This study aimed to compare the efficacy and safety of immune checkpoint inhibitors (ICIs) combined with antiangiogenic agents in patients with unresectable hepatocellular carcinoma (HCC).We conducted a systematic literature search of articles published between the establishment of the database and February 2022. Data were extracted and analyzed using STATA 14.0.Six randomized controlled trials (RCTs) (980 patients for combination therapy and 565 patients for monotherapy) and 5 single-arm studies (246 patients for ICIs combination therapy) were enrolled. The objective response rate (ORR) and disease control rate (DCR) were 26% and 70%, respectively, after ICIs combination therapy. Compared with monotherapy in RCTs, ICIs combination therapy resulted in higher progression-free survival (PFS) and overall survival (OS), but also increased the incidence of adverse events (AEs). Increased incidences of fatigue, hypertension, hyperbilirubinemia, proteinuria, and nausea were more common after ICIs combination therapy.The analysis results reveal that ICI-combined anti-angiogenesis therapy has higher efficacy than either ICIs or anti-angiogenesis options for unresectable HCC, but it is necessary to manage the AEs.
This video presentation demonstrates the progress of a patient diagnosed with stage IB 1 cervical squamous cell carcinoma by the FIGO stage and undergoing radical hysterectomy of cervical cancer under fluorescence laparoscopy. After disinfecting the tissue, a 0.5 mL ICG tracer was injected into the cervix at 3 and 9 o’clock to trace the sentinel lymph node. Bilateral internal iliac sentinel lymph nodes were removed under a fluorescence microscope, and pelvic lymph node dissection was performed. Then, the circular ligaments on both sides of the uterus were removed, the broad ligaments on both sides were opened, and the uterosacral ligament, main ligament, and bilateral parametrium tissues were removed. Finally, the vaginal wall was incised 3 cm below the outer cervical opening without a uterine manipulator. The vaginal stump on both sides of the excised specimen was clipped, the excised specimen was removed through the vagina, and the vaginal stump was sutured with the edge of the v-loc absorbable suture.
Abstract Backgrounds: The relationship of Iron deficiency and thyroid hormone have been researched a lot among pregnant or other healthy population. However, invisible iron deficiency, namely shortage of sFer level, has been barely investigated among Chinese pregnant women. This study aimed to explore the effects of sFer status on thyroid function in a population-based upper first-class hospital. Methods A total of 781 singleton pregnant women of gestation in Shanghai General Hospital took part in this retrospective cohort study. The participants were divided into four groups by quartiles of serum ferritin levels (Q1–4). Binary logistic regressions were used to examine the strength of association between the different traits and the serum ferrin (sFer) quartiles separately, where Q1 (lowest ferritin quartile) was taken as the base reference. One-way ANOVA was adopted to compare the averages of the different variables across Sfer quartiles. Categorical measures were compared by Fisher exact test or chi-square test. Results As the sFer concentration rises, incidence of premature birth (15.8%vs 12.3% vs 9.20% vs 6.20% p = 0.016) as well as threatened miscarriage (14.8% vs 7.2% vs 8.70% vs 6.70% p = 0.021)presented a downward trend. Compared with the other sFer group, subjects of the low sFer group were older, were more often found to have lower serum γT3 and FT4 levels in early pregnancy but not in middle pregnancy. Conclusions The correction of invisible iron deficiency with inadequate sFer status prior to pregnancy or during early pregnancy is imperative, not only to prevent anemia, but also for maintaining optimum thyroid function and normal fetal development. For clinicians, sFer status of pregnant women should be attached great importance apart from attention to iron level.
BACKGROUND The aim of this study was to investigate the expression and silencing of the S100A8 gene, which encodes the S100 calcium-binding protein A8 (S100A8), and apoptosis and phosphorylation of protein kinase B (Akt) in tissue samples of endometrial carcinoma and HEC-1A endometrial adenocarcinoma cells in vitro. MATERIAL AND METHODS Immunohistochemistry (IHC) was used to detect expression of the S100A8 protein in 74 tissue samples of endometrial cancer and 22 normal endometrial tissue samples. A stable S100A8 gene knockdown cell line was constructed using lentiviral packing short hairpin RNA (shRNA) transfected into HEC-1A cells. S100A8 mRNA and S100A8 protein levels were detected by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blotting. The effects of expression of the S100A8 gene by endometrial cancer cells was investigated by the MTT assay, cell cycle and apoptotic assays, qRT-PCR, and Western blotting. RESULTS IHC showed high levels of expression of S100A8 protein in endometrial carcinoma tissues, and HEC-1A adenocarcinoma cells (in G1 and G2). Increased expression of S100A8 protein was found endometrial cancer tissues compared with normal endometrial tissues (79.7% vs. 4.5%). S100A8 gene knockdown reduced cell proliferation in the HEC-1A cells compared with control cells, induced cell apoptosis, inhibited the phosphorylation of protein kinase B (Akt), and induced the expression of pro-apoptotic genes, including the cytochrome C gene, CYCS, BAD, BAX, FOXO1, FOXO3, CASP9, and CASP3. CONCLUSIONS In endometrial carcinoma cells, down-regulation of the S100A8 gene induced cell apoptosis via inhibition of the phosphorylated or active form of protein kinase B (Akt).
Abstract Background Lymph node status is one of the most important prognosis factors in determining adjuvant treatment in endometrial cancer (EC). However, lymphadenectomy bears significant surgical and postoperative risks. The use of the sentinel lymph node mapping (SLNM) has emerged as an alternative method to complete lymphadenectomy in EC. There remains controversy surrounding the SLNM in high-risk disease and its false negative rate (3%). We previously identified miR-204-5p is tumor suppressor miRNA associated with lymph node metastasis in endometrial cancer tissues. Here, we report serum miR-204-5p in EC patients have potential early diagnostic value combined with sentinel lymph node mapping. Methods The relative expression levels of miR-204-5p were detected by quantitative RT-PCR in the serum of 52 EC patients (total SLNM), 20 benign ovarian cyst patients and 20 myoma patients. The miR-204-5p expression was also detected in endometrial cancer tissues by in situ hybridization. Results Our results showed that serum miR-204-5p expression was down-regulated in EC patients than that in the benign ovarian cyst or myoma patients ( p < 0.01).In accordance with final pathological evaluation, positive SLN EC patients have a significant lower level of miR-204-5p compared with negative SLN EC patients. The area under the ROC curve of miR-204-5p was 0.923, 95% CI(0.847, 1.000), and the diagnostic value with a sensitivity of 87.2% specificity of 80.0%. Conclusions Lower miR-204-5p expression is associated with lymph node metastasis in these SLN(+) EC tissues, indicate that down-regulation of serum miR-204-5p in EC patients have potential early diagnostic value combined with sentinel lymph node mapping.
Objective To explore the pathological features of lung biopsy and promote the development of clinical lung puncture technique to improve the rate of lung cancer diagnosis in lung biopsy.Methods The HE and immunohistochemical staining results of 387 cases lung biopsy specimens were retrospectively analyzed.The clinical pathological features were analyzed.Results There were 284 cases(73.39%) malignant lesions in 387 lung biopsy specimens,of which adenocarcinoma was the most common.And there were 81 cases(20.93%) benign lesions,of which the majority cases were inflammation.22 cases(5.68%) clot necrosis material were found.The phenotype analysis of 138 cases that won't diagnosed exactly showed 113 cases with lung cancer.Conclusion The lung tissue biopsy is a simple,effective method to screen lung cancer.With the immunohistochemistry,improvement of puncture technique and optimization of production processes,the diagnosis rate of lung cancer will be improved significantly.
Abstract Background Perineal trauma refers to damage to the genitalia during the birthing process and can occur spontaneously or as a result of an episiotomy or female genital mutilation (FGM). Objective To perform a systematic review and network meta-analysis investigating the effectiveness of different PFMT relevant strategies in the prevention of perineal trauma. Search strategy PubMed, Embase, the Cochrane Library, CINAHL, CNKI, CBM, WANFANG DATABASE, and ClinicalTrials.gov were searched for citations published in any language from inception to 1 July 2021. Selection criteria Randomised controlled trials (RCTs) of PFMT relevant prevention strategy to prevent perineal trauma in pregnant women. Data collection and analysis Data were independently extracted by two reviewers. Relative treatment effects were estimated using network meta-analysis (NMA). Main results Of 12632 citations screened, 21 RCTs were included. Comparing with usual care, “PFMT combine with perineal massage” and PFMT alone showed more superiority in intact perineum (RR=5.37, 95%CI: 3.79 to 7.60, moderate certainty; RR=2.58, 95%CI: 1.34 to 4.97, moderate certainty), episiotomy (RR=0.26, 95%CI: 0.14 to 0.49, very low certainty; RR=0.63, 95%CI: 0.45 to 0.90, very low certainty), and OASIS (RR=0.35, 95%CI: 0.16 to 0.78, moderate certainty; RR=0.49, 95%CI: 0.28 to 0.85, high certainty). “PFMT combine with perineal massage” show superiority in reducing perineal tear (RR=0.41, 95%CI: 0.20 to 0.85, moderate certainty). Conclusion In this systematic review, the finding on the perineal trauma indicated that “PFMT combine with perineal massage” and PFMT showed more superiority to prevent perineal trauma.
Objective To investigate the methods of pathological examination on body fluids cell blocks and effects of immunohistochemistry in its diagnosis.Methods The HE and immunohistochemical staining of the body fluids cell blocks were used to analyse the clinical pathological features of 148cases.Results There were 65cases malignant lesions in 148body fluids cell blocks according to microscopic morphology and immunohistochemical staining.In the malignant cases,there were 60cases had defined tissue sources,including 45cases of lung cancer,six ovarian cancer,3gastrointestinal cancer and 11other cases.The coincidence rate between the body fluids cell blocks diagnosis and surgical specimen diagnosis was 95.5%.Conclusion To selecte some appropriate immune markers according to clinical history and HE morphology can help the tumor diagnosis and to determine the tissue origin.The examination of body fluids cell blocks is important for tumour patients without indications for surgery.
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