Objective: To observe the anxiety and depression experienced by patients with suspected and confirmed COVID-19 during hospitalization and isolation. Methods: A cross-sectional survey was performed with 66 patients with suspected and confirmed COVID-19 who were admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from February 9, 2020, to February 22, 2020. The data collected including sex, age, education level, and nucleic acid test results. Anxiety, depression, and sleep disorders were evaluated using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Pittsburgh Sleep Quality Index Scale (PSQI), respectively. Statistical analysis: SPSS 23.0 software was used for data processing, and multifactor logistic regression analysis was used to identify the independent risk factors. Spearman correlation analysis was used to study the correlations among the observed indicators; P <0.05 was considered statistically significant. Results: The incidences of anxiety, depression, and sleep disorders in the suspected case group were 18.2%, 18.2%, and 39.4%; the incidences of anxiety, depression, and sleep disorders in the diagnosed group were 42.4%, 57.6%, and 69.7%. The incidence of sleep disorders was higher than the domestic norm, and the difference was statistically significant ( P <0.05). Logistic regression analysis adjusted for multiple factors showed that the main factor affecting anxiety was age; the main factors affecting depression were age and a positive nucleic acid test; and the main factor affecting sleep disorders was age. The anxiety, depression and sleep disorder scores were significantly positively correlated ( P <0.05). Conclusion: Patients with suspected and confirmed COVID-19, especially people aged 50 years and over, have significant anxiety, depression and sleep disorders. Anxiety, depression and sleep disorders in patients with confirmed cases are more serious than those in patients with suspected cases. It is necessary to focus on the psychological state of such patients, actively conduct psychological counseling, and reduce their anxiety and depression.

AIMS:Atypical chemokine receptors (ACRs) have been reported to scavenge or alter the localization of their chemokine ligands. However, CRAM, a newly identified ACR member, is lack of ligand scavenging properties. The present study was to investigate the clinical significance of CRAM in cervical carcinoma.METHODS:The expression of CRAM in primary cervical cancer and paired normal tissues from adjacent regions was examined using Real time PCR. Moreover, CRAM protein expression was analyzed in 272 cervical specimens including 50 normal cervical tissues, 40 cases of carcinoma in situ of cervix (CIS), and 182 cases of cervical cancer by immunohistochemistry.RESULTS:Real time PCR showed that the expression level of CRAM was markedly higher in cervical cancer than that in normal cervical tissues. The expression rate of CRAM in normal cervical tissues, CIS, and cervical cancer increased gradually (p < 0.01). In addition, the expression level of CCL19 was positively associated with that of CRAM (p < 0.05). Moreover, high expression level of CRAM was correlated with lymph node metastasis and histological subtype. In multivariate Cox regression analysis, high expression level of CRAM was a negative indicator for both overall (p = 0.028) and recurrence-free survival (p = 0.010).CONCLUSION:The present study suggested that CRAM could be a clinical prognostic marker for patients with cervical cancer and might be a potential therapeutic target for cervical cancer. Our data extended previous research on the predictive value of ACRs.

Objective Atypical chemokine receptors (ACRs), including CCX-CKR, DARC, and D6, have been reported to be involved in cancer invasion and metastasis. The objective of this study was to investigate the prognostic importance of ACRs in patients with cervical squamous cell carcinoma (CSCC). Methods The expression of three ACRs was investigated by immunohistochemical (IHC) examination in a total of 317 cervical specimens including 40 normal cervical tissues, 50 cases of carcinoma in situ of cervix (CIS), and 227 cases of CSCC by immunohistochemistry. Results The expression rate of DARC and CCX-CKR in CSCC, CIS, and normal cervix increased gradually (p<0.01). D6 expression is decreased in CSCC compared to either in CIS or in normal cervix (p<0.05). In addition, the expression of CCL2 and CCL19 was inversely associated with ACR expression (p<0.05), while that of LCA was positively correlated with ACR expression (p<0.05). Moreover, DARC expression, CCX-CKR expression, and ACR coexpression were negatively correlated with lymph node metastasis (P<0.01). D6 expression and ACR coexpression were negatively related to tumor size (p=0.018) and recurrence (p=0.028). In multivariate Cox regression analysis, CCX-CKR expression was a positive indicator for overall survival (p=0.008), and D6 expression was an independent predictor of both overall and recurrence-free survival (p=0.041) in CSCC. Conclusions Our results suggest that the loss of ACRs may play important roles in the tumorigenesis and migration of cervical cancer. ACR expression may be considered as prognostic markers in patients with CSCC.

AIMS:Primary peritoneal serous carcinoma (PPSC) is an unusual neoplasm that has not been properly characterized. To better define the clinicopathological and immunohistochemical features of PPSC, we present 6 such cases.METHODS:The 6 patients consisted of one man and 5 women, ranging in age from 45 and 75 years. None of the patients had any history or clinical evidence of tumor elsewhere. The immunohistochemical profile was examined using antibodies against β-catenin, E-cadherin, wnt5a, EGFR, VEGF, vimentin, Ki67, and P53.RESULTS:Of all the 6 PPSC cases, 5 cases presented stage IIIC and 1 case presented stage IV. Microscopically, 5 cases were poorly differentiated and 1 was moderately differentiated. All cases showed positive staining for β-catenin, E-cadherin, vimentin, VEGF, P53, and Ki67, 4 cases expressed EGFR, and all cases were consistently negative for wnt5a.CONCLUSIONS:We described 6 cases of PPSC with clinicopathological and immunohistochemical features. The findings provide basic knowledge of PPSC.

The aim of this study was to explore the difference of long-term prognosis of different treatment regimens in patients with stage IB2, IIA2 cervical cancer.

Objective: To investigate the effect of neoadjuvant chemotherapy (NACT) on microvessel density (MVD)/ lymphatic microvessel density (LMVD) in locally advanced uterine cervical cancer and its clinical impact. Methods: Seventy patients with ⅠB2-ⅡB cervical cancer were recruited, and the surgical specimens of cervical cancer tissues were collected. The MVD and LMVD of cervical cancer were examined by immunohistochemistry, and the relationship between clinical response of NACT and the clinicopathological characteristics was analyzed. Results: The levels of MVD and LMVD in cervical cancer tissues were significantly higher than those in the normal cervical tissues (P＜0.001; P=0.028). The MVD was related to the depth of cancer invasion (P=0.039), and the LMVD was related to the level of serum squamous cell carcinoma antigen (SCCAg) and the lymph node metastasis (P=0.017; P=0.049). The level of MVD was significantly decreased after NACT as compared with that before NACT (P=0.019). As compared with the levels of MVD and LMVD before NACT, these levels were both decreased after NACT (P=0.019; P=0.176). The overall response rate of NACT was 70.0% (49/70), and the complete response rate was 21.4% (15/70). Multivariate analysis displayed that the depth of cancer invasion was an independent factor related to the response of NACT (P=0.018, odds ratio = 0.169). Conclusion: NACT can be helpful to reduce the level of MVD and the volume of tumor in locally advanced cervical cancer. DOI:10.3781/j.issn.1000-7431.2011.12.007

Objective By means of comparing the therapeutic effect of different surgical methods combined with postoperative radiotherapy to squamous cell carcinoma of the vulva,to find out the best treatment method.Methods A retrospective analysis was adopted which involves 150 patients with primary squamous cell carcinoma of the vulva treated at Sun Yat-sen University Cancer Center from January 1980 to December 2005.Meanwhile,survival rate was calculated by life table method.Kaplan-Meirer method was used to evaluate the prognostic factors in univariate analysis.And the independent prognostic factors were provided through COX regression model.Results For the patients with positive lymph nodes,the 5-year survival rate of the patients who underwent radical vulvectomy and en bloc resection of inguinofemoral and/or pelvic lymph nodes and radiotherapy,radical vulvectomy and resection of intumescent inguinofemoral lymph nodes and radiotherapy,radical vulvectomy and radiotherapy,and radical vulvectomy and en bloc resection of inguinofemoral and/or pelvic lymph nodes were 29%、25%、17%、67%,respectively(P=0.031).And the 5-year progression-free survival rate were 100%、50%、67%、83%,respectively(P=0.016).For the patients without intumescent lymph nodes before surgery,the 5-year survival rate(84% vs.46%,P=0.010) and progression-free survival rate(97% vs.62%,P0.001) of the patients who underwent radical vulvectomy and en bloc resection of inguinofemoral and/or pelvic lymph nodes is significant higher than the patients who underwent radical vulvectomy and radiotherapy.Conclusion TTo the patients with advanced stage disease,vulvar lesions resection and en bloc resection of lymph nodes and postoperative radiotherapy is necessary.And to the patients with early stage disease,vulvar lesions resection and en bloc resection of lymph nodes is suggested.

目的探讨舒芬太尼-异丙酚-氧化亚氮复合麻醉应用于非体外循环冠状动脉搭桥手术的可行性。方法22例行非体外循环冠状动脉搭桥手术患者,以异丙酚(1.5~2)mg·kg-1、咪唑安定(3~5)mg、舒芬太尼1μg·kg-1、哌库溴铵0.15mg·kg-1诱导插管。麻醉维持:新鲜气流量2L·min-1(O2∶N2O为1∶1),异丙酚(3~4)mg·kg-1·h-1、舒芬太尼1μg·kg-1·h-1泵入,间断静注哌库溴铵维持肌松。记录血流动力学各项指标,术后观察拔管时间和在ICU停留时间。结果术中血液动力学稳定,未出现严重心律失常和心肌缺血改变,无1例改体外循环。平均麻醉时间(164±37)min,输血(536±62)ml,输液(3025±153)ml。术后拔管时间为(3.6±1.1)h,在ICU停留时间(2.2±0.8)d。结论舒芬太尼-异丙酚-氧化亚氮复合麻醉用于非体外循环冠状动脉搭桥手术是一种安全、有效的麻醉方法,符合“快车道”心脏手术麻醉的要求。

Objective: To investigate the effects of three anesthetic methods on level of Peptides Endothelin-1(ET-1) and Angeotensin Ⅱ(AngⅡ) in patients undergoing off-pump coronary bypass grafting(OPCAB).Methods: 62 patients undergoing OPCAB were separated into two groups: patients in group A were anesthetized by general anesthesia and group B in combination of thoracic epidural anesthesia and general anesthesia.To all patients,the level of ET-1 and AngⅡof plasma before operation(T_1),at the end of operation(T_2) and 24h(T_3) were detected and operating outcomes were observed.Result: There were no significantly differences in operating outcomes among two groups.In two groups,the level of ET-1 and AngⅡin T_2,T_3 were higher than that in T_1 Compared to group B.Conclusions: In patients undergoing OPCAB,combination of thoracic epidural anesthesia can more effectively suppress the increase of plasma ET-1 and AngⅡlevel than general anesthesia,providing better heart protection during operation.