Accuracy of frozen section in management and prediction of lymph node metastasis in endometrial carcinoma

Objective: This study aimed to investigate clinical factors affecting the concordance between frozen section (FS) and paraffin section (PS) findings in endometrial cancer, and evaluate the role of FS in predicting lymph node (LN) metastases. Methods: Tumor grade and depth of myometrial invasion based on FS and PS findings were compared in 376 patients. Clinical factors affecting the accuracy of FS in predicting LN metastasis were evaluated. Overall survival was compared between patients who underwent lymphadenectomy and those who did not. Results: Overall concordance of tumor grade was 78.6% (147/187). Later age at menopause (p = 0.011) and a lower systolic/diastolic ratio of endometrial blood flow (p = 0.015) were associated with high concordance between FS and PS for tumor grade. Overall concordance for the depth of myometrial invasion was 97.8% (178/182). There was greater concordance between FS and PS for myometrial invasion in patients with postmenopausal bleeding (p = 0.018) and lower abdominal pain (p = 0.013). G1 and G2 + no myometrial invasion predicted no metastasis; G1 + <1/2 myometrial invasion predicted a 2.4% risk of both pelvic LN and para-aortic LN metastasis. G2 + <1/2 myometrial invasion predicted a 4.8% risk of pelvic LN metastasis. Patients undergoing lymphadenectomy showed relatively longer survival than those without lymphadenectomy (p = 0.086). Conclusion: The accuracy of FS in determining tumor grade and myometrial invasion appears to be reliable. LN metastases cannot be predicted adequately by intraoperative FS. We recommend complete surgical staging for all patients with endometrial cancer

An Expedient SERS Strip Tactic for Rapid On-Site Detection with Long-Time Sensitivity and Repeatability

Surface-enhanced Raman spectroscopy (SERS) has attracted lots of interest in academic and industrial fields in recent years. The improvement in long-time sensitivity and repeatability is highly demanded by the on-site applications. Herein, we present an expedient SERS strip tactic with these desired advantages. Specifically, the tactic utilized the outstanding stability of colloidal particles to maintain the SERS materials during the storage. Upon usage, the strip is rapidly prepared on-site, and then the targets were sampled with a dip-coating and heating method, which is designed to standardize the whole detection process with the sensitivity kept. Thanks to the tactic, only one-third of SERS sensitivity decay was observed for rhodamine 6G after half a year. Besides rhodamine 6G, the SERS spectra of different animal blood samples were also investigated with the SERS strip tactic, and a species-based discrimination capability was preliminarily demonstrated

Suppression of endothelial cell migration by tumor associated macrophage-derived exosomes is reversed by epithelial ovarian cancer exosomal lncRNA

Abstract Objective To study the mechanism by which epithelial ovarian cancer (EOC)-derived exosomes restore the migration of endothelial cells that is suppressed by TAM-derived exosomes. Methods Exosomes were isolated from TAMs in the ascites of patients with EOC. The effect of exosomes on the expression of endothelial cell miRNA was monitored by PCR. The miRNA mimics were transfected to explore their effects. Microarray data and literature searches were used to predict target genes and the impact of target gene pathways, and small interfering RNA was used to target these genes. We used migration assays to determine whether ovarian cancer cell-derived exosomes participate in the regulation of TAMs and endothelial cells. We used microarray data to identify the target lncRNA, and we constructed target lncRNA expression plasmids to validate targets by Western blotting. Results We separated TAMs from the ascites of patients with EOC and isolated exosomes from TAM supernatants. After co-culture with HUVECs, these exosomes were efficiently incorporated into HUVECs. The migration of HUVECs was suppressed significantly in the exosome group compared with blank controls (P < 0.05).The miRNA mimic transfection and target gene prediction found that TAM-derived exosomes targeted the miR-146b-5p/TRAF6/NF-κB/MMP2 pathway to suppress endothelial cell migration; this result was supported by PCR and Western blotting analyses. The expression of exosomal miR-146b-5p isolated from serum in the EOC group was significantly increased compared to healthy individuals. Finally, TAM-derived exosomes and EOC SKOV3-derived exosomes in combination stimulated HUVEC cells and overcame the inhibition of endothelial cell migration caused by TAM-derived exosomes. Two lncRNAs that were carried by SKOV3-derived exosomes were identified as NF-κB pathway-associated genes by Western blotting. Conclusion TAM-derived exosomes can inhibit the migration of endothelial cells by targeting the miR-146b-5p/TRAF6/NF-kB/MMP2 pathway. However, EOC-derived exosomes can transfer lncRNAs to remotely reverse this effect of TAMs on endothelial cells

Patient needs in psoriasis treatment and their influencing factors: A nationwide multicentre cross-sectional study in China

Background: The management and treatment of psoriasis has rarely considered patient needs, which are numerous, multi-dimensional and are of great importance to improving treatment outcomes. Objectives: This study aimed to evaluate and compare the patients' needs for psoriasis treatment and identify factors predicting the need to make patient-centred decisions about treatment. Materials and Methods: This nationwide multicentre cross-sectional study included subjects between October 2020 and August 2021. The status quo of the needs in psoriasis treatment and their influencing factors were analysed mainly using the Chi-square test and binary logistic regression. Results: Information on sociodemographic and clinical characteristics were obtained. Factor analysis of a specially designed questionnaire showed that rapid skin clearance, reduced treatment expense and fewer hospital visits or treatment time were the first three patient needs in psoriasis treatment. Several influencing factors were important including the sociodemographic characteristics of gender, marital status, education level and family history, special location of skin lesions, dermatology life quality index (DLQI), Investigator's Global Assessment modified 2011 (IGA mod 2011), condition of the episode, clinical type of psoriasis, seasonal exacerbation and therapy. Conclusions: Patients with psoriasis pursued a wide range of treatment goals, with the most desired being rapid skin clearance, reduced treatment expense and time-saving. Paying attention to sex, marital status, education level, the special location of skin lesions and the DLQI will help dermatologists develop patient-centred treatment, meet the patient's needs and eventually improve the treatment outcomes