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Objective@#To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (PC) chemotherapy regimens on the fertility and prognostic outcomes in malignant ovarian germ cell tumor (MOGCT) patients who underwent fertility-sparing surgery (FSS). @*Methods@#A propensity score matching algorithm was performed between the BEP and PC groups. The χ2 test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factor of DFS. @*Results@#We included 213 patients, 185 (86.9%) underwent BEP chemotherapy, and 28 (13.1%) underwent PC chemotherapy. The median age was 22 years (range, 8–44 years), and the median follow-up period was 63 months (range, 2–191 months). Fifty-one (29.3%) patients had a pregnancy plan, and 35 (85.4%) delivered successfully. In the before and after propensity score matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during-pregnancy status, and live birth between the BEP and PC groups (p>0.05). Fourteen (6.6%) patients experienced recurrence, including 11 (5.9%) in the BEP group and 3 (10.7%) in the PC group. Four (1.9%) patients in the BEP group died. Kaplan-Meier analysis revealed no significant differences in DFS (p=0.328) and OS (p=0.446) between the BEP and PC groups, and the same survival results were observed in the after matching cohort. @*Conclusion@#The PC regimen is as safe as the BEP regimen for MOGCT patients with fertility preservation treatment, and no differences were observed in fertility and clinical prognosis.
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Objective To clarify the role of claudin-4 in endometrial tumorigenesis and explore claudin-4 be as potentially useful agent in the treatment of endometrial carcinoma.Methods The expression of claudin-4 in 62 endonetrioid endometrial carcinoma (EEC),30 atypical hyperplasia endometrial tissue and 60 human normal endometrium was determined using immunohistochemistry and realtime PCR.Ninety female BALB/c mice were transplanted with Ishikawa endometrial cancer cells,which were divided into three groups with different intraperitoneal treatments with cisplatin,paclitaxel and saline solution.After the observation period,the tumors were extracted and stained with monoclonal antibody against claudin-4.The messenger RNA expression of claudin-4 was also detected using real-time PCR.Results Among the EEC samples,34％ (21/62) showed medium staining for claudin-4 and 66％ (41/62) showed intense staining.In atypical hyperplasia group,27％ (8/30) showed weak staining,53％ (16/30) showed medium staining and 20％ (6/30) showed intense staining for claudin-4.Of the normal endometrial tissue,47％ (28/60) showed weak staining and 53％ (32/60) showed no staining for claudin-4.According to real-time PCR,the relative quantity of claudin-4 was 170 ± 12 in EEC group,89 ± 15 in atypical hyperplasia group and 18 ± 3 in normal endometrium.Compared with those in atypical hyperplasia group and normal endometrium group,the protein and mRNA expression of claudin-4 were significantly increased in the group of EEC (all P ＜ 0.05).In the study of Ishikawa xenografts,no significant changes in tumor volume and claudin-4 expression were shown in paclitaxel group compared with that in the control group.Nevertheless,a significant reduction of the tumor growth and a significant decrease in claudin-4 expression were observed in cisplatin group.After cisplatin treatment,the tumor volume was significantly decreased [(0.51 ±0.21) versus (0.73 ±0.12) cm3],and the mRNA expression of claudin-4 was also significantly decreased (153 ± 35 versus 273 ± 27).Conclusion These results demonstrate that claudin-4 is strongly expressed in EEC,which may be a useful biomarker to monitor the effects of chemotherapy in patients with endometrial carcinoma.
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Objective To study the blood pressure changing patterns in normal pregnancy and pregnancy induced hypertension(PIH). Methods 24 hour ambulatory blood pressure monitoring (ABPM) were performed in 38 cases of normal pregnancy and 36 cases of PIH during 18～20,28～30 and 38～40 gestational week. Results The 24 hour mean blood pressure were increased with pregnancy advanced. In normal pregnancy, a typical circadian rhythm of blood pressure pattern was shown that it increases during the day and decreased during the night with the disparity of (16.3? 4.1)%, (14.1?3.2)% and (15.7?2.0)% in three different gestational week respectively. In moderate and severe PIH, the 24 hour mean blood pressure,blood pressure load and the frequence of abnormal rhythm were significantly higher than those in mild PIH and normal pregnancy, while the disparity between day and night blood pressure was lower. Conclusion The blood pressure patterns show a typical circadian rhythm in most normal pregnancy. The more severe the PIH is, the higher rate of abnormal blood pressure rhythm occured.
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Objective To study the in vitro effects of sonodynamic management on human ovarian cancer cell line HRA. Methods Hematoporphyrin was selected as a sonosensitizer and ultrasound with certain intensity was used to activate hematoporphyrin.Then MTT assay and clony-forming efficiency assay were applied to determine the growth inhibitory effects of ovarian cancer cells. Electron microscope was applied to detect the morphological changes of the cells. Cell apoptosis was analyzed using flow cytometry. Results Hematoporphyrin had no significant inhibitory effects on the cells. However, when hematoporphyrin was used before ultrasound,it could enhance the killing effects of ultrasound(P