With the advancement research on target therapy,more and more target drugs have been applied in the treatment of endometrial cancer,including anti-TKI or monoclone antibody and inhibitors in molecular signal pathways like mTOR,all of which have shown good therapeutic effects.As there were only on some phaseⅡclinical trials,so randomized stageⅢclinical trials are required to confirm these effects.In this review,the author discusses the advancement of target therapy in endometrial cancer.

Objective To investigate the effect of IGF-1 on the TGF-β3 induced chondrogenesis of MSCs encapsulated in alginate beads and its application in cartilage tissue engineering.Methods MSC chondrogenesis in alginate beads was induced by TGF-β3 and/or IGF-1.Collagen type Ⅱ,aggrecan and Sox-9 expression was evaluated by immunostaining,RT-PCR and Western blot,respectively.Scanning electron microscope and laser confocal microscope were used to observe the differentiated chondrocytes when cultured on the chitosan-based scaffold.Results TGF-β3 with IGF-1 induced MSCs in alginate beads to express the higher level of collagen type Ⅱ,aggrecan and Sox-9 than any other growth factor alone (P＜0.05).The correlation coefficient between Sox9 and collagen type Ⅱ or aggrecan was 0.95 and 0.91,respectively.The chitosan-based scaffold supported the cell's adhesion,migration and proliferation.Conlusion IGF-1 enhances the TGF-β3-induced MSC chondrogenesis via upregulating Sox9 expression.The chitosan-based scaffold is biocompatible with the differentiated chondrocytes.

Uterine papillary serous carcinoma is a special pathological type of endometrial cancer. It is similar to ovarian papillary serous carcinoma in histology and can have distant metastasis when it is still confined to the endometrium. As it is very aggressive and has a rather poor prognosis,complete surgical staging is necessary in the treatment,assisted by radiotherapy and chemotherapy. In this review,the author discussed the recent research advances in uterine papillary serous carcinoma.

This assay reviewed the feeding arteries of CHL and summarized the mechanism,technologic method and common embolization agent of interventional therapy,as well as its effect,indications,contraindications and complications.

Objective To preliminarily explore the early process of hepatitis B virus (HBV) infection in HepG2 cells induced by dimethyl sulfoxide(DMSO) ,and provide cytological bases for mechanism study of HBV infection in vitro .Methods HepG cells were divided into the DMSO inducing group and control group ,and were cultured 4 days by DMEM containing 1 .5% DMSO and normal DMEM respectively ;changes of cellular morphology were observed .In addition ,selected ECV304 cells as the negative con‐trol group and treated with DMSO .Cells in the three groups were incubated 2 hours with HBV positive serum after culturing 24 hours ,then trypsin digestive solution ,HepG2 cells and ECV304 cells were collected and polymerase chain reaction (PCR) was used for the determination of HBV DNA .Simultaneously ,the blank control group was set ,and the position of HBsAg on HepG2 cells were detected by using indirect immunofluorescence .Results HepG2 cell volume in the DMSO inducing group was obviously in‐creased .HBV DNA was found in HepG2 cells both in DMSO inducing group and control group ,and DMSO inducing group ex‐pressed much stronger .The results of IIF shown that green fluorescent signals of cell membrane and cytoplasm of HepG 2 cells in the DMSO inducing group were increased obviously ,while the results of HBV DNA and IIF both were negative in the negative con‐trol group .Conclusion DMSO could facilitate adsorption of HBsAg in some extent ,which are benefit for completing the process of early infection .

Objective To explore the feasibility of application of data mining in the study on selection and specificity of acupoints.Methods The ancient and modern prescription data of acupuncture treating migraine and functional dyspepsia were regarded as sample data. Database techniques and natural language processing techniques were introduced to structurize and standardize acupuncture prescription data. Based on association rule data mining, the self-developed Acupuncture Data Mining System was applied to discover the rules of selection of acupoints.Results There were collected 634 and 386 prescriptions of acupuncture treating migraine and functional dyspepsia respectively. In the prescriptions treating migraine, acupoints distributed on Gallbladder meridian and Triple Energizer meridian accounted for 40.5% and 50.6% in ancient time and modern time respectively, and specific points accounted for 84.0% and 82.8% in ancient time and modern time respectively. In the prescriptions treating functional dyspepsia, acupoints distributed on Conception vessel, Bladder meridian and Stomach meridian accounted for 62.1% and 75.7% in ancient time and modern time respectively, and specific points accounted for 70.0% and 83.3% in ancient time and modern time respectively.Conclusion The result of data mining proves that the rule of selection of acupoints is "selecting acupoints along the affected meridian" and "mostly selecting specific points", and the specificity of acupoints is "where the meridian goes, where the qi accumulates".

Objective To evaluate the clinical significance of positive peritoneal cytology in patients with endometrial cancer.Methods The records of 315 patients with endometrial cancer who were operated at Cancer Hospital, Fudan University between January 1996 and December 2008 were reviewed.Peritoneal cytology were performed and diagnosed in all patients.Factors related with peritoneal cytology were analyzed by correlation analysis.Log-rank test and Cox regression test was used for the analysis of prognosis,respectively.Results (1) Peritoneal cytology were positive in 30 (9.5%) patients.Positive peritoneal cytology was associated with pathological subtype ( P = 0.013 ), stage ( P = 0.000 ), myometrial invasion ( P =0.012), lymph-vascular space invasion ( P = 0.012 ), serosal involvement ( P = 0.004 ), cervical involvement ( P = 0.016), adnexal involvement ( P = 0.000), and omental involvement ( P = 0.000), with no association with grade ( P = 0.152 ) and lymph node metastasis ( P = 0.066 ).( 2 ) Three-year overall survival (OS) and progression-free survival(PFS) were 93.0% and 85.5% ,respectively.Positive peritoneal cytology, surgical stage, pathological subtype, myometrial invasion, grade, and lymph-vascular space invasion were significantly associated with worse prognosis by univariate analysis ( P ＜ 0.05 ), while only surgical-pathology stage and myometrial invasion were independent prognostic factors by multivariate analysis ( P ＜ 0.05 ).For 30 cases with positive peritoneal cytology, the patients with no high risk factors shown significantly prognoses better than those with any risk factors.The results shown that for patients with late stage (stage Ⅲ - Ⅳ ) endometrial cancer with positive peritoneal cytology was significantly associated with the worse OS and PFS by multivariate analysis ( P = 0.006).Conclusions Positive peritoneal cytology was associated with serosal involvement, cervical involvement, adnexal involvement, omental involvement, and late stage.Therefore, peritoneal cytology should be performed and reported separately as a part of full surgical staging procedure.

Background and purpose: The role of lymphadenectomy for endometrial cancer is still controversial. Few gynecologists in China carry out pelvic and/or para-aortic lymphadenectomy for patients with endometrial cancer. The aim of the current study was to investigate the role of systematic lymphadenectomy in the treatment strategy of endometrial cancer and the feasibility in carrying out the surgery. Methods: We performed a retrospective chart review of all patients with endometrial cancer who experienced surgical staging at Cancer Hospital, Fudan University from January 2005 to July 2008. Lymph nodes metastatic status, alteration of adjuvant therapy and surgical complications were discussed. Results: Nineteen (14.8%) of 128 patients undergoing systematic lymphadanectomy had lymph node metastases: both pelvic and para-aortic in 7 patients, only pelvic in 8 patients, and exclusively isolated to the para-aortic area in 4 patients. Therefore, more than half of the patients with lymphatic dissemination had para-aortic lymph nodes metastases. Tumor grade, histological type, myometrial invasion and lymph-vascular space invasion were associated with lymph nodes metastases. Adjuvant chemotherapy and/or tumor-directed radiotherapy were needed for 15 patients upstaged due to lymph-nodal invasion (P<0.05). Furthermore, adjuvant therapy was eliminated for 50 intermediate/intermediate-high risk patients with negative lymph nodes and extrauterine spread. Complications were found in 8 patients: 3 pelvic infection, 2 residual vaginal bleeding, and 1 pero-bowel obstruction, 1 deep venous thrombosis accompanied with lymphocyst, and 1 lacunar infarction. The median time of the procedure was 150 minutes, median blood loss was 300 mL, and 27 patients received blood transfusion. Conclusion: The findings of the current study suggest that it is safe and feasible to carry out systematic lymphadenectomy in women with endometrial cancer. Surgical staging can assess the status of lymph nodes, provide accurate prognostic information, and help to formulate adjuvant therapy after surgery.

Objective The aim of this study was to find whether modified radical hysterectomy or radical hysterectomy improves local-regional control for patients with stage Ⅰ endometrioid carcinoma. Methods The medical records of patients with stage Ⅰ endometrioid carcinoma who were enrolled in Cancer Hospital of Fudan University between 1996 to 2008 after undergoing modified radical hysterectomy or radical hysterectomy were reviewed.The Kaplan-Meier method was used for time-to-event analysis with recurrence and death as the end points. Results Among 518 women with stage Ⅰendometrioid carcinoma, 474 underwent modified radical/radical hysterectomy and bilateral salpingo-oophorectomy±pelvic lymphadenectomy±peri-aortic lymphadenectomy+cytology.Twelve patients (2.5%) received neoadjuvant chemotherapy or vaginal brachytherapy before operation, and 73 patients (15.4%) received postoperative adjuvant therapy (pelvic external beam radiotherapy or chemotherapy or combination).After a median follow-up of 30 months,16 relapses were observed.Eight patients suffered with distant metastases, 4 with vaginal recurrences and 4 with pelvic recurrences.The 3-year and 5-year cumulative vaginal recurrence rates were 1.4% and 2.0%. The 3-and 5-year cumulative local-ragional recurrence rates were 2.5% and 3.1%. The 3-and 5-year actuarial overall survival rates were both 98.1%.The 5-year local-regional recurrence rates for stage Ⅰa, stage Ⅰb, stage Ⅰc were 3%, 3.7% and 0 (P=0.649), and the 5-year survival rates were 98.3%, 97.8% and 100% (P=0.399). There was no evidence of benefit in terms of lympnadenectomy in patients with stage Ⅰ endometrioid carcinoma(P value were 0.525 and 0.665,respectively).The median operating time was 135 minutes, the median blood loss was 300 mL, and 15.4% of the patients needed blood transfusion. Surgery associated morbidity was 7%, and no one died of surgery associated morbidity. Conclusions Modified radical hysterectomy or radical hysterectomy is a viable and possibly preferable option for patients with stage Ⅰ endometrioid carcinoma.Randomized clinical trials were urgently needed to address the utility of modified radical hysterectomy in stage Ⅰ endometrial cancer.

Objective To investigate clinical effect of reattribution-cognitive-pharmacy model (RCPM) in the treatment for irritable bowel syndrome(IBS). Methods 125 subjects with diarrhea predominant irritable bowel syndrome (IBS-D) were divided into two groups randomly. 62 patients in group A were treated with 10 ～ 20 mg of paroxetine without any other medication or psychological interview and 63 patients in group B received RCPM with interviewing once a week for 6 sessions and took 10 ～ 20 mg of paroxetine in the same way as group A after a week. The effect was evaluated at the end of 4 weeks and 12 weeks by a questionnaire. Results At the end of 4 weeks,29 patients in group A reported a reduction in abdominal pain,and 28 reported a reduction in stool frequency ,and 12 patients stopped taking paroxetine because of worrying about those side effect . In group B 48 reported a reduction in abdominal pain ,and 42 reported a reduction in stool frequency ,and 3 patients stopped taking paroxetine. At the end of 12 weeks,36 patients in group A reported a reduction in abdominal pain ,and 30 reported a reduction in stool frequency,and 14 patients stopped taking paroxetine because of worry about those side effect. In group B,54 cases reported a reduction in abdominal pain,and 45 reported a reduction in stool frequency,and 5 patients stopped taking paroxetine because of no obvious improvement. Conclusion RCPM can alleviate the abdominal pain and bowl movement frequency of IBS-D,and it seems better than paroxetine treatment alone. RCPM can improve compliance of paroxetine in patients with IBS-D.