Abstract Objective The aim of this study is to explore the efficacy and safety of chemotherapy (CT) as a monotherapy in patients with recurrent intermediate/high-risk factors following radical hysterectomy for stage IB-IIA cervical cancer. Methods A retrospective analysis was conducted on the medical records of patients diagnosed with stage IB-IIA cervical cancer who underwent radical hysterectomy at the People’s Hospital of Suzhou High-tech District between 2010 and 2020. A total of 66 patients with intermediate or high-risk factors for recurrence were treated exclusively with CT. This cohort included 42 patients in the intermediate-risk group and 24 in the high-risk group. Treatment protocols consisted of 4–6 cycles of paclitaxel and cisplatin drugs for the intermediate-risk group, and 6 cycles for the high-risk group. The relapse-free survival (RFS), recurrence rates, and common CT-related adverse reactions, including bone marrow suppression, nausea and vomiting, and diarrhea, were assessed for both groups. Results (1) The cumulative 3-year RFS rates for the intermediate-risk and high-risk groups were 97.3% (36/37) and 82.4% (14/17), respectively, with cumulative 5-year RFS rates of 97.1% (34/35) and 82.4% (14/17), respectively. The Log rank test revealed no significant difference between the two groups (P > 0.05), (χ² = 2.718, P = 0.099). The 5-year recurrence rates in the intermediate-risk and high-risk groups were 2.38% (1/42) and 12.50% (3/24), respectively. (2) The incidence of grade III bone marrow suppression in the intermediate-risk and high-risk groups was 21.19% (11/42) and 25.00% (6/24), respectively, while the incidence of grade IV bone marrow suppression was 11.90% (5/42) and 8.33% (2/24), respectively. There was no statistically significant difference in bone marrow suppression grades between the two groups (P > 0.05). Conclusion CT with paclitaxel and cisplatin, administered as monotherapy post-radical hysterectomy for stage IB-IIA cervical cancer, demonstrates satisfactory survival benefits with an acceptable safety profile. Moreover, no significant differences were observed in prognosis or adverse reactions between the different risk groups treated solely with CT.

In contrast to the decreasing trends in developed countries, the incidence and mortality rates of cervical squamous cell carcinoma in China have increased significantly. The screening and identification of reliable biomarkers and candidate drug targets for cervical squamous cell carcinoma are urgently needed to improve the survival rate and quality of life of patients. In this study, we demonstrated that the expression of MUC1 was greater in neoplastic tissues than in non-neoplastic tissues of the cervix, and cervical squamous cell carcinoma patients with high MUC1 expression had significantly worse overall survival than did those with low MUC1 expression, indicating its potential for early diagnosis of cervical squamous cell carcinoma. Next, we explored the regulatory mechanism of MUC1 in cervical squamous cell carcinoma. MUC1 could upregulate ITGA2 and ITGA3 expression via ERK phosphorylation, promoting the proliferation and metastasis of cervical cancer cells. Further knockdown of ITGA2 and ITGA3 significantly inhibited the tumorigenesis of cervical cancer cells. Moreover, we designed a combination drug regimen comprising MUC1-siRNA and a novel ERK inhibitor in vivo and found that the combination of these drugs achieved better results in animals with xenografts than did MUC1 alone. Overall, we discovered a novel regulatory pathway, MUC1/ERK/ITGA2/3, in cervical squamous cell carcinoma that may serve as a potential biomarker and therapeutic target in the future. MUC1 is overexpressed in cervical squamous cell carcinoma. MUC1 regulates ERK phosphorylation, and subsequently upregulates ITGA2 and ITGA3 expression to promote tumorigenesis in cervical squamous cell carcinoma. A combination drug regimen targeting MUC1 and ERK achieved better results compared than MUC1 alone.

目的 探讨腹腔镜下精准经阴道无张力尿道悬吊术治疗女性压力性尿失禁的疗效和安全性.方法 选择2022年1月至2023年1月在苏州高新区人民医院接受腹腔镜下精准经阴道无张力尿道悬吊术治疗的压力性尿失禁女性患者31例,将尿道中段位置的阴道筋膜缝合固定于Cooper韧带,以达到对尿道的承托,术后随访12个月,分析术中出血量、手术时间、有无手术并发症,及术后1、3、12个月的疗效.采用泌尿生殖障碍量表简版、尿失禁影响问卷简表及国际尿失禁咨询委员会尿失禁问卷简表,评估术前及术后1、3、12个月患者生活质量的变化.结果 患者均在腹腔镜下顺利完成手术并完成12个月的随访.术后1、3个月的治愈率均达到90.32%,术后12个月的治愈率达到87.10%.所有患者术后1、3、12个月泌尿生殖障碍量表简版、尿失禁影响问卷简表及国际尿失禁咨询委员会尿失禁问卷简表评分均显著低于术前,差异有显著性(P＜0.05).术后1、3、12个月泌尿生殖障碍量表简版、尿失禁影响问卷简表及国际尿失禁咨询委员会尿失禁问卷简表评分比较无明显变化,差异无显著性(P＞0.05).结论 腹腔镜下精准经阴道无张力尿道悬吊术治疗女性压力性尿失禁效果确切稳定,术后并发症少,且可同时进行盆腔其他脏器相关疾病的手术,是治疗女性压力性尿失禁可选择的有效方式.

It is widely accepted that kisspeptin plays an integral role in the regulation of reproduction. Genetic variations in the KISS1 gene have been frequently reported to be linked to reproductive diseases, but there is still a lack of data on the association between KISS1 variations and female reproductive disorders. The present study aimed to examine the association of three missense SNPs in the KISS1 gene including rs12998, rs35431622, and rs4889 in association with idiopathic recurrent pregnancy loss (iRPL). A total of 720 individuals were recruited in this study. The DNA from the blood sample was extracted and genotyped using the PCR method. Haplotype and linkage disequilibrium (LD) have also been analyzed. The results of this study suggested that rs12998 G > A and rs4889 C > G had a significant association with iRPL (p < 0.05); while rs35431622 A > G didn’t indicate any association with iRPL. A significant association was also found for three haplotypes including C-A-A, G-G-G, and G-G-A in this population. The analysis also showed a significant LD between rs12998 and rs35431622 (P < 0.0005). The rs12998 G > A and rs4889 C > G variants of KISS1 are linked to unexplained recurrent pregnancy loss and may be risk factors for this disease.

目的 探究血清雌二醇(E2)、孕酮(P)、血管内皮生长因子(VEGF)及子宫内膜厚度在异位妊娠的水平变化及临床诊断价值.方法 选取2019年5月至2021年5月苏州高新区人民医院妇产科收治的疑似异位妊娠孕妇114例为研究对象,其中经病理学或手术检查确诊的79例为病例组,其他35例为对照组.比较两组孕妇血清E2、P、VEGF水平差异,并使用彩色多普勒超声仪测定两组孕妇的子宫内膜厚度,以ROC曲线分析各项指标单独或联合诊断早期异位妊娠的价值.结果 病例组孕妇的血清E2、P及子宫内膜厚度低于对照组,VEGF水平显著高于对照组,差异均有统计学意义(t=7.654,P<0.05).二元Logistic分析显示,E2、P水平降低,VEGF水平升高及子宫内膜厚度降低均为异位妊娠的危险因素(P<0.05).ROC显示,E2、P、VEGF、子宫内膜厚度对异位妊娠诊断的AUC分别为0.795、0.904、0.838、0.861,四项联合检测的AUC为0.978,敏感度、特异度为100％、85.7％,优于单一检测(P<0.05).结论 异位妊娠孕妇血清E2、P、VEGF检测及子宫内膜厚度的检查对疾病的早期诊断具价值较高,四者联合诊断的敏感度及特异性更高.

目的 检测子宫内膜异位症(endometriosis,EMT)患者血清微小核糖核酸(miRNA,miR)-455和脂肪酸结合蛋白4(fatty acid binding protein 4,FABP4)水平,并探讨二者的相关性及临床意义.方法 选择2018年6月～2021年3月苏州高新区人民医院妇产科收治的73例EMT患者作为观察对象(EMT组),另选取同期健康体检人员75例作为对照组,采用实时荧光定量PCR(qRT-PCR)检测两组血清miR-455水平,ELISA法检测血清FABP4水平,Pearson法分析EMT患者血清miR-455和FABP4表达水平相关性,ROC曲线分析血清miR-455,FABP4表达对EMT的诊断价值.结果 与对照组相比,EMT组患者血清FABP4水平(17.34±4.25ng/ml vs 8.56±2.74ng/ml)显著增高,miR-455水平显著降低(0.67±0.08 vs 1.05±0.19),差异均有统计学意义(t=14.977,15.780,均P<0.001).随着EMT分期的升高,EMT患者血清FABP4表达水平显著升高,血清miR-455表达水平显著降低,差异均有统计学意义(F=31.108,160.947,均P<0.001).相关性分析显示,EMT患者血清miR-455表达水平与FABP4呈负相关(r=-0.482,P<0.05).血清miR-455和FABP4联合诊断EMT的曲线下面积为0.922,敏感度和特异度分别为87.67％和81.33％.结论 EMT患者血清中miR-455低表达,FABP4水平较高,与患者病情严重程度相关,可能成为EMT早期诊断的分子标志物.

目的 探讨少腹逐瘀汤辅助宫腔镜手术治疗对子宫内膜息肉患者术后复发率的影响.方法 选择2019年6月-2021年1月江苏省常州市武进中医医院收治的子宫内膜息肉患者124例为对象,根据治疗方法不同将患者分为对照组和试验组,每组各62例.对照组采用宫腔镜手术治疗,术后常规给予抗生素预防感染,并于下次月经后半周期即月经来潮后第15天,口服黄体酮胶囊,每次100mg,每天2次,连续用药15d(1个疗程).试验组在对照组基础上加用少腹逐瘀汤,连续服用4周.用药4周后评估患者相关指标,并完成12个月随访,比较两组症状消失时间、子宫内膜厚度、血浆黏度、纤维蛋白原、月经量,以及治疗后6、12个月的妊娠率及复发率.结果 试验组治疗后月经量增多、倦怠无力、五心烦热、面色晦暗及小腹疼痛症状消失时间均显著短于对照组(P＜0.05);两组治疗4周后子宫内膜厚度、血浆黏度、纤维蛋白原、月经量均显著低于本组治疗前(P＜0.05);试验组治疗4周后子宫内膜厚度、血浆黏度、纤维蛋白原、月经量均显著低于对照组(P＜0.05);随访12个月,试验组妊娠率显著高于对照组(P＜0.05);复发率显著低于对照组(P＜0.05).结论 宫腔镜手术后加用少腹逐瘀汤能显著缩短子宫内膜息肉患者症状消失时间,改善子宫内膜厚度及血液流变学水平,可调节患者月经量,提升患者妊娠率,降低复发率,值得推广应用.

目的 分析宫颈癌组织中双特异性磷酸酶14(DUSP14)、微小RNA-873-3p(miR-873-3p)表达与患者临床病理特征及预后的关系.方法 选取2015年1月至2016年8月苏州高新区人民医院收治的82例宫颈癌患者作为研究对象,留取其癌组织及癌旁组织,收集国际妇产科联盟(FIGO)分期、分化程度等临床资料.采用免疫组织化学法检测DUSP14蛋白表达,采用实时荧光定量聚合酶链反应(qRT-PCR)法检测miR-873-3p水平;采用Spearman法分析癌组织中DUSP14与miR-873-3p表达水平的相关性;采用Kaplan-Meier法分析癌组织中DUSP14、miR-873-3p表达水平与预后的关系;采用多因素Cox回归分析影响宫颈癌患者预后的因素.结果 宫颈癌患者癌组织DUSP14蛋白阳性表达率高于癌旁组织,miR-873-3p表达水平低于癌旁组织,差异具有统计学意义(P<0.05).宫颈癌患者癌组织DUSP14、miR-873-3p表达水平与FIGO分期、分化程度、淋巴结转移、肌层浸润深度有关(P<0.05).宫颈癌患者癌组织DUSP14与miR-873-3p表达水平呈负相关(r=-0.482,P<0.05).DUSP14蛋白阳性表达宫颈癌患者5年生存率低于DUSP14蛋白阴性表达患者(χ2=16.724,P<0.05);miR-873-3p高表达宫颈癌患者5年生存率高于miR-873-3p低表达患者(χ2=14.131,P<0.05).DUSP14、FIGO分期是宫颈癌患者死亡的独立危险因素(P<0.05),miR-873-3p是宫颈癌患者死亡的保护因素(P<0.05).结论 宫颈癌组织中DUSP14高表达,miR-873-3p低表达,二者与FIGO分期、分化程度、淋巴结转移、肌层浸润深度及预后密切相关.

目的 探讨p16/Ki-67细胞双染对宫颈高级别鳞状上皮内病变(HSIL)的预测价值.方法 以2018年7月至2019年7月该院高危型人乳头状瘤病毒检测阳性患者为研究对象,进行p16/Ki-67细胞双染、宫颈液基细胞薄层技术(TCT)及阴道镜下宫颈活检.以病理结果作为"金标准",评价p16/Ki-67细胞双染和TCT的筛查效能.结果 共297例患者纳入研究,HSIL及以上者占16.84％(50/297),p16/Ki-67总阳性率为32.66％(97/297),TCT提示意义不明的不典型鳞状细胞及以上者占21.21％(63/297).p16/Ki-67细胞双染对HSIL的灵敏度、特异度、阳性似然比、受试者工作特征曲线下面积均高于TCT,2种方法对HSIL的检测差异有统计学意义(P＜0.001).结论 p16/Ki-67细胞双染对HSIL检测效果较TCT更佳,建议临床推广.

Objective:To explore influencing factors of group B Streptococcus (GBS) in genital tract of pregnant women in third trimester and its effects on outcomes of pregnant women and infants.Methods:From August 2016 to August 2018, a total of 1 149 pregnant women in third trimester who received prenatal examination in People′s Hospital of Suzhou High-tech Zone and detection of GBS DNA by fluorescence quantitative PCR at gestational age of 35-37 weeks were selected as research subjects. By retrospective analysis method, they were divided into study group (n=81, GBS DNA+ in genital tract), and control group (n=1 068, GBS DNA- in genital tract). Measures of intrapartum antibiotic prophylaxis (IAP) was taken to subjects in study group. Clinical data of 2 groups such as age, educational background, gravidity, parity, history of abortion, mode of delivery, gestational age and body mass index (BMI) at delivery, serum vitamin D levels, rates of gestational diabetes mellitus (GDM), premature rupture of membranes, postpartum hemorrhage, and follow-up of GBS infection of neonates in study group at 4 weeks after birth were collected. Independent-samples t test, Mann-Whitney U test and chi-square test were used for statistical comparisons. Multivariate unconditional logistic regression analysis was used to analyze influencing factors of GBS infection in genital tract of pregnant women in third trimester. The procedure in this study was in line with the requirements of Helsinki Declaration of the World Medical Association revised in 2013, and has been approved by the Ethics Committee of People′s Hospital of Suzhou High-tech Zone (Approval No. 2016-001).Results:①There were no statistically significant differences in composition ratio of primipara and multipara, history of abortion, incidence of GDM and serum vitamin D levels between two groups (P>0.05). While there were statistically significant differences in age, composition ratio of educational background and BMI at delivery between two groups (t=-2.004, P=0.045; χ2=69.972, P<0.001; t=7.054, P<0.001). ②Multivariate unconditional logistic regression analysis showed that BMI≥25 kg/m2 at delivery and high school education level or below were independent risk factors for GBS infection in genital tract of pregnant women in third trimester (OR=2.901, 6.137, 95%CI: 1.782-4.722, 3.737-10.078, all P<0.001). ③The incidence of puerperium infection and neonatal pneumonia in study group were 3.7% (3/81) and 4.9% (4/81), which were significantly higher than those in control group 0.8% (9/1 068) and 1.0% (11/1 068), respectively, and both differences were statistically significant (P=0.047; χ2=6.150, P=0.013). ④Among 81 neonates of study group, positive rate of GBS at 1 week after birth was 53.1% (43/81). The incidence of early onset GBS pneumonia in neonates was 2.5% (2/81).Conclusions:BMI≥25 kg/m2 at delivery and high school education level or below are independent risk factors for GBS infection in genital tract of pregnant women in third trimester, and may lead to increased incidence of puerperium infection and neonatal pneumonia.

Objective:To screen the differentially expressed exosomal miRNAs derived from liver cancer stem cells (LCSCs) and its effect on the malignant biological characteristics of liver cancer cells.Methods:miRNA expression profile chip was used to analyze the differentially expressed exosomal miRNA derived from LCSCs. The effects of miRNA on malignant phenotypes of LCSCs were identified. The cells were further treated with doxorubicin at different concentrations (0, 150, 300 μmol/L), and the expression level of miR-196a was detected by quantitative real-time PCR (qRT-PCR). The apoptosis of liver cancer cells cultured by exosomes derived from LCSCs (Exo-NC group) and exosomes derived from miR-196a inhibited LCSCs (Exo-Inhibitor group) and the activity of caspase3/7 under the action of exosomes from LCSCs were detected. Nude mice were randomly divided into Do-PBS group, Do-Exo-Inhibitor group and Do-Exo-NC group using random number table method, with 5 mice in each group, and the effect of miR-196a on nude mice xenograft tumor model with liver cancer cells was analyzed.Results:In this study, exosomes were isolated and purified from CD133 + Huh7 stem cell culture supernatant. miR-7162-3p, miR-1910-5, miR-3613-3p, miR-196a and miR-155-5p were up-regulated, while miR-1246 and miR-3613-5p were down-regulated. miR-7162-3p, miR-196a and miR-155-5p in exosomes had important effects on the self-renewal ability of LCSCs. miR-1910-5p, miR-196a and miR-155-5p had important effects on the invasion ability of liver cancer stem cells, among which miR-196a had the most significant inhibitory effect. Treatment for 24 h, the miR-196a expression level of the 0, 150 and 300 μmol/L doxorubicin was 0.96±0.05, 1.23±0.05 and 2.33±0.03 respectively, with a statistically significant difference ( F=996.90, P<0.001). Treatment for 48 h, the miR-196a expression level of the 0, 150 and 300 μmol/L doxorubicin were 1.02±0.07, 2.35±0.05 and 2.89±0.55 respectively, with a statistically significant difference ( F=303.00, P<0.001). When the concentration of doxorubicin was 0 and 300 μmol/L, the apoptosis rates of the Exo-NC group were 9.37%±0.19% and 11.64%±0.27%, and those of the Exo-Inhibitor group were were 18.80%±1.91% and 22.79%±1.57%, with statistically significant differences ( t=4.41, P=0.048; t=4.96, P=0.038). When doxorubicin was not used, the ratios of caspase3/7 in the Exo-NC group at 24 h and 48 h were 0.94±0.08 and 0.97±0.09, and those in the Exo-Inhibitor group were 1.56±0.01 and 1.58±0.01, with statistically significant differences ( t=11.41, P=0.008; t=6.07, P=0.026). Under 300 μmol/L doxorubicin, the ratios of caspase3/7 in the Exo-NC group at 24 h and 48 h were 0.95±0.07 and 1.36±0.08, and those in the Exo-Inhibitor group were 2.84±0.08 and 3.20±0.14, with statistically significant differences ( t=24.20, P=0.002; t=15.78, P=0.004). The results of xenograft tumor in nude mice showed that the tumor volumes of Do-PBS, Do-Exo-Inhibitor and Do-Exo-NC groups increased successively, which were (1 051.86±89.90) mm 3, (1 310.91±86.66) mm 3 and (2 185.14± 352.34) mm 3 respectively, with a statistically significant difference ( F=30.28, P<0.001). The weights of the transplanted tumors in the 3 groups increased successively, which were (0.36±0.10) g, (0.39±0.12) g and (0.76±0.16) g respectively, with a statistically significant difference ( F=11.81, P=0.002). The expression of miR-196a in tumors was significantly decreased after miR-196a inhibitor transfection. The expression levels of the 3 groups were 1.05±0.16, 0.38±0.08 and 2.17±0.26, with a statistically significant difference ( F=48.93, P<0.001). Conclusion:The exosomal secreted by LCSCs can enhance the resistance of liver cancer cells to doxorubicin by miR-196a.

目的 探究系统护理干预对B族链球菌(GBS)感染产妇相关指标的影响.方法 选取2016年5月-2017年5月于苏州高新区人民医院接受治疗的GBS感染产妇140例,按照随机数字法分为一般护理组、系统干预组各70例,对一般护理组患者进行常规护理,对系统干预组患者进行系统护理干预.对2组患者护理前后心理状况、生活质量、自我护理能力进行评价,并对2组患者住院时间、护理质量、不良妊娠结局、新生儿不良结局及患者家属满意度进行统计对比.结果 护理后系统干预组患者HAMD、HAMA评分分别为(13.88±4.13)、(12.61±4.11)分,均低于一般护理组的(17.65±4.56)、(16.58 ±4.46)分,生活质量评分为(64.63 ±5.06)分,高于一般护理组的(60.54 ±4.97)分(均P＜0.05).护理后系统干预组患者各项自我护理能力评分均高于一般护理组(均P＜0.05).系统干预组患者平均住院时间为(4.56±0.38)d,短于一般护理组的(5.32±0.57)d,护理质量评分为(93.53±7.21)分,高于一般护理组的(86.77±6.59)分(均P＜0.05).系统干预组不良妊娠结局发生率为4.29％,低于一般护理组的17.14％ (P ＜0.05).系统干预组新生儿不良结局发生率低于一般护理组(P＜0.05).系统干预组患者家属总满意率高于一般护理组(P＜0.05).结论 对GBS感染产妇进行系统护理干预,能够改善患者生活、心理状况,提升患者自我护理能力,改善患者妊娠结局,使患者及家属更加满意.

[目的]探讨肝癌干细胞来源外泌体中差异表达的蛋白质,重点分析外泌体ANXA2分子对肝癌恶性生物学特性(自我更新、侵袭和转移能力)的影响.[方法]采用无血清悬浮培养法和干细胞标志物流式分选术分离人肝癌干细胞;分别采用干细胞球形成实验、体外侵袭转移能力鉴定分离所得肝癌干细胞;采用蛋白质谱分析肝癌干细胞来源外泌体中的差异表达蛋白质;siRNA靶向抑制ANXA2表达后,分别进行肝癌细胞球形成实验、体外侵袭与迁移实验检测外泌体ANXA2对人肝癌细胞自我更新、侵袭、转移能力的影响;收集肝癌患者和正常人血浆,通过凝胶排阻层析联合CD63免疫磁珠分离纯化外泌体,Western blot检测外泌体中ANXA2表达情况,结合临床病理资料,综合分析外泌体ANXA2的临床相关性.[结果]成功分离得到肝癌干细胞CD133+SK-Hep-1,其具有典型的肿瘤干细胞生物学特性.与CD133-SK-Hep-1细胞外泌体相比,CD133+ SK-Hep-1肝癌干细胞来源外泌体中具有多种差异表达蛋白,其中外泌体ANXA2表达明显上调.siRNA靶向抑制肝癌干细胞ANXA2表达后,其外泌体中ANXA2表达也下降.分别采用PBS、siRNA靶向抑制肝癌干细胞ANXA2后外泌体(Exo-LCSCs-siANXA2)、肿瘤干细胞来源外泌体(Exo-LCSCs)刺激肝癌细胞系HepG2、SNU398,其自我更新、侵袭和转移能力依次增强.Western blot结果显示,肝癌患者血浆外泌体ANXA2表达明显高于健康人血浆;肝癌患者血浆外泌体ANXA2表达与患者年龄、性别无明显相关性,而与肿瘤TNM分期和转移显著相关.[结论]高表达ANXA2的肝癌干细胞的外泌体对肝癌细胞恶性生物学特性具有调控作用.

宫颈癌是常见的妇科恶性肿瘤之一,在女性生殖系统恶性肿瘤中发病率居于第三位,病死率居于第二位.近年来研究发现,黏蛋白(mucin,MUC)的异常表达与宫颈癌的发生、发展、侵袭、转移、复发等恶性行为密切相关.该文简要综述宫颈癌病因;黏蛋白结构特点、功能及其在宫颈癌中表达情况,并进一步阐述MUC在宫颈癌诊断、治疗、预后中的作用.

Increasing studies have demonstrated that most tumors consisted a subpopulation of cells with stem cell properties, known as cancer stem cells (CSCs). Accumulating evidence indicated that CSCs may be critical driving force for several types of cancer. Hence, it was necessary to develop therapeutic approaches specifically targeting CSCs. In this review, first, the biological properties of CSCs were introduced, including the self-renewal and differentiation, high tumorigenesis and invasiveness, resistance to chemotherapy and radiotherapy, genetic and epigenetic variations. Meanwhile, CSCs-targeted therapeutic strategies were summarized, including targeting cell surface markers, signaling pathways, CSC niches, differentiation therapy, and drug resistance for CSCs. Furthermore, clinical trials on anti-CSCs therapies supported the efficacy of these therapies, as well as their combination with conventional chemotherapy and radiotherapy. CSCs could be significantly eradicated, eventually resulting in inhibited tumor growth, metastasis, and recurrence. Thus, selectively targeting CSCs with various agents may be a novel and promising therapeutic strategy against cancer.

目的:探讨官腔镜联合腹腔镜子宫肌瘤剔除术对患者血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)及生活质量的影响.方法:124例2～5型子宫肌瘤患者,均分为开腹组和联合组,开腹组采用传统开腹子宫肌瘤切除术,联合组采用腹腔镜联合官腔镜子官肌瘤切除术;比较2组患者手术时间、肛门排气时间、住院时间、术中出血量、术后镇痛药物使用率、并发症发生率及术后1年的复发率;于手术前及术后第3天,采用SF-36量表评分评价2组生活质量,比较2组患者的血清CRP、IL-6、TNF-α及IL-8水平.结果:与开腹组比较,联合组手术时间、肛门排气时间、住院时间显著缩短,术中出血量、术后镇痛药物使用率及术后并发症发生率显著低于对照组(P＜0.05),术后随访1年两组患者子宫肌瘤复发率比较,差异无统计学意义(P＞0.05);手术前两组患者血清CRP、IL-6、TNF-α、IL-8水平及SF-36各维度评分比较,差异无统计学意义(P＞0.05);术后第3天,2组患者血清CRP、IL-6、TNF-α、IL-8水平及SF-36各维度评分显著高于手术前,开腹组血清CRP、IL-6、TNF-α、IL-8水平显著高于联合组、SF-36各维度评分显著低于联合组,差异有统计学意义(P＜0.05).结论:官腔镜联合腹腔镜治疗2～5型子宫肌瘤效果优于传统开腹子宫肌瘤切除术,且能提高患者生活质量.

目的:研究分析盆底超声评价全子宫切除术后盆底功能障碍的临床效果.方法:分别对40例全子宫切除术后压力性尿失禁患者(研究A组)、40例全子宫切除术后器官脱垂患者(研究B组)及40例全子宫切除术后无盆底功能障碍患者(对照组)进行盆底超声检查,并观察比较3组缩肛状态、静息状态、VALSALVA状态的形态改变,将相关数据测量记录.结果:1)研究B组在缩肛状态下的M肛提肌裂孔前后径、A肛提肌裂孔面积均优于对照组;2)研究A组与研究B组在静息状态下的M肛提肌裂孔前后径、N肛提肌裂孔横径、A肛提肌裂孔面积、Y肛提肌左右支夹角均优于对照组;3)研究A组与研究B组在VALSALVA状态下,M肛提肌裂孔前后径、A肛提肌裂孔面积、Y肛提肌左右支夹角均优于对照组;均有明显差异(P＜0.05).结论:应用盆底超声评价全子宫切除术后盆底功能障碍,可以清晰地查看女性盆底器官的动态变化,操作便捷,重复性好.

目的:观察中药灌肠+散结镇痛胶囊治疗对腹腔镜盆腔子宫内膜异位症患者术后复发率的影响.方法:选择77例行腹腔镜手术治疗的盆腔子宫内膜异位症患者,随机分为两组,对照组41例患者术后采用散结镇痛胶囊治疗,而研究组36例患者应用散结镇痛胶囊+中药保留灌肠治疗,观察两组治疗效果及疾病复发情况.结果:研究组总疗效为97.22％,明显优于对照组的82.93％(P＜0.05);用药期间,研究组不良反应率5.56％,而对照组为4.88％,组间差异不明显(P＞0.05);随访1年发现,研究组无复发病例,但对照组出现5例(12.20％),组间差异显著(P＜0.05).结论:盆腔子宫内膜异位症患者术后联合应用散结镇痛胶囊+中药灌肠能够显著提高临床疗效,降低术后复发率,且其安全性较高.

目的：探讨腹腔镜在妇科急腹症中的应用效果。方法200例妇科急腹症患者，将其按照手术方法的不同分为观察组(120例)和对照组(80例)，对照组采用常规开腹治疗，观察组采用腹腔镜治疗，比较两组的手术效果。结果两组的手术成功率均为100%，差异无统计学意义(P>0.05)。观察组的手术时间、术中出血量少于对照组，术后肛门排气时间、下床活动时间、住院时间短于对照组，术后疼痛评分低于对照组，使用镇痛剂的例数少于对照组，差异有统计学意义(P<0.05)。结论腹腔镜治疗妇科急腹症创伤小、术后恢复快，是较为理想的治疗方法。

目的 分析甲氨蝶呤联合米非司酮在异位妊娠保守治疗中的临床价值.方法 回顾性分析2011年1月～2013年12月我院收治的200例异位妊娠患者的临床资料,根据治疗方法不同,将患者分为2组,对照组和观察组,比较两组患者的疗效差异.结果 对照组100例异位妊娠患者,经米非司酮治疗,总有效率为81％;观察组100例异位妊娠患者,经甲氨蝶呤联合米非司酮治疗,总有效率为95％,明显高于对照组,经比较,P＜0.05差异具有统计学意义.观察组患者的血β-HCG转阴时间、包块消失时间、住院时间均明显低于对照组,输卵管通畅率高于对照组,经比较,P＜0.05,差异具有统计学意义.结论 甲氨蝶呤联合米非司酮在异位妊娠保守治疗中的临床疗效确切,值得推广应用.