Volume 96  ·  Issue 35  ·  2016

cryptogenic stroke (CS) refers to ischemic stroke (IS) whose etiology cannot be determined with complete examination methods. Its etiology hypothesis IS based on the theory of remote embolization^[1]。 Atrial fibrillation (AF) is a significant risk factor for embolism and stroke^[2]In the past, it was reported that the detection rate of atrial fibrillation in cryptogenic stroke patients was 4.9% ~9.2%, and with the improvement of equipment, the detection rate can be as high as 25%^[3]。 Therefore, the screening of atrial fibrillation is very critical. A clear etiological diagnosis will not only change the direction of treatment, from antiplatelet therapy to anticoagulation, but also related to the formulation of stroke prevention strategies in this group of people.

To retrospectively investigate the clinical characteristics, risk factors of Cytomegalovirus (CMV) infection in patients with underlying rheumatic diseases.

Clinical records of 263 rheumatic patients with or without CMV infection, hospitalized from March 2011 to June 2014 in Peking University People′s Hospital, were analyzed.Clinical characteristics were summarized and compared in CMV positive and negative groups, to investigate the risk factors for CMV infection.Statistical analyses were conducted with SPSS 20.0 software.

A total of 62 rheumatic patients were found to have CMV infection, with 48 regarded as CMV viremia, 7 diagnosed as CMV pneumonia, while the remaining 7 suffered both CMV viremia and pneumonia.Eleven of 62 patients (17.7%) had a fatal outcome.Systemic lupus erythematosus (SLE) was the most commonly underlying disease (41.9%), followed by Sjögren syndrome (16.1%) and systemic vasculitis (12.9%). Lymphopenia and the reduction of CD4⁺ T lymphocytes, corticosteroids, cyclophosphamide (CTX) or mycophenolate mofetil (MMF), combined use of more than 2 immunosuppressants and other severe underlying infections as risk factors for CMV infection in rheumatic patients.Meanwhile, the total dose of CTX wasn′t different significantly between CMV positive and negative groups.Multivariate analysis revealed that large or pulsed dose of corticosteroids, combined use of immunosuppressants, and severe underlying infections remained independent risk factors for CMV infection.

Lymphocytes, particularly the CD4⁺ T subsets, might play a vital role in the regulation and control of CMV infection.Other underlying infections, undergoing large dose corticosteroids therapy or combined use of immunosuppressants could be the risk factors for CMV infection in rheumatic patients.

To explore the preliminary clinical efficacy and safety of multi-electrode synchronous radiofrequency ablation via switching controller for treating large hepatocellular carcinoma.

A total of 20 patients with large hepatocellular carcinoma from minimally invasive Interventional department of Sun Yat-sen University Cancer Center were enrolled in this retrospective study from December 2013 to December 2014.The procedures were conducted with multi-electrode synchronous radiofrequency ablation via switching controller under CT guidance.The necrosis rate of tumor was assessed by the following imaging examination.The single factor analysis of variance (ANOVA) was employed to compare the total bilirubin, albumin, renal function, blood coagulation function before and after ablation, to evaluate the safety of treatment.

Twenty patients with a total of 31 lesions accepted 23 times ablation procedures using multi-electrode synchronous radiofrequency ablation via switching controller.The recent evaluation after treatment was as followed: complete necrosis rate 51.6% (16/31), nearly complete necrosis rate 22.6% (7/31), partial necrosis rate 9.7% (3/31), treatment effectiveness rate (necrosis rate > 50%) 83.9%.The necrosis rate which was less than half volume of the tumor was only seen in 5 cases with huge hepatocellular carcinoma (16.1%). No dead cases appeared after ablation procedures.The patients′ total bilirubin elevated moderately after ablation procedures and reversed to normal level after liver function protection treatment.There were no statistical differences of renal function and blood coagulation function before and after ablation.After ablation procedures, 5 cases (21.7%, 5/23) appeared fever, 6 cases (26.1%) with vomiting, only 3 cases (13.0%, 3/23) with moderately severe pain in 3 days after ablation and remitted after taking oral analgesics in one week.

The clinical efficacy of multi-electrode synchronous radiofrequency ablation via switching controller for large hepatocellular carcinoma is satisfactory with guaranteed security, which can be a choice for treating large hepatocellular carcinoma.

To initially explore MRI features and its changing trends including of lung tumors after Argon-Helium cryoablation therapy, and enhance the recognition of MR findings of lung tumors postcryoablation.

Twenty-three cases of patients with twenty six nodules of pulmonary malignance who received Argon-Helium cryoablation therapy in Henan Cancer Hospital from July 2014 to January 2016 were enrolled.All patients underwent unenhanced and dynamic contrast-enhanced MRI scans at pre-and 1-day, 1-week, 1-, 3-, 6-, 12-month postcryoablation. Two radiologists independently reviewed MRI images, signal intensity in the ablated zone on T₁WI and T₂WI were assessed by a 5-point scale.The changing trends of size and signal intensity with time were showed by time-maximum diameter and time-score curve.Time-signal intensity curves based on dynamic enhanced sequence were also performed.

Typical MRI findings includes: heterogeneous signal intensity on both T₁WI and T₂WI at 1-day postcryoablation(26/26, 100%). Hyper-intense on T₁WI(22/26, 84.6%) and T₂WI(17/26, 65.4%) with a hypo-intense rim at 1-week postcryoablation.Decreasing signal intensity on T₁WI(17/26, 65.4%) and increasing signal intensity on T₂WI(22/26, 84.6%) at 1-month.Signal intensity declined to the level of muscle on both T₁WI(18/26, 69.2%) and T₂WI(19/26, 73.1%) at 3-month, nineteen ablated zone turned into patchy shape(19/26, 73.1%). The maximum diameter was largest at 1-day and gradually shrunk with time. The mean score value toped at 1-week and gradually decreased. A straight line type without definite enhancement was found from 1-day to 1-month postcryoablation, an inflow curve with a mild delayed enhancement was seen from 3- to 12- month. Totally 4 recurrence (4/26, 15.4%) all occurred at 3-month and were lack of a complete hypo-intense rim at 1-week postcryoablation.

MRI findings of lung tumors postcryoablation are characteristic, a complete hypo-intense rim at 1-week is helpful to determine further recurrence, 1-week to 3-month is an important period to observe significant change of the ablation zone, MRI is valuable in identifying the ablation zone and can reflect its evolution with time.

To evaluate the clinical value of changes of maximum standardized uptake value (SUVmax) in series ¹⁸F-FDG PET/CT imaging before and after chemotherapy for non-small cell lung cancer.

From July 2008 to July 2014, a total of 18 patients with pathological confirmed advanced NSCLC who received systemic chemotherapy were enrolled.¹⁸F-FDG PET/CT scans were performed before, 3-4 weeks after 2-4 cycles chemotherapy, 3-4 weeks after the end of chemotherapy for all patients, and added fourth scan for 3 patients 1 year later.The SUVmax of region of interesting was calculated.The histological diagnosis or clinical findings in a 36 months follow-up period served as the standard of control.

New metastases foci were found by ¹⁸F-FDG PET/CT scans before chemotherapy in 7 of 18 patients.The plans of chemotherapy for 5 patients were changed as therapeutic responses were evaluated according to changes of SUVmax.Targeted therapy was added for 2 patients after the end of chemotherapy.There was a statistically significant difference in outcome of survival analysis between patients performed PET/CT scans and non-performed (P<0.05).

Changes of SUVmax in series ¹⁸F-FDG PET/CT imaging before and after chemotherapy could be used to evaluate therapeutic response and effectively predict survival in patients with advanced NSCLC.

To investigate the different genotype and allele frequency distribution of ADAM33 gene T1, T2, V4, S2 sites Mongolian population, and discuss the relationship between ADAM33 gene polymorphism and bronchial asthma.

From January 2014 to December 2015, a total of 180 cases of Mongolian patients with asthma were detected, compared with 186 cases of healthy Mongolian as controled and screening significant genes.Selected restriction fragment length polymorphism (PCR-RFLP) method to detected ADAM33 gene polymorphism.According to condition , the asthma group was divided into mild(n=83), medium group(n=47)and severe group(n=50). The distribution difference of different genotype and every genotype of V4 FEV1, eosinophils, IgE comparison were compared , and analysis their correlation.

In ADAM33 , the distribution of T1 sites (AA and AG genotypes) had statistical significance compared asthma group with control group(χ²=8.810, 8.294, P<0.05,OR=1.983, 0.500). The OR value of G allele was 0.580.The distribution of S2 site(CC genotype) had statistical significance(χ²=4.277, P<0.05), theOR value of G allele was 1.423.the distribution of V4 sites (GC and GG genotypes) had statistical significance between the two groups (χ²=7.880, 10.313, P<0.05),OR value was 0.459, 2.130, G allele OR value was 1.496.The distribution frequency difference of each genotype in V4 sites in mild, medium and severe group was statistically significant (χ²=16.049, P<0.05), and compared various genotypes of FEV1, IgE, the difference was statistically significant (P<0.05), for each genotype of T2 site in asthma group and the control group there was no statistically significant in the distribution (χ²=1.218, 0.248, 1.287, P>0.05).

T1, V4, S2 locus polymorphism of ADAM33 gene may play a role in the Mongolian asthma population, and T2 locus polymorphism may has no relationship with Mongolian asthma patients.And the genotype polymorphism of V4 sites may be associated with asthma severity.

To investigate the correlation between post-stroke pneumonia and outcome in patients with acute brain infarction.

Consecutive acute cerebral infarction patients who were hospitalized in Department of Neurology, Jinan Military General Hospital were prospectively recruited from August 2010 to August 2014. The baseline data including age, sex, the National Institute of Health Stroke Scale (NIHSS) scores, type of Oxfordshire Community Stroke Project (OCSP: total anterior circulation infarct, partial anterior circulation infarct, posterior circulation infarct and lacunar infarct), fasting blood glucose etc. after admission were recorded. Post-stroke pneumonia was diagnosed by treating physician according to criteria for hospital-acquired pneumonia of the Centers for Disease Control and Prevention. Recovery was assessed by modified Rankin Scale (mRS) 180 days after stroke by telephone interview (mRS≤2 reflected good prognosis, and mRS>2 reflected unfavorable prognosis). Multinominal Logistic regression analysis, Kaplan-Meier curve and log rank test were used.

A total of 1 249 patients were enrolled, among them 173 patients were lost during follow-up. A total of 159 patients had post-stroke pneumonia, while 1 090 patients were without post-stroke. Compared with patients without post-stoke pneumonia, patients with post-stroke pneumonia were older (67±13 vs 63±12 years, P=0.000), more severe (NIHSS, 15(14) vs 4(4), P=0.000). Compared with patients without post-stoke pneumonia, more patients with post-stroke pneumonia suffered from heart failure (12.58% vs 3.40%, P=0.000), atrial fibrillation (26.42% vs 8.81%, P=0.000), myocardial infarction (10.06% vs 5.05%, P=0.016), recurrent brain infarction (30.19% vs 22.66%, P=0.045), total anterior circulation infarct type of OCSP (46.54% vs 19.63%, P=0.000), posterior circulation infarct of OCSP (39.62% vs 25.51%, P=0.001); more patients suffered from disorder of consciousness (60.38% vs 9.27%, P=0.000), dysphagia (34.59% vs 19.89%, P=0.000), vomiting (26.42% vs 8.81%, P=0.000), aphasia (35.85% vs 16.61%, P=0.000) since onset. The morbidity of post-stroke pneumonia among patients with unfavorable outcome (29.37%(111/378)) was significantly higher than that among patients with favorable outcome (3.73%(26/698)) (P=0.000). Post-stroke pneumonia was an independent prognostic factor for long-term unfavorable outcome (OR=2.414, 95%CI: 1.336-4.361, P=0.004) and long-term mortality (OR=2.132, 95%CI: 1.229-3.699, P=0.007). According Kaplan-Meier estimation, the cumulative 180 days survival of patients with post-stroke pneumonia was lower than those without post-stroke pneumonia (62.04%(85/137) vs 93.29%(876/939)); Log-rank test: χ ²=137.32, P=0.000.

Acute brain infarction patients with post-stroke pneumonia are older, more severe; more suffering from heart failure, atrial fibrillation, myocardial infarction; more suffering from disorder of consciousness since onset. Post-stroke pneumonia is an independent prognostic factor for long-term unfavorable outcome and for long term mortality in patients with acute brain infarction.

To investigate the effectiveness and advantage of improved microsurgery for fulminant hemorrhagic dilation of the fourth ventricle.

The clinical data of 21 patients with fulminant hemorrhagic dilation of the fourth ventricle were analyzed retrospectively.All patients underwent hemorrhage evacuation and improved atlantooccipital decompression via middle suboccipital trans-cerebellar vermis approach, with preceding external ventricular drain.

One patient died of brainstem failure postoperative, and 20 patients were followed up from 6 to 17 months.There were 8 patients whose KPS exceeded 90, 6 patients whose KPS were 60 to 90, 4 patients whose KPS were 30 to 60, and two patients whose KPS were lower than 30.There was no recurrence of hydrocephalus and posterior fossa fluid.

The improved microsurgery for fulminant hemorrhagic dilation of the fourth ventricle not only could effectively raise the success rate of salvage, but also greatly reduce postoperative complications compared with traditional mode.

To compare the clinical efficacy of the direct anterior approach (DAA) and the posterolateral approach (PLA) for total hip arthroplasty (THA) in the lateral decubitus position.

From July to December, 2014, 104 patients randomly divided into two equal groups of the DAA group and the PLA group underwent unilateral primary THA procedures.All procedures were performed by the same surgeon in the Department of Orthopaedics, the Affiliated Anhui Provincial Hospital of Anhui Medical University.General data, perioperative index, postoperative function and radiological evaluation were recorded and statistically analyzed.

The patients had an average follow-up of 14 (range, 10-16) months.No significant differences were detected with respect to the operation time, incision length, preoperative Hb concentration and transfusion rate between two groups (P> 0.05 for all comparisons). However, there were significant differences associated with the intraoperative bleeding, postoperative drainage and postoperative Hb concentration in the two groups(P<0.05 for all comparisons). The DAA group showed significant superior outcomes compared with the PLA group in the Harris hip scores [(83.6±7.1) vs (79.8±6.6),P<0.05], WOMAC[ (28.9±6.1) vs (36.1±6.9),P<0.001], and VAS pain scores[ (2.2±0.9) vs (2.9±1.1),P<0.05]at 1 month after surgery. No differences were seen between the study groups in the evaluation of radiography and the incidence of adverse event (P> 0.05 for all comparisons).

Compared with the posterolateral approach, the present study shows the exciting results in patients underwent the DAA THA in the lateral decubitus position at early follow-up.The advantages of THA using the DAA include less operative trauma, alleviation of postoperative pain, and faster postoperative rehabilitation. It is a safe, reliable and effective surgery approach.

To assess the pain control efficiency of continuous adductor canal block in total knee arthroplasty.

From October to December 2015, patients with severe knee osteoarthritis undergoing primary unilateral TKA were observed clinically.All of the patients received ultrasound-guided continuous adductor canal block after surgery.NPRS Pain score in rest and activity at 2, 6, 12, 24, 48 h after surgery were collected, preoperative and postoperative quadriceps strength at 24, 48 h were analyzed. Opioids consumption and anesthesia related adverse effects were also recorded.

All of the patients were enrolled. Rest pain control was fairly good(1.8±1.5), (2.4±1.5), (2.7±1.3), (2.7±1.7), (2.3±1.4) score, but the patients were not satisfied with activity pain control(3.1±2.1), (3.1±2.1), (4.2±2.2), (4.7±2.5), (6.2±2.4) score. There were statistically differences comparing the NPRS in rest pain with the score in activity, except for the results between each other at 6 hours (P=0.252>0.05)after surgery.The results showed no significant differences comparing quadriceps strengthpreoperatively with 24, 48 h postoperatively by repeated measurements variance analysis.Eight patients acquired additional use of dolantin once (100 mg/per time) within 24 h and among them three patients acquired once dolantin during 24 to 48 h. Eleven patients complained nausea postoperatively, one reported vomiting and one experienced xerostomia.

Ultrasound-guided continuous adductor canal block can reduce resting pain after TKA, but has a limited effect in activity pain control.Quadriceps strength had been spared after ACB, which might performearly benefits in rehabilitation. ACB-related complications need further observation to be defined.

To explore the relationship between fetal radius loss and chromosomal abnormalities.

Collect data of 3 100 cases pregnant women who had been checked in the second hospital of Jilin University from 2012 to 2015.There were 8 cases of absent radius, except 1 case of fetal lost follow-up, the remaining 7 cases had complete ultrasound, chromosome examination and the result of induction.The relationship between fetal radius loss and chromosomal abnormalities were analysed.

There were 1 case of 21 trisomy syndrome, 1 case of trisomy 13 syndrome, 2 cases of trisomy 18, 2 cases of chromosome translocation, 1 case of normal chromosome result and 1 case was lost to follow-up of the 8 absent radius fetuses.

Through a comparison between the chromosome and ultrasonic characteristics of fetuses who have absent radius, we had indicated the relationship of fetal radius deletion and chromosomal anomaly, improved the positive rate of chromosome invasion examination, and provided the reference for eugenics.

To evaluate the level of lexiscan-induced blood-brain barrier opening of healthy rabbits via CT perfusion weighted imaging (PWI) scan.

Between November 2014 and May 2015, thirty New Zealand white rabbits were randomly assigned into three groups: the experimental group A1 which received one injection of lexiscan(1 ml/kg); the experimental group A2 which received three times injection of lexiscan(total dose: 1.5 ml/kg), finished within 15 minutes; the control group B which was injected the same volume normal saline(1 ml/kg), after 30 minutes, CT PWI scan was performed. Then cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and permeability surface(PS) of the region of interest of each group were acquired and compared statistically. Five cases of each group were injected with 2% Evans blue intravenously posterior to imaging. After one hour of infusion, all the animals were killed. Their brains were examined for the determination of Evans blue distribution.

Both the values of CBF and CBV and the staining with Evans blue of the group A1(CBF: (89.88±2.21), (81.42±4.28) ml·(100 g)^-1·min^-1; CBV: (3.97±0.43), (3.66±0.16) ml/g)and group A2 (CBF: (75.16±0.84), (63.66±7.21) ml·(100 g)^-1·min^-1; CBV: (4.07±0.01), (3.75±0.05) ml/g) were higher than those of the group B(CBF: (20.08±5.08), (14.58±8.62) ml·(100 g)^-1·min^-1; CBV: (0.85±0.04), (0.65±0.17) ml/g), the differences were all statistically significant (all P<0.01). While there was no statistically difference between group A1 and group A2(P>0.05). The value of PS of the group A2((22.43±8.09), (20.20±7.01)ml·(100 g)^-1·min^-1 )was higher than that of group A1((13.82±4.44), (10.12±2.44)ml·(100 g)^-1·min^-1) and group B(0.00, 0.00)(the lowest one), the differences were all statistically significant(all P<0.01). The value of MTT of the group A1((2.50±0.82, 2.47±0.10) s) had no statistical difference with group A2 and group B, while the value of group A2((4.50±0.17), (4.72±0.15) s) was higher than that of group B((1.88±0.09), (1.99±0.00) s), the differences were all statistically significant (P<0.05).

Changes in hemodynamics of lexiscan-induced blood-brain barrier opening can be monitored by CT PWI scan. When the total dose of lexiscan increasing, the level of the BBB opening is higher with significantly increased CBF, CBV, PS and MTT.

To explore the influences of body mass index (BMI) on blood pressure control rate in elderly coronary heart disease (CHD) outpatients with hypertension.

In this multicenter, non-intervention and cross-sectional survey, the elderly coronary heart disease patients with hypertension aged 60 years or over were recruited from 165 hospitals in 21 provinces or cities across China from April to July 2011, and 5 140 cases of elderly CHD patients with hypertension were finally included into the study. The cases were divided into low BMI group (n=130 cases), normal body mass index (BMI) group (n=1 390 cases), overweight (n=2 418 cases), obesity group (n=662 cases) according to the different levels of BMI. Clinical data and blood pressure control rate were compared among the groups, and relationships of different BMI levels with blood pressure control rate were analyzed by the binary classification unconditioned Logistic regression equation.

There was a statistically significant difference in blood pressure control rate of general population, men and women patients among low BMI group, normal BMI group, overweight and obesity group (χ²=66.346, 58.995, 26.044, respectively, P<0.001), blood pressure failure rate in obesity group (73.7%) was higher than that in overweight group (65.8%) and normal BMI group (57.5%) (P<0.05), and overweight group was also higher than normal BMI group (P<0.05); blood pressure failure rate in obesity men was higher than that in normal BMI and low BMI group (P<0.05), overweight group was higher than normal BMI group (P<0.05); blood pressure failure rate in obesity women was higher than that in normal BMI and low BMI group (P<0.05). There was a statistically significant difference in blood pressure control rate of different age groups (60-70, 71-80, >80 years old) among low BMI group, normal BMI group, overweight and obesity group (χ²=37.729, 20.007, 15.538, respectively, P<0.001). Blood pressure failure rate in obesity patients with 60-70 years old was higher than that in overweight and normal BMI group (P<0.05), blood pressure failure rates in obesity and overweight patients with 71-80 and > 80 years old were also higher than those in normal BMI group (P<0.05). Multivariable Logistic regression equation showed that overweight in overall population (OR=1.313, 95%CI 1.170-1.731, P<0.05), obesity (OR=2.295, 95%CI 2.295-1.496, P<0.05) were independent risk factors for blood pressure failure rate, in addition, obesity was also risk factor for blood pressure failure rate in men and women patients.

Increased BMI has an adverse effect on blood pressure control rate in elderly CHD outpatients with hypertension, and may be the independent risk for blood pressure failure rate in those patients. Much more attention should be given to control BMI level so as to increase the blood pressure success rate and improve the patients′ prognosis.

A 40-year-old female, unemployed, was admitted to the hospital on August 24, 2015 mainly due to "headache and fever for 3 months". The patient developed headache 3 months before admission (end of May 2015), which was intermittent and could be improved by rest. The self-measured body temperature was lower than 38℃ once, and no diagnosis and treatment were made. Two and a half months ago (June 3), the headache worsened and the body temperature was low fever (37~37.9 ℃). Local head CT showed no abnormalities and no treatment. Two months ago (June 22, 2015), he was hospitalized in a hospital in Hubei Province, and was given lumbar puncture examination and anti-infective and antiviral treatment (details unknown), but his symptoms did not improve. Six days later (June 28, 2015), the body temperature reached 38.5℃, and the next day, he was transferred to an affiliated hospital of a university and diagnosed as "meningitis and otitis media". The head MRI examination was completed, meningitis was considered, and "antibacterial and antiviral" treatment was given for 11 days (piperacillin and sulbactam sodium 5.0 g, twice/d; ganciclovir 0.25 g, once/d). The body temperature dropped to normal, and the headache was slightly relieved. After continuing treatment for 10 days, he had fever and headache again, and changed to ceftazidime 2.0 g, twice/d, teicoplanin 0.4 g, once/d, for 2 days. At this time, the body temperature reached 39 ℃, and the headache was not relieved. One month ago (July 20, 2015), I was transferred to a hospital in Hubei Province. My body temperature fluctuated from 37.5 to 38℃. I was diagnosed with "tuberculous meningitis". I was given meropenem 0.5 g, once/8 h, three times/d for 7 days, levofloxacin 0.2 g, twice/d for 25 days, isoniazid injection 0.5 g, once/d for 22 days, oral pyrazinamide 0.5 g, three times/d, rifampicin 0.45 g, once/d, dexamethasone 10 mg, once/d for 7 days, reduced to 5 mg, once/d for 6 days, my body temperature gradually dropped to normal, and my headache was relieved. After stopping dexamethasone, the patient intermittently developed low fever, up to 37.9℃, accompanied by afternoon sweating, and headache was more obvious than before. Reexamination head MRI + enhancement: left fissure meningeal enhancement, and the lesion was enlarged compared with the previous Mingqian. For further diagnosis and treatment, I came to Xuanwu Hospital of Capital Medical University. Since the onset of the disease, I ate normally and lost about 5 kg of weight. Past history: 39 years of history of otitis media in the left ear. Family history: father is deceased and has suffered from tuberculosis.

Early diagnosis of ovarian epithelial cell carcinoma is difficult, and it is difficult to distinguish benign and malignant by other methods except pathological diagnosis. 70% of ovarian epithelial cell carcinoma have reached the advanced stage when diagnosed. The prognosis of ovarian epithelial cell carcinoma is extremely poor, and effective treatments include cytoreductive surgery, paclitaxel and platinum-based chemotherapy. Approximately 80% of patients with ovarian epithelial cell carcinoma relapse after the initial treatment described above^[1]。 Therefore, there is an urgent need for a new marker to detect ovarian epithelial cell carcinoma early, so as to better understand its molecular biological characteristics and give more suitable and effective treatment. Although CA125 is currently widely used as a serological marker to evaluate the therapeutic effect of ovarian epithelial cell carcinoma and as a disease follow-up method after first-line treatment, it has limitations in guiding personalized treatment and cannot provide effective information for second-line treatment. Tumor circulating cells are active tumor cells released from the primary tumor, which can lead to tumor recurrence in situ or distant metastasis through the circulatory system. These cells have tumor-specific genotypes and phenotypes that can grow in new microenvironments. Many previous studies have shown that tumor circulating cells have prognostic significance in many solid tumors, such as breast cancer, colon cancer, stomach cancer, lung cancer, and prostate cancer. Detection of tumor circulating cells in the peripheral blood of patients with ovarian epithelial cell carcinoma has proven feasible^[2]However, the positive rate and median of tumor circulating cells in ovarian epithelial cell carcinoma are lower than those in other malignancies, such as metastatic breast cancer. Because distant metastasis of ovarian epithelial cell carcinoma only occurs in 1/3 of patients, and most of them occur in the advanced stage of the disease, the low detection rate may be due to the fact that most patients do not have enough tumor cells in their blood at the time point of detection to evaluate their clinical relevance.

Resveratrol (RSV) is a polyphenol phytoestrogen, mainly derived from grape, red wine, peanut and other plants. Its main biological effects include anti-inflammatory, anti-cancer, anti-aging and improving bone repair^[1,2,3,4]Etc. Mesenchymal stem cells (MSCs) exist widely in various tissues of the whole body, and have strong proliferative ability and multidirectional differentiation potential. Because of their wide source, low immunogenicity and strong osteogenic ability, MSCs are now regarded as ideal seed cells for bone injury repair and bone tissue engineering.