Objective To explore the impact of systematic retroperitoneal lymphadenectomy (SL) in patients with advanced ovarian cancer. Methods The data on 188 patients with FIGO stageⅢC epithelial ovarian cancer were retrospectively analyzed. All the patients underwent primary debulking surgery and then received platinum-based chemotherapy. The patients were divided into SL group and non-systematic lymphadenectomy (USL) group. Progression free survival (PFS) and overall survival (OS) times were analyzed. Results PFS and OS were higher in SL group than in USL group (36 versus 17 months and P = 0.022; 58 versus 52 months and P = 0.041). Univariate analysis showed that both SL and optimal debulking surgery were the independent prognostic factors , but multivariate analysis indicated that optimal debulking surgery was the only independent prognostic factor. However , for 143 patients without enlarged retroperitoneal lymph nodes , multivariate analysis showed that either SL or optimal debulking surgery were the independent prognostic factor (P = 0.040 and P = 0.014). Conclusions Optimal debulking surgery is helpful in improvement of the survival in patients with advanced ovarian cancer. For patients without enlarged retroperitoneal lymph nodes, SL still has a positive effect on the prognosis.

Accidents, Occupational ; Acute Disease ; Adult ; Humans ; Male ; Sulfuric Acid Esters ; poisoning

Objective Severe acute respiratory syndrome is recently emerged infectious disease caused by a novel coronavirus, but its immmunopathological mechanism has not yet been fully elucidated. Method We established the SARS animel model and investigated changes in plasma inflammatoy cytokines monkeys and rats. 8 monkeys with PCR and antibody positive were detected. Serum levels of inflammatory cytokines interleukin(IL)-6,IL-10,Th-1 cytokine,interferon(INF)-? and tumor necrosis factor(TNF)-? were measured by enzyme-linked immunosorbent assays(ELISA).Result The concentration of IL-10 and TNF-?were not significantly different in model and control group.IL-6 showed marked elevation of at least 10 days, and there was a positive relationship between the level of IL-6 and pulmonary pathological changes. The INF-? level decreased. Conclusion The result of sera level of SARS animal model avoid the disturbance of anti-viral drug and corticosteroid, it suggest that there are different immunoregulatory events during SARS and may contribute to our understanding of the pathogenesis.

Objective To evaluate the effects of Prinsepia utilis Royle oil (PURO) on the synthesis of ceramide and expression of acid ceramidase N-acylsphingosine amidohydrolase 1 (ASH1),and to explore the mechanisms underlying its moisturizing and skin barrier-repairing effects.Methods Keratinocytes from human foreskin tissue were classified into 2 groups to be cultured in keratinocyte-serum free medium (K-SFM) with or without the presence of PURO.Enzyme linked immunosorbent assay (ELISA) was performed to measure the level of ceramide in the culture supernatant of keratinocytes at 0,3,8,24 and 48 hours.The back of nude mice was divided into 4 areas,i.e.,test area,matrix area,blank control area and negative control area.Acetone and ether were used to destroy the epidermal barrier in the test,matrix,and blank control areas,then,the former 2 areas were topically treated with emulsions containing 1％ PURO and matrix,respectively,and the blank control area remained untreated.The epidermal barrier remained intact and untreated in the negative control area.Noninvasive methods were used to determine transepidermal water loss (TEWL),epidermal moisture content and skin lipid content in these areas on day 0,1,3,and 7.Skin tissue was obtained from these areas on day 0 and 7 followed by an immunohistochemical study for the quantification of ASH1 expression.Results The level of supernatant ceramide increased with time in the PURO-treated keratinocytes,which was significantly higher at 24 hours and 48 hours than at 0 hour (1.3817 ± 0.100 and 1.3737 ± 0.047 vs.0.7630 ± 0.143,both P ＜ 0.05).The supernatant ceramide was also elevated in the PURO-treated keratinocytes compared with untreated keratinocytes at 24 and 48 hours (both P ＜ 0.05).Noninvasive skin tests showed a gradual decrease in the TEWL,but an increase in the epidermal moisture content and skin lipid content with time in the 3 epidermal barrier-destroyed areas.As far as the test area was concerned,TEWL value was significantly lower on day 3 and 7 than on day 0 (10.85 ± 0.64 and 8.01 ± 0.58 vs.12.65 ± 0.71,both P ＜ 0.05),while a significant increment was observed in the skin lipid content on day 3 and 7 compared with day 0 (29.14 ± 0.40 and 31.30 ± 0.88 vs.27.02 ± 0.65,both P ＜ 0.05),as well as in the epidermal moisture content on day 1,3 and 7 compared with day 0 (13.98 ± 0.28,15.00 ± 0.38 and 15.86 ± 0.18 vs.11.74 ± 0.62,all P＜ 0.05).On day 7,there was a statistical decline in TEWL value,but an elevation in epidermal moisture content,skin lipid content and ASH1 expression in the test area compared with the matrix area and blank control area (all P ＜ 0.05).Also,the expression of ASH1 was upregulated on day 7 compared with day 0 in the 3 barrier-destroyed areas (all P ＜ 0.05).Conclusion PURO may exert skin-moisturizing and barrier-repairing effects by enhancing the synthesis of ceramide and expression of acid ceramidase ASH1.

Objective To investigate the correlation of epidermal distribution of lamellar bodies and expression of ceramidase with skin barrier dysfunction in polymorphous light eruption.Methods Forty-seven patients with polymorphous light eruption and 40 healthy volunteers were recruited into this study.Noninvasive instruments were used to measure skin sebum content,transepidermal water loss(TEWL)and water content in stratum corneum in all of the subjects.Then,tissue specimens were obtained from the lesions at sunexposed sites in the patients and normal skin of the healthy volunteers.The ultrastructure and distribution of lamellar bodies were observed with transmission electron microscopy in five lesion and control specimens.Immunohistochemistry was performed to detect the expression of ceramidase in the tissue specimens.Results Compared with the normal skin from healthy volunteers,the lesions from patients showed decreased number of lamellar bodies in the granular layer and prick cell layer with a disorganized arrangement.Ceramidase was positively expressed in 20 lesion specimens and 36 normal control specimens,weakly expressed in 21 lesion specimens and 4 normal control specimens,and negative in 6 lesion specimens; there was a significant difference in the expression of ceramidase between the lesion specimens and normal control specimens(P ＜ 0.01).The lesions also showed high TEWL(34.2191 ± 12.70 vs.16.8350 ± 6.50,P ＜ 0.01),lower water content in stratum corneum(22.7319 ± 8.71 vs.29.4250 ± 5.08,P ＜ 0.01)and similar skin sebum content compared with the normal skin.Conclusions There is a disturbance in the synthesis of ceramide in patients with polymorphous light eruption,which may contribute to the impairment of skin barrier.

Objective To analyze the clinical features of Weber-Christian disease (WCD) and to make a review of the literature for early diagnosis and treatment.Methods The clinical features of an atypical WCD patient who had been misdiagnosed as polymyositis were analyzed.Results WCD was characterized by subcutaneous nodules and systemic symptoms.Repeating physical examination and biopsy in time were important if the nodules were not obvious.Conclusion WCD is often misdiagnosed because of the complicated clinical manifestations.Carefully physical examination and timely biopsy are help for early diagnosis.

Objective To investigate the relationship of Toll-like receptors (TLRs) 2 and 4 with the occurrence of chloasma.Methods Peripheral blood samples were collected from 40 patients with chloasma and 40 healthy human controls,and skin samples were also collected from the lesions of 10 of the patients and normal skin of 10 of the healthy controls.Real time (RT)-PCR was performed to measure the mRNA expressions of TLR2 and TLR4 in skin lesions and blood samples.An immunohistochemical test was conducted to observe the expressions of TLR2 and TLR4 in skin lesions.Statistical analysis was carried out by t test.Results The expressions of TLR2 and TLR4 mRNAs were both significantly higher in skin lesions of the patients than in normal skin of the controls (9.72 ± 2.93 vs.5.10 ± 2.69,t =3.67,P＜ 0.01; 9.52 ± 2.88 vs.4.77 ± 1.90,t =4.36,P＜ 0.01),while no significant difference was found in the mRNA expressions of TLR2 or TLR4 in peripheral blood between the patients and controls (both P ＞ 0.05).As the immunohistochemical test revealed,TLR2 was absent in both the epidermis and vascular endothelial cells in 6 normal control skin samples,weakly expressed in the basal layer of the epidermis but absent in vascular endothelial cells in 4 normal skin samples,and no TLR4 expression was observed in either the epidermis or vascular endothelial cells in these control skin samples.Among the 10 skin samples from chloasma lesions,3 showed TLR2 expression in the whole epidermis,7 in both basal cell layer and prickle cell layer but not in vascular endothelial cells in the superficial dermal layer,all showed strong TLR4 expression in the basal cell layer and weak TLR4 expression in the prickle cell layer,and 3 exhibited TLR4 expression in vascular endothelial cells in the superficial dermal layer.Conclusion TLR-mediated immune responses in local skin might be related to the occurrence of chloasma.

Objective To evaluate the effects of pregnancy weight control program based on structure- process- outcome model to improve women′s health status and pregnancy outcomes. Methods On the basis of Donabedian′s structure- process- outcome quality of care model, a pregnancy weight control program designed and carried out for the middle and late pregnancy. The structure, process and outcome of the pregnancy weight control program were evaluated to ensure the quality of the pregnancy weight control program. In addition, the women′s pregnancy outcomes were investigated after intervention. Results the prenatal BMI in the intervention group [ (23.06±1.11) kg/m2 ] were lower than those in the control group [(25.52±1.89) kg/m2 ], and the incidence of cesarean section (including cesarean section without indication), neonatal macrosomia, labor block, neonatal asphyxia, postpartum hemorrhage, pregnancy induced diabetes and hypertension in the intervention group were significantly lower than those in the control group, P<0.01 or 0.05. Conclusion Donabedian′s structure- process- outcome quality of care program is an effective approach to improve women′s pregnancy outcomes.

AIM: To investigate the effect of ecdysterone (EDS) on H9c2 cardiomyocytes after oxidative stress.METHODS:H9c2 cells were cultured in vitro and divided into control group, high dose (2 μmol/L) of EDS group, middle dose (1.5 μmol/L) of EDS group, low dose (1 μmol/L) of EDS group, and H2O2 group.H9c2 cardio-myocytes in H 2 O2 group and high , middle and low doses of EDS groups were exposed to H 2 O2 for 6 h to establish the model of oxidative stress.The viability of the H9c2 cells was detected by CCK-8 assay.The apoptosis of H9c2 cells was analyzed by flow cytometry.The levels of lactate dehydogenase (LDH) and creatine kinase-MB (CK-MB) in the culture medium, and the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the H9c2 cells were measured by colorime-try.The generation of reactive oxygen species (ROS) and the mitochondrial membrane potential were evaluated by flow cy-tometry and confocal laser scanning microscopy .The protein levels of Bax , Bcl-2 and cleaved caspase-3 in the H9c2 cells were determined by Western blot .RESULTS:Ecdysterone at the selected concentrations had no effect on the viability of H9c2 cells.Compared with control group, the levels of LDH, CK-MB, ROS and MDA, and the apoptotic rates of the H9c2 cells were significantly increased after treated with H 2 O2 , but were decreased by EDS treatment in a dose-dependent man-ner.The levels of SOD and mitochondrial membrane potential of the H 9c2 cells in H2 O2 group were reduced significantly compared with control group , but high, middle and low doses of EDS treatments up-regulated the levels of SOD and mito-chondrial membrane potential in H 2 O2-treated H9c2 cells.The protein levels of Bax and cleaved caspase-3 in the H9c2 cells in H2 O2 group showed significant elevation in comparison with control group , and the protein expression of Bcl-2 de-clined in H2 O2 group compared with control group , but high, middle and low doses of ecdysterone treatments down-regula-ted the protein levels of Bax , cleaved caspase-3 and up-regulated the expression of Bcl-2 in H2 O2-treated H9c2 cells. CONCLUSION:Ecdysterone attenuates the effect of H 2O2-induced oxidative stress on H9c2 cardiomyocytes.The mecha-nism may be involved in scavenging oxidative stress products , increasing antioxidant enzyme activity and improving mito-chondrial function .

Objective To compare the dosimetry and toxicities between postoperative fixed-field intensity-modulated radiotherapy (FF-IMRT) and image-guided radiation therapy/volumetric modulated arc therapy (IGRT-VMAT) for cervical cancer.Methods A total of seventy patients with stage I b-Ⅱa postoperative cervical cancer who had high risk factors,were divided into FF-IMRT (FF-IMRT group,n =35)and IGRT-VMAT (IGRT-VMAT group,n =35),to compare the difference of target dose and adverse reaction between the two groups.Results In the IGRT-VMAT group,the interfractional setup errors in the x,y,and z axes were (0.25±0.14) cm,(0.26±0.16) cm,and (0.24±0.18) cm,respectively;the intrafractional setup errors in the x,y,and z axes were (0.1±0.09) cm,(0.12±0.09) cm,and (0.11±0.09) cm,respectively;the margins in the x,y,and z axes were 0.75 cm,0.84 cm,and 0.78 cm,respectively.Under the same dosimetric conditions,the IGRT-VMAT group was superior to the FF-IMRT group in terms of conformity index,treatment time,and number of monitor units (P=0.000).The Dmean and volume receiving high-dose irradiation for the bladder,rectum,and small intestine were significantly lower in the IGRT-VMAT group than in the FF-IMRT group (P=0.000).Compared with the FF-IMRT group,the IGRT-VMAT group had a significantly reduced incidence of acute and chronic gastrointestinal,urinary,and hematologic toxicities (P＜ 0.05).Conclusions IGRT-VMAT can correct setup error online,shorten the treatment time,reduce the dose to organs at risk,and alleviate acute and chronic toxicities,and is especially suitable for patients with postoperative small bowel position changes.