Objective To evaluate the clinical value of the afterloading brachytherapy inverse intensity-modulated radiotherapy of gynecological tumor.Methods Twenty patients with cervical cancer,were randomly divided into A and B groups,10 cases for each group.Group A received the afterloading brachytherapy inverse intensity-modulated radiotherapy.Group B received the three-dimensional comformal afterloading brachytherapy.The target volume dose distribution,organs at risk (rectum,bladder),shortterm curative effect and radioactive complications were analyzed on both groups.Results The dose homogeneity index of the target volume of group A was 52.43-± 0.45,better than that of group B (46.37 ± 1.45) (t =0.92,P ＜ 0.05).The maximum dose of rectum and bladder of group A were about 37％,35％,less than that of group B (t =1.34,1.39,P ＜ 0.05).The 75％ prescription dose irradiated volume of rectum and bladder of group A were about only 1/2 of group B (t =1.23,1.13,P ＜ 0.05).The local control rate of 96％ for group A was better than 93％ for group B (t =1.25,P ＜ 0.05).Conclusions Afterloading brachytherapy inverse intensity-modulated radiotherapy technique could be better than the three-dimensional comformal afterloading brachytherapy.It should be recommended for gynecological tumor.

Ultrastructural localization of alkaline phosphatase (AKP) was observed with histochemical method in 10 cases of endometrium. AKP was localized on plasma membranes of glandular cells in normal proliferative and adenomatous hyperplastic endometrium. Uhrastractural、locatization of AKP has no significant change in endometrial cancer. In differentiated endometrial cancer AKP was predominantly localized on microvilli and apical plasma membranes of tumor cells which were adjacent to glandular cavity; and in undifferentiated cancer AKP was evenly distributed on plasma membaanes of tumor cells.

Objecfive To investigate the relationship between single nucleotide polymorphism-56(SNP-56)in calpain-10(CAPN-10)gene and polycystic ovary syndrome(PCOS)in Chinese.Methods The genotypes of SNP-56 of CAPN-10 were determined through polymerase chain reaction Tm-shift genotyping method in 638 local women in Shandong Province.Among them,334 were patients with PCOS (PCOS group)and 304 were normal women(control group).The baseline parameters including levels of serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),testosterone(T)and lipid,as well as the body mass index(BMI)and waist/hip ratio(WHR)were measured.Glucose tolerance and insulin releasing before and after loading with 75 g of glucose were also assayed.Results(1)The frequencies of two allelotypes or three genotypes did not differ between PCOS women and normal women(P＞0.05).(2)In PCOS group,patients with AA genotype had a significantly higher plasma glucose of 180 minutes OGTT(5.7±2.2)mmol/L[P＜0.01 compared to Gagenotype(4.9±1.2) mmol/L,P＜0.01 compared to GG genotype(4.9±1.4)mmol/L]and serum total cholesterol(TC)level(4.9±1.0)mmol/L[P＜0.05 compared to Gagenotype(4.5±0.9)mmol/L].(3)Compared to PCOS patients with GA+GG genotype(P＜0.05,P＜0.01)or GG genotype(P＜0.05,P＜0.01),there was significantly higher attack rate of diabetes and tumor in the family history of patients with AA genotype.Conclusions These findings suggest that CAPN-10 gene SNP-56 which may not contribute to the genetic susceptibility of PCOS plays a role in glucose and lipid metabolism in Chinese PCOS patients.It may also be correlated with attack rate of diabetes and tumor in the family history of PCOS patients.

Objective To explore the security,pregnancy outcomes,and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy (RT).Methods Thirty-two young patients ＜ 40 years of age with early cervical cancer from May 2004 to July 2012 admitted in Tumor Hospital Xiangya School of Medicine of Central South University were divided into two groups based on different operation methods:vaginal radical trachelectomy (RVT) group and abdominal radical trachelectomy (RAT) group.The clinical data were analyzed by One-way Anova and multivariate Cox stepwise regression analysis.Results The operation duration,number of lymph node dissection,the height of the cervical resection,postoperative hospitalization time,incidence of vascular injury and incidence of postoperative lymphocele were respectively (250 ± 82) min,15 ± 6,(2.31 ± 0.21) cm,(9.2 ± 2.9) d,1/18 and 1/18 in RVT group,while (263 ±60) min,16 ±8,(2.32 ±0.26) cm,(10.3 ±3.5) d,0 and 1/14 in RAT group.There was no statistically significant difference between the two groups (all P ＞ 0.05).The blood loss (281 ±201) ml in RVT group was significantly lower than that in the RAT group (492 ±320) ml (P ＜0.05).The length of Vaginal hysterectomy[(2.61 ±0.50) cm] and the width of parametrial resection[(2.38 ±0.36) cm] in RVT group were significantly less than those[(2.95 ±0.10),(2.81 ±0.22) cm] in the RAT group (all P ＜ 0.05).The pregnancy rate between RVT group (3/18) and RAT group (2/14) were no significant difference (P ＞ 0.05).One-way Anova analysis showed that the recurrence of early cervical cancer was related to tumor size in diameter (F =4.911,P =0.047),while there were no correlation with age,clinical stage,histological type and surgical approach (all P ＞ 0.05).Multivariate analysis showed that tumor diameter size was an independent risk factor for tumor recurrence (3 =0.259,P =0.031).Conclusions RT for young patients with early cervical cancer is feasible.Pregnancy outcomes after RT need to be study in the future.Tumor size in diameter is the major risk factor for tumor recurrence.

Objective To investigate the relationship between the expression of β-catenin and drug-resistance mechanism of choriocarcinoma according to the expression of β-catenin in JEG-3 cells (human choriocarcinoma cell line) and drug resistant JEG-3/VP16 cells.Methods The mRNA and protein expressions of β-catenin were analyzed with reverse transcription-polymerase chain reaction(RT-PCR) and Western blotting.Flow cytometry was used to determine the percentages of β-catenin-positive cells in the two choriocarcinoma cell lines.Results Both drug resistant choriocarcinoma cells and drag sensitive cells were found to express β-catenin; but the expression of β-catenin mRNA (1.43 ±0.24) and protein(1.49 ±0.17)in drug resistant choriocarcinoma cells was found much higher than that in drug sensitive cells(0.65 ±0.14,0.66 ±0.16,P ＜0.01).And according to detect by flow cytometry,we found the number of β-catenin-positive cells in JEG-3/VP16 cells [(40.13 ±5.17) ％] was much more than that in JEG-3 cells [(13.15 ± 1.48) ％,P ＜ 0.01].Conclusions β-catenin was highly expressed in the drug resistant choriocarcinoma cell line (JEG-3/VP16).It indicates β-catenin might be involved in the drug resistance mechanism of choriocareinoma.

Objective:To explore the selection and effects of flap/myocutaneous flap repair methods for the defect after perineum tumor resection.Methods:From January 2011 to February 2017, 31 patients with vulvar tumor who were admitted to Hunan Cancer Hospital underwent repair of wound after tumor resection with various flaps/myocutaneous flaps. The patients were composed of 5 males and 26 females, aged 39-76 years, with 27 vulvar cancer and 4 Paget′s disease in primary diseases. The size of defects after vulvar tumor radical resection ranged from 8.0 cm×4.5 cm to 27.5 cm×24.0 cm. According to the theory of perforasome, the defects were repaired by the external pudendal artery perforator flap, deep inferior epigastric artery perforator flap, rectus abdominis myocutaneous flap, anterolateral thigh flap, internal pudendal artery perforator flap, gracilis myocutaneous flap, and profunda artery perforator flap based on the specific size and location of perineum and groin where the defect was located. According to the blood supply zone of flap, totally 17 local translocation flaps, 18 axial flaps/myocutaneous flaps, and 7 V-Y advancement flaps were resected, with an area of 7.0 cm×4.0 cm to 21.0 cm×13.0 cm. All the flaps/myocutaneous flaps were transferred in pedicled fashion, and the donor sites were closed without tension. The number of flaps/myocutaneous flaps, wound closure, flaps/myocutaneous flaps survival, and follow-up were observed and recorded.Results:Altogether 42 flaps/myocutaneous flaps were harvested in 31 patients. Two flaps/myocutaneous flaps were used in 11 cases for large circular defect repair. All the defects achieved tension-free primary closure. The blood supply of 32 flaps/myocutaneous flaps was good, while insufficient blood supply was noted in the other 10 flaps/myocutaneous flaps. Seventeen flaps/myocutaneous flaps survived smoothly. Wound dehiscence occurred in 5 flaps/myocutaneous flaps 8 to 14 days postoperatively, which was healed with dressing change. Temporary congestion was noted in 7 flaps/myocutaneous flaps 2 to 5 days postoperatively, which recovered without special treatment. Three flaps/myocutaneous flaps had infection 7 to 15 days postoperatively, two of which recovered after dressing change, while the other one had partial necrosis and received debridement and direct closure. Two flaps/myocutaneous flaps were totally necrotic 8 to 15 days postoperatively, which were repaired with pedicled rectus abdominis myocutaneous flap after debridement. Seven flaps/myocutaneous flaps had partial necrosis 7 to 20 days postoperatively and were healed after dressing change. Twenty-four patients were followed up for 9-38 months. The color of flaps/myocutaneous flaps was similar to that of the surrounding skin, the shape of vulva was natural, the movement of hip joint was not limited, the function of micturition and defecation was not affected, and tumor recurrence was noted in 3 patients.Conclusions:For the complicated large defect after perineum tumor resection, the flexible application of different forms of flaps/myocutaneous flaps to repair according to different areas regains the appearance and function. However, there are many complications, so it is necessary to further strengthen the postoperative care.