[Oncological outcomes of laparoscopic radical trachelectomy for early stage cervical cancer].

Objective: To analyze and summarize the oncological outcomes after laparoscopic radical trachelectomy (LRT) for early stage cervical cancer. Methods: The clinical data and follow-up results of 148 patients with early stage cervical cancer who underwent LRT in Renji Hospital, School of Medicine, Shanghai Jiao Tong University from July 2014 to June 2023 were collected, while tumor outcomes and postoperative pregnancy were analyzed retrospectively. Results: (1) General situation: the median age of 148 patients with LRT was 33 years (range: 19-42 years). Pathological type: 111 cases of squamous cell carcinoma, 36 cases of adenocarcinoma, 1 case of adenosquamous carcinoma. International Federation of Gynecology and Obstetrics (2018) stage: 17 cases of stage Ⅰa1 with lympho-vascular space invasion, 25 cases of stage Ⅰa2, 102 cases of stage Ⅰb1, and 4 cases of stage Ⅰb2. (2) Tumor outcomes: 148 patients were followed up regularly after LRT, and the median follow-up time was 59 months (range: 2-104 months). During the follow-up period, 5 cases of tumor recurred (including 1 death), and the median recurrence time was 10 months (range: 4-33 months). Among them, there were 3 cases of pelvic metastasis, 1 case of distant metastasis, and 1 case of both pelvic and distant metastasis. Both 3-year and 5-year disease-free survival rates of 148 patients were 94.5%, and the 5-year overall survival rate was 98.9%. (3) Postoperative pregnancy: among 148 patients with LRT, 67 patients had pregnancy requirements, followed up for 1 year, and 20 of them were pregnant, with a pregnancy rate of 29.9% (20/67). Among the 20 pregnant patients, 2 cases early abortion, 1 case mid-term abortion, and 17 cases gave birth (including 4 cases of premature birth and 13 cases of full-term birth). Conclusion: Under the condition of strict control of surgical indications, guaranteed surgical scope and tumor-free operation, LRT in patients with early cervical cancer has a good outcome.

Factors associated with fatal outcome of children with enterovirus A71 infection: a case series.

Enterovirus A-71 (EV-A71) may be fatal, but the natural history, symptoms, and signs are poorly understood. This study aimed to examine the natural history of fatal EV-A71 infection and to identify the symptoms and signs of early warning of deterioration. This was a clinical observational study of fatal cases of EV-A71 infection treated at five Chinese hospitals between 1 January 2010 and 31 December 2012. We recorded and analysed 91 manifestations of EV-A71 infection in order to identify early prognosis indicators. There were 54 fatal cases. Median age was 21.5 months (Q1-Q3: 12-36). The median duration from onset to death was 78.5 h (range, 6 to 432). The multilayer perceptron analysis showed that ataxia respiratory, ultrahyperpyrexia, excessive tachycardia, refractory shock, absent pharyngeal reflex, irregular respiratory rhythm, hyperventilation, deep coma, pulmonary oedema and/or haemorrhage, excessive hypertension, tachycardia, somnolence, CRT extension, fatigue or sleepiness and age were associated with death. Autopsy findings (n = 2) showed neuronal necrosis, softening, perivascular cuffing, colloid and neuronophagia phenomenon in the brainstem. The fatal cases of enterovirus A71 had neurologic involvement, even at the early stage. Direct virus invasion through the neural pathway and subsequent brainstem damage might explain the rapid progression to death.

[A retrospective study on the outcomes of the oncology, fertility and pregnancy in patients with early-stage cervical cancer after undergoing the fertility-sparing treatments].

OBJECTIVE: To explore the outcomes of the oncology, the fertility and pregnancy on patients with early-stage cervical cancer after undergoing fertility-sparing treatments, and to investigate its value on clinical treatment. METHODS: A total of 29 patients with cervical cancer (stage Ⅰa2-Ⅰb1) who had undergone the fertility- sparing treatments in Renji Hospital, School of Medicine, Shanghai Jiaotong University from February 2010 to September 2015 were analyzed retrospectively. Surgical procedures included transvaginal cervical cold knife conization (CKC) + laparoscopic pelvic lymphadenectomy (PLD) or total laparoscopic uterine cervix extensive resection (RT; contains PLD); 48 patients with early cervical cancer under going laparoscopic uterine extensive resection (RH; contains PLD) by the same group of physicians in the same period were chosen as the control group. The perioperative related indicators, postoperative specimen examination, pregnancies after surgery and postoperative tumor follow- up results were retrospectively analyzed and compared between the two groups. RESULTS: (1) Among these 29 patients in the study group, 26 cases were underwent the fertility-sparing surgery quick frozen pathological examinations were positive in 3 cases, which underwent total laparoscopic RT eventually. (2) The perioperative related indicators: compared with the study group and the control group, the operation time [(182±21), (147±24) minutes, respectively] has significant difference (t=6.563, P<0.01). There were no significant difference (P> 0.05) in intra-operative blood loss [(102±26), (99±34) ml], postoperative aerofluxus time [(1.3±0.4), (1.1±0.9) days], the average length of hospital stay [(11.2±2.1), (10.6±3.5) days], rate of urine retention [10%(3/29), 10%(5/48)] and rate of postoperative infection [3% (1/29), 2%(1/48)]. (3)Postoperative specimen examination: compared with the study group and the control group, there were no significant difference (P>0.05) innumber of removed lymphatic nodes (23.4±4.1, 22.8±3.9), length of cardinal ligament [(2.9±0.5), (3.0±0.6) cm], lengthof uterosacral ligament [(2.6±0.7), (2.8±0.4) cm], length of removed vaginal [(3.4±0.3), (3.5±0.3) cm]. (4) Pregnancies after surgery and postoperative tumor follow-up results: in the study group, only 14 patients had fertility requirement after treatments. Pregnancies occurred in 5 women (5/14), which included1 case of full-term labor, 1 case of preterm labor, and 3 cases of spontaneous abortion. The Average follow-up time in postoperative patients of the study group and control group was 29.4, and 30.2 months respectively. In follow- up period, compare with study group and the control group, there was no significant difference (χ(2)=0.004, P> 0.05) in the recurrence rate [4% (1/26), 4% (2/48)]. CONCLUSION: Fertility-sparing surgery of early-stage cervical cancer is safe but the outcome of the fertility and pregnancy is still need toimprove.

Exploring laccase genes from plant pathogen genomes: a bioinformatic approach.

To date, research on laccases has mostly been focused on plant and fungal laccases and their current use in biotechnological applications. In contrast, little is known about laccases from plant pathogens, although recent rapid progress in whole genome sequencing of an increasing number of organisms has facilitated their identification and ascertainment of their origins. In this study, a comparative analysis was performed to elucidate the distribution of laccases among bacteria, fungi, and oomycetes, and, through comparison of their amino acids, to determine the relationships between them. We retrieved the laccase genes for the 20 publicly available plant pathogen genomes. From these, 125 laccase genes were identified in total, including seven in bacterial genomes, 101 in fungal genomes, and 17 in oomycete genomes. Most of the predicted protein models of these genes shared typical fungal laccase characteristics, possessing four conserved domains with one cysteine and ten histidine residues at these domains. Phylogenetic analysis illustrated that laccases from bacteria and oomycetes were grouped into two distinct clades, whereas fungal laccases clustered in three main clades. These results provide the theoretical groundwork regarding the role of laccases in plant pathogens and might be used to guide future research into these enzymes.

First Report of Powdery Mildew Podoshaera tridactyla on Prunus hypoleuca in China.

Prunus hypoleuca (≡ Maddenia hypoleuca), a native plant in China, grows in the Qinling Mountains that lie at the intersection of several forest regions in north, central, and southwest China. In October 2013, P. hypoleuca suffering from heavy powdery mildew infections was found with approximately 75% of the plants affected. The powdery mildew at first appeared as circular to irregular white patches, which subsequently showed abundant hyphal growth on both sides of leaves, leading to the withering of the leaves. A voucher specimen was maintained in the Mycological Herbarium of Northwest A & F University (Accession No. HMNWAFU-CF 2013166). Hyphal appressoria were nipple-shaped or nearly absent. Conidiophores were cylindrical, measured 83 to 110 × 10 to 12.5 µm, and produced two to five immature conidia in chains with a crenate outline. Foot-cells of conidiophores were straight, cylindrical, and 28 to 62 × 7 to 10 µm. Conidia were hyaline, ellipsoid to ovate, and measured 20 to 32 × 14 to 21 µm (length/width ratio 1.4:1.8). Chasmothecia were scattered or gregarious, depressed globose, and 65 to 112 µm in diameter. Appendages, arising from the upper half of the chasmothecia, usually had two to four dichotomous branches, and were one to three and a half times as long as the chasmothecial diameter. A single ascus in a chasmothecium was subglobose or broadly ellipsoid-ovoid, measured 66 to 86 × 47 to 76 µm and contained six to eight ascospores. The ascospores were ellipsoid-ovoid and 15 to 27 × 12 to 18 µm. The fungus was identified as Podosphaera tridactyla based on its anamorph and teleomorph characteristics (1,2). To confirm the identification, 28S rDNA and the ITS region were amplified. The ITS5/P3 and then PM5/ITS4 primers were used to amplify the ITS region by nested PCR. The primers LSU1/LSU2 were used to amplify the 28S rDNA, and the cloned fragments were sequenced. The 28S rDNA and ITS region sequences were deposited in GenBank (Accession Nos. KJ879240 and KM213121). A GenBank BLAST search of two sequences revealed 99% identity with P. tridactyla infecting Prunus salicina Lindl. in Korea (3). Based on ITS and a 28S rDNA phylogenetic tree, the two sequences retrieved from the Chinese specimen clustered within a strongly supported clade (bootstrap value = 100%) with P. tridactyla (JQ517296 and AB022393, respectively). Cladistic trees were constructed using the neighbor-joining method with the Kimura two-parameter substitution model in MEGA 5.0. Branch robustness was assessed via bootstrap analysis with 1,000 replicates. Phylogenetic analysis data were in agreement with morphological characters (3). To our knowledge, this is the first report of powdery mildew caused by P. tridactyla on P. hypoleuca. While Koch's postulates have not been carried out because of the biotrophic nature of the pathogen, the present report serves as a novel resource in order to improve the understanding of the etiology and epidemiology of the powdery mildew (P. tridactyla) on P. hypoleuca. The occurrence of P. tridactyla, a common powdery mildew on Prunus s. lat., supports recently published results of phylogenetic analyses of the Prunus complex, indicating that Maddenia must be reduced to synonymy with Prunus (4). References: (1) U. Braun. Beih. Nova Hedwigia 89:1, 1987. (2) U. Braun and R. T. A. Cook. Taxonomic Manual of the Erysiphales (Powdery Mildews), CBS Biodiversity Series No. 11. CBS, Utrecht, Netherlands, 2012. (3) S. C. Lee et al. Res. Plant Dis. 18:49, 2012. (4) J. Wen and W. T. Shi. PhytoKeys 17(2):39, 2012.

Molecular characterization and functional analysis of the Nep1-like protein-encoding gene from Phytophthora capsici.

Phytophthora capsici is an aggressive plant pathogen that affects solanaceous and cucurbitaceous hosts. Nep1-like proteins (NLPs) are a group of effectors found particularly in oomycetes and considered important virulence factors. We identified an NLP gene (phcnlp1) from the highly virulent P. capsici strain Phyc12 that had an encoded polypeptide of 476-amino acid residues and a predicted molecular mass of 51.75 kDa. We performed quantitative reverse transcription-polymerase chain reaction to detect the expression pattern of phcnlp1 during various phases of interaction with the host plant, and the results showed that phcnlp1 was increasingly expressed during symptom development after P. capsici infection of pepper leaves. We also confirmed that phcnlp1 caused significant necrosis on tobacco plants when expressed based on potato virus agroinfection. All results indicated that phcnlp1 belongs to the NLP gene family and is important for the pathogenesis of P. capsici in its hosts.

Human lung cancer cell line SPC-A1 contains cells with characteristics of cancer stem cells.

Cancer stem cells (CSCs) play important roles in occurrence, development, recurrence and metastasis of cancer. Isolation and identification of CSCs have been performed from some cancer tissues or cells. In this paper, human lung adenocarcinoma stem cells were induced and isolated from SPC-A1 cells and their characteristics were determined. SPC-A1 cells were cultured in serum-free medium and epidermal growth factor and basic fibroblast growth factor were added into the medium to induce the formation of multicellular tumor spheroids. The results showed that floating multicellular tumor spheroids (named pulmospheres) were formed 5-10 d after the induction of SPC-A1 cells. Real-time PCR analysis showed that in the pulmospheres, the marker of bronchioalveolar stem cells, Clara cell secretary protein and the marker of AT2 cells, alveolar surfactant protein C were highly expressed. Furthermore, such embryonic stem cell markers as octamer-binding transcription factor 4 (OCT-4), Bmi-1, and thyroid transcription factor -1 (TTF-1) were also highly expressed. Some miRNAs as hsa-miR-126, hsa-miR-145, hsa-let-7g, hsa-let-7d, hsa-let-7c, hsa-let-7e and hsa-miR-98, which were lowly expressed in SPC-A1 cells, were not expressed in the pulmospheres. Cell cycle analysis showed that 94.29 % of the pulmosphere cells were in G1 stages. Further study showed that these cells possessed higher proliferation and invasion activity than SPC-A1 cells. Tumorigenicity activity experiments on BALB/c nude mice showed that 1 × 103 of the pulmosphere cells could form tumors with similar pathological features with lung adenocarcinoma. In conclusion, lung adenocarcinoma stem cells were enriched in the pulmosphere cells and were with high tumorigenicity.

Identification of 18 genes encoding necrosis-inducing proteins from the plant pathogen Phytophthora capsici (Pythiaceae: Oomycetes).

Phytophthora capsici is an aggressive plant pathogen that affects solanaceous and cucurbitaceous hosts. Necrosis-inducing Phytophthora proteins (NPPs) are a group of secreted toxins found particularly in oomycetes. Several NPPs from Phytophthora species trigger plant cell death and activate host defense gene expression. We isolated 18 P. capsici NPP genes, of which 12 were active during hypha growth from a Phytophthora stain isolated from pepper (Capsicum annuum) plants in China. The 18 predicted proteins had a sequence homology of 46.26%. The 18 Pcnpp sequences had a conserved GHRHDWE motif and fell into two groups. Eleven sequences in group 1 had two conserved cysteine residues, whereas the other seven sequences in group 2 lacked these two cysteine residues. A phylogenetic tree was constructed on the basis of the alignment of the predicted protein sequences of 52 selected NPP genes from oomycetes, fungi and bacteria from Genbank. The tree did not rigorously follow the taxonomic classification of the species; all the NPPs from oomycetes formed their own clusters, while fungal sequences were grouped into two separate clades, indicating that based on NPPs, we can separate oomycetes from fungi and bacteria, and that expansion of the NPP family was a feature of Phytophthora evolution.

Association of gastric cancer with tyrosine hydroxylase gene polymorphism in a northwestern Chinese population.

Gastric cancer (GC) is a common and complex disease caused by multifactors. The aim of our study was to investigate the association of the common polymorphisms detected in insulin-like growth factor (IGF)-II, IGF-1 receptor, insulin-like growth factor binding protein 1 (IGFBP1), insulin (INS) and tyrosine hydroxylase (TH) with susceptibility to GC in a northwestern Chinese population. One hundred and fifty-four GC patients and 166 healthy controls were investigated in our study. The genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. The frequencies of CC and CT genotypes of TH were significantly higher in GC patients than in controls, as the odds ratios were 3.03 (95%CI 1.438-6.362, P=0.003) and 1.97 (95%CI 1.218-3.167, P=0.005), respectively. No association was found between the polymorphisms of IGF-II ApaI, insulin-like growth factor-1 receptor MnlI, IGFBP1 Bgl II and INS-23HphI and the development of GC. The presence of CC and CT genotypes of TH was associated with a significantly increased risk of GC. But the polymorphisms of other genes detected did not indicate an increased risk of GC in the investigated population.

[Pedicle graft of intestine seromuscular layer and skin graft for repair of abdominal wall defect].

OBJECTIVE: To explore an effective method to repair the abdominal wall defect. METHODS: From July 1996 to December 2000, 7 cases with abdominal wall defect were repaired by pedicle graft of intestine seromuscular layer and skin graft, among them, intestinal fistula caused by previous injury during operation in 4 cases, abdominal wall defect caused by infection after primary fistulization of colon tumor in 2 cases, abdominal wall invaded by intestinal tumor in 1 case. Exploratory laparotomy was performed under general anesthesia, the infective and edematous tissue around abdominal wall defect was gotten rid off, and the pathologic intestine was removed. A segment of intestine with mesentery was intercepted, and the intestine along the longitudinal axis offside mesentery was cutted, the mucous layer of intestine was scraped. The intestine seromuscular layer was sutured to the margin of abdominal wall defect, and grafted by intermediate split thickness skin. RESULTS: The abdominal wall wound in 6 cases were healed by first intention, but part of grafted skin was necrosed, and it was healed by second skin graft. No intestinal anastomotic leakage was observed in all cases. Followed up 1 to 2 years, there were no abdominal hernia or abdominal internal hernia. All the cases could normally defecate. The nutriture of all cases were improved remarkably. CONCLUSION: Pedicle graft of intestine seromuscular layer is a reliable method to repair abdominal wall defect with low regional tension, abundant blood supply and high successful rate.

[Preparation of yuanhuacine by low pressure column chromatography].

Preparation of yuanhuacine by low pressure column chromatography gives high separation rate, short washing time and one time crystallization, which comes up to the standard published by the Ministry of Public Health. The method is simple and convenient.

Characteristics of women having abortion in China.

A pre-coded, closed response questionnaire was administered to women at abortion clinic sites in August 1985. The convenience sample was comprised of 1200 women, 200 samples in both Chengdu and the Lianshan Yi Autonomous Region in Sichuan Province, 400 in Nanjing and Jiangsu Province, and 400 in the municipality of Shanghai. The women were interviewed by physicians as part of the women's intake medical history. The sample yielded 574 respondents who were urban and 624 who were rural. The number of previous abortions reported ranged from 0 to 5. Nearly half of the abortion recipients had had at least one prior abortion and 18% had had two or more prior abortions. Education, age, marriage duration and residence have apparent effect on abortion order. The urban respondents reported an average of 1.08 children vs 1.60 children for the rural respondents. Approximately 72% of the respondents claimed to have been using a contraceptive method at the time they became pregnant. The most commonly used method was the IUD (41.6%), followed by the pill (21.3%) and the condom only (16.5%). Residence appeared to be the greatest factor determining the type of contraceptive methods. The data presented here are limited and cannot be generalized to the larger population. However, they do shed some light on the contraception characteristics of a group of women who undergo abortion procedures in China. Their response to questions to contracepting behavior prior to abortion suggests that the problem, in part, is behavioral. For example after the expulsion of the IUD, no other method was substituted to avert pregnancy. In order to alleviate the problem of contraceptive failure, and subsequent abortion, there are policy as well as training and education implications for the state.

[Yuanhuacin film for menstruation induction and termination of early pregnancy: analysis of 382].

Yuanhuacin Film was used in 382 cases, 26 cases for menstrual induction (successful rate 100%) and 356 for termination of early pregnancy. Among the latter group 336 cases resulted in complete abortion (94.4%), 12 cases in incomplete abortion (3.4%) and 8 cases in failure (2.2%). The embryonic sacs were discharged within 34.66 +/- 33.73 (means +/- s) hours. The amount of vaginal bleeding was less than or equal to that of menstruation, which lasted for 8.18 + 9.14 (means +/- s) days with mild abdominal pains. In the complete abortion group 237 cases (70.5%) were followed up and 236 cases were found to restore their menses within 40 days (99.6%), and 157 cases have decreased amount or the same amount of menstrual flow (66.2%), while in 80 cases the amount was increased (33.8%).