Diagnostic accuracy of the FRAIL scale for frailty screening in community-dwelling older adults with diabetes: A cross-sectional study.

There is limited evidence on the diagnostic accuracy of the FRAIL scale in community-dwelling older adults with diabetes. This study aimed to validate the diagnostic accuracy and determine the optimal cutoff point of the FRAIL scale in community-dwelling older adults with diabetes using the Fried Frailty Phenotype as the reference standard. A total of 489 community-dwelling older adults with diabetes aged 60 or above were recruited in this cross-sectional study. The FRAIL scale showed good diagnostic accuracy for frailty screening. The optimal cutoff point for frailty screening in older adults with diabetes was 2. The agreement between the FRAIL scale and the Fried Frailty Phenotype was substantial. The FRAIL scale classified more participants as frail (29.24%) than the Fried Frailty Phenotype (22.09%). These findings provide evidence that the FRAIL scale is a valid tool that can be applied to community-dwelling older adults with diabetes.

Decidual small extracellular vesicles induce trophoblast invasion by upregulating N-cadherin.

Small extracellular vesicles (sEVs) are important mediators of cell-to-cell communication involved in the successful establishment of a pregnancy. Human decidual stromal cells play a key role in regulating trophoblast invasion. Nevertheless, the regulatory functions of decidual stromal cells-derived sEVs in human trophoblast cells are still unclear. In this study, primary human decidual stromal cells were isolated, and immortalized human endometrial stromal cell line (HESCs) were decidualized into human decidual stromal cells (HDSCs) using hormonal cocktail containing medroxy progesterone 17-acetate (MPA), estrogen and cAMP analog. HDSC-sEVs were isolated from both primary human decidual stromal cells and immortal HDSCs, respectively, and identified by transmission electron microscopy and western blotting. EV uptake assay indicated that HDSC-sEVs could be uptaken by trophoblast cells. HDSC-sEVs could increase the invasiveness and the expression level of N-cadherin of trophoblast cells with elevated phosphorylation of SMAD2 and SMAD3 in the cells. Silencing of N-cadherin could block cell invasion induced by HDSC-sEVs, while knockdown of SMAD2 and SMAD3 could inhibit the upregulation of N-cadherin in trophoblast cells. Taken together, our results suggested a regulatory effect of HDSC-sEVs in the invasion of trophoblast cells, and HDSC-sEVs may be important mediators of trophoblasts during embryo implantation and placentation.

The role of the hypoxia-Nrp-1 axis in the activation of M2-like tumor-associated macrophages in the tumor microenvironment of cervical cancer.

To explore the mechanisms through which hypoxic tumor microenvironment (TME) modulates the transition of tumor-associated macrophages (TAMs). The migration ability of RAW264.7 macrophages was determined by transwell assay. Flow cytometric, western blot and immunofluorescence analyses of CD206 further validated the M2 polarization of macrophages. Immunofluorescence, western blot and qRT-PCR were performed to detect the expression of neuropilin-1 (Nrp-1) and carbonic anhydrase IX (CAIX). An intermittent hypobaric hypoxia (IH) animal model was established to evaluate the role of hypoxia in activating M2-like TAMs in vivo. We also used immunohistochemistry to analyze the association between CAIX, CD163+ macrophages and Nrp-1 in a series of 72 human cervical cancer specimens. We found that the hypoxic cervical TME educated the recruited macrophages to transform into the M2 phenotype. Nrp-1 expression was significantly increased in hypoxia-primed cervical cancer cells. Blocking Nrp-1 expression prevented hypoxic cells from recruiting and polarizing macrophages towards the M2 phenotype. Hypoxia exposure significantly increased the expression of Nrp-1 as well as the infiltration of macrophages in vivo. Consistently, immunochemical staining in serial tissue sections of cervical cancer revealed upregulated levels of Nrp-1 in CAIX-positive hypoxic regions along with a concurrent significant elevation of M2 macrophages. Nrp-1 and M2-like TAMs were related to the malignant properties of cervical cancer, such as the FIGO stage and lymph node metastasis. Nrp-1 plays critical roles in hypoxic TME-induced activation and pro-tumoral effects of TAMs in cervical cancer. Interfering with Nrp-1 may be a potential therapeutic strategy in treating cervical cancer.

Study on the cephalopelvic relationship with cephalic presentation in nulliparous full-term Chinese pregnant women by MRI with three-dimensional reconstruction.

PURPOSE: To analyze the relationship between fetal head size and maternal pelvis size using magnetic resonance imaging (MRI) with a 3-D reconstruction technique. METHODS: A total of 301 nulliparous full-term Chinese pregnant women with cephalic presentation were enrolled and received MRI examinations before labor onset. Data were collected and imported into Mimics software to reconstruct the maternal pelvis and fetus. RESULTS: Of 301 pregnant women, 212 underwent vaginal delivery and 32 received cesarean section. The body mass index (BMI) was significantly different between the vaginal delivery group and the suspected cephalopelvic disproportion (CPD) group; the larger the BMI, the higher was the risk of CPD. The transverse diameter of the pelvic inlet and the posterior sagittal diameter of the midpelvis were significantly larger in the vaginal delivery group, compared with the suspected CPD group. Fetal weight > 3.5 kg could be used as a diagnostic indicator for CPD. CONCLUSIONS: BMI is a risk factor for CPD, and fetal weight < 3.5 kg is an important diagnostic indicator for natural delivery in Chinese pregnant women.

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Ovarian Cancer: A Systematic Review and Meta-Analysis of Observational Studies.

BACKGROUND AND AIMS: Published data on the prognostic role of neutrophil-to-lymphocyte ratio (NLR) in ovarian cancer are controversial. We conducted this meta-analysis to obtain a more accurate assessment of prognostic significance of NLR in ovarian cancer. MATERIALS AND METHODS: We conducted a systematic literature search using the electronic databases PubMed, Web of Science, and Embase up to May 2016. Hazard ratio (HR) and odd ratio (OR) with 95% confidence interval (95% CI) were calculated. Subgroup analyses were carried out to explore the source of heterogeneity. Statistical analysis was performed using Stata 10.0. RESULTS: A total of 12 studies, consisting of 3,854 patients, which met our criterion were selected in this meta-analysis. Our pooled results showed that high pre-treatment NLR level was significantly associated with poorer overall survival (OS) (HR: 1.69, 95% CI 1.29-2.22) and shorter progression free survival (PFS) (HR 1.63, 95% CI 1.27-2.09). Additionally, increased NLR was also significantly correlated with advanced FIGO stage (OR 2.32, 95% CI1.79-3.00), higher serum level of CA-125 (OR 3.33, 95% CI 2.43-4.58), more extensive ascites (OR 3.54, 95% CI 2.31-5.42) as well as less chemotheraputic response (OR 0.53, 95% CI 0.40-0.70). The findings from most of subgroup meta-analyses were consistent with those from the overall meta-analyses. CONCLUSIONS: Elevated pre-treatment NLR could served as a predicative factor of poor prognosis for ovarian cancer patients.

Orthotopic Xenograft Mouse Model of Cervical Cancer for Studying the Role of MicroRNA-21 in Promoting Lymph Node Metastasis.

Cervical cancer is the most frequent cause of gynecologic cancer-associated death worldwide. Animal models that demonstrate metastatic patterns consistent with the clinical course of cervical cancer are urgently needed to conduct studies focused on understanding the mechanisms of the disease and identifying optimal treatments. To address this, we established an orthotopic xenograft model of cervical cancer in female NOD-SCID mice using SiHa and ME180 cell lines stably expressing green fluorescent protein to evaluate the role of microRNA-21 (miR-21) in spontaneous lymph node metastasis in vivo. In this case, SiHa and ME180 cells were transduced by lentivirus to stably express green fluorescent protein and miR-21. Overexpression of miR-21 promoted proliferation, migration, and invasion of SiHa and ME180 cells in vitro. Finally, an orthotopic xenograft model of human cervical cancer was successfully established in NOD-SCID mice. Using this model, we confirmed that overexpression of miR-21 resulted in an increase in the size of primary tumors and in the frequency of spontaneous lymph node metastasis at the time of excision. Therefore, the use of the orthotopic xenograft model should allow for the investigation of novel factors that affect metastasis of cervical cancer and presents an opportunity to evaluate potential therapeutic agents that may inhibit the spread of the disease.

Preterm Birth and Subsequent Risk of Acute Childhood Leukemia: a Meta-Analysis of Observational Studies.

BACKGROUND: Preterm birth (PTB) has been recognized as a crucial long term risk factor for multiple non-communicable diseases. However, studies between the relationship of PTB and the risk of acute childhood leukemia have yielded inconclusive results. Therefore, we performed a meta-analysis to systematically review the current literature to investigate whether PTB is associated with increased risk of acute childhood leukemia. METHODS: Three electronic databases (PubMed, Web of Science, and EMBASE) were searched up to December 1st, 2015. Relevant studies reporting the association between PTB and subsequent risk of acute childhood leukemia were included for further evaluation. Statistical analysis was performed using Revmen 5.3 and Stata 10.0. RESULTS: A total of 12 studies for acute childhood leukemia, eight studies for acute lymphoblastic leukemia (ALL), and seven studies for acute myeloid leukemia (AML) were included in the current meta-analyses. We calculated pooled odds ratio (OR) and 95% confidence interval (CI) to evaluate the relationship between PTB and acute childhood leukemia as well as its two subtypes: ALL and AML. Our results suggested that PTB was significantly associated with increased risk of acute childhood leukemia (OR = 1.09, 95% CI = 1.02-1.17, P = 0.01) and AML (OR = 1.42, 95% CI = 1.21-1.67, P < 0.01). However, PTB was not significantly associated with an increased risk of ALL (OR = 1.04, 95% CI = 0.96-1.13, P = 0.29). CONCLUSION: Our data showed that PTB increased the risk of AML. Further studies are required to explore causality and dissect the biological mechanisms involved.

Chronic Hepatitis B Infection is Associated with Decreased Risk of Preeclampsia: A Meta-Analysis of Observational Studies.

BACKGROUND/AIMS: Preeclampsia is a complex multi-system obstetric syndrome and remains one of the leading causes contributing to maternal and perinatal mortality and morbidity. Previous epidemiological studies regarding the association between chronic hepatitis B virus (CHB) infection and the risk of preeclampsia have reported inconsistent results. Therefore, we conducted a meta-analysis to investigate the association between CHB infection and preeclampsia. METHODS: The electronic database was searched until January 1st, 2016. Relevant studies reporting the association between CHB infection and the risk of preeclampsia were included and for further evaluation. Statistical analysis was performed using Stata 10.0 (Stata Corp). RESULTS: Three observational cohort studies and eight case-control studies, including 11566 preeclampsia patients, were identified. A significant negative association between CHB infection and preeclampsia was observed (odds ratio = 0.77, 95% confidence interval, 0.65- 0.90, P=0.002, fixed-effect model). CONCLUSIONS: Findings from our meta-analysis indicate that CHB infection may decrease the risk of preeclampsia in Asian population. Future prospective cohorts in different countries with larger sample sizes are warranted to ascertain the causality and pathophysiological studies are required to explore the possible biological mechanisms involved.

P-glycoprotein expression and localization in the rat uterus throughout gestation and labor.

Uterine tissues contain the efflux transporter P-glycoprotein (P-gp, encoded by Abcb1a/1b gene), but little is known about how it changes through gestation. Our aim was to investigate the expression profile and cellular localization of P-gp in the pregnant, laboring and post-partum (PP) rat uterus. We propose that during pregnancy the mechanical and hormonal stimuli play a role in regulating myometrial Abcb1a/1b/P-gp. Samples from bilaterally and unilaterally pregnant rats were collected throughout gestation, during labor, and PP (n=4-6/gestational day). RNA and protein were isolated and subjected to quantitative PCR and immunoblotting; P-gp transcript and protein were localized by in situ hybridization and immunohistochemistry. Expression of Abcb1a/1b gene and membrane P-gp protein in uterine tissue (1) increased throughout gestation, peaked at term (GD19-21) and dropped during labor (GD23L); and (2) was upregulated only in gravid but not in empty horn of unilaterally pregnant rats. (3) The drop of Abcb1a/1b mRNA on GD23 was prevented by artificial maintenance of elevated progesterone (P4) levels in late gestation; (4) injection of the P4 receptor antagonist RU486 on GD19 caused a significant decrease in Abcb1 mRNA levels. (5) In situ hybridization and immunohistochemistry indicated that Abcb1/P-gp is absent from myometrium throughout gestation; (6) was expressed exclusively by uterine microvascular endothelium (at early gestation) and luminal epithelium (at mid and late gestation), but was undetectable during labor. In conclusion, ABC transporter protein P-gp in pregnant uterus is hormonally and mechanically regulated. However, its substrate(s) and precise function in these tissues during pregnancy remains to be determined.

TRPV6 is a prognostic marker in early-stage cervical squamous cell carcinoma.

Transient receptor potential vanilloid 6 (TRPV6) has been shown to promote caner proliferation in several solid tumors, leading to unfavorable clinical outcomes. Our study aimed to elucidate the clinical significance of TRPV6 in patients with early-stage cervical squamous cell carcinoma (CSCC). The mRNA expression of TRPV6 was measured in 12 paired early-stage CSCC specimens and six cervical carcinoma cell lines using quantitative real-time PCR (qRT-PCR). Western blotting and immunohistochemistry (IHC) were employed to examine the protein expression level of TRPV6 in four paired specimens, 175 paraffin-embedded early-stage CSCC specimens, and 50 normal cervical tissues (NCTs), respectively. Statistical analyses were performed to evaluate the clinical significance of TRPV6 expression. The expressions of TRPV6 mRNA and protein were both significantly downregulated in early-stage CSCC tissues and cervical cancer cell lines. IHC analyses revealed that TRPV6 was downregulated in 136 (77.7 %) of 175 early-stage CSCC specimens. Moreover, TRPV6 expression in early-stage CSCC was significantly correlated with the tumor stage (P < 0.001), tumor growth type (P < 0.001), tumor size (P = 0.008), and differentiation grade (P = 0.003). The early-stage CSCC patients with a low TRPV6 expression level had a short progress-free survival (PFS) and overall survival (OS) duration. Univariate and multivariate analyses identified TRPV6 as an independent prognostic factor for early-stage CSCC patients' survival. We demonstrated that TRPV6 was downregulated in CSCC, which was correlated with unfavorable survival outcomes of early-stage CSCC patients. TRPV6 may be used as a novel prognostic marker for early-stage CSCC.

Acylglycerol kinase is over-expressed in early-stage cervical squamous cell cancer and predicts poor prognosis.

Acylglycerol kinase (AGK) had been shown to contribute to cancer progression and unfavorable clinical outcomes of patients. Our study aimed to investigate the expression pattern and clinical significance of AGK in patients with early-stage cervical squamous cell cancer (CSCC). The protein and messenger RNA (mRNA) expression of AGK was analyzed in six cervical cancer cell lines and four paired early-stage CSCC specimens and normal cervical tissues (NCT), using Western blotting and real-time PCR (RT-PCR). And we investigated the AGK protein expression in paraffin-embedded specimens from 140 patients with early-stage CSCC and 30 cases of NCT by immunohistochemistry (IHC). Statistical analyses were performed to evaluate the clinicopathological significance of AGK expression. The expressions of AGK protein and mRNA were significantly up-regulated in cervical cancer cell lines and cancer tissues. IHC analyses revealed that AGK was highly expressed in 93 (66.4 %) of 140 early-stage CSCC specimens, but in none of the NCT. Moreover, AGK expression in early-stage CSCC was significantly correlated with tumor stage (P < 0.001), tumor size (P < 0.001), and tumor type (P < 0.001). Early-stage CSCC patients with high AGK expression level had shorter progress-free survival (PFS) and overall survival (OS) time compared with patients with low AGK expression levels. Univariate and multivariate analyses identified AGK expression level as an independent prognostic factor for survival of early-stage CSCC patients. We showed that AGK was over-expressed in cervical cancer cell lines and clinical tissues, and over-expression of AGK was associated with poor survival outcomes of early-stage CSCC patients. AGK can be used as an independent prognostic marker for early-stage CSCC.

Circulating retinol-binding protein 4 levels in gestational diabetes mellitus: a meta-analysis of observational studies.

Retinol-binding protein 4 (RBP4) is a novel adipocyte-derived cytokine playing an important role in the regulation of energy metabolism and insulin sensitivity. Although the association between RBP4 and metabolic dysfunction is well established, studies on the relationship between circulating RBP4 levels and the risk of gestational diabetes mellitus (GDM) have yielded inconclusive results. We performed a meta-analysis to investigate whether women with GDM had higher circulating RBP4 levels than the normglycemic pregnant women. PubMed, Web of Science and EMBASE were searched up to 1 August 2014. A total of 14 studies comprised of 884 women with GDM and 1251 normglycemic pregnant women were included. The overall results suggested that maternal circulating RBP4 levels were significantly higher in GDM than their normal controls (SMD: 0.49 µg/ml, 95% CI: 0.23-0.75 µg/ml, p < 0.001, random effect model). However, stratified results indicated that this significant difference only existed in the second/third trimester and was limited to Asian populations. Furthermore, subgroup analysis according to matched maternal age and BMI still demonstrated that GDM had higher circulating RBP4 levels than the normal controls. Our findings suggested that Asian women with GDM had increased circulating RBP4 levels in their second/third trimester.

[Research about improving flowability of powder of Chinese herbs extracts by surface modification technology].

In this study, modification technology by surface coating was used to improve the flowability of powder of Chinese herbs extracts. Seven kinds of powder of Chinese herbs extracts were coated with 1% silica nanoparticles using an under-driven Comil. The powder characteristics tester was used to evaluate the flowability of uncoated and coated powders. Surface morphology and particle size distribution of powders were compared by scanning electron microscope (SEM) and optical microscope. The powder hygroscopicity was also investigated. The results showed that, after modification, angle of repose, angle of spatula, compressibility and adhesiveness extremely decreased, and flowability index substantially increased, the powder flowability was significantly improved, especially Gegen and Dahuang extracts powders. Scanning electron microscopy images showed the distribution of silica nanoparticles on the host drug particle surfaces. There were no remarkable changes in the particle size distribution and hygroscopicity of all powders after coating. Therefore, Comilling for surface coating modification technology was an effective method to improve the flowability of Chinese herbs extracts and suggested a possible way forward to enhance the quality of Chinese drugs pharmaceutics in their study and manufacture.

[Relationship between pigment epithelium-derived factor expressed in placentas and the pathogenesis of preeclampsia disease].

OBJECTIVE: To investigate the effect of pigment epithelium-derived factor (PEDF) on the pathogenesis of preeclampsia disease, by detecting the expression of PEDF in the placentas, as well as the relationship between PEDF and the production of placental vessels. METHODS: A study was performed in 60 cases of pregnant women with preeclampsia in the obstetrical department of Nanfang Hospital affiliated to southern medical university from October 2011 to January 2013, in which 30 cases were patients with mild preeclampsia(mPE) and other 30 cases were those with severe preeclampsia (sPE).40 normal pregnant women who also been hospitalized and delivered were selected as control group. The expression of PEDF and micro-vessel density (MVD) in placentas were assayed by using western blot and SP immunohistochemical method, then the relationship between PEDF and MVD was analyzed. RESULTS: (1) The pathological changes of placentas:the placental weight were lightened obviously in the mild preeclampsia and severe preeclampsia groups, the reduced blood vessels and luminal stegnosis were found in chorionic villus, basement membrane of trophocytes were thickening. The hyperplasia syneytiotrophoblast were like nodosity, with focus infarction, fibrinoid necrosis, or thrombogenesis.While there was no the above mentioned pathological alteration in normal control group. (2)The levels of PEDF expression in mild and severe preeclampsia group were 0.63 ± 0.09, 0.93 ± 0.07, while 0.47 ± 0.04 in control group, which in mild and sever preeclampsia groups were significantly higher than that in normal group (P < 0.05). Compared to mild preeclampsia group, the expression of PEDF was significantly increased in severe preeclampsia group, there was statistical significance between the difference (P < 0.05).(3) The amount of microvessel density (MVD) in mild and severe preeclampsia group were 106 ± 9, 93 ± 8, while 136 ± 9 in control group, which were significantly reduced in mild and severe preeclampsia group, compared to that in normal control group (P < 0.05). And it was significantly lower in severe preeclampsia group than that in mild preeclampsia group (P < 0.05). (4) The expression of PEDF was negatively correlated with the amount of MVD in mild and severe preeclampsia group (r = -0.426, P < 0.05; and r = -0.646, P < 0.05 respectively), which was also negative in control group (r = -0.589, P < 0.05). CONCLUSION: Increased PEDF expression in placentas of women with preeclampsia induce the dysfunction of the placental vascular reconstruction and the pathological alteration like ischemic and hypoxia in placentas, which may be involved in pathogenesis and pathogenic progress of preeclampsia.

[Prenatal diagnosis of agenesis of corpus callosum and its relationship with fetal chromosomal abnormalities].

OBJECTIVES: To evaluate prenatal imaging diagnosis of agenesis of corpus callosum and to investigate the relationship between ACC and chromosomal abnormalities. METHODS: Forty singleton pregnancies diagnosed ACC prenatally in Southern Medical University,Nanfang Hospital,General Hospital of Guangzhou Military Command of PLA and Shenzhen Maternity and Children Health Care Hospital from 2007 to 2012 were recruited. The correlation between ACC and chromosomal abnormalities, the consistence of sonographic characteristics and MRI diagnosis were analyzed retrospectively. RESULTS: (1) Among the 40 cases, 15 (38%, 15/40) were diagnosed isolated ACC, while 25 (63%, 25/40) were non-isolated ACC.In the non-isolated ACC cases, 18 (72%) had central nervous system abnormalities, including cerebellar vermis hypoplasia,Dandy-Walker syndrome, cerebellar cyst, holoprosencephaly, etc.Extra-CNS abnormalities were identified in 16 cases, including 5 cardiac abnormalities, 3 facial abnormalities, 2 congenital anomalies of urinary system, 1 limb skeletal abnormality and 5 other congenital anomalies.(2) In the 40 cases, 3 were chromosomal polymorphisms, including 2 cases of 46,XX, 1qh+ and 1 case of 46,XY, 13cenh+. Chromosomal abnormalities were identified in 4 cases, including trisomy13, trisomy18, trisomy 21 and 47,XYY.(3) 36 cases(90%, 36/40) diagnosed by ultrasound were consistent with MRI, while 4 cases were different with MRI.37 pregnancies were terminated, in which 28 cases were confirmed by fetal autopsy.3 cases continued pregnancy and ACC was confirmed by postnatal MRI.(4) 25 non-isolated ACC and 12 isolated ACC pregnancies were terminated. Among the 3 isolated ACC cases that continued pregnancy, 2 were term delivery and 1 was premature delivery. All of them were confirmed by postnatal MRI.No mental or growth retardation was found during follow-up. CONCLUSION: MRI was prior to detect cases with non-isolated ACC and could be a supplementary method in the diagnosis and classification of ACC. Compared with isolated ACC, non-isolated ACC had a higher incidence of chromosomal abnormalities.

[Analysis of normal pelvis morphometry of modern Chinese southern Han female and its correlation with age].

OBJECTIVE: To analyze the normal pelvis morphometry of Chinese southern Han female and its correlation with age. METHODS: From August 2009 to September 2011, 289 Han nationality females who received pelvis CT scan at Nanfang Hospital of Southern Medical University were eligible for the study. Their mean age was 43.5 years, with normal body development and no pelvic abnormality. The patients were divided into 3 age groups: 25 to 40 (n = 109), 41 to 50 (n = 115), and >50 years (n = 65). After constructing a three-dimensional digital model of the pelvis, the following parameters were measured, including transverse inlet diameter, posterior sagittal diameter of pelvic inlet, sagittal inlet, diagonal conjugate, biischial diameter, posterior sagittal diameter of midpelvis, sagittal midpelvic diameter, intertuberous distance, posterior sagittal diameter of outlet, angle of pubic arch, sagittal outlet, penal height, sacrum length and sacrum curvature. The relationship between all parameters and age was analyzed. RESULTS: (1) The posterior sagittal diameters of pelvic inlet of the 25 to 40 age group, 41 to 50 age group, >50 years age group were (53 ± 8), (51 ± 7), (48 ± 6) mm. The sagittal inlet of the three groups were (122 ± 8), (120 ± 9), (114 ± 8) mm. And the diagonal conjugate of the three groups were (135 ± 10), (132 ± 9), (127 ± 9) mm. All had significant differences among the three groups (P < 0.01) . (2) The posterior sagittal diameter of midpelvis of the three groups were (43 ± 6), (44 ± 6), (43 ± 7) mm, and the sagittal midpelvic diameter of the three groups were (119 ± 8), (120 ± 8), (119 ± 7) mm, with no significant difference among the three groups (P > 0.05). (3) The intertuberous distance of the three groups were (122 ± 11), (121 ± 10), (117 ± 11) mm, and the posterior sagittal diameter of outlet of the three groups were (56 ± 9), (58 ± 8), (57 ± 9) mm. There was no significant difference among the three groups (P > 0.05) .(4) Penal height of three groups were (31 ± 3), (33 ± 3), (34 ± 3) mm, there was with significant differences (P < 0.01) .(5) Pearson correlation analysis showed that penal height was positively correlated with age (r = 0.331, P < 0.05), while sagittal inlet, posterior sagittal diameter of inlet, diagonal conjugate, intertuberous distance, angle of pubic arch, sacrum length and sacrum curvature were negatively correlated with age (r = -0.120 to -0.343, P < 0.05). CONCLUSIONS: The shape of the pelvic inlet of Chinese southern Han female changed from sagittal elliptic into transverse elliptic form, and the posterior part of pelvic inlet became larger.Sacral concavity was increased and the pelvis became deeper. Mid pelvis and the pelvic outlet was almost unchanged, and showed no correlation with age.

[Clinical value of MLPA in the prenatal gene diagnosis of Duchenne muscular dystrophy].

OBJECTIVE: To investigate the clinical value of multiplex ligation-dependent probe amplification (MLPA) in the prenatal gene diagnosis of high risk pregnant women from Duchenne muscular dystrophy (DMD) families. METHODS: The 155 high risk pregnant women from DMD families were recruited from 2005 to 2012 in 4 hospitals in Guangzhou, such as Southern Hospital of Southern Medical University and the Third Affiliated Hospital of Guangzhou Medical University. Among all the samples, 7 were chorionic villus samples taken from early-stage pregnancy and 148 were amniotic fluid samples from mid-stage pregnancy. After the maternal contamination was eliminated, the fetal DMD gene screening was carried out by using MLPA. The mutation rates in DMD exons were calculated in all the 155 families. RESULTS: (1) Among the 155 fetuses of the DMD high risk pregnant women, there were 72 male fetuses and 83 female fetuses. In the male fetuses, there were 27 sufferers (38%). In the female fetuses, there were 28 carriers (34%). And there were 100 normal fetuses. (2) Among the 27 DMD sufferers, 22 cases were DMD exon homozygous deletions (14.2%, 22/155) and 5 cases were DMD exon duplications (3.2%, 5/155). Among the 28 carriers, 25 cases were gene heterozygous deletions (16.1%, 25/155) and 3 cases were gene heterozygous duplications (1.9%, 3/155). In the 155 families, the DMD mutations mainly occurred in exons 45-52, and the exon 49 had the highest mutation rates of 22 times. (3) Among the 7 cases of prenatal gene diagnosis using chorionic villus samples, 2 fetuses had the identical DMD genotypes with their mothers and probands. One was a DMD sufferer and the other was a carrier. Termination or continuation of pregnancy was suggested based on the genotype of the fetus. CONCLUSIONS: MLPA provides an accurate method in the prenatal diagnosis of DMD. It could be used to distinguish DMD gene homozygous deletions from heterozygous deletions and duplications. Therefore, it is valuable for DMD prenatal diagnosis in high-risk women. Chorionic villus sampling can be applied to the early prenatal diagnosis for DMD disease.

Nephrometric scoring system: Recent advances and outlooks.

A nephrometry scoring system is a key standard to evaluate the feasibility of partial nephrectomy (PN). Whether based on two-dimensional or three-dimensional images, simplicity, effectiveness, and practicality are the keys to the nephrometric scoring system. Since the emergence of RENAL score in 2009, numerous scoring systems based on different anatomical parameters are established to seek accurately and few parameters to assess the risk of PN and complications. This study aimed to achieve a three-game winning streak in PN more easily and efficiently (negative resection margin, maximum preservation of normal nephron function, and avoiding short-term and long-term complications). Using PubMed, we counted 28 kinds of nephrometric scoring systems. We considered only English literatures published and excluded editorials, commentaries, and meeting abstracts. To the best of our knowledge, this is to date and most comprehensive summary as well as an outlook of the nephrometric scoring system.

Acute lung inflammatory response and injury after hemorrhagic shock are more severe in postpartum rabbits.

OBJECTIVE: The acute respiratory distress syndrome may complicate postpartum hemorrhagic shock and resuscitation, but its mechanisms are not yet well defined. We studied the lung inflammatory response to postpartum hemorrhagic shock and resuscitation in a rabbit model and the role of the nuclear factor-κB pathway. DESIGN: Randomized, controlled, prospective study. SETTING: University hospital laboratory. SUBJECTS: Nonobstetric (not pregnant nor postpartum) and obstetrical (within 2 hrs postpartum) rabbits. INTERVENTIONS: Nonobstetric and obstetric female New Zealand white rabbits underwent fixed-pressure or fixed-volume hemorrhagic shock for 30 mins and then were rapidly resuscitated with the shed blood and Ringer's solution. Finally, they were either monitored for survival time or euthanized by exsanguination for lung tissue examination 24 hrs after hemorrhage. MEASUREMENTS AND MAIN RESULTS: After hemorrhagic shock and resuscitation, median survival time in obstetric rabbits (3 days) was significantly shorter (p<.05) than that in nonobstetric rabbits (5 days). Compared with nonobstetric rabbits, obstetric rabbits had more severe lung injury as indicated by alveolar and interstitial fluid accumulation and marked neutrophil sequestration and greater lung injury score, myeloperoxidase activity, expression of intercellular adhesion molecule-1, serum tumor necrosis factor-α levels, and nuclear factor-κB activation, and lower serum interleukin-10 levels (p<.05 for all). CONCLUSIONS: After hemorrhage and resuscitation, obstetric rabbits had significantly shorter survival time and more severe lung injury than nonobstetric rabbits. The mechanism may be through upregulation of the signal transductions of the nuclear factor-κB pathways.

Up-regulation of cadherin 17 and down-regulation of homeodomain protein CDX2 correlate with tumor progression and unfavorable prognosis in epithelial ovarian cancer.

OBJECTIVE: Cadherin 17 (CDH17), belonging to the 7D-cadherin superfamily, represents a novel oncogene, which is involved in tumor invasion and metastasis. Its expression has been demonstrated to be regulated by caudal-related homeobox transcription factor CDX2. The roles of 2 biomarkers have been conflictingly explained. Therefore, the aims of this study were to investigate the expression patterns of CDH17 and CDX2 in human epithelial ovarian cancer (EOC) and to evaluate the clinical significance of these 2 markers in the progression and prognosis of EOC. METHODS: CDH17 and CDX2 expressions in 182 paraffin-embedded EOC specimens were detected by immunohistochemical staining. Associations of their expression with clinical pathological factors and overall survival were statistically evaluated. RESULTS: Compared with normal surface ovarian epithelium tissues, CDH17 expression was upregulated and CDX2 expression was downregulated in EOC tissues. There was a negative correlation between CDH17 and CDX2 expression in EOC tissues (r = -0.76, P = 0.001). Tumors with high CDH17 expression were more likely to have advanced stage (P = 0.01) and higher grade (P = 0.03). Patients with low CDX2 expression were more frequently to be at the advanced stage of disease (P = 0.01). In addition, univariate analysis indicated that the patients with high CDH17 expression correlated with poor prognosis in patients with EOC (P = 0.001), as opposed to CDX2 (P = 0.003). Especially, the survival rate of patients with EOC with CDH17-high/CDX2-low expression was the lowest (P < 0.001). Multivariate statistical analysis showed that the conjoined expression of CDH17/CDX2 was an independent prognostic indicator of EOC (P = 0.01). CONCLUSIONS: Our data suggest that both the up-regulation of CDH17 and the down-regulation of CDX2 may be associated with the advanced stage of EOC. A conjoined detection of CDH17/CDX2 expression may be associated with unfavorable prognosis in patients with this disease.