目的:研究TRAIL对卵巢癌COC1/DDP细胞生长的影响，以及化疗药物DDP等对TRAIL受体（DR4、DR5）表达的影响，揭示TRAIL与COC1/DDP细胞顺铂耐药性的关系。方法:用MTT法检测不同浓度TRAIL蛋白和TRAIL与DDP联合用药对COC1/DDP细胞生长的影响，用RTPCR方法检测DDP对TRAIL受体（DR4、DR5）表达的影响。结果:①TRAIL蛋白对COC1/DDP细胞生长有抑制作用，且随着TRAIL蛋白浓度升高，细胞抑制率逐渐上升。②DDP（2.5μg/mL）对COC1/DDP细胞生长抑制作用较弱（抑制率为3.31%），DDP在加入TRAIL蛋白后对细胞生长抑制率显著升高（Plt;0.05）。③DDP使COC1/DDP细胞的DR5表达水平显著增强为正常对照组的3.54倍（Plt;0.001）。结论:TRAIL蛋白对COC1/DDP细胞生长有抑制作用，DDP与TRAIL联合使用COC1/DDP细胞生长抑制更明显，TRAIL可逆转COC1/DDP细胞对DDP的耐药性，耐药性的逆转可能与DDP导致TRAIL受体DR5水平增高促进了肿瘤细胞的凋亡有关。
Ovarian cancer is one of the common malignant tumors of female genital organs. In gynecological tumors, the incidence rate of ovarian cancer ranks the third after cervical cancer and uterine body cancer, but the death rate of ovarian cancer ranks the first, posing a serious threat to women’s life and health. In recent years, the National Comprehensive Cancer Network (NCCN) clinical practice guidelines for ovarian cancer has become an important basis for diagnosis and treatment of ovarian cancer. In this paper, we interpret the latest version (version 4. 2017) of NCCN clinical practice guidelines for ovarian cancer for its better clinical application.
ObjectivesTo systematically review the epidemiology of high-risk human papillomavirus (HPV) infections in western Chinese females.MethodsPubMed, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect epidemiological studies on female genital high-risk HPV infection in western China from January 2000 to July 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, and then, meta-analysis was performed by using R software.ResultsA total of 35 studies involving 149 037 objects were included. The results of meta-analysis showed that: the total infection rate of high-risk HPV in the northwest was 12.21% (95%CI 10.0% to 16.72%), and that in the southwest was 17.48% (95%CI 13.55% to 21.4%). The infection rate of high-risk HPV among healthy females in the northwest was 10.03% (95%CI 10.0% to 11.67%), while that in the southwest was 14.94% (95%CI 11.51% to 18.38%). CINⅠ, CINⅡ-Ⅲ and cervical cancer patients in the northwest with high-risk HPV infection rate were 70.31% (95%CI 49.0% to 91.61%), 84.29% (95%CI 68.36% to 100.22%) and 89.35% (95%CI 74.15% to 104.55%), respectively. The infection rates of patients with corresponding lesions in the southwest were 59.06% (95%CI 45.87% to 72.25%), 83.79% (95%CI 76.62% to 90.96%), and 81.07% (95%CI 67.77% to 94.37%), respectively.ConclusionsCurrent evidence shows that the epidemiological pattern of female genital high-risk HPV infection in western China is basically consistent with overseas. The high-risk HPV subtypes are subtype 16, 18, 31, 52, 53 and 58. The HPV vaccine used in China has basically covered the prevalent high-risk HPV subtypes in Western China. The wide application of vaccine may reduce the incidence and mortality of cervical precancerous lesions and cervical cancer, which will ensure reproductive health females in Western China. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
The mortality rate of ovarian cancer is the highest among female reproductive tract malignancies. Although most patients have undergone recurrent treatments such as surgery, chemotherapy, and targeted therapy, the recurrence rate is still high. The exploration of scholars in this field has never stopped. In recent years, remarkable achievements have been made in the medical treatment of ovarian cancer. The research of poly adenosinediphosphate-ribose polymerase, immunotherapy (immunocheckpoint inhibitor monotherapy, immune checkpoint inhibitor combined with other drugs) and anti-angiogenic drugs have provided new methods for the treatment of this disease, and throughout the whole process of ovarian cancer treatment. This paper summarizes this, and aims to provide a reference for the clinical treatment of ovarian cancer.
Objective To evaluate the diagnostic accuracy of liquid-based cytology versus conventional cytology for cervical neoplasia. Methods Such databases as PubMed, Embase, The Cochrane Library, Cochrane Central Register of Controlled Trials, CNKI and CBM were searched to collect the random control trials (RCTs) about evaluating the diagnostic accuracy of liquid-based cytology versus conventional cytology for cervical neoplasia published before June, 2010. According to the inclusive and exclusive criteria, two assessors independently screened the studies, extracted the data, assessed the quality and conducted meta-analysis by using RevMan 5.0 and Metadisc 1.4 softwares. Results A total of five RCTS were eligible. With the ASCUS regarded as the abnormal critical value, there were significant differences between liquid-based cytology and conventional cytology in specificity for CIN 3+ (RR=0.97, 95%CI 0.97 to 0.97, Plt;0.000 01) and CIN 2+ of high risk population (RR=1.01, 95%CI 1.01 to 1.01, Plt;0.000 01), but no significant differences were found in other outcomes. Conclusion Based on the current evidence of evidence-based medicine, the liquid-based cytology is of neither more specificity nor more sensitivity for detecting high grade CIN than the convention cytology in the regular screening program, but it seems to be of more specificity in high risk group.
Objective To evaluate the diagnostic accuracy of human papillomavirus test for cervical neoplasia. Methods The Cochrane Library (Issue 2, 2010), Cochrane Central Register of Controlled Trials (Issue 2, 2010), and the following databases as CBMdisc, CNKI, MEDLINE, PubMed, and EMbase were all searched from their establishment to June 2010 to get all the randomized control trials (RCTs), and the relevant magazines and the references of the included studies were also searched. The screening, data extraction and quality assessment were conducted in accordance with the inclusion and exclusion criteria by two reviewers independently. The software Metadisc 1.4 was used to perform meta-analyses, and the forest plots and SROC curves were drewn with the RevMan 5.0 software. Results A total of 7 RCTs involving 171 604 subjects were included. The meta-analyses showed, the sensitivity of the HPV test for detecting cervical neoplasia (CIN) was higher than that of the conventional cytology test; the difference in sensitivity for detecting CIN in or above second grade was only found between the test of HPV combined with cervical cytology and the test of conventional cytology (Plt;0.00001), but the HPV test obviously lowered its diagnostic specificity. Among the following three tests for diagnosing CIN, such as, the single test of HPV, the combined test of HPV and cervical cytology, and the test of HPV followed by cytology shunting, the statistic differences compared with the conventional cytology test were found (Plt;0.01) except the last test (P=0.41) which had no difference in diagnosing CIN in or above the first grade. Conclusion The current evidence indicates that, compared with the conventional cytology test, the HPV combined with the cytology test can improve the sensitivity for diagnosing CIN in or above the second grade, but the HPV test cannot improve the specificity for cervical neoplasia. The application of human papillomavirus test for detecting cervical neoplasia needs to be further studied.
目的 通过对1例原发于宫颈的胎盘部位滋养细胞肿瘤（PSTT）的资料及相关文献的复习，全面介绍胎盘部位滋养细胞肿瘤的临床特征、病理特点、治疗方式及预后。 方法 对收治1例罕见原发于宫颈部位的PSTT的临床病理资料进行分析，并以“胎盘部位滋养细胞肿瘤”为主题词查阅中国知网（CNKI）及PubMed等文献数据库进行文献复习。 结果 该例原发于宫颈部位的PSTT患者术后化学疗法后，目前情况良好，已随访3年，无复发及转移征象。2011年9月1日前，CNKI数据库共报道300余例PSTT病例，PubMed数据库共160余例，其中有2例原发于宫颈部位的PSTT。原发于宫颈部位的PSTT罕见，易误诊，往往需要宫颈活组织检查或宫颈搔刮才能确诊。 结论 原发于宫颈部位的PSTT的预后是否遵循PSTT尚需收集更多的病例证实。PSTT因其发病率低，临床表现多无特异性，通常需要通过诊断性刮宫、活组织检查甚至术后病理检查才能确诊。PSTT首选的治疗方式为手术，多数患者病灶清除后可治愈，对有高危因素的患者术后宜选择依托泊苷+甲氨蝶呤+放线菌素D+环磷酰胺+长春新碱（EMA-CO）方案或依托泊苷+甲氨蝶呤+放线菌素D+依托泊苷+顺铂（EMA-EP）方案进行化学治疗，以期改善预后。
Gynecology and obstetrics teaching has strong practicality. Because of the lack of practice on patients who has strong self-protection consciousness and the likely injury due to invasive operation, students and young doctors can’t have many opportunities to make actual clinical operation which limits their abilities of clinical skills. Based on this, the virtual reality medical education in the teaching of obstetrics and gynecology develops fast these days because of its necessity, ethicality, and economical effect, which might be popularized. It plays a very important role in cultivating young doctors’ manipulative ability, training "three basics and three strictness", mastering abstract knowledge, and quantitative assessing effect of clinical teaching.