Evaluation of serum CA125, HE4 and CA724 and the risk of ovarian malignancy algorithm score in the diagnosis of high-grade serous ovarian cancer.

AIM: To develop a new algorithm for the detection of high-grade serous ovarian cancer (HGSOC). METHODS: Patients diagnosed with HGSOC, borderline ovarian tumours (BOTs) or benign ovarian masses (BOMs) were enrolled between February 2019 and December 2020. Patients with BOTs or BOMs were grouped as non-HGSOC. The cases were divided randomly into a training cohort (two-thirds of cases) and a validation cohort (one-third of cases). Logistic regression was used to find risk factors for HGSOC and to create a new algorithm in the training cohort. Receiver operating characteristic curves were used to compare the diagnostic value of tumour biomarkers. Sensitivity and specificity of tumour markers and the new algorithm were calculated in the training cohort and validation cohort. RESULTS: This study found significant differences in age; BRCA1/2 mutation status; CA125, CA724 and HE4 levels; and Risk of Ovarian Malignancy Algorithm score between the two groups.Logistic regression analysis showed that CA125 and BRCA1/2 were risk factors for HGSOC. A new algorithm combining CA125 and BRCA1/2 increased the specificity of CA125 for diagnosis of HGSOC. The new algorithm had sensitivity of 81.08% and specificity of 93.10% in the training cohort. CONCLUSION: The new algorithm using CA125 and BRCA1/2 helped to distinguish between patients with HGSOC and patients with non-HGSOC.

Conservative treatment of hepatic portal vein gas after transarterial chemoembolization treatment for liver metastasis of postoperative esophageal cancer: a case report.

Background: Hepatic portal vein gas (HPVG), which is a rare clinical manifestation, is usually considered a sign of critical illness. If the treatment is not timely, it will lead to intestinal ischemia, intestinal necrosis, and even death. There is still no consensus on whether to adopt surgical or conservative treatment for HPVG. Herein, we report a rare case of conservative treatment of HPVG after transarterial chemoembolization (TACE) treatment in a patient with liver metastasis of postoperative esophageal cancer, who received long-term enteral nutrition (EN). Case Description: A 69-year-old male patient, who had undergone surgery for esophageal cancer, needed long-term use of jejunal feeding tube implantation for enteral nutritional support due to postoperative complications. About 9 months after the operation, multiple metastases of the liver were detected. To control the progress of the disease, TACE was conducted. EN was restored on the second day after TACE, and the patient was discharged on the fifth day. On the night of discharge, the patient suddenly experienced abdominal pain, nausea, and vomiting. Abdominal computed tomography (CT) showed that the abdominal intestinal lumen was obviously dilated, liquid and gas plane shadowing was visible, and gas was visible in the portal vein and its branches. The physical examination showed that peritoneal irritation was present, and bowel sounds were active. Blood routine examination showed an increase in neutrophil and neutrophil. Symptomatic treatment, including gastrointestinal decompression, anti-infection, and parenteral nutritional support, was provided. On the third day after the presentation of HPVG, abdominal CT reexamination showed that HPVG had disappeared and the intestinal obstruction was relieved. Repeated blood routine shows a decrease in neutrophil and neutrophil. Conclusions: Elderly patients who require long-term EN support should avoid early EN support after TACE, as this can prevent intestinal obstruction and HPVG. If the patient suddenly experiences abdominal pain after TACE, CT scan should be performed in a timely manner to determine whether there is intestinal obstruction and HPVG. If the above type of patient experiences HPVG, conservative treatments such as early gastrointestinal decompression, fasting, and anti-infection treatment can be provided first without high-risk factors.

Analysis of risk factors for implantable venous access port catheter fracture with internal jugular vein.

BACKGROUND: To investigate the risk factors of the in vivo implantable venous access port (IVAP) catheter fracture. METHODS: We retrospectively analyzed 3,102 cases of patients with vascular access devices from November 2013 to March 2016 in the hospital by PACS. The clinical and radiographic features (age, occupation, living habit, IVAP duration, intravascular outer catheter angle, location of catheter tip and IVAP implantation site) were summarized to analyze the related risk factors of fracture in the 3,102 patients. RESULTS: There were 15 cases of fracture in 3,102 patients, and the fracture site were located at the entrance of the internal jugular vein (IJV) (n=12), the outlet of the vascular access devices (n=1), the distal portion of the catheter (n=2). Fracture was closely related to the factors of port time, age and occupation, but not related to the location of the port, the position of the catheter tip and the angle of the inner and the outer catheter. Age and IVAP duration were an independent risk factor for IVAP catheter fracture. CONCLUSIONS: Implantable vascular access devices are approved by its advantages of being safe, effective and less invasive. It is important to clarify the related factors and early prevention of fracture.

Melatonin rescues impaired penetration ability of human spermatozoa induced by mitochondrial dysfunction.

Fertilization failure often occurs during in vitro fertilization (IVF) cycles despite apparently normal sperm and oocytes. Accumulating evidence suggests that mitochondria play crucial roles in the regulation of sperm function and male fertility. 3-Nitrophthalic acid (3-NPA) can induce oxidative stress in mitochondria, and melatonin, as an antioxidant, can improve mitochondrial function by reducing mitochondrial oxidative stress. The role of sperm mitochondrial dysfunction in fertilization failure during IVF is unclear. The present study revealed that spermatozoa with low, or poor, fertilization rates had swollen mitochondria, increased mitochondria-derived ROS, and attenuated mitochondrial respiratory capacity. 3-NPA treatment enhanced mitochondrial dysfunction in sperm. Spermatozoa with poor fertilization rates, and spermatozoa treated with 3-NPA, had reduced penetration ability. The concentration of melatonin was decreased in semen samples with low and poor fertilization rates. Melatonin, not only decreased excessive mitochondria-derived ROS, but also 'rescued' the reduced penetration capacity of spermatozoa treated with 3-NPA. Taken together, the study suggested that mitochondria-derived ROS and mitochondrial respiratory capacity are independent bio-markers for sperm dysfunction, and melatonin may be useful in improving sperm quality and overall male fertility.

MicroRNA-466 inhibits cancer cell migration and invasion in hepatocellular carcinoma by indirectly mediating the downregulation of ROCK2.

MicroRNA-466 was recently characterized as a tumor suppressor with known biological function in prostate cancer. The aim of the current study was to investigate the possible involvement of microRNA-466 in hepatocellular carcinoma (HCC). The current study demonstrated that the expression level of microRNA-466 was significantly downregulated; while the mRNA expression level of Rho-associated coiled-coil containing protein kinase 2 (ROCK2) was significantly upregulated in tumor tissue compared with adjacent healthy tissue samples obtained from patients with HCC. In addition, the relative plasma level of microRNA-466 was significantly decreased, while the relative plasma level of ROCK2 was significantly increased in patients with HCC compared with healthy controls. Expression levels of microRNA-466 and ROCK2 were inversely correlated in tumor tissue but not in adjacent healthy tissue samples obtained from patients with HCC. Plasma levels of microRNA-466 and ROCK2 were inversely correlated in patients with HCC but not in healthy controls. In addition, reduced plasma levels of microRNA-466 may have a diagnostic value in the detection of early stage HCC. MicroRNA-466 overexpression significantly suppressed ROCK2 expression in HCC cells, whereas ROCK2 overexpression did not significantly affect microRNA-466 expression. MicroRNA-466 overexpression significantly suppressed, while ROCK2 overexpression significantly enhanced HCC cell migration and invasion. In addition, ROCK2 overexpression partially reversed the inhibitory effect of microRNA-466 overexpression on HCC cell migration and invasion. Taken together, these results suggest that microRNA-466 may inhibit HCC cell migration and invasion by indirectly mediating the downregulation of ROCK2.

[Short-term medication of L-carnitine before intracytoplasmic sperm injection for infertile men with oligoasthenozoospermia].

OBJECTIVE: To observe the pregnancy promoting effect of L-carnitine combined with intracytoplasmic sperm injection (ICSI) in treating male infertility with oligoasthenozoospermia. METHODS: We assigned 129 patients with oligoasthenozoospermia to receive 2 weeks of oral L-carnitine followed by ICSI (medication group, n = 42) and ICSI alone (control group, n = 87). We compared the sperm concentration and motility, the percentage of grade a + b sperm, and sperm deformity before and after L-carnitine medication, as well as the rates of fertilization, cleavage, available embryo and clinical pregnancy between the two groups. RESULTS: The percentage of grade a + b sperm was significantly increased after L-carnitine medication as compared with the baseline ([13.5 +/- 10.7] % vs [9.6 +/- 7.2] %, P<0.05), and so was the rate of available embryo in the medication group after ICSI in comparison with that of the control group (77.50% vs 69.04%, P<0.05). CONCLUSION: Short-term medication of L-carnitine can improve sperm quality and raise the success rate of ICSI.

[Causes of urinary tract infection and its prevention in patients with indwelling urinary catheter: report of 152 cases].

OBJECTIVE: To investigate the causes of urinary tract infections occurring in patients with indwelling urinary catheter, and to find the preventive means against this condition. METHODS: The clinical data of 152 such cases admitted between March, 2000 and February, 2002 in our department were reviewed. RESULTS: In this group of patients, 57 (37.5%) developed urinary infections due to the indwelling catheter, a rate significantly lower than that among previous cases (46.6%, P < 0.05) treated in our department. CONCLUSION: Careful evaluation of the indications for indwelling urinary catheter, strict aseptic procedures and shortened indwelling time of the catheter may help prevent the occurrence of the infection.