The inhibited migration of dendritic cells (DCs) from lesion tissue to draining lymph nodes is a possible way for tumors to achieve immune evasion. In a previous study, we demonstrated that high concentrations of Prostaglandin E2 (PGE2), which were expressed in tumor microenvironments, inhibited DCs' migration. However, the specific mechanism is not yet clear. The current study aims to use the murine bone marrow-derived DCs (BMDCs) to demonstrate the possible signaling pathway of PGE2. The mRNA and protein expressions of the Epac1-Rap1 axis and PKA-CREB axis were determined after administration of PGE2 on DCs. Then, the agonist and antagonist of these molecules were used to treat DCs. The migration capability of DCs was detected as well as the RhoA activation levels. The mRNA and protein of Epac1 were barely undetectable in DCs. The use of Epac1 agonists showed no impact on DCs' migration capability and RhoA activation levels. The activation levels of Rap1 and protein expressions of Rap1a and Rap1b were not affected by PGE2 administration. The using of Rap1a and Rap1b antagonists demonstrated no impact on DCs' migration capability and RhoA activation levels. Moreover, the PKA activation levels and phosphorylated CREB1 were increased by the administration of PGE2 on DCs. The application of a PKA inhibitor attenuated the effect of PGE2 in a 3D migration assay and in vivo experiment. These results suggest that the PKA-CREB axis, instead of Epac1-Rap1, probably associates with the intracellular signaling pathway induced by high PGE2 levels, which demonstrates an inhibitory effect on DCs' migration. These findings can bring a different perspective on immunological surveillance of tumor progression.

Determination of the genomic copy number of Cre transgene is critical for the establishment of transgenic animal models. We demonstrate a real-time quantitative polymerase chain reaction (RT-qPCR) based method for genomic copy number determination of improved Cre (iCre), which was tested in a transgenic mouse model of CYP19A1-iCre. The standards were derived from tandem repeats of iCre fragments which were constructed by a new application of megaprimer PCR. Two rounds of megaprimer PCR were used to obtain specific tandem repeats of iCre fragments, which were subsequently cloned into pUCm-T vectors. After the fragments of IL-2 (reference gene) were ligated into the same vectors, standards with copy number ratios (CNR) of 0.5, 1, 2, 4, 8, and 16 between iCre and IL-2 were completed. The R2 values of the standard curves exceeded 0.99. The calculated CNR value of the quality control sample was satisfactory. Multiple copies of iCre were detected in founder mice. After several passages, the copy number of iCre gradually decreased to a single copy, which was consistent with theoretical expectation. The established method is a universal and sensitive program for genomic copy number determination of iCre in transgenic mice.

Objective: To analyze the effect of surgical experience with laparoscopic radical hysterectomy (LRH) on oncological outcome in cervical cancer patients. Methods: We retrospectively compared the oncological outcomes of 1469 patients with stage IB1 cervical cancer receiving LRH from 2004 to 2016. The surgical volume for each surgeon was defined as low (fewer than 50 surgeries), mid (51-100 surgeries), and high (100 surgeries or more). Kaplan-Meier curves and the Cox proportional hazards model were used to estimate the effect of surgical experience on the oncological outcomes of patients. Results:A total of 1405 cases were included in this study. The average operative times of the low-volume (n = 427), mid-volume (n = 396) and high-volume (n=582) groups were 270, 260 and 227 minutes, respectively (P < 0·001), and mean blood loss was 218 ml, 197 ml and 179 ml, respectively (P = 0·004). The 5-year OS of the low-volume, mid-volume and high-volume groups was 96·1%, 93·1% and 92·5%, with 5-year DFS rates of 92·0%, 87·5% and 87·6%, respectively. There was no significant difference among the three groups. However, surgery volume was not an independent risk factor for shorter OS or DFS after controlling for case mix, nor was surgeons’ experience after 1:1 PSM (Propensity score matching) between each two of the three groups. Conclusion: The results showed that surgeons’ surgical volume did not affect the oncological outcome of LRH but that operative time and blood loss were significantly improved with a higher surgical volume.

Cervical cancer is the fourth most common malignant tumors in female worldwide. Cirular RNAs (circRNA) represent a new class of regulatory RNA and play a pivotal role in the carcinogenesis and development of tumors. However, their functions have not been fully elucidated in cervical cancer. In this study, we identified an upregulated circRNA, circ_0001589, both in fresh clinical samples and tissue microarray of cervical cancer. Transwell assay and cell apoptosis assay by flow cytometry demonstrated circ_0001589 promotes epithelial–mesenchymal transition (EMT)‐mediated cell migration and invasion, and enhanced cisplatin resistance in vitro. In addition, in nude mice model, circ_0001589 increased the number of lung metastases and recovered xenograft growth from cisplatin treatment in vivo. Mechanistically, RNA pull‐down assay, RNA immunoprecipitation, and dual‐luciferase reporter assay disclosed that circ_0001589 function as an competing endogenous RNA to sponge miR‐1248, which directly target the 3′ untranslated region of high mobility group box‐B1 (HMGB1). Thereby, circ_0001589 upregulated HMGB1 protein expression and accelerate cervical cancer progression. The rescue experiments also revealed that miR‐1248 overexpression or HMGB1 knockdown partially reversed the regulatory functions of circ_0001589 on cell migration, invasion, and cisplatin resistance. In summary, our findings suggest the upregulation of circ_0001589 promoted EMT‐mediated cell migration and invasion, and enhanced cisplatin resistance via regulating miR‐1248/HMGB1 axis in cervical cancer. These results provided new evidence for understanding the carcinogenesis mechanism and finding new therapeutic target for cervical cancer.

Endometrial cancer (EC) is one of the most common cancers among women, while the incidence of EC is rising. Many studies have found that Kinesin family member 15 (KIF15) is highly expressed in a series of cancers, but the role of KIF15 in EC is unclear. We detected the expression level of KIF15 in a microarray of EC tissues by immunohistochemical staining (IHC), and analyzed the correlation between the expression level of KIF15 and the pathological characteristics of patients. After inhibit the expression of KIF15 in EC cells with lentivirus, cell proliferation and apoptosis were detected respectively by CCK8 assay, flow cytometry and tunnel assay. Transwell assay and wound healing assay were used to examine the migration ability and invasion ability of EC cells. Spheroid formation assay was used to evaluate cell self-renewal ability. In vivo tumor xenograft model was used for validation. The expressions of epithelial-mesenchymal transition, cancer stem cells, and Wnt/β-catenin signaling molecules were detected by Western blotting. The results showed that the expression of KIF15 in EC tissues was higher than that in normal endometrial tissues, while the expression level of KIF15 in EC was positively correlated with the pathological grade of the tumor. The down-regulation of KIF15 reduced the proliferation, colony formation, invasion, migration and self-renewal ability of EC cells, while promoted cell apoptosis. Knockdown of KIF15 inactivates the Wnt/β-catenin signaling of EC cells, inhibitors of Wnt signaling can counteract the enhanced self-renewal ability caused by KIF15 overexpression. Therefore, KIF15 may be a new potential target for diagnosis and treatment of EC.

目的 利用巢式 PCR结合高分辨率熔解曲线(HRM)技术,改进点突变模式小鼠的基因分型方法.方法 以ob/ob鼠和 db/db鼠为样本,剪小鼠脚趾编号并提取基因组 DNA.根据突变位点参考序列设计巢式 PCR 引物并进行两轮扩增后,对产物进行 HRM 分析,获得基因分型结果.同时,通过 PCR-SBT 法和 PCR-RFLP 法对分型结果的准确性进行验证.结果 对 80 只ob/ob鼠和 65 只db/db鼠进行了检测,巢式PCR-HRM 法能够准确地分辨出 3 种基因型.在 ob/ob鼠中,鉴定得到的纯合子、杂合子和野生型分别为 21、47 和 12 只.而在 db/db 鼠中,纯合子、杂合子和野生型分别为 23、33 和 9 只.巢式 PCR-HRM 法的分型结果与 PCR-SBT 法和 PCR-RFLP 法的结果高度一致,且分型结果与小鼠表型一致.结论 建立的巢式 PCR-HRM 法是一种快速、简便、准确度高的基因分型方案,适用于大批量点突变模式小鼠的基因分型鉴定.

目的 探讨国际妇产科联盟(FIGO)2018分期ⅠA～ⅡA期子宫颈癌患者术后辅助治疗的规范性对肿瘤学结局的影响.方法 在中国子宫颈癌临床诊疗项目大数据库中筛选FIG02018Ⅰ A～ⅡA期接受规范手术治疗的子宫颈癌患者,比较术后治疗规范与术后治疗不规范患者的5年总体生存率(OS)和无瘤生存率(DFS).结果 (1)纳入符合入组标准的FIGO 2018 Ⅰ A～ⅡA期接受规范手术治疗5638例(包括术后治疗规范2205例,术后治疗不规范3433例),中位随访时间44个月(术后治疗规范组43个月,术后治疗不规范组46个月).(2)Kaplan-Meier生存分析显示,术后治疗规范组肿瘤学结局明显优于术后治疗不规范组(OS:95.7％ vs.88.7％,P＜0.001;DFS:92.1％ vs.83.4％,P＜0.001).(3)Cox多因素分析显示,术后治疗不规范组发生死亡的风险是术后治疗规范组的1.556倍(HR=1.556,95％CI 1.135～2.133,P=O.006),发生复发/死亡的风险是术后治疗规范组的1.391倍(HR=1.391,95％CI 1.113～1.737,P=0.004).结论 从肿瘤学预后分析,术后治疗规范患者肿瘤学结局优于术后治疗不规范者,故术后治疗规范性需要得到重视.

目的 探讨腹腔镜下乙状结肠代阴道成形术的安全性,了解其性生活的状况并评估患者性生活满意度与健康女性有无差异.方法 收集2014年1月至2019年1月该院行腹腔镜下乙状结肠代阴道术的11例患者为研究对象,通过6～36个月的规律随访了解人工阴道的状况,对研究组中8例有规律性生活的患者与30例健康女性进行女性性功能指数量表(FSFI)评价并进行统计学比较评估术后的性生活满意度.结果 在随访的11例患者中,术中、术后并发症发生率低,性生活满意度良好,8例有规律性生活的患者性生活满意度与健康女性比较差异无统计学意义(P>0.05).结论 腹腔镜下乙状结肠代阴道成形术并发症发生率低,术后性生活比较满意.

Objective To investigate the role of ski-related novel protein N (SnoN) in the pathogenesis of intrauterine adhesion (IUA) and its association with transforming growth factor-β1 (TGF-β1) and Smad4 in endometrial tissue in IUA patients. Methods Endometrial tissues of 20 severe IUA patients (sIUA group) and 20 healthy women with uterine septum (control group) were collected from our 2 departments during January 2019 and October 2020. Immunohistochemical assay, Western blotting and reverse transcription quantitative polymerase chain reaction (RT-qPCR) were used to detect the expression of SnoN, TGF-β1 and Smad4 in the endometrial tissue of the control and sIUA groups. The correlations of their expression levels in the endometrial tissues were analyzed with Spearman rank correlation analysis to investigate the association of the levels and IUA. Results The expression levels of TGF-β1 and Smad4 were significantly higher, while that of SnoN was obviously lower in the sIUA group than the control group (all P < 0.01). In the endometrial tissues from the sIUA group, the expression of Smad4 was positively correlated with that of TGF-β1 (r=0.468 9, P < 0.05). However, the TGF-β1 expression was negatively correlated with that of SnoN (r=-0.483 5, P < 0.05). Conclusion SnoN may be involved in the pathogenesis of IUA via the TGF-β1/Smad4 signal pathway.

目的 从肿瘤学结局角度对比FIGO 2018子宫颈癌新分期Ⅰ B3期开腹广泛性子宫切除手术(ARH)、新辅助化疗后开腹手术(NACT)、根治性放化疗(R-CT)3种治疗方式的差异,探讨Ⅰ B3期子宫颈癌适宜治疗策略.方法 基于中国子宫颈癌临床诊疗项目数据库,纳入FIGO 2018子宫颈癌Ⅰ B3期病例,在真实世界研究比较ARH组、NACT组及R-CT组的5年总体生存率(OS)及无病生存率(DFS).结果 (1)从数据库中纳入FIGO 2018子宫颈癌Ⅰ B3期病例1434例,其中ARH组830例、NACT组484例、R-CT组120例.中位随访时间为46个月(ARH组55个月、NACT组44个月、R-CT组32个月).(2)NACT组、ARH组及R-CT组之间5年OS差异有统计学意义(97.0％ vs.91.1％ vs.78.1％,P＜0.001),5年DFS差异有统计学意义(92.3％ vs.87.4％ vs.71.1％,P＜0.001).(3)Cox回归分析提示NACT组发生死亡的风险是ARH组的0.352倍(HR=0.352,95％CI 0.189～0.654,P=0.001),不是复发/死亡的独立影响因素(HR=0.592,95％CI 0.391～0.898,P=0.202);R-CT组发生死亡的风险是ARH组的2.997倍(HR=2.997,95％CI 1.754～ 5.121,P＜0.001),R-CT组发生复发/死亡的风险是ARH组的2.832倍(HR=2.832,95％CI 1.803～4.449,P＜0.001).结论 比较3种治疗方式的肿瘤学结局,FIGO 2018子宫颈癌Ⅰ B3期接受新辅助化疗后开腹手术的肿瘤学结局最佳,接受开腹广泛性子宫切除手术次之,接受根治性放化疗较差.因此,Ⅰ B3期的合适治疗方式可能是新辅助化疗后手术.

目的 卵巢叶酸受体α(αFR)在上皮性卵巢癌中高表达.文章拟构建靶向 αFR的嵌合抗原受体(CAR)修饰NK-92细胞(NK-92-αFR-CAR),并验证其对αFR阳性靶细胞的杀伤效能,为卵巢癌的临床治疗提供新策略.方法 选择偏爱密码子技术设计人源化抗αFR抗原的CAR分子基因;构建慢病毒表达载体pLenti-αFR-CAR;包装慢病毒并感染NK-92细胞;Western blot、qPCR及流式细胞术检测αFR-CAR分子在NK-92细胞中的表达效率.LDH释放实验和ELISA检测NK-92-αFR-CAR细胞对αFR阳性卵巢癌细胞的杀伤活性.结果 双酶切pLenti-αFR-CAR重组质粒可见分子质量和αFR-CAR分子一致的基因片段.Western blot和qPCR证明αFR-CAR分子在NK-92细胞中确有表达,并且经嘌呤霉素筛选后,αFR-CAR的表达效率超过90％.NK-92-αFR-CAR细胞对卵巢癌细胞的杀伤效应及细胞因子分泌水平呈抗原依赖性,即肿瘤细胞表面αFR表达水平越高,NK-92-αFR-CAR细胞对其杀伤效应越强.NK-92-αFR-CAR细胞与SK-OV-3细胞或A2780细胞共培养后,其IFN-γ分泌水平(5007.81±180.37、2668.30±180.37)较NK-92细胞(360.80±8.44、285.86±12.39)和NK-92-EV细胞(378.75±21.76、292.10±21.76)表达更高(P<0.01);TNF-α分泌水平(964.27±74.95、585.73±83.53)较NK-92细胞(247.92±5.96、231.03±10.47)和NK-92-EV细胞(230.04±13.66、215.13±7.89)表达更高(P<0.01).但与A-431细胞共培养,3种细胞中IFN-γ 和TNF-α 表达差异无统计学意义(P<0.05).结论 NK-92-αFR-CAR细胞具有分泌大量IFN-γ 和TNF-α 细胞因子并特异杀伤αFR阳性卵巢癌细胞的能力,这为NK-92-αFR-CAR细胞进入后续的临床前和临床研究奠定了基础.

高考结束后,学校迎来新学年的学生,学生进入了梦寐以求的高等学府,又是一个人生历程的起点,医学院校为人们全生命周期护航,又开始周而复始的工作.此刻每一名学生和每一个教员都会有一个新的思考,要造就自己,要培养出优秀合格的学生,如何走好入学的"第一步",万丈高楼打好地基十分重要,立德树人和专业学习相得益彰,相互促进,教学相长,才能使自己成为合格的医务工作者,才能造就为人群健康保驾护航的出色专家.

目的 探讨在真实世界研究条件下的Ⅰ A1 (LVSI+)～ⅡA2期子宫颈癌腹腔镜与开腹手术的长期肿瘤学结局.方法 基于中国子宫颈癌临床诊疗大数据库,在真实世界研究及1:1倾向评分匹配条件下,比较匹配前后ⅠA1(LVSI+)～ⅡA2期子宫颈癌腹腔镜与开腹手术5年总体生存率(OS)及无病生存率(DFS).结果 (1)将中国子宫颈癌临床诊疗大数据库中2009年1月1日至2016年12月31日全部的Ⅰ A1 (LVSI+)～ⅡA2期15 515例子宫颈癌腹腔镜及开腹手术病例纳入研究中,腹腔镜组5205例,开腹组10 310例,两组患者5年OS无差异,5年DFS腹腔镜组低于开腹组(OS:88.7％ vs.90.3％,P--0.678,DFS:84.3％ vs.86.4％,P=0.006),Cox多因素分析提示腹腔镜手术是患者死亡和复发/死亡的独立危险因素(OS:HR=1.233,95％CI 1.073～1.417,P=0.003;DFS:HR=1.314,95％CI1.184～1.458,P＜0.001);但两组患者在年龄、组织学类型、分期及术后病理中高危因素等存在差异,再行1:1匹配后发现腹腔镜组(4317例)与开腹组(4317例)5年OS及DFS腹腔镜组均低于开腹组(OS:89.3％ vs.92.6％,P=0.009,DFS:84.8％ vs.89.1％,P＜0.001),且腹腔镜手术是影响患者死亡和复发/死亡的独立危险因素(OS:HR=1.341,95％CI 1.114～1.616,P--0.002;DFS:HR=1.454,95％CI 1.265～1.670,P＜ 0.001).(2)进一步限定子宫切除类型为QM-B型/C型进行分析,腹腔镜组5019例,开腹组9473例,两组患者5年OS无差异,5年DFS腹腔镜组低于开腹组(OS:89.0％ vs.90.5％,P=0.630,DFS:84.3％ vs.86.6％,P=0.005),Cox多因素分析提示腹腔镜手术是影响患者死亡与复发/死亡的危险因素(OS:HR=1.229,95％CI 1.065～1.418,P=0.005;DFS:HR=1.324,95％CI 1.190～1.474,P=0.005);行1:1匹配后腹腔镜组(4210例)与开腹组(4210例)5年OS及DFS比较:腹腔镜组均低于开腹组(0S:89.5％ vs.92.1％,P=0.014,DFS:84.2％ vs.88.2％,P＜0.001),Cox多因素分析提示腹腔镜手术是影响患者死亡与复发/死亡的独立危险因素(OS:HR=1.330,95％CI 1.109～1.595,P=0.002;DFS:HR=1.404,95％CI 1.226～1.607,P＜0.001).结论 在真实世界研究条件下,Ⅰ A1(LVSI+)～ⅡA2期子宫颈癌腹腔镜组5年OS及DFS均低于开腹组,且腹腔镜手术是影响患者死亡及复发/死亡的独立危险因素.

目的 探讨2004-2015年国内开展腹腔镜手术治疗子宫颈癌的情况并分析其相关因素.方法 采取多中心回顾性研究方法,收集2004-2015年,国内共计37家医院(南方医科大学南方医院、安徽省肿瘤医院、中日友好医院等)妇科手术治疗的子宫颈癌患者,分析其12年间腹腔镜手术治疗子宫颈癌的整体情况.根据入组标准共纳入24 757例,其中开腹手术18 701例为对照组,腹腔镜手术6056例为观察组,收集相关临床资料,分析腹腔镜手术占比的变化趋势及两组资料的差异.结果 12年间,国内37家医院子宫颈癌总手术量增长7.31倍,年增长率为19.82％;子宫颈癌腹腔镜手术量增长252倍,年增长率为65.31％;相关因素分析发现患者年龄、FIGO分期、病灶大小、子宫切除类型和就诊医院类型是手术方式选择的影响因素(P＜0.05).结论 近12年来,国内子宫颈癌腹腔镜手术开展迅速,医生更倾向于选择早期、病灶小、年轻的患者实施该术式.

目的 探讨高强度聚焦超声消融(HIFU)联合促性腺激素释放激素激动剂(GnRH-a)及左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌病痛经的疗效.方法 回顾性分析2015年7月—2016年1月临床诊断为子宫腺肌病有痛经症状,并按照自愿原则采用HIFU+GnRH-a+LNS-IUS治疗方案的30例患者的临床资料,分析其临床疗效.结果 治疗前与治疗后3、6、12、24月痛经VAS评分分别为[(7.4±1.1)、0、(1.2±0.9)、(1.0±0.9)、(1.2±1.1)分],差异有统计学意义(P<0.01);子宫体体积分别为[(216.5±80.6)cm3、(68.9±22.3)cm3、(92.9±40.5)cm3、(119.1±49.3)cm3、(141.7±60.3)cm3],差异有统计学意义(P<0.01);并发症包括节育环下移、单侧卵巢囊肿、不规则阴道出血等.结论 HIFU联合GnRH-a及LNG-IUS治疗子宫腺肌病痛经,可有效延长疗效时间、降低复发率,可作为较持久地综合保守治疗优选方案之一.

妇科门诊手术室是妇科门诊患者实施手术的场所,随着研究者对新型冠状病毒认识的不断加深,患者流行病学特点和临床症状不典型,通过健全新型冠状病毒肺炎疫情期间妇科门诊手术的防控措施,增强医护人员的感染防控意识,才能早日打赢疫情防控阻击战.本文从概述、人员培训、门诊医生的排查、质量监督、防护用品的管理、消毒及建立应急流程方面进行了探讨,为后续的防控工作提供参考依据.

Continuous human papillomavirus (HPV) infection is a critical cause of cervical lesions; however, the specific mechanism is currently not clear. E6 is one of the most important oncoproteins associated with HPV, which regulates synthases in the production of prostaglandin E2 (PGE(2)). Notably, PGE(2) has been reported to be upregulated in cervical lesions. An insufficient number of mature dendritic cells (DCs), which is unable to cause an effective immune response, is an important cause of cervical lesions. Therefore, this study explored the possible causes of HPV16-positive cervical lesions by identifying the relationship between E6, PGE(2) and DCs. Firstly, the distribution and status of DCs in clinical biopsy specimens and animal models were analyzed with immuno-histochemistry and flow cytometry, which demonstrated that the migratory ability of DCs was inhibited in HPV16-positive cervical lesions. Furthermore, using immunohistochemistry, western blotting and ELISA, it was revealed that as the degree of cervical lesions increased, the expression of PGE(2) and its synthases increased. Subsequently, as determined using Transwell and 3D migration assays, it was revealed that a high concentration of PGE(2) inhibited the migration of DCs, which may explain the phenomenon observed in cervical lesions. Notably, E6 was identified to regulate PGE(2) expression. The in vivo experiments indicated that E6 may increase the expression levels of PGE(2) in cervical lesions, which could eventually induce inhibition of the migration of DCs. In conclusion, the present study suggested that E6 regulated overproduction of PGE(2), which may induce inhibition of DC migration in HPV16-positive cervical lesions.

生殖健康是人类健康的重要内容之一,它不仅关系到人们的性健康和生育健康,也与后代的健康密切相关.随着改革开放,中国社会和经济的发展,青少年的性观念日益开放,而中国长辈对于性教育难以启齿,校园的性知识教育缺失,食品添加管控力度不足,性成熟期提前及低龄化,对于意外怀孕防控不足,无痛和可视人工流产技术进步及无痛人流广告的过度宣传,造成了青少年面临着意外妊娠后重复人流、不安全人流及人流后并发症及性传播疾病的增加,严重影响未来的生育力[1-2].世界卫生组织(World Health Organization,WHO)近年统计数据显示,每年全球约有4800 万女性实施人工流产,其中我国占27.1 ％[3].欧盟合作的课题在我国 30 个省市自治区调查近 8 万例人工流产,年龄 <24 岁者占28.5 ％[4].未婚人工流产、重复流产已成为一个广泛关注和亟待解决的社会问题,也是影响我国女性青少年生殖健康的重大公共卫生问题之一.

Objective: To compare the long-term oncological outcomes between laparoscopic and abdominal surgery in stage Ⅰa1 （lymph-vascular space invasion-positive, LVSI+）- Ⅰb1 cervical cancer patients with different tumor sizes. Methods: Based on the Big Database of Clinical Diagnosis and Treatment of Cervical Cancer in China (1538 project database), patients with stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer who treated by laparoscopic or abdominal surgery were included. The 5-year overall survival (OS) and 5-year disease-free survival (DFS) between the two surgical approaches were compared under 1∶1 propensity score matching (PSM) in different tumor diameter stratification. Results: (1) A total of 4 891 patients with stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer who underwent laparoscopy or laparotomy from January 1, 2009 to December 31, 2016 were included in the 1538 project database. Among them, 1 926 cases in the laparoscopic group and 2 965 cases in the abdominal group. There were no difference in 5-year OS and 5-year DFS between the two groups before matching. Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS (HR=1.367, 95%CI: 1.105-1.690, P=0.004). After 1∶1 PSM matching, 1 864 patients were included in each group, and there was no difference in 5-year OS between the two groups （94.1% vs 95.4%, P=0.151）. While, the inferior 5-year DFS was observed in the laparoscopic group (89.0% vs 92.3%, P=0.004). And the laparoscopic surgery was associated with lower 5-year DFS (HR=1.420, 95%CI: 1.109-1.818, P=0.006). (2) In stratification analysis of different tumor sizes, and there were no difference in 5-year OS and 5-year DFS between the laparoscopic group and abdominal group in tumor size ≤1 cm, >1-2 cm and >2-3 cm stratification (all P>0.05). Cox multivariate analysis showed that laparoscopic surgery were not related to 5-year OS and 5-year DFS (P>0.05). In the stratification of tumor size >3-4 cm, there was no difference in 5-year OS between the two groups (P>0.05). The 5-year DFS in the laparoscopic group was worse than that in the abdominal group (75.7% vs 85.8%, P=0.025). Cox multivariate analysis suggested that laparoscopic surgery was associated with lower 5-year DFS (HR=1.705, 95%CI: 1.088-2.674, P=0.020). Conclusions: For patients with stage Ⅰa1 （LVSI+）-Ⅰb1 cervical cancer, laparoscopic surgery is associated with lower 5-year DFS, and the adverse effect of laparoscopic surgery on oncology prognosis is mainly reflected in patients with tumor size >3-4 cm. For patients with tumor sizes ≤1 cm, >1-2 cm and >2-3 cm, there are no difference in oncological prognosis between the two surgical approaches.

压力性尿失禁(stress urinary incontinence,SUI)是指喷嚏、咳嗽、大笑或运动时腹压增高后出现不自主的尿液自尿道口漏出.SUI限制了女性日常活动及运动,严重影响其生活质量,并导致巨大心理压力.SUI的危险因素有:年龄、遗传 因素、雌激素水平降低、便秘、慢性咳嗽及肥胖等[1],其中肥胖是SUI的独立危险因素[2].