Neoadjuvant chemotherapy for locally advanced cervical cancer reduces surgical risks and lymph-vascular space involvement.

Neoadjuvant chemotherapy (NACT), which can reduce the size and therefore increase the resectability of tumors, has recently evolved as a treatment for locally advanced cervical cancer. NACT has been reported to decrease the risk of pathologic factors related to prognosis of cervical cancer. To further assess the effects of NACT on surgery and the pathologic characteristics of cervical cancer, we reviewed 110 cases of locally advanced cervical cancer treated with radical hysterectomy with or without NACT at the People's Hospital of Peking University between January 2006 and December 2010. Of 110 patients, 68 underwent platinum-based NACT prior to surgery (NACT group) and 42 underwent primary surgery treatment (PST group). Our results showed 48 of 68 (70.6%) patients achieved a complete response or partial response to NACT. Estimated blood loss, operation time, and number of removed lymph nodes during surgery, as well as complication rates during and after surgery were not significantly different between the NACT group and the PST group. The rates of deep stromal invasion, positive parametria, positive surgical vaginal margins, and lymph node metastasis were not significantly different between the two groups. However, the rate of lymph-vascular space involvement (LVSI) was significantly lower in the NACT group than in the PST group (P = 0.021). In addition, the response rate of NACT was significantly higher in the patients with chemotherapeutic drugs administrated via artery than via vein. Our results suggest that NACT is a safe and effective treatment for locally advanced cervical cancer and significantly decreases the rate of LVSI.

Analgesia effect of premixed nitrous oxide/oxygen during the rehabilitation after total knee arthroplasty: a study protocol for a randomized controlled trial.

BACKGROUND: The morbidity of knee arthritis is increasing among aged people and total knee arthroplasty has been its mainstream treatment to date. Postoperative rehabilitation is an important part of the procedure. However, the intense pain during the functional exercise involved has always been a challenge for both patients and health care professionals. The aim of this study is to test the analgesic effect of a mixture of nitrous oxide/oxygeb (1:1) inhalation for patients who are doing functional exercise 1 month after total knee arthroplasty. METHODS/DESIGN: This double-blind, randomized, placebo-controlled study will be implemented in the Rehabilitation Department in the General Hospital of Ningxia Medical University. Patients aged between 50 and 75 years who underwent a primary unilateral total knee arthroplasty are eligible for inclusion. The key exclusion criteria include: epilepsy, pulmonary embolism, intestinal obstruction, aerothorax. The treatment group (A) will receive a pre-prepared nitrous oxide/oxygen mixture plus conventional treatment (no analgesics), and the control group (B) will receive oxygen plus conventional treatment (no analgesics). Patients, physicians, therapists, and data collectors are all blind to the experiment. Assessments will be taken immediately after functional exercise begins (T0), 5 min (T1) after functional exercise begins, and 5 min after functional exercise has finished (T2). Patients will be randomly allocated between a treatment group (A) and a control group (B) in a ratio of 1:1. Primary outcome, including pain severity in the procedure, will be taken for each group. Secondary outcomes include blood pressure, heart rate, oxygen saturation, side effects, knee joint range of motion, Knee Society Score (KSS), rescue analgesia need, and satisfaction from both therapists and patients. DISCUSSION: This study will focus on exploring a fast and efficient analgesic for patients who are doing functional exercise after total knee arthroplasty. Our previous studies suggested that the prefixed nitrous oxide/oxygen mixture was an efficacious analgesic for the management of burn-dressing pain and breakthrough cancer pain. The results of this study should provide a more in-depth insight into the effects of this analgesic method. If this treatment proves successful, it could be implemented widely for patients doing functional exercise in the rehabilitation department. TRIAL REGISTRATION: ChiCTR-INR-17012891 . Registered on 6 October 2017.

[Clinical analysis of eight cases of bone metastasis of uterine carcinomas].

OBJECTIVE: To investigate the clinical feature, risk factors and prognosis of bone metastasis from uterine carcinomas. METHODS: Eight cases of bone metastasis of uterine carcinomas in our hospital from Mar 2001 to June 2005 were studied retrospectively. These eight women, aged 35 to 74, suffered from cervical cancer (5/8) and endometrial carcinoma (3/8) respectively. RESULTS: (1) The interval between diagnosis of primary carcinoma and detection of bone metastases was within 2 years. The average interval was 5.3 months in patients with poorly differentiated tumor, and 21 months in the other patients. (2) Specific pathology type and poorly differentiated carcinomas may be risk factors of bone metastasis. (3) Three patients did not receive therapy of bone metastasis, and died within 6 months. In the other five patients, four are still alive. CONCLUSIONS: The interval between diagnosis of uterine carcinoma and detection of bone metastases is within two years. The most common sites are pelvic bone and vertebrae. Specific pathology type and poorly differentiated carcinomas may be risk factors of bone metastasis. The prognosis of bone metastasis of uterine carcinomas is poor. Treatment of bone metastasis is primarily palliative and may prolong survival.

[Roles of matrix metalloproteinases and tissue specific inhibitors of metalloproteinases in dentinogenic ghost cell tumor and ghost cell odontogenic carcinoma].

OBJECTIVE: To investigate the roles of matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP) in dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC). METHODS: The expressions of MMP-2, MMP-9, MMP-14, TIMP-1 and TIMP-2 were examined in 15 DGCT cases and 9 GCOC cases by immunohistochemistry. Their mRNA expression in one DGCT case and one GCOC case were investigated by RT-PCT.MMP-2 and MMP-9 protein activities in the two cases were analyzed by gelatin zymography. RESULTS: MMP-9 and TIMP-1 expressions elevated greatly in GCOC, and there was a significant difference (P < 0.05) in TIMP-1 expression between GCOC and DGCT.Pro-MMP-9, MMP-9 activated form, pro-MMP-2, and MMP-2 activated forms were detected in the GCOC case, while pro-MMP-9 and MMP-9 activated form were very faint in the DGCT case. The mRNA level of MMP-9 elevated obviously in the GCOC case, which was similar to that of TIMP-1. CONCLUSIONS: The elevated expression of MMP-9 and TIMP-1 may influence the behaviour of GCOC.

[The role of matrix metalloproteinases and their tissue inhibitors in oral lichen planus].

OBJECTIVE: To investigate the role of MMP-2, MT1-MMP and TIMP-2 in the carcinogenesis of oral lichen planus (OLP). METHODS: Immunohistochemistry was performed to examine the expression of OLP and compare with that of NOM. RESULTS: The expression of these proteinases significantly increased from NOM, non-atrophic OLP, to atrophic OLP and OSCC. The expression of MMP-2 and MT1-MMP in atrophic OLP was significantly higher than in non-atrophic OLP. Furthermore, the expression of TIMP-2 consequently increased with the increasing of the MMP, but the increase of TIMP-2 was less than that of MMP. CONCLUSIONS: MMP may be useful marker to judge the possibility of malignant change of OLP.