1.Value and safety of abdominal paraaortic lymph node dissection in the treatment of early-stage endometrial carcinoma
Xiao YAN ; Kaijiang LIU ; Kuerban GULINA
Journal of Medical Postgraduates 2016;29(9):949-953
Objective Systematic pelvic lymph node ( SPLN) +abdominal paraaortic lymph node ( APLN) dissection re-mains controversial in the treatment of endometrial carcinoma , especially in the early stage of the tumor .This study aims to investigate the value and safety of APLN dissection in the treatment of early-stage endometrial carcinoma . Methods We retrospectively ana-lyzed the clinical data about 109 cases of early-stage endometrial adenocarcinoma , 56 treated by SPLN dissection ( group A ) and the other 53 by SPLN+APLN dissection ( group B ) .We compared the postoperative complications , recurrence and metastasis , and progno-sis-related factors between the two groups of patients . Results No statistically significant difference was found in the incidence rate of postoperative complications between groups A and B ( 19.64% vs26.41%, P>0.05).Recurrence and metastasis were found in 12 of the 109 patients, 10 in group A and 2 in group B (17.86%vs 3.77%, P=0.019).Multivariate logistic regression analysis showed that the independent factors of recurrence and metastasis includ -ed the differentiation degree (OR=7.385, 95%CI:1.877-29.062), pathologic stage (OR=5.444, 95%CI:1.673-17.720), range of lymph mode dissection (OR=19.171, 95%CI:2.242 -163.946), and range of lesion focus (OR=12.524, 95%CI:1.186-132.280), with the range of lymph mode dissection as the greatest influencing factor on prognosis . Conclusion SPLN+APLN dissection can reduce the recurrence and metastasis and improve the prognosis of early -stage endometrial adenocarcinoma , and therefore is safe and feasible for the treatment of the tumor .
2.Total laparoscopic hysterectomy using YSZ-1 uterine manipulator: A clinical analysis of 78 cases
Shuzhong YAO ; Ling LI ; Kaijiang LIU
Chinese Journal of Minimally Invasive Surgery 2001;0(01):-
Objective To investigate the clinical value of the YSZ-1 uterine manipulator in total laparoscopic hysterectomy.Methods Total laparoscopic hysterectomy was employed in a total of 78 women by using the LigaSure,ultrasonic scalpel,and the YSZ-1 uterine manipulator.The anterior fornix was opened and the manipulator was placed on the lip of the cervix.Then the uterus was completely removed.Results The operation was completed smoothly in all the 78 patients.The operating time was 45~90 min(mean,63 min),and the intraoperative blood loss was 40~100 ml(mean,65 ml).No urinary tract injuries,vaginal bleeding,or other postoperative complications occurred.The length of postoperative hospital stay was 4~7 d(mean,5.3 d).Follow-up examinations in the 78 patients for 3~6 months(mean,4 months) showed that the vaginal wound normally healed up. Conclusions Use of the YSZ-1 uterine manipulator in total laparoscopic hysterectomy makes the procedure easier and safer.The YSZ-1 uterine manipulator is a useful laparoscopic instrument.
3.A retrospective study on the outcomes of the oncology, fertility and pregnancy in patients with early-stage cervical cancer after undergoing the fertility-sparing treatments
Yuxin SUN ; Qing LIU ; Kaijiang LIU ; Peiquan LI ; Zhijun HU
Chinese Journal of Obstetrics and Gynecology 2016;51(6):442-447
Objective To explore the outcomes of the oncology, the fertility and pregnancy on patients with early-stage cervical cancer after undergoing fertility-sparing treatments, and to investigate its value on clinical treatment. Methods A total of 29 patients with cervical cancer (stage Ⅰa2-Ⅰb1) who had undergone the fertility-sparing treatments in Renji Hospital, School of Medicine, Shanghai Jiaotong University from February 2010 to September 2015 were analyzed retrospectively. Surgical procedures included transvaginal cervical cold knife conization (CKC)+laparoscopic pelvic lymphadenectomy (PLD) or total laparoscopic uterine cervix extensive resection (RT; contains PLD); 48 patients with early cervical cancer under going laparoscopic uterine extensive resection (RH; contains PLD) by the same group of physicians in the same period were chosen as the control group. The perioperative related indicators, postoperative specimen examination, pregnancies after surgery and postoperative tumor follow-up results were retrospectively analyzed and compared between the two groups. Results (1) Among these 29 patients in the study group, 26 cases were underwent the fertility-sparing surgery quick frozen pathological examinations were positive in 3 cases, which underwent total laparoscopic RT eventually. (2) The perioperative related indicators: compared with the study group and the control group, the operation time [(182 ± 21), (147 ± 24) minutes, respectively] has significant difference (t=6.563, P<0.01). There were no significant difference (P>0.05) in intra-operative blood loss [(102±26), (99±34) ml], postoperative aerofluxus time [(1.3±0.4), (1.1±0.9) days], the average length of hospital stay [(11.2 ± 2.1), (10.6 ± 3.5) days], rate of urine retention [10%(3/29), 10%(5/48)] and rate of postoperative infection [3%(1/29), 2%(1/48)]. (3)Postoperative specimen examination:compared with the study group and the control group, there were no significant difference (P>0.05) innumber of removed lymphatic nodes (23.4 ± 4.1, 22.8 ± 3.9), length of cardinal ligament [(2.9 ± 0.5), (3.0 ± 0.6) cm], lengthof uterosacral ligament [(2.6±0.7), (2.8±0.4) cm], length of removed vaginal [(3.4±0.3), (3.5±0.3) cm]. (4) Pregnancies after surgery and postoperative tumor follow-up results:in the study group, only 14 patients had fertility requirement after treatments. Pregnancies occurred in 5 women (5/14), which included1 case of full-term labor, 1 case of preterm labor, and 3 cases of spontaneous abortion. The Average follow-up time in postoperative patients of the study group and control group was 29.4, and 30.2 months respectively. In follow-up period, compare with study group and the control group, there was no significant difference (χ2=0.004, P>0.05) in the recurrence rate [4%(1/26), 4%(2/48)]. Conclusion Fertility-sparing surgery of early-stage cervical cancer is safe but the outcome of the fertility and pregnancy is still need toimprove.
4.Two-dimentional liquid phase chromatographic proteome profiles in Uighur women with uterine cervix cancer
Xia GUO ; Abudula ABULIZI ; Guizhen WU ; Kaijiang LIU
Journal of Central South University(Medical Sciences) 2009;34(7):624-629
Objective To establish differential protein expression profile specific for serum proteome of cervical carcinoma in Uighur women by protein 2-dimensional liquid phase chromatogra-phy. Methods We collected and prepared sera of cervical carcinoma from Uighur women, and sepa-rated and processed data using 2-dimensional liquid phase chromatography system specific for protein (ProteomeLabTM PF-2D ). Results A differential expression profile of serum proteome based on characteristics of protein isoelectrie point and hydrophobic features was successfully established. Fifty-six differentially expressed protein spots were found, among which there was an obvious difference in 12 peaks. Conclusion Two-dimensional liquid phase chromatography is an effective and feasible method to establish differential expression profile of serum proteome and to offer a new way for the screening of serum protein markers of Uighur women with cervical carcinoma.
5.Analysis of the effects of different treatment methods in patients with stage Ⅰb2 bullky cervical cancer
Nana HAN ; Wenyu SHAO ; Kaijiang LIU ; Yan MA
China Oncology 2015;(1):56-62
Background and purpose:A variety of measures are taken preoperatively to reduce the tumor size of stageⅠb2 bulky cervical cancer before surgery. Which one is safer and more effective, currently, there is no consensus. This article compared the effect in 3 different treatment methods (neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy and operation) on patients with stageⅠb2 bulky cervical cancer, and provided evidence for clinical decision. Methods:Retrospective analysis the clinical date of 133Ⅰb2 bulky cervical cancer patients, who received preoperative neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy and direct operation from Apr. 2006 to Oct. 2010 in our hospital. Results: The effective rates of neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy group were 91.8% and 92.5%, respectively, there was no statistical difference(P>0.05). The tumor size got smaller after treatment compared with the size before treatment (P<0.05);The pathological efifciency rates were 95.56%and 97.30%, respectively, the difference was not statistically significant (P>0.05). The bleeding volume of neoadjuvant chemo radio therapy group was significantly higher than those in the other 2 groups (158.9±50.7 vs 116.8±45.5, 123.1±30.2;P<0.05), the infection of immediate surgery group was more severe than the other 2 groups (P<0.05). The pairwise comparison of average operation time in neoadjuvant chemotherapy group, neoadjuvant chemoradiotherapy group, and the immediate surgery group, pairwise comparisons of neoadjuvant chemotherapy group and the immediate surgery group in bleeding, comparion of neoadjuvant chemotherapy group and neoadjuvant chemoradiotherapy group on postoperative infection, and the comparison of the 3 groups on pelvic organ injury and lymphocele, had no statistical difference(P>0.05);Pathological examination showed that vascular invasion in surgery group had statistical differences than other 2 groups (P<0.05), there was no patient with positive margin in the 3 groups, and the lymph node metastasis rates also had no statistical difference (P>0.05);Besides, there were no statistical difference on vascular invasion between the 3 groups (P>0.05);And on 3-year overall survival, disease-free survival there was no statistical difference between the 3 groups (P>0.05). Conclusion:Neoadjuvant chemotherapy can effectively reduce tumor size for patients with stage Ⅰb2 bulky cervical cancer before operation, it is better than direct surgery or preoperative chemoradiotherapy in improving the resection rate, and reducing postoperative pathological positive rate, and infection. Neoadjuvant chemotherapy can improve the pathological complete remission rate. The combination of radiation and chemotherapy might produce synergistic effect on huge cervical tumor, but it can’t improve the survival rate. Therefore, neoadjuvant chemotherapy is the best choice for the stageⅠb2 cervical cancer patients. Therefore, a long-term follow-up or large sample randomized controlled trials is necessary to assess the prognosis of preoperative neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy.
6.Clinical analysis of two different chemotherapy regimens for concurrent chemoradiotherapy in advanced cervical cancer for Uyghur women
Lufang WANG ; Nana HAN ; Mingfang RU ; Kaijiang LIU
The Journal of Practical Medicine 2014;(18):2928-2930
Objective To compare theshort-term efficacy and safety between TP and PVB scheme chemoradiation for advanced cervical cancer. Methods Between January 2012 and January 2014, 187 Xinjiang uygur patients with advanced cervical cancer (stageⅡb to Ⅳa) who received concurrent chemoradiotherapy in Xinjiang medical university affiliated tumor hospital were analyzed. A1l cases were divided into two groups receiving radiotherapy concomitant (n = 104), PVB group (n = 83). Theshort-term efficacy and toxicity was evaluated four weeks aftertreatment. Results For squamous cell carcinomas, the response rates were 85.9% and 73.5% in TP and PVB group respectively (P > 0.05). For Non-squamous cell carcinomas (adenocarcinoma and adenosquamous), the response rates were 75.7% and 40% in TP and PVB group respectively (P < 0.05). B one marrow suppression, neurotoxicity, gastrointestinal reactionwere significant different between two groups (P <0.05). Liver and kidney functiondisorder, blood cellsreduction, and radiation damagewere not significantly different (P > 0.05). Conclusions For cervical squamous cell carcinomas, theshort-term efficacy of two chemotherapy regimens is similar while forNon-squamous cell carcinomas, TP regimengroup is superior toBone marrow suppression and neurotoxicity in TP regimengroup is significantly higher than PVB group (P < 0.05), while gastrointestinal adverse reaction lower than PVBgroup.
7.Screening based on MetaCoreTM analysis of potential plasma biomarkers specific for cervical cancer in Uyghur women
Xia GUO ; Kaijiang LIU ; Guizheng WU ; Abulizi ABUDULA
Chinese Journal of Clinical Oncology 2013;(17):1020-1024
Objective:This study constructs networks and screens potential early-warning plasma biomarkers specific for cervical cancer in Uygur women based on the proteomic data of a previous study by using MetaCoreTM Analysis. This study also explains the canceration mechanism of cervical cancer. Methods:A total of 43 plasma differential core proteins, which were analyzed and identified by proteomic techniques, underwent enrichment analysis of protein functional annotation, biological process, cellular component, GeneGo network distribution and network construction, and biomarker assessment by using MetaCoreTM online bioinformatics software. Results:The result of the MetaCoreTM analysis shows that the negative regulation of cellular component organization, reverse cholesterol transport, and negative regulation of response to stimulus were the most frequently identified functions of the selected differential proteins. The regulation of metabolism, bile acid regulation of lipid metabolism, negative farnesoid X-activated receptor-dependent regulation of bile acid concentration, inflammation complement system, cytoskeleton actin filaments, signal transduction estrogen receptor 1 membrane pathway, and inflammation interleukin-6 signaling were identified as the canonical pathways that are overrepresented in cervical cancer. The MetaCore network of selected proteins, which was constructed using the shortest path algorithm with four plasma proteins (antithrombinⅢ(ATⅢ), clusterin (CLU), villin1 (VIL1), and immunoglobulin kappa locus (IGK@)) as candidate biomarkers, was screened. Conclusion:The proteins ATⅢ, CLU, VIL1, and IGK@can be considered candidate plasma biomarkers of cervical cancer. The mechanism of occurrence and de-velopment of cervical cancer was further explained by MetaCoreTM bioinformatics analysis, thereby enhancing the early-warning system for cervical cancer.
8.Granulocyte-Colony Stimulating Factor Mobilizing Autologous Peripheral Blood Stem Cells Transplantation to Form Cardiac Myoid Cells and Angiogenesis
Wenhua LIU ; Yongsheng CHEN ; Xuesong JIANG ; Kaijiang YU ; Haibo LI
Chinese Journal of Rehabilitation Theory and Practice 2007;13(7):626-629,封三
Objective To study autologous peripheral blood stem cells (PBSCs) transplantation for cardiac myoid cells formation and angionesis after recombinant human granulocyte-colony stimulating factor (rhG-CSF) mobilizing. Methods The 60 white Japanese big-ear rabbits were divided into 3 groups, i.e. transplantation (T) mobiliztor (M) and control (C) groups, each group with 20 rabbits. Myocardial infarction (MI) model was developed by ligating the anterior descending coronary artery. G-CSFs were given continually for 7 d in T and M groups since 1 h after MI model development. Cell suspension which derived from the peripheral blood and labeled with BrdU which prepared 1 week ago were injected into infarction regions and borders, while in C groups only the same doses saline was injected. The survival and differentiation of the implanted cells were detected with histological analyses and capillary densities. Results BrdU positive cells which were taken on immature cardiac myoid cells were observed at infarcted areas in T group, which were detected as the Actin positively. HE stains showed that the structures of infarction regions were deranged in C group, but in T and M groups cell arrangements were arranged regularly. Meanwhile, there were a large amount of neogenesis capillaries. The capillaries densities were respectively (58.2 ± 11.5) and (52.3±6.0) per high-power field in T and M groups, while in C group was (21.6±4.9) (P<0.01 ). In C group blue collagen fibers were much more than T and M group under Masson stains (P <0.01). In T and M groups the cardiac functions were much better than in the C group at the end of 4 weeks, especially ejection fraction were respectively (65.34±2.54)% and (63.40±2.84)% in M and T groups. In C group it was only (50.51 ±6.47)% (P<0.01). Conclusion After G-CSF mobilizing the implanted PBSCs may survive and differentiate into cardiac myoid cells in infarcted areas and vicinities, at the same time promote neogenisis and improve cardiac function. It is significant that cell transplantation will treat the cardiac infarction in future.
9.The value of PET/CT in the diagnosis of early cervical cancer with retroperitoneal lymph node metastasis
Zhijun HU ; Kaijiang LIU ; Qing LIU ; Hong ZHU ; Peiquan LI ; Yuxin SUN ; Xuanxuan ZHAO
Journal of Chinese Physician 2021;23(2):193-197,202
Objective:To investigate the value of positron emission tomography/computed tomography (PET/CT) in diagnosis of retroperitoneal lymph node metastasis for early cervical cancer.Methods:Retrospectively analyze the preoperative PET/CT examination results and postoperative pathological results of patients with early cervical cancer who underwent surgical treatment from May 5, 2019 to August 31, 2020, and analyze the clinical characteristics, so as to explore the high risk factors of PET/CT in the diagnosis of retroperitoneal lymph node metastasis.Results:The accuracy, sensitivity, specificity and area under the curve (AUC) of PET/CT in the diagnosis of retroperitoneal lymph node metastasis were 75.2%, 60.0%, 81.3% and 0.707, respectively. Univariate analysis showed that 2009 International Federation of Gynecology and Obstetrics (FIGO) stage, tumor diameter >4 cm, lymphovascular space involvement (LVSI) positive, depth of invasion, high squamous cell carcinoma antigen (SCC-Ag) level and cytological grade were important factors for PET/CT in the diagnosis of retroperitoneal lymph node metastasis ( P<0.05); Multivariate analysis showed that tumor diameter >4 cm was an independent risk factor for PET/CT diagnosis of retroperitoneal lymph node metastasis ( P=0.015). Conclusions:PET/CT has a certain diagnostic value in the evaluation of retroperitoneal lymph node metastasis, but it can not fully reflect the facticity of lymph node metastasis; tumor diameter > 4cm is an independent risk factor for PET/CT in the diagnosis of retroperitoneal lymph node metastasis.
10.High volume hemofiltration therapy in patients with multiple organ dysfunction syndrome
Kaijiang YU ; Mingyan ZHAO ; Yan GAO ; Limin LIU ; Hongliang WANG ; Dongsheng FEI
Chinese Journal of General Surgery 2001;0(09):-
Objective To study the effect of high volume hemofiltration(HVHF) in patients with multiple organ dysfunction syndrome (MODS). Methods Nineteen MODS patients were divided into two groups randomly, 10 patients receiving HVHF and 9 patients treated by routine continuous venovenous hemofiltration(CVVH).Artery blood was sampled before and 2、4、8 hours after HVHF and CVVH, concentrations of Scr, BUN, TNF?, IL 1?, IL 6 and blood gas were measured.Results In both HVHF group and CVVH group, the 4th hour Scr、BUN decreased significantly, renal function improved. In HVHF group compared with pre-treatment level the 4th hour concentrations of TNF?[(1 759?506)ng/L vs. (1 265?397)ng/L]、IL-1?[(964?185)ng/L vs. (511?124)ng/L]、IL-6[(1 332?415) ng/l vs. (726?243)ng/L] decreased singificantly. In CVVH group, the 4th hour concentrations of TNF?[(1 799?511) vs.(1 327?421) ng/L] decreased significantly (all P