentiation, nonsquamous cell carcinoma, parametrial invasion, positive pelvic lymph node, and lymphovascular invasion (P < 0.05) were independent risk factors for recurrence. CONCLUSIONS: Neoadjuvant chemotherapy may reduce RS-associated complications and postoperative radiotherapeutic and radiochemotherapeutic adverse effects in Chinese patients with LACC.

[Effects of hyperthermia combined platinum-based drugs on ovarian cancer cell lines SKOV3].

OBJECTIVE: To investigate the effects and mechanisms of hyperthermia combined with various platinum-based drugs cis-platinum (DDP), carboplatin (CBP), oxaliplatin (OXA) on the proliferation and apoptosis of ovarian cancer cell lines SKOV3. METHODS: SKOV3 cells were treated with different concentrations of anticancer drugs DDP (final concentration respectively 0, 1.25, 2.5, 5.0, 10.0, 20.0 microg/mL), CBP and OXA (both final concentration respectively 0, 2.5, 5.0, 10.0, 20.0, 40 microg/mL) at a temperature of 42 degrees C for hyperthermia or 37 degrees C for normal temperature. Methyl thiazolyl tetrazolium (MTT) method was used to test growth ratios of ovarian cancer cell lines SKOV3. Real-time PCR was adopted to detect the expression level of excision repair cross-complementing group 1 (ERCC1) and Survivin mRNA in SKOV3 cells. RESULTS: DDP, CBP and OXA inhibited the growth of SKOV3 in a dose-dependent manner (P < 0.05). Hyperthermia could increase the sensitivity of SKOV3 to cis-platinum, carboplatin and oxaliplatin (P < 0.05). The half inhibitory concentration (IC50) values of DDP, CBP and OXA were (7.271 +/- 0.096) microg/mL, (37.609 +/- 0.779) microg/mL and (28.328 +/- 0.698) microg/mL respectively. When combined with hyperthermia, the IC50 values of DDP, CBP, and OXA were (2.075 +/- 0.244) microg/mL, (19.591 +/- 0.453) microg/mL, (19.089 +/- 0.424) microg/mL (P < 0.05). The increased sensitivity index was 2.075 +/- 0.244 for cis-platinum, 1.92 +/- 0.044 for carboplatin, 1.484 +/- 0.039 for oxaliplatin. After the treatment of hyperthermia, the expression of ERCC1 and Survivin mRNA showed downward trend. ERCC1 decreased more significantly in the group of hyperthermia combined with carboplatin, and Survivin decreased more significantly in the group of hyperthermia combined with oxaliplatin (P < 0.05). CONCLUSION: Hyperthermia can enhance the sensitivity of ovarian cancer SKOV3 cells to platinum-based drugs, which may be related to the down regulation of ERCC1 and Survivin expression.

[Expression of CLIC1 and IGFBP7 in complete hydatidiform mole].

OBJECTIVE: To investigate the expression level of chloride intracellular channel 1 (CLIC1) and insulin-like growth factor binding protein 7 (IGFBP7) in complete hydatidiform mole (CHM) and estimate the relationship between the expression level and clinical prognosis. METHODS: Immunohistochemistry (IHC) method was used to detect the expression level of P57(KIP2) in order to differentiate CHM. CLIC1 and IGFBP7 expression level of CHM were measured by IHC method then. RESULTS: (1) According to the P57(KIP2) expression result 66 patients were diagnosed as CHM (85.71%). Fourteen of 66 patients progressed into gestational trophoblastic neoplasia (GTN), which accounted for 21.21%. (2) The results of IHC showed that CLIC1 significantly higher expressed in malignant group than spontaneous regressive group (P = 0.014). IGFBP7 significantly down-regulated in malignant group (P = 0.002). (3) Pearson correlation analysis results revealed that there were no relation between the expression of CLIC1 and IGFBP7 (P = 0.761). Logistic regression analysis indicated that down-regulation of IGFBP7 was the independent risk factors of CHM progression, P = 0.005, OR = 8.493 (95% confidence interval (CI): 1.878-38.401); Serum hCG > 5 x 10(5) mIU/mL was the independent risk factors of CHM progression too, P = 0.011, OR = 11.251 (95% CI: 1.731-73.151). (4) Receiver operator characteristic curve (ROC curve) results showed that the area under the curve (AUC) of CLIC1 was 0.707. The optimum cut off was 10.5, and correspondingly sensitivity was 42.90%, specificity 94.20%. AUC of IGFBP7 was 0.764. The optimum cut off was 7.0, and the correspondingly sensitivity and specificity were 64.30% and 78.80% respectively. Combining the two markers in series, the sensitivity of predicting the prognosis of CHM was 21.42%, while the specificity was 100%. When combining in parallel, the sensitivity and specificity were 85.71% and 71.15% respectively. CONCLUSION: Up-regulation of CLIC1 and down-regulation of IGFBP7 might pay an important role in progression of CHM, but there was no relationship between the expression levels of them. The predictive values of malignance transformation of CHM with the two biomarkers were with certain accuracy, and combining them in parallel test could improve accuracy. They are promising to be candidate prognostic markers of CHM.

[The protein expression of ERCC1 and survivin in epithelial ovarian carcinoma and their clinical significance].

OBJECTIVE: To investigate the protein expression of ERCC1 (excision repair cross complementation group 1) and survivin gene in platinum-resistant and platinum-sensitive epithelial ovarian carcinoma (EOC), and to explore the relationship among ERCC1 expression, survivin expression, the major clinicopathological characteristics as well as platinum sensitivity. METHODS: Expression of ERCC1 and survivin were detected in 64 EOC tissues by immunohistochemical method. RESULTS: No significant differences were found in patients' age, FIGO stage, pathological type, histological grade, pelvic lymph node and/or vessel infiltration, in all of three pairs of comparison. They were platinum-sensitive group vs. platinum-resistant group, ERCC1-positive group vs. ERCC1-negative group and surviving-positive group vs. survivn-negative group (all P > 0.05). The positive rate of ERCC1 expression (67.85%, 19/28) in platinum-resistant patients' tissues was significantly higher than that in platinum-sensitive patients' tissues (25.00%, 9/36) (P = 0.001). While the positive rate of survivin in platinum-resistant patients' tissues (78.57%, 22/28) was slightly higher than that of in platinum-sensitive patients' tissues (75.00%, 29/36), however without significant (P = 0.74). No evidence was found that the expression of ERCC1 correlate with the expression of survivin (r(s) = 0.12, P = 0.36) too. The proportion of platinum-resistant in patients with coexpression of ERCC1 and surviving (65.22%, 15/23) was insignificantly lower than that of in patients with single expression of ERCC1 (80.00%, 4/5) (P = 0.91). CONCLUSION: Expression of ERCC1 in EOC patients' tumor tissue could be a predictive indicator for their platinum susceptibility and it might be helpful for prevention and reverse of platinum resistance in clinical practice. The expression of survivin seems of no definite value in prediction of platinum susceptibility.

[Clinical and pathological analysis on ovarian granulosa cell tumors].

OBJECTIVE: To identify different clinical and pathological features for adult and juvenile granulosa cell tumors. METHODS: The clinical records of 42 patients with granulosa cell tumors of ovary, including pathological features, treatments and follow up results between April 2001 and September 2009 were reviewed. RESULTS: 1) There were 38 newly diagnosed cases after 2001, and 4 cases were relapsed cases diagnosed before 2001. The 38 cases accounted for 3.13% of ovarian cancer cases treated in our hospital. 2) Twenty nine of the 38 cases (76.3%) were Adult Type, while the other 9 (23.7%) were Juvenile Type. The median onset age were 53 and 25 years old for the Adult Type and Juvenile Type, respectively, which shows significant difference (z = -2.990, P = 0.003). 3) The most common symptoms and signs were abdominal pain (44.7%), vaginal bleeding (42.1%), and abdominal mass (76.3%). The most common complications were endometrial hyperplasia (52.6%) and hysteromyoma (21.1%). 4) Stage I, II and III comprised 73.7%, 23.7% and 2.6% of the 38 cases, respectively. Ten patients ng the underwent conservative unilateral oophorectomy or ovarian enucleation. Twenty patients underwent total abdominal hysterectomy plus bilateral salpingo-oophorectomy. Eight patients underwent cytoreductive surgery. The 42 patients had been followed up for 7 to 175 months, with 14 patients lost of contact. No death was recorded. Inhibin, calretinin, and vimentin were demonstrated to be useful for the diagnosis of granulose cell tumors. CONCLUSION: With low incidence rate, ovarian granulosa cell tumor is a low-grade malignant and functional tumor. Most are unilateral diseases. Most Adult-type granulosa cell tumors occur in middle aged and elderly people, while most juvenile granulosa cell tumors occur in adolescents and children. Acute abdomen symptom may occur but ascites are less likely to occur in patients with granular cell tumors than those with epithelial ovarian cancers. Ovarian granulosa cell tumors are usually detected early, but easily relapse. Long-term follow-up is needed.

[The expression of RhoC and Ki67 in cervical intraepithelial neoplasia and squamous carcinoma of cervix].

OBJECTIVE: To detect the expression of RhoC and Ki67 in squamous carcinoma of cervix and to reveal the correlation of RhoC and Ki67 with clinic pathological parameters of cervix carcinoma. METHODS: The expressions of RhoC and Ki67 were evaluated in 26 cases of cervical intraepithelial neoplasia (CIN) and 57 cases of squamous carcinoma of cervix(SCC) by immunohistochemistry, while 14 cases of normal cervical epithelium(NCE) were taken as control. RESULTS: Immunohistochemical staining demonstrated RhoC expression in 82.46% (47/57) of SCC, 15.38% (2/13) of CIN II/III, and negative expression in NCE and CIN I. The positive rate of RhoC expression in SCC was significantly higher than that in NCE and CIN (P < 0.05). The expression of RhoC in SCC was significantly correlated with pelvic lymph node metastasis and depth of stroma infiltration, but not correlated with age, FIGO staging,histologic grade and vascular space involvement. The positive rates of Ki67 expression in NCE, CIN I, CIN II/III and SCC were 28.57%, 38.46%, 100% and 96.49% respectively. The positive rates of Ki67 expression in SCC and CIN II/III were significantly higher than those in NCE and CIN I (P < 0.05). The expression of Ki67 in SCC was not correlated with the major clinic pathological parameters. There was no obvious relationship between the expression of RhoC gene and Ki67 antigen in SCC (P > 0. 05). CONCLUSIONS: The overexpression of RhoC may play an important role in the invasion and metastasis of SCC. RhoC may be a potential marker to identify SCC patients with high risk of invasion and metastasis.

[Experimental study on inhibition of cervical carcinoma siha cell proliferation by siRNA expression vector].

OBJECTIVE: To observe the effect of HPV16E7 specific expression vector on cell proliferation in cervical carcinoma SiHa cells. METHODS: The HPV16E7 siRNA expression vector and empty expression vector were transfected into SiHa cells by liposome. The effects on E7 mRNA and E7 protein expression, cell cycle phase and cell growth rate were examined respectively by real-time RT-PCR, FCM and MTT assay. RESULTS: The HPV16E7 siRNA expression vector significantly inhibited the expression levels of E7 mRNA and E7 protein, the inhibition rates being 92.15% and 84.30% respectively. It also inhibited the transition from G, phase to S phase and the growth of SiHa cell line. CONCLUSION: HPV16E7 specific siRNA expression vector could specifically and efficiently inhibit the expression of E7 gene and hence it could regulate cell cycle and inhibit cell proliferation in cervical carcinoma SiHa cells. siRNA expression vector

[Survivin expression in ovarian germ cell tumors].

OBJECTIVE: To investigate the relationship between the expression of survivin and the development of ovarian germ cell tumors (OGCT). METHODS: Survivin expressions in normal ovaries (n = 10) and ovarian germ cell tumors (n = 29) were detected with labelled streptavidin biotin method. RESULTS: No survivin protein was expressed in normal ovaries. Survivin protein was found in the cytoplasm and/or the nuclear of cells of 58.6% (17/29) of the ovarian germ cell tumor samples (P < 0.05). There was no significant correlations between surviving protein and the pathologic types, stage, lymphonode metastasis, AFP and volume of ascites of the tumors (P > 0.05). CONCLUSION: High expression of survivin protein may trigger the pathogenesis of the ovarian germ cell tumors.

[TRAIL impacts in growth and apoptosis of human ovarian carcinoma cell line SKOV3].

OBJECTIVE: To investigate the effect of TRAIL on growth and apoptosis of ovarian carcinoma cell line SKOV3. METHODS: The effects of TRAIL alone and/or associating with DDP to treat on SKOV3 cells growth inhibition were measured by MTT assay, and the changes of DR4 and DR5 mRNA were detected by RT-PCR technique. The cell cycle and apoptosis index were analyzed by technique of Flow Cytometry (FCM). RESULTS: The soluble TRAIL protein had the inhibiting effect on the growth SKOV3 cells. The DDP increased the ability of TRAIL to SKOV3 cell growth inhibition. The apoptotic indexes (AI) of SKOV3 cells detected by FCM were 5.9%, 13.4% and 39.5% for control group, TRAIL group and TRAIL plus DDP group, respectively. The DDP increased the DR5 expressing in SKOV3 cells by 1.95 folds than control group and by 1.54 times for the DR4 expressing than the control group (P < 0.05). CONCLUSIONS: The soluble TRAIL has the effect on inhibiting the growth of SKOV3 cells. The combination use of TRAIL and DDP increases significantly the growth-inhibiting ratio to SKOV3 cells. The AI of SKOV3 cell is raised after TRAIL intervening in. The DDP can increase the expressions of DR4 and DR5 in SKOV3 cells.

[Comparative study of that synergistic effect of cisplatin combined with compound herbal medicinal prescription for tonic quality and activating blood circulation is on SKOV3 cell proliferation and apoptosis].

OBJECTIVE: To investigate the synergistic effects on cell apoptosis and growing restriction of SKOV3 cells by the combination of compound herbal medicinal prescription (CHMP) with cisplatin (DDP). METHODS: Cisplatin and two CHMP for tonic quality(CHMP1) and activating blood circulation (CHMP2), which was medicated serum, were prepared and used to treat the human ovarian carcinoma cell line SKOV3. By serum pharmacologic method, the growth and apoptosis of SKOV3 cell were observed at different time points(24,48,72, 96 h) with different concentrations of medicated serum. Coefficient of drug interaction (CDI) between CHMP, and CHMP2 was studied by MTT method. The effects of control group(A group),CHMP1 group(B group),CHMP2 group (C group), DDP group(D group), CHMP1 + DDP group(E group), CHMP2 + DDP group(Fgroup)to SKOV3 cell were studied by flow cytometry; and the cell apoptosis was observed by agarose electrophoresis; the expressions of TNFR1, caspase-8 on each group were analyzed by Western blot method. RESULTS: Synergistic effects were found between herbal medicinal mixtures and DDP, Restraining rate of SKOV3 and CHMP serum concentration was not in a dose-dependent manner as DDP was. CDI between CHMPI and CHMPS was found to be significant difference (CDI of CHMP1, CHMP2 and DDPwas 0.66, 0.58 respectively). It showed that the combined treatment was able to get better effect than single drug treatment. The performed agarose electrophoresis revealed the extracted DNA to show a typical ladder patterns for cell apoptosis. The analysis results of western blot showed the increased expressions of TNFR1 and caspase-8 after combined using of medicine, which were accord to the rates of apoptosis. CONCLUSIONS: CHMP drug granules show the synergistic effects with DDP, and the suppressing functions in the course of cell proliferation, and the inducing effect on apoptosis of human ovarian carcinoma cell line SKOV3 in vitro. And this mechanism is showed to be sponsored by the activation of TNFR1 and Caspase-8.

[Survivin expression in ovarian carcinoma].

OBJECTIVE: To explore the possible relationship between expression of survivin and molecular mechanisms in patients with ovarian carcinoma (OC). METHODS: Survivin expressions in normal ovaries (n= 10), ovarian bordline tumors (n = 21), and ovarian serous cystadenomas (n = 38) were investigated by means of immunohistochemistry. RESULTS: No survivin protein was expressed in normal ovaries. Survivin protein was found in cytoplasm and/or in nucleus of tumor cell. Survivin expression was revealed in 42.9% (9/21) of ovarian bordline tumors; no significant correlation was observed between survivin expression and pathologic types or CA125 values (P > 0.05). Survivin protein was found in 76.3% (29/38) of ovarian serous cystadenomas, displaying a significantly higher expression than that in bordline tumors (P < 0.05). Survivin expression was positively correlated with tumor stage, histological grade and lymphonode metastasis (P < 0.05), whereas it was not significantly correlated with CA125 values, volume of ascites, and presence/absence of tumor cells in ascites (P > 0.05). CONCLUSION: High expression of Survivin protein may be related with the differentiation and metastasis of epithelial ovarian carcinoma.