Porphyromonas gingivalis bacteremia increases the permeability of the blood-brain barrier via the Mfsd2a/Caveolin-1 mediated transcytosis pathway / 国际口腔科学杂志·英文版

Bacteremia induced by periodontal infection is an important factor for periodontitis to threaten general health. P. gingivalis DNA/virulence factors have been found in the brain tissues from patients with Alzheimer's disease (AD). The blood-brain barrier (BBB) is essential for keeping toxic substances from entering brain tissues. However, the effect of P. gingivalis bacteremia on BBB permeability and its underlying mechanism remains unclear. In the present study, rats were injected by tail vein with P. gingivalis three times a week for eight weeks to induce bacteremia. An in vitro BBB model infected with P. gingivalis was also established. We found that the infiltration of Evans blue dye and Albumin protein deposition in the rat brain tissues were increased in the rat brain tissues with P. gingivalis bacteremia and P. gingivalis could pass through the in vitro BBB model. Caveolae were detected after P. gingivalis infection in BMECs both in vivo and in vitro. Caveolin-1 (Cav-1) expression was enhanced after P. gingivalis infection. Downregulation of Cav-1 rescued P. gingivalis-enhanced BMECs permeability. We further found P. gingivalis-gingipain could be colocalized with Cav-1 and the strong hydrogen bonding between Cav-1 and arg-specific-gingipain (RgpA) were detected. Moreover, P. gingivalis significantly inhibited the major facilitator superfamily domain containing 2a (Mfsd2a) expression. Mfsd2a overexpression reversed P. gingivalis-increased BMECs permeability and Cav-1 expression. These results revealed that Mfsd2a/Cav-1 mediated transcytosis is a key pathway governing BBB BMECs permeability induced by P. gingivalis, which may contribute to P. gingivalis/virulence factors entrance and the subsequent neurological impairments.

Eosinophil-to-neutrophil ratio predicts outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis / 国际脑血管病杂志

Objective:To investigate the predicting value of eosinophil-to-neutrophil ratio (ENR) for outcomes at 3 months after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis in the Department of Neurology, Huai'an First People's Hospital from July 2019 to July 2022 were included retrospectively. Multivariate logistic regression model was used to determine the independent correlation between ENR and outcomes at 3 months after intravenous thrombolysis. The receiver operating characteristics (ROC) curve was used to evaluate the predictive value of ENR levels for poor outcomes at 3 months after intravenous thrombolysis. Results:A total of 352 patients with AIS receiving intravenous thrombolysis were enrolled, including 240 men (68.1%), age 66.46±12.00 years old. The median National Institutes of Health Stroke Scale score was 8 (interquartile range, 5-13). At 3 months after onset, 215 patients (61.0%) had good outcomes, 137 (38.9%) had poor outcomes. Univariate analysis showed that the median ENR×10 2 level of the poor outcome group was significantly lower than that of the good outcome group ( Z= –7.305, P<0.01). Multivariate logistic regression analysis showed that lower ENR×10 2 was an independent risk factor for poor outcomes at 3 months after intravenous thrombolysis (odds ratio 0.619, 95% confidence interval 0.514-0.745; P<0.01). ROC curve analysis showed that the area under the curve for ENR×10 2 predicting the poor outcomes after intravenous thrombolysis was 0.731 (95% confidence interval 0.678-0.784; P<0.01). The optimal cutoff value was 0.625 and the corresponding sensitivity and specificity were 94% and 40%, respectively. Conclusion:Lower ENR before intravenous thrombolysis in patients with AIS is independently associated with the poor outcomes at 3 months.

Systemic immune-inflammation index predicts hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the predictive value of systemic immune-inflammatory index (SII) for hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (sICH) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received intravenous thrombolysis in the Department of Neurology, Huai’an First People’s Hospital from July 2019 to July 2022 were included retrospectively. The head CT was performed at 24 h after intravenous thrombolysis and determined whether HT existed. sICH was defined as brain parenchymal hematoma, and the National Institutes of Health Stroke Scale (NIHSS) scores increased by ≥4 compared with the baseline, or the patient died within 36 h after onset. Multivariate logistic regression analysis was used to determine the independent correlation between SII and HT and sICH after intravenous thrombolysis. The receiver operating characteristics (ROC) curve was used to evaluate the predictive value of SII for HT and sICH after intravenous thrombolysis. Results:A total of 352 patients with AIS received intravenous thrombolysis were enrolled, including 240 males (68.1%), aged 66.46±12.00 years. The median baseline NIHSS score was 8 (interquartile range, 5-13), and the median SII is 531.91×10 9/L (interquartile range, 351.20-896.91×10 9/L). HT occurred in 62 patients (17.6%) and sICH occurred in 27 patients (7.7%). Univariate analysis showed that the SII of the HT group was significantly higher than that of the non-HT group ( Z=–2.731, P=0.006), and the SII of the sICH group was significantly higher than that of non-sICH group ( Z=–4.125, P<0.01). Multivariate logistic regression analysis showed that the increased SII was the independent risk factor for HT (odds ratio [ OR] 1.001, 95% confidence interval [ CI] 1.000-1.001; P=0.004) and sICH ( OR 1.001, 95% CI 1.001-1.002; P<0.01). ROC curve analysis shows that the area under curve of SII predicting HT was 0.610 (95% CI 0.535-0.686; P=0.006), and the best cutoff value was 488.48×10 9/L. The corresponding sensitivity and specificity were 69% and 47% respectively. The area under the curve of SII predicting sICH was 0.739 (95% CI 0.636-0.842; P<0.01), and the best cutoff value was 846.56×10 9/L, the corresponding sensitivity and specificity were 70% and 77% respectively. Conclusion:The increased SII at admission can predict the risks of HT and sICH in patients with AIS after intravenous thrombolysis.

Blood cells predict the outcomes of patients with acute ischemic stroke after endovascular therapy / 国际脑血管病杂志

Endovascular therapy has been proved to be the best treatment for acute ischemic stroke caused by large vessel occlusion, but its efficacy is closely associated with time, so it is of great significance to obtain biomarkers that can predict its outcome early. Blood cells can reflect inflammatory reaction, which is very low cost and easy to obtain. This article expounds the predictive value of blood cells on the outcomes of acute ischemic stroke after endovascular therapy.

Establishment of Endoscopic Surgical Innovative System of Recurrent Nasopharyngeal Carcinoma / 肿瘤防治研究

Nasopharyngeal carcinoma (NPC) is a common malignant tumor in China. Radiotherapy is the first-line treatment. After appropriate radiotherapy, about 5%-15% patients experience recurrence. In view of the poor efficacy and high incidence of severe late toxicities associated with re-irradiation, salvage surgery by the transnasal endoscopic approach is recommended for recurrent NPC (rNPC). Compared with re-irradiation, endoscopic surgery can better prolong survival, improve the quality of life, and reduce complications and medical expenses of patients with rNPC. However, the complexity of the nasopharyngeal skull base enhances the difficulty and risk of surgery. Expanding the boundary of surgical resection remains a clinical challenge for otolaryngologists. In this regard, to help more advanced patients with rNPC, the surgical innovative system of NPC needs to be established by multi-disciplinary cooperation, involving skull base anatomy-based investigation, appropriate administration of the internal carotid artery (ICA), repair of skull base defect, and establishment of various types of endoscopic endonasal nasopharyngectomy.

Thrombus formation associated with operation procedure and clinical outcome in patients with acute ischemic stroke undergoing mechanical thrombectomy / 中华神经科杂志

Objective:To evaluate the association between thrombus composition and mechanical recanalization,operation procedure and clinical outcome.Methods:One hundred and ninety-two consecutive stroke patients with large-vessel occlusion treated by mechanical thrombectomy using a stent retriever and (or) aspiration catheter in the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University between January 2018 and January 2020 were collected. The retrieved thrombi were quantitatively analyzed for red blood cells, white blood cells, platelets, and fibrin. The patients were divided into two groups, a erythrocyte-rich group and a fibrin-rich group based on the predominant composition in the clot. The clinical prognosis, CT value of thrombus, procedure time,number of recanalization maneuvers, and degree of vascular recanalization were compared between the two groups.Results:The retrieved clot from 138 patients with acute ischemic stroke from internal carotid artery occlusion ( n=56), middle cerebral artery occlusion ( n=62), intracranial segment of vertebral artery or basilar artery occlusion( n=20) were histologically analyzed. Erythrocyte-rich clots were present in 59 cases, while fibrin-rich clots were present in 79 cases. Cardioembolic thrombi had higher proportions of fibrin/platelets [77.2%(61/79)], less erythrocytes than noncardioembolic thrombi [45.8%(27/59), χ2=8.115, P=0.004]. Patients with erythrocyte-rich thrombi had a smaller number of recanalization maneuvers [2 (1, 2) vs 3 (2, 4), Z=-7.613, P<0.001], shorter procedure time [45 (30, 60) min vs 80 (60, 90) min, Z=-6.944, P<0.001], higher thrombus CT value [42 (32, 53) vs 36 (31, 41), Z=-2.003, P=0.045], good clinical prognosis (the ratio of modified Rankin Scale score ≤2, 62.7% (37/59) vs 39.2% (31/79), χ2=7.444, P=0.006). There was no significant difference in the location of vascular occlusion between the two groups. Conclusion:For patients whose thrombotic components are mainly red blood cells, the cause of stroke may be non cardiogenic cerebral embolism, the CT value of embolus is relatively high, the embolus is easy to remove, and the clinical prognosis is relatively good.

Factors related to postoperative adjuvant therapy of locally advanced cervical cancer and building of a nomogram prediction model / 国际肿瘤学杂志

Objective:To explore the related factors of postoperative adjuvant therapy for cervical cancer stagedⅠB1-ⅡA2 [according to 2018 International Federation of Gynecology and Obstetrics (FIGO) staging standard], and to establish a nomogram model to predict the risk of postoperative adjuvant therapy for locally advanced cervical cancer.Methods:A total of 714 patients with cervical squamous cell cancer staged FIGO ⅠB1-ⅡA2 treated by surgery in Anhui Provincial Hospital were selected as the research objects from January 2009 to December 2019, and their clinicopathological data were analyzed. Multiple logistic regression analysis was used to determine the influencing factors, and a nomogram model was established to predict the risk of postoperative adjuvant treatment of cervical cancer. The predictive performance of the model was evaluated with the consistency index (C-index), and the compliance of the model was evaluated with the calibration curve.Results:Univariate analysis suggested that postoperative adjuvant therapy for cervical cancer was associated with gravidity ( χ2=11.506, P=0.001), underlying disease (hypertension or diabetes) ( χ2=7.668, P=0.006), squamous cell cancer antigen (SCC-AG) level ( χ2=19.392, P<0.001), imaging risk factors ( χ2=16.392, P<0.001), FIGO stage ( χ2=25.686, P<0.001), tumor size ( χ2=9.392, P=0.025) and surgical path ( χ2=16.590, P<0.001). Multivariate logistic regression analysis suggested that the number of pregnancy >2 times ( OR=1.951, 95% CI: 1.355-2.808, P<0.001), SCC-Ag ≥1.5 μg/L ( OR=2.021, 95% CI: 1.444-2.829, P<0.001), FIGO stage ⅠB3-ⅡA2 [ⅠB3 ( OR=1.933, 95% CI: 1.139-3.282, P=0.015); ⅡA1 ( OR=2.723, 95% CI: 1.556-4.765, P<0.001); ⅡA2 ( OR=3.159, 95% CI: 1.502-6.646, P=0.002)], with underlying disease (hypertension or diabetes) ( OR=1.867, 95% CI: 1.051-3.318, P=0.033), imaging risk factors ( OR=1.997, 95% CI: 1.127-3.537, P=0.018), without neoadjuvant therapy [preoperative neoadjuvant therapy for 1 cycle ( OR=0.402, 95% CI: 0.207-0.783, P=0.007)] and laparoscopic surgery ( OR=2.177, 95% CI: 1.524-3.112, P<0.001) were independent influencing factors for postoperative adjuvant treatment of cervical cancer. Based on the screened variables, the nomogram model to predict the risk of postoperative adjuvant treatment for cervical cancer has good predictive performance (C-index was 0.702) and compliance. Conclusion:The number of pregnancy >2 times, SCC-Ag ≥1.5 μg/L, FIGO stage ⅠB3-ⅡA2, with underlying disease (hypertension or diabetes), imaging risk factors, without neoadjuvant therapy, and laparoscopic surgery are independent influencing factors for postoperative adjuvant treatment of cervical cancer. A nomogram model has been constructed to predict the risk of postoperative adjuvant therapy for locally advanced cerrical cancer, and it can provide evidence for clinical treatment selection.

Trend in proportion and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer / 中华妇产科杂志

Objective@#To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China.@*Methods@#The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient's stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed.@*Results@#(1) The total number of hospitalized patients with stage Ⅰa2 to Ⅱa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01) . The constituent ratio of patients aged 35 years or younger was significantly greater during 2004—2010 than that during 2011—2016 [12.6% (820/6 484) and 8.5% (1 068/12 557) , respectively; χ2=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stage Ⅰ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05).@*Conclusions@#The trend in proportion among hospitalized patients for stage Ⅰa2 to Ⅱa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion >1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.

Trend in proportion and clinicopathological characteristics of young women with stageⅠa2 toⅡa2 cervical cancer / 中华妇产科杂志

Objective To analyze the 13 years trend in proportion, risks factors and clinicopathological characteristics of young women with stage Ⅰa2 to Ⅱa2 cervical cancer by using multi-center data of cervical cancer in China. Methods The clinicopathological data of 46 313 patients with cervical cancer treated from 37 hospitals in China were obtained from January 2004 to December 2016. Using clinical and pathologic data, each patient′s stage was reclassified by the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system. A total of 19 041 patients were selected according to the following criteria: FIGO stage Ⅰa2 to Ⅱa2, underwent type B or C radical hysterectomy and pelvic lymphadenectomy. All the patients were divided into two groups: the study group of 1 888 patients aged 35 years or younger and the control group of 17 153 patients aged over 35 years. The 13 years trend in proportion of young women with stage Ⅰa2 to Ⅱa2 cervical cancer, risks factors and clinicopathological characteristics of two groups were retrospectively analyzed. Results (1) The total number of hospitalized patients with stageⅠa2 toⅡa2 cervical cancer increased annually. However, a downward trend of patients aged 35 years or younger was observed (P<0.01). The constituent ratio of patients aged 35 years or younger was significantly greater during 2004—2010 than that during 2011—2016 [12.6% (820/6 484) and 8.5% (1 068/12 557), respectively; χ2=82.101, P<0.01]. (2) Compared with patients aged over 35 years, patients aged 35 years or younger had an earlier age at menarche, a later age at marriage, lesser gravida and parity (all P<0.01). The positive rate of high-risk HPV infection was not statistically different between two groups (all P>0.05). (3) The proportions of stageⅠ, exophytic type and non-squamous histological type in patients aged 35 years or younger were clearly higher than those in patients aged over 35 years (83.4% vs 68.5%, P<0.01; 63.2% vs 56.2%, P<0.01; 13.9% vs 12.0%, P<0.05, respectively). Whereas the poor differentiation ratios of the two groups had no statistical significance (P>0.05). (4) As for the postoperative pathological risk factors, the rate of surgical margin involvement in patients aged 35 years or younger was lower than that aged over 35 years (1.1% vs 1.8%, P<0.05), and the rate of depth of stromal invasion >1/2 in patients aged 35 years or younger was lower than that in patients aged over 35 years (40.1% vs 50.9%, P<0.01). In addition, there were no significant difference in parametrial margin involvement, tumor size and lymph vascular space invasion between two groups (all P>0.05). Conclusions The trend in proportion among hospitalized patients for stageⅠa2 toⅡa2 cervical cancer in young women is decreasing yearly. Compared with cervical cancer in middle-aged and elderly women, cervical cancer in young women have an earlier age at menarche, a higher proportion of stage Ⅰ patients and non-squamous histological type. In terms of the postoperative pathological risk factors, the rate of surgical margin involvement and depth of stromal invasion>1/2 in young women with cervical cancer are lower than in middle-aged and elderly women.

The surgical management of nasal skull base schwannoma under endonasal endoscope: a retrospective review of 52 cases / 中华耳鼻咽喉头颈外科杂志

Objective@#To discuss the surgical technique and outcome of nasal skull base schwannoma treated under endonasal endoscope.@*Methods@#Fifty-two patients with nasal skull base nonvestibular schwannoma were treated under endonasal endoscope from May 2006 to June 2017 in Shanghai E&ENT Hospital. Of the patients, there were 21 men and 31 women. The age of the patients ranged from 33 to 71 years.Schwannoma mainly came from trigeminal nerve.Clinical symptoms included facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus. Surgical approaches included pure endonasal endoscope approach (18 cases) and endoscopic endonasal resection asissted with sublabial transmaxillary approach (34 cases).@*Results@#Total tumor resection was achieved in 42 patients(80.8%), subtotal resection in 8 patients, and partial resection in 2 patients. The relief rate of facial numbness, facial pain, nasal obstruction, headache, hypopsia, diplopia and tinnitus were 68.8%, 45.5%, 100.0%, 90.0%, 60.0%, 40.0% and 100.0%, respectively. During surgery, cerebrospinal fluid leakage was observed in 5 cases. All cases were successfully repaired with a nasoseptal flap or autologous fascia lata and fat obtained from thigh. Four cases with recurrence were observed in the follow-up period (6-134 months).@*Conclusion@#Endonasal endoscopic approach is a safe and feasible procedure for schwannoma in nasal cavity, paranasal sinus, orbital apex, pterygopalatine fossa, infratomporal fossa, cavernous sinus and Meckel cave.

Early growth response gene-1 regulates host cell autophagy in HTLV-1 infection / 中华微生物学和免疫学杂志

Objective To investigate the influence of early growth response gene-1 (EGR1) on the autophagy of host cells following infection with human T cell leukemia virus type 1 (HTLV-1).MethodsA HTLV-1-positive cell line MT2 was co-cultured with HeLa cells for 24 h to construct the virus early infection model.Immunoblotting assay was used to detect the expression of HTLV-1 core protein p19 and EGR1.Luciferase reporter gene analysis was used to detect the transcriptional activity of 5′-regulatory sequence of EGR1 at different time points after co-culturing.An effective small interfering RNA (siRNA) targeting EGR1 was screened out and transfected into HeLa cells by Lipofectamine 2000.Then the transfected HeLa cells were co-cultured with the HTLV-1-positive cell line MT2 for 24 h.Immunoblotting assay was used to detect HTLV-1 core protein p19, EGR1 and autophagy-related protein LC3.Real-time PCR was performed to detect viral load.Autophagosome was analyzed by immunofluorescence after co-culturing.Results The expression of EGR1 and the transcriptional activity of pEGR1-luc gradually increased after co-culturing HeLa cells with MT2 cells for 8 h (P<0.01).The expression of EGR1 was positively correlated with host cell autophagy following HTLV-1 infection.The effective siRNA for silencing the expression of EGR1 was obtained and named as siE2.The viral load, the expression of HTLV-1 core protein p19 and the proportion of LC3B/LC3A in the co-culture model were markedly down-regulated by RNA interference with siE2, which was concomitant with a persistent decrease of intracellular autophagosome (P<0.01).Conclusion EGR1 is associated with host cell autophagy and viral replication in HTLV-1 infection.

Experimental study on ovarian cancer immunotherapy by EpCAM activated dendritic cells induce antigen-specific CD8+ cytotoxic T lymphocytes / 中国免疫学杂志

Objective:To observe the effect on ovarian cancer immunotherapy by dendritic cells (DC) which activated by Epithelial cell adhesion molecule (EpCAM) induce antigen-specific CD8+ cytotoxic T lymphocytes (CTL) and to provide some help to ovarian cancer immunotherapy.Methods: Interleukin (IL)-12,and IL-10 of DC were tested after inducing by EpCAM.Subsequently,EpCAM specific CTL CD8+ was induced by EpCAM-DC.The therapeutic effect and interferon (IFN)-γ of EpCAM-DC-CD8+ CTL on normal ovarian epithelial cells IOSE80 and ovarian cancer cell SKVO3 was detected.After treatment of EpCAM-DC-CD8+ CTL,the volume of ovarian tumor of bearing BALB/c-nu/nu mice was detected.Meanwhile,the morphology changes of tumor tissue were observed by HE staining.Results: Compared with PBS,EpCAM stimulation significantly inceased surface markers DC80,DC83,DC86 and HLA-DR levels,and added up to 4.79,4.85,4.60 and 10.91 times (P0.05).However,the killing rate of EpCAM-DC-CD8+ CTL on SKVO3 cells was 6.82-folds as much as that of DC-CD8+ CTL.Animal experiments showed that ovarian cancer transplantation tumor volume ratio after EpCAM-DC-CD8+ CTL treatment,was significantly lower than PBS group and DC-CD8+ CTL group,which reached 0.27 and 0.28 times,respectively (P<0.05).HE staining showed that EpCAM-DC-CD8+ CTL treatment resulted in significant changes of tumor tissues in pathology.Conclusion: EpCAM protein stimulated the maturation of DC that induced the production of EpCAM specific CD8+ CTL.EpCAM-DC-CD8+ CTL can effectively kill ovarian tumor cells and delay the growth of tumor,which is of great significance for the immunotherapy of ovarian cancer.

Gene expression profiles in response to ΔNp63α overexpression in human cervical cancer cell line SiHa / 安徽医科大学学报

Objective To analyze the gene expression profiles in response to ΔNp63α overexpression, and screen the potential target genes or signal pathways regulated by ΔNp63α. Methods To generate ΔNp63α overexpressed SiHa cells ( SiHa-ΔNp63α) and the control cells ( SiHa-NC) , recombinant lentivirus transfection was performed. Microarray was applied to detect the change of gene expression profiles, and the results were analyzed with bioinfor-matic software. Quantitative real-time PCR was used to validate the expression levels of selected genes. Results Among the 1405 differentially expressed genes which were statistically significant, >1. 5 fold increase or reduce of gene expression, 843 were up-regulated and 562 were down-regulated in SiHa cells with ΔNp63α overexpression. The genes were mostly involved in cell development,cycle regulation, signal transduction, communication, adhe-sion, metastasis and invasion, etc. The involved signal pathways consisted of antigen processing and presentation, cytokine-cytokine receptor interaction, cell adhesion, complement and coagulation cascades, and so on. Conclu-sion The research on the potential target genes or mediated signal pathways regulated by ΔNp63α could be helpful to explain the development of cervical cancer.

Comparison of the rate and inlfuence factors of intraoperative and postoperative complications of cervical cancer treated by laparoscopic radical hysterectomy / 中国内镜杂志

Objective Through comparative study of the rate and influence factors of intraoperative and postoperative complications of cervical cancer after laparoscopic radical hysterectomy which to guide the clinical practice of this kind of surgery in the future. Methods The clinical data of 314 patients undergoing laparoscopic radical hysterectomy from January 2013 to December 2015, the complication rate was observed, and the inlfuencing factors were analyzed by the method of multiple factor analysis. Result The number of intraoperative complications were 20 cases, accounting for 6.37%, the number of postoperative complications were 80 cases, accounting for 25.48%. Intraoperative complications influence factors including FIGO, surgery time, doctors surgery experience [OR

Investigation on invasion situation of cardinal ligament in stage ⅠA2- ⅡA2 cervical cancer and its risk factors analysis / 重庆医学

Objective To investigate the invasion situation of cardinal ligaments(CL) in stage Ⅰ A2 - ⅡA2 cervical cancer and to find the high risk clinicopathological factors affecting its invasion .Methods The retrospective analysis was performed on the clinicopathological data in 2 982 patients with cervical cancer treated by operation extracted in 5 hospitals from January 2004 to De‐cember 2014 .Results (1) Totally 855 cases according with the research condition were included .The CL invasion was found in 20 cases(2 .3% ) .No CL invasion occurred in the stage ⅠA2 ,the CL invasion rate in the stage ⅠB1 was 1 .7% ,in the stage ⅠB2 was 1 .2% ,in the stage ⅡA1 was 5 .7% and in the stage ⅡA2 was 2 .9% .With the increase of FIGO staging ,the CL invasion rate had no significant increase(P=0 .269) .(2) The infiltration rate of left CL and right CL had no statistical difference among the stageⅠA2- ⅡA2(P=1 .000) .And the invasion rate of the left CL with different FIGO stages had no statistical difference(P=0 .286) , while the right one had statistical difference(P=0 .005) ,in which the highest was in the stage ⅡA1 (4 .3% ) .(3)The univariate a‐nalysis found that lymph‐vascular invasion ,cervical stroma infiltration depth ,pelvic lymph node metastasis ,uterus body infiltration and vaginal fornix infiltration were the risk factors of CL invasion(P<0 .01);the further multivariate analysis determined that the invasion of uterine body(OR=11 .858) ,pelvic lymph node metastasis(OR=6 .359 ,) ,vaginal fornix infiltration(OR=6 .012 ,) were the risk factors for CL invasion(P<0 .05) .Conclusion The invasion rate of CL invasion in early stage cervcial cancer is low .The invasion of uterine body ,pelvic lymph node metastasis and vaginal fornix filtration are the risk factors for CL invasion in the stageⅠA2- ⅡA2 cervical cancer .

Design and biomechanical evaluation of atlantoaxial lateral mass fusion cage / 中华骨科杂志

Objective To design an atlantoaxial lateral mass fusion cage and evaluate its biomechanical stability when it is combined with atlantoaxial vertebral pedicle screw fixation.Methods Forty-six sets of CT 3D reconstruction pieces of the normal atlantoaxial junction were chosen to measure sagittal diameter and transverse diameter of atlantoaxial lateral mass joint,sagittal diameter and transverse diameter of epistropheus lateral mass and space height of atlantoaxial lateral mass joint.An atlantoaxial lateral mass fusion cage was designed on this basis.Six fresh human cadaveric cervical spines (C0-C4) were used as samples to measure 3D motion range of C1,and 2 segments under 1.5 N · m load.3D motion range of samples under the following situations was measured at random:intact state,unstable state (ligament around odontoid process was cut off),fixation with atlantoaxial joint screw+Gallie steel wire,atlantoaxial pedicle screw,atlantoaxial lateral mass joint fusion cage+atlantoaxial vertebral pedicle screw.Results Corresponding width/length of fusion cage is 8/11,9/12,10/13 mm,respectively,and the height is designed to 3.5,4.0,and 4.5 mm,respectively.The motion range of three internal fixation methods is less than that under intact state and unstable state.The difference has statistical significance.The C1+C2+cage fixation produces the least motion range in lateral bending and axial rotation directions and generates the highest motion range in flexion/extension direction.But,the difference has no statistical significance.Conclusion The C1+C2+cage internal fixation technique has similar stability with common atlantoaxial intemal fixation method and can provide extra atlantoaxial fusion spots.Thus,it may be a feasible alternative for atlantoaxial fusion when the posterior arch of the atlas is absent.

The expression and significance of HIF-1α,VEGF, VEGFR-1 and VEGFR-2 in missed abortion patients / 安徽医科大学学报

Objective To study the expressions and clinical significance of hypoxia inducible factor-1α( HIF-1α) ,vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-1 (VEGFR-1) and vascular endothelial growth factor receptor-2 (VEGFR-2) in the villi tissue of patients with missed abortion (MA) and early pregnant women. To explore the influence of hypoxia on placenta angiogenesis in missed abortion. Methods To de-tect the expression of HIF-1α,VEGF,VEGFR-1 and VEGFR-2 in the villi tissue of 35 cases of MA patients( re-search group) and 32 early pregnant women( control group) who underwent induced abortion surgery by immuno-histochemistry,and the results were statistical analysis. Results HIF-1α,VEGF,VEGFR-1 and VEGFR-2 were ex-pressed both in the villi tissue of research group and the control group. The expression of HIF-1α was higher in the research group than in the control group(P<0. 05). The expressions of VEGF,VEGFR-2 were significantly lower in the research group than in the control group ( P<0 . 05 ); the expression of HIF-1α was positively correlated with VEGF,VEGFR-1and VEGFR-2 in the control group, and the expression of HIF-1α was negatively correlated with VEGF and VEGFR-2 in the research group (P<0. 05),which had no correlation with VEGFR-1. Conclusion The expression of HIF-1α in the villi tissue of MA is up-regulated, the blood vessel formation of placenta decreases by adjusting the VEGF and VEGFR-2 genes transcription,which maybe is the important causes for MA.

Analysis of risk factors of children with cerebral palsy in Xinxiang area / 中华实用儿科临床杂志

Objective To explore the risk factors of children with cerebral palsy during pregnancy and neonatal period in Xinxiang area.Methods A retrospective analysis of the relevant research data of cerebral palsy children in Xinxiang area was performed.The research objects were children with cerebral palsy born from May 1,2005 to April 30,2010.At the same time,3 healthy children were selected as the control group to analyze the related risk factors causing cerebral palsy in children.Results The risk factors of children with cerebral palsy in Xinxiang city were as follows : maternal nutritional status, vaginal bleeding during pregnancy, pregnancy-induced hypertension syndrome, and abnormal production history were associated with cerebral palsy (x2 =2.313,13.296,5.034,7.434, all P ＜ 0.05)during the perinatal period;related factors during neonatal period were premature birth,severe asphyxia, severe jaundice, and intracranial infection(x2 =4.637,29.50,4.633,5.107, all P ＜ 0.05).Multivariate Logistic regression analysis showed the history of severe asphyxia (OR =2.340,95 ％ CI: 1.250-4.440), severe jaundice (OR =4.110, 95％ CI:2.430-6.740) ,premature birth(OR =2.570,95％ CI: 1.410-4.770) ,pregnancy-induced hypertension syndrome (OR =2.350,95 ％ CI:I.020-5.440), vaginal bleeding during pregnancy (OR =73.600,95 ％ C1:3.060-17.750) and abnormal production history(OR =5.710,95％ CI: 1.250-26.310) were independent risk factors causing children with cerebral palsy.Conclusions The history of severe asphyxia, severe jaundice, premature birth, pregnancy-induced hypertension syndrome, vaginal bleeding during pregnancy and congenital dysplasia are independent risk factors of children with cerebral palsy in Xinxiang area.It should be strengthened to screen and standardize the management of high-risk newborn infants with cerebral palsy, and do well management for perinatal high-risk pregnant women management.Early prevention can help to reduce the incidences of cerebral palsy in local area.

Biomechanic analysis of the stability and vertebra strain distribution of asymmetrical posterior internal fixation in minimally invasive transforaminal lumbar interbody fusion / 局解手术学杂志

Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.

Expression of LC3B in cervical squamous carcinoma and its relationship with Ki-67 expression / 临床与实验病理学杂志

Purpose To investigate the expression of autophagy-related protein LC3B in cervical squamous carcinoma and its relation-ship with Ki-67 expression. Methods To detect the expression of LC3B in 16 cases of normal cervical tissues and 126 cases of squa-mous cell carcinoma by immunohistochemical staining. In addition, Ki-67 protein was also detected in 126 cases of squamous cell car-cinoma in the same assay. The relationship between LC3B expression and Ki-67 in cervical squamous cell cancer was statistical analy-sis. Results Expression level of LC3B were significantly lower in cervical squamous carcinoma than normal squamous epithelial cells (P<0. 05), and the expression of LC3B was negatively correlated with Ki-67(rs = -0. 248, P<0. 05). Conclusion It appears that decreased levels of autophagy which indicated by low expression of LC3B may promote cancer cell proliferation in the early stages of cervical squamous cell carcinoma, which provides a clinical referential evidence for further explore the mechanism of autophagy in cer-vical cancer development.