Objective: To conduct a systematic review and meta-analysis of studies evaluating the oncological and fertility outcomes of early-stage endometrial cancer (EC) treated with the levonorgestrel-releasing intrauterine system (LIUS)-based regimens. Methods: The Meta-analyses Of Observational Studies in Epidemiology statement for meta-analyses was followed. Searches were conducted on MEDLINE, Embase, PubMed, Preprints, and the Cochrane Central Register of Controlled Trials from January 1990 to August 4, 2022. The Joanna Briggs Institute Critical Appraisal Checklist was used for quality assessment. The primary endpoint was the complete response (CR) rate and the secondary endpoints were relapse, pregnancy, and live birth rate. Results: A total of 25 studies (821 women) were included. The CR rate of LIUS-based regimens was 63.4% (95% confidence interval [CI]=52.3%–73.2%), with 29.6% (95% CI=23.3%–36.8%) of cases experiencing recurrence during follow-up. In sensitivity analyses, patients younger than 45 years of age with a body mass index <30 kg/m2 who were treated with LIUS-based regimens achieved a high CR rate of 84.6% (95% CI=80.3%–88.1%) over a median follow-up of more than 24 months. Overall pregnancy and live birth rates were 37.9% (95% CI=24.1%–53.9%) and 39.3% (95% CI=24.0%–57.0%), respectively. No statistical differences were apparent in CR or relapse rates among the LIUS+GnRH agonist, LIUS+oral progesterone, or hysteroscopic resection followed by LIUS subgroups. Conclusion LIUS-based therapies are viable for the conservative management of early-stage endometrioid EC on CR and fertility outcome.

BACKGROUND: Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs (NSAIDs) for treating knee osteoarthritis (OA). We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms (FPC) with loxoprofen sodium cataplasms (LSC) in treating patients with knee OA. METHODS: This is an open-label, non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital. Overall, 250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio. Both medications were administered to patients for 28 days. The primary outcome was the change of pain measured by visual analog scale (VAS) score from baseline to day 28 (range, 0-10 points; higher score indicates worse pain; non-inferiority margin: 1 point; superiority margin: 0 point). There were four secondary outcomes, including the extent of pain relief, the change trends of VAS scores, joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and adverse events. RESULTS: Among 250 randomized patients (One patient without complete baseline record in the flurbiprofen cataplasms was excluded; age, 62.8 ± 10.5 years; 61.4% [153/249] women), 234 (93.6%) finally completed the trial. In the intention-to-treat analysis, the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior, and also superior to that in the LSC group (differences and 95% confidence interval, 0.414 (0.147-0.681); P <0.001 for non-inferiority; P = 0.001 for superiority). Similar results were observed of the VAS scores for the current pain and pain during exercise. WOMAC scores were also lower in the FPC group at week 4 (12.50 [8.00-22.50] vs . 16.00 [11.00-27.00], P = 0.010), mainly driven by the dimension of daily activity difficulty. In addition, the FPC group experienced a significantly lower incidence of adverse events (5.6% [7/124] vs . 33.6% [42/125], P <0.001), including irritation, rash and pain of the skin, and sticky hair uncovering pain. CONCLUSIONS This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief, joint function improvement, and safety profile.
Humans ; Female ; Middle Aged ; Aged ; Osteoarthritis, Knee/drug therapy* ; Flurbiprofen/therapeutic use* ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Pain/drug therapy* ; Treatment Outcome ; Double-Blind Method

Objective To investigate the effects of fresh lumbar osteoporotic vertebral compression fracture (OVCF) on spinopelvic sagittal parameters and distribution of Roussouly types.Methods One hundred and eight patients with one-level fresh lumbar OVCF and 110 patients with simple osteoporosis (OP) were diagnosed and treated at Department of Orthopedic Surgery,Shougang Hospital from January 2016 to August 2017.The basic clinical data of all the patients were documented and their lumber spines were classified by Roussouly types.The 2 groups were compared in terms of spinopelvic sagittal parameters such as pelvic incidence (PI),pelvic tilt (PT),sacral slope (SS),and lumbar lordosis (LL) and Roussouly types.The correlation between Roussouly types and fracture segments was observed in OVCF group.Results There was no significant different in PI between OVCF and OP groups (50.35° ± 11.00° versus 51.96° ± 11.73°) (P ＞ 0.05).PT in OVCF group (18.79°± 9.51°) was significantly larger than that (16.19°± 9.03°) in OP group while SS (31.56° ± 7.88°) and LL (40.22°± 12.29°) in the former significantly smaller than those in the latter (35.77° ± 8.82° and 47.89° ± 13.20°,respectively) (P ＜ 0.05).Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OVCF group were 35,40,28 and 5 cases,respectively,with types Ⅰ and Ⅱ accounting for 69.5％;Roussouly types Ⅰ,Ⅱ,Ⅲ and Ⅳ in OP group were 17,30,49 and 14 cases,respectively,with type Ⅲ being predominant (44.5％).There was a significant difference between the 2 groups in distribution of Roussouly types (P ＜03.05).In OVCF group,fractures of L1 and L2 vertebrae accounted for 82.4％.There was a significant correlation between fracture segments and lumbar Roussouly types (P =0.034).Conclusions Patients with fresh lumbar OVCF tend to have a forward gravity and sagittal disequilibrium,leading to posterior pelvic rotation,increased PT,decreased SS,and downward shift of the apex of the lumbar curve.Their Roussouly classification is mainly type Ⅰ or type Ⅱ.

Objective To study the relationship between regional cerebral blood flow (rCBF) in matter lesion (WML) and cognitive impairment by arterial spin labeling (ASL).Methods Fourteen WML patients served as a WML group and 9 WML-free subjects served as a control group.Their neuropsychology was assessed and their rCBF was measured by ASL.Results The MoCA score,positive rate of symbol digit modalities test (SDMT),verbal fluency test (VFT) and digital span test forward and backward (DST F and B) were significantly lower while the trail making test-A (TMT-A) score and positive rate of Stroop B test and psychomotion speed test were significantly higher in WML group than in control group (P＜0.05,P＜0.01).The rCBF in regional WML was significantly slower in right and left semioval center,anterior and posterior horn of right and left lateral ventricle than that in normal white matter region (P＜0.01).The rCBF in WML was positively related with DST F and B (P＜0.05).The rCBF in NAWM was positively related with VFT (P＜0.01).Conclusion ASL can show the relationship between rCBF and cognitive impairment,especially executive function,attention and memory in elderly WML patients and decreased rCBF can thus increase their risk of cognitive impairment and dementia.

Objective By comparing clinical efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with conventional low viscosity bone cement for osteoporotic vertebral compression fractures,to explore the clinical value of treatment of osteoporotic vertebral compression fractures with high viscosity bone cement.Methods In this prospective study,100 patients with one-level OVCF and older than 70 years were diagnosed and treated in our hospital from June 2014 to December 2015,which were randomly divided into 2 groups (50 patients in each),applied unilateral percutaneous vertebroplasty with high viscosity bone cement and bilateral percutaneous kyphoplasty with conventional low viscosity bone cement,respectively.Collected data of basic clinical informations (including age,gender,body mass index,etc.),preoperative and postoperative visual analog scales (VAS),Oswestry disability questionnaire (ODI),operative time,intraoperative X-ray times,the amount of bone cement injection,leakage of bone cement,anterior vertebral height and kyphosis (Cobb angle) of preoperative and postoperative,and statistical analysis.Results There were significant improvement of both VAS and ODI scores of the postoperative 1 day,3 months and 12 months compared with preoperative,but there was no significant difference between two groups;The operative time,intraoperative fluoroscopy times,bone cement injection amount and intraoperative bone cement leakage of high viscosity bone cement PVP group were significantly less than those of low viscosity bone cement PKP group (P＜0.05);the anterior vertebral height and kyphosis improved,and there was a significant difference between preoperative and postoperative of low viscosity bone cement PKP group (P＜0.05).Conclusion The efficacies of unilateral PVP with high viscosity bone cement and bilateral PKP with conventional low viscosity bone cement for osteoporotic vertebral compression fractures are the same,which can relieve pain and improve function of life significantly.However,the high viscosity bone cement PVP is simpler surgical procedure,with shorter operative time,less intraoperative radiation,less bone cement leakage rate.The domestic bone cement injection device can significantly reduce the cost of surgery,it worth to be widely used for clinical application.

BACKGROUND:The conservative treatment of humeral fracture is difficult to achieve a good reduction. Minimaly invasive percutaneous plate fixation has been widely used, and has good repair results, but the specific mechanism of action is not clear.
OBJECTIVE:To compare the repair effect of different fixation methods on proximal humerus fractures.
METHODS: From August 2011 to October 2014, we selected 96 patients with proximal humerus fractures from the Shougang Hospital of Peking University. These patients were equaly divided into two groups according to the principle of random draw. Patients in the control group were treated with open reduction and conventional surgery fixation. Patients in the treatment group received minimaly invasive percutaneous plate fixation. Operation time, intraoperative blood loss, incision length and postoperative hospital stay were recorded in both groups. At 8 weeks after treatment, patients received radiography to identify the reduction. Range of motion of the shoulder joint was scored. Within 8 weeks after treatment, the occurrence of complications was observed and compared in both groups.
RESULTS AND CONCLUSION:Intraoperative blood loss, incision length and postoperative hospital stay were significantly less in the treatment group than in the control group (P < 0.05). No significant difference in operation time was found between the two groups (P > 0.05). At 8 weeks after treatment, the excelent and good rate of reduction was significantly higher in the treatment group than in the control group (98%, 81%,P < 0.05). Flexion, abduction, external rotation and internal rotation scores were significantly higher in the treatment group than in the control group (P < 0.05). Bone compartment syndrome, vascular injury, infection and bleeding were significantly lower in the treatment group than in the control group (P < 0.05). These findings confirm that compared with open reduction and internal fixation, minimaly invasive percutaneous plate fixation of proximal humerus fractures has less impact on the body, can promote reduction of the fracture, has few complications, and contributes to the recovery of shoulder function.

BACKGROUNDCytochrome b5 reductase 2 (CYB5R2) is a potential tumor suppressor that inhibits cell proliferation and motility in nasopharyngeal carcinoma (NPC). Inactivation of CYB5R2 is associated with lymph node metastasis in NPC. This study aimed to explore the mechanisms contributing to the anti-neoplastic effects of CYB5R2.

METHODSPolymerase chain reaction (PCR) assays were used to analyze the transcription of 84 genes known to be involved in representative cancer pathways in the NPC cell line HONE1. NPC cell lines CNE2 and HONE1 were transiently transfected with CYB5R2, and data was validated by real-time PCR. A chick chorioallantoic membrane (CAM) embryo model was implanted with CYB5R2-expressing CNE2 and HONE1 cells to evaluate the effect of CYB5R2 on angiogenesis. An immunohistochemical assay of the CAM model was used to analyze the protein expression of vascular endothelial growth factor (VEGF).

RESULTSIn CYB5R2-transfected NPC cells, PCR assays revealed up-regulated mRNA levels of Fas cell surface death receptor (FAS), FBJ murine osteosarcoma viral oncogene homolog (FOS), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), integrin beta 3 (ITGB3), metastasis suppressor 1 (MTSS1), interferon beta 1 (IFNB1), and cyclin-dependent kinase inhibitor 2A (CDKN2A) and down-regulated levels of integrin beta 5 (ITGB5), insulin-like growth factor 1 (IGF1), TEK tyrosine kinase (TEK), transforming growth factor beta receptor 1 (TGFBR1), and VEGF. The angiogenesis in the CAM model implanted with CYB5R2-transfected NPC cells was inhibited. Down-regulation of VEGF by CYB5R2 in NPC cells was confirmed by immunohistochemical staining in the CAM model.

CONCLUSIONCYB5R2 up-regulates the expression of genes that negatively modulate angiogenesis in NPC cells and down-regulates the expression of VEGF to reduce angiogenesis, thereby suppressing tumor formation.

Animals ; Carcinoma ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Chickens ; Cytochrome-B(5) Reductase ; Down-Regulation ; Gene Regulatory Networks ; Genes, Tumor Suppressor ; Humans ; Nasopharyngeal Neoplasms ; Neovascularization, Pathologic ; Oxidoreductases ; Real-Time Polymerase Chain Reaction ; Transfection ; Up-Regulation ; Vascular Endothelial Growth Factor A

Objective To investigatethe constituents of enteroviruse which can cause hand‐foot‐and‐mouth disease(HFMD) ,and prevent against the development of new prevailing strains and provide basis for prevention and control of HFMD in Luoyang city . Methods Reverse‐transcription polymerase chain reaction (RT‐PCR) was used to identify the type of RNA of stool specimen of HFMD cases in Luoyang ,to distinguish the subtype of strain ,9 enterovirus‐positive specimens which coxcackie virusA16(CA16)‐and enterovirus71(EV71)‐negative were selected randomly for 5′UTR sequencing .strain‐specific primers were used to detect posi‐tive samples in 75 CA16‐ and EV71‐negative but other enterovirus‐positive specimens by using real time RT‐PCR .Composition characteristics of CA6 were further analyzed .Results Primary screening was conducted with the results of 5′UTR sequencing of 9 commonent erovirus‐positive specimens and there were 5 CA6‐positive ,which were prevailing strains;there were 20 CA6‐positive of 75 commonenterovirus‐positive specimens ,the proportion of CA6‐positive in enterovirus‐positive specimens was 29 .76% (25/84) . Thirteen samples were collected from male and 12 from female ,2 cases resulted in severe symptoms ,5 from city and 20 from coun‐try .Conclusion The composition of commonent erovirus which results in HFMD was complex and the proportion of CA6 was higher ,which should be pay more attention .

Objective To explore the clinical value of MRI in diagnosing and treating cesarean scar pregnancy (CSP).Methods A retrospective analysis was conducted on the clinical manifestations of 54 patients diagnosed with CSP between January 2009 to January 2013 in Peking University Third Hospital.Based on the patients' MRI image and other clinical datas,we did transvaginal operation on patients with CSP1,and transvaginal combined with abdominal operations on patients with CSP2.The intraoperative blood loss,operation time,postoperative hospital stay,and the length of time required for of serum hCG dropping to normal of the patients were analyzed.Results The average age of the 54 patients was (34±5) years and the average duration of gestation was (56± 16) days,all patients' vital sign were stable,the hCG level was 23-142 962 U/L before treatment.Twelve patients were diagnosed with CSP1 by MRI,and 5 of them had focus of 1-2 cm in diameter,the 5 patients' serum hCG level was 436-1 159 U/L and 23-32 days after drug administration,their hCG level returned to normal; the other 7 patients had focus of 2.0-4.4 cm in diameter,and their hCG level was 2 218-63 446 U/L,lesion resection was done on the 7 patients by hysteroscope or under B-uhrasound monitor.Forty-two patients were diagnosed with CSP2,and their focus were 1.0-7.1 cm in diameter,and serum hCG level were 23-142 962 U/L.We did bilateral uterine artery occlusion by laparoscope or laparotomy during operation for 22 patients or bilateral uterine artery embolization (UAE) before operation for 20 patients,then we did lesion resections.The blood loss during operation of CSP1 or CSP 2 was 50.1,267.2 ml; operation time was 30,128 minutes; postoperative hospital stay was 4.6,6.7 days;their serum hCG returned to normal 13-30 days after the surgery.All the 54 patients' uterus were preserved,and the patients undergoing operations were all cured without the second operation.Conclusion MRI is an effective method to conduct clinical treatment in CSP.

OBJECTIVE: To discover the relationship of transcriptional levels and promoter methylation status of CHFR gene in human nasopharyngeal carcinoma,to discuss the significance and epigenetic mechanism of CHFR inactivation in NPC, and to evaluate the feasibility of detecting methylated CHFR in nasopharyngeal swab as a means for diagnosis of NPC. METHOD: Transcriptional levels of CHFR was evaluated by RT-PCR. Methylation specific PCR was used to detect the methylation status of CHFR in NPC cells, normal nasopharyngeal epithelia, primary tumors and their paired nasopharyngeal swabs. Detailed methylation status was confirmed by bisulfite sequencing. NPC cells were treated by the methyltransferase inhibitor 5-aza-dC and the reactivation of CHFR was evaluated by RT-PCR. RESULT: CHFR transcription was inactivated in NPC. The methylation frequency in NPC primary tumors and their paired swabs were 65.5% and 63.8%, respectively, with a 86.2% concordance. Bisulfite sequencing revealed a dense methylation in NPC cells and primary tumors, but all the normal nasopharyngeal epithelia were unmethylated. CHFR expression were restored after 5-aza-dC treatment. CONCLUSION CHFR is epigenetically inactivated by promoter methylation in NPC. Detecting methylated CHFR can be served as a useful non-invasive means for diagnosis of NPC.
Aged ; Carcinoma ; Cell Cycle Proteins ; genetics ; DNA Methylation ; Epigenesis, Genetic ; Female ; Gene Silencing ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; genetics ; pathology ; Neoplasm Proteins ; genetics ; Neoplasm Staging ; Poly-ADP-Ribose Binding Proteins ; Promoter Regions, Genetic ; Ubiquitin-Protein Ligases