Purpose:To assess the postoperative effects that maybe associated with the closure or non closure of peritoneum at transabdominal radical surgery of cervical carcinoma, and observe the feasibility of applying peritoneal non closure technique in gynaecological tumor operations.Methods:852 patients undergoing radical surgery in our hospital between August 1998 to August 2001 were divided randomly into two groups: peritoneum closed ( n = 407) or peritoneum open ( n = 445). Student u test and Chi square test were used for statistical analysis of the results: operative duration, bowel function restoration, febrile duration, antibiotics requirement, lymphadenocyst formation, pelvic infection and ileus and incision healing of the two groups.Results:As compared to the closure of peritoneum, the length of operation time and bowel function restoration were shorter, febrile duration was shorter, the morbidity of pelvic infection and lymphadenocyst formation were lower, antibiotics requirement was fewer, the incidence of ileus and wound infection was significantly less frequently seen in the non closure group( P

Objective To evaluate the ability of diffusion tensor imaging (DTI )and DTT to differentiate the central prostate cancer(PCa )from benign prostate hyperplasia (BPH ).Methods 16 CG-PCa cases and 30 BPH cases proven by Histopathologi-cally had been performed MRI and DTI.ADC values and FA values of CG-PCa and BPH were respectively measured,comparing whether there is any discrepancies between two groups.For DTT maps,two observers record the score using a four-point scale and compare the differences between two groups of lesions about fibers continuity and density.Results ADC values and FA values in BPH-PCa were:(1 357±163)×10-6-(1 058±196)×10-6 mm2/s,and (356±116)×10-3- (407±132)×10-3 respectively. ADC value between the two groups was statistically significant difference (P< 0.05).While FA values was not(P>0.05).Interob-server agreement regarding the scale was good (k =0.723).The two viewers'DTT map score of CG cancer were 2.9±0.9;2.8± 1.0,the BPH were 1.8±0.7;1.7±0.8.The DTT map score between the two groups for two viewers were all statistically signifi-cant difference (P< 0.05).Conclusion ADC values can significantly differentiate CG-PCa from BPH,FA values cannot.DTT maps can describe prostate more institute,providing a certain value in distinguish PCa from BPH.

Objective To investigate the efficacy of postoperative concurrent chemoradiotherapy for early-stage cervical adenosquamous carcinoma and adenocarcinoma.Methods A total of 62 patients with cervical adenosquamous carcinoma,149 patients with cervical adenocarcinoma,and 2687 patients with cervical squamous cell carcinoma,all of whom were in stage Ⅰ B-Ⅱ A and were treated from 2006 to 2012,were enrolled,and some of them received postoperative pelvic radiotherapy ± para-aortic extended field radiation ±afterloading radiotherapy.The chemotherapy regimen consisting of DDP,TP,and FP was given to these patients.The chi-square test was used for comparison of general clinical data,the Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis.Results Cervical adenosquamous carcinoma and adenocarcinoma had no significant differences in clinicopathological features (P=0.107-0.639).The high-risk patients with adenocarcinoma had a higher recurrence rate than their low-risk counterparts even after adjuvant radiotherapy or chemoradiotherapy (P=0.000).In the patients treated with surgery and radiotherapy,those with adenosquamous carcinoma had the shortest median survival time,followed by those with adenocarcinoma and squamous cell carcinoma (P =0.134,0.787);in the patients treated with surgery and concurrent chemoradiotherapy,those with adenocarcinoma had the shortest median survival time,followed by those with adenosquamous carcinoma and squamous cell carcinoma (P=0.131,0.643),and the median survival time showed a significant difference between the patients with adenocarcinoma and those with squamous cell carcinoma (P =0.000).In the patients with adenosquamous carcinoma and adenocarcinoma,the patients treated with postoperative concurrent chemoradiotherapy had higher incidence rates of short-term adverse reactions than those treated with postoperative radiotherapy (P=0.037,0.003),but the incidence rates of long-term adverse reactions showed no difference between the two groups of patients (P=0.861,0.655).In the patients with adenosquamous carcinoma,the patients treated with postoperative concurrent chemoradiotherapy had a lower rate of distant metastasis (P =0.003) and prolonged median overall survival and disease-free survival (both increased by 17 months) (P=0.811,0.799),as compared with those treated with postoperative radiotherapy,while in the patients with adenocarcinoma,the median overall survival and disease-free survival were reduced by 11 and 9 months,respectively (P=0.330,0.115).Conclusions Compared with postoperative radiotherapy,postoperative concurrent chemoradiotherapy for early-stage high-risk cervical adenosquamous carcinoma can reduce the rate of distance metastasis.Compared with radiotherapy,postoperative concurrent chemoradiotherapy for adenosquamous carcinoma and adenocarcinoma cannot improve survival time.

Objective To investigate the changes of the cytokines on the aortas of atherosclerosis (AS) rats. Methods Zymosan-liquid medical paraffin suspension (contain Zymosan 20 mg/kg) was injected intra- peritoneally once a week for 10 times and given intraperitoneal injections of ovalbumin, 2.5 mg/kg, once a week for 7 times after initial subcutaneous sensitization. All animals were fed cholesterol-rich diet to induce AS. Electron microscopy was used to observe the foam cells, and RayBio Rat Cytokine Antibody Array 1.1 was employed to detect the cytokines in the aorta wall. Results Electron microscopy showed all models had monocytes migration from lumen to subendothelium in the aorta and formed to foam cell for phagocytosis lipid, indicating typical characteristic of AS in the rats. Most pro-inflammatory cytokines were increased except Fractalkine and IL-6, but anti-inflammatory cytokines were all slightly decreased. Conclusion Inflammation and immune can induce the formation of foam cells. The balance of pro-inflammatory cytokines and anti-inflammatory cytokines is broken is the important reasons of atherogenesis。

BACKGROUND:The periodontal ligament stem cels can promote periodontal tissue regeneration, providing a new way for the treatment of periodontitis. OBJECTIVE:To observe the inflammatory microenvironment effects on the biological properties of periodontal ligament stem cels. METHODS: Periodontal ligament stem cels from healthy controls and patients with periodontitis were primarily cultured by tissue digestion method, purified using limited dilution method, and identified through detection of CD146 and STRO-1. Then, passage 3 cels were taken and denoted as normal control and inflammation groups folowed by osteogenic induction. RESULTS AND CONCLUSION:Purified cels from two sources both expressed STRO-1 and CD146. Periodontal ligament stem cels in the inflammation group showed higher multiplication capacity, but the osteogenesis ability was lower compared with the normal control group. The expressions of Runx2 mRNA and Osterix mRNA were dropped significantly after the stimulus of tumor necrosis factor-α (P < 0.05), but the interleukin-1β and interleukin-6 did not have a significant impact. Tumor necrosis factor-α at 0.1 and 1 μg/L had no significant effects on the expression of Runx2 mRNA, but the expression of Runx2 mRNA was decreased significantly after treatment with 10 μg/L tumor necrosis factor-α (P< 0.05). It is confirmed that the molecular signaling mechanism inside the periodontal ligament stem cels is changed under inflammatory microenvironment, so that the differentiation capacity of cels from the inflammatory sources is lowered. Moreover, tumor necrosis factor-α is one of the key factors and its optimalconcentration is 10 μg/L.

Objective To study the difference between intensity-modulated radiation therapy (IMRT) and three dimensional conformal radiation therapy (3D-CRT) for pelvic radiation of post-operative treatment with gynecologic malignant tumor. Methods A prospective investigation study was conducted on 183 patients of post-operative patients with whole pelvic radiation therapy of cervical cancer or endometrial cancer in Zhejiang Cancer Hospital [IMRT group (n=85) and 3D-CRT group (n=98)] from Oct. 2015 to Oct. 2016. The two groups received same dose (45 Gy in 25 fractions). Comparison of two groups with radiation dosimetry:the score according to the Radiation Therapy Oncology Group (RTOG) acute radiation injury grading standards before and after radiotherapy reaction, the score from functional assessment of cancer therapy scale-cervix (FACT-Cx) scale and expanded prostate cancer index composite for clinical practice (EPIC-CP) scale were also analyzed. Results (1) There were no significant effect with age, culture level, family economic condition and ratio of radiochemotherapy between two groups (all P>0.05). (2) Dosimetric comparison for IMRT vs 3D-CRT:the average dose of planning target volume (PTV) decreased(46.1 ± 0.4) vs(46.4 ± 0.5)Gy, V45 dose percentage increased(95.2 ± 1.0)%vs (93.3 ± 2.0)%, intestinal bag dose of V40 decreased(24.4 ± 6.8)%vs (36.5 ± 15.9)%, rectal V40 dose percentage decreased(73.9 ± 12.3)%vs (85.4 ± 8.4)%, and lower rectal V45 dose percentage(32.8 ± 13.4)%vs (71.5 ± 13.7)%, bladder V40 dose percentage decreased(55.5 ± 13.0)% vs (84.4 ± 13.0)%. Bone marrow V20 lower:(67.9 ± 5.4)% vs (79.5 ± 6.6)%, V10 lower:(82.1 ± 6.0)% vs (86.3 ± 6.6)%; there were significant differences (all P<0.05). There was no significant difference between the dose of V45 in the intestinal pouch and bladder (P>0.05). (3) Acute radiation injury classification for IMRT vs 3D-CRT:big or small intestine:Ⅱ-Ⅲreaction [13%(11/85) vs 24% (24/98); χ2=3.925, P=0.048], there was significant difference. Bladder: Ⅲ reaction [19% (16/85) vs 26% (25/98); χ2=1.171, P=0.279], there was no significant difference. Radiochemotherapy of bone marrow suppression:Ⅲ-Ⅳreaction (14/20), the incidence rate [26%(14/54) vs 31%(20/65);χ2=0.339, P=0.562], the difference was not statistically significant. (4) Quality of life scale by FACT-Cx scale in IMRT vs 3D-CRT:there were no significant difference before radiotherapy (82 ± 16 vs 85 ± 16;t=1.279, P=0.203), while there was significant difference after radiotherapy (76 ± 14 vs 71 ± 18;t=-2.160, P=0.032). EPIC-CP scale score:before radiotherapy they were (16±7 vs 15±6;t=-0.174, P=0.862) ,but after radiotherapy (18±7 vs 22± 7; t=3.158, P=0.002), there was significant difference between them. Before and after radiotherapy, the increased EPIC-CP scale of the IMRT group vs 3D-CRT group were 3 ± 4 and 6 ± 4, the 3D-CRT group was significantly higher, the difference was statistically significant (t=5.500, P=0.000). Conclusion IMRT has shown that there are a significant benefit for the post-operative patients with cervical cancer and endometrial cancer compared to 3D-CRT.

Objective To report two cases of severe pulmonary complication after bortezomib treatment for multiple myeloma. Methods Two cases of severe pulmonary complication after bortezomib treatment patients with relapsed multiple myeloma wereas discussed with review of literature. Results Two relapsed MM patients were treated with bortezomib and thalidomide or dexametbasone. Cough, dyspnea, fever and hypoxia developed after completion of bortezomib. Chest X-ray revealed bilateral pulmonary infiltrates,but infection was not identified with sputum cultures, and broad-spectrum antibiotics were ineffective.Conclusion Severe pulmonary injury was rare complication in patients receiving treatment for multiple myeloma, however, it was a life-threatening disorder. Prophylaxis corticosteroids maybe effective. Although corticosteroids are effective, but the mechanism of lung injury associated with bortezomib is unclear, and further evaluation of this potential toxicity is appropriate.

OBJECTIVETo investigate the value of detecting thyroid transcription factor 1 (TTF-1) and Noval aspartic proteinase of pepsin family A (napsin A) in pleural fluid cell blocks in cytopathologic diagnosis of pulmonary adenocarcinoma.

METHODSConventional cell smears of pleural effusions were obtained from 48 patients with a history of lung adenocarcinoma for cytological analysis. The cell blocks were prepared using the cytological specimens and examined with immunohistochemistry for TTF-1 and napsin A. The rates of a positive diagnosis of pulmonary adenocarcinoma were compared between the two methods, and the diagnositic value of TTF-1 and napsin A in pleural fluid cell blocks was evaluated.

RESULTSImmuno- histochemistry of the cell block sections yielded a significantly higher positive rate of diagnosis than cytological analysis of conventional cell smear (84.44% vs 55.56%, P<0.05). Most of the pleural fluid cell blocks showed positive expressions of TTF-1 (36/38, 94.74%) and napsin A (30/38, 78.95%), and none of samples showed TTF-1 or napsin A expression in the mesothelial cells (P<0.05). The combination detection of TTF-1 and napsin A in pleural fluid cell blocks had a high diagnosis value with a diagnostic sensitivity of 97.37% and a specificity of 100% for pulmonary adenocarcinoma.

CONCLUSIONSThe combined detection of TTF-1 and napsin A in pleural fluid cell blocks facilitates cytopathologic diagnosis of pulmonary adenocarcinoma.

Adenocarcinoma ; diagnosis ; metabolism ; Aspartic Acid Endopeptidases ; metabolism ; Biomarkers, Tumor ; metabolism ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; metabolism ; Nuclear Proteins ; metabolism ; Pleural Effusion ; Sensitivity and Specificity ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism

Under the background of " Internet+ medical treatment" and the continuous deepening of face recognition technology research, the face recognition industry has continued to mature, and face recognition has been initially applied in medical fields such as hospital management, auxiliary medical care, and epidemic prevention and control. At the same time, face recognition technology brings problems including error risk, technical cracking risk, privacy risk, equality risk, abuse risk, and other issues in practice, which seriously threaten the personal and property rights and interests of the public. On the basis of summarizing the specific application direction of face recognition technology in hospitals, the authors sorted out the legal regulation of face recognition in China, and proposed that it should be based on technology research and development, strengthen the " gatekeeper" responsibility of medical institutions, improve legal system and recommendations for strengthening judicial leadership in order to improve the legal regulations of face recognition technology, reduce the risk of infringement by medical institutions in the application of face recognition technology, and protect the legitimate rights and interests of citizens.

Objective To explore the clinical significance of serum squamous cell carcinoma antigen (SCC?Ag) in early cervical squamous cell carcinoma. Methods The clinicopathological data and follow?up information of 1435 patients with stageⅠA2?ⅡA cervical squamous cell carcinoma were collected. The correlation between serum SCC?Ag level and clinicopathological feature and prognosis were analyzed.The best cut?off of serum SCC?Ag for predicting pelvic lymph node metastasis and survival of cervical squamous cell carcinoma patients were also identified. Results The result of univariate analysis showed that The International Federation of Gynecology and Obstetrics (FIGO) staging, tumor size, depth of cervical stromal invasion, lymphovascular space involvement, pelvic lymph node metastasis, common iliac lymph node metastasis and para?aortic lymph node metastasis were significantly related with serum SCC?Ag level (all P＜0.05). The result of multivariate logistic regression analysis showed that tumor size, depth of cervical stromal invasion, pelvic lymph node metastasis and common iliac lymph node metastasis were the independent risk factors of preoperative serum SCC?Ag＞2.65 ng／ml ( all P＜0.001). Multivariate Cox regression analysis showed that lymphovascular space involvement, SCC?Ag＞3.15 ng／ml, common iliac lymph node metastasis and tumor size ＞4 cm were the independent prognostic risk factors ( all P＜0.05). The univariate analysis showed that, the tumor size, FIGO stage, depth of cervical stromal invasion and SCC?Ag level were significantly related with the recurrence of 1 096 patients without postoperative high risk factors ( all P＜0.05). Multivariate logistic regression analysis showed that FIGO stage (OR＝1.671) and SCC?Ag＞2.65 ng／ml (OR＝4.490) were the independent risk factors for recurrence (both P＜0.05). The best cut off of SCC?Ag for predicting early postoperative cervical lymph node metastasis of cervical squamous cell carcinoma was 2.65 ng／ml, the sensitivity was 60.8%,the specificity was 71.8%. The best cut off of SCC?Ag for predicting prognosis of cervical squamous cell carcinoma was 3.15 ng／ml, the sensitivity was 53.5%, the specificity was 71.1%.Conclusions Preoperative serum squamous cell carcinoma antigen is an independent prognostic risk factor of survival of patients with early cervical squamous cell carcinoma, and is significantly related with recurrence of patients without postoperative high?risk factors. It can be used as a reference factor for postoperative adjuvant radiotherapy.