Cyclooxygenase-2(COX-2)is an inducible enzyme that regulates prostaglandin synthesis and is overexpressed at sites of inflammation and in several epithelial cancers.Data indicate that COX-2 is involved in the regulation of apoptosis,angiogenesis,and immune response.The biological function of COX-2 appears to be associated with tumorigenesis.Recently, multiple studies have shown that COX-2 plays a critical role not only in maintenance of the endometrium during the menstrual cycle,but also in the progression of endometrial cancer.This review outlines the status of COX-2 expression and its association with clinicopathologic features and clinical outcome in endometrial cancer.

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.

Purpose:To explore the clinical feature,and treatment of primary cervical lymphoma. Methods:Clinical data and follow-up survey data of 26 cases were retrospectively analyzed with SSPS software. Results:Primary cervical lymphoma could occur in any age group of women. The misdiagnosis rate was as high as 57.69% (15/26 case).Three of 26 patients died,the five years survival rate was 88.46%.Conclusions:Primary cervical lymphoma is rare,which was very often misdiagnosised. The treatment consisted of an combination of chemotherapy,operation and radiotherapy,which could improve curative results and reduce relapse.

Purpose:To investigate the feasibility of detecting intraoperatively blue sentinel lymph node (BSLN) in patients with cervical cancer and to evaluate the accuracy of predicting pelvic lymph node disease. Methods:Between May 2002 and Jun 2003,29 patients with cervical cancer FIGO stage Ⅰb ( n =3),stage Ⅱa ( n =21),stage Ⅱb ( n =5) underwent BSLNs detection. During operation 4ml of methlene blue or lymphazurin was injected into the cervical tissue around the tumor or 3′,6′,9′,12′ of normal appearance of cervix about 0.5cm deep. Blue lymph duct and BSLNs were observed and located carefully for 10 minutes. Tumor characteristics,surgical findings,and location and number of BSLNs were recorded and correlated with pathologic results to get the accuracy and false-negative rate.Results:Among 29 patients underwent this technique,BSLNs were seen in 24 patients. Total detection rate was 83%(24/29). Location of BSLNs was mainly in obturator and internal iliac group. BSLNs located in left internal iliac group in 11 patients and 13 patients in right internal iliac group,10 patients in left obturator group,and 14 patients in right obturator group. 3 patients had BSLNs in both iliac and internal iliac group. Among 24 patients with BSLNs,there were 6 patients with lymph node metastases. 5 patients had only SLN metastases and one patient had both SLN and other lymph node disease. 18 patients had neither SLNs nor other pelvic lymph nodes metastases. The false-negative rate was 0.Conclusions:Intraoperatively BSLN detection was feasible and safe. Sentinel lymph node was representative of the lymphatic basin.

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.

Purpose:To evaluate the relationship between the expressions of MDR and GST-? and the response to neoadjuvant chemotherapy and prognosis in cervical carcinoma. Methods:The expressions of MDR and GST-? were examined by Envision immunohistochemistry using pretreatment biopsy specimens. The stage distribution of 57 patients in the study was 7 stage Ib, 35 stage IIa, 15 stage IIb. Treatment consisted of 2 courses of neoadjuvant chemotherapy followed by radical hysterectomy and lymphonectomy. If the patient was found to have parametrial involvement, pelvic lymph node metastasis, microscopic tumor emboli or disease in vagina stemp, she was given adjuvant radiotherapy after operation. All patients were followed up and the median follow-up time was 35 months (21-66 months). Statistical method used was SPSS 8.0 package. Results:There were 14 patients with cervical carcinoma who had expression of MDR. The rate of expression of MDR was 24.6% (14/57). Also there were 29 patients who had expression of GST-?. The rate of expression was 50.8% (29/57). The total response rate of neoadjuvant chemotherapy was 81%. The complete clinical response rate was 19% (11/57) and partial response rate was 61% (35/57). All patients were treated by operation following chemotherapy and 13 patients were given adjuvant radiotherapy after operation. The 5-year survival rate in stage Ib was 100%, stage IIa 90% and stage IIb 78.5%. The results showed the expression of MDR was related to response of neoadjuvant chemotherapy and 5-year survival. It is 93%(40/43) in group of MDR(-) and 43%(6/14) in group of MDR(+)( P =0.001). But it was not related to FIGO, histopathologic, parametrial involvement, and pelvic lymph nodes metastasis. The expression with GST-? only related to response of chemotherapy. The response rate in the group with expression of GST-? is 69% and it is 93% in the group with GST-?(-)( P =0.02).Conclusions:The response rate of neoadjuvant chemotherapy in group of MDR(-) and GST-?(-) was better than in the group with expression of MDR and GST-?. The measure of MDR and GST-? is helpful to predict the response of neoadjuvant chemotherapy in cervical cancer and MDR may related to prognosis of cervical cancer.

Objective To investigate whether cytomegalovirus (CMV) infection is associated with chronic allograft nephropathy (CAN). Methods 131 patients underwent kidney transplantation from August 1, 1999 to November 30, 2000 were enrolled in this study. CMV-pp65 antigen load (the number of CMV-pp65-positive leukocytes) in peripheral blood within 6 months of posttransplant was detected, and TGF-? 1 mRNA expression in renal allograft biopsy was measured at the 7th month after transplant. The renal functions of the patients were followed up at least three years. Results The TGF-? 1 mRNA level in allografts of the patients with long-time and high-level CMV-pp65 antigen load was obviously higher that that of the patients without. 3 years after transplant, there were lower Ccr and more renal dysfunction in the patients with long-time and high-level CMV-pp65 antigen load than in the patients without, the difference of which was significant between the two groups of patients. Conclusion Serious CMV infection with long duration can damage the function of kidney graft, and is a risk factor for renal dysfunction.

Objective To explore the relationship between diethylhexylphthalate (DEHP) and peritoneal sclerosis and its possible mechanism. Methods Isolated human peritoneal mesothelial cells (HPMC) was cultured for five days in culture solution with varied doses of DEHP ７．７?of 10-6mol/L (A group), 5.4?１０－５mol/L (B group) and 2. 2?10-4 mol/L (C group) respectively. Culture solution without DEHP was as control. Total collagen synthesis and secretion was assayed by 3H-proline incorporation. ELISA method was used to detect the level of secreted fibronectin (FN) . The expression of FN mRNA , collagen ImRNA, collagen Ⅲ mRNA and TGF－?l mRNA was determined by RT-PCR. Results (1)HPMC expressed FN, laminin, collagen Ⅲ and TGF-?１. (2)DEHP stimulated FN and collagen expression with a higher level in C group compared with control(P

Objectives To investigate the expression features and roles of the costimulatory molecules and T lymphocyte subsets from patients with chronic nephritis.Methods The expression of the costimulatory molecules CD 28 and CD 137 on PBMC (peripheral blood mononuclear cells) and T lymphocyte subsets from 52 patients with chronic nephritis were studied by immunophenotyping and flow cytometry analysis.Results The T lymphocyte subsets from patients with chronic nephritis showed an obvious imbalance with reversing CD 4/CD 8 ratio,decreasing CD + 4T cells and increasing CD + 8T cells.The expression of the costimulatory molecule CD 28 on T cells was significantly lower compared with normal controls (P

Objective To explore the relationship between urine TGF-? 1 concentration and long-term function of renal allograft. Methods From August 1, 1999 to December 30, 2000, the urinary content of TGF-? 1 was determined in 146 patients who had had renal transplantation one year ago but with normal renal function. The relative content of urine TGF-? 1 was 172.5～533.1pg/mg Cr. Forty patients each with higher or lower urine TGF-? 1 concentrations were selected to form group Ⅰ and Ⅱ. Two years later, renal function variables, blood and urine TGF-? 1 concentrations were compared between the two groups. The relation between urine TGF-? 1 and chronic allograft nephropathy (CAN)was assessed. Biopsies of transplanted kidneys were carried out in recipients whose creatinine was higher than normal. Results Three years after transplantation, creatinine clearance rate was lowered by 12.8?10.6ml/min in group Ⅰ patients, and 29.6% of them were diagnosed as CAN. Compared with group Ⅱ, the lowering of creatinine clearance rate was more intense and the incidence of CAN was higher, with obviously higher urinary TGF-? 1 content. The differences were significant. Conclusions TGF-? 1 may play a role in the pathogenesis of CAN after renal transplantation, and urinary TGF-? 1 may be considered as an indicator in assessing long term renal function in such case.