Vaginally administered PGF2alpha for cervical dilatation in nulliparas prior to suction curettage

Because of the need for an atraumatic method to dilate the cervix when performing artificial abortion by suction curettage, cervical dilatation following vaginally administered PGF2alpha was studied. A 50 mg PGF2alpha vaginal suppository was administered to 40 (treated group) first trimester nulliparas 3 hours prior to progressive cervical dilatation from a 19 (circumference in mm) Pratt dilator to a 35 Pratt dialator. The smallest-sized dilator that met resistance was interpreted as being the amount of clinically significant cervical dilatation. The results were compared to 20 (control group) first trimester nulliparas who received no PGF2alpha studied in an identical manner. Independent of gestational age, treated patients were dilated significantly more than the control patients. When subjects of similar gestational age were compared, PGF2alpha treated subjects were more often dilated sufficiently to perform abortion (55%) by suction curettage than control group subjects (5%). Those PGF2alpha subjects needing further dilatation to accept an appropriate sized cannula for their gestational age needed less dilatation than did those subjects of similar gestational age in the control group. No serious complications of PGF2alpha per se were observed and the most frequent side effects, vomiting and diarrhea, did not appear severe enough to limit the clinical practicability of the method.     

Biochemical blood parameters in people with a normal crystalline lens and in cataracts]

The activity of Na+,K+ATPase, gamma-glutamyltranspeptidase, ceruloplasmin, total antioxidative activity of water-soluble antioxidants, the contents of vitamins C and E, free amino-nitrogen and peroxide resistance of erythrocytes were determined at the blood's plasma of healthy persons (120 persons) and suffered from aged cataract (437 persons) of three aged groups (up to 40 years, 40-60 years and elder then 60 years). We have shown, that changes, which has been connected with cataractogenesis and age dependent changes are not equal. The lowering of activity of Na+,K(+)-ATPase, gamma-glutamyltranspeptidase and level of vitamin E was expressed less during the ageing, then during the development of lenses opacification. The increase of activity of oxidase during the cataractogenesis is less significant, then age depended inhibition of this enzyme. The opposite tendency (the lowering of activity at the patients with cataract is more expressed, then compensatory activations of these parameters at the persons of the corresponding age with transparent lenses) was revealed for total antioxidative activity of water-soluble antioxidants.     

Degradation of DRAK1 by CUL3/SPOP E3 Ubiquitin ligase promotes tumor growth of paclitaxel-resistant cervical cancer cells

Despite favorable responses to initial chemotherapy, drug resistance is a major cause limiting chemotherapeutic efficacy in many advanced cancers. However, mechanisms that drive drug-specific resistance in chemotherapy for patients with advanced cancers are still unclear. Here, we report a unique role of death-associated protein kinase-related apoptosis-inducing kinase 1 (DRAK1) associated with paclitaxel resistance in cervical cancer cells. Interestingly, DRAK1 protein level was markedly decreased in paclitaxel-resistant cervical cancer cells without affecting its mRNA expression, which resulted in an increase in tumor necrosis factor receptor-associated factor 6 (TRAF6) expression, as well as an activation of TRAF6-mediated nuclear factor-kappa B (NF-κB) signaling cascade, thereby promoting tumor progression. DRAK1 depletion markedly increased the chemotherapeutic IC₅₀ values of paclitaxel in cervical cancer cells. Ectopic expression of DRAK1 inhibited growth of paclitaxel-resistant cervical cancer cells in vitro and in vivo. Furthermore, DRAK1 was markedly underexpressed in chemoresistant cervical cancer patient tissues compared with chemosensitive samples. We found that DRAK1 protein was destabilized through K48-linked polyubiquitination promoted by the Cullin scaffold protein 3 (CUL3) / speckle-type POZ (poxvirus and zinc finger protein) protein (SPOP) E3 ubiquitin ligase in paclitaxel-resistant cells. Collectively, these findings suggest that DRAK1 may serve as a potential predictive biomarker for overcoming paclitaxel resistance in cervical cancer.Subject terms: Cancer therapeutic resistance, Ubiquitylation     

Immunosuppression as a high-risk factor in the development of condyloma acuminatum and squamous neoplasia of the cervix

The iatrogenic immunosuppression in renal transplant recipients has been associated with an increased incidence of malignancy in these patients. Among 132 female transplant recipients at risk for the development of squamous lesions of the cervix, 11 (8.5%) developed cervical condylomas. Six (4.5%) of the 11 patients developed cervical neoplasia. The average age of the patients at the time of initial diagnosis was 32.2 years. The lag time from transplantation to the diagnosis of the condyloma was 22.4 months, and the lag time from transplantation to the diagnosis of cervical neoplasia was 38.0 months. The increased incidence of condylomas as well as of intraepithelial neoplasia of the cervix in this group of patients with an established higher risk of malignancy supports the hypothesis that condylomas may represent a precursor lesion of cervical cancer. Immunosuppression should be included among the high-risk factors in the development of cervical neoplasia.     

大肠埃希菌在肿瘤患者肠外的分布及耐药谱分析

目的：了解大肠埃希菌在肿瘤患者肠外的分布和感染情况及耐药性。方法：参照全国临床检验操作规程,采用K-B法对云南省肿瘤医院58例肿瘤患者继发大肠埃希菌感染进行分析及对9种抗生素的耐药谱测定。结果：各类肿瘤患者中,以宫颈癌及继发大肠埃希菌感染多见,其中,宫颈癌为28.30%。肺癌为26.87%。从标本来源来看,以尿液标本最多,为63.79%,其次为痰液12.07%及分泌物12.07%。结论：大肠埃希菌在肿瘤患者肠外分布广泛,所致感染较严重,经耐药谱测定发现大肠埃希菌多重耐药类型多,提示对肿瘤患者治疗应重视局部微生态平衡及控制感染。     

Dopaminergic and serotonergic drug use: a nationwide register-based study of over 1,300,000 older people

Objective

To investigate the use of dopaminergic and serotonergic drugs in elderly people.

Methods

We analyzed data on age, sex and dispensed drugs for individuals aged ≥65 years registered in the Swedish Prescribed Drug Register from July to September 2008 (n = 1 347 564; 81% of the total population aged ≥65 years in Sweden). Main outcome measures were dopaminergic (enhancing and/or lowering) and serotonergic (enhancing and/or lowering) drugs and combinations of these.

Results

Dopaminergic and serotonergic drugs were used by 5.6% and 13.2% the participants, respectively. Female gender was related to use of both dopaminergic and, particularly, serotonergic drugs. Higher age was associated with use of dopamine lowering drugs and serotonergic drugs, whereas the association with use of dopamine enhancing drugs declined in the oldest old. The occurrence of combinations of dopaminergic and serotonergic drugs was generally low, with dopamine lowering + serotonin lowering drug the most common combination (1.6%). Female gender was associated with all of the combinations of dopaminergic and serotonergic drugs, whereas age showed a mixed pattern.

Conclusion

Approximately one out of ten older patients uses serotonergic drugs and one out of twenty dopaminergic drugs. The frequent use of dopaminergic and serotonergic drugs in the elderly patients is a potential problem due to the fact that aging is associated with a down-regulation of both these monoaminergic systems. Future studies are needed for evaluation of the impact of these drugs on different cognitive and emotional functions in old age.     

Elevated cytokeratin-19 expression associated with apoptotic resistance and malignant progression of human cervical carcinoma

Cytokeratin-19 is an intermediate filament protein associated with the integrity of cell structure, and its elevated expression has been reported to correlate with the disease progression of oesophagus and lung cancers. In this study, we examined the level of cytokeratin-19 in five cervical cancer cell lines by immunobinding and Western blotting analyses. Compared with two control cell lines, FS-4 (foreskin cell line) and G9T (glioma cell line), all five cervical carcinoma cell lines (Caski, CC7T, ME180, HeLa and SIHA) showed higher cytokeratin-19 expression. By double-staining flow cytometry, expression of cytokeratin-19 in cervical cancer cells was suggested to be in a cell cycle-independent manner. Furthermore, we could specifically localize the SIHA cell-derived tumours in nude mice by injecting with cytokeratin-19-recognized radiolabelled MAb Cx-99 antibody, suggesting the possibility of using cytokeratin-19 as a marker of cervical carcinoma. A clinical investigation was therefore performed on 19 patients (11 patients with cervical carcinoma and eight patients with benign neoplasia). In the 11 patients having cervical carcinoma, all eight patients with advanced stages and one out of three patients with early stage diseases showed higher cytokeratin-19 protein contents than the other 10 patients with benign neoplasia. This suggested that elevation of cytokeratin-19 level was associated with cervical cancer staging. In addition, we have studied the biological significance of elevated cytokeratin-19 level in malignant cervical cancer. The apoptotic rate of cervical carcinoma cells in response to cisplatin was increased if their cellular cytokeratin-19 level was reduced by specific antibody MAb Cx-99. These results indicated that elevation of cytokeratin-19 expression could associate with the apoptotic resistance and malignant progression of cervical carcinoma. This revised version was published online in June 2006 with corrections to the Cover Date.     

成都市人乳头瘤病毒16型感染与宫颈病变的相关性分析

本研究旨在探讨人乳头瘤病毒(human papillomavirus,HPV)16感染与宫颈病变的关系,为宫颈癌防治提供科学依据。通过核酸杂交法进行HPV感染分型,纳入1 057例HPV阳性且行组织切片病理学检查的患者,对各级别宫颈病变中HPV16构成比、不同年龄组HPV16阳性患者中宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)Ⅱ及以上病变的患病率,以及HPV16单一与多重感染患者中CINⅡ及以上病变的患病率进行分析。结果显示,在1 057例HPV阳性患者中,352例感染HPV16,CINⅢ中HPV16构成比最高,各级别病变中HPV16构成比差异有统计学意义。随着病变级别增加,HPV16构成比有增高趋势(P0.05)。不同年龄组HPV16阳性患者中CINⅡ及以上病变的患病率差异有统计学意义(P0.05),且随年龄增加而升高(P0.05)。HPV16单一、双重与三重以上感染患者中,CINⅡ及以上病变的患病率差异有统计学意义(P0.05),且随着感染型别种类增加,患病率降低(P0.05)。本研究显示,HPV16与高级别宫颈病变有较明显的相关性,老年HPV16阳性患者检出宫颈癌的概率更高。因此,应高度重视HPV16持续性感染,做到及时诊断与治疗,以减少宫颈高级别病变和宫颈癌的发生。     

Cervical mucus concentration of prostaglandins E2 and F2α after pretreatment with mifepristone in the first trimester of pregnancy

Cervical dilatation and softening after pretreatment with mifepristone are well documented. As this effect is similar to that observed after local application of prostaglandin E₂ (PGE₂) it is tempting to speculate that the effect of mifepristone is mediated via an increase of the endogenous secretion of prostaglandins from the cervical mucosa. Eighteen healthy women in the first trimester of pregnancy were treated with oral mifepristone (200 mg) 48 and 24 hours before legal abortion by vacuum aspiration and 18 women in the same age of gestation without any pretreatment served as controls. Cervical mucus was collected for measurement of prostaglandins by radioimmunoassay before administration of the drug and in connection with vacuum aspiration. The cervical dilatation at the time of surgery was significantly increased in women given mifepristone as compared with untreated women (7.6 versus 5.8 mm). The wet weight of collected cervical mucus was significantly increased in mifepristone treated women. The amount of PGE₂ and prostaglandin F_2α per sample was unchanged in mifepristone-treated women, whereas the concentration was lower as an effect of dilution due to an increased yield in cervical secretion observed after mifepristone treatment. The present observation does not give any support to the hypothesis that mifepristone-induced cervical maturation is mediated via an increase in cervical prostaglandin production.     

Measurement of human cervical compliance

A critical evaluation of the various methods for the measurement of the compliance of the human cervix uteri was made. The resistance of this tissue to a dilating force was measured by a previously constructed strain gauge instrument¹ equipped with exchangeable Pratt cervical dilators. The dilating resistance offered by the cervical canal was recorded on a polygraph at a constant paper speed. Control experiments in which the dilating instrument was allowed to meet artificial cellulose tissue showed that the peak value recorded was of importance for estimating cellulose tissue resistance. Measurements of the area under the curve were shown to be of minor importance in this system. Using this technique in clinical applications, it was also shown that peak resistance provides the most accurate measurement of human cervical resistance.     

择期经阴道宫颈环扎术与期待疗法治疗宫颈机能不全的效果比较

目的:比较择期经阴道宫颈环扎术以及期待疗法治疗宫颈机能不全的效果。方法:选择2017年10月~2019年10月我院收治的201例宫颈机能不全患者,将其随机分为两组。对照组100例患者采取期待疗法,即卧床休息,口服地屈孕酮,每次服用的剂量为10 mg,每日2次,一直服药到30孕周;观察组101例患者择期经阴道宫颈环扎术,比较两组的早产率、成功妊娠率、新生儿出生体重以及分娩孕周。结果:对照组100例宫颈机能不全患者中,22例患者流产(占22.00%),78例患者获得活婴(占78.00%),78例成功分娩的患者中,47例患者≥37周分娩,31例患者<37周分娩,早产率为39.74%(31/78)。观察组的101例患者中,8例患者流产(占7.92%),93例患者获得活婴(占92.08%)。93例成功分娩的患者中,81例患者≥37周分娩,12例患者<37周分娩,早产率为12.90%(12/93);12例早产的患者中,4例患者由于胎膜早破和胎儿窘迫,而在孕32~33周采取剖宫产手术,2例患者由于胎膜早破臀位,而在孕35~36周时采取剖宫产手术,6例患者在孕35~36周早产。观察组宫颈机能不全患者的早产率明显低于对照组(P<0.05),且成功妊娠率、新生儿出生体重以及分娩孕周明显高于或长于对照组(P<0.05)。结论:与期待疗法相比较,择期经阴道宫颈环扎术不但可以明显延长宫颈机能不全患者的分娩孕周,提高成功妊娠率,还能改善新生儿的预后、降低早产的风险。     

Epidemiology and Risk Factors of Cervical Spine Injury during Heating Season in the Patients with Cervical Trauma: A Cross-Sectional Study

Purpose

The purpose of this study was to describe the epidemiology of cervical spine injury in the patients with cervical trauma and analyze its associated risk factors during the special heating season in North China.

Methods

This cross-sectional study investigated predictors for cervical spine injury in cervical trauma patients using retrospectively collected data of Hebei Provincial Orthopaedic Hospital from 11/2011 to 02/2012, and 11/2012 to 02/2013. Binary logistic regression analysis was used to determine risk factors for cervical fractures/dislocations or cord injury.

Results

A total of 106 patients were admitted into this study. Of all, 34 patients (32.1%) were treated from 11/2011 to 02/2012 and 72 patients (67.9%) from 11/2012 to 02/2013. The mean age was 41.9±13.3 years old; 85 patients (80.2%) were male and 82 (77.4%) from rural areas. Eighty patients (75.5%) were caused by fall including 45 (42.5%) by severe fall (>2 m). Sixty-five patients (61.3%) of all suffered injuries to other body regions and 32 (30.2%) got head injury. Thirty-one patients (29.2%) sustained cervical cord injury with cervical fractures/dislocations. Twenty-six (83.9%) of cervical cord injury patients were from rural areas and 24 (77.4%) of those resulted from fall including 15 (48.4%) from severe fall (>2 m). Logistic regression displayed that age (OR, 1.47; 95% CI, 1.05–2.07), head injury (OR, 5.63; 95% CI, 2.23–14.26), were risk factors for cervical cord injury and snowing (OR, 8.25; 95% CI, 2.26–30.15) was a risk factor for cervical spine injury due to severe fall (>2 m).

Conclusions

The elder male patients and patients with head trauma are high-risk population for cervical cord injury. As a seasonal factor, snowing during heating season is of note a risk factor for cervical spine injury resulting from severe fall (>2 m) in the patients with cervical trauma in North China.     

Polymorphism in the Matrix Metalloproteinase-2 Gene Promoter is Associated with Cervical Neoplasm Risk in Mexican Women

Matrix metalloproteinase-2 (MMP-2) is an enzyme with proteolytic activity on matrix proteins, and previous studies have revealed a strong association between the MMP-2 −1306C→T polymorphism and the risk of several types of cancer. Our study looked at whether this polymorphism contributed to the development of cervical neoplasia by analyzing 54 patients with invasive squamous cell cervical cancer, 100 patients with cervical intraepithelial neoplasia, and 126 control subjects. The MMP-2 CC genotype was more frequent in the cancer patients when compared with the control group (OR 2.57; 95% CI 1.15–5.86). The association of cervical cancer with the CC genotype was more pronounced in women who had first coitus at an early age (OR 3.96; 95% CI 1.46–11.06). The CC genotype was associated with intraepithelial neoplasia only in women with first coitus at 19 years old or younger. The data suggest that the MMP-2 −1306C→T polymorphism contributes to the development of squamous cell cervical cancer in the population studied, especially in women who had first coitus at an early age.     

TP53 codon 72 polymorphism does not affect risk of cervical cancer in patients from The Gambia

AIMS: A case-control study was performed to investigate the relationship between cervical cancer and TP53 polymorphism at codon 72 in young black African women from The Gambia. MATERIALS AND METHODS: The TP53 polymorphism at codon 72 was examined by PCR amplification and SSCP analysis in 40 patients with primary cervical cancer and in 20 healthy women of the same age and from the same geographical area. The occurrence of TP53 polymorphism in combination with the HPV-16 E6 genotype (assayed by PCR) was evaluated. RESULTS: The distribution of TP53 genotypes in cervical cancer patients and in the control group was not statistically different (p = 0.45) and homozygosity for argine at residue 72 was not associated with cervical cancer (odds ratio: 1.24; 95% confidence interval 0.21-9.16). Similarly, a different genotype distribution, cervical cancer and presence of HPV-16 E6 were not observed. CONCLUSIONS:These results cannot rule out an association between TP53 polymorphism at codon 72, HPV infection and the etiology of cervical cancer in this population sample.     

内皮脂肪酶rs3829632多态性与江苏地区宫颈癌易感性的关联关系及机制研究

目的:探讨内皮脂肪酶(endothelial lipase, EL)rs3829632多态性对江苏地区女性宫颈癌易感性的影响。方法:采用病例-对照研究收集南通市妇幼保健院和南通市肿瘤医院宫颈癌病人328例及年龄匹配的对照人群356例,采集血标本提取基因组DNA运用DNA测序法对rs3829632位点进行基因分型;提取宫颈癌病理组织的m RNA及蛋白运用实时荧光定量PCR及Western blot检测其中EL的表达水平。结果:与基因型为rs3829632 TT的个体相比,携带rs3829632 C等位的个体宫颈癌患病风险显著升高;在宫颈癌病人中,rs3829632 CC基因型个体病理组织中EL的表达水平显著高于其他基因型个体。结论:EL rs3829632 C等位携带者其宫颈癌患病风险性升高,这一结果可能与发生在启动子区域的rs3829632影响了EL的表达及功能进而改变了宫颈细胞的脂质代谢状态有关。