Objective To investigate how tumor-associated macrophages(TAMs)in cervical cancer cells respond to AMPK through phenotypic transformation.Methods RT-qPCR and Western blot were used to detect AMPK expression in cervical cancer tissues and HeLa,SiHa and Caski cell lines.The AMPK knockout cell line of HeLa cells was generated using the siRNA technique.The malignant biological behavior of cancer cells mediated by the AMPK/CCL18 axis was investigated using CCK-8,scratch assay and Transwell assay.Cell conditioned medium from each group was collected,and cervical cancer cell conditioned medium was co-cultured with human mononuclear cells(THP-1)to assess THP-1 recruitment and the expression of macrophage typing related markers.The impact of AMPK on tumor proliferation was also evaluated in nude mice.Results QRT-PCR and Western blot analysis showed that the mRNA(1.78±0.30)and protein(1.71±0.33)expression levels of AMPK in cancer tissues were significantly higher than those in adjacent tissues(1.00±0.10,1.00±0.11),and the differences were statistically significant(t=5.966,4.990,all P<0.01).Compared with normal cervical epithelial cells(HUCEC),the mRNA and protein expression of AMPK were significantly increased in three cell lines(HeLa,SiHa,Caski),and the differences were statistically significant(F=5.958,3.457,all P<0.01).Compared with the NC group,knocking down AMPK inhibited the proliferation of cervical cancer cells(1.33±0.18 vs 0.82±0.25),migration(180.07±7.64 vs 126.98±29.00),and invasion(115.90±13.19 vs 68.61±12.87)in cervical cancer cells,with statistical significance(t=4.015,4.337,6.285,all P<0.01).The study found that THP-1 cells exhibited significant reductions in migration(49.34±3.91 vs 33.96±10.94),invasion(28.54±3.06 vs 19.54±6.16)and M2-type polarization(1.01±0.13 vs 0.55±0.11)when AMPK reduction was induced,and these differences were statistically significant(t=3.242,3.207,6.510,all P<0.01).In vivo experiments further supported these findings,showing that AMPK reduction led to significant decreases in tumor volume(721.56±93.70mm3 vs 520.02±47.54mm3)and weight(1.19±0.06g vs 0.86±0.20g),with statistically significant differences(t=4.289,3.582,P<0.01).Conclusion Through modulating M2 polarization in TAMs,the AMPK/CCL18 axis increases cervical cancer cells'proliferation,migration and invasion.AMPK/CCL18 inhibition could provide novel therapeutic targets and approaches for cervical cancer treatment.

Objective To investigate how tumor-associated macrophages(TAMs)in cervical cancer cells respond to AMPK through phenotypic transformation.Methods RT-qPCR and Western blot were used to detect AMPK expression in cervical cancer tissues and HeLa,SiHa and Caski cell lines.The AMPK knockout cell line of HeLa cells was generated using the siRNA technique.The malignant biological behavior of cancer cells mediated by the AMPK/CCL18 axis was investigated using CCK-8,scratch assay and Transwell assay.Cell conditioned medium from each group was collected,and cervical cancer cell conditioned medium was co-cultured with human mononuclear cells(THP-1)to assess THP-1 recruitment and the expression of macrophage typing related markers.The impact of AMPK on tumor proliferation was also evaluated in nude mice.Results QRT-PCR and Western blot analysis showed that the mRNA(1.78±0.30)and protein(1.71±0.33)expression levels of AMPK in cancer tissues were significantly higher than those in adjacent tissues(1.00±0.10,1.00±0.11),and the differences were statistically significant(t=5.966,4.990,all P<0.01).Compared with normal cervical epithelial cells(HUCEC),the mRNA and protein expression of AMPK were significantly increased in three cell lines(HeLa,SiHa,Caski),and the differences were statistically significant(F=5.958,3.457,all P<0.01).Compared with the NC group,knocking down AMPK inhibited the proliferation of cervical cancer cells(1.33±0.18 vs 0.82±0.25),migration(180.07±7.64 vs 126.98±29.00),and invasion(115.90±13.19 vs 68.61±12.87)in cervical cancer cells,with statistical significance(t=4.015,4.337,6.285,all P<0.01).The study found that THP-1 cells exhibited significant reductions in migration(49.34±3.91 vs 33.96±10.94),invasion(28.54±3.06 vs 19.54±6.16)and M2-type polarization(1.01±0.13 vs 0.55±0.11)when AMPK reduction was induced,and these differences were statistically significant(t=3.242,3.207,6.510,all P<0.01).In vivo experiments further supported these findings,showing that AMPK reduction led to significant decreases in tumor volume(721.56±93.70mm3 vs 520.02±47.54mm3)and weight(1.19±0.06g vs 0.86±0.20g),with statistically significant differences(t=4.289,3.582,P<0.01).Conclusion Through modulating M2 polarization in TAMs,the AMPK/CCL18 axis increases cervical cancer cells'proliferation,migration and invasion.AMPK/CCL18 inhibition could provide novel therapeutic targets and approaches for cervical cancer treatment.

Objective To explore the clinical efficacy of biofeedback electrical stimulation plus pelvic floor muscle training (PFMT) in the treatment of stress urinary incontinence (SUI) after total hysterectomy.Methods The research objects who underwent total hysterectomy and complicated SUI were selected from January 2014 to December 2017 in our hospital.They were randomly divided into two groups:the study group (n =55) received biofeedback electrical stimulation plus PFMT treatment,while the control group (n=55) received PFMT treatment only.To record and compare the efficacy related indicators of the two groups.Results The indexes and scores of 3/6 months in the two groups were significantly improvedafter treatment.After 3 months the treatment,the study group had less leakage of urine [(4.3 ± 1.2)g vs (5.7 ± 1.9) g],better recovery of muscle strength of Ⅰ/Ⅱ muscle fibers [(3.5 ± 0.9) grade vs (2.8 ± 1.1) grade &(3.7 ± 0.6) grade vs (3.2 ± 1.2) grade],and better score of international consultation on incontinence questionnaire-short form (ICI-Q-SF) questionnaire [(2.7 ± 1.4) vs (4.5 ± 2.2)] compared with the control group,with statistically significant difference (P ≤ 0.05).After 6 months treatment,compared with the contiol group,the study group had less leakage of urine pad test [(1.4 ± 0.7) g vs (2.6 ± 1.1) g],better recovery of muscle strength of type Ⅰ/Ⅱ muscle fiber [(4.2 ±0.8) grade vs (3.5 ± 1.1)grade & (4.7 ±0.5) grade vs (4.0 ±0.9)grade],and better ICI-Q-SF score [(2.7 ± 1.4) vs (4.5 ±2.2)] (P ≤0.05).Conclusions Compared with using the PFMT alone,biofeedback electrical stimulation plus PFMT treatment had less leakage,better pelvic floor muscle strength and better subjective symptoms.