Objective:To explore the correlation between long non-coding RNA LOC101927476 (LncRNA LOC101927476), stage-specific embryonic antigen-4 (SSEA-4), and intronic microRNA-28 (hsa-miR-28) and postoperative recurrence/metastasis of ovarian cancer.Methods:A total of 195 patients with ovarian cancer who underwent surgical treatment in The First People’s Hospital of Shangqiu and The First Affiliated Hospital of Zhengzhou University from Jan. 2021 to Oct. 2022 were selected. Patients were divided into occurrence group and non-occurrence group according to whether they had recurrence/metastasis within 2 years after surgery. R package "Match It" and the 1∶1 principle for propensity score matching (PSM) were used to compared the expression of LncRNA LOC101927476, SSEA-4 mRNA, and hsa-miR-28 in different tissues and two groups. Multivariate logistic regression analysis was used to analyze the correlation between various detection indicators in cancer tissues and postoperative recurrence/metastasis of ovarian cancer. The value of LncRNA LOC101927476, SSEA-4 mRNA, hsa-miR-28, and their combined use in predicting recurrence/metastasis in cancer tissues was analyzed using the receiver operating characteristic (ROC) curve. The external calibration curve was used to analyze the combined predicts of the consistency between the incidence of recurrence/metastasis and the actual incidence.Results:In cancer tissues, the expression of LncRNA LOC101927476 and hsa-miR-28 was lower than that in adjacent tissues, while the expression of SSEA-4 mRNA was higher ( P<0.05). The expression of LncRNA LOC101927476 and hsa-miR-28 in the occurrence group was lower than that in the non-occurrence group, while the expression of SSEA-4 mRNA was higher than that in the non-occurrence group ( P<0.05). Multivariate logistic regression analysis showed that the increase of LncRNA LOC101927476, SSEA-4 mRNA, and hsa-miR-28 were independent factors associated with the recurrence/metastasis of ovarian cancer after surgery ( P<0.05). ROC analysis showed that the AUCs of LncRNA LOC101927476, SSEA-4 mRNA, hsa-miR-28, and their combined prediction of ovarian cancer recurrence/metastasis after surgery were 0.730, 0.767, 0.832, and 0.915, respectively ( P<0.001). Comparing the AUC of the combination with that of the individual, it was found that the AUC of the combination was significantly higher than that of LncRNA LOC101927476, SSEA-4 mRNA, and hsa-miR-28 ( Z=3.924, 2.995, 2.078, P=0.000, 0.003, 0.038). The calibration curve of the external dataset showed that the combined prediction of the incidence of recurrence/metastasis was basically consistent with the actual incidence, and the two curves had a high degree of fit. Conclusions:The expression of LncRNA LOC101927476, SSEA-4, and hsa-miR-28 in cancer tissues is associated with postoperative recurrence/metastasis of ovarian cancer, which can provide a reference for early clinical prediction of recurrence/metastasis. The combined application of the three can further improve the predictive value, help to early warn the risk of recurrence/metastasis, and provide important reference information for clinical personalized prevention intervention.

Objective:To explore the correlation between long non-coding RNA LOC101927476 (LncRNA LOC101927476), stage-specific embryonic antigen-4 (SSEA-4), and intronic microRNA-28 (hsa-miR-28) and postoperative recurrence/metastasis of ovarian cancer.Methods:A total of 195 patients with ovarian cancer who underwent surgical treatment in The First People’s Hospital of Shangqiu and The First Affiliated Hospital of Zhengzhou University from Jan. 2021 to Oct. 2022 were selected. Patients were divided into occurrence group and non-occurrence group according to whether they had recurrence/metastasis within 2 years after surgery. R package "Match It" and the 1∶1 principle for propensity score matching (PSM) were used to compared the expression of LncRNA LOC101927476, SSEA-4 mRNA, and hsa-miR-28 in different tissues and two groups. Multivariate logistic regression analysis was used to analyze the correlation between various detection indicators in cancer tissues and postoperative recurrence/metastasis of ovarian cancer. The value of LncRNA LOC101927476, SSEA-4 mRNA, hsa-miR-28, and their combined use in predicting recurrence/metastasis in cancer tissues was analyzed using the receiver operating characteristic (ROC) curve. The external calibration curve was used to analyze the combined predicts of the consistency between the incidence of recurrence/metastasis and the actual incidence.Results:In cancer tissues, the expression of LncRNA LOC101927476 and hsa-miR-28 was lower than that in adjacent tissues, while the expression of SSEA-4 mRNA was higher ( P<0.05). The expression of LncRNA LOC101927476 and hsa-miR-28 in the occurrence group was lower than that in the non-occurrence group, while the expression of SSEA-4 mRNA was higher than that in the non-occurrence group ( P<0.05). Multivariate logistic regression analysis showed that the increase of LncRNA LOC101927476, SSEA-4 mRNA, and hsa-miR-28 were independent factors associated with the recurrence/metastasis of ovarian cancer after surgery ( P<0.05). ROC analysis showed that the AUCs of LncRNA LOC101927476, SSEA-4 mRNA, hsa-miR-28, and their combined prediction of ovarian cancer recurrence/metastasis after surgery were 0.730, 0.767, 0.832, and 0.915, respectively ( P<0.001). Comparing the AUC of the combination with that of the individual, it was found that the AUC of the combination was significantly higher than that of LncRNA LOC101927476, SSEA-4 mRNA, and hsa-miR-28 ( Z=3.924, 2.995, 2.078, P=0.000, 0.003, 0.038). The calibration curve of the external dataset showed that the combined prediction of the incidence of recurrence/metastasis was basically consistent with the actual incidence, and the two curves had a high degree of fit. Conclusions:The expression of LncRNA LOC101927476, SSEA-4, and hsa-miR-28 in cancer tissues is associated with postoperative recurrence/metastasis of ovarian cancer, which can provide a reference for early clinical prediction of recurrence/metastasis. The combined application of the three can further improve the predictive value, help to early warn the risk of recurrence/metastasis, and provide important reference information for clinical personalized prevention intervention.

Objective:To investigate the effects of vitamin D and ethinyl estradiol and cyproterone tablets in the treatment of patients with polycystic ovary syndrome (PCOS) on ovarian function and glucose and lipid metabolism.Methods:147 PCOS patients treated in our hospital from Jan. 2021 to May. 2023 were selected as the research objects. According to the different treatment methods, they were divided into a control group of 75 cases and an observation group of 72 cases. The control group were treated with dynylestradiol and cyproterone. Ketone tablets treatment, the observation group was supplemented with vitamin D on the basis of the control group. Fasting blood-glucose (FPG), total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL cholesterol (LDL-C), fasting serum insulin (FINS) ], as well as improvement in ovarian function (menstrual scarcity, ovulation and pregnancy), clinical efficacy of treatment, and occurrence of adverse effects.Results:After treatment, FPG, FINS, TC, TG, and LDL-C levels in the observation group were significantly lower and HDL-C levels were significantly higher in the observation group than those in the control group ( P<0.05). After treatment, MOD and AFC were significantly higher and ovarian volume was significantly lower in the observation group than those in the control group ( P<0.05). The rate of scanty menstruation was 13.89%, the rate of ovulation was 83.33%, and the rate of pregnancy was 62.50% in the observation group, and 62.50%, 64.00%, and 44.00% in the control group, respectively. Scanty menstruation in the observation group was significantly lower than that in the control group, and the improvement of ovulation and pregnancy was significantly higher than that in the control group ( P<0.05). The total effective rate in the observation group was 95.83.%, and that in the control group was 73.33%, the total efficiency of the observation group was higher than that of the control group ( P<0.05). The incidence of adverse reactions during the treatment period was 6.94% in the observation group and 9.33% in the control group, and there was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05) . Conclusion:The combination of vitamin D and ethinyl estradiol and cyproterone tablets in the treatment of PCOS can more effectively improve ovarian function and glucose and lipid metabolism, increase ovulation rate and pregnancy rate, with definite clinical results and fewer adverse reactions.

Objective:To investigate the effects of vitamin D and ethinyl estradiol and cyproterone tablets in the treatment of patients with polycystic ovary syndrome (PCOS) on ovarian function and glucose and lipid metabolism.Methods:147 PCOS patients treated in our hospital from Jan. 2021 to May. 2023 were selected as the research objects. According to the different treatment methods, they were divided into a control group of 75 cases and an observation group of 72 cases. The control group were treated with dynylestradiol and cyproterone. Ketone tablets treatment, the observation group was supplemented with vitamin D on the basis of the control group. Fasting blood-glucose (FPG), total cholesterol (TC), triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL cholesterol (LDL-C), fasting serum insulin (FINS) ], as well as improvement in ovarian function (menstrual scarcity, ovulation and pregnancy), clinical efficacy of treatment, and occurrence of adverse effects.Results:After treatment, FPG, FINS, TC, TG, and LDL-C levels in the observation group were significantly lower and HDL-C levels were significantly higher in the observation group than those in the control group ( P<0.05). After treatment, MOD and AFC were significantly higher and ovarian volume was significantly lower in the observation group than those in the control group ( P<0.05). The rate of scanty menstruation was 13.89%, the rate of ovulation was 83.33%, and the rate of pregnancy was 62.50% in the observation group, and 62.50%, 64.00%, and 44.00% in the control group, respectively. Scanty menstruation in the observation group was significantly lower than that in the control group, and the improvement of ovulation and pregnancy was significantly higher than that in the control group ( P<0.05). The total effective rate in the observation group was 95.83.%, and that in the control group was 73.33%, the total efficiency of the observation group was higher than that of the control group ( P<0.05). The incidence of adverse reactions during the treatment period was 6.94% in the observation group and 9.33% in the control group, and there was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05) . Conclusion:The combination of vitamin D and ethinyl estradiol and cyproterone tablets in the treatment of PCOS can more effectively improve ovarian function and glucose and lipid metabolism, increase ovulation rate and pregnancy rate, with definite clinical results and fewer adverse reactions.

Objective:To investigate the clinical significance and biological effect of long non-coding RNA (lncRNA) NRSN2-AS1 in ovarian cancer.Methods:The expression of NRSN2-AS1 was detected by real-time quantitative PCR (RT-qPCR) in 84 cases of ovarian cancer tissues and corresponding normal adjacent tissues, and the relationship between NRSN2-AS1 expression and clinical data of patients was analyzed. Human ovarian epithelial cells HOSEpiC and human ovarian cancer cells A2780 and OVCAR3 were cultured in vitro, and overexpression or interference of NRSN2-AS1 and control plasmids were respectively transfected into A2780 and OVCAR3 cells as the blank group, overexpression group and control group, interference group. CCK-8 assay was used to detect cell proliferation, while transwell invasion and migration assay were used to detect the change of cell metastasis ability, RT-qPCR and Western blot were used to detect the expressions of SRY related HMG box transcription factor 12 (SOX12), a potential downstream gene of NRSN2-AS1.Results:The expressions of NRSN2-AS1 in ovarian cancer tissues and cells were significantly higher than normal adjacent tissues, and the high expression of NRSN2-AS1 was significantly correlated with poor prognosis, lymph node metastasis and high clinical stage ( P<0.05). In the blank and overexpression group, the expressions of NRSN2-AS1 were 1.00±0.08 and 5.78±0.41, the expressions of SOX12 mRNA were 1.00±0.10 and 3.08±0.23, the expression of SOX12 protein were 1.00±0.08 and 7.26±0.39, the invasion cells per field were 22.7±4.9 and 79.0±6.2, and the migration cells per field were 26.5±4.1 and 43.5±4.5. In the control and interference group, the expression of NRSN2-AS1 were 1.00±0.11 and 0.37±0.04, the expressions of SOX12 mRNA were 1.00±0.07 and 0.59±0.05, the expression of SOX12 protein were 1.00±0.07 and 0.36±0.03, the invasion cells per field were 68.3±6.1 and 30.6±5.5, and the migration cells per field were 85.2±7.0 and 22.7±4.2. Compared with the blank group, the expression of SOX12 mRNA and protein in the overexpression group was significantly increased ( P<0.05), and the cell proliferation and metastasis ability were significantly enhanced ( P<0.05). Compared with the control group, the expression of SOX12 mRNA and protein in the interference group was significantly decreased, and the ability of cell proliferation and metastasis was suppressed significantly ( P<0.05) . Conclusion:The expression of NRSN2-AS1 is up-regulated in ovarian cancer, which is closely related to poor prognosis and progression of ovarian cancer. NRSN2-AS1 can promote the expression of SOX12 and the malignant behavior of ovarian cancer cells in vitro.

Objective:To explore the effects of miR-485-5p on cisplatin-resistant ovarian cancer cells and it’s mechanism.Methods:RT-qPCR was used to detect the expression of miR-485-5p in human normal ovarian epithelial cell line (IOSE-80) and ovarian cancer cell lines (A2780,SKOV3,OVCAR3,OVCA433) . Cisplatin (DDP) -resistant ovarian cancer cells were constructed and the expression of miR-485-5p and EGFR was detected. CCK8 assay was used to detect cell proliferation ability in each group. Cell apoptosis was measured by flow cytometry.Results:Compared with IOSE-80 cell, miR-485-5p expression was decreased in each ovarian cancer cell lines, while the expression of EGFR was increased (all P<0.05) .The expression of miR-485-5p in SKOV3/DDP cell lines was further decreased while EGFR expression was further increased than that in SKOV3 cells ( P<0.05) . Transfection of miR-485-5p mimic into SKOV3/DDP cells could inhibit cell proliferation and induce apoptosis, but the results were reversed when cells were transfected with miR-485-5p inhibitor (all P<0.05) . The proliferation was increased while apoptosis was decreased in EGFR transfected SKOV3/DDP cells, but this effects was partially offseted by miR-485-5pmimic. Conclusion:miR-485-5p participates in the regulation of cisplatin resistance of ovarian cancer cells, and overexpression of miR-485-5p can promote the chemosensitivity of ovarian cancer, which may be achieved through negative regulation of EGFR.

Objective:To compare the efficiency of the early-follicular phase long-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol, the mid-luteal phase short-acting GnRH-a long protocol and the gonadotropin-releasing hormone antagonist (GnRH-A) protocol in poor ovarian responders classified by Poseidon criteria, and to explore the most appropriate and effective ovarian hyperstimulation protocol in each Poseidon criteria.Methods:The clinical data from poor ovarian responders according to the Poseidon criteria who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in the Reproductive Medicine Center of the First Clinical College of Zhengzhou University were retrospectively analyzed by a cohort study. The patients were further divided into lower age group (<35 years) and high age group (≥35 years). The data of baseline characteristics and clinical outcomes in each ovarian hyperstimulation protocol group were analyzed and compared. Results:Totally 1249 eligible subjects were recruited in the study, including 410 patients in lower age group and 839 patients in high age group. In lower age group, early-follicular phase long-acting GnRH-a long protocol was associated with higher oocyte number (5.6±3.6 vs. 4.6±3.2 vs. 2.4±1.7, P<0.001) and No. of transferable embryos (2.2±1.6 vs. 1.6±1.6 vs. 1.1±1.1, P<0.001), lower cancellation rate of embryo transfer [20.8% (33/159) vs. 39.5% (49/124) vs. 69.3% (88/127), P<0.001], higher pregnancy rate per transfer [40.9% (65/159) vs. 29.0% (36/124) vs. 15.7% (20/127), P<0.001], and higher live birth rate [31.4% (50/159) vs. 23.4% (29/124) vs. 12.6% (16/127), P<0.001] than mid-luteal phase short-acting GnRH-a long protocol and GnRH-A protocol. However, there was no significant difference in implantation rate and abortion rate among three protocols ( P>0.05). In high age group, the early-follicular phase long-acting GnRH-a long protocol was associated with higher oocyte number (3.9±2.8 vs. 3.1±2.3 vs. 2.5±1.8, P<0.001) and No. of transferable embryos (2.8±2.0 vs. 2.4±2.0 vs. 2.1±1.7, P<0.001), lower cancellation rate of embryo transfer [19.5% (60/307) vs. 28.7% (102/355) vs. 53.3% (56/105), P<0.001] than mid-luteal phase short-acting GnRH-a long protocol and GnRH-A protocol. However, there was no statistical significance in implantation rate, pregnancy rate, abortion rate and live birth rate among the three protocols ( P>0.05). Conclusion:It seems that the early-follicular phase long-acting GnRH-a long protocol was more effective in clinical outcomes than the mid-luteal phase short-acting GnRH-a long protocol and the GnRH-A protocol for young patients with POR. It is worth emphasizing that the older the patient is, the lower the live birth rate will be. The characteristics and prognosis of patients should be used to develop clinical management strategies especially for the POR crowd.

Objective:To compare the efficiency of the early-follicular phase long-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol, the mid-luteal phase short-acting GnRH-a long protocol and the gonadotropin-releasing hormone antagonist (GnRH-A) protocol in poor ovarian responders classified by Poseidon criteria, and to explore the most appropriate and effective ovarian hyperstimulation protocol in each Poseidon criteria.Methods:The clinical data from poor ovarian responders according to the Poseidon criteria who underwent in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in the Reproductive Medicine Center of the First Clinical College of Zhengzhou University were retrospectively analyzed by a cohort study. The patients were further divided into lower age group (<35 years) and high age group (≥35 years). The data of baseline characteristics and clinical outcomes in each ovarian hyperstimulation protocol group were analyzed and compared. Results:Totally 1249 eligible subjects were recruited in the study, including 410 patients in lower age group and 839 patients in high age group. In lower age group, early-follicular phase long-acting GnRH-a long protocol was associated with higher oocyte number (5.6±3.6 vs. 4.6±3.2 vs. 2.4±1.7, P<0.001) and No. of transferable embryos (2.2±1.6 vs. 1.6±1.6 vs. 1.1±1.1, P<0.001), lower cancellation rate of embryo transfer [20.8% (33/159) vs. 39.5% (49/124) vs. 69.3% (88/127), P<0.001], higher pregnancy rate per transfer [40.9% (65/159) vs. 29.0% (36/124) vs. 15.7% (20/127), P<0.001], and higher live birth rate [31.4% (50/159) vs. 23.4% (29/124) vs. 12.6% (16/127), P<0.001] than mid-luteal phase short-acting GnRH-a long protocol and GnRH-A protocol. However, there was no significant difference in implantation rate and abortion rate among three protocols ( P>0.05). In high age group, the early-follicular phase long-acting GnRH-a long protocol was associated with higher oocyte number (3.9±2.8 vs. 3.1±2.3 vs. 2.5±1.8, P<0.001) and No. of transferable embryos (2.8±2.0 vs. 2.4±2.0 vs. 2.1±1.7, P<0.001), lower cancellation rate of embryo transfer [19.5% (60/307) vs. 28.7% (102/355) vs. 53.3% (56/105), P<0.001] than mid-luteal phase short-acting GnRH-a long protocol and GnRH-A protocol. However, there was no statistical significance in implantation rate, pregnancy rate, abortion rate and live birth rate among the three protocols ( P>0.05). Conclusion:It seems that the early-follicular phase long-acting GnRH-a long protocol was more effective in clinical outcomes than the mid-luteal phase short-acting GnRH-a long protocol and the GnRH-A protocol for young patients with POR. It is worth emphasizing that the older the patient is, the lower the live birth rate will be. The characteristics and prognosis of patients should be used to develop clinical management strategies especially for the POR crowd.

Background and purpose:For patients with advanced lung adenocarcinoma harboring an activating EGFR gene mutation, the current standard of care is EGFR-TKI alone. This study aimed to compare efficacy and safety of gefitinib plus chemotherapy with gefitinib or chemotherapy alone for treating advanced lung adenocarcinoma with an activatingEGFR gene mutation.Methods:This study included 61 patients with lung adenocarcinoma harboring an acti-vatingEGFR gene mutation (19 exons deletion and exon 21 L858R mutations) whose ECOG performance status was 0 or 1. Patients were randomly divided into 3 groups. Group A (n=20) were given carboplatin/pemetrexed of a 4-week cycle, six cycles at most, plus gefitinib (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1; gefitinib 250 mg/d, d 5-21), and then re-ceived pemetrexed of a 4-week cycle plus gefitinib as maintenance therapy; Group B (n=20) were given carboplatin/peme-trexed of a 4-week cycle, six cycles at most (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1), then received pemetrexed as maintenance therapy; Group C (n=21) were given gefitinib (gefitinib 250 mg/d). Patients continued to receive therapy until disease progression or unacceptable toxicity or death. The primary end point was middle PFS and 12 months PFS rate. The secondary end points included objective response rate and adverse events.Results:Groups A and C both lost 1 case during follow-up. Median PFS for patients was 20.1 months (95%CI:18.0-22.2) in group A, 5.5 months (95%CI:3.9-7.2) in group B, and 9.8 months (95%CI:6.8-12.8) in group C. PFS rates of 12 months for groups A, B and C were 78.9%, 15.0% and 40.0%, respectively. The overall objective response rates for groups A, B and C were 84.2%, 35.0% and 65.0%, respectively. Serious adverse events were reported by 36.8% for group A, 30.0% for group B, and 5.0% for group C. The most common grade 3/4 adverse events were neutropenia (3 cases in group A, 4 cases in group B), fatigue (2 cases in group A, 2 cases in group B) and liver function impairment (2 cases in group A, 1 case in group C).Conclusion:Among patients withEGFR mutant lung adenocarcinoma, combination of chemotherapy with gefitinib as first-line treatment demonstrates an improvement in PFS. Long-term survival results will be further followed up.

Objective To investigate the clinical features of uterine empyema complicated with perforation of the uterus,the causes of misdiagnosis and measures of reducing misdiagnosis.Methods Twenty clinical cases from 2008 to 2013 in the First People's Hospiptal of Shangqiu were treated postmenopausal,uterine empyema and uterine perforation,and 16 cases of whose first diagnosed leak or misdiagnosed patients were retrospectively analyzed.Summarize the clinical characteristics,misdiagnosis and experiences in order to reduce the misdiagnosis of the disease.Results Among 20 cases of uterine perforation and Uterine empyema,16 cases first diagnosed misdiagnosed,and the incidence was 80％ (16/20).One case was diagnosed tumor torsion,1 case of diagnosis of pelvic abscess,14 cases first diagnosed of surgery (8 cases of acute peritonitis,gastrointestinal perforation in 4 cases and 2 cases of perforated appendicitis).It all occurred in postmenopausal women,and the main clinical features were that:high fever,lower abdominal pain,feel bloated in the rectal,mass pelvic cavity,weakened movement of intestine and cervical disturbance pain.results of emoyemic bacteria culture were mainly colon bacillus (E.coli).The main causes of misdiagnosis were atypical clinical manifestations,clinicians lack of comprehensive analysis and dynamic observation of the disease,over-reliance on laboratory examinations;their performance was often the first diagnosis of acute abdomen surgery,the surgeon only undergraduate examination,as well as undergraduate diagnosis of inertia thinking,neglect gynecological examination.All patients had a one-time cure after surgery.Conclusion Uterine empyema complicated with uterine perforation occurs mainly in postmenopausal women,which had a higher rate of misdiagnosis.Correctly diagnosis and timely treatments make benefits to the prognosis.