Objection To study the safety and effect of enhanced recovery after surgery (ERAS) in patients with endometriosis and adenomyosis. Methods:Totally 483 patients with endometriosis and adenomyosis who were admitted to Shengjing Hospital of China Medical University from August 1, 2017 to August 31, 2018 were included. Totally 183 patients underwent ERAS (ERAS group) and 255 patients underwent conventional pathway (control group) were enrolled. Perioperative intestinal function, pain score, inflammatory index, postoperative complications and length of hospital stay were analyzed.Results:Compared with control group, the time of postoperative exhaust in ERAS group was earlier [(37.57±12.10) h vs. (47.28±17.36) h, P<0.001]. Postoperative pain score was decreased [8：00 am at postoperative day 1 (2.86±0.89 vs. 2.96±0.92); 8：00 am at postoperative day 2 (1.99±0.73 vs. 2.41±0.82), all P<0.001]. The increase of D-dimer in blood after surgery was lower [1.67(0.68,3.04) vs. 3.17(1.55,5.72), P<0.001]. Postoperative hospital stay was shorter [(5.20±1.07) d vs.(5.52±1.46) d, P=0.009]. Conclusion:The application of ERAS path in patients with endometriosis and adenomyosis can shorten the postoperative exhaust time, reduce the postoperative pain, improve the postoperative hypercoagulability of blood and reduce the length of hospital stay. ERAS is safe, feasible and effective in patients with endometriosis and adenomyosis.

Objection To study the safety and effect of enhanced recovery after surgery (ERAS) in patients with endometriosis and adenomyosis. Methods:Totally 483 patients with endometriosis and adenomyosis who were admitted to Shengjing Hospital of China Medical University from August 1, 2017 to August 31, 2018 were included. Totally 183 patients underwent ERAS (ERAS group) and 255 patients underwent conventional pathway (control group) were enrolled. Perioperative intestinal function, pain score, inflammatory index, postoperative complications and length of hospital stay were analyzed.Results:Compared with control group, the time of postoperative exhaust in ERAS group was earlier [(37.57±12.10) h vs. (47.28±17.36) h, P<0.001]. Postoperative pain score was decreased [8：00 am at postoperative day 1 (2.86±0.89 vs. 2.96±0.92); 8：00 am at postoperative day 2 (1.99±0.73 vs. 2.41±0.82), all P<0.001]. The increase of D-dimer in blood after surgery was lower [1.67(0.68,3.04) vs. 3.17(1.55,5.72), P<0.001]. Postoperative hospital stay was shorter [(5.20±1.07) d vs.(5.52±1.46) d, P=0.009]. Conclusion:The application of ERAS path in patients with endometriosis and adenomyosis can shorten the postoperative exhaust time, reduce the postoperative pain, improve the postoperative hypercoagulability of blood and reduce the length of hospital stay. ERAS is safe, feasible and effective in patients with endometriosis and adenomyosis.

Objective To evaluate the diagnostic value of rectal endoscopic ultrasonography for recto-vaginal endometriosis (RVEM).Methods The clinical data of 36 patients who met the criteria for RVEM between September 2009 and September 2016 in Shengjing Hospital were analyzed.Rectal endoscopic ultrasonography was compared with colonoscopy and pelvic magnetic resonance imaging (MRI) in terms of preoperative diagnosis and their conformance with surgical and postoperative pathological findings.Results Rectal endoscopic ultrasonography was superior to colonoscopy and pelvic MRI in diagnosing RVEM,invasive bowel disease,and the invasive level in the preoperative assessment (P ＜ 0.05),and in its conformance with surgical and postoperative pathological findings.Conclusion Rectal endoscopic ulwasonography is a reliable technique for diagnosing RVEM,with good accuracy in the preoperative diagnosis of invasive bowel disease and its level of invasiveness.

OBJECTIVETo summarize the experience of the chemotherapy regimen cisplatin + fluorouracil + vincristine (C5V) for hepatoblastoma, and analyze the factors associated the outcome.

METHODA retrospective analysis was conducted for the outcome of hepatoblastoma. Sixty-three patients who received the regimen of C5V as the first choice of chemotherapy were reviewed, including 37 males and 26 females. The age at diagnosis ranged from 2 days after birth to 124 months, median 15 months. Four patients with stage I, 16 patients with stage II, 28 patients with stage III, 15 patients with stage IV disease were enrolled in the study. Nine patients had primary tumor resection while the remain by 54 received neoadjuvant chemotherapy. The median follow-up time was 30 months.

RESULTForty patients had delayed surgery, including 35 patients with regimen C5V alone, the others were treated with regimen C5V and cisplatin + adriamycin (CITA). The mean time of neojuvant chemotherapy was (3.4 ± 1.7) cycles. The mean time of chemotherapy after surgery was (5.3 ± 2.0) cycles. In 12 cases the (24.5%) tumor recurred after surgery. The margin of resection less than 0.5 cm , vascular invasion, stage III or IV disease were all the high risks of relapse (P = 0.049,0.001,0.022, respectively). Two-year overall survival (OS) and 5-year OS of the study was 61.1% and 58.7%, respectively. The 2-year OS and 5-year OS of stage I to III were 75.0% and 75.0%, 100.0% and 100.0%, 65.8% and 61.4%. The 1-year OS and 3-year OS of stage IV was 20.0%, 13.3%, respectively. Univariate analysis showed that age at diagnosis less than 60 months, vascular invasion, thrombocythemia at diagnosis, stage III or IV, tumor resection was the prognostic factor (P = 0.019, <0.001,0.011, <0.001, respectively). Multivariate analysis showed that tumor resection and age at diagnosis less than 60 months were both the prognostic factor (P < 0.001, 0.004, respectively ).

CONCLUSIONThe regimen of C5V is useful for hepatoblastoma. Tumor resection is the key factor of treatment. Prognostic factor is composed of age, stage, and clinical sign at diagnosis.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Cisplatin ; administration & dosage ; Doxorubicin ; administration & dosage ; Female ; Fluorouracil ; administration & dosage ; Hepatoblastoma ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Liver Neoplasms ; drug therapy ; Male ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Vincristine ; administration & dosage

Objective To study the role of ARHI protein and COX-2 protein and to explore their correlation in pathogenesis of adenocarcinoma of the uterine cervix.Methods The expression of ARHI and COX-2 protein were detected both in 40 cases of adenocarcinoma of the uterine cervix and in 30 cases of normal cervix by immunohistochemistry.Results The positive rate of the expression of ARHI protein in adenocarcinoma of the uterine cervix was 50.0％ (20/40),which lower than that in normol cervix controls 90.0％ (27/30),the difference was significant ( x2 =12.43,P ＜ 0.05 ) ; The positive rate of the expression of COX-2 protein in adenocarcinoma of the uterine cervix was 82.5 ％ (33/40),which higher than that in normol cervix controls 0 (0/30),the difference was significant (x2 =46.16,P ＜ 0.05 ) ;The positive expression rate of ARHI was negatively correlated with the clinical stage of cervical adenocarcinoma ( x2 =3.96,P ＜ 0.05 ) disease and pathological grade (x2 =7.04,P ＜ 0.05 ).COX-2 protein was positively correlated with pathological grade (x2 =7.04,P ＜0.05 ),but had no correlation with the clinical stage of cervical adenocarcinomacervical adenocarcinoma stage of diseas(P ＞ 0.05) ;The expression of ARHI protein and COX-2 protein wasn't correlated with lymph nodeatic meatastasis(P ＞ 0.05);The expression of ARHI protein had correlation with the expression of COX-2 protein (r =0.31,P ＜ 0.05 ).Conclusion Inactivation of ARHI gene and the abnormal expression of COX-2 protein are involved in the origin of cervical adenocarcinoma,their synergistic reaction may play an important role in tumor origin of cervical adenocarcinoma.

ObjectiveTo detect the expression of ARHI protein in adenocarcinoma of the uterine cervix and normal uterine cervix tissue, and explore the pathogenesis of cervical cancer. MethodsThe expression of ARHI protein in 30 cases of adenocarcinoma of the uterine cervix tissue and 30 cases of normal uterine cervix tissue was detected by immunohistochemistry and analyzed the relationship between ARHI protein and adenocarcinoma of the uterine cervix. ResultsThe expression of ARHI protein in adenocarcinoma of the uterine cervix tissue[46.67％(14/30)]was lower than that in normal uterine cervix tissue[90.00％(27/30)],the difference was significant (P＜0.05). There was intimate correlation between ARHI protein and histological grade, FIGO stage of adenocarcinoma of the uterine cervix tissue (P ＜ 0.05), there was no correlation between ARHI protein and lymphatic metastasis (P＞0.05). ConclusionsThe expression of ARHI protein in adenooarcinoma of the uterine cervix decreases which indicates the expression of ARHI protein take part in the carcinogenesis of adenocarcinoma of the uterine cervix. It can be used as a new diagnostic indicator of adenocarcinoma of the uterine cervix.

Objective To investigate the relationship between the expression of DEK and Hpa infection in uterine cervical carcinogenisis.Methods Formalin-fixed,paraffin-embedded samples including 45 cases of squamous cell carcinomas,25 cases of cervical intraepithelial neoplasia CINⅢ,and 20 cases of CINI-Ⅱ,10 cases of normal cervical tissues were studied using polymer detection system for immunohistochemical technique to examine the expression of DEK and Hpa.Results The positive ratios of DEK in cancer tissues,normal cervical intraepithelial lesions,normal cervical tissues positive rates were 88.9％,24.4％,10.0％,respectively.The positive ratio of expressions of DEK in cervical carcinomas was significantly higher than CIN and normal cervical tissues (x2 =38.054,P ＜0.01 ;x2 =5.774,P ＜0.05).The positive ratios of expressions of Hpa in normal cervical tissues,CIN and cervical cancers were 75.6％,24.4％ and 10.0％,respectively.The positive ratio of expressions of Hpa in cervical carcinomas was significantly higher than CIN and normal cervical tissues ( x2 =31.69,P ＜ 0.01 ; x2 =12.94,P ＜ 0.01 ).The expression of DEK and Hpa in cervical lesions was highly related in the cervical cancer tissues( r =0.617,P =0.001 ).Conclusions DEK and Hpa possibly played an important role in the development of cervical cancer.Cervical intraepithelial lesions and cervical carcinoma might be associated with changes in the expression of DEK and Hpa,and interact together to influence the development of CIN and cervical cancer.

Objective The cell proliferation, cell cycle, apoptosis and the impact of senescence after RNAi were performed. This research provided a theoretical and experimental basis of the prevention and treatment of cervical cancer. Methods According to DEK nucleotide sequence in G enebank, 56 nt o1igonucleotide fragment containing specific target DEK sequence was designed with computer software, and the fragnent was synthesized and cloned into the eukaryotic expressed plasmid vector psiRNA-hH ineo.Then it was transfected into CaSki cells by lipofectamine. DEK mRNA and protein expression were detected to verify the gene silence effect by RT-PCR and Western blot analysis. CaSki cell proliferative inhibition rates were accessed by MTT assay at the 48th hour after DEK siRNA transfection, at the same time cell cycle and cell apoptosis were analyzed by flow cytometry, and SA - β-galactosidase enzyme cytochemiatry was used to identify cell senescence. Results DEK mRNA and protein expression was significantly reduced in psiRNA- hHDEK transfected CaSki cells(0. 28 ±0. 02). Cell proliferation was decreased, cell cycle was inhibited, and cell apoptosis and senescent cells were increased afar DEK gene was silenced. Concluslon DEK siRNA eukaryotic expression vector was successfully constructed and DEK gene expression of CaSki cells was effectively silenced. DEK gene silencing could induce CaSki cells into apoptosis and senescence.DEK gene played an important role in the occurrence and evolution of cervical cancer, which was not only a senescence suppressor gene but also an apeptosis suppressor gene.

Objective To assess the prevalence and clinicopathologic significance of the microsatellite instability(MSI),PTEN mutations and their correlations in endometrial carcinogenesis.Methods The MSI analysis was performed using five microsatellite markers in paired uterine endometrial carcinoma(UEC) and atypical endometrial hyperplasia(AH).PTEN mutations were detected by single-strand conformation polymorphism(FCR-SSCP) analysis and DNA sequencing in UEC,AH and normal epithelium(NE).Rescults There was a significant difference in the incidence of PTEN mutations among AH,UEC and NE(P<0.01).PTEN mutations changed significantly in AH-the direct precursor to UEC(P<0.01).PTEN mutations correlated significantly with the clinical stage of the UEC(P<0.05).In UEC with MSI,PTEN mutations were detected in the short coding mononucleotide repeats(A) in 2(18.2%) of the 11 carcinomas.PTEN had a substantially higher frequency of mutations in UEC with MSI compared with the frequency of mutations in UEC without MSI(P<0.05).Conclusion PTEN mutations and MSI were two of the most common genetic alterations and correlated with each other in uterine endometrioid carcinoma.PTEN mutations might be secondary to deficiencies in mismatch repair and give some explanation for the frequent presence of PTEN mutations in MSI positive UEC.

Objective To detect COX-2 mRNA in cervical cancer and normal cervix, and explore the pathogenesis of adenocarcinoma of the uterine cervix. Methods COX-2 expression was detected by RT-PCR to explore the relationship between COX-2 and the adenocarcinogenon of cervical cancer in 36 cases of adenocarcinoma of the uterine cervix and 15 cases normal cervical tissue. Results The positive rate of COX-2 mRNA in adenocarcinoma of the uterine cervix tissues (55.6%) was higher than that of normal tissues ( 20. 0% ), the difference was significant ( P ＜ 0. 05). The expression of COX-2 mRNA was associated with stages and clinical grading of tumor ( P ＜ 0. 05), but no significant difference was found between stages and clinical grading of uterine cervix adenocarcinoma( P ＞ 0. 05). Conclusion The hyper expression of COX-2 mRNA in uterine cervix adenocarcinoma took part in the carcinogenesis of tumor.