Background: The Lymphadenectomy in Ovarian Neoplasms (LION) study revealed that systemic lymphadenectomy did not bring survival benefit for advanced ovarian cancer patients with clinically normal lymph nodes and was associated with a higher incidence of operative complications. However, there is no consensus on whether lymphadenectomy has survival benefit or not in early epithelial ovarian cancer (EOC). Methods We designed the LOVE study, a multicenter, randomized controlled, phase III trial to compare the efficacy and safety of comprehensive staging surgery with or without lymphadenectomy in stages IA-IIB EOC and fallopian tube carcinomas (FTC). The hypothesis is that the oncological outcomes provided by comprehensive staging surgery without lymphadenectomy are non-inferior to those of conventional completion staging surgery in early-stage EOC and FTC patients who have indications for post-operative adjuvant chemotherapy. Patients assigned to experimental group will undergo comprehensive staging surgery, but lymphadenectomy. Patients assigned to comparative group will undergo completion staging surgery including systematic pelvic and para-aortic lymphadenectomy. All subjects will receive 3–6 cycles of standard adjuvant chemotherapy. Major inclusion criteria are pathologic confirmed stage IA-IIB EOC or FTC, and patients have indications for adjuvant chemotherapy either confirmed by intraoperative fast frozen section or previous pathology after an incomplete staging surgery. Major exclusion criteria are non-epithelial tumors and low-grade serous carcinoma. Patients with severe rectum involvement which lead to partial rectum resection will be excluded. The sample size is 656 subjects. Primary endpoint is disease-free survival.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.

Objective: To estimate the impact of lymph node dissection on survival in patients with apparent early-stage epithelial ovarian cancer (EOC). Methods: We conducted a retrospective review of patients with clinical stage I–II EOC. All patients underwent primary surgery at Sun Yat-sen University Cancer Center between January 2003 and December 2015. Demographic features and clinicopathological information as well as perioperative adverse events were investigated, and survival analyses were performed. Results: A total of 400 ovarian cancer patients were enrolled, and patients were divided into 2 groups: 81 patients did not undergo lymph node resection (group A), and 319 patients underwent lymph node dissection (group B). In group B, the median number of removed nodes per patient was 25 (21 pelvic and 4 para-aortic nodes). In groups A and B, respectively, the 5-year progression-free survival (PFS) rates were 83.3% and 82.1% (p=0.305), and the 5-year overall survival (OS) rates were 93.1% and 90.9% (p=0.645). The recurrence rate in the retroperitoneal lymph nodes was not associated with lymph node dissection (p=0.121).The median operating time was markedly longer in group B than in group A (220 minutes vs. 155 minutes, p<0.001), and group B had a significantly higher incidence of lymph cysts at discharge (32.9% vs. 0.0%, p<0.001). Conclusion In patients with early-stage ovarian cancer, lymph node dissection was not associated with a gain in OS or PFS and was associated with an increased incidence of perioperative adverse events.

Objective To establish a monkey model of muscle atrophy by fixing the right lower limb and set up e-valuation criteria for that model. Methods Twelve healthy,6-7 year old male cynomolgus monkeys(body weight 6-7 kg)were used in this study. All animals were normal and had no malformed lower limb bones. Right lower limbs of the an-imals were fixed with fiberglass bandage(from knee joint to anklebone)for 15 weeks. Body weight,crus perimeter and crus volume were recorded every two weeks. MRI examinations of the gastrocnemius muscle were conducted at weeks 11,13 and 15. Muscle biopsy was taken for pathological examination at week 15. Results There were no obvious changes of body weight during the experiment. At 15 weeks after modeling,the right crus perimeter and crus volume of the experimental an-imals were significantly decreased(P <0.05),and some biochemical indexes such as serum creatinine,gloucose and al-kaline phosphatase were significantly decreased(P <0.05), while cholesterol was significantly increased(P <0.05).MRI showed atrophy of the right gastrocnemius muscle. Muscle biopsy also showed muscle atrophy and muscle fibers be-came thinner in the right gastrocnemius,and the cross-section area of the muscle fibers was significantly decreased. Con?clusions It is easy to operate and establish a muscle atrophy model in Cynomolgus monkeys by fixing the right lower limb. This model is suitable for objective and easy evaluation of muscle atrophy by measurement of crus perimeter and crus volume of the limb,blood biochemical parameters,MRI examination,and histopathological examination in combination.

Objective: To explore the efficacy of tenofovir disoproxil and adefovir dipivoxil treatment in patients with hepatitis B virus e antigen (HBeAg) negative was analyzed through the comparison of highly sensitive HBV viral load monitoring with HBV genotyping and drug resistance mutations. Methods: The clinical data of newly diagnosed chronic hepatitis B patients from January 2015 to June 2017 in outpatients and inpatients were randomly divided into tenofovir and adefovir group. Quantitative detection of HBV DNA levels before therapy and at 12, 24, 48, 96, and 120 weeks after therapy were determined for HBV genotypes and drug-resistant mutations in HBeAg-negative patients. Student’s t-test was used to compare the measurement data between groups. The data of comparison between groups were tested by χ ². Results: A total of 106 cases of HBeAg-negative patients were collected. Tenofovir disoproxil had a higher rate of HBV DNA suppression (54%) than adefovir dipivoxil treatment (42%), but the difference was not statistically significant (P = 0.19). After 120 weeks of treatment, a total of 46 patients (93.9%) were enrolled in the tenofovir disoproxil group with HBV DNA quantitation < 2 000 IU / ml. Adefovir dipivoxil group of patients with HBV DNA < 2 000 IU / ml a total of 40 cases, accounting for 75.5%. The difference between the two groups was statistically significant (P < 0.05). For 49 cases of HBeAg-negative patients, HBV B, C, B and C were mixed before tenofovir dipivoxil treatment, and C1653T, A1762T and G1764A mutation sites were detected in patients with D genotype. Patients C, B, C, B, and C were examined for C1673T, G1896, G1858, G1899A. After treatment, the detection rate of the above mutation sites decreased, but C1653T, C1673T and G1899A were not detected. New mutation sites such as G1915A / C, L180M, M204V, V207I / L, T184A and V173L were detected, Low resistance rate (25%). Conclusion Tenofovir disoproxil can be recommended as a treatment for HBeAg-negative patients. For HBeAg-negative patients, the choice of high-sensitivity detection of HBV DNA levels, better monitoring of anti-HBV efficacy.

Objective To evaluated the improving effect of training method of point-line-plane on development quotient in premature infants with brain injury.Methods 174 cases of premature children with brain injury were randomly divided into study group (89 cases) and control group (85 cases).Control group given Bobath and Vojta traditional rehabilitation training,and the study group was given training method of point-line-plane.Patients in both groups were evaluated synthetically based on The Evaluation Chart on Neu-robehavioral Development of Children Aged 0-6 Years,developed by Capital Institute of Pediatrics,prior to the treatment,and after the first,the second,and the third course of the training programs,respectively.Re-sults The score of developmental quotient ( DQ) between study group and control group was no significantly different(P>0.05).Compared with before treatment, the scores of DQ was significantly increased after the first, the second and the third course of training treatment in study group and control group((82.71±12.28) vs (81.17±9.63), t=0.859, P>0.05;(89.65±10.02) vs (87.02±7.39), t=1.747, P>0.05). Compared with the control group, the scores of DQ in study group was no significant difference after the first and the second course of treatment,but there was significantiy different after the third course treatment((95.26±8.87) vs (91.31±7.63), t=2.945, P=0.004).Conclusion The training method of point-line-plane can improve the clinical efficacy of premature infants with brain injury at the early phase, which is worth widely applying in clinical practice.

OBJECTIVE: To evaluate the prognostic implication of human papillomavirus (HPV) viral load in cervical cancer patients who underwent radical hysterectomy. METHODS: We conducted a retrospective review of patients with stage IA2 through stage IIIA cervical carcinoma who underwent radical hysterectomy at Sun Yat-sen University Cancer Center between January 2005 and December 2009. Patients who had undergone preoperative hybrid capture 2 testing to detect HPV DNA were included. A total of 346 patients positive for HPV DNA were enrolled and stratified into two groups according to the median HPV viral load. RESULTS: HPV viral load was significantly correlated with lymphovascular space invasion (p=0.026) and deep stromal invasion (p=0.024). However, other factors, such as age, stage, histologic grade, histologic type, lymph node metastasis, and tumor size, were not significantly associated with viral load. Low HPV viral load was correlated with poor disease-free survival in univariate analysis (p=0.037) and multivariate analysis (p=0.027). There was no significant difference in overall survival with regard to initial HPV viral load. CONCLUSION: Low initial HPV viral load may be a poor prognostic factor for cervical cancer patients who have undergone radical hysterectomy.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/*diagnosis/surgery/virology ; Female ; Humans ; Middle Aged ; Papillomaviridae/*isolation & purification ; Papillomavirus Infections/complications/diagnosis/surgery/virology ; Prognosis ; Retrospective Studies ; Treatment Outcome ; Uterine Cervical Neoplasms/*diagnosis/surgery/virology ; *Viral Load ; Young Adult

Objective To determine whether hybrid three dimensional diffusion tensor imaging (3D DTI) contributes incremental value to standard T2WI technique for assessing neurovascular bundles (NVB) around the prostate. Methods This retrospective institutional review board-approved study included 69 consecutive patients with prostate tumor who underwent MRI including conventional T2WI and 3D DTI . DTI data were postprocessed and hybrid 3D DTI and axial T2W images were obtained. Three radiologists with one, five and thirteen years of experience in reading prostate MRI and one urologist with three years of surgical experience in urology who were blinded to patient data independently recorded their levels of preference on a five-point scale of the NVBs around the prostate on the basis of T2WI alone and hybrid 3D DTI and T2WI, respectively. The differences of scores of T2WI and hybrid 3D DTI and T2WI of the four doctors were compared by using nonparametric Wilcoxon rank. Results The average scores of hybrid 3D DTI to T2WI and alone T2WI to assess NVBs for 3 radiologists and one urologist were 4.4±0.6, 4.3±0.8, 4.2± 0.6, 4.9±0.3 and 2.9±0.8, 3.0±1.1, 1.6±0.7, 3.8±0.5, respectively. The hybird 3D DTI to T2WI improved the discrimination abilities of NVBs around the prostate for 3 radiologists and one urologist (Z values were-12.791,-9.737,-14.538,-14.901, P<0.01 respectively).The added value of hybrid DTI to T2WI for urologist is the highest, and experienced radiologist is the smallest. Conclusion The hybrid 3D DTI
contributes significant incremental value to the standard T2WI technique for assessing NVB around the prostate.

ObjectiveTo investigate ABCG5 and ABCG8 gene in the occurrence and development of cholesterol gallstone and cholesterol polyp.MethodsClinical data of 60 patients who underwent cholecystectomy in the First Afifliated Hospital of Sun Yat-sen University from March 2012 to March 2014 were studied retrospectively. Of the 60 patients, 31 were males and 29 were females with a mean age of (49±6) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to the results of pathological diagnosis, the patients were divided into the cholesterol gallstone group (gallstone group), the cholesterol polyp group (polyp group) and the routine cholecystectomy group (control group). The relative expression of ABCG5 and ABCG8 mRNA in gallbladder epithelial cells was determined by real-time fluorescence quantitative polymerase chain reaction (PCR). The comparison of the relative mRNA expression between three groups were conducted using One-way analysis of variance and LSD-t test.ResultsThe relative expression of ABCG5 and ABCG8 mRNA was 3.3±0.9 and 6.9±1.5 respectively in gallstone group, which were signiifcantly higher than 2.4±0.6 and 4.3±1.5 in control group (LSD-t=23.58, 16.55;P<0.05). The relative expression of ABCG5 and ABCG8 mRNA was 2.6±0.7 and 4.6±1.3 respectively in polyp group and no signiifcant difference was observed when comparing with those in control group (LSD-t=1.18, 0.73;P>0.05).ConclusionABCG5 and ABCG8 gene may play a role in the occurrence and development of cholesterol gallstone and cholesterol polyp through different mechanisms.