Oncological and Reproductive Outcomes of Fertility-sparing Surgery in Women with Early-stage Epithelial Ovarian Carcinoma:A Multicenter Retrospective Study

Summary:With delayed childbearing in women,preservation of fertility is an important issue for reproductive-age patients with epithelial ovarian carcinoma(EOC).Fertility-sparing surgery(FSS)can be considered in patients with early-stage disease in order to preserve fertility and improve quality of life.In order to evaluate oncological safety,attitudes toward childbearing and reproductive outcomes in women with EOC who underwent FSS,this multicenter retrospective study was conducted.Between January 2005 and December 2014,total of 87 young women with FIGO stage I EOC were included,with their clinicopathologic parameters in relation to disease-free survival(DFS)and overall survival(OS)assessed.Attitudes toward childbearing,ovarian function and fertility were studied in women undergoing FSS(n=36).As a result,in contrast to radical sur ery,FSS did not affect prognosis by Kaplan-Meier curves(log-rank test;DFS:P=0.484;OS:P=0.125).However,two of the three recurrence cases and both death cases were in FSS group stage IC.All women undergoing FSS resumed regular menstrual periods after chemotherapy.Only 16(44.44%)had tried to conceive,and 17 pregnancies occurred in 15(93.75%)women.Among 20 women who did not attempt conception,the most common reason was not being married(70%),followed by already having children(15%).In summary,FSS is considered safe in young women with stage IA EOC.Regular menstruation and good obstetric outcomes can be achieved.This study also provides some insight into the attitudes and social factors regarding fertility in EOC patients.

Pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma in vitro

AIM: To understand the pathogen characteristics and its sensitivity against antimicrobial agents in fatal bacterial granuloma after eyelid trauma (FBGT) in vitro, and to provide laboratory evidence for diagnosis. METHODS: The FBGT pathogens were isolaated and cultured with reformed rabbit-brain anaerobic enriched broth (RRAB), and identified by ATB/API 20A system. The minimum inhibiting concentration (MIC) was determined by anaerobic broth dilution method. RESULTS: A total of 22 strains of pathogen were separated from 21 patients with FBGT and identified as Propionibacterium acnes (PA) by ATB/API 20A system. The MIC of ciprofloxacin for 22 PA strains was 0.0625-0.5mg/L, the MIC of penicillin, ampicillin, ampicillin/sulbactam, cefoperazone, lincomycin, and imipenem/cilastatin were 0.125-0.5mg/L, the MIC of ticarcillin/clavulanic acid was 0.250-1.000mg/L, and the MIC of metronidazole was 64-256mg/L. The pathogen of FBGT was strictly anaerobic PA, which growed slowly and better in nutritious RRAB broth. All PA were resistant to metronidazole, but susceptive to other routine antimicrobial agents, such as penicillin, ampicillin and lincomycin. CONCLUSION: FBGT should not be treated with metronidazole. Clinicians should choose combined use of drugs or operation to treat FBGT according to patients' individual condition and the results of drug sensitivity test.

Investigating the Mechanism of Qu Du Qiang Fei 1 Hao Fang Formula against Coronavirus Disease 2019 Based on Network Pharmacology Method

Objective:Qu Du Qiang Fei 1 Hao Fang(QDQF1)is a novel Chinese herbal medicine formula used to treat coronavirus disease 2019(COVID-19).However,the pharmacological mechanisms of action of QDQF1 remain unclear.The objective of this study was to identify the effective ingredients and biological targets of QDQF1 for COVID-19 treatment.Materials and Methods:The effective ingredients and mechanisms of action of QDQF1 were analyzed by using network pharmacology methods,which included an analysis of the effective ingredients and corresponding targets,COVID-19-related target acquisition,compound-target network analyses,protein-protein interaction network analysis,Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses,and molecular docking studies.Results:In total,288 effective QDQF1 ingredients were identified.We identified 51 core targets from the 148 targets through an overlap between putative QDQF1 targets and COVID-19-related targets.Six key components,including formononetin,kaempferol,luteolin,naringenin,quercetin,and wogonin were identified through component-target network analyses.GO functional enrichment analysis of the core targets revealed 1296 items,while KEGG pathway enrichment analysis identified 148 signaling pathways.Nine central targets(CCL2,CXCL8,IL1B,IL6,MAPK1,MAPK3,MAPK8,STAT3,and TNF)related to the COVID-19 pathway were identified in the KEGG pathway enrichment analysis.Furthermore,molecular docking analysis suggested that the docking scores of the six key components to the nine central targets were better than those to remdesivir.Conclusions:QDQF1 may regulate multiple immune-and inflammation-related targets to inhibit the progression of severe acute respiratory syndrome coronavirus 2,and thus,may be suitable for the treatment of COVID-19.

Prognostic value of human papillomavirus 16/18 genotyping in low-grade cervical lesions preceded by mildly abnormal cytology

Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus （HPV） 16/18 genotyping in 273 patients with LSIL/CINI. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV （hrHPV） were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases （69.6%） regressed, 37 （13.6%） persisted, and 46 （16.8%） progressed. HPV16/18 positivity （hazard ratio （HR）, 2.708; 95% confidence interval （CI）, 1.432-5.121; P=-0.002） is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.

Clinical Study with Randomized Control on the Therapy of Integrated Chinese and Western Medicine in Treating Neurological Autoimmune Diseases:A Meta-Analysis

Objective: The main objective of this study is to evaluate the effects of integrated Chinese and Western medicine in the treatment of neurological autoimmune diseases. Materials and Methods: The literature was comprehensively searched to collect the randomized controlled trials about integrated Chinese and Western medicine in the treatment of neurological autoimmune diseases. Neurological autoimmune diseases mainly occur in the central nervous system(CNS) and peripheral nervous system. Therefore, multiple sclerosis(MS) was chosen as the representative in the CNS, and Guillain–Barre syndrome(GBS) was chosen as the representative in the peripheral nervous system. Extended Disability Status Scale(EDSS) score, effective rate, clinical symptom score, neurological functional sign score, recurrence frequency, and incidence rate of adverse reactions were chosen as the markers of outcome variables of MS, and the effective rate and Hughes score were also chosen as the markers of outcome variables of GBS. Results: For MS, the results showed that there was a significant difference in statistical analysis between the experimental group and the control group in EDSS score, the effective rate, and the recurrence frequency. However, through the comparison of clinical symptom score, neurological functional sign score, and incidence rate of adverse reaction of both two groups, the results showed that there was no significant difference in the statistical analysis. For GBS, through the comparison of effective rate and Hughes score of both two groups, the results showed that there was a significant difference in statistical analysis. Conclusions: The study demonstrated that compared with Western medicine, the therapy of integrated Chinese and Western medicine was more effective in treating neurological autoimmune diseases.

Platelet RNA signature independently predicts ovarian cancer prognosis by deep learning neural network model

Dear Editor,Platelets are circulating anucleate cytoplasmic fragments of megakaryocytes and characterized by their functions in wound healing and vascular integrity maintenance.Increasing evidence highlights the extensive reciprocal signaling interactions between platelets and tumor cells(Haemmerle et al.,2018).Tumor cells activate and aggregate platelets to sustain proliferation(Cho et al.,2012),resist apoptosis,and promote metastasis(Haemmerle et al.,2017).

Therapeutics of Integrative Medicine Ameliorate Immunological Disorders of the Nervous System: A Meta-Analysis

Objective: The objective of the study is to evaluate the therapeutic efficacy of integrative medicine in the treatment of immunological disorders of the nervous system. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were adopted to conduct this study, which included randomized controlled trials with a confirmed diagnosis of multiple sclerosis(MS), myasthenia gravis(MG), and Guillain–Barre syndrome(GBS), all of which were treated with integrative medicine. The effective rate, recurrent frequency, and disease score were used as the markers of outcome variables for the meta-analysis. Results: A total of 48 randomized control trials were included. The effective rates of treatment with integrative medicine were noticeably higher than those with Western medicine alone for the three diseases. The recurrence frequency for MS and the recurrence rate for MG treated with integrative medicine were reduced more than those with Western medicine alone. The Extended Disability Status Scale, acetylcholine receptor antibody, and Hughes scores for MS, MG, and GBS, respectively, treated with integrative medicine were significantly lower than those with Western medicine alone. The risks of bias in the literature evaluation showed that the quality of the included studies was not high. Conclusions: Compared to treatment with Western medicine alone, integrative medicine might ameliorate immunological disorders of the nervous system.