Repeat cervical cytologic testing,human papillomavirus(HPV)testing and immediate colposcopy are currently the most general managements in women with atypical squamous cells of undetermined significance(ASCUS)result.However,the efficacy of these three methods is hampered by strong subjectivity,high false negative and positive rates.With the development of the aetiology of cervical cancer,there is good evidence that biomarkers for persistent HPV infection,HPV integration,instability of host genes and malignancy triage ASCUS more objectively and efficiently.The three-dimensional multiparameter biomarker-based detection may be the predominant method for the triage of women with abnormal cervical cancer screening result.

Objective To evaluate which parameters of transvaginal color Doppler ultrasonography(TVCDU) can effectively reflect blood flow in ovarian tumors. Methods TVCDU was preoperatively used to determine all the parameters of blood flow in 60 women with epithelial ovarian cancer(EOC) and 36 with benign ovarian cystadenomas (control group). Microvessel density(MVD) was tested in the tissue samples by immunohistochemical method(SP method). The parameters of TVCDU in EOC were compared with those in control group.The correlation between MVD and the parameters in EOC group and control group was analyzed. Results ①Statistical differences of arteria showing rate, arteria number, vasculature type, diastolic notch, PI, RI, S/D, TAMXV were seen between EOC group and control group(P

Objective　To explore the expression and significance of p21WAF1 and p53 in HCC. Methods　Immunohistochemical method (IHC) was used to localize and semi-quantitate the proteins of p21WAF1 and p53 and to observe the relationship between the expression of p21WAF1 and the different histopathologic characters in 38 patients of HCC and their peri-cancer tissue as well as 5 normal liver tissue. Results　Of all 38 cases, both p21WAF1 and p53 expression were significantly higher in tumor than that in corresponding non-tumors liver tissue; 14 (36.8 %) of 38 cases showed p21WAF1 positive staining, 28 cases (73.7 %) were p53 positive, p21WAF1＋/p53＋ or p21WAF1-/p53－ were observed in 18, while 20 cases showed p53＋/p21WAF1－ or p53－/p21WAF1＋. p21WAF1＋ was seen in 1 of 38 (2.6 %) corresponding non-cancerous tissue and 2 of 5 normal liver tissue. p53 protein was not detected neither in the non-tumorous tissue nor in normal liver. No significant association was found between the expressions of p21WAF1 and p53(P＞0.05) in HCC. Their was no significant correlation between p21WAF1 or p53 expression and the different histopathologic characters of tumor (differentiating grades, intrahepatic metastasis and/or cancerous thrombi within portal veins). Conclusion　Both p21WAF1 and p53 proteins are over expressed in HCC than that in corresponding non-tumorous liver tissue, but there is no relationship between them. Both p53-independent and p53-dependent mechanism may play a role in regulating p21WAF1 expression in HCC. p21WAF1 immunostaining cannot be used to assess the status of p53 in any given cell or tissue.

OBJECTIVETo assess the effect of perioperative goal-directed fluid therapy (GDFT) on clinical outcomes in elective colorectal resection.

METHODSA total of 42 patients undergoing elective colorectal resection between March 2013 and December 2014 were recruited prospectively. GDFT was administrated based on corrected left ventricular ejection time and stroke volume using the esophageal Doppler monitoring. These patients were compared with a historical cohort of 58 patients managed without GDFT from January 2012 to February 2013. The primary endpoint was postoperative hospital stay and complication rate.

RESULTSThere was no significant difference in the overall fluid volumes administered intraoperatively between two groups [(2657±1037) ml vs. (2846±1444) ml, P>0.05], but patients in GDFT group received higher volume of colloid fluids [(935±556) ml vs. (688±414) ml, P<0.05]. After a period of concordance at the start of operation, corrected left ventricular ejection time, stroke volume and cardiac index increased in GDFT group compared with control group (all P<0.05). No significant differences were found in postoperative hospital stay [(11.27±6.42) d vs. (12.04±7.18) d, P>0.05] and total complication rate (26.5% vs. 25.9%, P>0.05) between two groups, but GDFT group had earlier postoperative flatus [(3.52±0.84) d vs. (4.48±0.71) d, P<0.05] and faster tolerated diet [(5.92±1.18) d vs. (6.83±0.95) d, P<0.05].

CONCLUSIONSPatients undergoing elective colorectal resection do not benefit from intraoperative GDFT. Further studies should be carried out to investigate whether GDFT can be routinely used during colorectal resection.

Colectomy ; Elective Surgical Procedures ; Fluid Therapy ; Goals ; Humans ; Length of Stay ; Perioperative Care ; Postoperative Period ; Prospective Studies ; Stroke Volume ; Treatment Outcome

Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group(NACT)and adjuvant chemotherapy group(ACT)according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group(P＞0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group(P＜0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve(P＜0.05),but no significant difference in OS survival curve(P＞0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ(T4)and stage Ⅲcolon cancer.

Objective:To compare the efficacy of transcatheter arterial embolization (TAE) with laparotomy in the treatment of severe liver injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 48 patients with severe liver injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from December 2013 to June 2020, including 28 males and 20 females; aged 16-75 years [(45.7±6.2)years]. There were 25 patients with grade III, 15 grade IV and 8 grade V according to the American Association for the Surgery of Trauma (AAST) classification. After general treatments such as infusion and hemostasis, TAE was performed in 26 patients (TAE group) and laparotomy in 22 patients (laparotomy group). The operation time and length of hospital stay were compared between the two groups. Erythrocyte, hemoglobin and serum creatinine were compared before operation and at postoperative 1 day. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed before operation and at postoperative 1, 3, 7 days. Complications were observed.Results:All patients were followed up for 12-60 months [(17.1±9.1)months]. The operation time and length of hospital stay were (65.7±9.2)minutes and (21.6±6.6)days in TAE group, significantly shorter than (162.5±28.1)minutes and (31.5±7.4)days in laparotomy group ( P<0.05 or 0.01). There was no significant difference between the two groups referring to erythrocyte, hemoglobin and serum creatinine before operation and at postoperative 1 day (all P>0.05). There was no significant difference in ALT and AST between the two groups before operation (all P>0.05). TAE group showed ALT level of 1 154(884, 1 698)U/L, (975.3±400.9)U/L and (403.4±232.9)U/L at postoperative 1, 3, 7 days, significantly lower than 2 053(1 965, 2 132)U/L, (1 604.1±188.2)U/L and (915.3±160.5)U/L in laparotomy group (all P<0.05). TAE group showed AST level of (1 313.2±542.0)U/L, 525(302, 971)U/L and 174(84, 324)U/L at postoperative 1, 3, 7 days, significantly lower than (1 962.9±245.4)U/L, 1 478(1 089, 1 677)U/L and 837(674, 1 006)U/L in laparotomy group ( P<0.05 or 0.01). The complication rate was 26.9% (7/26) in TAE group, significantly lower than 59.1% (13/22) in laparotomy group ( P<0.05). Conclusion:For severe liver injury, TAE can significantly shorten operation time and length of hospital stay, accelerate the recovery of liver function and reduce the complication rate in comparison with laparotomy.