Effects of White Noise on Pain Scores and Salivary Cortisol Levels in Surgical Neonates: A Randomized Controlled Trial.

BACKGROUND: Neonates experience varying intensities of pain after surgery. While white noise has been used for postoperative pain relief in infants, its effects on neonates after surgery need further exploration. PURPOSE: This study aimed to evaluate the effects of white noise on pain scores and salivary cortisol levels in surgical neonates. METHODS: In this randomized controlled trial, 64 neonates scheduled for surgery were recruited and assigned by block randomization into 2 groups. The intervention group listened to white noise at 50 dB, while the control group listened to white noise at 0 dB, for 30 minutes 6 times for 48 hours postoperatively. Pain scores, measured by the COMFORTneo Scale, and salivary cortisol levels were compared. RESULTS: Although pain scores decreased after surgery in all subjects, no statistically significant difference was observed between the 2 groups (P = .937). There was a significant difference between pre- and postintervention pain scores in the intervention group only (P = .006). Salivary cortisol levels decreased after intervention in the intervention group, but there was no significant difference between pre- and postintervention levels in the 2 groups (P = .716). IMPLICATIONS FOR PRACTICE: Given the reduction in pain scores and salivary cortisol concentrations after white noise intervention, white noise shows potential as an adjunctive soothing measure for neonates after surgery. IMPLICATIONS FOR RESEARCH: Future studies are needed to confirm the efficacy and utility of white noise intervention in clinical settings.

Preliminary identification of soil fungi for the degradation of polyurethane film.

Polyurethane (PU) is a versatile plastic that boasts high environmental resistance. The biodegradation of PU has become a hot topic of research aimed at finding ways to potentially solve PU pollutants. Identifying microorganisms capable of efficiently degrading PU plastics is pivotal for the development of a green recycling process for PU. This study aimed to isolate and characterize PU-degrading fungi from the soil of a waste transfer station in Luoyang, China. We isolated four different fungal strains from the soil. Among the isolates, the P2072 and P2073 strains were identified as Rhizopus oryzae (internal transcribed spacer identity, 99.66%) and Alternaria alternata (internal transcribed spacer identity, 99.81%), respectively, through microscopic, morphologic, as well as 18S rRNA sequencing. The degradation ability of strains P2072 and P2073 was analyzed through measurement of weight loss, and they exhibited a degradation rate of 2.7% and 3.3%, respectively, for the PU films after 2 months' growth in mineral salt medium (MSM) with PU films as the sole carbon source. In addition, the P2073 strain exhibited protease activity in the presence of PU. To our knowledge, R. oryzae has never been reported as a PU-degrading fungus. This study provides a new perspective on the biodegradation of PU.

Effects of Holliday Junction-Recognition Protein-Mediated C-Jun N-Terminal Kinase/ Signal Transducer and Activator of Transcription 3 Signaling Pathway on Cell Proliferation, Cell Cycle and Cell Apoptosis in Bladder Urothelial Carcinoma.

The Holliday Junction-Recognition Protein (HJURP) was upregulated in several tumors, which was associated with poor outcome. This study investigated the effects of the HJURP-mediated c-Jun N-terminal kinase (JNK)/ signal transducer and activator of transcription 3 (STAT3) pathway on bladder urothelial carcinoma (BLUC). Online databases were used to analyze HJURP expression in BLUC and the correlation of HJURP to JNK1 [mitogen-activated protein kinase 8 (MAPK8)], JNK2 (MAPK9), STAT3, marker of proliferation Ki-67 (MKI67), proliferating cell nuclear antigen (PCNA), cyclin dependent kinase 2 (CDK2), CDK4 and CDK6. HJURP expression was detected in BLUC cells and human normal primary bladder epithelial cells (BdECs). BLUC cells were treated with HJURP lentivirus activation /shRNA lentivirus particles or JNK inhibitor SP600125. HJURP was upregulated in BLUC tissues and correlated with poor prognosis of patients (all P < 0.05). HJURP in tumor positively correlated with MAPK8 (R = 0.30), MAPK9 (R = 0.30), STAT3 (R = 0.15), MKI67 (R = 0.60), PCNA (R = 0.46), CDK2 (R = 0.39), CDK4 (R = 0.24) and CDK6 (R = 0.21). The JNK inhibitor SP600125 decreased p-JNK/JNK and p-STAT3/STAT3 in BLUC cells, which was reversed by HJURP overexpression (P < 0.05). The HJURP-mediated JNK/STAT3 pathway promoted BLUC cell proliferation and inhibited cell apoptosis (P < 0.05). HJURP reversed the arrested G0/G1 phase of BLUC cells by SP600125. HJURP acted as an oncogene to regulate BLUC cell proliferation, apoptosis and the cell cycle by mediating the JNK/STAT3 pathway. Therefore, HJURP targeting might be an attractive novel therapeutic target for early diagnosis and treatment in BLUC.

NEDD4L inhibits migration, invasion, cisplatin resistance and promotes apoptosis of bladder cancer cells by inactivating the p62/Keap1/Nrf2 pathway.

PURPOSE: This study identified the function of neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) on bladder cancer (BLCA). METHODS: NEDD4L expression in BLCA patients was scrutinized. The function of NEDD4L on the viability, apoptosis, migration and invasion of BLCA cells was evaluated by cell counting kit-8, flow cytometry and Transwell assays. The effect of NEDD4L on the cisplatin (DDP) resistance of the DDP-resistant BLCA cells was explored. The influence of NEDD4L on the p62/Keap1/Nrf2 pathway activity in BLCA cells was tested by Western blot. Rescue experiments were implemented to verify whether NEDD4L regulated BLCA cell malignant behavior by mediating the Keap1/Nrf2 pathway activity via p62. The effect of NEDD4L on the growth and the p62/Keap1/Nrf2 pathway activity in vivo was researched in xenograft tumor nude mice models. RESULTS: The down-regulated NEDD4L in BLCA patients was associated with unfavorable survival. NEDD4L suppressed the viability (inhibition rate 57.1%/49.0%), migration (inhibition rate 49.7%/77.1%), invasion (inhibition rate 50.6%/75.7%), promoted the apoptosis of T24/5637 cells (promotion rate 243.8%/201.9%), reduced IC 50 of DDP-resistant T24/5637 cells from 132.2/101.8 to 57.81/59.71 µM, respectively, and inactivated the p62/Keap1/Nrf2 pathway in T24/5637 cells. p62 up-regulation partially abrogated the inhibition of NEDD4L on the Keap1/Nrf2 pathway activity, the malignant behavior of BLCA cells, and the DDP resistance of DDP-resistant BLCA cells. NEDD4L overexpression inhibited the tumor growth and the p62/Keap1/Nrf2 pathway activity in vivo in BLCA. CONCLUSION: NEDD4L inhibits the progression of BLCA by inactivating the p62/Keap1/Nrf2 pathway. It may be an effective target for BLCA treatment.

Comparative transcriptome analysis of wild type and a pectate lyase mutant strain of Bacillus subtilis.

Transcriptome analysis for the original Bacillus subtilis K1 strain and UV mutagenic strain UW07 with high yield of pectate lyase was implemented with RNA-seq. The function of genes was annotated and metabolic pathways were classified to look for different expression genes and classify these genes into related metabolic pathways to reveal the high-yield mechanism of pectate lyase in UW07. The results showed that 397 genes were up-regulated and 617 genes were down-regulated compared with the original strain. The up-regulated genes were mainly involved in ABC transporters, two-component system, biosynthesis of amino acids, and carbon metabolism.

Ultrasonic Phased Array Imaging Approach Using Omni-Directional Velocity Correction for Quantitative Evaluation of Delamination in Composite Structure.

The ultrasonic detectability of buried defects within composite materials is dependent on the anisotropy of the composite material by which the propagation property of acoustic wave in each direction is variably affected. In this study, the characteristics of acoustic waves propagating in different directions for composite materials are explored based on the full matrix capture (FMC) data using an ultrasonic phased array. The elastic constant of multidirectional carbon fiber reinforced plastic (CFRP) laminate is first derived based on the genetic algorithm. The characteristics of transmitted and reflected waves in higher angles are predicted by implementing the Christoffel equation, and the focal law used in post-processing of FMC data can be optimized accordingly. The imaging results of the total focusing method (TFM) using the improved focal law are compared with the results of the conventional TFM. The results suggest that the optimized TFM can effectively characterize the defect by reducing the background noise. Furthermore, since it is impractical to theoretically correct angle-dependent velocity for in situ inspection, a linear extrapolation method based on the experimentally measurable velocity at low angles is proposed to estimate the velocity profile at higher angles. The imaging results using the fast extrapolated velocity profile is then compared with the theoretical, and it has been demonstrated that while the difference between the images using the theoretical focal law and the linearly extrapolated one is barely visible, the later one is overwhelmingly advantageous to be realiszd for engineering practices.

Nobiletin as an inducer of programmed cell death in cancer: a review.

Cancer resistance to therapy is a big issue in cancer therapy. Tumours may develop some mechanisms to reduce the induction of cell death, thus stimulating tumour growth. Cancer cells may show a low expression and activity of tumour suppressor genes and a low response to anti-tumour immunity. These mutations can increase the resistance of cancer cells to programmed cell death mechanisms such as apoptosis, ferroptosis, pyroptosis, autophagic cell death, and some others. The upregulation of some mediators and transcription factors such as Akt, nuclear factor of κB, signal transducer and activator of transcription 3, Bcl-2, and others can inhibit cell death in cancer cells. Using adjuvants to induce the killing of cancer cells is an interesting strategy in cancer therapy. Nobiletin (NOB) is a herbal-derived agent with fascinating anti-cancer properties. It has been shown to induce the generation of endogenous ROS by cancer cells, leading to damage to critical macromolecules and finally cell death. NOB may induce the activity of p53 and pro-apoptosis mediators, and also inhibit the expression and nuclear translocation of anti-apoptosis mediators. In addition, NOB may induce cancer cell killing by modulating other mechanisms that are involved in programmed cell death mechanisms. This review aims to discuss the cellular and molecular mechanisms of the programmed cell death in cancer by NOB via modulating different types of cell death in cancer.

Toxic effects of triphenyltin on the silkworm Bombyx mori as a lepidopterous insect model.

Triphenyltin (TPT) is a widely used reagent in various industries and agriculture, but is also known to accumulate in natural ecosystems and animal tissues. Hence, the aim of this study was to comprehensively assess the toxicity of TPT in the silkworm Bombyx mori as a model insect. The results showed that TPT exposure for the entire 5th instar larval stage significantly reduced the weight of silkworm pupa and inhibited development of the silkworm midgut. Following exposure to 2 µg/kg of TPT for 4 days, differentially expressed genes in midgut were associated with enriched pathways involved in the metabolism of carbohydrates, lipids, and amino acids, as determined by RNA sequencing. Furthermore, the metabolic profiles of the intestinal content of silkworms exposed to 2 µg/kg of TPT for 4 days were markedly altered and differential metabolites produced by metabolism of carbohydrates, lipids, and amino acids were enriched as determined by non-targeted GC-MS/MS metabolomics. This study provides novel insights into the mechanisms underlying the toxicity of TPT and emphasizes the risks posed by such pollutants released into the environment.

Sensitivity of PCR analysis (melting curve method) in diagnosis of Pulmonary Tuberculosis (PTB) based on Bronchoalveolar Lavage (BAL) by bronchoscope.

Objectives: To evaluate the sensitivity of the real-time PCR assay melting curve method in the diagnosis of pulmonary tuberculosis (PTB) by analyzing bronchoalveolar lavage fluid (BALF) obtained from bronchoscopy. Methods: A total of 214 PTB patients who were treated at Xuancheng People's Hospital respiratory and infection department during January 2018 to January 2021 were included in this study. Bronchoscopic bronchoalveolar lavage fluid (BALF) examined by polymerase chain reaction (melting curve method), BALF smear, BALF culture, lipoarabinomannan (LAM) antigen test for diagnosis of tuberculosis (TB) (LAM-TB), acid-fast stain (AFS), and serum adenosine deaminase (ADA) test were conducted respectively to compare their positive predictive values (PPVs). Results: Of the 214 patients with confirmed PTB, 84.11% were BALF melting curve method positive, significantly higher than the positive results yielded by other PTB screening tests, i.e., LAM-TB (69.16%), AFS (51.87%), ADA (49.07%), BALF culture (62.15%), and BALF smear (41.12%) (p<0.05, respectively). The PPVs were increased to 92.06%, 93.93%, 92.99%, 95.79%, and 91.12% when BALF melting curve method was performed in combination with LAM-TB, AFS, ADA, BALF culture, and BALF smear, respectively, significantly higher than that produced by BALF melting curve method or the combined use of any two of the non-BALF melting curve method tests (p<0.05, respectively). Conclusion: BALF melting curve method is an ideal diagnostic approach to PTB, which is of a higher diagnostic value compared with LAM-TB, AFS, ADA, BALF culture, and BALF smear.

Analysis of diagnostic characteristics and clinical related factors of 70 patients with atelectasis by painless bronchoscopy.

Objectives: To analyze the diagnostic characteristics and clinical related factors of patients with atelectasis by painless electronic bronchoscopy. Methods: A retrospective analysis was performed on 70 patients with atelectasis admitted to Xuancheng People's Hospital from April 2019 to June 2021. The clinical data of the patients and the diagnosis characteristics under painless electronic bronchoscope were analyzed, and the clinical related factors were investigated. Results: Seventy patients with atelectasis underwent pathological examination and bacteriological examination after painless electronic bronchoscopy, including 16 cases (22.86%) of inflammation, 11 cases (15.71%) of tuberculosis, 36 cases (51.43%) of tumor, one case (1.43%) of inflammatory polyp, one case (1.43%) of congenital dysplasia, two cases (2.86%) of foreign body inhalation, and three cases (4.29%) of other symptoms. Male patients with atelectasis showed most cauliflower-like tumors and mucosal swelling under electronic bronchoscopy (P<0.05), while female patients showed scar occlusion/stenosis at most (P<0.05). Middle-aged and elderly patients under electronic bronchoscopy showed most cauliflower-like tumors, scar stenosis/occlusion and mucosal swelling cavity, while young patients mainly showed necrosis and purulent secretions. Heavy smokers were most likely to have cauliflower-like tumors, while non-smokers were predominantly with scar stenosis/occlusion. Conclusions: Painless electronic bronchoscopy is of great value in the clinical diagnosis of patients with atelectasis, and it is likely to further clarify the etiology of atelectasis. Age, sex, and quantity of smoking may be clinical factors associated with atelectasis.

Saliniquinone Derivatives, Saliniquinones G-I and Heraclemycin E, from the Marine Animal-Derived Nocardiopsis aegyptia HDN19-252.

Four new anthraquinone derivatives, namely saliniquinones G-I (1-3) and heraclemycin E (4), were obtained from the Antarctic marine-derived actinomycete Nocardiopsis aegyptia HDN19-252, guided by the Global Natural Products Social (GNPS) molecular networking platform. Their structures, including absolute configurations, were elucidated by extensive NMR, MS, and ECD analyses. Compounds 1 and 2 showed promising inhibitory activity against six tested bacterial strains, including methicillin-resistant coagulase-negative staphylococci (MRCNS), with MIC values ranging from 3.1 to 12.5 µM.

Retinal vascular abnormalities and their associations with cardiovascular and cerebrovascular diseases: a Study in rural southwestern Harbin, China.

BACKGROUND: Limited data is available on retinal vessel morphology in the north China. The study aimed to evaluate the prevalence of retinal vascular abnormalities (RVAs) and investigate their associations with the self-reported diagnosis of cardiovascular and cerebrovascsular diseases (CCVds) in a rural adult population of northeast China. METHODS: A population-based, cross-sectional study was conducted, using the cluster random sampling method. One eye of each participant was photographed with a non-mydriatic fundus camera. RVAs including focal and general arteriolar narrowing (FAN and GAN), arteriovenous nicking (AVN), arteriolar sheathing (AS), and retinopathy were evaluated. Data on self-reported diagnosis of cardiovascular and cerebrovascular diseases and status of smoking and alcohol drinking were obtained from questionnaires. RESULTS: Among the 6267 participants with an age ≥ 50 years, photographs were obtained of 99.2%, with quality sufficient to perform retinal evaluations in 82.5%. The prevalence of FAN, AVN, AS, retinopathy and GAN were 9.1, 8.9, 5.0, 6.6 and 6.2%, respectively. All the retinal lesions were associated with hypertension (all P < 0.01). After adjusting for age, gender, and left/right eyes, hypertension, hyperlipidaemia, diabetes mellitus, habits of past or current smoking and alcohol consumption, AVN was strongly associated with the self-reported diagnosis histories of coronary heart diseases(CHD) (OR, 1.44; 95% CI, 1.09, 1.89) and retinopathy was significantly associated with a self-reported diagnosis of stroke (OR, 2.05; 95% CI, 1.18, 3.57). CONCLUSIONS: The overall prevalence of retinal microvascular abnormalities in this population was relatively higher than that reported in other regions of the world. Retinopathy is associated with the self-reported diagnosis of stroke while AVN was associated with the self-reported diagnosis of CHD, but the remaining retinal lesions were not consistently associated with CCVds. Thus, an examination of retinal microvascular characteristics may offer clues to CCVds and could be a potentially novel biomarkers for CCVds risk.

Selecting the Best Elements from Previous Kidney Tumor Scoring Systems to Restructure Efficient Predictive Models for Surgery Type.

OBJECTIVE: The aim of this work was to select the best elements from previous scoring systems to restructure efficient predictive models for surgery type. METHODS: Sixteen elements were selected from 7 systems (RENAL, PADUA, DAP, ZS, NephRO, ABC, and CI). They were divided into 6 categories (tumor max. size, exophytic/endophytic, correlation with collecting system or sinus, tumor location, contact situation with the parenchyma, invasion depth). Three elements, selected from 3 different categories, were integrated to establish a total of 320 new models. According to AUC rank, optimized models were developed, and these models were divided into 3 sections. An analysis of the distribution of the 6 categories was made to explore the predictive capacities of the models. RESULTS: A total of 166 consecutive patients were included. Seventy-five patients underwent radical nephrectomy operations. The AUC of the 7 systems ranged from 0.81 to 0.844. Three optimized models (AUC 0.88) were developed to predict surgery type. These optimized models were composed of DAP (D), PADUA, (sinus), and ABC; DAP (D), RENAL (N), and ABC; NePhRO (O), PADUA (UCS), and ABC. Two categories ("exophytic/endophytic," p < 0.001; "correlation with collecting system or sinus," p = 0.001) were nonuniformly distributed. CONCLUSIONS: Seven systems held good predictive power for surgery type. Three optimized models were developed. "Correlation with collecting system or sinus" is a critical factor for predicting surgery type.

Hierarchical CNTs@CuMn Layered Double Hydroxide Nanohybrid with Enhanced Electrochemical Performance in H2S Detection from Live Cells.

The precise monitoring of H2S has aroused immense research interest in the biological and biomedical fields since it is exposed as a third endogenous gasotransmitter. Hence, there is an urgent requisite to explore an ultrasensitive and economical H2S detection system. Herein, we report a simple strategy to configure an extremely sensitive electrochemical sensor with a 2D nanosheet-shaped layered double hydroxide (LDH) wrapped carbon nanotubes (CNTs) nanohybrid (CNTs@LDH), where a series of CNTs@CuMn-LDH nanohybrids with varied amounts of LDH nanosheets grafted on a conductive CNTs backbone has been synthesized via a facile coprecipitation approach. Taking advantage of the unique core-shell structure, the integrated electrochemically active CuMn-LDH nanosheets on the conductive CNTs scaffold, the maximum interfacial collaboration, and the superior specific surface area with a plethora of surface active sites and ultrathin LDH layers, the as-prepared CNTs@CuMn-LDH nanoarchitectures have exhibited superb electrocatalytic activity toward H2S oxidation. Under the optimum conditions, the electrochemical sensor based on the CNTs@CuMn-LDH nanohybrid shows remarkable sensing performances for H2S determination in terms of a wide linear range and a low detection limit of 0.3 nM (S/N = 3), high selectivity, reproducibility, and durability. With marvelous efficiency achieved, the proposed sensing platform has been practically used in in situ detection of abiotic H2S efflux produced by sulfate reducing bacteria and real-time in vitro tracking of H2S concentrations from live cells after being excreted by a stimulator which in turn might serve as early diseases diagnosis. Thus, our core-shell hybrid nanoarchitectures fabricated via structural integration strategy will open new horizons in material synthesis, biosensing systems, and clinical chemistry.

Superlattice stacking by hybridizing layered double hydroxide nanosheets with layers of reduced graphene oxide for electrochemical simultaneous determination of dopamine, uric acid and ascorbic acid.

A self-assembled periodic superlattice material was obtained by integrating positively charged semiconductive sheets of a Zn-NiAl layered double hydroxide (LDH) and negatively charged layers of reduced graphene oxide (rGO). The material was used to modify a glassy carbon electrode which then is shown to be a viable sensor for the diagnostic parameters dopamine (DA), uric acid (UA) and ascorbic acid (AA). The modified GCE displays excellent electrocatalytic activity towards these biomolecules. This is assumed to be due to the synergistic effects of (a) excellent interfacial electrical conductivity that is imparted by direct neighboring of conductive rGO to semiconductive channels of LDHs, (b) the superb intercalation feature of LDHs, and (c) the enlarged surface with an enormous number of active sites. The biosensor revealed outstanding electrochemical performances in terms of selectivity, sensitivity, and wide linear ranges. Typically operated at working potentials of -0.10, +0.13 and + 0.27 V vs. saturated calomel electrode, the lower detection limits for AA, DA and UA are 13.5 nM, 0.1 nM, and 0.9 nM, respectively, at a signal-to-noise ratio of 3. The sensor was applied to real-time tracking of dopamine efflux from live human nerve cells. Graphical abstract Schematic of the preparation of a superlattice self-assembled material by integrating positively charged semiconductive sheets of Zn-NiAl layered double hydroxide (LDH) with negatively charged reduced graphene oxide (rGO) layers. It was applied to simultaneous electrochemical detection of dopamine (DA), uric acid and ascorbic acid.

A Multi-Module Electrodynamic Exciter with a Variable Pole-Arc Ratio Disk Halbach Array for a High-Bandwidth Dynamic Torsional Stiffness Test.

In this paper, a multi-module electrodynamic exciter based on moving-magnet disk voice coil motor is presented to meet the demands of high torque and high bandwidth in a dynamic torsional stiffness test. A variable pole-arc ratio disk Halbach array (VPAR-DHA) is proposed, so that both high torque density and low rotor inertia can be obtained through enhancing the magnetic field in the working range. The analytical quasi-3-D model of VPAR-DHA was set up by using the harmonic function method, with the consideration of end-effects by a correction function. Electromagnetic structure optimization was carried out with the analytical model, and verified by 3-D finite-element (FEM) results. The proposed design was experimentally tested and verified with a prototype that achieved a peak dynamic torque output of 40 Nm at a frequency of 120 Hz, and a stroke of ±1°. The proposed method can also be easily extended to satisfy various demands of dynamic torsional stiffness test.

Analysis and Optimization of a Novel 2-D Magnet Array with Gaps and Staggers for a Moving-Magnet Planar Motor.

This paper presents a novel 2-D magnet array with gaps and staggers, which is especially suitable for magnetically levitated planar motor with moving magnets. The magnetic flux density distribution is derived by Fourier analysis and superposition. The influences of gaps and staggers on high-order harmonics and flux density were analyzed, and the optimized design is presented. Compared with the other improved structures based on traditional Halbach magnet arrays, the proposed design has the lowest high-order harmonics percentage, and the characteristics of flux density meet the demand of high acceleration in horizontal directions. It is also lightweight and easy to manufacture. The proposed magnet array was built, and the calculation results have been verified with experiment.

[Expression of chemokine CXCL12 and its receptor (CXCR4 and CXCR7) in different molecular subtypes of human breast carcinoma and the clinical significance].

OBJECTIVE: To study the expressions and the clinical significance of chemokine CXCL12 and its receptor CXCR4, CXCR7 in the human breast carcinoma (BC) with different molecular subtypes.
 Methods: The mRNA expressions of CXCL12, CXCR4 and CXCR7 in tissues from 80 patients with different molecular subtype of BC were measured by qRT-PCR. The protein expressions of CXCL12, CXCR4 and CXCR7 in paraffin-embedded samples from 160 patients with different molecular subtypes were detected by immunohistochemical staining.
 Results: The mRNA expression levels of CXCL12, CXCR4 and CXCR7 in HER-2 positive BC and TNBC tissues were significantly higher than those in luminal A and luminal B subtype BC tissues (all P<0.05), but their expressions were not different between luminal A and luminal B subtype BC tissues or between HER-2 positive BC and TNBC tissues. The positive expression rates of CXCL12 protein in HER-2 positive BC and TNBC tissues were significantly higher than those in luminal A and luminal B subtype BC tissues (all P<0.05), while their expressions were not different between luminal A and luminal B subtype BC tissues or between HER-2 positive BC and TNBC tissues. CONCLUSION: High expressions of the gene CXCL12 and its receptor CXCR4 and CXCR7 in HER-2 positive BC and TNBC may be closely associated with their poor prognosis. Inhibition of their expressions in HER-2 positive BC and TNBC may provide a strategy for treating BC in clinic.

[Meta-analysis of endoscopic axillary lymph node dissection versus conventional open excision for breast cancer].

OBJECTIVE: To compare the surgical outcome and the clinical value between endoscopic axillary lymph node dissection and conventional open excision in the treatment of breast cancer. 
 METHODS: A computer-based online search of Medline, PubMed, Embase, Ovid, Cochrane Library, Vip, Wanfang, CNKI and Chinese Biological Medicine Database was performed, and conference literatures were manually searched. Using the Cochrane Collaboration guidelines, all randomized controlled trials comparing endoscopic axillary lymph node dissection and conventional open excision were systematically reviewed. The Cochrane Collaboration's RevMan 5.0 software was used for data analysis. 
 RESULTS: A total of 25 studies involving 3 028 patients were included. The results of Meta-analyses showed that there were no significant difference in the number of lymph nodes harvested and recurrence between endoscopic axillary lymph node dissection and conventional open excision (P>0.05). The operative time of endoscopic axillary lymph node dissection was longer than that of conventional open excision. However, it was superior to open excision in the rate of complication and intra-operative blood loss (P<0.05).
 CONCLUSION: As a minimally invasive surgery technique to treat breast cancer, endoscopic axillary lymph node dissection might be a promising replacement for conventional axillary lymph node dissection.

[A case of Sagliker syndrome and literature review].

We analyzed the characters of Sagliker syndrome by reporting a case of Sagliker syndrome and reviewed literature. We found that Sagliker syndrome had low incidence rate, young onset age, and was more common in women. There were high levels of alkaline phosphatase and parathyroid hormone in the blood of the patients. Patients with Sagliker syndrome with primary onset of non-diabetic nephropathy usually had chronic glomerulonephritis. We thought that secondary hyperparathyroidism in patients with Sagliker syndrome was induced by parathyroid hyperplasia, but high levels of alkaline phosphatase and parathyroid hormone in the blood of the patients with the secondary hyperparathyroidism were the main cause of Sagliker syndrome. Parathyroidectomy could stop the progress of Sagliker syndrome, but it could not reverse the occurrence of skeletal malformation.