Castleman Disease with Retroperitoneal Invasion of Iliac Vascular Zone: A Case Report of Unicentric Type & Review of the Literature

Castleman Disease is a rare nonneoplastic lymphoproliferative disorder that can be found in any lymph node station with unknown etiology. The current cumulative number of reported cases is minimal. We report a case of a 44-year-old woman with a hard mass in the pelvic retroperitoneal that has been gradually increasing in size for many years. Abdominopelvic MRI scan showed a left retroperitoneal mass and visible calcifications. The patient underwent resection of the left retroperitoneal mass and the pathological diagnosis was Castleman disease of hyaline vascular type.

Expression of C-Kit & PDGFRα and correlation with chemotherapy resistance in ovarian serous carcinomas:a clinical study

Objective： To investigate the expression of C-Kit and PDGFRa and their correlation with chemotherapy resistance in ovarian serous carcinoma. Methods： We undertook SP immunohistochemical technique to examine the expression of C-Kit and PDGFRa in 59 cases with ovarian serous carcinomas, using archival paraffin-embedded specimens. Then we observed the correlation with chemotherapy resistance. Results： C-Kit and PDGFRa immunostainings were observed posi- tively expressed in 57.63% and 66.10% cases. C-Kit expression was statistically correlated with the progression of disease after first-line chemotherapy （P 〈 0.05）, but PDGFRa was not statistically significant （P 〉 0.05）. There were great difference between of C-Kit and PDGFRa expressions in samples of different differentiated and clinical stages of ovarian serous carcinomas （P 〈 0.01 or P 〈 0.05）. Conclusion： C-Kit is statistically correlated with chemotherapy resistance, while PDGFRa is not correlated.

Herlyn-Werner-Wunderlich Syndrome: A Case of Report and Literature Review

Background: Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare type of female reproduction tract malformation, often accompanied by abnormal development of the ipsilateral urinary system, which shows mostly double uterus and the absence of the kidney on the oblique side. Case Report: An 11-year-old patient presented with lower abdominal distension and pain for 2 days and was suspected of vaginal haematoma. Conclusion: Ipsilateral renal agenesis was confirmed by ultrasound during hospitalization, and the diagnoses of obstructed hemivagina and ipsilateral renal anomaly syndrome were established. The aim of this study was to present the diagnostic and therapeutic approaches in HWWS, and to draw attention to the challenges in its diagnosis, which can coexist with multiple complications.

Clinical Observation of 242 Cases of Polycystic Ovary Syndrome

Objective: To compare the clinical effect and safety between letrozole (LE) and clomiphene citrate (CC) stimulated cycles in women with polycystic ovary syndrome (PCOS). To evaluate the effectivenesses and benefits of letrozole for ovulation induction in infertile women with PCOS. Methods: We retrospectively analyze the clinical data of 242 cases of the first ovulation induction cycle patients with PCOS, who referred to the Department of Reproductive Medicine, The First Affiliated Hospital of Yangtze University from June 2016 to June 2018, and were randomly divided into letrozole group and control group. The experimental group received Letrozole 2.5 mg/d for 5 days during days 3 - 7 of menstrual cycle. The control group was given clomiphene citrate 100 mg/d for 5 days during days 3 - 7 of menstrual cycle. Progynova will be used when the follicular diameter is 14 mm. Results: Letrozole group had less mature follicles, lower estrogen levels, thicker endometrium and higher ovulation rate in HCG day. But there is no difference between two groups in clinical pregnancy rate, single pregnancy rate, abortion rate, prenatal pregnancy delivery and newborns. Conclusion: Letrozole and clomiphene citrate have similar effect on ovulation induction, but we still need a lot of clinical data of letrozole about the safety of follicle, embryo, fetus and newborns.

Characteristics of the Distribution of Ferritin in Epithelial Ovarian Tumor Patients: Results of a Retrospective, Observational Study

Purpose: To investigate the ferritin distribution in epithelial ovarian cancer patients according to the FIGO stage in the prognosis of epithelial ovarian cancer. Method: All ovarian cancer patients were divided into two groups according their FIGO stage. Benign ovarian tumor patients were analyzed as the control. Serum ferritin, serum iron, and other related medical index were detected by automatic instruments for all patients. In addition, ferritin heavy chain (FHC) and ferritin light chain (FLC) proteins were detected by immunohistochemical staining in 60 epithelial ovarian cancer (EOC) patients and 30 benign ovarian tumor (BOT) patients, which were diagnosed in our department between 2011 and 2016. Results: The serum ferritin concentration was significantly higher in the EOC group than in the BOT group (172.56 ± 99.39 ng/mL vs 78.18 ± 43.06 ng/mL;p μmol/L vs 14.92 ± 6.36 μmol/L;p p p p p p p > 0.05). Conclusion: Patients showed an overexpression of ferritin and a downregulation of serum iron correlated with the prognosis of epithelial ovarian cancer, which may be a new target for diagnosis and treatment of epithelial ovarian cancer.

The Application of Quantum Dots Double-Labeling Immunofluorescence Technology in Detection of PR and CD146 in Paraffin-Embedded Tissue Sections of Endometrioid Adenocarcinoma

Objective: The aim was to detect the expression of PR and CD146 in paraf-fin-embedded tissue sections of endometrioid adenocarcinoma by using QDs double-labeling immunofluorescence, and evaluate the applied value of QDs double-labeling immunofluorescence in endometrioid adenocarcinoma. Methods: To detect the expression of PR and CD146 on 140 cases of paraffin-embedded tissue sections of endometrioid adenocarcinoma by using QDS double-labeling immunofluorescence. Results: The co-expression of PR and CD146 in the endometrioid adenocarcinoma can be detected by QDs double-labeling immunofluorescence, and there was no correlation between them (P > 0.05). Conclusion: QDs double-labeling immunofluorescence can detect the localization and co-expression of PR and CD146 in the endometrioid adenocarcinoma.

Clinical Performance of ADNEX (The Assessment of Different NEoplasias in the adneXa) Model in Early Diagnosis and Staging of Benign and Malignant Ovarian Tumors

Objective: To investigate the clinical value of ADNEX model in early diagnosis and staging of benign and malignant ovarian tumors. Method: 136 cases of ovarian cancer patients treated in our hospital were retrospectively analyzed using the ADNEX risk model and MRI data. The accuracy of the two diagnostic methods was compared with the results of pathological examination as gold standard. Results: For qualitative assessment, the accuracy and sensitivity of the ADNEX model were 78.70% and 93%, while the accuracy and sensitivity of MRI examination were 80.1%, and 90.7%, respectively. The diagnostic values of the two methods were not statistically different (P > 0.05). For ovarian tumor staging, the ADNEX model was significantly less accurate and specific for staging borderline tumor than MRI examination, although it had significantly higher sensitivity (P 0.05). Conclusion: ADNEX risk model has certain diagnostic and predictive value to distinguish benign from malignant ovarian tumors. It is useful to detect and exclude ovarian tumor. However, for early diagnosis, it is not accurate enough and further study is needed to validate this usefulness.

Mullerian Agenesis in One of the Non-Identical Twins: A Case Report and Literature Review

Mullerin agenesis also referred as mullerian aplasia, Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) or vaginal agenesis is the congenital anomaly of vertical fusion defect of mullerian system resulting in variable abnormalities of female reproductive tract with normal functioning ovaries. It is second most common cause of primary amenorrhea after gonadal agenesis. The occurrence of mullerian agenesis in twins is very rare. We present the case of one of the non-identical twins, 22 years female, with primary amenorrhea. Her elder twin sister had a normal female reproductive system. In our case, diagnosis was supported by presence of definitive primary amenorrhea with well-developed secondary sexual characteristics. Normal physiological hormonal levels ruled out the ovarian or pituitary pathology. Imaging studies like ultrasonography and magnetic resonance imaging (MRI) provided additional confirmation.

Caveolin-1 Polymorphism (rs7804372) and Cancer Risk: A Meta-Analysis of 15 Case-Control Studies

Purpose: Epidemiological studies have assessed the association between Caveolin-1 polymorphism and cancer risk. However, published data are still inconclusive. To clarify this inconsistency, we conducted a meta-analysis to evaluate the relationship between Caveolin-1 polymorphism (rs7804372) and cancer susceptibility. Methods: We conducted a comprehensive literature search, using PubMed, Embase, Medline, Web of Science, CNKI, and Wanfang database, which included English and Chinese literatures. The latest updated date was January 2018. The following search terms were performed to retrieve the relevant articles: ((CAV1) OR (Caveolin-1) OR (rs7804372)) AND (cancer OR tumor OR carcinoma OR neoplasms OR malignancy) AND (polymorphism OR mutation OR variant OR genotype). Odds ratio (OR) with 95% confidence interval (CI) was used to estimate the pooled effect. Results: In the overall analysis, this kind of polymorphism showed a significant association with increased risk of cancer: allelic model (T/A;OR = 1.33, 95% CI: 1.19 - 1.49;P < 0.0001), homozygous (TT/AA;OR = 1.73, 95% CI: 1.37 - 2.18;P < 0.0001), and heterozygous genetic models (TT/TA;OR = 1.23, 95% CI: 1.14 - 1.33;P < 0.0001), the dominant genetic model (TT + TA/AA;OR = 1.58, 95% CI: 1.28 - 1.96;P < 0.0001), and the recessive genetic model (TT/TA + AA;OR = 1.34, 95% CI: 1.20 - 1.50;P < 0.0001). In addition, the stratified analysis of the results was carried out by ethnicity, HWE status, and cancer types. The outcome indicated that Caveolin-1 rs7804372 polymorphism was associated with an increased risk of cancer. Conclusion: The present study demonstrated that the allele T of Caveolin-1 (rs7804372) polymorphism might associate with increased susceptibility to cancer, and might predict worse survival in patients with various types of cancer. However, further well-designed studies are required to evaluate this association.

Ulipristal Acetate (UPA): An Alternative Option to Surgery for Uterine Fibroids in Reproductive Age: A Review

Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options available are surgical and non-surgical, but the mode of management leans on several factors, such as severity of symptoms, patient’s age, myoma characteristics, desire to preserve uterus and fertility. Alternative approach to surgery for the treatment of symptomatic females with uterine myomas has been recognized. Ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term management of uterine fibroids. There are evidences promoting an important role for progesterone pathways in the pathophysiology of uterine fibroids which supports the use of ulipristal acetate. The availability of alternative choices to surgical intervention is very necessary especially for those willing to preserve uterus and fertility. One of the alternatives is with ulipristal acetate, which has been proven to treat fibroid symptoms effectively.

Research Progress of Nectin-4 as a Targeted Therapy for Ovarian Cancer

Ovarian cancer is one of the most common gynecological malignancies. The 5-year survival rate of ovarian cancer is only 50%, which is considered to be the most lethal gynecologic malignant tumor.The high mortality of ovarian cancer patients can be attributed to chemotherapy resistance, extensive intraperitoneal metastasis and other factors.Tumor antigens are expressed on the surface of tumor cells and represent potential drug targets.One of the antigens is tumor associated nectin-4, which is a member of the immune globulin superfamily.This review highlights the role of nectin-4 as a therapeutic target for ovarian cancer, and discusses the relevant research data, which is an effective new direction in the treatment of ovarian cancer.Although there are still some challenges, targeted therapy is still a promising treatment for ovarian cancer.

Prognostic Factors in COVID-19 Pneumonia with Severe Acute Respiratory Distress Syndrome: An Observational Study

Purpose: To identify prognostic factors in patients with coronavirus disease 2019 (COVID-19)-associated severe acute respiratory distress syndrome (ARDS). Methods: In this study, we included 45 patients with COVID-19-associated ARDS hospitalized at The First Affiliated Hospital of Yangtze University in Jingzhou, Hubei, China, between January 22, 2020, and March 6, 2020. Clinical data and outcomes were reviewed and analyzed according to the Berlin definition. Findings: Men were more likely to develop severe ARDS than women (11 [91.7%] vs. 1 [8.3%]). Factors associated with severe ARDS included sex (male) (hazard ratio [HR], 13.75;95% confidence interval [CI], 1.45 - 130.24), neutrophil count (HR, 55.00;95% CI, 5.02 - 602.15), lymphocyte count (HR, 40.00;95% CI, 4.83 - 331.00), prothrombin time (HR, 12.14;95% CI, 1.19 - 123.62), D-dimer (HR, 11.00;95% CI, 1.16 - 103.94), total bilirubin levels (HR, 5.00;95% CI, 0.93 - 26.79), albumin (HR, 17.5;95% CI, 2.67 - 114.85), blood urea nitrogen levels (HR, 28.60;95% CI, 2.89 - 283.06), lactate dehydrogenase levels (HR, 6.00;95% CI, 1.17 - 30.73), and C-reactive protein levels (HR, 15.87;95% CI, 2.40 - 111.11). Conclusion: Laboratory indicators, such as neutrophil count and lymphocyte count, could play an important role in the diagnosis of severe ARDS and guide clinical decision-making for patients with ARDS.

Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stage cervical cancer:a randomized,non-inferiority,multicenter trial

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB–IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415–1.757;P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.

Methodologies for the establishment of an orthotopic transplantation model of ovarian cancer in mice

This study used different methods to establish an animal model of orthotopic transplantation for ovarian cancer to provide an accurate simulation of the mechanism by which tumor occurs and develops in the human body. We implanted 4T1 breast cancer cells stably-transfected with luciferase into BALB/c mice by using three types of orthotopic transplantation methodologies： （1） cultured cells were directly injected into the mouse ovary; （2） cell suspension was initially implanted under the skin of the mouse neck; after tumor mass formed, the tumor was removed and ground into cell suspension, which was then injected into the mouse ovary; and （3） a subcutaneous tumor mass was first generated, removed, and cut into small pieces, which were directly implanted into the mouse ovary. After these models were established, in vivo luminescence imaging was performed. Results and data were compared among groups. Orthotopic transplantation model established with subcutaneous tumor piece implantation showed a better simulation of tumor development and invasion in mice. This model also displayed negligible response to artificial factors. This study successfully established an orthotopic transplantation model of ovarian cancer with high rates of tumor formation and metastasis by using subcutaneous tumor pieces. This study also provided a methodological basis for future establishment of an animal model of ovarian cancer in humans.