Objective To explore the sensitivity and specificity of colposcopy directed biopsy (CDB) and the value of loop electrosurgical excision procedure (LEEP) for the diagnosis and treatment of microinvasive cervical cancer (MCC). Methods One hundred and thirty five patients with MCC were diagnosed with LEEP in Obstetrics and Gynecology Hospital, Fudan University from April 2008 to November 2010, and were retrospectively analyzed on CDB diagnoses and following treatment after LEEP. According to patient′s desire for preservation of fertility and cone margin status, following strategies after LEEP included follow-up, second LEEP, hysterectomy, modified radical hysterectomy and radical hysterectomy. Single and multiple factors related to residual lesions after LEEP were analysed with Pearson Chi-square test and logistic regression model, respectively. Results CDB diagnosed MCC with a sensitivity of 4.4%(6/135), specificity of 100.0%(4 680/4 680), and false negative rate of 95.6%(129/135). Among the 135 patients, 29 did not receive further treatment in our hospital and lost contact. One hundred and six patients had secondary treatment or follow-up in our hospital, 4 of among which were closely followed up;one hundred and two received further treatment, which included 6 cases with second LEEP (3 received extrafascial hysterectomy after repeat LEEP), 59 cases hysterectomy, 14 cases modified radical hysterectomy and 26 cases radical hysterectomy. For factors related to residual lesions after LEEP, single factor analysis showed that the ratio of residual lesion in patients aged 27-39, 40-49 and 50-65 years were respectively 19.0%(11/58), 15.4%(10/65) and 5/12 (χ2=4.505, P=0.105). Residual lesions occurred in 24.7%(23/93) of patients with positive LEEP margins, which was more than that 7.1%(3/42) of patients with negative LEEP margins (χ2=5.756, P=0.016). The ratio of residual lesions in patients with positive endocervical, ectocervical and deep stromal margins were respectively 29.6%(8/27), 17.1%(7/41)and 30.6%(11/36;χ2=2.275, P=0.321). Residual lesions in patients with or without lymph vascular space invasion (LVSI) were 2/7 and 18.8%(24/128), respectively (χ2=0.412, P=0.521). The ratio of residual lesions in patients with invasion depth of<1 mm was 17.1%(7/41), 1-<3 mm was 19.0%(16/84), and 3-5 mm was 3/10, with no significant difference among three groups (χ2=0.870, P=0.647). Logistic regression analysis showed positive cone margin (OR=5.069, P=0.014) and age (OR=1.080, P=0.024) were the independent risk factors of residual lesions after LEEP conization. Conclusions CDB alone is not adequate for the diagnosis of MCC. For young patients who desire to preserve fertility with a negative cone margin, close follow-up is acceptable. Cone margin status and age are two independent risk factors for residual lesions after LEEP.

Adult ; Cochlear Implantation ; Female ; Hearing Loss, Sensorineural ; etiology ; surgery ; Humans ; Meniere Disease ; complications ; surgery

Adolescent ; Adult ; Child ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Administration, Sublingual ; Bacterial Vaccines ; administration & dosage ; immunology ; Child ; Child, Preschool ; Double-Blind Method ; Female ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin A, Secretory ; analysis ; Male ; Pseudomonas Vaccines ; Recurrence ; Respiratory Tract Infections ; immunology ; prevention & control ; Treatment Outcome

OBJECTIVETo study the effects of acitretin on the expression of signaling pathway-related genes in an epidermal squamous-cell carcinoma cell line.

METHODSThe mRNA expression levels of STAT3, cyclin D1 and p42/44MAPK were detected in a human epidermal carcinoma cell line A431 by RT-PCR. Their expressions at protein level were studied by Western blot. The expression levels were studied in cells treated with or without 10(-5) mol/L acitretin at different time intervals.

RESULTS(1) Acitretin could significantly inhibit the expression of STAT3 and cyclin D1 mRNA in a time-dependent manner (P < 0.05). The STAT3 and cyclin D1 protein expression levels were down-regulated. Acitretin could also down-regulate the p42/4MAPK mRNA expression. (2) After incubation with acitretin, the mRNA level of cyclin D1 cells was positively correlated with that of STAT3 (P < 0.05). The cyclin D1 protein level was also positively correlated with that of STAT3 (P < 0.05). However there was no correlation of mRNA levels between cyclin D1 and p42/44MAPK.

CONCLUSIONRegulation of the Jak/STAT3 signaling pathway may play an important role in the effect of acitretin on epidermal squamous-cell carcinoma cells. The abnormal expression of STAT3 can be regarded as a prerequisite for acitretin treatment effect.

Acitretin ; pharmacology ; Antineoplastic Agents ; pharmacology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Cyclin D1 ; biosynthesis ; genetics ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Humans ; Mitogen-Activated Protein Kinase 1 ; biosynthesis ; genetics ; Mitogen-Activated Protein Kinase 3 ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; STAT3 Transcription Factor ; biosynthesis ; genetics ; Signal Transduction

OBJECTIVE To establish a UPLC method to determine the content of hesperidin,honokiol,magnolol and atrc-tylodine in Huoxiangzhengqi Soft Capsule.METHODS The chromatographic column of Acquity UPLC BEH C18(100 mm×2. 1 mm,1.7μm) was used.The mobile phase was composed of acetonitrile and 0.2% formic acid solution in gradient elution. The flow rate was 0.4 mL/min.The column temperature was 30 ℃.The UV detection wavelength was 284 nm(hesperidin), 290 nm(honokiol and magnolol) and 336 nm(atrctylodine).RESULTS The linear ranges of hesperidin,honokiol,magnolol and atrctylodine were 0.025 3~1.012 0,0.021 4~0.854 0,0.024 4~0.976 0,0.003 3~0.130 0 mg/mL respectively.The average recoveries(n =6)of hesperidin,honokiol,magnolol and atrctylodine were between 97.7% and 100.3% with RSD less than 1.9%.CONCLUSION The method is accurate,sensitive and specific,and could be used for the quality control of Huox-iangzhengqi Soft Capsule.

Objective To evaluate the long-term therapeutic effects of repairing the whole auricular defects with osseointegrated prosthetic ears. Methods From January 2002 to December 2005, 62 patients (63 ears) with the whole auricular defects were treated with osseointegrated prosthetic ears and followed up for 5- 8 years (median 6.5 years) after operations. In all cases, the following items were analyzed: stability and dislocation rate of the implants fixing prosthetic ears, infection of tissues surrounding implants, time and appearance satisfaction of wearing prosthetic ears, rate and time length of replacement of prosthetic ears, and presence of systemic complications or not. Results All 63 ears were healed with one surgery, with the appearances of life like shapes, stable fixation, and natural color. Infection of implants and their surrounding tissues occured in all cases, but didn't influence the stability of the implants. All 126 implant particles in 63 ears survived after one surgery, execpt that 4 implant particles were dislocated by trauma. In all cases, the time of wearing prosthetic ears was more than 8 hours per day. Because of color fading and breakage, average time length of replacement of prosthetic ears was 3.0 years. There were no intracranial or systemic complications. Conclusions Osseointegrated prosthetic ears can be used in the treatment of the patients with the whole auricular defects, because of its safety and reliability, the stability of long-term therapeutic effects, and the good satisfaction of the patients.

Objective To investigate the clinical significance of intact canal wall mastoidectomy combined with facial recess opening in the treatment of secretory otitis media of children. Methods The clinical data of 17 children ( 19 ears) with recurrent secretory otitis media yet failed tube insertion more than 3 times, and treated with intact canal wall mastoidectomy combined with facial recess opening, in the Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of SUN Yat-sen University, were reviewed. And because of the eustachian tube dysfunction, 7 ears simultaneously accepted tube insertion, which were removed after 1 to 3 months. Results Pathological examination of the lesions in middle ear and mastoid of the 19 ears, revealed cholesterol granuloma in 9 ears and inflammatory granulation in 10 ears. All 19 ears recovered with normal tympanic membranes. There were 16 ears with type A tympanogram and 3 ears with type C tympanogram ( negative pressure less than 150 mm H2O). The air-bone gaps were less than 15 dB in 3 months after surgery. There was no recurrence in all cases after 2 - 3 years follow-up. Conclusions In case of recurrent otitis media in children, especially when tube insertion is ineffective, intact canal wall mastoidectomy combined with facial recess opening can be adopted to clear the lesions thoroughly, and to establish long-time and effective ventilation of eustachian tube, tympanic cavity,tympanic antrum, and mastoid.

OBJECTIVE To investigate how MLKL functions on the membrane and explore its electrophysiological characters and structure. METHODS The full-length human MLKL were expressed in SF21 cells and purified using glutathione-sepharose affinity chromatography. The currents of purified MLKL proteins were recorded in avoltage-clamp mode using a Warner BC-535 bilayer clamp amplifier. The currents were digitized using pCLAMP 10.2 software. HEK293 cells were cultured and transfected with MLKL plasmid. Cell viability was examined using the CellTiter- Glo Luminescent Cell Viability Assay kit. RESULT MLKL forms cation channels that are permeable preferentially to Mg2+ rather than Ca2+ in the presence of Na+ and K+. Moreover,each MLKL monomer contains five transmembrane helices:H1, H2, H3 , H5 and H6 of the N-terminal domain which is sufficient to form channels. Finally, MLKL-induced membrane depolarization and cell death exhibit a positive correlation to its channel activity.

OBJECTIVETo evaluate the radiation induced parotid dysfunction in nasopharyngeal carcinoma (NPC) patients who had received different methods of radiotherapy.

METHODSFrom January 1996 to January 2000, 380 NPC patients were divided into conventional fraction (CF-175 patients), late-course accelerated hyperfractionation (LCAF-63 patients) and intensity modulated radiation therapy (IMRT-142 patients) groups. Conventional radiotherapy was given with a total dose of 70 Gy. Patients in the LCAF group were treated with the same fractionation as CF group until the dose of 36 - 40 Gy, then followed by LCAF radiotherapy to a total dose of 75 Gy. IMRT in the form of full-course was given to a total dose of 72 Gy. Acute parotiditis was observed during the treatment. The parotid secretory function was examined 2 years after radiotherapy.

RESULTSThe dose of parotid in IMRT was much lower than those in the other 2 groups. Extreme damage rates of parotid secretory function in CF, LCAF and IMRT groups were 81.7%, 81.0% and 69.7% (P < 0.05); acute parotiditis rates were 23.4%, 20.4% and 41.3% respectively, with the differences among the 3 groups significant (P < 0.05).

CONCLUSIONThe radiation parotid functional damage differs in the various methods of radiotherapy. IMRT, being able to improve the tumor target coverage and spare the adjacent critical structures, is indicated for NPC.

Adolescent ; Adult ; Carcinoma, Squamous Cell ; radiotherapy ; Dose Fractionation ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Parotid Gland ; physiopathology ; radiation effects ; Parotitis ; etiology ; Radiation Injuries ; physiopathology ; Radiotherapy, Intensity-Modulated ; methods