Relationship between HPV-16 infection and the progression of vaginal intraepithelial neoplasia.

OBJECTIVE: To explore the relationship between infection with human papillomavirus (HPV)-16 and the development of vaginal intraepithelial neoplasia (VaIN). METHODS: This is a retrospective study. 78 patients with suspected VaIN admitted to the gynecologic clinic of Affiliated Hospital of Guilin Medical College from August 2016 to December 2020 who were confirmed to have HPV-16 infection by HPV rapid flow-through hybridization method were selected as the research subjects. The copy numbers of HPV-16 early genes E2 and E6 were detected by quantitative real-time PCR amplification to analyze the integration status of the virus. RESULTS: The episomal form of HPV-16 exists in all levels of VaIN. As the pathological level of VaIN increased, the episomal form of HPV-16 gradually decreased, and a disruption of the E2 gene became more frequent. However, there was no significant difference between different levels of VaIN (P>0.05). With the increased severity of cytology results, the percentage of the episomal form of HPV-16 decreased from 76.47% in atypical squamous cells of undetermined significance (ASC-US) to 44.44% in the high-grade squamous intraepithelial lesion (HSIL) (χ2 =4.780, P<0.05). However, the integrated form of HPV-16 did not increase significantly as the severity of cytology increased (χ2=2.215, P>0.05). CONCLUSION: HPV gene integration may occur before the onset of VaIN. However, the occurrence of HPV-16 integration is not a risk factor leading to the malignant progression of VaIN. An E2 gene disruption is more common in the early events after HPV-16 infection. HPV-16 gene integration may be the main reason for persistent HPV-16 infection.

Knowledge, attitude and behaviour of general practitioners in Shanghai during the pandemic of COVID-19: a cross-sectional study.

OBJECTIVES: To understand the knowledge, attitude and behaviour of general practitioners (GPs) towards COVID-19 and to provide evidence for improved prevention and control measures against the pandemic. STUDY DESIGN: A cross-sectional study was conducted with 1018 GPs in Shanghai from 21 February to 2 March 2020 using the WeChat platform. METHODS: Stratified random cluster sampling was performed according to the regional division of urban, urban-rural fringe and rural areas. This study used a self-designed mobile questionnaire. The questionnaire collected information on knowledge, attitudes and behaviours regarding COVID-19 prevention and control. RESULTS: A total of 989 questionnaires were declared valid. The average scores of GPs' knowledge, attitude and behaviour towards COVID-19 were 6.14±1.42 (range 0-10), 13.59±4.42 (range 0-25) and 7.82±1.53 (range 0-10), respectively. Multiple linear regression analysis showed that the knowledge score of male GPs was lower than that of female GPs (p=0.002). In addition, the 'attitude' score of female GPs was higher than that of male GPs (p=0.004). The 'behaviour' score of GPs in urban areas was lower than that of GPs in urban-rural fringe areas (p<0.001). The higher the knowledge score, the higher the behavioural score was observed to be (p<0.001). CONCLUSIONS: The scores of knowledge, attitude and behaviour of Shanghai GPs towards COVID-19 were limited at the beginning of the COVID-19 outbreak. As a hopeful measure, the early implementation of proper training programmes for GPs in times of crisis will contribute to disease control and prevention. Lessons learnt from the current pandemic will hopefully help GPs handle similar future challenges and potential novel pandemics.

A cavernous hemangioma of infundibulopelvic vessels presenting as an adnexal tumor: A rare case report and literature review.

RATIONALE: Female reproductive organ angiomas are rarely reported and are accidentally found during surgery. Angiomas arising from infundibulopelvic vessels presenting as adnexal masses are even rarer, and a few doctors have experience in their management. PATIENTS MAIN CONCERNS AND IMPORTANT CLINICAL FINDINGS: Herein, we report the case of a 40-year-old woman who was admitted after a physical examination revealed an ovarian mass. The physical examination revealed a palpable adnexal mass in the right pelvic cavity. Ultrasound showed a 4.5 × 4.0 × 5.0 cm space-occupying lesion close to the right ovary, which had many echogenic lines and calcifications in its cystic cavity. PRIMARY DIAGNOSIS: Right adnexal mass. INTERVENTIONS: Laparoscopic surgery was performed in all the patients. During the surgery, the mass was found to be a retroperitoneal hemangioma with distorted and dilated vessels. We separated the right infundibulopelvic vessels and performed tumor resection with minimal blood loss. OUTCOMES: The patient recovered well, and no abnormalities were observed during the following 2 years. Pathological results showed that this adnexal mass was a type of cavernous hemangioma arising from the infundibulopelvic vessels. LESSONS: Surgical removal of the affected tissues is an aggressive treatment of choice for cavernous hemangiomas. Laparoscopic resection of infundibulopelvic hemangioma is feasible, and gynecologists are qualified for this operation, as long as damage to the iliac vessels is avoided.

Knowledge and behaviour of community residents' face mask-wearing during the COVID-19 pandemic: a cross-sectional study in Shanghai, China.

OBJECTIVES: COVID-19 is an infectious disease spreading through respiratory droplets. Using a face mask correctly is one of the essential preventive measures. We launched a survey to discover the current face mask-wearing problems for better prevention and control of the pandemic. SETTING/PARTICIPANTS: A cross-sectional study was conducted with 1240 residents in Shanghai during 18-28 February 2020. Stratified random sampling was adopted in the urban area, urban-rural fringe area and rural area. A mobile self-designed questionnaire was used. MAIN OUTCOME MEASURES: Analysis of the demographic and sociological factors influencing residents' face mask type selection, disposable surgical mask-wearing behaviour, replacement time and the storage method for reuse of disposable surgical masks. RESULTS: The accuracy of residents' face mask type selection was rated 41.61% (513/1233), and that of urban-rural fringe residents, low-education residents, elderly residents, were low, respectively (p<0.001). 96.67% of residents always wore face masks in crowded public places. Multiple-factor analysis showed that region, gender and education level were the influencing factors for entirely fitting the disposable surgical mask to the face. Region was an influencing factor for not touching the mask's external surface while wearing or removing it. Education level was an influencing factor for recognising the external and inner mask surface, upper and lower edge of a disposable surgical mask. The accuracy of the mask replacement time was 25.63% (316/1223). It was low with elderly, low-education residents, respectively (p<0.001).The accuracy of residents' storage method for reuse of disposable surgical mask was 3.81% (47/1233), and region, age and education level were influencing factors. CONCLUSIONS: Shanghai residents recorded a high rate of wearing face masks. Selection of an appropriate type of face mask, disposable surgical mask-wearing behaviour, replacement time and storage method for reuse of disposable surgical masks should be particularly emphasised in future behaviour change interventions.

Sclerosing stromal tumor of the ovary with masculinization, Meig's syndrome and CA125 elevation in an adolescent girl: A case report.

BACKGROUND: Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of the ovary. It was first reported and named in 1973. These tumors typically present with pelvic/abdominal pain and tenderness, a mass, and/or abnormal menses, but rarely present with masculinity in children and adolescents. Only 2 cases of these tumors have been reported in premenarchal girls, who demonstrated hormonal activity, with a history of the development of a virilizing female due to hyperandrogenism. Here, we report a case of a giant SST with obvious masculinity combined with Meig's syndrome and CA125 elevation. CASE SUMMARY: A 17-year-old female presented with a 7-year history of the development of masculinity and a 2-year history of amenorrhea. She had hirsutism, acne, obvious laryngeal prominence, and voice deepening. Physical examination showed a male suprapubic hair pattern and a 4.0 cm × 1.5 cm enlarged clitoris. Laboratory tests showed that the testosterone level was > 15.00 ng/mL (normal range: 0.14-0.76 ng/mL), and androstenedione level was > 10.00 ng/mL (normal range: 0.3-3.3 ng/mL). A computed tomography scan of the abdomen and pelvis was carried out and showed a large, solid and cystic, partly calcified pelvic mass in the right ovary measuring 27.1 cm × 20.0 cm × 11.0 cm, 15 cm above the umbilicus (to the level of the upper part of L1). Intraoperative findings at laparotomy revealed a large tumor arising from the right ovary. Approximately, 500 mL of pale-yellow clear liquid was found in the pelvic cavity. A right salpingo-oophorectomy was performed. Microscopic examination and immunohistochemical staining of the surgical specimen showed an SST of the ovary. CONCLUSION: This report is remarkable as our patient was not only diagnosed with an SST of the ovary, which is extremely rare in this age group, but was the largest and most obvious reported patient with this tumor who presented with virilization. Therefore, gynecologists should be aware of this potential complication in adolescent girls with a mass in the ovary.

Trichosanthin inhibits the proliferation of cervical cancer cells and downregulates STAT-5/C-myc signaling pathway.

BACKGROUND: Previous studies have indicated that Trichosanthin (TCS) exerts anti-virus, immunoregulation and a broad spectrum anti-tumor pharmacological activities. Trichosanthin is a promising agent for the treatment of cervical cancer. However, the exact effects and potential mechanism of TCS on cervical cancer are not well known. METHOD: The cell viability of TCS on cervical cancer cell lines (HeLa and caski cells) were detected by a Cell Counting Kit-8 (CCK-8) assay. Cell proliferation was measured by Ki-67 staining and cell apoptosis was detected by flow cytometry. Cell migration and invasion were detected by wound assay and transwell assay, respectively. The levels of E-cadherin, N-cadherin, Snail, Bcl-2, Caspase-3, p-STAT5, STAT5, p-C-myc, C-myc were detected by western blot. RESULTS: The present study showed that TCS inhibited the proliferation of HeLa and caski cells and reduced Ki-67 and P-C-myc expression. In addition, flow cytometric analysis showed that TCS induced the apoptosis of HeLa and caski cells. The potent effect of TCS on cell apoptosis as determined by the increase the levels of caspase-3 and decrease the levels of Bcl-2. TCS also inhibited cervical cancer cell invasion, migration and epithelial-mesenchymal transition (EMT). Furthermore, TCS treatment markedly inhibited the activation of STAT5/C-myc signaling pathway. CONCLUSION: In conclusion, the present study suggest that TCS inhibits the proliferation, migration and EMT of human cervical cancer cells, which maybe mediated by inhibiting the activation of STAT5/C-myc signaling pathway.

[Trans-differentiation of Human Amniotic Epithelial Cells into Follicle-like Structure].

OBJECTIVE: To determine whether hAECs can differentiate into follicle-like structure. METHODS: hAECs were isolated from human term placenta and cultured sequentially in medium supplemented with 5% human follicular fluid. The morphology of the cells was examined by inverted microscope. Changes of estradiol levels and expressions of germ cell specific gene in the cultured medium were detected by chemiluminescence immunoassay and Real time-Polymerase Chain Reaction (RT-PCR), respectively. RESULTS: Oocyte-like cells (OLCs) were found in those cultured in the medium supplemented with 5% human follicular fluid. The OLCs gradually aggrandized, shrunk and finally disappeared over time. However, this phenomenon was not observed in the control group. Higher expressions ofDAZLandGDF9were found in the follicle group compared with the control which medium without 5% human follicular fluid (P< 0.05), with two peaks. No significant difference in the expression ofSCP3was found between the two groups (P>0.05). Estradiol was detected in the culture medium of the follicle group in a mode of decreasing-rising-decreasing, but not in the control group. CONCLUSION: hAECs have the potential to trans-differentiate into the follicle-like structure in vitro.