Rational of topical photodynamic therapy (PDT) with 5-aminolevulinic acid (5-ALA) for treatment of endocervical canal low-grade squamous intraepithelial lesion with high-risk human papillomavirus infection.

BACKGROUND: The detection and continuous monitoring of low-grade squamous intraepithelial lesions (LSIL) within the endocervical canal pose considerable challenges, and the effectiveness of ablation treatment is also constrained. In this context, the potential efficacy of 5-aminolevulinic acid photodynamic therapy (5-ALA PDT) in targeting these concealed lesions merits exploration. The present study undertakes a comprehensive analysis of the clinical effectiveness and safety aspects associated with the utilization of 5-ALA PDT. METHODS: A retrospective analysis was conducted on a cohort of 13 patients who were diagnosed with LSIL within the endocervical canal, concomitant with high-risk human papillomavirus (hrHPV) infection. These patients were subjected to treatment with 5-ALA PDT and subsequently monitored over a period of 3-6 months following the intervention. RESULTS: The study cohort comprised 13 patients, among whom 4 presented with isolated lesions within the endocervical canal, 5 exhibited LSIL involving both the endocervical canal and the cervix vaginal portion, 3 displayed LSIL within the endocervical canal in conjunction with vaginal involvement, and 1 patient demonstrated lesions across all three of these anatomical sites. All identified lesions underwent therapeutic intervention via 5-ALA PDT. Before treatment initiation, 9 patients returned positive results in the liquid-based cytologic test (LBC), 4 displayed concurrent multiple hrHPV infections, and 5 manifested infections specifically with HPV 16/18. Subsequent to the application of 5-ALA PDT, regression was observed in the LBC results of all patients, with only 3 individuals retaining a singular type of hrHPV infection. Adverse reactions following treatment encompassed mild aberrant vaginal secretions and mild to moderately pronounced distending abdominal discomfort, all of which were remitted within a span of 7 days. CONCLUSIONS: Within the context of LSIL within the endocervical canal in association with hrHPV infection, the findings affirm the efficacy and safety of 5-ALA PDT as a viable therapeutic modality.

Obstetric outcomes in pregnancy with pulmonary hypertension: A retrospective study of 78 cases at one center.

OBJECTIVE: To identify the vary of obstetric outcomes by the severity of pulmonary hypertension (PH). METHODS: A retrospective study involved pregnancies with PH in one certain academic institution. Total 78 pregnancies with PH were classified into three groups according the mean pulmonary arterial systolic pressure: mean pulmonary arterial systolic pressure 30-49 mm Hg (mild-PH group), mean pulmonary arterial systolic pressure 50-69 mm Hg (moderate-PH group) and mean pulmonary arterial systolic pressure ≥ 70 mm Hg (severe-PH group). The clinical features and obstetric outcomes were described and compared among three groups. RESULTS: The incidence of PH was 0.23%, including 57 cases in mild-PH group, 10 cases in moderate-PH group and 11 cases in severe-PH group. Meanwhile, pregnancies with mild PH present NYHA class I/II (P < 0.001). General anesthesia (P < 0.001) and advanced intensive care (P = 0.011) were supplied for pregnancies with severe PH. There was no significant difference in rate of caesarean delivery. Furthermore, severity of PH increased the risk of neonatal death (P = 0.040). CONCLUSION: The severity of PH seems to be a poor prognosis of neonatal death. Intensive care should be provided for pregnancies with severe PH.

Nuclear G protein-coupled oestrogen receptor (GPR30) predicts poor survival in patients with ovarian cancer.

Objective To demonstrate the correlation between nuclear and cytoplasmic G protein-coupled oestrogen receptor (GPR30) expression and clinicopathological features and outcome in patients with ovarian cancer. Methods Nuclear and cytoplasmic GPR30 expressions were determined using immunohistochemistry to identify the intracellular location in tissues from patients with ovarian cancer. Data were correlated with clinicopathological characteristics and outcomes. Results Tissue samples were obtained from 110 patients with epithelial ovarian cancer between 2005 and 2010. Nuclear GPR30 was significantly more frequent in the group of patients with recurrence. The presence of nuclear GPR30 predicted lower overall survival) and 5-year progression-free survival in all patients with ovarian cancer and overall survival in patients with high grade ovarian cancer. Cytoplasmic GPR30 was observed significantly more often in advanced ovarian cancer and did not predict survival. Conclusion This study showed that nuclear GPR30 is an independent negative prognostic indicator in patients with ovarian cancer, especially in those with a high grade malignancy.

Early pregnancy following multidrug regimen chemotherapy in a gestational trophoblastic neoplasia patient: A case report.

RATIONALE: Gestational trophoblastic neoplasia is a group of rare tumors that can be cured using chemotherapy. The use of artificial contraception for at least 1 year is recommended not only due to the high recurrence rate in the first year after treatment, but also because of the unclear genetic toxic effects of multidrug regimen chemotherapy on reproductive cells. There is no consensus about the contraception duration, but most patients want to have children. PATIENT CONCERNS: This case involved a 33-year-old female suffering from gestational trophoblastic neoplasia and 5-fluorouracil + actinomycin-D chemotherapy. She became pregnant 1 month after finishing the chemotherapy. DIAGNOSIS: Gestational trophoblastic neoplasia. INTERVENTIONS: No treatment during pregnancy. OUTCOMES: The patient had a full-term normal delivery, and the baby showed normal development and growth after a follow-up of 48 months. LESSONS: Pregnancy soon after chemotherapy can be viable with rigorous prenatal care.

[Anti-mycobacteria drugs therapy for periductal mastitis with fistula].

OBJECTIVES: To study the etiology, clinical and pathologic characteristics of periductal mastitis with fistula and estimate the effect of anti-mycobacterial agents for periductal mastitis with fistula. METHODS: Totally 27 patients of periductal mastitis with fistula received anti-mycobacteria drugs therapy from December 2008 to September 2011 were analyzed retrospectively. All of the patients were female. The mean age at onset was 28 years (range 15 to 40 years old). The main clinical manifestation of the 27 patients was breast fistula, including 21 patients with single fistula and 6 patients with multiple fistula. Three patients manifested with pure fistula, 14 patients with both fistula and lump, 10 patients with fistula, lump and abscess. The samples including pus or tissues of all patients were underwent bacteria culture and all patients core needle biopsy. All patients were given primary anti-mycobacteria drugs therapy, parts of patients received surgery based on the evaluation of medical treatment. RESULTS: The common bacteria culture of all patients failed to demonstrate any causative microorganism. Four cases were selected randomly to undergo PCR of mycobacteria, only one case was identified as Massiliense in bacteria culture of mycobacteria. Twenty-seven patients with periductal mastitis with fistula were treated with anti-mycobacterial agents (isoniazid, rifampicin and ethambutol or pyrazinamide of triple oral drugs) for 1 to 3 months, the fistula of all 27 patients were closed well. Sixteen patients were treated with the agents only and cured. Eleven patients received surgical treatment after treated with the medical agents. None of the patients were given mastectomy. All patients had no reccurence until now. CONCLUSIONS: The periductal mastitis with fistula has a closely relationship with the infection of nontuberculosis mycobacteria. Those patients could be treated with triple anti-mycobacterial agents and could also avoided mastectomy.

[The clinical study of high-frequency ultrasound-guided vacuum-assisted biopsy for breast microcalcifications].

OBJECTIVE: To evaluate the clinical application of high-frequency ultrasound-guided vacuum-assisted biopsy for breast microcalcifications. METHODS: Sixty-six patients with 70 lesions of microcalcifications detected at mammography underwent high-frequency ultrasound-guided vacuum-assisted biopsy from July 2009 to October 2010. All patients were female, aged 24 to 61 years (median age 40 years). Among 70 lesions of microcalcifications, unilateral lesions were 62 cases and bilateral lesions were 4 cases. The clinical factors that affected the success of biopsy were investigated by χ(2) test and Logistic regression analysis. RESULTS: Among 70 lesions of microcalcifications, the successful rate of biopsy was 72.9% (51/70). The biopsy successful rate of microcalcifications without and with masses were 65.2% (30/46) and 87.5% (21/34) respectively (χ(2) = 3.960, P = 0.047). The biopsy successful rate of microcalcifications of maximal diameter more than 5 mm was higher than that of maximal diameter less than 5 mm (88.9% vs. 55.9%, χ(2) = 9.633, P = 0.002). The Logistic regression analysis showed that the types and maximal diameter of microcalcifications were the main factors that affected the success of biopsy. CONCLUSION: The clinical application of high-frequency ultrasound-guided vacuum-assisted biopsy was an effective option for the diagnosis of breast microcalcifications, especially for the type of microcalcifications with masses and the maximal diameter more than 5 mm.

[Study on PLB induction and proliferation of Dendrobium officinale].

OBJECTIVE: To study on the optimal medium ingredients for PLB induction and proliferation of Dendrobium officinale. METHODS: Seed embryos of Dendrobium officinale were cultivated in MS medium as the basic medium, along with different plant hormones like 6-BA, NAA,2,4-D and KT or their combinations added with organic additives like PE, BE, AE and CM. RESULTS: BA and NAA combination was not conductive to germination and the germination ratio was even lower than that of MS medium; 10% PE and CM was beneficial to PLB induction; 2,4-D was not conductive to growth and proliferation; A certain concentration of BA, KT and NAA was beneficial to PLB proliferation; KT at 1.0 mg/L recorded the highest 40 d PLB proliferation times at 9.0; PE, CM and AE could promote the PLB proliferation at different levels, among which 10% CM was the most effective. CONCLUSION: The optimized medium ingredients suitable for PLB induction are MS +10% CM +1.0g/L AC; The optimized medium ingredients suitable for PLB proliferation are MS + 1.0 mg/L KT + 0.2 mg/L NAA + 10% CM.

Correlation of real-time gray scale contrast-enhanced ultrasonography with microvessel density and vascular endothelial growth factor expression for assessment of angiogenesis in breast lesions.

OBJECTIVE: The purpose of this study was to determine the correlation of real-time gray scale contrast-enhanced ultrasonographic (CEUS) patterns and parameters with microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression for assessment of angiogenesis in breast lesions. METHODS: Real-time gray scale CEUS was performed in 53 women with breast lesions. Contrast-enhanced ultrasonographic patterns and quantitative parameters were analyzed. Mean MVD and VEGF expression in breast lesions were measured by immunohistochemical analysis. RESULTS: Surgical pathologic analysis showed 25 benign and 28 malignant lesions. Different CEUS patterns were observed in the high- and low-MVD and -VEGF groups. Microvessel density and VEGF expression were significantly associated with heterogeneous enhancement with or without perfusion defects and radial or penetrating vessels surrounding the lesions (P< .05). The enhancement order and degree were significantly related to MVD (P< .01) but not correlated with VEGF expression (P> .05). Malignant and benign lesions did not differ significantly in time-intensity parameters (P> .05). The peak intensity, rise in intensity, maximum rise slope of the curve, wash-out slope of the curve, and area under the time-intensity curve (area) were statistically correlated with MVD (P< .05). The highest correlation (r=0.56; P< .001), however, was between the area and MVD. No significant association was found between any CEUS parameters and VEGF expression (P> .05). CONCLUSIONS: Contrast-enhanced ultrasonographic patterns and parameters of breast lesions are more closely correlated with MVD than VEGF expression. Real-time gray scale CEUS has a potential role in evaluating angiogenesis in breast lesions, but CEUS parameters are not correlated with the malignancy or benignity of breast tumors.

Microvascular architecture of breast lesions: evaluation with contrast-enhanced ultrasonographic micro flow imaging.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of micro flow imaging (MFI) of the microvascular architecture with contrast-enhanced ultrasonography for classification of breast lesions as benign or malignant and the microvascular architectural patterns. METHODS: Contrast-enhanced ultrasonography and MFI were performed in 61 women with breast lesions. The microvascular morphologic and distribution features of the breast tumors were evaluated with MFI. Receiver operating characteristic curve analysis was used to evaluate the diagnostic value of MFI, and the microvascular architectural patterns were analyzed. RESULTS: Surgical pathologic analysis showed 29 benign and 32 malignant lesions. For MFI, the area under the receiver operating characteristic curve (A(z)) value for the overall features of the blood vessels for classification of breast lesions was 0.94. The accuracy, sensitivity, and specificity were 90.2% (55/61), 93.8% (30/32), and 86.2% (25/29), respectively. The A(z) value for the morphologic and distribution features of peripheral blood vessels was 0.91, which was significantly higher than the A(z) value for the morphologic and distribution features of interior vessels (P= .019). The microvascular architecture of the 61 lesions was categorized into 3 patterns: treelike, root hair-like, and crab claw-like. Benign lesions mainly displayed the treelike pattern (17 [58.6%]); malignant lesions tended to display the crab claw-like pattern (20 [62.5%]); and the root hair-like pattern was shown in both benign and malignant lesions (11 [37.9%] and 8 [25%], respectively). The microvascular architecture showed significant differences between benign and malignant lesions (P< .001). CONCLUSIONS: Micro flow imaging can clearly delineate the microvascular architecture of breast lesions and can aid in discrimination between benign and malignant breast lesions.

[Community type and species diversity of broadleaved-Korean pine mixed forest in northeast China].

In this paper, the community types of broadleaved-Korean pine mixed forest in Northeast China were identified, and the groups of tree relationship were established based on TWINSPAN. The species diversities at 4 locations in Northeast China, i.e., Changbai Mountain, Datudingzi Mountian, Pingding Mountian and Fenglin Nature Reserve, were compared. The results showed that 264 species belonging to 147 genera in 64 families were recorded in 24 plots, and the 24 plots were identified into 7 community types and 3 groups. The 33 tree species were divided into 8 groups according to their relations. Herbaceous plants possessed the greatest species richness and diversity, followed by shrubs and trees. At the 4 locations, Changbai Mountain owned the highest average species richness of 63. The diversities of tree layer and shrub layer in Changbai Mountain and Datudingzi Mountain were higher than those in Pingding Mountain and Fenglin Nature Reserve. The diversity of herb layer in Fenglin Nature Reserve was 2. 83, being higher than that at other 3 locations. The shrub layer in Pingding Mountain and the herb layer in Changbai Mountain had the lowest evenness of 0.71 and 0.80.