Objective To investigate the chemosensitivity of ovarian cancer SKOV3ip1 multicellular aggregates to cisplatin and taxol and to explore the possible mechanisms accounting for the effect Methods Liquid overlay system was employed to obtain multicellular aggregates (MCA) We detected the resistance with trypan blue exclusion testing, clonogenic assay, cell cycle profiles and apoptosis with flow cytometry Results MCA cells showed higher cell viability than monolayer cells ( P =0 045 and P =0 003, respectively). After 40 ?mol/L cisplatin exposure for 12 hours, no clone (≥50 cells) was formed After 10 ?mol/L taxol exposure for 12 hours, the clone formation showed significant difference in 100 cell group between multicellular aggregates and monolayer cells ( P

Purpose Polypoid endometriosis is an uncommon and distinctive variant of endometriosis, and its detailed histopathological features have been investigated and analysed. Methods A retrospective analysis was performed in 10 cases with polypoid endometrio-sis by comparing clinical data, histopathologic and immunohistochemical changes. Results The patients were 27 to 54 years ( mean 39. 4 years) of age. The most common clinical presentations were a pelvic mass. The intraoperative findings suggested a neoplasm. Sites of involvement in order of frequency included ovary, uterine serosa and cervix. Polypoid, pink, gray or tan masses ranged up to 9 cm in maximal dimension. On microscopic examination, the polypoid masses were composed of an admixture of endometriotic glands and stroma. Most commonly glandular architectural patterns were simple hyperplasia. Tubal epithelial metaplasia was common. The stroma was fibrous, resembling to some extent the stroma of the endometrial polyp and atypical stromal cells can be seen. Nine cases were associated with usual endometriosis. Follow-up data in nine patients indicated that all of patients were alive without evidence of re-sidual disease. The main lesion in the differential diagnosis is a mullerian adenosarcoma. Conclusion Polypoid endometriosis is a rare manifestation of endometriosis, and probably is overgrowth of local ectopic endometrium based on endometriosis. Understanding of such lesions is avoided misdiagnosing for other benign or malignant tumors on clincal, intraoperative or pathologic assesment, and influ-ences the clinical treatment.

Objective To observe the impact of Angong Niuhuang Wan(安宫牛黄丸) on orexin-A,neuropeptide Y(NPY) and Leptin in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Total 50 mild and moderate cases of OSAHS which were definitely diagnosed by the results of polysomnogram′s monitoring were selected and randomly divided into treatment group and control group(each n=25).The treatment group took one pill of Angong Niuhuang Wan everyday before sleep for 30 days,while the control group received no treatment.Then the levels of orexin-A,NPY and Leptin were tested by radio-immune assay and enzyme linked immunosorbent assay(ELISA) to compare the changes of 3 indexes before and after the treatment and compare the result differences between the two groups.Results Compared with the control group,after treatment,apnea hypopnea index(AHI) and arousal index of treatment group were obviously decreased((16.33?3.57) times/h vs.(22.23?9.98) times/h,(103.58?32.90) times/s vs.(127.89?42.78) times/s),the average pulse oximetric saturation(MSpO2) and the lowest pulse oximetric saturation(LSpO2) were significantly increased(0.950?0.032 vs.0.934?0.048,0.830?0.041 vs.0.826?0.127,P0.05).The correlative analyses indicated that the levels of orexinA,Leptin and NPY in the patients of OSAHS had positive correlations with AHI(r1=0.445,r2=0.480,r3=0.454) and awareness index(r1=0.613,r2=0.510,r3=0.479,P

Objective To clarify the clinicopathological features of ovarian clear cell carcinoma derived from endometriotic cyst (EC-OCCC).Methods Totally 54 cases of EC-OCCC were recruited in the current retrospective study.The relation between ages, clinical symptoms and signs, surgical and pathological stages, serum CA125, findings of ultrasound, treatments and the sites of tumors, macro-and micro-features and expression of immunostainings were analyzed.Results (1) Clinical features: the ages of patients were (50±6) years old (range 31-62 years old).Pelvic mass was the major complaint of 50 patients (93％, 50/54).Forty-five cases belonged to International federation of Gynecology and Obstetrics (FIGO) stage Ⅰ, 4 cases were stage Ⅱ and another 5 cases were stage Ⅲ.Serum CA125 was elevated in 21 cases (54％, 21/39) before therapy.Doppler ultrasound showed 46 cases (85％, 46/54) had solid masses in pelvis.(2) Pathological findings: 52 cases (96％, 52/54) had their tumor unilaterally, and 2 cases (4％, 2/54) occurred bilaterally.The maximal diameters of endometriotic cyst (EC) ranged from 1.5 to 23.0 cm and maximal diameters of ovarian clear cell carcinoma (OCCC) components were from 0.5 to 12.0 cm.Fifty-one cases (94％, 51/54) had their tumor within EC, which showed focally irregular protrudings, grey-white papillae or solid nodules attached to the cyst wall.Three cases (6％, 3/54) appeared as irregular thickened wall of the cysts, ranged from 1.5 to 6.0 cm in the maximal length, with the microscopic features of EC and OCCC and the transitional areas between the 2 morphologies.All cases expressed cytokeratin (CK) 7 and pan-CK AE1/AE3, 17 cases (33％, 17/51) expressed ER and 5 cases (10％, 5/51) expressed PR.TP53 showed mutational phenotype in 19 cases (36％, 19/53).Sixteen cases (30％, 16/54) combined with uterine adenomyosis and 25 cases (46％, 25/54) with endometriosis at other sites.(3) Survival survey: during the period of 39.1 months follow-up, 3 cases relapsed and 2 cases died.(4) There was a significant difference of serum CA125 between patients of early-and advanced-stages (P=0.049).There were no differences identified in ages, diameters of EC and OCCC, the expression level of ER, PR and TP53, the co-existence of adenomyosis and endometrosis, as well as ultrasonic findings (P＞0.05).Conclusion EC-OCCC could be recognized in early stage by symptoms and ultrasound due to accompanied endometriotic cysts, resulting in relatively good prognosis.

Gynecological pathology, formed in the late 19th century, has greatly prompted the development of gynecology with its continuous exploration since the early time. In the progress of over 130 years, gynecological pathology has formed a completed set of scientific system by absorbing the contemporary advanced technologies and cooperating with gynecologists. In China, the late-started gynecological pathology has been faced with the dilemma of imbalanced regional development and endowed with the dual tasks of dissemination and self-improvement. In future, gynecological pathology in China needs to solve the following problems: (1) improving diagnostic accuracy of squamous intraepithelial lesions of the female genital tract and cervical adenocarcinoma in situ; (2) giving special attention to the correct diagnosis of hormone-related diseases especially tumor-like lesions; (3) focusing our efforts on the difficulties in clinical practice as well as the growing demands of clinical treatments; (4) actively utilizing molecular biological techniques and exploring options in accord with domestic conditions; (5) standardizing diagnostic terminology and providing the essential prognostic parameters for clinical application.

OBJECTIVE:To establish a method for simultaneous determination of gallic acid,magnoflorine,ellagic acid,jatrorrhizine hydrochloride,palmatine hydrochloride,berberine hydrochloride and curcumin in Siwei jianghuang decoction powder.METHODS:HPLC method was adopted.The determination was performed on Capcell Pak C18-MG Ⅱ column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid (gradient elution) at the flow rate of 0.8 mL/min.The detection wavelengths were 270 nm (0-60 min,gallic acid,magnoflorine,ellagic acid,jatrorrhizine hydrochloride,palmatine hydrochloride,berberine hydrochloride) and 428 nm (60-70 min,curcumin).The column temperature was set at 30 ℃,and sample size was 10 μL.RESULTS:The linear ranges of gallic acid,magnoflorine,ellagic acid,jatrorrhizine hydrochloride,palmatine hydrochloride,berberine hydrochloride and curcumin were 0.249 6-1.497 6,0.284 0-1.704 0,0.075 6-0.453 6,0.015 9-0.095 9,0.023 6-0.141 6,0.098 2-0.589 0 and 0.060 4-0.362 4 μtg (r≥0.999 8).The limits of detection were 6.24,4.73,7.56,2.36,3.20,6.54,6.04 ng,and the limits of quantitation were 17.47,16.08,20.86,7.31,10.24,19.62,19.32 ng,respectively.RSDs of precision,stability (12 h),reproducibility tests were lower than 2.0％ (n=6).The recoveries were 95.45％-103.47％ (RSD=0.86％-1.98％,n=9).CONCLUSIONS:Established method is simple,accurate,reliable and suitable for simultaneous determination of 7 components such as gallic acid in Siwei jianghuang decoction powder.

OBJECTIVE:To optimize extraction technology of cortex of Berberis dictyophylla by ethanol. METHODS:Using the contents of magnoflorine,jatrorrhizine hydrochloride,palmatine hydrochloride and berberine hydrochloride,the amount of extract as evaluation indexes,the effects of ethanol amount,volume fraction of ethanol and extraction time on extraction technology were investigated by uniform design method-comprehensive scoring method. The extraction methods of first time, second time and third time were investigated by 3 times of uniform design test. The optimal schemes of 3 times of extraction test were determined and validation test was conducted,and the transfer rates were calculated. RESULTS:The optimal technology was as follows as coarse powder of cortex of B. dictyophylla,15-fold 75% ethanol,extracting for 2 times,120 min each time. In validation test,the contents of magnoflorine,jatrorrhizine hydrochloride,palmatine hydrochloride and berberine hydrochloride were 58.96,4.82,3.07,23.29 mg/g after B. dictyophylla was extracted by optimization technology for 2 times. The transfer rates were 93.85%,95.02%,96.28%,94.88%,respectively(RSD=3.87%,2.64%,4.00%,3.91%,n=3). CONCLUSIONS:The optimal ethanol reflux extraction technology of cortex of B.dictyophylla is reasonable and feasible with good stability.

Objective: To identify underlying reasons for discrepant cases of positive cytology but negative histology. Methods: Cases with positive cytology and negative histology from 2008 to 2016 were retrieved from Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University. Low grade squamous intraepithelial lesion or higher grade lesions were considered as positive cytology test in the study. Consecutive follow-up biopsies and as well as sites of biopsy were documented for analysis. Results: Overall positive rate of biopsy followed positive cytology was 74.3%(8 990/12 097). Of the negative biopsies, 675 cases were followed-up with multiple biopsy. Two-hundred and eighty-seven cases (42.5%, 287/675) were confirmed to have lesions. Comparing with those with initial positive biopsiews, patients of the latter group were significantly older and had other specimen types including vaginal biopsy, cone biopsy and hysterectomy. The final histological diagnoses were well correlated with cytological results (Kappa=0.505, P<0.01). Conclusions Qualified cervical cytology is complimentary to histological diagnosis. Clinicians should not ignore the positive cytological result prior to a normal histological diagnosis. In contradictory cases, repeated colposcopy and biopsy at extended anatomic sites may reveal additional lesions.

Objective: To describe the clinicopathological features of synchronous mucinous metaplasia and neoplasia of the female genital tract (SMMN-FGT). Methods: The sample consisted of 7 cases of SMMN-FGT recorded from November 2014 to September 2017 at Obstetrics and Gynecology Hospital, Fudan University.PAP method was used in immunohistochemistry.Clinical histories were retrieved and pathological slides were reviewed. Results: The patients were 37 to 70 years old(mean 54 years old). All patients showed endometrial mucinous lesions associated with cervical lesions. Three cases were an admixture of minimal deviation adenocarcinoma(MDA) and gastrictype adenocarcinoma(GAS). Three cases were an admixture of lobular endocervical glandular hyperplasia (LEGH), atypical LEGH and focal gastrictype adenocarcinoma in situ, one of which had early invasive gastrictype adenocarcinoma.Endometrium showed a structure of LEGH in one patient with focal simple gastric mucinous metaplasia in her cervix. Gastric mucinous differentiation was found in unilateral fallopian tube in 6 patients. Ovarian mucinous lesions were found in 3 patients. p16 was negative staining in 6 cases and positive in 1 case. CK7 was diffusely positive in all lesions. CK20 and CDX2 were negative or only focally positive.The expression of MUC6 was strongly positive staining or focal staining. p53 in GAS and GAS in situ had mutant expression, but wild expression in MDA region. Patients were followed up for 2 to 34 months and no recurrence was found. Conclusions SMMN-FGT is a series of rare mucinous lesions involving multiple areas of the female genital tract, including benign or malignant lesions with gastric differentiation. It is not related to infection with high-risk human papilloma virus. When cervical gastrictype lesions are found, SMMN-FGT should be considered and should be differentiated from metastatic mucinous adenocarcinoma.

Objective:Placental pathology reflects the health condition of both mother and fetus during pregnancy, providing information about pathogenesis especially in adverse pregnancies, and may provide guidance on subsequent pregnancies. Description on the placental changes after long-term use of rivanol is lacking, and this evaluated the placental changes, with emphasis on the differential diagnosis from other primary placental lesions.Methods:A total of 85 placentas from rivanol induced abortion submitted to the Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University from Januaury 2017 to October 2019 were reviewed; and 81 gestational-age-matched cases of spontaneous abortion or preterm delivery during the same period were also included as the control group. Diagnoses were based on the consensus statement of 2016 Amsterdam Placental Workshop Group. Statistical differences were analyzed by individual diagnostic terms.Results:The maternal age in rivanol group was (30.5±4.1) (range 22-41) years, compared with (30.9±4.3) (range 22-44) years in the control group. Gestational age was (23.2±3.5) (range 17-35) weeks and (23.3±2.8) (range 17-33) weeks in the rivanol and control groups. The incidence of chorioamnionitis in rivanol group was 91.8%, significantly higher than the control (63.0%, P<0.05); and there were more stage 1 (subchorionic) maternal response in rivanol than in the control (61.0% vs.28.6%, P<0.05) groups. In addition, acute deciduitis was also more common in rivanol group (27.1% vs. 13.6%, P<0.05). No significant difference was observed in fetal inflammatory responses (vasculitis of vessels in chorion plate and umbilical cord); maternal malperfusion (narrowing of intervillous space, increased intervillous fibrin deposition, decidual arteriopathy, villous infarction and retroplacental hematoma); and fetal malperfusion (villous stromal hemorrhage and avascular villi). Conclusions:The chemical chorioamnionitis caused by rivanol is characterized by maternal inflammatory response of low stage and high grade. The use of rivanol has no obvious impact on the fetal inflammatory response, maternal malperfusion and fetal malperfusion. Such morphologic changes may reflect the original placental lesions.