Objective To investigate the risk factors of cervical cancer in Chinese married women in recent 10 years in order to provide evidence based approaches for cervical cancer prevention and control Methods Eight case-control studies from 2002 to 2011 were selected from research literatures by using keywords such as cervical cancer, risk factors, influential factors and case-control study, cancer, risk factors, factors andcase-control study as the search term.We adopted the Mentel-Haensel fixed effect model and Dersimonion-Laird random effect model to gain a comprehensive and quantitative assessment of cervical cancer and its risk factors.Results Among the 8 case-control studies,the total number of cases and controls were 2868 and 8045,respectively.The risk factors included human papilloma virus (HPV) (RR =5.47,95 ％ CI:3.40-8.82),family history of cervical cancer (RR =2.40,95 ％ CI:1.39-4.16),number of abortions (RR =1.74,95％ CI:1.49-2.03),first sexual intercourse age number of sexual partners (1.72,95％ CI:1.36-2.16),low cultural level (RR =1.68,95％ CI:1.18-2.40).Conclusion The major risk factors for cervical cancer among married women in China included HPV,family history of cervical cancer,number of abortions,first sexual intercourse age number of sexual partners and low cultural level.

Purpose: To discuss the influences of blood vasculature of pulmonary carcinoma to the intervention methods and curative effect and its clinical significance. Materials and Methods.(1) The bronchical arterigrams in 60 cases of advanced stage pulmonary carcinoma were analyzed retrospectively. (2) 35 cases were treated with BAI(bronchical arterial infusion) and BAE(bronchical arrterial emboliza- tion), 25 cases with BAI alone. Treatment persisted for 4 weeks. Results: 36 cases were hypervascular 20 cases with moderate vasculature and 4 cases belonged to hypovascular. The efficiency rate of BAI and BAE 76.7% and total efficieney rate is 95%. No severe complications have taken place. Conclusion: BAI and BAE are effective for pulmonary carcinomas of hypervasculas and moderate vascular types. They are safe, effective and simple methods.

BACKGROUND:There are stil about 10%-30%of patients presenting no obvious improvement of symptoms after lumbar disc herniation surgery, which are col ectively known as the lumbar spine post-surgery failure syndrome, and lumbar instability is one of the important reasons. OBJECTIVE:To evaluate the feasibility and efficacy of surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation on lumbar intervertebral disc protrusion concurring lumbar instability via MAST Quadrant retractor. METHODS:From December 2011 to October 2012, 62 cases of lumbar intervertebral disc protrusion concurring lumbar instability were treated with posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor. There were 38 female and 24 male ranging in age from 37 to 69 years (average 53.7 years). After operation, al patients were fol owed-up to evaluate the effect of the treatment. RESULTS AND CONCLUSION:The operative time was 90-210 minutes, average 145 minutes, and the amount of blood loss was 50-300 mL, average 120 mL. The hospitalization time was 5-9 days, average 6 days. Al incisions healed by first intention. Al patients were fol owed up 7.2 months on average (from 3 to 10 months). The preoperative JOA score was (10.25±2.34) points. The postoperative JOA score decreased to (18.31±3.12) points at the fol ow-up after 1 month and (25.35±2.61) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). The preoperative VAS score was (8.24±1.15) points. The postoperative VAS score decreased to (2.97±1.12) points after 1 month and (1.13±0.39) points at the last fol ow-up, showing significant difference when compared with preoperative score (P<0.01). According to reforming Macnab standard, the results were excel ent in 53 cases and good in 9 cases at the last fol ow-up. The surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor is a safe, effective and minimal y invasive surgical technique in treating lumbar intervertebral disc protrusion concurring lumbar instability.

e the individual choice depending on their different conditions.

Objective To analyze the changes in epidemiology and treatment of hospitalized patients with cervical cancer during 1990-2007.Methods Overall.4648 patients witIl cervical cancer were diagnosed in our hospital from Jan 1990 to Nov 2007.but only 4223 patients with initial treatment in Oily hospital were studied retrospectively.Pearson Chi-square test was used to compare tlle age,stage,histopathologie type and treatment metheds between different times.Results (1)The meal]age of cervical cancer patients gradually decreased over the past 18 years,from 54.4 years during 1990-1999 to 47.2 years during 2000-2007:the proportion of young patients aged≤35 years increased from 4.77%(89/1865)during 1990-1999 to 11.75%(277/2358)during 2000-2007.(2)The proportion of patients with cervical cancer(stage I a-H a)increased from 14.32%(267/1865)during 1990-1999 to 40.75%(961/2358)during 2000-2007,whereas the proportion of patients with cervical cancer(stage Ⅱ b-lV)decreased from 85.68%(1598/1865)during 1990-1999 to 59.25%(1397/2358)during 2000-2007.(3)There was no significant change in histopathologie type of cervical cancer,and squamous cell careinoma of cervix remained the main type of cervical cancer.(4)The treatment pattern of cervical cancer changed significantly:radiotherapy was the main method(75.28%)for eervical cancer during 1990-1 999.but during 2000-2007.it was replaced by concurrent chemoradiotherapy(35.79%).Conclusions The proportion of young women with cervical cancer was increased during 1990-2007.and at the same period early stage cervical cancer increased.but late stage cervical cancer decreased.It is obvious that chemotherapy has become the important therapy in cervical cancer.

Objective To investigate the risk factors for ovarian metastasis and the possibility of ovarian preservation in patients with endometrial carcinoma.Methods The clinicopathological features of endometrial carcinoma patients who were diagnosed and treated initially with a surgical staging procedure from Jan 1997 to Dec 2006 in our hospital were retrospectively reviewed.Results Of the 638 cases reviewed,36(5.6%,36/638)had ovarian metastasis.Univariate analysis revealed that histological type and grade,myometrial invasion,positive peritoneal fluid cytology,pelvic lymph node metastasis,invasion of parauterine,para-aortic node metastasis and invasion of uterine serosa were significantly associated with ovarian metastasis(P＜0.05);while age,lymph-vascular invasion and cervical invasion wen not significantly associated with ovarian metastasis(P＞0.05). Factors predictive of ovarian metastasis by multivariate analysis were ranked as follows according to risk intensity:pelvic lymph node metastasis,positive peritoneal cytology,and histological grade.Conclusion In young patients with grode 1 endometrioid carcinoma,with no pelvic lymph node metastasis,no para-aortic lymph node metastasis,no myometrial invasion and with negative peritoneal fluid cytology,ovarian preservation could be considered.

Objective To investigate the relationship between adhesion molecule CD44v6,intercellular adhesion molecule-1 (ICAM-1) and lymph node metastasis in early stage of cervical squamous cell carcinoma.Methods Seventy-four specimens of cervical cancer stage Ⅰ b1,20 specimens of normal cervical tissue and 20 specimens of cervical squamous cell in situ carcinoma were collected from Jiangxi Provincial Maternal and Child Health Care Hospital.The expression of CD44v6 and ICAM-1 in cervical tissue was detected by real-time PCR and immunohistochemistry.The lymphatic vessel density (LVD) labeled by D2-40 was detected by immunohistochemistry.The relationship of CD44v6,ICAM-1 and LVD with the differentiation degree and lymph mode metastasis was investigated.Results The positive expression rate of CD44v6 and ICAM-1 in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma tissues was gradually increased,which were 0,75.00％,87.84％ and 10.00％,45.00％,81.08％ respectively.Their mRNA expression amount was gradually increased,which were 0,0.24±0.02,1.02±0.11 and 0.10 ± 0.00,0.19±0.02,1.03 ± 0.10 respectively,the differences were statistically significant (P＜0.01).LVD was gradually increased in normal cervix,cervical squamous cell carcinoma in situ,and cervical carcinoma (P＜0.01).The expression of CD44v6,ICAM-1 and LVD in low differentiated cervical carcinoma tissue was higher than that in high and middle differentiated cervical carcinoma (P＜0.01).The expression of CD44v6,ICAM-1and LVD in lymph node metastasis was higher than that in non-lymph node metastasis (P＜0.01).The expression of CD44v6,ICAM-1 and LVD in cervical cancer tissue had each two positive correlation (P＜0.01).Conclusion CD44v6 plays a promoting role in the progression of cervical cancer,which with ICAM-1 and LVD synergically promote the cervical cancer development,and could be used as an effective indicator for judging lymph node metastasis and diagnosis of cervical cancer.

Objective To analyze the clinicopathologic features of mucinous cervical adenocarcinoma (ADC) and supply some reference for its diagnosis,treatment and prognosis.Methods Totally 88 cases with primary mucinous ADC diagnosed between January 2003 and December 2007 in Jiangxi Maternal and Child Health Hospital were retrieved.Their clinical and pathological data were reviewed and analyzed.Results Among 88 patients,70 cases of them were endocervical ADC,11 cases were minimal deviation adenocarcinoma (MDA),2 cases were intestinal subtype and 5 cases were villoglandular ADC.The positive rate of cervical Pap smear cytology was only 28％ (10/36).There were 10 cases were performed several times of cervical Pap smear cytology test and biopsies,while still no abnormality was found.Finally,7 cases of them were diagnosed by cervical excisional biopsy and endocervical curettage,including 5 cases with endocervical ADC and 2 cases with MDA; 2 cases (1 case with stage Ⅰ b1 endocervical ADC and 1 case with Ⅰ b1 MDA) were diagnosed by cold knife conization,and 1 case with stage Ⅰ b1 endocervical were diagnosed by uteroscopically directed biopsy.The overall 5-year survival rate was 60.0％.Using univariate analysis results showed that age (P =0.046),stage (P =0.007),tumor size (P =0.007) and therapeutic methods (P =0.009) were significant prognostic factors.Multivariate analysis showed that therapeutic methods was an independent predictor for survival (P =0.013).Stage Ⅱ b-Ⅲ b MDA patients occupied 7/11 of all MDA patient,while there was only one such patient of 5 cases with villoglandular ADC.The overall HPV infection rate was 65％ (57/88),and there was no obvious differences about the HPV infection rates among different types of mucinous ADC.Conclusions Cervical smear cytology is of little significance to the diagnosis of mucinous cervical adenocarcinoma.Early stage mucinous ADC is difficult to be detected,especially for MDA.Cervical excisional biopsy,endocervical curettage,cold knife conization,uteroscope are beneficial to its diagnosis.Therapeutic methods is an important prognostic factor for mucinous ADC and comprehensive treatment should be given to those patients with risky postsurgical factors.

Objective To compare the clinical effects and side events between simple synchronal radiochemotherapy(group A) and cervical local implantation chemotherapy combined with synchronal radiochemotherapy(group B) in advanced cervical cancer.Methods Sixty patients with primary cervical cancer,admitted to our hospital from January 2009 to December 2009,were enrolled into the study.The clinical staging of these patients ranged from Ⅱb to Ⅲb.The patients were randomly divided into two different therapy groups.In group A,patients received external irradiation by X-rays and intracavitary by 192 Ir and PT chemotherapy(n=30).In group B,patients received cervical local implantation of fluorouracil palliative 400-500 mg in addition of external irradiation by X-rays and intracavitary by 192 Ir and PT chemotherapy(n=30).The short-term effect and complications were compared between the two groups.Results The effective rate of group A was significantly higher than the second group(97% vs.80%,x2=4.706,P＜ 0.05).The most common complication was myelosuppression.In group A we observed 8 cases had grade Ⅰ,10 cases had grade II,9 cases had grade Ⅲ,3 cases had grade Ⅳ myelosuppression.In group B we observed 8 cases had grade Ⅰ,12 cases had grade Ⅱ,7 cases had grade Ⅲ,3 cases had grade Ⅳ myelosuppression.There were no significantly differences in the comparisons of this complication between the two groups(x2=0.432,P＞0.05).Conclusion The cervical local implantation chemotherapy combined with synchronal radiochemotherapy might improve the prognosis in advanced cervical cancer patients without increasing toxic side effects.

Objective:To analyze the prenatal clinical characteristics and genetic etiology of Wolf-Hirschhorn syndrome manifested by severe fetal growth restriction (FGR).Methods:Clinical data of three pregnant women admitted to Changsha Hospital for Maternal and Child Health Care from 2018 to 2020 due to severe FGR with or without other malformations diagnosed by prenatal ultrasound were collected. Amniotic fluid samples obtained by ultrasound-guided amniocentesis were analyzed by conventional G-banding staining technique and single nucleotide polymorphism array (SNP array). Parental peripheral blood cells were collected for SNP array to verify the source of variation.Results:(1) The karyotypes of both case 1 and 2 were normal, while case 3 had an abnormal karyotype of 46,XN,der(4)(9pter→9p23::4p15.31→4qter). (2) SNP array indicated a 7.8 Mb microdeletion in 4p16.3p16.1 cytoband in case 1 and a 5.5 Mb microdeletion in 4p16.3p16.2 cytoband in case 2, which were both de novo copy number variations. Case 3 harbored a 19.88 Mb deletion in 4p16.3p15.31 and a 10.89 Mb duplication in 9p24.3p23. (3) All three fetuses were diagnosed as Wolf-Hirschhorn syndrome, and their parents chose to terminate the pregnancies after genetic counseling. Conclusions:Considering the possibility of genetic disease, invasive prenatal diagnosis is suggested when prenatal ultrasonography showed severe FGR, regardless of other malformations, to clarify the cause and guide genetic counseling.