[Ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes based on Robson classifications]

Objective: To investigate the ratio of transfer cesarean section after trial of labor and maternal-fetal outcomes based on Robson classifications. Methods: The delivery data by cesarean section in Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2009 to December 31st, 2015 (gestational age ≥28 weeks and newborn birth weight >1 000 g) were retrospectively collected. The ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes were analyzed by weighted adverse outcome score in different Robson classifications. Results: (1) The highest ratio of transfer cesarean section after trial of labor was classification 9 (all abnormal lies, including previous cesarean section and breech were excluded) reached 47.31% (431/911) , followed by classification 2 (nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation who had labour induced) accounted for 44.90%(409/911). (2)The tops of weighted adverse outcome score of transfer cesarean section after trial of labor were classification 10 (single cephalic pregnancy at <37 weeks gestation, including women with previous cesarean delivery) 24.55, classification 5 (single cephalic pregnancy multiparous women, with at least one previous cesarean delivery, ≥37weeks gestation) 3.64. Conclusion: Carefully evaluating the delivery mode and emphasizing the intrapartum management in nulliparous women with a single cephalic pregnancy, at ≥37 weeks gestation who had labour induced and trial of labor after cesarean section is essential to reduce the risk of adverse outcomes in transfer cesarean section after trial of labor.

[Potential value of FDG PET-CT in predicting occult lymph node metastasis in clinical stage ⅠA lung adenocarcinoma]

Objective: To investigate the predictive value of (18)F-FDG PET-CT scan for occult lymph node metastasis in patients with stage ⅠA lung adenocarcinoma. Methods: The image and pathological data of 272 patients with stage ⅠA lung adenocarcinoma from October 2006 to September 2015 were retrospectively analyzed. All patients underwent preoperative (18)F-FDG PET-CT scan followed by lobectomy and systematic lymph node dissection. The correlation between occult lymph node metastasis and the maximum standardized uptake value (SUV(max)) of primary tumor as well as other clinicopathological factors was analyzed to screen the risk factors of occult lymph node metastasis in stage ⅠA lung adenocarcinoma. Results: Occult lymph node metastasis was detected in 50 patients (18.4%), with 24 (8.8%) patients of pN1 involvement and 26 (9.6%) of pN2 involvement. Among the 272 patients enrolled, 39 had pure ground glass nodule, 59 had part-solid nodule and 174 had solid nodule. All patients with pure ground glass nodule or nodule≤1 cm were pN0. For the 233 patients with part-solid and solid nodule, no lymph node metastasis was found in T1a stage (tumor length ≤1 cm). Primary tumor SUV(max) (Z=-5.663, P<0.001), nodule type (χ(2)=21.586, P<0.001), tumor location (χ(2)= 12.790, P< 0.001), histological grade (χ(2)= 22.784, P< 0.001) and visceral pleural invasion (χ(2)=5.357, P=0.021) showed significant differences between occult lymph node metastasis group (pN+ ) and non-lymph node metastasis group (pN0). With SUV(max)=2.405 as cut-off value, the sensitivity and specificity for predicting occult lymph node metastasis were 90.0% and 61.7%, the area under curve was 0.761(95%CI=0.700~0.823), and the negative predictive value was 95.8%. Multivariate analysis revealed that SUV(max) >2.405 (P<0.001), central location (P=0.030) and higher histological grade (P=0.024) were independent predictors of occult lymph node metastasis. Conclusions: For clinical stage ⅠA adenocarcinoma, primary tumor SUV(max) > 2.405, central location and higher histological grade were independent risk factors for occult lymph node metastasis. Systematic lymph node dissection may be avoided in lung adenocarcinoma with pure ground glass density, tumor length ≤1 cm or SUV(max) ≤ 2.405, due to the very low probability of nodal involvement.

[Evaluating inferior vena cava wall invasion in renal cell carcinoma tumor thrombus with MRI]

OBJECTIVE

To evaluate the diagnostic performance of MRI for the assessment of inferior vena cava (IVC) wall invasion by IVC thrombus in patients with renal cell carcinoma (RCC).

METHODS

We retrospectively collected patients who underwent radical nephrectomy and thrombectomy for RCC between 2010 and 2018 at Peking University First Hospital. All the patients underwent imaging on a 1.5 Tesla or 3.0 Tesla MRI scanner. Fifty-six patients met the inclusion criteria. Preoperative imaging was reviewed by two radiologists blinded to details of the patient's surgical procedure and histopathology. Two radiologists measured the maximum anterior-posterior diameter and coronal diameters of the IVC and renal vein, and the craniocaudal extent of tumor thrombus, and evaluated the MRI features of IVC thrombus, including occlusion of the IVC lumen, the margin of the tumor thrombus (smooth vs. irregular), contact of the IVC thrombus and IVC wall, and altered signal of the IVC wall. Univariable and multivariable associations of clinical and radiographic features with IVC wall invasion were evaluated by Logistic regression.

RESULTS

Of the 56 patients [male: 43, female: 13, mean age: (55.64±0.43) years], 17 (30.36%) were detected with IVC wall invasion, and most were clear cell carcinoma. Tumor thrombus with IVC wall invasion showed an increase in length of IVC thrombus [(7.91±3.59) cm vs. (5.94±3.57) cm, P=0.049], and more features of complete occlusion of the IVC lumen (P=0.002), irregular margin of the IVC thrombs (P=0.005), contact of the IVC thrombus and IVC wall (P=0.001), and altered signal of the low-intensity vessel wall (P<0.001), with a sensitivity of 94.12% and a specificity of 79.49%.

CONCLUSION

The present study indicates that MRI could be a means of evaluating RCC with IVC wall invasion, and the combination of tumor thrombus length and subjective impression of IVC wall invasion achieved a high sensitivity and specificity for diagnosis.

[Philadelphia chromosome-negative myeloid neoplasms in patients with Philadelphia chromosome-positive chronic myeloid leukemia during tyrosine kinase inhibtor-therapy]

Objective: To compare the clinical features between the 2 cohorts developing myelodysplastic syndrome or acute myeIogenous Ieukemia in Philadelphia chromosome-negative cells (Ph(-) MDS/AML) and maintaining disease stable in the patients with Philadelphia chromosome-positive chronic myeloid Ieukemia (Ph(+) CML) who had clonal chromosomal abnormalities in Philadelphia chromosome-negative metaphases (CCA/Ph(-)) during tyrosine kinase inhibtor (TKI) - therapy. Methods: We retrospectively analyzed Ph(+) CML patients who developed CCA/Ph(-) during TKI-therapy from May 2001 to December 2017. Results: Data of CCA/Ph(-) 63 patients, including 7 progressing to Ph(-) MDS/AML and 56 remaining disease stable were collected. Compared with those with stable disease, patients with Ph(-)MDS/AML had lower hemoglobin (P=0.007) and platelet (P=0.006) counts, and higher proportion of peripheral blasts (P<0.001) when the first time CCA/Ph(-) was detected, and more mosonomy 7 abnormality (5/7, 71.4%) when MDS or AML was diagnosed; meanwhile, trisomy 8 (32/56, 57.1%) was more common in those with stable disease. Outcome of the patients with Ph(-) MDS/AML were poor. However, most of those with CCA/Ph(-) and stable disease had optimal response on TKI-therapy. Conclusions: A few patients with Ph(+) CML developed CCA/Ph(-) during TKI-therapy, most of them had stable disease, but very few patients developed Ph(-) MDS/AML with more common occurrence of monosomy 7 or unknown cytopenia. Our data suggested the significance of monitoring of peripheral blood smear, bone marrow morphology and cytogenetic analysis once monosomy 7 or unknown cytopenia occurred.

[Characteristics of initial diagnosis in autoimmune liver disease: an 18-year, retrospective single-center study]

Objective: To analyze the chorological changes of diagnosis in patients with autoimmune liver disease (AILD) and related factors for early diagnosis. Methods: A total of 581 patients with age ranged from 16 to 81 were retrospectively analyzed, who were admitted to Tianjin Medical University General Hospital with AILD during January 2000 to December 2017. Age at diagnosis, diagnostic method and cirrhosis at diagnosis were compared in different groups according to admission period as 2000-2005, 2006-2011, 2012-2017. Results: The diagnostic rate of AILD showed an upward trend during the past near two decades. The proportion of AILD patients diagnosed via health examination was increasing year by year mainly by elevated transaminases (P<0.001). The mean age at diagnosis in our AILD patients were younger at present, especially in men (P=0.044). The proportion of cirrhosis at diagnosis was gradually reduced in three different periods respectively [77.78%(21/27), 41.58% (79/190), 25.00%(91/364), P<0.001], which were coincident in patients with autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) (P<0.001). The shrinking trend of cirrhosis at diagnosis was significantly correlated with the increasing application of health examination (r=-0.549, P<0.001). Conclusions: Extensive application of health examination expands the diagnostic rate of AILD. During the past 18 years, more young patients are diagnosed with AILD. The proportion of severe cases such as cirrhosis at diagnosis is decreasing. Screening of immunological examinations in patients with abnormal transaminases is needed and critical to the early diagnosis of asymptomatic AILD.

[Application of optical coherence tomography angiography in evaluation of retinal microvascular changes in patients with obstructive sleep apnea syndrome]

Objective: To assess the changes of retinal microvasculature in patients with obstructive sleep apnea syndrome (OSAS) evaluated by optical coherence tomography (OCTA). Methods: Adult OSAS patients who visited Beijing Tongren Hospital from Jan 2016 to Apr 2016 and complained of snoring were included in this study. The patients' general information, results of polysomnography, and OCTA parameters were collected. Patients were divided into three groups according to their apnea hypopnea index (AHI) results: Mild-moderate group, AHI≤30/h; Severe group, 30/h<AHI≤60/h; Extremely severe group, AHI>60/h, and clinical characteristics, polysomnography and OCTA parameters among the three groups were compared. Results: A total of 27 patients were included in this study with 21 males (77.8%) and 6 females (22.2%). Mean age was (41.7±10.0) years, and the mean body mass index was (27.9±4.5) kg/m(2;) Neck circumference was 31-48 cm, mean (39.8±4.3) cm; 8 patients (29.6%) suffered from hypertension that could be controlled; Epworth sleepiness scale scored 1-18 points and mean (8.5±4.4) scores; AHI ranged between 5.5 and 92.1/h with a mean of (46.4±28.6)/h. There were 9 (33.3%), 7 (25.9%), and 11 (40.7%) patients in mild-moderate group, severe group, and extremely severe group, respectively. Compared with severe group, the optic nerve head and radial peripapillary capillaries (RPC) peripapillary vascular density in extremely severe group were significantly decreased (62.4%±1.9% vs 60.3%±1.9%, P=0.041; 64.7%±1.7% vs 62.2%±2.3%, P=0.036). Conclusions: OCTA has rapid, safe, and objective characteristics in assessing the retinal microvascular changes in OSAS patients. Retinal microvascular damage in patients with OSAS is associated with the disease severity. Reduction of retinal microvascular density in patients with OSAS may be associated with intermittent hypoxia.

[The relationship between dietary pattern and serum C-reactive protein concentration]

In order to explore the relationship between dietary pattern and C-reactive protein (CRP) in Xiamen residents, 2 904 subjects from 3 districts of Xiamen City were selected by a multi-stage stratified random sampling method. The food frequency questionnaire was used for dietary survey and serum CRP concentration was determined simultaneously. The dietary model was established by factor analysis and the relationship between different dietary patterns and serum CRP concentration was analyzed. Five dietary patterns were obtained by the factor analysis. After the adjustment of gender, age, occupation, education, marriage status, income, smoking, drinking and body mass index, the healthy dietary pattern was negative associated with the serum CRP concentration [OR(95%CI):0.62(0.42-0.90)]. The Serum CRP concentration of residents with a healthy dietary pattern is lower.

[Laparoscopic versus open surgery for simultaneous resection of synchronous colorectal liver metastases]

Objective: To compare the short-term outcomes and long-term outcomes between open and laparoscopic approaches for simultaneous resection of primary colorectal cancer and synchronous liver metastases. Methods: Patients underwent simultaneous resection of primary colorectal cancer and synchronous liver metastases at Department of General Surgery, Huashan Hospital, Fudan University between January 2014 and October 2017 were included.The totally laparoscopic surgery patients were matched 1∶1 based on propensity score to the open surgery patients.Continuous and categorical variables were compared using non-parametric Mann-Whitney U test and Fisher exact test.Survival curves of overall survival(OS) and disease-free-survival(DFS) were plotted by Kaplan-Meier method, and compared according to Log-rank test. Results: A total of 41 patients were included. After propensity score matching, 12 patients fell into each of the two groups(totally laparoscopic approach group and open approach group). Baseline characteristics were similar between the two groups.There was no difference regarding the to the proportion of major liver resection.Statistically significant difference was observed in term of intra-operative blood loss (250 ml vs.450 ml, Z=-2.005, P=0.045) and fluid infusion(2 430 ml vs. 3 150 ml)(Z=-2.488, P=0.012). Post-operative stay and overall morbidity were similar between the two groups.However, adverse event worse than Clavien-Dindo Ⅱ morbidity did not occur in the laparoscopic approach group.No postoperative mortality happened in either group within 30 days of surgery. Regarding to long-term outcomes, OS and DFS were similar between the two approaches. Conclusion: Laparoscopic approaches for simultaneous resection of primary colorectal cancer and synchronous liver metastases may be associated with reduced blood loss, without adversely affecting long-term outcomes in selected patients.

Risk factors and a predictive nomogram for non-sentinel lymph node metastases in Chinese breast cancer patients with one or two sentinel lymph node macrometastases and mastectomy

Background

Two ongoing prospective randomized trials are evaluating whether omitting axillary lymph node dissection (alnd) in patients with breast cancer (bca) and sentinel lymph node (sln) macrometastases undergoing mastectomy is safe. Determining predictive risk factors for non-sln metastases and developing a model to predict the probability of those patients having non-sln metastases is also important.

Methods

This retrospective study enrolled 396 patients with bca and 1-2 slns with macrometastases who underwent alnd and mastectomy between January 2012 and December 2016. Factors influencing the non-sln metastases were determined, and a predictive nomogram was formulated. Performance of the nomogram was evaluated by its area under the curve (auc).

Results

We developed a predictive nomogram with an auc of 0.81 (cross-validation 95% confidence interval: 0.75 to 0.86) that included 4 factors (tumour size, histologic grade, and number of negative slns and axillary lymph nodes on imaging).

Conclusions

Our predictive nomogram assesses the risk of non-sln metastases in patients with bca and 1-2 sln macrometastases undergoing mastectomy.

Scale law of complex deformation transitions of nanotwins in stainless steel

Understanding the deformation behavior of metallic materials containing nanotwins (NTs), which can enhance both strength and ductility, is useful for tailoring microstructures at the micro- and nano- scale to enhance mechanical properties. Here, we construct a clear deformation pattern of NTs in austenitic stainless steel by combining in situ tensile tests with a dislocation-based theoretical model and molecular dynamics simulations. Deformation NTs are observed in situ using a transmission electron microscope in different sample regions containing NTs with twin-lamella-spacing (λ) varying from a few nanometers to hundreds of nanometers. Two deformation transitions are found experimentally: from coactivated twinning/detwinning (λ < 5 nm) to secondary twinning (5 nm < λ < 129 nm), and then to the dislocation glide (λ > 129 nm). The simulation results are highly consistent with the observed strong λ-effect, and reveal the intrinsic transition mechanisms induced by partial dislocation slip.

[Effects of electrospun collagen nanofibrous matrix on the biological behavior of human dental pulp cells]

OBJECTIVE

To compare cell adhesion, proliferation and odontoblastic differentiation of human dental pulp cells (hDPCs) on electrospun collagen nanofibrous matrix (Col_NFM) with that on collagen flat film (Col-FF), to investigate the biological effect of collagen nanofibrous matrix on hDPCs.

METHODS

The surface morphology of the two different collagen scaffold was analyzed by scanning electron microscopy (SEM), and the contact angle and the swelling ratio were also measured. Then hDPCs were implanted on the two different collagen scaffolds, the cell morphology was observed using SEM and laser scanning microscope (LSM), and cell proliferation was evaluated by the CCK-8 assay. After hDPCs cultured on the two different collagen scaffold with odontoblastic medium for 14 days, the expression of odontoblastic differentiation related genes was detected by real-time PCR, and alizarin red staining was used to test the formation of mineralized nodules.

RESULTS

From the SEM figures, the fibers' diameter of Col_NFM was (884±159) nm, and there were abundant three dimensional connected pore structures between the fibers of Col_NFM, while the surface of Col_FF was completely flat without pore structure. The contact angle at 0 s of Col_NFM was 85.03°±4.45°, and that of Col_FF was 98.98°±5.81°. The swelling ratio of Col_NFM was approximately 3 folds compared with dry weight sample, while that of Col_FF was just 1 fold. Thus Col_NFM indicated better hydrophilicity and swelling property. SEM and LSM showed that hDPCs on Col_NFM presented an irregular and highly branched phenotype, and could penetrate into the nanofibrous scaffold. In contrast, the cells were spread only on the surface of Col_FF with a spindle-shaped morphology. CCK-8 assays showed that hDPCs on Col_NFM showed higher proliferation rate than on Col_FF. After hDPCs were cultured on the two different collagen scaffolds with odontoblastic medium for 14 days, more expressions of odontoblastic differentiation related genes, such as dentin sialophosphoprotein (DSPP) and dentin matrix proten-1 (DMP1) were determined in Col_NFM group (P<0.05), and more mineralization depositions were also observed in Col_NFM group according to the results of alizarin red staining.

CONCLUSION

Col_NFM with nanoscale microstructure achieves better hydrophilic and swelling properties than Col_FF, and hDPCs cultured with Col_NFM present higher activity on cell adhesion, proliferation and odontoblastic differentiation.

[A retrospective analysis of CO(2) laser and microdebrider for the treatment of severe juvenile on-set recurrent respiratory papillomatosis]

Objective: Juvenile on-set recurrent respiratory papillomatosis (JORRP) can be an aggressive and potentially life-threatening disease. To emphasize the importance of complication prevention in local excision surgery, the single-center experience of RRP treatment in a group of patients with relatively short recurrence-free-interval (>4 times/yrs) was reported. Methods: Data of 49 patients underwent papilloma resection during 2002-2013 were retrospectively analyzed. Combined techniques of laser microsurgery and microdebriders were used to remove papillomas, prevent the formation of scar tissue and improve respiratory distress. Forty-nine cases were followed up for 99.0[74.5; 121.0]months, ranging from 39 to 185 months. The age of disease onset was 2[1; 3] years old. Most of the patients had difficulty in breathing(42 of 49 cases). Seven patients had hoarseness.53.0% patients had subglottic or trachea papillomatosis spreading. The rate of complications, synechia formation, tracheal stenosis, needing for tracheostomy, mortality was recorded. Patients were followed up for at least three years. The characteristics of the patients, improvement in symptoms, recurrence-free interval, and the rate of tracheal extubation were evaluated. Wilcoxon signed ranks test and chi-square test were used for data comparation. Results: Long-term relieve in disease(≤2 surgeries were needed/year) were achieved in 29(59.1%) subjects, in which 8(16.3%) of the subjects did not need surgical treatment for at least 3 years. Long-term relieve had been achieved in 25 of subjects who did not accept tracheostomy. Seven subjects did not need surgical treatment for at least 3 years. The rate of successful tracheal extubation was 53.8% in 13 patients who had undergone tracheostomy. Three cases dead of intrapulmonary spread. Conclusions: Combined techniques of laser microsurgery and microdebriders are effective in improvement in both respiratory distress and voice quality. The combined technique are helpful to avoid inevitable long-term stenotic complications, ultimately affecting the quality of life.

[Oncolytic property of HSV-1 recombinant viruses carrying the human IL-12]

Objective: Constructed the recombinant HSV-1 deleted ICP47 and inserted human IL-12, and investigate the virus' replication ability and oncolytic property in vitro and vivo. Methods: The recombinant HSV-1 deleting ICP47 (MH1005) and then inserting human IL-12 (MH1006) were obtained with bacterial artificial chromosome technology.The replication ability and the efficiency of inhibiting tumor were detected in several nerve tumor cell lines infected with HSV-wt, MH1005 and MH1006 respectively.The murine tumor model was established by subcutaneous inoculation Neuro-2a cells on both sides of mice back respectively.A dosage of 2×10(6) PFU of HSV-wt, MH1001(recombinant HSV-1 deleted IR), MH1005, MH1006 and Mock were injected 3 times intratumorally on one side of mice back in every 3 days, the tumor volume and survival rate of the mice were measured. Results: The replication abilities of MH1005, MH1006 and HSV-wt in 293FT cells were insignificant (P>0.05); the replication abilities of recombinant HSV-1 in G422 and Neuro-2a were higher than that in SK-N-SH; and the nerve tumor cells could be inhibited significantly by recombinant HSV-1.After 15 days of treatment, on the mouse backside with injection treatment, the tumor volumes of group HSV-wt (6 267±484), MH1001 (5 730±1 071), MH1005 (4 537±538)and MH1006 (4 150±476)mm(3) were smaller than that of group Mock (6 957±722) mm(3) significantly (all P<0.01); on the mouse backside without injection treatment, the tumor volumes of group MH1005 (5 952±607) and MH1006 (5 473±661) mm(3) were smaller than those of HSV-wt (6 785±1 063), MH1001 (6 774±808) and Mock (6 957±190) mm(3) significantly (all P<0.05); after 35 days of treatment, the mice survival rates of group MH1005 (100%) and MH1006 (100%) were higher than those of MH1001 (67%), HSV-wt (50%) and Mock (33%) significantly (all P<0.05). Conclusion: MH1005 and MH1006 can infect nerve tumor cells and replicate at high level, the viruses not only kill tumor cells directly but also induce immunological rejection to tumor, and prolong the survival of mice bearing tumor.

Downregulation of miR-145-5p contributes to hyperproliferation of keratinocytes and skin inflammation in psoriasis

BACKGROUND

The extensive involvement of microRNAs (miRNAs) in the pathogenesis of psoriasis is well documented. However, little is known about the contribution of specific miRNAs to the prevalence of this disease.

OBJECTIVES

To explore the role of miR-145-5p in psoriasis.

METHODS

miRNA microarray analysis was performed in four patients with psoriasis and four controls. Quantitative reverse-transcriptase polymerase chain reaction and fluorescence in situ hybridization were used to identify the dysregulated miRNAs. Luciferase assays were performed to determine whether miR-145-5p targets mixed-lineage kinase (MLK)3. CCK-8 assay and Magnetic Luminex Assay were performed to measure cell proliferation and chemokine secretion. Western blot analysis was used to investigate the protein levels of MLK3 and its downstream effectors. Mouse models of psoriasis were established for in vivo experiments.

RESULTS

miR-145-5p was downregulated in psoriatic lesional skin. Luciferase assays showed that MLK3 is a direct target of miR-145-5p. Overexpression of miR-145-5p in normal human epidermal keratinocytes (NHEKs) suppressed cell proliferation and secretion of chemokines. In contrast, silencing miR-145-5p promoted NHEK proliferation and increased chemokine secretion. Silencing MLK3 abrogated miR-145-5p inhibitor-induced promotion of cell proliferation and chemokine expression. miR-145-5p regulates nuclear factor-κB and signal transducer and activator of transcription 3 by targeting MLK3. Delivery of agomiR-145-5p into the skin decreased epidermal hyperplasia and ameliorated psoriasis-like dermatitis. Delivery of antagomiR-145-5p led to the opposite effects.

CONCLUSIONS

Our findings indicate that miR-145-5p negatively regulates proliferation and chemokine secretion of NHEKs by targeting MLK3, and downregulation of miR-145-5p contributes to skin inflammation in psoriasis lesions.

[Value of the apparent diffusion coefficient in diffusion weighted imaging at 3.0T MR for differentiating lacrimal gland tumors]

Objective: To investigate the diagnostic value of apparent diffusion coefficient in diffusion weighted imaging at 3.0 T MR for the differentiation in the larcrimal gland tumors. Methods: A total of 73 cases, 36 males and 37 female; mean age 14-81(44±15)years, with lacrimal gland tumors confirmed by pathology in Beijing Tongren Hospital were retrospectively analyzed between January 2011 and April 2016.All cases underwent the preoperative routine MRI and DWI scan, the ADC values were measured in region of interest within the solid zone. The cases were divided into benign and malignant group by the histopathology, according the different pathological categories, the malignant cases were further divided into the epithelial and non-epithelial malignacy. The receiver operating characteristic curve (ROC) was constructed using various cut points of ADC for different parameters to confirm the diagnostic threshold value and evaluate the diagnostic efficacy. Results: There were totally 77 lesions in 73 cases, of which 69 involved unilateral lacrimal gland,4 bilateral lacrimal glands. The mean ADC value of malignant and benign masses in lacrimal gland was (1.36±0.16) and (0.90±0.30)×10(-3) mm(2)/s respectively. There was significantly statistical difference between the both(t=-8.319, P<0.01). The mean ADC value of epithelial and non-epithelial malignacy in lacrimal gland was (1.08±0.18) and (0.54±0.09)×10(-3) mm(2)/s respectively. There was significantly statistical difference between the both(t=11.988, P<0.01). The area under the ROC for distinguishing malignant from benign lesions was 0.940. Using an ADC value of 1.275×10(-3) mm(2)/s as the threshold value, the best result obtained had a sensitivity of 94.4%(34/36), specificity of 82.9%(34/41), accuracy of 88.3%(68/77). The area under the ROC for differentiating non-epithelial from epithelial malignacy was 1.0. Using an ADC value of 0.736×10(-3) mm(2)/s as the threshold value, the best result obtained had a sensitivity of 100%, specificity of 100%, accuracy of 100%. Conclusion: The ADC value is helpful in differentiation among different kinds of tumors in lacrimal masses.

[Effect of maternal age on pregnancy outcomes in Beijing]

Objective: To evaluate the maternal age at delivery in Beijing and the effect of maternal age on pregnancy outcomes. Methods: A retrospective analysis was conducted on 14 970 singleton pregnancies from 15 hospitals in Beijing from June 20(th) to November 30(th) in 2013. These hospitals were sorted by the numbers of delivery and chosen as clusters by systemic cluster sampling method. The data of age, diagnosis with gestational diabetes mellitus (GDM) and pre-eclampsia (PE), neonatal birth weight, gestational age at delivery, postpartum hemorrhage and infants admitted to the neonatal ICU (NICU) were collected. The 14 970 women were divided into 5 groups according to their ages at delivery: (1) less than 20 years (n=205), (2)20-<30 years (n=9 228), (3)30-<35 years (n=4 365), (4)35-<40 years (n=1 017), and(5) 40 years and older (n=155). T-test and χ(2) test were used for between-group comparison, and logistic regression analysis was used to examine the association between age and the risk of adverse pregnancy outcomes. Results: (1) The mean maternal age at delivery in 2013 in Beijing was (28±4) years old. Among them, 205 (1.4%, 205/14 970) delivered under 20 years of age; 1 172 (7.8%, 1 172/14 970) ≥35 years; and 155 (1.0%, 155/14 970) at 40 years and older. (2) The prevalence of diabetes, hypertension, overweight and obesity increased with age, and the incidence of these conditions were 3.4%, 4.3% and 31.4% in women with advanced age, respectively. (3) Compared with 20-<30 years group, less than 20 years was associated with significantly lower incidence of GDM [adjust OR (aOR)=0.393, 95%CI: 0.222-0.696] and cesarean section rate (aOR=0.549, 95%CI: 0.391-0.771), and higher incidence of preterm birth (aOR=2.144, 95%CI: 1.256-3.662). Moreover, 30-<35 years, 35-<40 years and 40 years and older groups all had significantly higher risk of GDM (30-34 years, aOR=1.513, 95%CI: 1.374-1.666; 35-<40 years, aOR=2.094, 95%CI: 1.786-2.455; ≥40 years, aOR=2.174, 95%CI: 1.492-3.167), preterm birth (aOR=1.219, 95%CI: 1.021-1.455; aOR=1.644, 95%CI: 1.251-2.161; aOR=2.141, 95%CI: 1.209-3.792), cesarean section (aOR=1.373, 95%CI: 1.268-1.486; aOR=2.960, 95%CI: 2.550-3.435; aOR=4.332, 95%CI: 2.920-6.426) and NICU admission rate (aOR=1.236, 95%CI: 1.059-1.443; aOR=1.337, 95%CI: 1.018-1.756; aOR=2.389, 95%CI: 1.385-4.121), when compared to the 20-<30 years of age group. Higher incidence of PE (aOR=1.292, 95%CI: 1.007-1.659) and postpartum hemorrhage (aOR=1.224, 95%CI: 1.048-1.429) were also noted in women of 30-<35 years, compared to 20-<30 years group respectively. Conclusion: Both advanced maternal age and adolescent pregnancy are associated with increasing risk of adverse pregnancy outcomes.

[The changes of plasma coagulation function in patients with glioma and its correlation with malignant grade of glioma]

Objective: To investigate the changes of activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time(TT), fibrinogen(FIB) and platelet counts(PLT) in plasma of patients with glioma, and to explore the correlations between PT, APTT, TT, FIB and PLT with malignant grades of glioma. Methods: One hundred and seventy-two patients with glioma and 47 health controls were investigated in a retrospective analysis. All patients were diagnosed and identified the WHO grade by pathologist after operation. Including 40 cases with glioblastoma multiforme, WHO Ⅳ grade, 45 cases with anaplastic astrocytoma, WHO Ⅲ grade, 46 cases with astrocytoma and oligodendroglia astrocytoma, WHO Ⅱ grade, and 41 cases with pilocytic astrocytoma. Results: PT was significantly shorter in patients with WHO Ⅰ-Ⅳ grade glioma than that in normal controls (P<0.05); APTT was significantly shorter in patients with WHO Ⅲ and Ⅳ grade glioma than that in normal controls and WHO Ⅰ grade glioma patients (P<0.05); FIB of WHO Ⅳ grade glioma was higher than that in normal control and WHO Ⅰ to Ⅲ grade glioma (P<0.05). While, there was no significant difference of TT and PLT among patients with WHO Ⅰ to Ⅳ and normal controls (P>0.05). Spearman correlation analysis showed that there was negative correlation between APTT and WHO grade (r=-0.200, P=0.007) as well as positive correlation between FIB and WHO grade (r=0.175, P=0.020); Pearson linear correlation analysis showed that there was negative correlation between APTT and Ki67 in patients with glioma. Conclusions: the levels of FIB and APTT in patients with glioma were correlated with WHO grade of glioma, and higher FIB, shorter APTT and PT in patients with WHO Ⅳ grade glioma indicated that there exist hypercoagulation states.

[Observation on pollinosis with vegetable food allergy]

Objective: To investigate the incidence of plant food allergy in patients with pollinosis and the effect of food allergens on the clinical symptoms of pollinosis patients. Method: A total of 40 patients with pollinosis and food allergy attended to the allergy Department of Duolun People's Hospital of Inner Mongolia were accepted skin prick test of inhaled allergens while the rhino conjunctivitis quality of life questionnaire(RQLQ) were also completed. The patients were divided into A and B groups randomly. Patients in group A were required for avoiding allergic plant foods intake but not them in group B. The two groups of patients with RQLQ, VAS and clinical symptom scores were statistically analyzed by P<0.05, the difference was statistically significant. Result: Forty cases were allergic to Artemisia. The most common allergic plant foods was peach, which accounted for 47.5%. Twenty-four patients were allergic to multiple foods simultaneously. Seventeen cases of pollinosis were preceded by food allergy, and 23 cases of food allergy were preceded by pollinosis. The mean values of RQLQ, VAS and symptom scores in group A were 81.44±14.31, 6.02±1.39, 10.60±3.68, respectively. The mean values of group B patients after 1 years were 100.73±21.66, 8.30±1.00, 13.45±3.51, the difference was statistically significant (P<0.01). The patients in group A complained that the symptoms were better than before. The mean values of RQLQ, VAS and symptom scores before intervention were 105.2±26.69, 7.00±1.71, 14.83±3.66, with significant difference (P<0.01). There was no significant improvement in the symptoms of Group B patients (P>0.05). Conclusion: Patients with pollinosis are often associated with food allergies. Reducing the intake of allergic plant foods should help alleviate symptoms.

[Follow-up research on hearing progression of GJB2 mutation associated hearing loss in children]

Objective: To analyze the auditory follow-up alteration of GJB2 associated hearing loss children. Method: Forty three children aged 0-5 years with homozygous or heterozygous mutations of gene attach to the Children' s Hearing Diagnostic Center of our hospital were enrolled in this study. Distortion product otoacoustic emissions and acoustic immittance, auditory brainstem response, auditory steady state response, acoustic impedance, pediatric behavior audiometry and other audiological tests were performed. The subjects had at least two audiology diagnosis results at different time; follow-up time was at least three months. According to the genotype, the subjects were divided into two groups: 23 cases(53.49%) in the truncating mutation/truncating mutation (T/T) group and 20 cases(46.51%) in the nontruncating mutation/truncating mutation (NT/T) group. Hearing levels of the first and last diagnoses and progression rate were compared between the two groups, and the progression value and progression rate were analyzed. Result: The average follow-up time was(19.63 ± 16.76) months. The frequency of c. 235delC (56.98%) in GJB2 gene mutations sites was highest in this group, followed by c. 109G> A (22.09%). The first diagnosis of hearing loss, T/T group was mainly severe(60.87%), NT/T group was mainly mild (50.00%); The degree of final hearing loss in the T/T group was mainly severe(50.00%) while the NT/T group was mainly mild(42.50%), and the T/T group was both heavier than the NT/T group. The difference was both statistically significant. Follow-up research on 43 cases(86 ears) showed that 3 cases(4 ears) developed hearing progression, 1 of them were bilateral progression, two was unilateral progression; the overall rate of progression was 4.65%(4/86), and the rate of progression in the T/T group was 2.17%(1/46) while the NT/T group was 7.50%(3/40). There was no significant difference between the two groups. The average progression of 4 ears was 11.25 dB HL, the average progression speed was 0.5 dB HL/month. Conclusion: This study showed that the degree of hearing loss of associated hearing loss children was mild to profound, and those with truncating mutations/truncating mutations were severer than those with nontruncating mutations/truncating mutations. Hearing progression was seen in both groups, it is suggested that children with GJB2 gene mutations hearing progression may occur during growth and development, therefore, they should be followed up regularly. .

[Association between airborne pollen distribution and allergic diseases in Beijing urban area]

Objective:The aim of this study is to investigate the impact of airborne pollen in urban Beijing area on the consultation rate of allergic diseases. Method:A modified pollen sampler was used to monitor the distribution of main airborne pollen during Jan 1st 2015 to Dec 31 2015.The consultation rate of allergic rhinitis and asthma was obtained meanwhile among allergy, ENT and pneumology department. Relationship between pollen and consultation rate was analyzed by Pearson index. Result:①Through the whole year of 2015 the total quantity of pollens amounted to 76164 grains. Two pollen peaks were observed which happened in spring (March 29.7%, April 34.8%) and autumn (August 9.9%, September 10.5%). The main airborne pollens in spring were cypress, sycamore, and poplar, while in autumn were artemisia, Chenopodiaceae, and Humulus. ②The peak consultation season of allergic rhinitis was presented in March to April and August to September with a positive correlation between allergy and ENT department (r=0.625, P<0.05). Consultation peak of asthma was observed in allergy department but not pneumology department. ③Allergic rhinitis and asthma consultation rate was higher in autumn than spring while the pollen distribution was the opposite. No correlation was found between consultation rate and pollen distribution P>0.05. Conclusion:The airborne pollen distribution was in accordance with consultation rate in allergy department. The pollen count in spring was higher than autumn in Beijing urban area with a consultation peak in autumn inversely. This indicates a higher sensitization ability of autumn pollen compared with spring pollen.

[Retrospectively analysis of the difference of bleeding frequency and hemophilic arthropathy between hemophilia A and hemophilia B patients]

目的

分析血友病A（HA）和血友病B（HB）的出血频率和X线分级情况、X线分级进展的危险因素及差异。

方法

回顾性分析2007年1月至2010年12月中国医学科学院血液病医院收治的211例血友病患者的临床资料，随访部分患者出血关节的X线Arnold-Hilgartner诊断分级结果。

结果

211例患者均为男性，其中HA 150例，HB 61例。HA组总体中位年均总出血次数、中位年均关节出血次数分别为20.5（0~48）、13.5（0~38）次，HB组总体中位年均总出血次数、中位年均关节出血次数分别为13（1~40）、8（0~33）次，中间型HA患者中位年均总出血次数和中位年均关节出血次数高于中间型HB患者[26（1~48）次对12（1~36）次，P<0.001；18（0~36）次对7.5（0~26）次，P=0.001]，而重型HA和HB患者中位年均总出血次数和中位年均关节出血次数比较差异无统计学意义[33（1~41）次对26（1~40）次，P=0.702；22（0~36）次对18（0~33）次，P=0.429]。108例HA、54例HB患者入院时行出血关节普通X线检查，HA患者血友病严重程度与关节X线Arnold-Hilgartner诊断分级呈正相关（r=0.063，P=0.004）；HB患者严重程度分级与关节X线Arnold-Hilgartner诊断分级无相关性（r=0.045，P=0.082）；36例HA和19例HB患者5年后复查病变关节X线片，总体HA与HB患者X线进展程度比较差异无统计学意义（z=1.941，P=0.052），但中间型HA患者进展程度高于中间型HB患者（z=0.076，P=0.002），重型HA和重型HB患者比较差异无统计学意义（z=3.139，P=0.945）。多因素分析显示关节出血次数[P<0.001，OR=1.166（95%CI 1.097~1.239）]和外伤[P=0.018，OR=2.842（95%CI 1.196~6.755）]是血友病患者关节X线Arnold-Hilgartner诊断分级进展的独立危险因素。

结论

HB患者出血频率低于HA患者，中间型患者差异尤其明显。中间型HB患者关节X线分级进展较中间型HA患者慢。关节出血次数和外伤是血友病患者关节X线Arnold-Hilgartner诊断分级进展的独立危险因素。

[The research progress in gingival invagination]

Gingival invagination is a type of gingival cleft that occurs during orthodontic space closure in some of the orthodontic patients who received tooth extraction. Clinical manifestations may be fine folds in attached gingiva surface, or deep cleft that penetrates the interdental papilla from the buccal to the lingual alveolar process. Gingival invagination can affect the health of local periodontal tissues, the effect and stability of orthodontic treatment. This article reviews the research progress of gingival invagination studies, including the definition, manifestations, causes, influencing factors and effects.

[Clinical observation on specific immunotherapy of allergic rhinitis with artemisia pollen]

Objective:The aim of this study is to observe the clinical efficacy of pollen specific immunotherapy with Artemisia in allergic rhinitis. Method:A total of 139 patients with allergic rhinitis who were positive for Artemisia pollen were selected for allergen skin pricking. All of them were treated with Artemisia pollen-specific immunotherapy. The patients were followed-up for 3 months, respectively before treatment (N), after treatment start interval. 3 months (D1, D2, D3) followup fill in the total score of nasal symptoms (TNSS), visual analogue scale (VAS) score, olfactory function grading, ocular symptom score (TOSS) and rhinoconjunctivitis quality of life questionnaire (RQLQ) )score. Result:TNSS：N>D1，N>D2，N>D3，D1,D2,D3 two of the three compared to no difference.VAS：N>D1，N>D2，N>D3，among D1,D2,D3, two of the three compared to no difference. Olfactory function classification:N>D1，N>D2，N>D3，among D1,D2,D3, two of the three compared to no difference.TOSS：N>D1，N>D2，N>D3，among D1,D2,D3,D1>D2,the rest had no difference. RQLQ: N>D1, N>D2, N>D3, D1>D2, D3>D1, D3>D2. Conclusion:The specific pollen immunotherapy of artemisia is effective in the treatment of allergic rhinitis, and the symptoms are obviously improved.

Computed tomography-quantified body composition predicts short-term outcomes after gastrectomy in gastric cancer

Background

Malnutrition is a common and critical problem that influences outcome in cancer patients. Body composition reflects a patient's metabolic profile and physiologic reserves, which might be the true determinant of prognosis. In the present study, which aimed to identify valuable new prognostic indicators, we investigated the association between computed tomography-quantified body composition and short-term outcomes after gastrectomy for gastric cancer.

Methods

Skeletal muscle index, mean muscle attenuation, and ratio of visceral-to-subcutaneous adipose tissue area (vsr) were calculated from preoperative computed tomography images. Low skeletal muscle index, low mean muscle attenuation, and high vsr were respectively termed "sarcopenia," "myosteatosis," and "visceral obesity." The association of body composition with postoperative complications and serum markers of nutrition and inflammation after radical gastrectomy were analyzed.

Results

The overall complication rate was significantly higher in the sarcopenia (62.5% vs. 27.3%, p = 0.001) and myosteatosis groups (38.2% vs. 4%, p = 0.002). Patients with visceral obesity had a higher incidence of inflammatory complications (20.3% vs. 6.5%, p = 0.01). Multivariate logistic regression analysis demonstrated that sarcopenia (p = 0.013), myosteatosis (p = 0.017), and low serum retinol-binding protein (p = 0.019) were independent risk factors for overall complications. Compared with control subjects, patients with sarcopenia had lower postoperative levels of serum retinol-binding protein (p = 0.007), and patients with visceral obesity had higher levels of C-reactive protein (p = 0.026).

Conclusions

Sarcopenia, myosteatosis, and visceral obesity were significantly associated with increased rates of postoperative complications and affected the postoperative nutrition and inflammation status of patients with gastric cancer.

[Clinical observation of thyroid-related adverse events induced by anti-PD-1 antibody SHR-1210 in patients with advanced solid tumor]

Objective: To assess the incidence and characteristics of thyroid dysfunction during anti-Programmed cell death 1 receptor (PD-1) antibody SHR-1210 therapy in patients with advanced solid tumor. Methods: The medical records of 98 patients who initiated SHR-1210 treatment between April 27, 2016 and June 8, 2017 in the phase 1 trial to evaluate the safety, efficacy, and pharmacokinetics of SHR-1210 in patients with advanced solid tumors were retrospectively reviewed. Serological tests of thyroid stimulating hormone (TSH) and free thyroxine (fT4) were measured at baseline and prior to each SHR-1210 administration. Results: A total of 86 patients had normal thyroid function before the first dose of SHR-1210 treatment. Nine out of 86 (10.5%) patients developed new onset hypothyroidism from euthyroid state. 12 patients presented thyroid dysfunction at baseline, 10 of whom were subclinical hypothyroid and 2 were hypothyroidism. Four out of 10 patients developed hypothyroidism from subclinical hypothyroid. Most patients with hypothyroidism were asymptomatic. Thyroid dysfunction occurred early (median, 55days) after the initiation of SHR-1210. The severity of hypothyroidism were all grade 1-2. No grade 3-4 hypothyroidism occurred. No patients discontinue the treatment of SHR-1210 due to clinical impact of the thyroid dysfunctions. Conclusions: Thyroid-related adverse events were common during anti-PD-1 antibody SHR-1210 treatment . The incidence of hypothyroidism is lower in patients with euthyroid state than in patients with thyroid dysfunction at baseline during SHR-1210 treatment . Thyroid function can be improved after thyroid hormone replacement. During SHR-1210 treatment, it is necessary to pay attention to monitor the thyroid function, especially in the patients with thyroid dysfunction at baseline. Trial registration: Chinese Clinical Trial Registry, 2016L01455.

[Analysis of genotypes and audiological characteristics of children with SLC26A4 gene pathogenic mutations]

Objective:To explore the correlation of SLC26A4 genotype and audiology.Method:The subjects were 70 children aged 0 to 7 years old, who were admitted to otological outpatient department.All subjects received nine crystal hereditary deafness gene chip and confirmed by (or)SLC26A4 gene full coding region detection.The patients were diagnosed as homozygous or compound heterozygous mutations.At the same time,acoustic immittance,auditory brainstem response, auditory steady state response and pediatric behavior audiometry, newborn hearing screening and other audiological tests were displayed. According to the genotype, the subjects were divided into two groups: group A (SLC26A4 gene homozygous mutation) in 40 cases, group B (SLC26A4 gene compound heterozygous mutation) in 30 cases. The frequency of SLC26A4 gene mutation, the two groups of genotypes and hearing screening results,the degree of hearing loss and audiometric configurations were analyzed statistically. Result: In 70 patients, the top 4 of the 70 patients with high frequency of mutations were IVS7-2A> G(76.43%), 2168A> G(15.00%), 1226G> A(2.86%) and 2000T> C(2.16%), respectively. 34.29% of newborns passed hearing screening with single or double ears, among which group A and group B were 32.50% and 36.67%,respectively. There was no statistically significant difference between two groups in hearing screening. The degree of hearing loss in group A(56.25%) and group B(48.33%) were mainly profound and there was no significant difference between them. The audiometric configurations: group A(60.00%) was mainly high frequency loss type, while group B(55.00%) was mainly flat type. The difference between them was statistically significant.Conclusion:The mutation sites of SLC26A4 gene were mainly IVS7-2A> G, and the degree of hearing loss was mostly profound. To the audiometric configurations,SLC26A4 gene homozygous mutant were mainly high frequency loss type, while SLC26A4 gene compound heterozygous mutant were mainly flat type. 34.29% children passed universal newborn hearing screening with one ear at least, which indicates SLC26A4 gene mutations can result in late-onset hearing loss, so those patients should be attached great importance..

[The sensitization feature of Cypress pollen in urban area of Beijing]

Objective: To explore the sensitization features of Cypress pollen in urban area of Beijing and analyze the seasonal changes. Methods: Four thousand two hundred and one patients in Department of Allergy of Beijing Shijitan Hospital during January to December 2017 were enrolled in this study and received skin prick test (SPT) of Cypress extract. Cypress sensitization was divided into two types: mono-sensitization and multiple-sensitization. Difference of sensitization rate between age, gender and visiting month was analyzed by chi-square test. Difference of visiting rate and sensitization rate among each month was analyzed by K-W test. Pearson test was carried out for correlation analysis. Results: Positive rate of Cypress pollen was 32.3% (1 358/4 201) in overall patients in which male had a higher positive rate than female (35.6% vs 30.1%, χ(2)=13.465, P<0.001). The positive rate was highest in age 11-20 years and 31-40 years and then decreased with age (P<0.001). Multi-sensitization was observed in this study with a rate of 27.5% (1 154/4 201) while mono-sensitization of Cypress was only 4.7% (199/4 201). The consultation rate during January to December was positively correlated with SPT positive rate of Cypress pollen (r(2)=0.715 9, P=0.001). The positive rate varied with season with the highest rate in March (53.0%, 316/596), followed by April (36.6%, 208/568). The season peak of positive rate was observed in adults but not children. Mono-sensitization rate varied with one season peak (spring) while multi-sensitization showed two season peaks (spring and autumn). Conclusion: Cypress sensitization is prevalent in urban area of Beijing and is prone to multi-sensitization, which changes with season with the peak in March.

[Estimation on the health life expectancy of adults in Zhejiang province, 2016]

Objective: To estimate the health-adjusted life expectancy (HALE) of adults in Zhejiang province and evaluate the health status of the adults. Methods: This study was based on the mortality data collected from Zhejiang Chronic Disease Surveillance Information and Management System, and mortality rates from the underreporting survey and self-reported health data in 2016. Hierarchical Ordered Probit (HOPIT) model was used to estimate the severity-weighted prevalence of disability. Sullivan's method was used to calculate the HALE. Results: After adjustment by HOPIT model, the severity-weighted prevalence of disability increased significantly with age (χ(2)=5 795.81,P<0.001), and it was higher in females than in males (χ(2)=5 353.27, P<0.001). The life expectancy and self-evaluated HALE were 59.08 years and 48.68 years, respectively, in those aged ≥20 years, the difference was 10.40 years due to disability. The proportion of HALE loss due to disability in the total life expectancy was 17.61%, and it increased with age. HALE was higher in males than in females (49.21 years vs. 48.14 years), and in urban residents than in rural residents (49.92 years vs. 47.43 years). Conclusion: The proportion of loss of HALE in the total life expectancy in adults was high in Zhejiang, and it higher in males than in females, in urban residents than rural residents. Programs on improving health care in women and rural residents should be promoted.

Treatment mechanism of tolerogenic dendritic cells on rheumatoid arthritis

This study aims to explore the possible mechanism of treatment of collagen-induced rheumatoid arthritis (RA) by tolerogenic dendritic cells (tDCs). Different methods were used to induce and cultivate tDCs, and suitable conditions for tDC cultivation were explored. The experimental RA induced by collagen in mouse was treated by the obtained tDCs, and the possible mechanism was explored. The serum concentration of TNF-α, IFN-β, IL-4 and anti-type II collagen antibody were detected by ELISA. The anti-type II collagen antibody of mice without treatment was higher than that without disease onset, while the Blank-DC group, VIP-DC group and Bay-D had no statistically significant differences (P>0.05). Compared to the group without disease onset, the TNF-α level of those without treatment was significantly higher, while INF-γ, IL-1β and IL-4 concentration showed no significant difference (P>0.05). Compared to the untreated group, the TNF-α and IL-1β concentration after VIP-DC treatment were significantly decreased, while IL-4 was increased (P less than0.05). In summary, VIP-DC and Bay-DC alleviate joint inflammation, synovitis and bone erosion by reducing the production of anti-type II collagen antibody, inhibiting proinflammatory factors and increasing inflammation inhibitors.

Influence of Shrinkage and Viscosity of Flowable Composite Liners on Cervical Microleakage of Class II Restorations: A Micro-CT Analysis

This study determined the influence of shrinkage and viscosity of flowable composite liners on the cervical microleakage of Class II restorations using micro-CT. Seven composites of varying viscosities were selected and included five giomers (Shofu Beautifil II [BF], Flow Plus F00 and F03 [F00 and F03], Flow F02 and F10 [F02 and F10]) and 2 nano-filled composites (3M-ESPE Filtek Z350 [Z350] and Filtek Z350 Flowable [Z350F]). Polymerization shrinkage (n=7) was assessed with the Acuvol volumetric shrinkage analyzer while complex viscosity was determined with the advanced rheometric expansion system at 25°C. Standardized Class II restorations incorporating 1-mm horizontal layers of different flowable liners and 3-mm oblique layers of BF or Z350 were subjected to a silver nitrate test for 24 hours and examined using micro-CT. Microleakage was determined at 0.1-mm intervals from the buccal to lingual surfaces providing 30 sites per specimen and scored accordingly. Statistical analysis was performed with the one-way ANOVA, Kruskal-Wallis test, and Spearman's rho correlation at a significance level of p<0.05. Mean volumetric shrinkage ranged from 5.33±0.17% to 2.35±0.02% for F02 to Z350, respectively. The flowable materials had significantly higher shrinkage than did their sculptable counterparts (BF and Z350). Complex viscosities ranged from 9.65 to 4.20 (Z350 and F10, respectively) at a frequency of 10 rad/s and from 8.16 to 3.28 (Z350 and F03, respectively) for 100 rad/s. Giomer restorations had significantly less leakage than did those restored with nano-filled composites. No microleakage was observed with restorations lined with F02 or F10. The use of flowable liners reduced cervical microleakage of Class II restorations. Interfacial integrity of Class II restorations was significantly correlated with liner viscosity, filler volume, and shrinkage.

[The treatment of Lemierre syndrome associated with cervical necrotizing fascitis]

Lemierre syndrome is a rare, potentially fatal condition characterized by internal jugular vein thrombosis following an acute oropharyngeal infection, often accompanied with cervical necrotizing fasciitis. This paper reviews 5 cases of Lemierre syndrome with cervical necrotizing fasciitis, extensive cervical drainage and sufficient antibiotics is crucial treatment for Lemierre syndrome, anticoagulation combined with antibiotics is safe and effective for propagation or nonresolution of the thrombus.

Effect of pH on uranium(VI) biosorption and biomineralization by Saccharomyces cerevisiae

Biosorption of radionuclides by microorganisms is a promising and effective method for the remediation of contaminated areas. pH is the most important factor during uranium biosorption by Saccharomyces cerevisiae because the pH value not only affects the biosorption rate but also affects the precipitation structure. This study investigated the effect of pH on uranium (VI) biosorption and biomineralization by S. cerevisiae. Cells have the ability to buffer the solution to neutral, allowing the biosorption system to reach an optimal level regardless of the initial pH value. This occurs because there is a release of phosphate and ammonium ions during the interaction between cells and uranium. The uranyl and phosphate ions formed nano-particles, which is chernikovite H₂(UO₂)₂(PO₄)₂·8H₂O (PDF #08-0296), on cell surface under the initial acidic conditions. However, under the initial alkaline conditions, the uranyl, phosphate and ammonium ions formed a large amount of scale-like precipitation, which is uramphite (NH₄)(UO₂)PO₄·3H₂O (PDF #42-0384), evenly over on cell surface.

[EMA/CO regimen for chemotherapy 24 patients with ultra high-risk gestational trophoblastic neoplasia]

Objective: To evaluate etoposide, methotrexate and dactinomycin (EMA) /cyclophosphamide and vincristine (CO) regimen for treatment of ultra high-risk gestational trophoblastic neoplasia (GTN) . Methods: A total of twenty-four ultra high-risk patients who had International Federation of Gynecology and Obstetrics (FIGO) prognostic scores greater or equal to 12 with liver, brain, or extensive metastases did poorly when treated with primary chemotherapy admitted in Women's Hospital, School of Medicine, Zhejiang University from January 2001 to December 2015. All of the patients were treated by EMA/CO regimen and followed up to death or December 2017. The clinical data of patients were analyzed retrospectively and the efficacy and toxicity of EMA/CO were evaluated. Results: All of the cases with ultra high-risk GTN had FIGO prognostic scores ≥12 (ranged 12-18, median 13.0) . Twenty patients (83%, 20/24) received EMA/CO regimen as primary treatment and 4 patients (17%, 4/24) had a history of failed chemotherapy. Seven patients (29%, 7/24) had metastasis of liver or brain and 17 patients (71%, 20/24) had no metastasis of liver and brain. Twenty-four patients received totally 167 courses of EMA/CO regimen (average 7.0 courses) . Sixteen patients achieved complete remission and 8 patients showed drug-resistant. The complete remission rate was 67% (16/24) and the resistance rate was 33% (8/24) . Of the 16 patients who got complete remission, 6 cases were treated with EMA/CO regimen alone, and 10 cases were treated by chemotherapy combined with surgery. For the 8 patients who showed drug-resistant to EMA/CO, 5 cases of them received EMA/etoposide and cisplatin (EP) regimen and 3 cases got remission, 1 case received methotrexate, dactinomycin and cyclophosphamide (MAC) regimen and got remission, 2 cases gave up treatment because of economic factors. The side effects of EMA/CO mainly included Ⅲ-Ⅳ degree neutropenia, anemia and alopecia. The incidence of Ⅲ-Ⅳ degree neutropenia during the treatment of EMA/CO was 21.6% (36/167) , the incidence of anemia was 96.4% (161/167) , and the incidence of alopecia was 60.5% (101/167) . In these 24 ultra high-risk GTN patients, 4 patients died during follow-up. In the 20 patients who got complete remission, no recurrence or secondary tumor by chemotherapy were occurred. Conclusion: EMA/CO is an effective regimen with manageable toxicity for patients with ultra high-risk GTN.

[The role of FOXO3a-Bim signaling in triptolide induced bladder cancer T24 cells apoptosis]

Objective: To investigate the role of FOXO3a-Bim signaling in triptolide induced bladder cancer T24 cells apoptosis. Methods: T24 cells were used and divided into control group, triptolide group(50 nmol/L), MK2206 group(50 nmol/L triptolide+ 5 μmol/L MK2206), FOXO3a-siRNA group(50 nmol/L triptolide+ 100 nmol/L FOXO3a-siRNA), Bim-siRNA group (50 nmol/L triptolide+ 100 nmol/L Bim-siRNA). MTT assay was used to analyze the cells growth inhibition.Annexin V/PI staining was implemented to detect cell apoptosis rate, the expression of p-Akt, Akt, p-FOXO3a, FOXO3a, Bim, Bax.Cleaved-caspase 3 was analyzed by Western blot. Results: After treatment with triptolide 25, 50, 100, 250 nmol/L, the cell growth inhibition rates at 24 hours(17%±9%, 24%±5%, 43%±8%, 61%±8%), 48 hours (20%±7%, 34%±6%, 56%±7%, 74%±5%) and 72 hours(32%±8%, 41%±7%, 69%±7%, 84%±3%) were significantly higher than control group respectively.The IC(50) at 24, 48, 72 hours were (113±10), (91±8), (68±5) nmol/L; the cell apoptosis rates at 24 hours (10%±4%, 15%±5%, 29%±8%, 46%±8%), 48 hours (16%±5%, 24%±6%, 40%±7%, 55%±9%) and 72 hours (27%±4%, 38%±5%, 50%±9%, 65%±8%) were significantly increased (P<0.05). Western blot showed that triptolide reduced the expression of p-Akt, p-FOXO3a and increased the expression of Bim, Bax, cleaved-caspase 3.The cell inhibition rate in Triptolide group (30%±8%) was significantly higher than that in the control group (P<0.05) and the rates in MK2206 group (54% ±6%), FOXO3a-siRNA group (18%±7%) and Bim-siRNA group (11%±6%) were also higher than the control group.Compared with the triptolide group, the inhibition rate in MK2206 group was significantly increased, but decreased in FOXO3a-siRNA group and Bim-siRNA group(P<0.05). Conclusion: Triptolide induces T24 cells apoptosis through FOXO3a-Bim signaling pathway.

[Serologic surveillance indicators analysis among syphilis-infected pregnant women in East China]

Objective: To analyze serologic surveillance indicators during pregnancy among syphilis-infected women who delivered in 2013 in East China. Methods: Data were from national 'Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management' and in total 5 206 syphilis-infected pregnant women who delivered in 2013 and in East China were involved in the analysis. Information on demographic characters, laboratory tests, and treatment regimens were collected. The maternal non-treponemal testing surveillance and titer distribution were described and compare the proportions between pregnant women receiving standard testing and non-standard testing, taking baseline testing and testing before delivery or at the third trimester. Multivariate logistic regression model was analyzed using maternal titer control as dependent variable, using prior history of syphilis infection, syphilis stages, titer, gestational weeks of treatment initiation and treatment regimens as independent variables in 3 940 pregnant women with both baseline testing results and testing results before delivery or at the third trimester. Results: The ages of the 5 206 syphilis infected pregnant women were (28.1±5.8) years old. The numbers of women received penicillin treatment, other treatment regimens and no treatment were 2 967 (57.0%), 281 (5.4%), and 1 958 (37.6%), respectively. The number of women with maternal seroconversion, 4-fold or greater titer decline, or titer increase were 349 (6.7%), 251 (4.8%) and 28 (0.5%). Multivariate analysis results showed that compared with pregnant women with prior history of syphilis, the OR(95%CI) for maternal titer control was 1.49 (1.18-1.88) among those with syphilis-infection history. Compared with pregnant women initiated treatment at 28 gestational weeks or before, the OR (95%CI) for maternal titer control was 4.09 (3.19-5.24) among those who initiated treatment after 28 gestational weeks. Compared with pregnant women initiated treatment at 28 gestational weeks or before, the OR (95%CI) for maternal titer control was 4.09 (3.19-5.24) among those who initiated treatment after 28 gestational weeks or received no treatment. Compared with pregnant women received penicillin treatment, the OR (95%CI) for maternal titer control among those received non-penicillin treatment and those received no treatment were 2.35 (1.46-3.76) and 1.55 (1.13-2.12), respectively. Conclusion: In East China, the proportion of women achieved seroconversion or 4-fold or greater titer decline during pregnancy was very low. Pregnant women with no prior history of syphilis infection, early maternal initiation of treatment, and penicillin treatment were more likely to reach maternal titer control.

[Comprehensive review of factors and preventions of mother to child transmission of hepatitis B virus]

Mother-to-child transmission of hepatitis B virus (HBV) is one of major public health issues. Difference is found on effect of preventions of mother to child transmission of HBV such as Hepatitis B vaccine, Hepatitis B immunoglobulin and antiretroviral drugs. Based on the risks of hepatitis B virus on children, influencing factors and interventions of HBV mother-to-child transmission were explored to improve prevention mother-to-child transmission of hepatitis B and to search appropriate strategies reducing mother-to-child transmission of HBV.

[Management strategies of granulation in tracheal post-tracheostomy caused by prolonged mechanical ventilation]

Objective:To analyze the effect and safety of treatment in patients with airway stenosis caused by tracheotomy for mechanical ventilation. Method: We treated the patients with airway stenosis caused by granulation tissue. The patients with grade Ⅰ,Ⅱ airway stenosis were treated with adjustable flange tracheostomy tube, and the holmium laser under a fibro-laryngoscope were applied for the patients with grade Ⅲ airway stenosis.Two hundred and sixteen patients were enrolled in this study. Forty-four patients had been found tracheal stenosis caused by granulomatous hyperplasia, accounting for 20.4% of all patients, including 12 cases of gradeⅠ, 18 cases of grade Ⅱ, and 14 cases of grade Ⅲ.Result:Thirty patients with grade Ⅰ and Ⅱ were replaced with adjustable flange tracheostomy cannula. Fourteen cases of grade Ⅲ airway stenosis were treated with Ho:YAG laser under a fibro laryngoscope. All cases were completed operation successfully. None of cases bleeding, perforated and asphyxia during operation. The clinical symptoms disappeared after operation, and endoscopy showed that airways of patients were smooth. No recurrence were found after operation.Conclusion: Replacement of adjustable flange tracheostomy tube and Ho:YAG laser can safely and effectively treat airway obstruction caused by tracheal granulation tissue hyperplasia after tracheotomy.

[The significance of clinical indicators of different Gram-stained bacteria resulted in secondary intracranial infection after craniocerebral operation]

Objective: To compare and analyze the clinical characteristics and laboratory parameters of central nervous system (CNS) infection caused by different Gram-stained bacteria after craniocerebral surgery, and to provide a preliminary basis for early anti-infection treatment to reduce the use of extended-spectrum antibiotics and the generation of resistant strains. Methods: A single center retrospective study was conducted to investigate the clinical data of patients with intracranial infection after craniocerebral surgery from January 2012 to December 2016 in PLA general hospital. The general conditions, clinical features, laboratory parameters, antibiotic treatments and prognosis were analyzed. Results: A toal of 813 cases of CNS infection after craniocerebral surgery were found during the 5-year period, with an incidence rate of 5.43% (813/14 986). The positive rate of cerebrospinal fluid (CSF)culture was 9.72% (79/813). According to the criteria, 71 cases were included in the study. Among all the cases, 64.8% (46/71) of which were Gram-positive bacteria (G(+) ) and 35.2% (25/71) were identified as Gram-negative bacteria (G(-)). The duration between surgery and meningitis events, as well as the period of antibiotic treatment for G(+) bacteria group were 5.0 (4.0, 6.0) days and (18.3±6.8) days, which were shorter than those of the G(-) bacteria group 9.0(7.0, 11.0) days and (29.2±9.9) days (Z=-6.184, t=-5.245, both P<0.01) , and the differences were statistically significant. The serum procalcitonin concentration in the G(+) group was lower than that in G(-) group [1.02(0.83, 1.27)μg/L vs 2.68(1.97, 5.07)μg/L, Z=-5.719, P<0.01]. The cerebrospinal fluid glucose content was higher than that of G(-) bacteria group[(2.13±1.30) mmol/L vs (1.09±0.95) mmol/L, t=3.512, P<0.01]. The protein level was lower than that of G(-) bacteria group [(1 615.93±848.83) mg/L vs (2 480.60±1 105.28) mg/L, t=-3.679, P<0.01]. Serum C-reactive protein concentrations in the two groups did not show any statistical significance [(96.2±46.1) mg/L vs (117.8±46.3) mg/L, t=-1.884, P>0.05]. In addition, the mortality rate of the G(-) bacteria group was 16.0% (4/25), and 0 in G(+) bacteria group. Conclusion: The time of onset of intracranial infection, serum PCT concentration, and cerebrospinal fluid glucose and protein content caused by Gram-positive bacteria and Gram-negative bacteria are found to be significantly different, and these findings could serve as a preliminary guide for the selection of antibiotics in early experiential anti-infective treatments without the etiology report.

[Experimental observation on the effect of bone marrow mesenchymal stem cells transplanting CXCR4 over gentamicin ototoxicity]

Objective:To observe the survival and migration ability of CXCR4-BMSCs in guinea pig cochlea with gentamycin induced sensorineural hearing loss, and to explore whether SDF-1/CXCR4 axis can mediate bone marrow mesenchymal stem cells (BMSCs) to cochlear homing.Method:BMSCs were isolated and extracted from guinea pigs. A bone marrow mesenchymal stem cell line with overexpression of CXCR4 was established. The animal model of sensorineural deafness was established by intraperitoneal injection of gentamicin［100 mg/(kg·d)］in 50 healthy guinea pigs. The successful deafness animals were randomly divided into three groups(14 rats in each group): sterilizing water group, BMSCs transplantation group and CXCR4-BMSCs transplantation group.Auditory brainstem response(ABR) were performed at 2 weeks and 4 weeks respectively after the tansplantation through cochlear tympanic pathway. The directional homing of the implanted cells in the cochlea was traced by the frozen section fluorescence of the cochlear tissue.Result:The hearing thresholds of the three groups were (91.3±5.2),(90.7±4.8)and (90.9±5.6)dB (SPL) respectively. There was no significant difference among them(P>0.05). In sterile Water group, the hearing thresholds were(89.7±6.4)dB and (89.2±6.7)dB respectively when detected on 2 and 4 weeks after transplantation. There were no significant difference(P>0.05);In BMSCs group, the hearing thresholds were (88.6±5.3)dB(SPL) on 2 weeks and (78.4±7.3)dB(SPL) on 4 weeks after transplantation. In CXCR4-BMSCs group, the hearing thresholds were(75.3±7.8)dB(SPL) on 2 weeks and (62.1±8.4)dB(SPL) on 4 weeks after transplantation. The differences were statistically significant (PThe hearing threshold was (75.3±7.8)dB (SPL) at 2 weeks after operation. The hearing enhancement was about 15 dB, the hearing threshold was (62.1±8.4)dB(SPL) at 4 weeks, the difference was statistically significant(P<0.05).Fluorescence tracing showed that the number of CXCR4-BMSCs homing cells was significantly increased, and showed a cohort like arrangement.Conclusion:The SDF-1/CXCR4 axis plays an important role in the directional homing and differentiation of the cells into the cochlea, which can improve the hearing repair ability of guinea pigs induced by gentamicin induced sensorineural deafness.

[Dynamic investigation of nutritional risk in patients with malignant tumor during hospitalization]

Objective: To prospectively investigate the changes in nutritional status of patients with malignant tumors during hospitalization by using nutritional risk screening (NRS2002), and to analyze the correlation between the nutritional status and clinical outcomes . Methods: This was a prospective and parallel research done by multi-center collaboration from 34 hospitals in China from June to September 2014.Hospitalized patients with malignant tumors inthese departments (Department of Gastroenterology, respiratory medicine, oncology, general surgery, thoracic surgery and geriatrics)were investigated. Only the patients with age≥ 18 years and hospitalization time between 7-30 days were included. During hospitalization, the physical indexes of human bodywere measured, and the NRS 2002 scores, and monitored the nutritional support at the time points of admission and 24 hours before discharge were recorded.And whether there was a nutritional risk in hospitalized patients and its association with clinical outcomes were investigated. Results: A total of 2 402 patients with malignancies were enrolled in this study. Seventy fourpatients who did not complete NRS2002 were eliminated, and 2 328 patients were included. The number of the main diseases was the top five, including 587 cases of colorectal cancer, 567 cases of lung cancer, 564 cases of gastric cancer, 146 cases of esophageal cancer, and 119 cases of liver tumor. At the time of discharge, compared with admission, the BMI, body weight, grip and calf circumferences of patients with malignant tumor were significantly decreased (P<0.05). The total protein, albumin, prealbumin and hemoglobin were significantly lower than those at admission (P<0.05). In 2 328 patients who were completed nutritional risk screening, the rate of malnutrition at admission was 11.1% (BMI =18.5, 258/2 328) and the rate of malnutrition at discharge was 10.9% (BMI =18.5, 254/2 328), there were no significant differences (χ(2)=0.019 7, P=0.888). There were 1 204 patients with nutritional risk at admission (51.7%, NRS2002 score≥3)and 1 352 patients with nutritional risk at discharge (58.1%, NRS2002 score≥3), with significant differences (χ(2)=49.9, P<0.001). The incidence of nutritional risk in patients with colorectal, stomach, and lung tumors at discharge was significantly higher than that at admission (P<0.05). The infective complications and other complications of patients with nutritional risk were significantly greater than those without nutritional risk at admission and at discharge.ICU hospitalization stay of patients with nutritional risk was increased significantly than those without nutritional risk at admission(P=0.042). Hospitalization expenses of patients with nutritional risk was increased significantly than those of patients without nutritional risk at discharge(P<0.01). Conclusion: The patients with malignant tumor have a higher incidence rate of malnutrition at both admission and discharge and malnutritionhas correlation with adverse clinical outcomes.The aboveindicators did not improve significantly at discharge.Doctors should pay more attention to the nutritional status (screening and evaluation)of patients before discharge and use appropriate and adequate nutrition support in order to prevent the weight loss and improve the life quality of patients.

[Preliminary research on Zhang Song's Jiu yuan fang (Formulary of Exploring Cause) of the Southern Song Dynasty]

Written by Zhang Song, a physician in the Southern Song Dynasty, Jiu yuan fang (Formulary of Exploring Cause) was a lost clinical experienced formulary book. Totally 124 items of its original texts were quoted and remained in some other ancient Chinese medical books, such as Fu zai wan an fang (Formulary for Absolute Safety), Bao qing ben cao zhe zhong (Compromised Materia Medica of Baoqing Reign), Bencaogangmu (Compendium of Materia Medica) and Puji Fang (Prescriptions for Universal Relief) etc. After compiling and editing these scattered records, it was found that Jiu yuan fang was the earliest book carrying the Yupingfeng Powder, with rather high value of literature research and significance of clinical application.

[Clinical characteristics of thyroid hormone resistance syndrome in two cases with different subtypes]

Objective: To analyze the clinical characteristics of children with two types of thyroid hormone resistance (RTH) syndrome, and to detect the variants of thyroid hormone receptor alpha(TRα) and TRβ gene in children. Method: Two children with RTH were reported in regard to clinical manifestation, laboratory examination and genetic variants. Some related reports in literature were reviewed. Result: Case 1 was a girl, 10 years old, with thyroid enlargement for several days and without thyrotoxicosis. Laboratory work-up revealed that free thyroxine (FT(4)) was 65.77 pmol/L (reference 12-22) , free triiodothyronine (FT(3)) was 15.36 pmol/L (reference 3.1-6.8) and thyroid stimulating hormone (TSH) level was normal. There was a likely pathogenic missense variant detected in TRβ gene and this patient was diagnosed with RTHβ. Case 2 was a boy, 3 years old, with classic features of hypothyroidism(growth retardation, developmental retardation, skeletal dysplasia) but had only borderline-abnormal thyroid hormone levels. Targeted sequencing showed a de novo heterozygous nonsense variant in TRα gene which is a pathogenic variant and this patient been diagnosed with RTHα. Conclusion: Thyroid enlargement is a common clinical manifestation of RTHβ, with laboratory work-up reveals elevated FT(4) and FT(3) levels but TSH level is normal. The clinical manifestations of RTHα are similar to those of hypothyroidism, but the thyroid hormone levels are almost normal. The gene sequence and the pathogenicity analysis for TRα and TRβ will help to make a definitive diagnosis.

[Study on relationship between Set gene expression and clinical manifestations in bone marrow of patients with acute myelogenous leukemia]

Objective: To explore the expression and significance of Set gene in Acute myeloid leukemia (AML) patients , and to analyze its effect for the prognosis of AML. Methods: The level of Set gene expression was detected by real-time PCR in 59 AML patients and 20 heathy people. The mutations in C-kit 8/17 gene, NPM1 gene and FLT3-TKD/ITD gene in 59 AML patients were detected by direct sequencing. Results: The level of Set gene expression[1.41(0.41-3.31)]was significantly higher in 59 AML patients.The expression of Set gene was correlated with the percentage of marrow blasts and CR in AML patients (P=0.040, P<0.001); the CR rate of Set gene high expression group was significantly lower than that of Set gene low expression group(32.1% vs 83.9%, P=0.01). In the intermediate-risk of AML patients with chromosome karyotype analysis, the CR rate of Set gene high expression group and low expression group were 34.8% and 88.9%, and there are significantly different between two groups(P<0.001); univariate and multivariate analysis showed that Set gene high expression group correlated with poor OS[4(2-15)months]and EFS[3(2-13)months])(P=0.021, P=0.017). It suggests that the Set gene maybe one of AML independent poor prognostic marker.The level of Set gene expression did not correlate with sex, age, WBC, HGB, PLT, FAB typing, chromosomal karyotype and NPM1, C-Kit8/17, CEBPa, FLT3-ITD/TKD gene mutations in AML patients(all P>0.05). Conclusions: The level of Set gene expression in bone marrow maybe play an important role in AML. The high expression of Set gene indicates poor prognosis in AML patients.

[S100A7 promotes the metastasis and epithelial-mesenchymal transition on HeLa and CaSki cells]

Objective: To elucidate the impact of over-expression of S100A7 on migration, invasion, proliferation, cell cycle, and epithelial-mesenchymal transition (EMT) in human cervical cancer HeLa and CaSki cells. Methods: (1) Immunohistochemistry of SP was used to examine the expression of S100A7 in 40 cases of squamous cervical cancer tissues and 20 cases of normal cervical tissues. (2) The vectors of pLVX-IRES-Neo-S100A7 and pLVX-IRES-Neo were used to transfect human cervical cancer HeLa and CaSki cells, and the positive clones were screened and identified. Next, transwell migration assay, cell counting kit-8 (CCK-8) assay and fluorescence activating cell sorter (FACS) were used to detect the effect of S100A7-overexpression on the migration, invasion, proliferation and cell cycle of cervical cancer cells. Furthermore, western blot was performed to observe the expression of epithelial marker (E-cadherin) and mesenchymal markers (N-cadherin, vimentin, and fibronectin) of EMT. Results: (1) S100A7 expression was significantly higher in cervical squamous cancer tissues (median 91.6) than that in normal cervical tissues (median 52.1; Z=-2.948, P=0.003) . (2) Stable S100A7-overexpressed cells were established using lentiviral-mediated gene delivery in HeLa and CaSki cells. S100A7 was detected by real-time quantitative reverse transcription PCR, S100A7 mRNA of S100A7-overexpressed cells were 119±3 and 177±16, increased significantly compared with control groups of median (P<0.01) . Compared with the control cells, the number of S100A7-overexpressed HeLa and CaSki cells that passed the transwell membrane assay were increased significanatly (572±51 vs 337±25, P<0.01; 100±8 vs 41±4, P<0.01) .Matrigel invasion assay showed that the number of S100A7-overexpressed HeLa and CaSki cells that passed the transwell membrane were respectively 441±15 and 110±14, elevated significantly compared with control cells (156±21 and 59±7; P<0.05) . However, S100A7 overexpression didn't influence the proliferation and cell cycle progression of HeLa and CaSki cells (P>0.05) . Expression of E-cadherin was dramatically decreased, while N-cadherin, vimentin, and fibronectin increased in S100A7-overexpressed cells. Conclusion: S100A7 enhances the migration, invasion and EMT of HeLa cells and CaSki cells, and may be plays an important role in the development of cervical cancer.

[Influence of setting time on bond strength of different bioactive pulp capping materials with dental adhesive]

OBJECTIVE

To investigate influence of setting time on bond strength of different bioactive pulp capping materials with self-etch or etch-and-rinse adhesive.

METHODS

Sixty specimens were prepared for each of the three tested capping materials, namely mineral trioxide aggregate (MTA), iRoot BP Plus (BP) and iRoot FS (FS). Specimens of each material were divided into three groups and bonded at three setting time points of the materials respectively: initial setting time (4 h for MTA, 2 h for BP and 20 min for FS), 24 h after application and 7 d after application. The specimen surfaces of each group were treated with self-etch mode or etch-and-rinse mode of one universal adhesive (Single Bond Universal, SBU) (n=10). The bonding area was restricted to a round area with 3 mm diameter, on which composite cylinders were build up with flowable composite and light cured completely. The shear bond strength was tested immediately with a shear strength tester and fracture mode was observed under stereo microscope and recorded. The mean shear bond strength for each group was analyzed with SPSS 19.0 software ANOVA method. The surface morphology of each material was observed after setting and acid treatment under scanning electron microscope.

RESULTS

There was no significant difference among the three tested materials at either initial setting point or 7 d after application (P<0.05). The bond strength of MTA was significantly higher than those of BP and FS 24 h after application in both bonding modes (P<0.05). For all the three tested materials, shear bond strength was significantly higher for complete setting group than for initial setting group of the same material (P<0.05). Under scanning electron microscope, the characteristic crystal patterns could be observed on the three bioactive materials surfaces after complete setting, the size of which was bigger for MTA than for BP and FS. These features were lost to some extent after self-etch primer application or phosphoric acid etching.

CONCLUSION

Based on the present results, adequate bond strength can be obtained for FS at initial setting time, which is comparable with BP and MTA. This implies that clinically composite restoration can be placed over bioactive direct capping materials after shortened initial setting process in one visit.