Objective To systematically evaluate the diagnostic value of TERC gene on high-grade squamous intraepithelial lesion (HGSIL) of the cervix. Methods Such databases as PubMed, EMbase, and The Cochrane Library were searched by March 31, 2012. According to the inclusion and exclusion criteria, the literature was screened and the data were extracted. The quality was evaluated in accordance with the quality assessment tool for diagnostic accuracy studies (QUADAS) and the meta-analysis was conducted by using Meta-Disc 1.4 software. Result A total of 12 studies involving 7 894 cases were included. The results of meta-analysis showed that the sensitivity, specificity and diagnostic odds ratios of TERC gene on HGSIL of cervix were 0.81 (95%CI 0.80 to 0.82), 0.83 (95%CI 0.82 to 0.84), 17.37 (95%CI 8.77 to 34.41), respectively. Conclusions The diagnostic value of TERC gene were medium in diagnosing HGSIL of the cervix alone, and it can be used as an optional method in clinical diagnosis.
Objective To evaluate the role of systematic lymphadenectomy (SL) vs. unsystematic lymphadenectomy (USL) for improving overall survival (OS) in epithelial ovarian cancer (EOC). Methods The databases such as PubMed, EMbase, The Cochrane Library, Evidence-Based Medicine Reviews (EBMR), CBM, CNKI and VIP were searched between January 1, 1995 and December 31, 2010, the randomized controlled trials (RCTs) and observational studies on SL vs. USL in treating EOC were included. Based on Cochrane handbook, the data were extracted, the methodological quality was assessed, and then meta-analyses were conducted by using RevMan 5.0 software. Results The total 13 studies involving 22 796 patients were included, including 5 420 patients in the SL group, and the other 17 376 patients in the USL group. Two of the 13 studies were RCTs, and the other 11 were observational studies (including 2 studies retrieved from SEER data). The analyses on 2 RCTs showed that compared with USL, a) SL could not improve 5-PFS (OR=0.70, 95%CI 0.40 to 1.22, P=0.21) in early-stage EOC (FIGO I to II), but it did improve 5-PFS (OR=0.62, 95%CI 0.40 to 0.96, P=0.03) in advanced-stage EOC (FIGO III to IV); b) SL could not improve 5-OS in both early-stage EOC (OR=0.84; 95%CI 0.44 to1.58, P=0.58) and advanced-stage EOC (OR=0.93, 95%CI 0.64 to 1.37, P=0.73); and c) SL could not improve 5-OS in both early-stage (OR=0.84, 95%CI 0.44 to 1.58, P=0.58) and advanced-stage (OR=0.93, 95%CI 0.64 to 1.37, P=0.73) of EOC patients who had optimal tumor dubulking surgery. The analyses on observational studies showed that compared with USL, a) SL could not improve 5-PFS in both early-stage EOC (OR=0.38, 95%CI 0.08 to 1.74, P=0.21) and advanced-stage (OR=2.88, 95%CI 0.95 to 8.72, P=0.06) EOC; b) Whether SEER impacts were excluded or not, SL did improve 5-OS in both early-stage EOC (OR=0.54, 95%CI 0.46 to 0.63, Plt;0.000 01) and advanced-stage (OR=0.47, 95%CI 0.43 to 0.52, Plt;0.000 01) EOC; and c) For EOC patients who had optimal tumor dubulking surgery, SL could not improve 5-OS in early-stage (OR=0.32, 95% CI 0.02 to 6.19, P=0.45), but it did improve 5-OS in advanced-stage (OR=0.53, 95%CI 0.32 to 0.88, P=0.01). Conclusion These findings suggest that maybe SL can improve 5-PFS and 5-OS in EOC. However, the efficacy of SL on 5-PFS and 5-OS is still undetermined, so more relevant studies are required for further investigating the role of SL in EOC.
目的 评价肿瘤细胞减灭术治疗复发上皮性卵巢癌（EOC）的作用，分析影响生存时间的因素。 方法 按Cochrane系统评价方法，计算机检索PubMed、EMbase、Medline、Cochrane Library、循证医学数据库（EBMR）、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CJFD）、清华同方等数据库，并手工检索相关领域杂志。检索时间从1985年1月1日－2011年11月30日，查找手术治疗复发EOC患者的回顾性、非随机前瞻性、病例对照研究，由两位研究者按照纳入排除标准筛选文献、评价质量并提取资料后，采用SPSS软件进行线性回归分析。 结果 共纳入48篇文献（回顾性文献40篇，非随机前瞻性文献7篇，病例对照研究1篇）共2 605例。简单线性回归分析结果显示满意切除比例与中位生存时间回归模型成立，有统计学意义（F=7.346，P=0.009），浆液性病理类型比例与中位生存时间回归模型成立，有统计学意义（F=5.537，P=0.025），残留病灶大小与中位生存时间回归模型成立，有统计学意义（F=4.249，P=0.045），多重逐步线性回归分析显示仅有满意切除比率对术后中位生存时间的影响有统计学意义（P=0.009）。 结论 二次肿瘤细胞减灭术主要适用于铂类敏感型可切除及孤立结节复发EOC患者，要获得明确二次肿瘤细胞减灭术治疗复发EOC对中位生存时间的影响，尚需进行大样本随机对照的研究。
ObjectiveTo explore the mechanism of postoperative recurrence of hepatocellular carcinoma(HCC) and predicting the candidate drug. MethodsThe differently expressed genes of the human gene expression profiles with 35 postoperative recurrence of HCC tissues and 41 no recurrence of HCC tissues were identified. Then enriched these genes with gene ontology(GO) terms and KEGG pathway, and predicting the candidate drugs for suppress the postoperative recurrence using Connectivity Map(cmap) database. ResultsSeveral pathways such as Focal adhesion and MAPK signaling pathway were found involve in postoperative recurrence of HCC. Moreover, two candidate small molecule drugs(bambuterol and lovastatin) were found may suppress and postoperative recurrence of HCC. ConclusionFocal adhesion and MAPK signaling pathway may involve in the postoperative recurrence of HCC, bambuterol and lovastatin may candidate drugs for treat postoperative recurrence of HCC.
ObjectiveTo systematically review the efficacy and safety of irinotecan as neoadjuvant chemotherapy (INAC) plus radical surgery (RS) for cervical cancer. MethodsWe searched databases including PubMed, EMbase, The Cochrane Library (Issue 10, 2014), CBM, CNKI, VIP and WanFang Data to collect clinical studies on INAC plus RS versus RS alone or other neoadjuvant chemotherapy drugs plus RS in the treatment of cervical cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 6 studies (4 RCTs and 2 CCTs) involving 596 patients were included. The results of meta-analysis showed that, compared with the RS alone group, the INAC group was superior in reducing operation time (MD=-16.17, 95%CI -21.88 to -10.46, P<0.000 01), intraoperative blood loss (MD=-39.56, 95%CI -51.96 to -27.17, P<0.000 01), increasing 3-years OS (OR=0.29, 95%CI 0.15 to 0.57, P<0.000 3), reducing incidence of positive parametrical involvement (OR=0.27, 95%CI 0.12 to 0.60, P=0.001) and incidence of lymphovascular space invasion (OR=0.24, 95%CI 0.09 to 0.61, P=0.003). However, there were no significant differences in the incidence of lymph node metastasis (OR=0.55, 95%CI 0.29 to 1.03, P=0.06) and positive surgical margin (OR=0.33, 95%CI 0.03 to 3.86, P=0.38) between the two groups. Compared with the paclitaxel plus RS group, there were no significant differences for the INAC group in the effective rate (OR=1.58, 95%CI 0.20 to 12.32, P=0.66) and the incidence of more than grade Ⅲ adverse events (OR=2.27, 95%CI 0.62 to 8.27, P=0.21). ConclusionINAC is effective and tolerable in the treatment of cervical cancer. Due to the limitation of quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the rule of lymph node metastasis in early gastric cancer (EGC) so as to provide a reasonable treatment. MethodsWe retrospectively analyzed the clinical data of 118 EGC patients who had been treated from January 2006 to December 2012,and a total of 8 potential factors associated with occurrence of EGC were evaluated by univariate analysis and multivariate logistic regression analysis. ResultsThe univariate analysis showed that ulcer,tumor size,depth of invasion and lymphatic involvement were correlated with lymph node metastasis (P<0.05).Multivariate logistic regression analysis showed that presence of an ulcer (OR=2.872),tumor of 3.0 cm or larger than that (OR=2.351),tumor invasion into the submucous layer (OR=3.461) and invasion into the lymphatic tubes (OR=1.784) were found to be independent risk factors. ConclusionLymph node metastasis of EGC is correlated with many factors,so EGC treatment choice should be made reasonably based on strict screening to exclude various risk factors before taking surgery.
ObjectiveTo observe the prevalence of ocular ischemic appearance (OIA) associated with carotid artery stenosis, and to explore the correlation between the ocular ischemic appearance and the carotid stenosis degree and location. MethodsA total of 132 patients with carotid artery stenosis diagnosed by color Doppler ultrasound and CT angiography were enrolled in this prospective study. The carotid stenosis degree and location were identified. The ophthalmic symptoms was inquired. The corrected vision, diopter, intraocular pressure, slit lamp microscope and fundus examination were used to determine if OIA exists. The correlation between the OIA and the carotid stenosis degree and location were analyzed. The carotid stenosis degree was divided into 4 types: mild (≤50%), moderate (<50% but ≤75%), severe (<75% but ≤99%) and occlusion (100%). ResultsThe distribution of carotid stenosis degree as follow: mild in 16 patients (12.1%), moderate in 46 patients (34.8%), severe in 50 patients (37.9%) and occlusion in 20 patients (15.2%). The stenosis located in the external carotid artery in 21 patients (15.9%), in internal carotid artery in 46 patients (34.8%), in crotch of extracranial internal carotid artery in 55 patients (41.7%), and in common carotid artery in 10 patients (7.6%). There were 54 patients (40.9%) with ocular ischemic diseases, which including retinal arterial obstruction (5 patients, 9.2%), retina change of venous stasis (13 patients, 24.1%), neovascular glaucoma (7 patients, 13.0%), ischemic optic neuropathy (19 patients, 35.2%), ocular ischemia syndrome (10 patients, 18.5%). The ophthalmic symptoms included transient amaurosis, decreased visual acuity, eye and periorbital pain, retinal hemorrhage and exudation, diplopia, rubeosis iridis and increased intraocular pressure. There was highly positive correlation between the carotid stenosis degree and OIA (r=0.287, P=0.018). There was no correlation between the carotid stenosis location and OIA (P>0.05). Conclusion40.9% carotid stenosis patients has OIA. There is relationship between the carotid stenosis degree and OIA, but carotid stenosis location showed no correlation with OIA.
A miniaturized, low-cost high-intensity focused ultrasound device is developed for the problems of cross-contamination and uneven sample fragmentation in conventional ultrasound devices. This device generates ultrasonic waves through a concave spherical self-focusing piezoelectric ceramic piece, and creates a cavitation effect in the focusing area to achieve sample fragmentation. The feasibility of the device is demonstrated by physical simulation, then a driving circuit with adjustable power is designed and manufactured to generate 0 ~ 22.4 W acoustic power, and finally paraffin-embedded sample dewaxing experiments are performed to verify the validation of the device. The experimental results show that the dewaxing efficiency and safety of the high-intensity focused ultrasound device is significantly better than those of traditional chemical methods, and this device is comparable with commercial ultrasonic instruments. In summary, the high-intensity focused ultrasound device is expected to be applied in automated nucleic acid extraction and purification equipment and has a broad application prospect in the field of sample pre-processing.
Objective To assess the safety and effectiveness of laparoscopic hysterectomy (LH) for women with benign gynecological diseases. Methods Such databases as CENTRAL (The Cochrane Library, Issue 5, 2012), MEDLINE, EMbase, CNKI, WanFang Data, VIP and CBM were searched from the date of their establishment to May 2012, meanwhile the relevant gray literature was also retrieved to identify the randomized controlled trials (RCTs) about LH versus abdominal hysterectomy (AH) for benign gynecological diseases. The literature was screened according to the inclusion and exclusion criteria by two reviewers independently, and the methodology quality was evaluated after extracting the data, then RevMan 5.1 software was used for meta-analysis. Results A total of 22 RCTs involving 3 304 patients were included. The results of meta-analysis showed that, compared with AH, LH was shorter in the time of both hospital stay (MD=–2.31, 95%CI –3.03 to –1.60, Plt;0.000 01) and postoperative recovery (MD=−13.86, 95%CI −17.70 to −10.03, Plt;0.000 01), and lower in the incidences of both postoperative fever and other nonspecific infections (OR=0.72, 95%CI 0.54 to 0.95, P=0.02), but it was higher in the incidence rate of intraoperative urinary systematic injuries (OR=2.41, 95%CI 1.21 to 4.82, P=0.012), and longer in the operation time (MD=20.27, 95%CI 3.95 to 36.59, P=0.03). There were no significant differences between the two groups in the incidence of complications such as intraoperative intestinal injuries, vessel injuries, postoperative fistulizaion, postoperative urethral dysfunction, postoperative vaginal infection, etc. (Pgt;0.05). Conclusion This systematic review shows when treating benign gynecological diseases, LH is superior to AH in shortening the time of hospital stay and postoperative recovery, and in decreasing the incidence of operative fever and other nonspecific infections, but it results in a higher incidence of intraoperative urinary systematic injuries and longer operative time. Because there is no result regarding to the postoperative long-term life quality, so it expects to be further proved by more high quality RCTs.