The Geometric Effects on the Stress of Arterial Atherosclerotic Plaques: a Computational Study

BACKGROUND

The rupture of atherosclerotic plaques could cause serious clinical events. The wall shear stress (WSS) and axial plaque stress (APS) could reflect the risk of plaque rupture. This study aimed to quantitatively investigate the geometric effects on WSS and APS using computational fluid dynamics (CFD).

METHODS

63 plaque models were developed from three severities (75%, 82%, and 89% in area), three eccentricities (the deviation of plaque throat from the arterial centerline: 0, 0.375 and 0.75mm), and 7 different length combinations of the proximal and distal stenotic segments (2mm-5mm, 3mm-5mm, 4mm-5mm, 5mm-5mm, 5mm-4mm, 5mm-3mm, 5mm-2mm). For each model, CFD simulation was performed to calculate the maximum and area-averaged WSS and APS on the proximal and distal stenotic segments. The multivariate analysis of variance and linear regression analysis were performed to quantitatively investigate the geometry-stress relationship.The results showed that, the severity and eccentricity of a plaque were linearly related to its WSS and APS. APS value on a segment (proximal or distal) of the plaque depended on the segmental length It was also shown that the difference of APS between proximal and distal segments depended exclusively on the difference of length between segments (all p<; 0.05).

CONCLUSION

The geometry of a plaque influences its WSS and APS. APS and its proximal/distal difference depend on the segmental lengths.

Role of Zebrafish fhl1A in Satellite Cell and Skeletal Muscle Development

Background:

Four-and-a-half LIM domains protein 1 (FHL1) mutations are associated with human myopathies. However, the function of this protein in skeletal development remains unclear.

Methods:

Whole-mount in situ hybridization and embryo immunostaining were performed.

Results:

Zebrafish Fhl1A is the homologue of human FHL1. We showed that fhl1A knockdown causes defective skeletal muscle development, while injection with fhl1A mRNA largely recovered the muscle development in these fhl1A morphants. We also demonstrated that fhl1A knockdown decreases the number of satellite cells. This decrease in satellite cells and the emergence of skeletal muscle abnormalities were associated with alterations in the gene expression of myoD, pax7, mef2ca and skMLCK. We also demonstrated that fhl1A expression and retinoic acid (RA) signalling caused similar skeletal muscle development phenotypes. Moreover, when treated with exogenous RA, endogenous fhl1A expression in skeletal muscles was robust. When treated with DEAB, an RA signalling inhibitor which inhibits the activity of retinaldehyde dehydrogenase, fhl1A was downregulated.

Conclusion:

fhl1A functions as an activator in regulating the number of satellite cells and in skeletal muscle development. The role of fhl1A in skeletal myogenesis is regulated by RA signaling.

[Estimation on the individual treatment effect among heterogeneous population, using the Causal Forests method]

Objective: This project aimed to explore the effectiveness of estimating individual treatment effect on real data, among the heterogeneous population, with Causal Forests (CF) method, to find out the characteristics of heterogeneous population. Methods: We designed and conducted four computer simulation schemes to verify the effect of estimating on individual treatment, using the CF under four different environments of the treatment effects. Real data was then analyzed for the catheterization on right heart. Results: Results from the simulation process showed that the values on individual treatment effect that were estimated by causal forests were consistent with the population effect as well as in line with the expected distribution under the setting of four different effect values. Results of real data analysis showed that values of individual treatment effect among most patients appeared positive, so the use of RHC could cause an increase of the '180-day mortality rate' in the sampled population. Patients with lower predicted probability of 2-mo survival and albumin were more likely to have a lower risk of death after using the RHC. Conclusion: CF method could be effectively used to estimate the individual treatment effect and helping the individuals to make decision on the receipt of treatment.

[Association of single nucleotide polymorphisms of TBX5 gene and environmental exposure index with susceptibility to oral cancer]

Objective: To explore the association of TBX5 polymorphisms and environmental exposure index with susceptibility to oral cancer. Methods: A case-control study was conducted to collect 300 oral cancer patients hospitalized in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Fujian Medical University from September 2010 to December 2016. A total of 445 non-tumor patients were selected as the control group. Questionnaires were used to collect the information of all subjects and 5 ml peripheral blood was collected to detect single nucleotide polymorphisms (SNPs) of the rs10492336 locus of TBX5 gene. According to the environmental exposure index score, subjects were divided into two groups, low risk group (0-2.31) and high risk group (2.32-11.76). To analyze the association of TBX5 gene rs10492336 SNPs, environmental exposure index and oral cancer and its interactions. Results: The age of all subjects in the case group and control group were (56.19±13.10) years and (54.56±12.48) years old. Compared with CC genotype, the OR (95%CI) values of the co-dominant genetic model AC genotype and the dominant genetic model AC+AA genotype were 0.69 (0.49-0.98) and 0.70 (0.51-0.97), respectively. Compared with the low risk group, the OR (95%CI) risk of oral cancer in the high risk group was 3.72 (2.55-5.43). The results of gene-environment interaction analysis showed that compared with the group with CC genotype and high risk of environmental exposure index, the OR (95%CI) value of oral cancer in the group with AC+AA genotype and low risk of environmental exposure index was 0.18(0.10-0.31). Furthermore there was a multiplicative interaction between rs10492336 SNPs and environmental exposure index (β=-0.405, P<0.001). Conclusion: This study suggests that the TBX5 gene rs10492336 SNPs and environmental exposure index were associated with oral cancer. And there was a multiplication interaction between rs10492336 SNPs and environmental exposure index.

[Association between the frequency of bowel movements and the risk of colorectal cancer in Chinese adults]

Objective: To examine the association between the frequencies of bowel movement (BMF) and the risk of colorectal cancer (CRC). Methods: In this study, 510 134 participants from the China Kadoorie Biobank (CKB) were included, after excluding those who reported as having been diagnosed with cancer at the baseline survey. The baseline survey was conducted from June 2004 to July 2008. The present study included data from baseline and follow-up until December 31, 2016. We used the Cox proportional hazards regression models to estimate the HR and the 95%CI of incident CRC with BMF. Results: During an average follow-up period of 9.9 years, 3 056 participants were documented as having developed colorectal cancer. In the site-specific analysis, 1 548 colon cancer and 1 475 rectal cancer were included. Compared with participants who had bowel movements on the daily base, the multivariable-adjusted HR (95%CI) for those who had more than once of BMF were 1.24 (1.12-1.39) for CRC, 1.12 (0.95-1.31) for colon cancer, and 1.37 (1.18-1.59) for rectal cancer. We further examined the association between BMF and CRC, according to the stages of follow-up, the corresponding HR (95%CI) for CRC, colon and rectal cancer were 1.59 (1.36-1.86), 1.43 (1.14- 1.80), and 1.76 (1.41-2.19) for the first five years, while such associations became statistically insignificant in the subsequent follow-up (P for all interactions were <0.05), as time went on. As for CRC, colon or rectal cancers among participants who had lower bowel movements, the risks were not significantly different from those who had bowel movements everyday. Conclusions: Participants who had BMF more than once a day, appeared an increased risk of CRC in the subsequent five years. Since abnormal increase of bowel movements is easily recognizable, programs should be set up on health self- management and early screening for CRC.

Correlation between MMP-2 gene polymorphism and cataract susceptibility

OBJECTIVE

To investigate the correlation between matrix metalloproteinase-2 (MMP-2) gene polymorphism and cataract.

PATIENTS AND METHODS

104 cataract patients and 100 healthy subjects were enrolled and assigned to the observation group and control group, respectively. General clinical data of the enrolled subjects were collected. The inflammatory factors were detected, and the rs243865 polymorphism of MMP-2 gene was detected using the TaqMan-MGB probe.

RESULTS

The levels of interleukin-6 (IL-6), IL-1β, C-reactive protein (CRP), and tumor necrosis factor-1α (TNF-1α) in the observation group were higher than those in the control group (p<0.05). There were significant differences in the genotype and allele distribution frequency between the two groups (p<0.05). In the genetic model analysis, the additive model was remarkably different between the two groups (p<0.05). However, the recessive model and dominant model were not different between the two groups (p>0.05).

CONCLUSIONS

Cataract is correlated with inflammatory factors, and the rs243865 polymorphism of MMP-2 gene has a correlation with the incidence of cataract.

[Evaluation of efficacy of immunosuppressive therapy plus recombinant human thrombopoietin for children with severe aplastic anemia]

Objective: To evaluate the therapeutic efficacy and safety of immunosuppressive therapy (IST) combined with recombinant human thrombopoietin (rhTPO) for severe aplastic anemia (SAA) in pediatric patients. Method: A retrospective case-control study was conducted and the clinical data of 45 pediatric patients with de novo SAA admitted to the Anemia Diagnosis and Treatment Center of Chinese Academy of Medical Sciences & Blood Disease Hospital during the period from December 2009 to December 2014 were analyzed. Among them, 15 patients were treated with the regimen of IST together with rhTPO and 30 patients were given IST treatment only. The variation characteristics of the peripheral blood routine as well as the transfusion of blood products was dynamically observed, and the therapeutic efficacy was assessed respectively after 3, 6 and 12 months after the treatment. In the meantime, adverse effects related to rhTPO application were recorded. Thereafter, the statistics of the two groups were compared by non-parametric rank sum test. Result: Among 45 pediatric patients, there were 26 male and 19 female, and the median age was 11 years (6-14). The number of patients received good hematological response(complete remission (CR) plus good partial response (GPR)) in the combinatory group versus vs. the IST group was 6 vs. 3 patients (χ(2)=3.906, P=0.048) at the 3rd month, 7 vs. 7 patients (χ(2)=1.568, P=0.210) at the 6th month, and 13 vs. 14 patients (χ(2)=6.667, P=0.01) at the 12th month respectively. For those achieved good hematological response at the 3rd month, the amount of platelets transfusion and red blood cells transfusion of the combined group were both less than that of the IST group during the period from the 10th to the 12th weeks (platelets transfusion: 1.4 U vs. 2.9 U, t=-3.523, P=0.002; red blood cells transfusion: 0.8 U vs. 2.6 U, t=-2.392, P=0.026). No serious adverse effect related to rhTPO application was observed in the IST combined with rhTPO group. Conclusion: Application of rhTPO can improve the short-term therapeutic efficacy of IST for pediatric SAA, alleviate transfusion dependence, and has a good safety profile.

Efficacy and safety of perioperative tranexamic acid in elderly patients undergoing trochanteric fracture surgery: a randomised controlled trial

INTRODUCTION

Trochanteric fractures result in a high frequency of considerable blood loss, a high incidence of blood transfusions, and a high risk of perioperative morbidity and mortality in elderly patients. This study aimed to evaluate the efficacy and safety of a three-dose regimen of tranexamic acid on blood loss and transfusion rate in elderly patients with trochanteric fractures.

METHODS

Eligible patients with trochanteric fractures surgically treated by dynamic hip screw and proximal anti-rotating intramedullary nail between March 2016 and October 2017 were enrolled in the study. Patients were randomly assigned to receive 15 mg/kg intravenous tranexamic acid dissolved in 100 mL of saline (TXA group) or 100 mL of saline solution (placebo group) over 10 minutes before, during, and after surgery. Perioperative blood loss, obvious blood loss, and hidden blood loss in the two groups were calculated separately. Vascular events and patient mortality over 6 months' follow-up were noted.

RESULTS

In total, 176 patients were included. Compared with the placebo group (n=88), patients in the TXA group (n=88) had less blood loss: perioperative blood loss was 205.5 mL (P<0.001), obvious blood loss was 125 mL (P<0.001), and hidden blood loss was 76.5 mL (P<0.001); reduced incidence of blood transfusion (17% vs 35%, P=0.007); and shorter hospital stays (median [interquartile range], 7 [6-8] vs 8.5 [7.5-9] days, P<0.001).

CONCLUSION

Tranexamic acid significantly lowered perioperative blood loss and blood transfusion rate without an increased risk of venous thromboembolism or mortality in elderly patients with trochanteric fractures treated with dynamic hip screw or proximal anti-rotating intramedullary nail.

A metabolite of endophytic fungus Cadophora orchidicola from Kalimeris indica serves as a potential fungicide and TLR4 agonist

AIM

To investigate the bioactive metabolite of endophytic fungus from Kalimeris indica.

METHODS AND RESULTS

A strain ZJLQ336 was separated from the leaves of K. indica. It was identified as Cadophora orchidicola based on the phylogenetic analysis of ITS-rDNA sequences. From the fermentation broth a metabolite cercosporamide (compound 1) was isolated, and its structure was determined by spectroscopic analysis. Additionally, this compound was subjected to bioactivity assays, including antifungal activity against seven plant pathogenic fungi, as well as its potential immunoregulatory effects on HEK-BLUE™-hTLR4 cells, splenocytes and macrophages. The results showed that cercosporamide had strong growth inhibition against five common plant pathogenic fungi, including Pestalotia diospyri, Botrytis cinerea, Fusarium oxysporum, Sclerotium rolfsii and Penicillum digitatum with EC₅₀ values of 5·29 × 10^-3 , 0·61, 0·93, 2·89 and 6·7 μg ml^-1 respectively. Among which S. rolfsii was one of the main pathogens in K. indica. Moreover, cercosporamide not only significantly stimulated TLR4 activation, splenocyte proliferation and production of cytokines, IFN-γ and TNF-α, but also up-regulated the production of TNF-α and NO in RAW264.7 macrophages clearly.

CONCLUSIONS

This is the first report of endophytic C. orchidicola from K. indica and its metabolite cercosporamide. The results of pharmacological tests highlight the potential fungicide and TLR4 agonist of cercosporamide.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study indicates endophytic fungi are good resources for natural bioactive metabolites. It also suggests that cercosporamide is a potential fungicide and TLR4 agonist.

[From coding sequence to non-protein coding region: advances in cleft lip and palate genetic mechanism researches]

With the continuous development of bioinformatics technology and precision medicine, genetic mechanism investigations of genetic diseases including cleft lip and palate (CLP) have been getting more and more attention. Researchers have focused on the coding sequence of the genome and successfully found many CLP causative mutations, but there still remain some unsolved questions. In recent years, researchers' vision has gradually shifted to non-protein coding region of the genome. This article reviews several coding sequence mutations, non-protein coding variants and their genetic mechanisms discovered in CLP researches.

[Efficacy and safety of haploidentical hematopoietic stem cell transplantation for 17 patients with paroxysmal nocturnal hemamoglobinuria]

目的

探讨单倍型造血干细胞移植治疗阵发性睡眠性血红蛋白尿症（PNH）的疗效和安全性。

方法

回顾性分析2013年1月至2017年9月采用亲缘单倍型移植治疗的17例PNH患者临床资料。

结果

17例患者中原发PNH 4例，再生障碍性贫血（AA）-PNH综合征13例。所有患者均以改良白消安+环磷酰胺联合抗胸腺细胞球蛋白（ATG）进行清髓性预处理。G-CSF动员的供者骨髓联合外周血干细胞作为移植物来源。环孢素A+吗替麦考酚酯+短程甲氨蝶呤预防移植物抗宿主病（GVHD）。移植后17例患者均获粒系及巨核系造血重建，粒细胞中位植入时间为移植后12（10~15）d，血小板中位植入时间为移植后14（11~45）d。所有患者在+30 d经植入鉴定证实为完全供者嵌合体。7例患者发生Ⅱ~Ⅳ度急性GVHD，4例发生慢性GVHD。中位随访时间为27.1（8.6~60.4）个月，17例患者中15例存活，2例死亡，死因分别为肺部重症感染和移植相关的血栓性微血管病。3年总生存率为（77.8±15.2）%。

结论

对于无完全相合供者的PNH患者，尝试进行单倍型造血干细胞移植有效、安全。

Early development of apoplastic barriers and molecular mechanisms in juvenile maize roots in response to La2O3 nanoparticles

The increasing occurrence of engineered nanoparticles (NPs) in soils may decrease water uptake in crops, followed by lower crop yield and quality. As one of the most common rare earth oxide NPs, lanthanum oxide (La₂O₃) NPs may inhibit the relative expressions of aquaporin genes, thus reduce water uptake. In the present study, maize plants were exposed to different La₂O₃ NPs concentrations (0, 5, 50 mg L^-1) for 72 h and 144 h right after the first leaf extended completely. Our results revealed that water uptake was reduced by La₂O₃ NPs through accelerating the development of apoplastic barriers in maize roots. The level of abscisic acid, determined by using ultra high performance liquid chromatography-tandem mass spectrometry, was increased upon La₂O₃ NPs exposure. Furthermore, ZmPAL, ZmCCR2 and ZmCAD6, the core genes specific for biosynthesis of lignin, were up-regulated by 3-13 fold in roots exposed to 50 mg L^-1 La₂O₃ NPs. However, ZmF5H was suppressed, indicating that lignin with S units could be excluded for the formed lignin in apoplastic barriers upon La₂O₃ NPs exposure. The level of essential component of apoplastic barriers - lignin was increased by 1.5-fold. The early development of apoplastic barriers was observed, and stomatal conductance and transpiration rate of La₂O₃ NPs-treated plants were significantly decreased by 63%-83% and 42%-86%, respectively, as compared to the control. The lignin enriched apoplastic barriers in juvenile maize thus led to the reduction of water uptake, subsequently causing significant growth inhibition. This is the first study to show early development of root apoplastic barriers upon La₂O₃ NPs exposure. This study will help us better understand the function of apoplastic barriers in roots in response to NPs, further providing fundamental knowledge to develop safer and more efficient agricultural nanotechnology.

The expression changes and correlation analysis of high mobility group box-1 and tissue factor in the serum of rats with sepsis

OBJECTIVE

To investigate the expression changes of high mobility group box-1 (HMGB-1) and tissue factor (TF) and their correlation in the serum of sepsis rat models.

MATERIALS AND METHODS

30 rats were divided into the sham-operated group, 15 rats were in the control group. The cecal ligation and puncture method was used to make the animal model with abdominal infection induced by sepsis. There were 15 rats in the sepsis group among which they were divided into 3 subgroups at different time points after modeling (after 6 hours, 12 hours, 24 hours). Cardiac function indicators of the rats in each subgroup were monitored, including heart rate (HR), left ventricular end-diastolic pressure (LVEDP) and left ventricular developed pressure (LVDP), and enzyme-linked immunosorbent assay (ELISA) was used to test the changes of the expression levels of HMGB-1 and TF in the serum of the rats after 6 hours, 12 hours, 24 hours. Pearson correlation analysis was used to analyze the correlation between HMGB-1 and TF.

RESULTS

HR and LVEDP of the rats in the sepsis group were significantly higher than those of the rats in the control group. The differences were statistically significant (p<0.050). LVDP of the rats in the sepsis group was markedly lower than that of the rats in the control group. The differences were statistically significant (p<0.050). The expressions of HMGB-1 and TF of the rats in the subgroups of the sepsis group were higher than those of the rats in the control group after 6 hours, 12 hours, 24 hours; the expression levels of HMGB-1 and TF of the rats with sepsis increased with time. The differences were statistically significant (p<0.050). When the expressions of HMGB-1 and TF of the rats in the sepsis group were compared with each other within the group the differences were significantly different (p<0.050). The expressions of HMGB-1 and TF in the subgroups at the 24th hour were significantly higher than those at the 6th hour. The differences were statistically significant (p<0.050). The differences of the expression of TF of the rats in the control group were not statistically significant (p>0.050). There was a significant positive correlation between HMGB-1 and TF of the rats in the sepsis group (r=0.772, p=0.002).

CONCLUSIONS

The expression levels of HMGB-1 and TF of the rats with sepsis gradually increased with time, and the level of HMGB-1 was positively correlated with the level of TF.

Nanoscale bubble ultrasound contrast agents-mediated suicide gene therapy system, Nanoscale bubble-LV5-YCD-TK/GCV/5-FC, effectively inhibits bladder cancer cell growth

OBJECTIVE

Bladder cancer is the 2nd most common reason for human genitourinary cancer-associated mortality. This study aimed to investigate the effects of Nanoscale bubble ultrasound contrast agents-mediated yeast-cytosine-deaminase-thymidine kinase/ganciclovir (YCD-TK/GCV) or YCD-TK/5-fluorocytosine (5-FC) suicide gene therapy system on BIU-87 cell growth.

MATERIALS AND METHODS

Targeted nanoscale bubble ultrasound contrast agents were prepared by utilizing thin-film hydration-sonication approach. Nanoscale bubble-LV5-YCD-TK/GCV(5-FC) was constructed and transfected to BIU-87 cells. Hematoxylin and eosin (HE) staining was used to evaluate inflammation. 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay was used to examine cell viability. Cell-cycle distribution was analyzed with cell cycle assay. Flow cytometry assay was utilized to test apoptosis of BIU-87 cells. YCD-TK expression was examined using Western blot and quantitative Real Time-PCR (qRT-PCR), respectively.

RESULTS

YCD-TK highly expressed in Nanoscale bubble mediated suicide gene therapy system. Nanoscale bubble-mediated suicide gene therapy system significantly induced inflammatory response and apoptosis compared to that of Nanoscale bubble group (p<0.05). Nanoscale bubble mediated suicide gene therapy system significantly reduced cell viability compared to that of the Nanoscale bubble group (p<0.05). Nanoscale bubble mediated suicide gene therapy system significantly inhibited cell cycle arrest compared to that of the Nanoscale bubble group (p<0.05). Nanoscale bubble-LV5-YCD-TK/GCV/5-FC therapy system significantly reduced BIU-87 cell viability compared to that of the Nanoscale bubble-associated groups (p<0.05).

CONCLUSIONS

Nanoscale bubble-mediated suicide gene therapy system, bubble-LV5-YCD-TK/GCV/5-FC, acts as a novel therapeutic strategy for bladder cancer treatment.

Amphiphilic polymer coated nanodiamonds: a promising platform to deliver azonafide

An amphiphilic polymer is grafted on nanodiamonds to improve the colloidal stability and to deliver an anticancer drug azonafide.

[Clinical significance of continuous transfixion suture for nasal septum in septoplasty]

Objective:To systemically evaluate the clinical significance of continuous transfixion suture for nasal septum in septoplasty. Method:Forty patients with nasal septum deviation were randomly assigned to the suture group including 20 patients who underwent endoscopic septoplasty followed by continuous transfixion suture for nasal septum, or the nasal packing group including 20 patients who underwent endoscopic septoplasty followed by nasal packing. Two groups were compared for the visual analogue scale (VAS) scores for postoperative rhinalgia, headache, lacrimation, dysphagia and sleep disorder, changes in mucociliary transport time (MTT) before and after surgery, and postoperative capillary hemorrhage. Patients were followed up for 2 weeks to observe the short-term postoperative complications. Result:Mean VAS scores for rhinalgia, headache, lacrimation, dysphagia and sleep disorder were all higher in nasal packing group than those in suture group (P<0.05); compared to suture group, there was greater prolongation of MTT before and after surgery in packing group (P<0.05); there was significant difference between two groups in postoperative capillary hemorrhage volume (P<0.05); in the nasal packing group, nasal synechia, nasal dryness and hyposmia were observed in 1, 3 and 2 patients, respectively, within 2 weeks postoperatively, whereas no short-term complications were observed in the suture group. Conclusion:Use of continuous transfixion suture in place of nasal packing following septoplasty can significantly improve the postoperative symptoms, protect nasal mucociliary clearance, and reduce short-term postoperative complications.

Evidence for involvement of a transformer paralogue in sex determination of the wasp Leptopilina clavipes

Transformer (tra) is the central gear in many insect sex determination pathways and transduces a wide range of primary signals. Mediated by transformer-2 (tra2) it directs sexual development into the female or male mode. Duplications of tra have been detected in numerous Hymenoptera, but a function in sex determination has been confirmed only in Apis mellifera. We identified a tra2 orthologue (Lc-tra2), a tra orthologue (Lc-tra) and a tra paralogue (Lc-traB) in the genome of Leptopilina clavipes (Hymenoptera: Cynipidae). We compared the sequence and structural conservation of these genes between sexual (arrhenotokous) and asexual all-female producing (thelytokous) individuals. Lc-tra is sex-specifically spliced in adults consistent with its orthologous function. The male-specific regions of Lc-tra are conserved in both reproductive modes. The paralogue Lc-traB lacks the genomic region coding for male-specific exons and can only be translated into a full-length TRA-like peptide sequence. Furthermore, unlike LC-TRA, the LC-TRAB interstrain sequence variation is not differentiated into a sexual and an asexual haplotype. The LC-TRAB protein interacts with LC-TRA as well as LC-TRA2. This suggests that Lc-traB functions as a conserved element in sex determination of sexual and asexual individuals.

Bone Metastases Pattern in Newly Diagnosed Metastatic Bladder Cancer: A Population-Based Study

Purpose: Based on a large-population analysis, we aimed to estimate the incidence and survival of bone metastases (BM) in initial bladder cancer (BC) patients and to identify the risk and prognostic factors of BC patients with BM.

Patients and methods: Using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, bladder cancer patients diagnosed between 2010 and 2014 were retrieved. Multivariate logistic and Cox regression analyses were employed to identify risk factors and prognostic factors for BM in BC patients. A Kaplan-Meier analysis with log-rank test was used to estimate the overall survival for BC and the difference between the survival curves.

Results: A total of 1,223 (1.39%) BC patients were diagnosed with de novo BM. Variables such as age between 41 to 60 years, black race, unmarried status, higher T stage, higher N stage, poor tumour differentiation grade, lung metastases, liver metastases, and brain metastases were positively associated with BM occurrence. The median survival for BC patients with BM was dramatically decreased to 4.0 months. Factors including advanced age, absence of surgery, and presence of lung, liver, or brain metastases all predicted worse survival.

Conclusion: BM can dramatically decrease the survival of bladder cancer patients. The findings of the present study can provide population-based identification of risk and prognostic factors for BC patients with BM at initial diagnosis, which can be used for BM occurrence prediction and individualized treatment plan-making.

[The relationship between the key nasal symptoms and the level of histamineand leukotriene D4 in serum and nasal secretions in allergic rhinitis]

Objective:To investigate the relationship between main nasal symptoms and the levels of histamine and leukotriene D4(LTD4) in serum and nasal secretions in allergic rhinitis(AR),and provide a preliminary guidance for individualized treatment in AR.Method:One hundred and eight cases of AR were divided into two groups,i.e.sneezing group and nasal congestion group,according to 2014 clinical guidelines for allergic rhinitis from January 2014 to June 2015.The levels of histamine and LTD4 in serum and nasal secretions were determined by enzyme-linked immunosorbent assay(ELISA) and the relationship was explored between the clinical main nasal symptoms score and the levels of histamine and LTD4.Result:The scores of sneezing(5.58±2.59)for AR were obviously related to the levels of histamine in serum(8.39±4.07)ng/ml and nasal secretion(5.06±2.47)ng/ml,(r=0.79,0.78,all P<0.05).The scores of nasal congestion(5.34±2.36) for AR were also related to the levels of LTD4 in serum(0.356±0.155 ng/ml) and nasal secretion(0.215±0.092)ng/ml,(r=0.74,0.72,all P<0.05).And the levels of histamine(8.39±4.07)ng/ml and LTD4(0.356±0.155) ng/ml in serum for AR patients were positively correlated with the levels in nasal secretions(r=0.99,P<0.01;r=0.98,P<0.01).Conclusion:In AR patients,the high levels of histamine and LTD4 in serum and nasal secretions are closely related to the sneezing symptoms and nasal obstruction symptoms,respectively.

[Clinical diagnosis and treatment of adenoid cystic carcinoma of the external auditory canal]

Objective:To discuss the clinical diagnosis, therapies and prognosis of adenoid cystic carcinoma of external auditory canal.Method:Eleven patients with adenoid cystic carcinoma of external auditory canal, who had been admitted to West China hospital, Sichuan university from April 2009 to October 2015 were recruited and a retrospective analysis was performed.Result:All the 11 patients were treated with surgery except one elderly with T1 stage who was only treated with radiotherapy(RT),1 of the 10 patients treated with surgery were added on radiotherapy after surgery. Following up for 12-104 months,the patient who was treated with RT alone has survived with carcinoma for 51 months by now,among the remainder stage T1 patients,one was reoperated for local recurrence 95 months after surgery, and therefore survived without recurrence.The other 2 patients all survived with free-disease;in the stage T2 patients,one was lost to follow-up after identified local recurrence with pulmonary masses 12 months after surgery, another one committed suicide because of family problems 56 months after operation,and the other one survived without recurrence for 57 months after surgery; the stage T3 patient survived without recurrence for 26 months at present;in the T4 patients, one died after gamma knife therapy for local recurrent disease with brain metastasis 22 months after surgery, another one died from pulmonary metastasis 17 months after surgery,and the other one survived without recurrence for 56 months.Conclusion:Adenoid cystic carcinoma of external auditory canal is a rare disease with high misdiagnosis rate and progresses slowly.Surgery is the preferred therapy.The prognosis is closely related to disease clinical stage at presentation type of pathology and surgical approaches. Adenoid cystic carcinoma of external auditory canal is characteristically susceptible to local recurrence and distant metastasis,inaddition to routine re-exam of ear,the patients should be reviewed carefully to exclude of pulmonary,brain and kidney metastasis during follow-up.

Molecular characteristic and pathogenicity analysis of a virulent recombinant avain infectious bronchitis virus isolated in China

A virulent infectious bronchitis virus (IBV), designated as CK/CH/GD/QY16 (referred as QY16), was isolated from a diseased chicken farm in Guangdong province, China, in 2016. The complete genome of the strain was sequenced and analyzed. The results show that the genome of QY16 consists of 27,670 nucleotides, excluding poly (A) tail, and that its genome organization is 5’ UTR-1a-1b-S-3a-3b-E-M-4b-4c-5a-5b-N-6b-3’ UTR-poly (A) tail. Sequence comparison among QY16 and other IBV strains was conducted and its results demonstrate that the S1 gene of QY16 has the highest nucleotide sequence identity with that of 4/91, and the other part of its genome is highly similar to that of YX10. The results of the phylogenic analysis show that the entire genome of QY16 and most of the QY16 genes are located in the same cluster as those of YX10, except for the S1 gene which is located in the same cluster with that of 4/91. It has been further confirmed by the RDP and SimPlot analysis that QY16 is a recombinant strain deriving from YX10 (as the major parental sequence) and 4/91 (as the minor parental sequence), and that the recombination occurs in a region which includes the 3’-terminal 1b sequence (85 nt) and the 5’-terminal S1 protein gene sequence (1,466 nt). The results of the vaccination-challenge test suggest that QY16 is a nephropathogenic strain of IBV and that the vaccine strains–H120 and 4/91—cannot provide effective protection against it. These results indicate that the continuing evolution of IBV strains by genetic drift and genetic recombination may lead to IBV outbreaks even among the vaccinated chickens in China.

Analysis on Forensic Expertise of 49 Medical Disputes in Prenatal Examination

OBJECTIVES

To analyze the cases of medical disputes involving prenatal examination from a point of view of forensic expertise, and to discuss the risk of medical disputes and the preventive measures.

METHODS

A retrospective analysis was conducted on 49 forensic expertise cases of medical disputes in prenatal examination which were identified in Academy of Forensic Science and Shanghai Di'an Forensic Science Limited Company from 2010 to 2017.

RESULTS

In recent years, the number of medical disputes involving prenatal examination showed an increasing trend year by year. The common causes of medical disputes were: uninformed or insufficiently informed disclosure （20 cases）; the propaganda and application of three-dimensional, four-dimensional ultrasound were not standardized （14 cases）; ultrasound examination and serological screening process were not standardized （12 cases）; no antenatal counseling （2 cases）, etc.

CONCLUSIONS

In order to minimize the occurrence of such medical disputes, hospitals or related associations should avoid the risk of prenatal examination through the standardization of management and operation.

[Establishment and characterization of an orthotopic murine model of mucosal malignant melanoma of the maxillary sinus]

Objective:To establish a stable and reliable orthotopic murine model of mucosal malignant melanoma of the maxillary sinus so as to provide animal models for further studying for pathogenesis and therapy of sinonasal malignancy.Method:B16 were implanted in the right maxillary sinus of male nude mice. After tumors appeared in right maxillary sinus, tumor growth and survival rate were recorded. The degree of tumor infiltration was observed through the MRI.Result:Mice with B16 implanted in right maxillary sinus developed primary tumors. The survival and the tumor volume were related to the number of tumor cells implanted. We found that the tumor can invade into nasal cavity, orbital cavity and the basilar region using MRI.Conclusion:We successfully established a model for mucosal malignant melanoma of the maxillary sinus. This model offers an experimental tool for further research on biological characteristics of sinonasal malignancy and the development of new therapy.

[Value discussion of radical sinus surgery for difficult-to-treat rhinosinusitis]

Objective:To investigate the efficacy of radical sinus surgery (RSS) on difficult-to-treat rhinosinusitis(DTRS) with nasal polyps. Method: We retrospectively analyzed the clinical data of 26 patients with DTRS that treated with RSS and patients who were not treated with RSS in our hospital from August 2013 to June 2017.The effect of RSS were evaluated by comparing the CT Lund-Kennery score,endoscope Lund-Kennery score,global VAS score and dysosmia VAS score before operation and 6 months after operation. Result: RSS group had more severe Lund-Kennery score,global VAS score and dysosmia VAS score than non-RSS group,and also had more previous surgeries,higher ratio of olfactory region polyps,and higher ratio of co-existing asthma and allergic rhinitis. However RSS group had a lower ratio with pus anot than non-RSS group. The eosinophil count in periheral blood between two groups had no statistical significance. Six months after RSS,the score of endoscope Lund-Kennery,global VAS and dysosmia VAS dependence. 14 patients were successfully cured(53.8%), 12 patients showed improvement(46.2%), no invalid cases. Conclusion: The global symptoms and olfaction of DTRS patients can be improved by RSS combine individual perioperative drug therapy.

[Extranodal NK/T-cell lymphoma, nasal type: a clinical analysis]

Objective:To explore the clinical diagnosis and treatment characteristics and clinical factors of extranodal NK/T-cell lymphoma, nasal type and provide the basis for clinical individual therapy and experience.Method:The 25 cases personal data of ENKTL received from December in 2009 to July in 2016 by our department including clinical manifestation, the serum EBV-DNA detection, imaging examination, Ann-Arbor staging, histological grade, treatment, and prognosis, etc. were retrospectively analyzed. All of the patients were pathological diagnosis and received standard, specification and system treatment. Single factor survival analysis was performed by Kaplan-Meier method and Log-rank test, and multivariate analysis was carried out using Coxproportional hazard model in the risk assessment about the factors affecting the prognosis of clinical.Result:Of the 25 patients, 15 cases(60%) were in stage ⅠE-ⅡE, which 1 year and 3 years (overall survival) OS were 100%, 100% respectively and 10 cases(40%) were in stage ⅢE-ⅣE, which 1 year and 3 years OS were respectively 40.0%, 26.7%. It had significant statistical difference (P= 0.000). Radiotherapy alone in 3 cases which 1 year and 3 years OS were respectively 100%, 100%;Chemotherapy alone in 6 cases, which 1 year and 3 years OS were 53.6% and 53.6%, respectively; 16 cases of comprehensive treatment combined radiation and chemotherapy which 1 year and 3 years OS are 84.6% and 84.6% respectively. There were significant difference between three kinds of treatment model (P= 0.027), and chemotherapy alone had the worst prognosis. Further multivariate analysis using Coxproportional hazard model showed that the course of the disease, B symptoms, EBV-DNA copy number positive, treatment mode closely associated with the prognosis (P were 0.006, 0.003, 0.010, 0.040 respectively).Conclusion:Extranodal NK/T-cell lymphoma, nasal type invasive is strong, the overall prognosis is poor. For early Ann Arbor staging, low risk and limited to the nasal cavity cases, radiotherapy alone curative effect is better. While for strong attack range or terminal patients, chemotherapy combined with radiotherapy is the first selection. In addition, this result shows that Ann Arbor staging, treatment pattern, the course of the disease, B symptoms, EBV-DNA copy number positive are independent prognostic factors.

Protein kinase TTK promotes proliferation and migration and mediates epithelial-mesenchymal transition in human bladder cancer cells

AIM

To investigate the expression level of TTK in bladder cancer, and its role in the proliferation and migration. To investigate the relationship between TTK and epithelial-mesenchymal transition (EMT).

PATIENTS AND METHODS

We compared the expression level of TTK between human bladder cancer tissues and normal bladder epithelial tissues from 70 patients using immunohistochemistry, qRT-PCR and western blotting. Subsequently, we conducted cell viability and cell migration experiments to investigate the effect of TTK on bladder cancer cells. Furthermore, we used qRT-PCR to detect the biomarkers of EMT to examine the relationship between TTK and EMT.

RESULTS

The expression level of TTK was significantly higher in bladder cancer tissues as compared to the adjacent noncancerous tissues (P < 0.001). The qRT-PCR, immunohistochemistry, and western blotting also showed the same trend. Furthermore, cell viability and cell migration assays showed that TTK promoted proliferation and migration of human bladder cancer cells, and mediated EMT.

CONCLUSION

This study showed that high expression of TTK can promote proliferation and migration, and might mediate the EMT process in human bladder cancer cells.

Ultraviolet lasing in Zn-rich ZnO microspheres fabricated by laser ablation

Zinc (Zn) surface plasmons (SPs) have been widely reported for their impressive performance in improving the optical properties of semiconductors. Zn is an effective metal with SPs response in the ultraviolet region, but the disadvantage of strong metal activity limits the application mentioned above. Here, in order to ensure the stability of metal Zn, ZnO/Zn microspheres were synthesized by an one-step laser ablation method to distribute Zn nanoparticles simultaneously on both inner and outer surfaces of ZnO microspheres. Lasing performance enhancement and a lower threshold were obtained in the composite which originates from the coupling between Zn SPs and the excitation light source. Accompanied by the lasing emission measurements, the coupling mechanism was explained through time-resolved photoluminescence spectroscopy (TRPL) for the samples by rapid annealing in situ. This work displays the results of lasing enhancement and the physical process of Zn SPs resonance in the ZnO/Zn microsphere.

Evaluation of posterior nutcracker phenomenon using multisection spiral CT

AIM

To prospectively evaluate the epidemiological, anatomical classification, clinical importance, and radiological features of posterior nutcracker phenomenon (PNP) in patients examined with multisection spiral computed tomography (MSCT).

MATERIAL AND METHODS

Patients who underwent abdominal enhanced MSCT from January 2012 to July 2016 were evaluated retrospectively. Combined with the blood, normal biochemistry, and urine tests, patients were assessed retrospectively for renal vein diameter measurements, the compression ratio of blood vessels, gender differences, anatomical classification, percentage of proteinuria and haematuria, and clinical symptoms.

RESULTS

The study included 6,225 consecutive patients, PNP was observed in 2.06% involving the CLRV in 1.22% and retro-aortic left renal vein in 0.84%. The proportion of posterior nutcracker syndrome (PNS) was lower in PNP (17.2%). There was no difference by sex and age in the prevalence of PNP (p>0.05). In patients with urological symptoms, the number of type II abnormalities was more frequent than type Ia and type Ib abnormalities. Meanwhile, the number of type II abnormalities was frequent than the other two types. There was a significant difference between PNS and asymptomatic PNP (aPNP) in all measured values (p<0.001), the ratio was >4, especially in type II abnormalities (ratio >5.0).

CONCLUSIONS

PNP is a type of left renal vein entrapment. It is exceptionally rare and might be underdiagnosed. MSCT and measured values can be useful in diagnosis and recognition.

Autoantibody against integrin αv β3 contributes to thrombocytopenia by blocking the migration and adhesion of megakaryocytes

Essentials The pathogenesis of immune thrombocytopenia (ITP) has not been fully clarified. We analyzed the role of anti-αvβ3 autoantibody in the pathogenesis of ITP in patients. Anti-αvβ3 autoantibody impeded megakaryocyte migration and adhesion to the vascular niche. Anti-αv β3 autoantibody potentially contributes to the pathogenesis of refractory ITP.

SUMMARY

Background The pathogenesis of immune thrombocytopenia (ITP) has not been fully clarified. Anti-αvβ3 integrin autoantibody is detected in chronic ITP patients, but its contribution to ITP is still unclear. Objectives To clarify the potential role of anti-αvβ3 integrin autoantibody in chronic ITP and the related mechanism. Methods Relationship between levels of anti-αvβ3 autoantibody and platelets in chronic ITP patients was evaluated. The influence of anti-αvβ3 antibody on megakaryocyte (MK) survival, differentiation, migration and adhesion was assessed, and the associated signal pathways were investigated. Platelet recovery and MKs' distribution were observed in an ITP mouse model pretreated with different antibodies. Result In this study, we showed that the anti-αvβ3 autoantibody usually coexists with anti-αIIbβ3 autoantibody in chronic ITP patients, and patients with both autoantibodies have lower platelets. In in vitro studies, we showed that the anti-αvβ3 antibody had no significant effect on the survival and proliferation of MKs, whereas it decreased formations of proplatelet significantly. Anti-αvβ3 antibody impeded stromal cell derived facor-1 alpha (SDF-1α)- mediated migration and inhibited the phosphorylation of protein kinase B. Anti-αvβ3 antibody significantly inhibited MKs' adhesion to endothelial cells and Fibrogen. The phosphorylation of focal adhesion kinase and proto-oncogene tyrosine-protein kinase Src induced by adhesion was inhibited when MKs were pretreated with anti-αvβ3 antibody. In in vivo studies, we showed that injection with anti-αv antibody delayed platelet recovery in a mouse model of ITP. Conclusions These findings demonstrate that the autoantibody against integrin αv β3 may aggravate thrombocytopenia in ITP patients by impeding MK migration and adhesion to the vascular niche, which provides new insights into the pathogenesis of ITP.

[One case of elderly patient with extremely severe burn complicated by ventricular tachycardia]

One elderly patient with extremely severe burn was admitted to our department on 4th August, 2017. The patient suffered multiple sustained ventricular tachycardia from post injury day 2 to 4 due to relatively high input volume during shock stage. Amiodarone could not be given through intravenous injection because of his low blood pressure. After consultation with cardiologist, ventricular tachycardia was corrected by electrical cardioversion of several times. According to this case, the first treatment is electrical cardioversion when elderly patient with extremely severe burn shows sustained ventricular tachycardia which can not be corrected with medicine.

Dynamic Handwriting Signal Features Predict Domain Expertise

As commercial pen-centric systems proliferate, they create a parallel need for analytic techniques based on dynamic writing. Within educational applications, recent empirical research has shown that signal-level features of students’ writing, such as stroke distance, pressure and duration, are adapted to conserve total energy expenditure as they consolidate expertise in a domain. The present research examined how accurately three different machine-learning algorithms could automatically classify users’ domain expertise based on signal features of their writing, without any content analysis. Compared with an unguided machine-learning classification accuracy of 71%, hybrid methods using empirical-statistical guidance correctly classified 79–92% of students by their domain expertise level. In addition to improved accuracy, the hybrid approach contributed a causal understanding of prediction success and generalization to new data. These novel findings open up opportunities to design new automated learning analytic systems and student-adaptive educational technologies for the rapidly expanding sector of commercial pen systems.

Retrospective Analysis of 24 Cases of Forensic Medical Identification on Traumatic Tympanic Membrane Perforations

OBJECTIVES

To study the case characteristics of forensic medical identification of traumatic tympanic membrane perforations, and to discuss the key points of forensic medical identification and evaluations methods for tympanic membrane perforations.

METHODS

Twenty-four cases of traumatic tympanic membrane perforations accepted by the Academy of Forensic Science during 2017 were retrospectively analysed. The data of perforation size, form, predilection site, healing time and healing mode were evaluated.

RESULTS

For the traumatic tympanic membrane perforations, the study showed that the small size of perforation （<1/2 quadrant） with irregular shape was common. The location of perforations was almost on the anterior and inferior quadrant, and centripetal migration healing was common. The healing rate within 6 weeks was up to 90%.

CONCLUSIONS

In the identification cases of traumatic tympanic membrane perforations, the key is to determine whether it is traumatic and whether it will heal spontaneously within 6 weeks. It is suggested to check the tympanic membrane weekly by an otic endoscope combined with acoustic impedance measurement at the sixth week, which can improve the accuracy, objectivity and scientificity of the identification.

Effects of dietary Lactobacillus rhamnosus CF supplementation on growth, meat quality, and microenvironment in specific pathogen-free chickens

The probiotic effects of Lactobacillus rhamnosus strain CF (Chen Fu) on growth performance, meat quality, and microenvironment in specific pathogen-free (SPF) chickens were investigated and compared with Enterococcus faecium. One-hundred-eighty 7-day-old SPF chickens were randomly assigned into 3 groups with 3 replicate pens of 20 chickens each. Group 1 served as a control that was fed a basal diet without probiotics supplementation. Groups 2 and 3 were fed the basal diet supplemented with L. rhamnosus CF and E. faecium, respectively. On d 12 and 24, BW, ADG, feed conversion ratio (FCR), dressing percentage (DP), and apparent digestibility of crude protein (AD-CP) were calculated. Meat color, fat content, shear force, water content, and pH value of breast and thigh muscles; ammonia, urea nitrogen, and uric acid content in plasma; pH value, Enterococcus, Lactobacillus, and E. coli in ceca; and ammonia emission were determined. Compared with group 1, group 2 exhibited higher BW, ADG, AD-CP, DP, cecal Lactobacilli, and muscle fat content (P < 0.05) as well as lower FCR, muscle water content, plasma ammonia, pH value, E. coli, and Enterococcus in ceca, and ammonia emission (P < 0.05), and group 3 exhibited higher BW, ADG, AD-CP, DP, and muscle fat content (P < 0.05), as well as lower FCR, meat color, plasma ammonia, E. coli and Enterococcus in ceca, and ammonia emission (d 24) (P < 0.05). Compared with group 3, group 2 exhibited lower plasma ammonia level, E. coli, and pH value in ceca and ammonia emission (P < 0.05) and higher AD-CP, meat color, pH value in thigh muscles, fat content in breast muscles, and number of Lactobacillus in ceca (P < 0.05). Thus, L. rhamnosus CF improves growth performance, meat quality, and microenvironment and is a potential probiotic additive in chickens.

Identification and Functional Studies of MYO1H for Mandibular Prognathism

Mandibular prognathism (MP) is regarded as a craniofacial deformity resulting from the combined effects of environmental and genetic factors, while the genetically predetermined component is considered to play an important role to develop MP. Although linkage and association studies for MP have identified multiple strongly associated regions and genes, the causal genes and variants responsible for the deformity remain largely undetermined. To address this, we performed targeted sequencing of 396 genes selected from previous studies as well as genes and pathways related with craniofacial development as primary candidates in 199 MP cases and 197 controls and carried out a series of statistical and functional analyses. A nonsynonymous common variant of MYO1H rs3825393, C>T, p.Pro1001Leu, was identified to be significantly associated with MP. During zebrafish embryologic development, expression of MYO1H orthologous genes were detected at mandibular jaw. Furthermore, jaw cartilage defects were observed in zebrafish knockdown models. Collectively, these data demonstrate that MYO1H is required for proper jaw growth and contributes to MP pathogenesis, expanding our knowledge of the genetic basis of MP.

Wnt5a suppresses inflammation-driven intervertebral disc degeneration via a TNF-α/NF-κB-Wnt5a negative-feedback loop

OBJECTIVE

This study was to investigate the molecular role of Wnt5a on inflammation-driven intervertebral disc degeneration (IVDD).

METHODS

The expression of Wnt5a was analyzed in human nucleus pulposus (NP) tissues with immunohistochemical staining. The effects of Wnt5a on matrix production were assessed by RT-qPCR and western blotting. Small interfering RNAs (siRNAs), promoter deletion assay, and promoter binding site mutant were used to reveal the molecular role of Wnt5a in TNF-α-induced matrix metalloproteinase (MMP) expression. The regulatory effects of TNF-α on Wnt5a were investigated with pharmachemical inhibitors and siRNA experiment.

RESULTS

The expression of Wnt5a was elevated in moderately degenerated human NP tissue with similar expression pattern of TNF-α. In NP cells, Wnt5a significantly increased aggrecan and collagen II expression. Inhibition of JNK or interfering Sox9 gene expression significantly suppressed Wnt5a-induced matrix production. AP-1(JunB) binding sites were located in Sox9 promoter and mutation of these sites sabotaged Wnt5a-induced Sox9 up-regulation and subsequent matrix genes expression. Notably, Wnt5a, which was induced by TNF-α, on the other way round suppressed TNF-α-NF-κB (p65) signaling and subsequent MMPs expression. In vivo studies with MR imaging confirmed the protective role of Wnt5a in IVDD.

CONCLUSIONS

Wnt5a, which can be induced by TNF-α, increased matrix production in a Sox9-dependent manner through the activation of JNK-AP1 (JunB) signaling, and antagonized TNF-α-induced up-regulation of MMPs through the inhibition of NF-κB signaling. It indicates that Wnt5a suppresses IVDD through a TNF-α/NF-κB-Wnt5a negative-feedback loop.

[Association between high risk human papillomavirus DNA load and cervical lesions in different infection status]

Objective: To explore the relationship between high risk HPV (HR-HPV) DNA load and cervical lesions in HR-HPV single/ multiple infections. Methods: Two thousand six hundred and forty-six women from Shanxi, Henan and Xinjiang were recruited into a cervical cancer screening program. Cervical exfoliated cell specimens collected from all of the participants were detected by hybrid capture Ⅱ (HC2), cytological diagnosis was performed according to the Bethesda System, and pathological diagnosis was interpreted using cervical intraepithelial neoplasia (CIN) terminology.Totally 571 cervical specimens were selected and retested to ascertain the HPV types and single/ multiple infections by liner array, a PCR-based method. Semi-quantitative result of HR-HPV DNA load (pg/ml) was estimated by HR HC2.According to the taxonomy of "International Human Papillomavirus Reference Center" , 13 HR-HPVs, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68, which could be detected by HR HC2 were divided into 4 subgroups. Results: The positive rate of HR-HPV in normal cervix (436 cases), CIN1 (88 cases), CIN2+ (47 cases) group were 29.82%, 85.23% and 100%, respectively. The overall prevalence and median viral load increased coordinating with the pathological degree of cervical lesions (P<0.001). The positive rate and viral load of single infection with HR-HPV belongs to α9 species increased coordinating with the pathological degree of cervical lesions (P<0.05). The viral load of single infection with HR-HPV belongs to α7 species in CIN1 group was higher than those of normal group and CIN2+ group, but without statistical significance (P=0.130). The viral load of multiple infections in CIN1 group was 559.13 pg/ml, significantly higher than 37.73 pg/ml of normal histology (P=0.025), but without significant difference of 332.91 pg/ml of CIN2+ group (P=0.790). The median viral load of HPV single infection in CIN1 group was 167.93 pg/ml, significantly lower than 559.73 pg/ml of multiple infections (P=0.044). The incidence of co-infection with HR-HPVs belong to α9 species was 80.56%, dominated in all patterns of multiple infections and their median viral load increased coordinating with the pathological degree of cervical lesions, but without significant difference (P>0.05). The incidence of co-infection with HR-HPVs belong to α7 species was 66.67%, their median viral load in CIN1 group was higher than that of CIN2+ group, but without statistical significance (P>0.05). Conclusions: Viral loads of single/ multiple infections with HR-HPVs belong to different species show different tendencies coordinating with the pathological degree of cervical lesions. Women with high grade of cervical lesion were dominantly infected with high viral load of HR-HPVs belong to α9 species, and the viral load of multiple infections is higher than that of single infection in low grade of cervical lesion.