Background and purpose:Vascular endothelial growth factor-C(VEGF-C) is ranked first as a lymphoangiogenic factor, which induces lymphatic proliferation and spread of solid tumors. Lymph node status remains the strongest prognostic factor in a variety of human malignant tumors including uterine cervical carcinomas and lymphnode metastasis is stimulated by tumor cell aggressiveness, such as abilities of growth and metastases.We examined the correlation between VEGF-C expression and tumor aggressiveness in cervical carcinomas with respect to clinicopathologic features and patient outcome and to see whether the expression of VEGF-C and its receptor in cervical carcinoma tissue and their paratumour tissue had a role in tumor metastasis and other clinical significance. Methods:48 fresh cervical cancer tissues and their paratumour tissue were examined by RT-PCR to detect the VEGF-C/KDR/Flt-4mRNA expression.Results:There was a significant difference of VEGF-C/KDR/Flt-4mRNA expression between the tumor , paratumour tissue and the normal controls. And there was no significant relationship between VEGF-C mRNA, KDR mRNA or flt-4mRNA expression with the pathological types and clinical stage of invasive carcinoma of cervix. However,expression was significantly associated with the grade of tumor pathology, lymph node metastasis, tumor size and the invasion of deep muscular layer(P

To explore the role of cytochrome C oxidase (CCO) in the pathogenesis of preeclampsiais, CCO activity was determined in 32 patients with preeclampsia and 26 normotension pregnancy women by the rate of cyanide-sensitive oxidation of reduced cytochrome c using ultraviolet spectrophotometry. The results showed that CCO activity was significantly lower in the preeclampsia group (0. 30±0. 39/min, n=32) than in the control group (0. 73±0. 54/min, n=26), P＜0. 01. The occurrence of IUGR in the preeclampsia group was significantly higher than in the control group (P＜0. 05). It was suggested that the decrease of activity of CCO might interfere with the function of electronic chains, result in the reduction of ATP production, leading to the mitochondria dysfunction and placental dysfunction in preeclampsia patients. Mitochondria dysfunction may be involved in the pathogenesis of preeclampsia.

The recombinant plasmids pGenesil-1-BIRC71 and pGenesil-1-BIRC72 were transfected into Hela cells and cisplatin was added with different concentrations in order to study the inhibitory effects of Livin gene, increase the apoptosis induced by cisplatin, and detect the expression of Bcl-2, Bax, caspase-3, and survivin genes. The pGenesil-1-BIRC71 and pGenesil-1-BIRC72 were transfected into Hela cells, and the expression levels of Livin, Bcl-2, Bax, caspase-3, and survivin genes were detected by using fluorescence quantitative real-time PCR. Then cisplatin at different concentrations (3.0, 6.0 and 9.9 microg/mL) was added into the transfected Hela cells, and 24, and 48 h later, the apoptosis rate was measured by flow cytometry. After transfection of pGenesil-1-BIRC71 and pGenesil-1-BIRC72 into Hela cells, the expression level of Livin gene was obviously reduced, and the apoptosis rate was significantly increased in transfection group as compared with control group (P<0.05). Cisplatin could increase the apoptosis rate in a dose- and time-dependent manner. After cisplatin was added, the expression levels of Bcl-2 mRNA were reduced, and those of Bax, caspase-3, and survivin mRNA were increased in transfection group as compared with those in control group (P<0.05). It was concluded that shRNA expression vector targeting Livin gene could inhibit the expression of Livin gene in Hela cells and enhance the apoptosis induced by cisplatin, which was related to the decreased expression of Bcl-2 and activation of Bax and caspase-3. Survivin might play an important role as an antagonist in the process of apoptosis induction.

To investigate the efficacy and the clinical value of total laparoscopic radical hysterectomy (TLRH) for the treatment of uterine malignancies, we performed a retrospective review of 87 patients with cervical cancer and 23 patients with endometrial carcinoma who underwent TLRH at Union hospital between June 2008 and September 2009. Data collected included operative time, estimated blood loss, lymph node count, time for the recovery of normal temperature and time to resumption of normal bladder function, intraoperative and postoperative complications. The procedure was completed laparoscopically in 108 patients. Two patients were converted to laparotomy due to common iliac vein injury. The mean overall operative time was 200.6+/-38.6 min; the mean operative blood loss was 280.5+/-128.3 mL; he mean number of pelvic lymph nodes that were resected wa26. 0+/-5.8. The time for recovery of normal temperature and the normal bladder function after the operation was 5.8+/-2.9 d and 15.2+/-4.3 d. There were 2 (1.8%) common iliac vein injuries during the operation and 10 (9.1%) bladder retentions post operation. It was concluded that TLRH is feasible, minimally invasive and provides promise for the treatment of uterine malignancies.

Objective:The short term results of laparoscopic radical hysterectomy and pelvic lymph nodes dissection for early uterine malignancy were investigated.Methods:70 patients with eady malignant uterine tumor who underwent a laparoscopic radical hysterectomy and pelvic lymph nodes dissection(TLRH+LPL)were retrospectively reviewed.At the samt time,48 patients were recruited to be the control group who had laparotomy radical hysterectomy and pelvic lymph nodes dissection(ARH+APL).Intraoperative and postoperative situations and complications between these two groups were analyzed.Results:70 patients underwent laparoscopic operation,but two cases changed to laparotomy(transfer rate 2.9%).The mean operation time,blood loss,number of dissected pelvic lymph nodes and postoperative temperature recovery time of TLRH+LPL group was significantly different from ARH+APL group(P<0.01),while there were no difference between these two groups on bladder function recovery time and occurance of postoperative complications.Conclusions:TLRH+LPL has the same feasibility and safety with ARH+APL,less invasive to the tissue,thus offers a good option of microinvasive therapy for female malignant tumor.

Objective　To investigate the effect of placental isoferritin in pathogenesis of preeclampsia and its predictive value. Methods　A prospective double-blinded study was performed. There were 120 initial normal pregnant women at earlier third trimester (from 24 to 34 weeks) in this study. Their plasma placental isoferritin and nitric oxide (NO) metabolites (nitrite/nitrate) (NO2-/NO3-) were examined by enzyme linked immunoabsorbent assay (ELISA) and Griess assay respectively. The outcomes of pregnancies were followed up. Results　In 120 initial normal pregnant women, 19 pregnant women occurred preeclampsia (preeclampsia group), and 101 cases were normal (normal group) at follow up. The levels of plasma placental isoferritin (PLF) were significantly decreased in preeclampsia group (285.31±53.73 mg/L) than that of normal group (699.05±203.03) mg/L, P＜0.01. The levels of plasma NO were significantly increased in preeclampsia group (54.57±32.71 μmol/L) than that of normal group (38.89±30.00) μmol/L, P＜0.05. The significant negative correlation between the plasma placental isoferritin and NO levels was observed（r=0.329，P<0.01）. At the cut point of 400 mg/L PLF level, the sensitivity, specificity, positive predictive value, negative predictive value and Kappa index of PLF level predicting on the outcomes of pregnancy with preeclampsia were 100%, 85.15%, 55.88%, 100%, 0.645. Conclusions　 The decrease of plasma placental isoferritin levels is associated with preeclampsia, and the endothelial cell damage may be one of its mechanism. The PLF may be an earlier predictor of preeclampsia at 24～34 gestational weeks.

Objective To investigate the main causes of the missed and delayed diagnosis of endometrial carcinomas.Methods Endometrial carcinoma and missed and delayed diagnosis were used as key words to search in the Chinese National Knowledge Infrastructure and Wanfang Data.Results There were 37 cases with details.Among these,10 cases were caused by false negative D&C (27.0％ of the total);14 cases were caused by misdiagnosis as uterine benign disease (37.8％ of the total);13 cases were caused by the overlooking of the primary symptoms because of the advanced diseases.Conclusions Paying more attention to the symptoms of endometrial carcinomas is necessary to reduce the missed and delayed diagnosis of endometrial carcinoma.

Lymph node metastasis represents a common way of distant spread of gynecologic malignancies and an independent risk factor of poor prognosis of patients. The pelvic and paraaortic lymphadenectomy is a critical part of the surgical treatment of gynecologic cancer, which potentially improves the survival outcomes of patients through clarifying the node status to guide the subsequent management and/or removal of positive nodes to reduce the tumor burden. However, when we make a decision about lymphadenectomy, we should balance the related survival benefits and morbidities impacting the long-term quality of life. It is noteworthy that the principles of lymph node management are varied between different types and different stages of tumors characterized with different clinical features. Moreover, the sentinel lymph node biopsy, which has been emerging as a promising alternative to traditional systematic lymph node dissection, provides new options while bringing new issues. Here, based on the latest progress in relevant fields, we attempt to figure out the distinct features and unanswered questions in the management of lymph nodes of patients with cervical cancer, endometrial cancer, and ovarian cancer, which may trigger meaningful thoughts regarding related clinical decision.

0.05).Among patients with advanced stage whose residual tumor ≤2 cm, 5-year survival was 65% and 30% for patients who did and did not undergo lymphadenectomy , respectively(P

Objective To study the effects of ropivacaine on the duration of labor and mode of delivery in the primigravidas using patient-controlled epidural analgesia (PCEA). Methods Retrospective analysis was performed. The 190 healthy, full-term, and single-fetus parturient primigravidas who received PCEA with 0.1% ropivacaine+fentanyl (1 ?g/ml ) were in the epidural analgesia group. Another 222 primigravidas who didnot receive PCEA were in the control group. The duration of labor and modes of delivery, and the neonatal Apgar scores in both two groups were recorded and evaluated. Results Those in the epidural analgesia group experienced a significantly longer first stage [(426?161) minutes], longer second stage [(54?27) minutes] and longer full duration of delivery [(489?166) minutes] than those in the control one [(409?170) minutes, (364?167) minutes and (37?22) minutes]. The rate of using pitocin in the epidural analgesia group (30.2 %) was significantly higher than that in the control group (4.1%). The cesarean section rate in epidural analgesia group (20.0 %) was lower than that in the control one (28.4%); while the rate of instrumental delivery in the epidural analgesia group (20.0%) was significantly higher than that in the control one (6.3%). In summary, there were significant differences between two groups in the duration of labor, the rate of using pitocin, the rate of instrumental delivery and the rate of cesarean section. But there were no differences found for those newborn who had Apgar scores less than 7 at the point of both one and five minutes (7.9% and 4.5%, 2.6% and 0.5% respectively). Conclusion Epidural ropivacaine labor analgesia lengthens the duration of labor and increases the rate of instrumental delivery, but it has no significant negative effects on the neonates.