ObjectiveTo analyze the expression and clinical significance of Maspin, vascular endothelial growth factor (VEGF) in endometrioid adenocarcinoma tissue samples. MethodsForty-nine cases of endometrioid adenocarcinoma, 12 cases of atypical hyperplasia of endometrium and 15 cases of normal endometrium were selected. Immunohistochemistry was used to study the expression of Maspin,as well as VEGF. ResultsThe expression of Maspin was none in normal endometrium,while the positive rates of Maspin in atypical hyperplasia of endometrium (41.7％, 5/12 ) and endometrioid adenocarcinoma (59.2％,29/49) were ascending, there was statistical significance among the three groups (P＜0.01 ). The positive rates of VEGF in normal endometrium ( 13.3％, 2/15 ), atypical hyperplasia of endometrium ( 33.3％, 4/12 ),endometrioid adenocarcinoma (67.3％ ,33/49) also were ascending (P＜ 0.01 ). The expression of Maspin was related with the FIGO stage in endometrioid adenocarcinoma (P=0.034), and the expression of VEGF was related with the myometrial invasion(P = 0.036). There was positve correlation between the expression of Maspin and VEGF (r = 0.307,P＜0.05). ConclusionsThe expression of Maspin, VEGF in tumor tissue has a significant correlation with the level of invasion of endometrioid adenocarcinoma. The expressions of Maspin,VEGF apparently play an essential role in the development and invasion of endometrioid adenocarcinoma.

Objective:Using the established epilepsy patient database to validate the efficacy of the web-based epilepsy diagnosis and anti-seizure medications (ASM) selection tool, EpiPick, for domestic epilepsy patients.Methods:The retrospective collection of clinical data was conducted on patients aged 10 and above who were diagnosed with epilepsy at the Comprehensive Epilepsy Center of the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2020, with regular follow-up and complete information. According to the first ASM recommended by the EpiPick tool and whether they are consistent with the actual ASM used by patients, patients were divided into EpiPick group and clinical group to verify the effectiveness of the EpiPick tool in selecting ASM. The drug retention rate, Engel score, and cumulative probability of no consecutive episodes within 30 months after using the first ASM were compared between the 2 groups, and Kaplan-Meier survival curves were drawn. Finally, the diagnostic results provided by the EpiPick tool were compared with the actual types of epileptic seizures diagnosed clinically, and consistency tests were performed.Results:A total of 364 epilepsy patients were included, including 237 in the EpiPick group and 127 in the clinical group. The ASM retention rates of patients in the EpiPick group and clinical group were 67.9%(161/237) and 56.7%(72/127), respectively, with statistically significant differences (χ2=4.534, P=0.039). Grades Ⅰ, Ⅱ, Ⅲ and Ⅳ according to the Engel scores in the EpiPick group patients who took the first ASM after diagnosis accounted for 47.3%(112/237), 14.8%(35/237), 12.7%(30/237), and 25.3%(60/237), respectively, compared to the clinical group of 32.3%(41/127), 11.8%(15/127), 11.0%(14/127), and 44.9%(57/127), respectively. There was a statistically significant difference in Engel scores between the 2 groups (χ2=14.968, P=0.002). The cumulative seizure-free rates in the EpiPick group at the 1st, 6th, 12th, 30th month and above after starting the first ASM were 73.8%, 61.2%, 53.2%, and 50.6%, respectively, which in the clinical group were 52.0%, 44.1%, 40.2%, and 33.5%, respectively. The logrank test showed a statistically significant difference in the cumulative probability of consecutive seizure freedom between the 2 groups ( HR=0.644 ,95% CI 0.476-0.871 ,P<0.001). After grouping by seizure type [focal seizures (196 cases) and generalized seizures (168 cases)], the cumulative seizure-free rates at the 1st, 6th, 12th, 30th month and above after starting ASM were significantly higher in the EpiPick group than in the clinical group (comparison between the 2 groups in patients with focal seizures: HR=0.654, 95%CI 0.443-0.964, P=0.004; comparison between the 2 groups in patients with generalised seizures: HR=0.586, 95%CI 0.361-0.954, P=0.014). Among 364 patients, 293 cases were clinically diagnosed with seizure classification consistent with the classification results of EpiPick tool. Agreement between the algorithm and the experts in classifying generalized seizures was 83.9%(104/124), which in classifying focal seizures was 78.8%(189/240; Kappa=0.591, P<0.001). Conclusion:Web-based EpiPick tool is suitable to be used to select the first ASM, and is portable for Chinese non-epilepsy specialists to choose ASM for epilepsy patients.