Comparison of the safety and efficacy of unilateral biportal endoscopic lumbar interbody fusion and uniportal endoscopic lumbar interbody fusion: a 1-year follow-up.

OBJECTIVES: To compare the short-term outcomes of unilateral biportal endoscopic lumbar interbody fusion (BLIF) and uniportal endoscopic lumbar interbody fusion (ULIF). METHODS: Sixty patients diagnosed with L4/5 spinal stenosis who underwent BLIF and ULIF were included (30 in each group). Clinical evaluation was performed preoperatively and postoperatively in the 1st week, 1st month, and 1st year. Factors such as the visual analogue score (VAS), Oswestry Disability Index (ODI), operative time, surgical complications, and radiological outcomes (fusion rate, screw loosening, and cage subsidence) were compared between the two groups. RESULTS: All patients showed improved mean VAS and ODI at all three postoperative follow-ups, and no statistically significant differences were detected between the BLIF and ULIF groups. The mean operative time in the BLIF group was shorter than that in the ULIF group. Nerve root injury occurred in two patients in the BLIF group, while leakage of cerebrospinal fluid occurred in one patient in the ULIF group. All adverse events were treated adequately prior to discharge. The fusion rates with definite and probable grades were significantly higher in the BLIF group than that in the ULIF group. One case of cage subsidence with no screw loosening occurred in each group. CONCLUSION: Both BLIF and ULIF are safe and effective surgical techniques. Compared with ULIF, BLIF has the advantages of shorter operative time and a higher fusion rate. Other merits of BLIF include a wider surgical field, greater maneuverability of instruments, visibility during cage implantation, and transverse orientation of the cage.

Secular trends of incidence and hospitalization cost of hip fracture in Tangshan, China.

We investigated the secular trends of the incidence and hospitalization cost of hip fracture in Tangshan, China. The incidence of hip fracture and the hospitalization cost were both increasing during the observation period. INTRODUCTION: The present study aimed to determine sex-, age-, and fracture type-specific incidence and annual changes in hip fractures in Tangshan, China, between 2007 and 2018. METHODS: We analyzed annual hip fracture incidence using urban hospital data during 2007-2018 and calculated incidence rate/100,000 person years in each age group and sex. We assessed annual changes in incidence among people aged >60 years using linear-by-linear association tests and evaluated hospitalization costs with the Kruskal-Wallis test. RESULTS: During the study period, we observed an increasing proportion of hip fractures in people >60 years old from 14.2 to 22.79%. Crude hip fracture incidence increased markedly from 140.87 to 306.56/100,000 in women (p < 0.01) and from 124.83 to 167.19/100,000 in men (p < 0.01) in the age group >60 years. Type-specific analysis indicated significantly increased trends in incidence of cervical and trochanteric fractures among women and cervical fracture among men (p < 0.01). In people aged 36-60 years, the trend of hip fracture increased significantly in both sexes. The total and cervical-to-trochanteric ratio in men increased, with significant upward trends (p < 0.01). The proportion of cervical fracture was higher than that for trochanteric fracture in women, with stable levels from 2007 to 2018. Hospitalization costs for cervical and trochanteric fractures increased by 51.91% and 53.20%, respectively, during 2011-2018. CONCLUSION: Tangshan will have an increasing burden on health care resources attributable to a considerable rise in hip fracture incidence and the older population. Further investigation of risk factors and subsequent implementation of effective measures to prevent hip fracture are needed.

[Comparison of serum GP73 and p62 measurement to predict short-term prognosis in patients with HBV-related acute-on-chronic liver failure].

Objective: To analyze the clinical value and predictive difference of serum Golgi protein 73 (GP73) and serum autophagy-related protein p62 levels in the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (ACLF). Methods: Clinical data of admitted cases to our hospital from October 2018 to April 2020 were retrospectively analyzed. Simultaneously, there were 32 cases with HBV-related ACLF in group A, 65 cases with hepatitis B virus-related cirrhosis in group B and C (Child-Pugh Class A, 34 cases as B group, and Child-Pugh B/C class, 31 cases as group C), and another 30 healthy subjects served as the control group (group D). The serum GP73 and p62 levels of the four selected groups were measured. ACLF group patients were followed up for 3 months to analyze the prognosis of the patients. The serum GP73 and p62 levels of patients who died and survived during hospitalization were compared. The data were analyzed by one-way analysis of variance, independent sample t-test, and Pearson's correlation analysis. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of GP73 and p62 levels in surviving patients. Results: GP73 levels in the four groups A, B, C and D were (284.30 ± 70.55) ng/ml, (125.33 ± 20.57) ng/ml, (159.82 ± 31.20) ng/ml, and (45.46 ± 10.22) ng/ml, respectively. The p62 levels were (1.30 ± 0.35) ng/ml, (2.88 ± 0.58) ng/ml, (2.02 ± 0.545) ng/ml, and (4.68 ± 1.03) ng/ml, respectively. GP73 detection value was significantly higher in group A than the other three groups (P < 0.05). Group D had significantly lower value than the other three groups (P < 0.05), and group C had significantly higher value than group B (P < 0.05). The detection value of p62 in group A was significantly lower than the other three groups (P < 0.05). Group D had significantly higher value than the other three groups (P < 0.05), and group B had slightly higher value than group C, and the differences were statistically significant (P < 0.05). There was a negative correlation between GP73 and p62 (r = -0.695, P < 0.001). Survived patients GP73 level in the ACLF group was significantly lower than dead patients [(212.17 ± 22.47) ng/ml and (340.08 ± 32.91) ng/ml, t = 12.493, P < 0.05], and p62 level was significantly higher than dead patients [(1.46 ± 0.28) ng/ml and (1.18 ± 0.35) ng/ml, t = 2.445, P < 0.05]. According to the ROC curve analysis results, the area under the curve (AUC) of GP73 was 0.865, the AUC of p62 was 0.750, and the combined AUC of the both was 0.968. Conclusion: Both GP73 and p62 have a certain predictive value for the short-term prognosis of HBV-related ACLF patients, but the combination of the two indicators has a higher predictive value.

[Clinical characteristics of patients with indication of cardiac implantable electronic devices implantation complicating with acute pulmonary thromboembolism].

Objective: To investigate the clinical characteristics of inpatients with the indication of cardiac implantable electronic devices (CIED) therapy and combined acute pulmonary thromboembolism (APTE). Methods: We retrospectively screened 8 641 inpatients who admitted with the indication of CIED implantation in Fuwai Hospital from January 2014 to May 2019. The clinical characteristics, management strategies and clinical outcome were analyzed for patients diagnosed as APTE. Results: APTE were identified in 45 (5‰) patients in this cohort, there were 18(40%) male patients, the average age was (73±8) years old and body mass index was (27±10) kg/m2.Thirty-two (70%) patients were at intermediate-risk and 13 (30%) at low-risk. Anti-coagulation therapy was initiated in 38(84%) patients, and 30 patients underwent CIED implantation (27 pacemaker, 2 CRT and 1 ICD). No postoperative bleeding or pocket hematoma were detected in the 23 patients taking anticoagulation medication before implantation. During an average of (30±7) months' follow up, thrombus was dissolved in 20 patients, hemorrhage complications were observed in 2 patients (1 cerebral hemorrhage and 1 hematuria), anticoagulation therapy was discontinued in these 2 patients. Among 15 patients without immediate CIED implantation and treated with anticoagulation therapy during hospitalization, 2 patients developed complete paroxysmal Ⅲ° atrioventricular block, and recovered after therapy during hospitalization. Seven patients were re-hospitalized for CIED implantation due to bradycardia. Five patients died during follow-up (3 sudden cardiac death, 1 APTE combined with cerebral infarction, and 1 pulmonary infection). Conclusion: APTE is not rare in patients with the indication of CIED implantation, CIED implantation and anti-coagulation therapy are safe for these patients, and transient atrioventricular block could be detected in APTE patients.

[Role of overexpression of myeloid cell leukemia-1-long in prognosis of malignant pleomorphic adenoma].

Objective: To evaluate the clinicopathological significance of the expression of the two myeloid cell leukemia-1 isoforms, myeloid cell leukemia-1-long (Mcl-1L) and myeloid cell leukemia-1-short (Mcl-1S) in malignant pleomorphic adenoma (MPA). Methods: A total of 56 patients with MPA treated with surgery, the expression of Mcl-1L and Mcl-1S were detected by quantitative real-time PCR (qPCR) in mRNA level, and by Western blotting in protein level, respectively. The correlation between clinicopathological parameters (gender, age, site, habits, size, node, metastasis, recurrence) was done using the chi-square test. Kaplan-Merier curve was used to analyze the survival in all patients, Log Rank test was performed to observe the difference between groups. Cox's proportional hazard test was used to identify the factors that were independent predictors of survival. Results: qPCR showed overexpression of Mcl-1L in 66.1%MPA patients (37/56), with significant difference in terms of tumor site, significantly higher expression of Mcl-1L in MPA (parotid gland: 2.21±1.07, sublingual gland: 2.12±1.08, other sites: 1.83±0.81) than benign pleomorphic adenoma tissue (1.00±0.19) (P<0.01). Western blotting analysis showed significantly higher expression of Mcl-1L in MPA (parotid gland: 1.02±0.43, sublingual gland: 0.71±0.29, other sites: 0.70±0.30) than benign pleomorphic adenoma tissue (0.39±0.08) (P<0.01). In malignant pleomorphic adenoma patients, high Mcl-1L expression was significantly associated with node positivity (P=0.045), advanced tumor size (P=0.002). Kaplan-Meier survival line analysis indicated a significantly lower survival time in Mcl-1L higher-expression patients (24.79±9.71) than lower-expression patients (30.59±9.01) (P=0.017). Multivariate analysis indicated Mcl-1L to be an independent prognostic factor for MPA (P=0.002). Conclusions: The studies suggest that overexpression of Mcl-1L is associated with poor prognosis in MPA. Mcl-1L is an independent prognostic factor in malignant pleomorphic adenoma.

LncRNA SNHG12 accelerates the progression of ovarian cancer via absorbing miRNA-129 to upregulate SOX4.

OBJECTIVE: To clarify whether long non-coding RNA (lncRNA) SNHG12 could regulate the proliferative and migratory abilities of ovarian cancer (OC) cells through mediating microRNA-129 (miRNA-129), thus influencing the progression of OC. PATIENTS AND METHODS: The expression patterns of SNHG12 and miRNA-129 in OC tissues and adjacent normal tissues were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Meanwhile, their expression levels in OC cell lines were also examined. Regulatory effects of SNHG12 and miRNA-129 on the proliferative and migratory abilities of OC cells were evaluated by cell counting kit-8 (CCK-8) and transwell assay, respectively. Through the dual-luciferase reporter gene assay, we explored the binding between miRNA-129 with SNHG12 and SOX4. A series of rescue experiments were conducted to clarify the role of SNHG12/miRNA-129/SOX4 regulatory loop in the progression of OC. RESULTS: SNHG12 was upregulated in OC tissues relative to adjacent normal ones. Patients with metastatic OC or those in stage III-IV had a higher level of SNHG12 compared with non-metastatic or stage I-II patients. The 5-year survival was markedly worse in OC patients with high-level SNHG12 than those in the low-level group. Similarly, SNHG12 was highly expressed in OC cell lines. Overexpression of SNHG12 accelerated A2780 and HO8910 cells to proliferate and migrate. We observed the binding between SNHG12 and miRNA-129, and the latter was lowly expressed in OC. The miRNA-129 overexpression partially reversed the promotive effects of SNHG12 on proliferative and migratory abilities of OC cells. Subsequently, SOX4 was proved to be the target gene of miRNA-129. The SOX4 overexpression was further confirmed to reverse the inhibitory effects of miRNA-129 on proliferative and migratory abilities of OC cells. CONCLUSIONS: SNHG12 accelerates the proliferative and migratory abilities of OC cells via sponging miRNA-129 to upregulate SOX4.

MiR-539-3p promotes the progression of epithelial ovarian cancer by targeting SPARCL1.

OBJECTIVE: The aim of this study was to investigate the effect of microRNA-539-3p (miR-539-3p) on the development of epithelial ovarian cancer (EOC), and to explore the possible underlying mechanism. PATIENTS AND METHODS: A total of 40 paired EOC tissues and adjacent normal ovarian tissues were surgically resected in Hanchuan People's Hospital. Quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR) was used to detect the expression of miR-539-3p in EOC tissues and cell lines. Targeted regulatory mechanism of miR-539-3p on SPARC-like protein 1 (SPARCL1) was identified by luciferase reporter and Western blot assays. Furthermore, the effects of miR-539-3p/SPARCL1 axis on the malignant behaviors of EOC cells, including proliferation, invasion and migration abilities, were confirmed by cell counting kit-8 (CCK-8), transwell and scratch wound assays. RESULTS: QRT-PCR showed that the expression of miR-539-3p was significantly up-regulated in EOC tissues and cell lines. SPARCL1 was a direct target of miR-539-3p in EOC cells. Overexpression of miR-539-3p significantly promoted the proliferation, migration and invasion of SKOV3 cells. Furthermore, co-transfection of miR-539-3p inhibitor and si-SPARCL1 could remarkably restore the migration and invasion abilities of SKOV3 cells. CONCLUSIONS: MiR-539-3p acted as an oncogene in EOC by targeting SPARCL1. MiR-539-3p/SPARCL1 axis, as a target for the treatment of EOC, might become a feasible and new method of tumor treatment.

CCL3 participates in the development of rheumatoid arthritis by activating AKT.

OBJECTIVE: To investigate whether CC chemokine 3 (CCL3) could exert a certain effect on rheumatoid arthritis (RA) by regulating inflammatory responses and provide a new direction for the treatment of RA. PATIENTS AND METHODS: Totally 47 RA patients (10 males and 37 females) with complete clinical data were included. Meanwhile, 27 healthy volunteers with same age and gender were recruited as healthy controls. The mRNA and protein level of CCL3 in the peripheral blood mononuclear cells (PBMCs) of RA patients and normal controls were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot, respectively. The inflammatory infiltration of synovial tissue was observed by hematoxylin and eosin (HE) staining. Immune fluorescence was used to further analyze the level of CCL3 in T and B cells of synovial tissue in RA patients. Simultaneously, real-time flow cytometry was applied to detect the level of CCL3 in T and B cells of PBMCs in the normal control group and the RA group. Western blot was used to detect the level of pAKT in RA-FLS treated with different concentrations of recombinant human CCL3. Besides, enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α) and receptor activator of nuclear factor kappa-B ligand (RANKL) in the culture supernatant of RA-FLS stimulated by different doses of recombinant human CCL3. RESULTS: The level of CCL3 in peripheral blood and synovial fluid of RA patients was markedly higher than that of normal controls. Inflammatory cells were infiltrated in synovial tissue of RA patients. Meanwhile, CCL3 was mainly expressed in CD4+ T cells. CCL3 treatment in rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS) could activate the PI3K/AKT signaling pathway to different degrees and increase the expression of cytokines including interleukin-6 (IL-6), IL-1ß, TNF-α, and RANKL. These results indicated that CCL3 might participate in the progression of RA by activating AKT. CONCLUSIONS: We showed that CCL3 enhanced the expression level of pro-inflammatory cytokines such as IL-6, IL-1ß, TNF-α, and RANKL by activating the PI3K/AKT signaling pathway. Besides, CCL3 could up-regulate CD4+T cells to mediate the inflammatory response of RA. These findings might provide new directions for the prevention of RA.

[Analysis on the factors related to the immediate success rate of radiofrequency catheter ablation on patients with idiopathic right ventricular outflow tract ventricular arrhythmia].

Objective: To analyze the clinical characteristics of patients with idiopathic right ventricular outflow tract (RVOT) ventricular arrhythmias (VA) and factors related to the immediate success rate of radiofrequency ablation. Methods: Patients diagnosed as idiopathic RVOT arrhythmia in Fuwai Hospital from February 2009 to January 2013 were retrospectively screened. Patients with structural heart disease or inherited arrhythmia were excluded. All patients underwent endocardial electrophysiological study and radiofrequency catheter ablation. Baseline clinical and operation records were collected and analyzed. Immediate success rate was defined as no inducible ventricular arrhythmia by isoprinosine and electrophysiological induction at the end of ablation. The origins of idiopathic RVOT were classified as septal, anterior, posterior, free wall site, epicardial and RVOT-aorta root site. Results: A total of 468 patients were finally included, and the age was (40.4±13.3) years old and 60.5%(283/468) patients were female. Immediate radiofrequency success rate was 89.3%(418/468). Patients were divided into ablation success group (n=418) and ablation failure group (n=50). Percent of female patients and patients with interventricular septal origin was significantly higher in the ablation success group than in ablation failure group (261(62.4%) vs. 22 (44.0%) , P=0.01, and 233(55.7%) vs. 18(36.0%), P=0.005), while percent of patients with epicardial origin was significantly lower in the ablation success group than in ablation failure group (17(4.1%) vs. 11(22.0%), P<0.001). Immediate success rate was the highest for patients with the septal origin and the lowest for patients with epicardial origin (92.8%(233/251) vs. 60.7%(17/28), P<0.05). Multivariate analysis showed that the origin site of VAs was the most important independent factor related to the success rate of ablation. Compared with the septal origin patients, patients with RVOT-aorta root and epicardial origin VAs faced with 1.82-fold and 8.26-fold increased risk of failed ablation, respectively (OR=2.82, 95%CI 1.05-7.57, and OR=9.26, 95%CI 3.60-23.86). Sex category was not the independent risk factor for failed ablation(OR=1.76, 95%CI 0.93-3.33, P=0.08) . Conclusions: The immediate success rate of radiofrequency catheter ablation for idiopathic RVOT ventricular arrhythmia is relative high, however, immediate success rate of radiofrequency catheter ablation is relatively low for patients with epicardial and RVOT-aorta root origin arrhythmia and VAs origin is an independent risk factor of immediate ablation success rate.

Effects of dl-3-n-butylphthalide on serum VEGF and bFGF levels in acute cerebral infarction.

OBJECTIVE: To observe the curative effect of dl-3-n-Butylphthalide (NBP) on patients with acute cerebral infarction (ACI) and its effects on levels of serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). PATIENTS AND METHODS: A total of 160 ACI patients treated in our hospital who met the criteria were selected and randomly divided into treatment group (n=80, including 42 males and 38 females) and control group (n=80, including 40 males and 40 females). The control group was treated with routine drug therapy, while the treatment group was treated with butylphthalide on this basis. The curative effect was evaluated using the National Institute of Health Stroke Scale (NIHSS) and the Activity of Daily Life Scale (ADL Scale). The levels of the two factors in serum were measured using enzyme-linked immunosorbent assay (ELISA), and the changes in the levels of the two factors in serum at different time points before and after treatment were compared between the two groups. RESULTS: After treatment, the levels of the two factors in serum in both groups were significantly increased compared with those before treatment (p<0.05), and the increase in treatment group was more significant than that in control group (p<0.05). The scores of ADL scale in both groups were significantly increased after treatment compared with those before treatment, and the increase in treatment group was more significant than that in control group (p<0.05). The scores of NIHSS in both groups were significantly decreased compared with those before treatment, and the decrease in treatment group was more significant than that in control group (p<0.05). CONCLUSIONS: NBP can improve the expressions of VEGF and bFGF in serum of ACI patients, and its effect is superior to that of conventional drugs.

Expression of T-lymphoma invasion and metastasis factor on the occurrence of oral squamous cell carcinoma.

In recent years, many studies have found that tumor metastasis-related gene T-lymphoma invasion and metastasis-inducing factor 1 (TIAM1) had abnormal high expression in a variety of tumor cells; however, there are few studies regarding its expression in oral squamous cell carcinoma (OSCC). This study aimed to observe the expression of TIAM1 in OSCC and investigated its clinical significance. The expression of TIAM1 in tissues from 120 cases of OSCC and oral mucosa from 40 normal cases was detected by immunohistochemistry, and the relationship between the expression of TIAM1 and the clinicopathological parameters of OSCC was analyzed. The positive expression rate of TIAM1 in the OSCC tissues was significantly higher than that in the normal oral mucosa (92.5% vs 0%). With the decrease of histological differentiation of OSCC, the increase of tumor node metastasis (TNM) stage and the occurrence of lymph node metastasis, the TIAM1 staining positive rate was gradually increased, and the difference was statistically significant (P less than 0.05). However, the expression of TIAM1 in the OSCC tissues was in no correlation with the gender and age of the patients. The expression of TIAM1 is closely related to the occurrence, development and metastasis of OSCC, and it can be used as a new marker for reflecting its biological behaviors.

[Extracapsular dissection versus superficial parotidectomy for treatment of parotid benign tumors: evidence based medicine analysis].

Objective:The aim of this study is to systematically assess the clinical outcomes of extracapsular dissection (ECD) and superficial parotidectomy (SP), and to provide evidences for the clinical decision for treatment of parotid gland benign tumors. Method:Relevant studies that compared the outcomes of extracapsular dissection and superficial parotidectomy for the parotid benign tumors were searched in Pubmed, CNKI and Wangfang data databases, and Meta-analysis was performed using software RevMan 5.0. Result:Fifteen studies were selected for the Meta-analysis. A total of 2 929 participants were included in those studies, of which 1 796 underwent ECD and 1 133 underwent SP. The recurrence rates for ECD and SP were 1.29% (23 of 1 776 cases) and 1.48% (16 of 1 081 cases), respectively. There were no statistically significant in recurrence rate between ECD and SP. The rates of transient facial nerve paresis for ECD and SP were 5.48% (74 of 1 350) and 22.94% (139 of 606), that of permanent facial nerve paralysis were 0.66% (8 of 1 221) and 2.71% (15 of 554). The incidences of Frey's syndrome in ECD group and SP group were 1.91% (26 of 1 360) and 16.71% (111 of 664), that of fistula in were 0.53% (5 of 946) and 2.96% (10 of 338). ECD could reduce the risk for complications compared with SP. Conclusion:This systematic review with Meta-analysis suggests that ECD has a similar recurrence rate as SP with fewer postoperative complications. ECD may be considered as an alternative surgical modality for select benign parotid tumor.

[Analysis of 2 204 stillbirths in 11 hospitals of Guangdong province].

Objective: To analyze the incidence and causes of stillbirth in 11 hospitals of Guangdong province, and to explore the appropriate interventions. Methods: Clinical data of stillbirth in 11 hospitals of Guangdong province were collected from January 2014 to December 2016. The gestational weeks, causes, maternal conditions and other factors were analyzed. Results: (1) From 2014 to 2016, 103 472 newborns were delivered in the 11 hospitals, and the number of stillbirth was 2 204, with the incidence of 2.13%. Among them, 0.71%(738/103 472) was therapeutic induction, 1.42%(1 066/103 472) was natural stillbirth. At different gestational age (<28 weeks, 28-<37 weeks and ≥37 weeks), the incidence of stillbirth was 55.63% (1 226/2 204), 28.45% (627/2 204) and 15.92% (351/2 204), respectively, with statistically significant difference (P<0.01). (2) For stillbirth<28 weeks, the first reason was therapeutic induction, accounting for 53.34% (654/1 226). For stillbirth during 28-37 weeks, pre-eclampsia was the major cause, accounting for 40.67% (255/627). And for full-term stillbirth, the causes were umbilical cord factors (19.37%, 68/351), abnormal labor (17.09%, 60/351). (3) In all the stillbirth cases, the incidence of fetal growth restriction (FGR) <28 weeks was significantly higher than that during 28-37 weeks [23.49% (288/1 226) vs 18.02% (113/627) , P<0.01]. (4) The stillbirth rate during labor was significantly higher in women ≥35 years old than in younger women [63.88% (191/299) vs 36.12% (108/299) ; χ(2)=9.346, P=0.000]. For the causes of stillbirth during labor, the incidence of severe maternal obstetrical complications [61.11% (33/54) vs 38.89% (21/54) ; χ(2)=3.323, P=0.002], abnormal labor [65.82% (52/79) vs 34.18% (27/79) ; χ(2)=4.067, P=0.001] and abnormal fetal position [66.63% (26/39) vs 33.37% (13/39) ; χ(2)=3.002, P=0.013] were higher in women ≥35 years old than in younger women. (5) Cesarean section during labor accounted for 33.77% (101/299) of stillbirth, including 76 cases of emergency cesarean section or converted to cesarean section during labor. Conclusions: (1) The incidence of stillbirth in the 11 hospitals is high, and the causes are different at different gestational ages, therefore, different interventions are needed to reduce the incidence in different gestational weeks. Supervision of therapeutic induction should be strengthened <28 gestational weeks; standard management of pregnancy might decrease the occurrence of natural death ≥28 weeks. (2) Attention should be paid to fetal body weight during pregnancy, especially FGR. (3) The stillbirth rate is high in elderly pregnant women, so it is important to strengthen the management of the elderly pregnant women.

[Serum CXCL-10 level in chronic hepatitis C patients with cryoglobulinemia and its influence on antiviral therapy].

Objective: To investigate the serum CXCL-10 level in chronic hepatitis C (CHC) patients with cryoglobulinemia and its influence on the effect of antiviral therapy. Methods: A total of 50 CHC patients were enrolled in the study. Cryoprecipitation was used to determine the nature of cryoglobulins in serum before treatment, and ELISA was used to measure the serum CXCL-10 level. The hepatitis C virus (HCV) genotype was detected, and serum HCV RNA level was measured at baseline, 4, 12, and 24 weeks of treatment, the end of treatment, and 24 weeks after treatment.. Results: Compared with the cryoglobulin-negative patients, the cryoglobulin-positive patients had significantly higher baseline levels of HCV RNA [(6.28±0.79) log10 copies/ml vs (5.48±1.20) log10 copies/ml, P = 0.009] and CXCL-10 (541.67±224.07 pg/ml vs 394.39±179.71 pg/ml, P = 0.015). After the treatment with pegylated interferon-α-2a and ribavirin, the cryoglobulin-positive patients had a significantly lower proportion of individuals who achieved rapid virological response compared with the cryoglobulin-negative patients (33.3% vs 82.6%, P < 0.001). The cryoglobulin-positive patients had a significantly lower rate of sustained virologic response than the cryoglobulin-negative patients (33.3% vs 78.3%, P = 0.001). Conclusion: The patients with cryoglobulinemia have higher serum levels of HCV RNA and CXCL-10 and poor outcomes compared with those without cryoglobulinemia.

[Clinical characteristics and outcomes of patients with acute aortic dissection: impact of hypertension].

OBJECTIVE: To observe the clinical characteristics and outcomes of patients with acute aortic dissection (AAD) and explore the impact of hypertension. METHODS: The present study enrolled 1 087 consecutive patients with AAD who were confirmed by computed tomographic scanning in Fuwai Hospital from January 2008 to December 2010. The major endpoints were in-hospital death and long-term mortality during follow up. RESULTS: A total of 595 (54.7%) patients were Stanford type A and 492 (45.3%) patients were Stanford type B. The median length of follow-up was 24.2 months (interquartile range 10.9, 40.8 months). The prevalence of hypertension was 67.4%(733 cases), and was significantly higher in type B patients than in type A patients (71.3%(351/492) vs. 64.2%(382/595), P=0.01). Regardless of Stanford classification, patients complicating with hypertension were older, had higher comorbidities (coronary heart diseases or diabetes), and less likely to receive surgical treatment compared with those without hypertension (all P<0.05). In Stanford type A AAD group, patients with hypertension had higher levels of admission blood pressure, serum creatinine and inflammatory markers (including WBC count, D-dimer and CRP) than those without hypertension (all P<0.05). In-hospital death (9.9% (38/382)vs. 5.6%(12/213), P=0.07) and long-term mortality (9.0% (31/344) vs. 8.9% (18/201), P=0.98) were similar in hypertensive and normotensive AAD type A patients. In type B AAD group, the in-hospital death rate was significantly higher in patients with hypertension than those without hypertension (5.4%(19/351) vs. 0.7%(1/141), P=0.02), while the long-term mortality was similar (6.9%(23/332) vs. 7.9%(11/140), P=0.71) between patients with and without hypertension. Multiple logistic regression analysis showed that hypertension did not predict the increased risk of in-hospital death of type A or type B AAD patients. The main protective factor of in-hospital mortality was operation in patients with type A AAD. The independent predictors of in-hospital death were age and surgical treatment in patients with type B AAD. CONCLUSIONS: Hypertension is a common co-morbidity in patients with AAD. AAD patients with hypertension are usually elder, have higher comorbidities of cardiovascular diseases, and less likely to receive surgical treatment compared with those without hypertension, but hypertension is not associated with increased risk of in-hospital and long-term mortality in both AAD type A and type B patients.

Effect of siRNA targeting HER2/neu on the proliferation and viability of prostate cancer PC-3M cells.

The aim of this study was to investigate the effect of a small interfering RNA (siRNA) targeting human epidermal growth factor receptor 2 (HER2/neu) on the proliferation and viability of prostate cancer PC-3M cells. Chemically synthesized siRNA targeting HER2/neu was transfected into PC-3M cells by using liposomes, and cells transfected with empty liposomes, a negative siRNA sequence, or nothing (untransfected) were used as controls. mRNA and protein levels of HER2/neu were detected using reverse transcription-polymerase chain reaction and western blot, respectively. The inhibitory action of HER2/neu siRNA on the in vitro growth of PC-3M cells was assessed by the cholecystokinin 8 assay and apoptosis was detected using flow cytometry. Cells transfected with HER2/neu siRNA showed decreased mRNA and protein levels of HER2/neu compared to control groups (P < 0.05). The survival rate of PC-3M cells decreased significantly after transfection with HER2/neu siRNA compared to that of untransfected cells (55.39 ± 1.60 and 81.42 ± 0.80%, respectively; P < 0.05). The apoptosis rate in cells transfected with HER2/neu siRNA was quite high (45.60 ± 0.70%) compared to that of blank control, empty liposome, and negative siRNA sequence groups (P < 0.05). In conclusion, siRNA targeting HER2/neu inhibits HER2/neu expression in PC-3M cells, resulting in an inhibition in proliferation and an induction of apoptosis.

1,25(OH)2D3 prolongs islet graft survival by inflammatory inhibition.

OBJECTIVE: This study aimed to determine the protective effect of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) against islet graft loss. METHODS: Proliferation of tumor necrosis factor (TNF)-α-induced macrophages was determined in vitro after treatment with different concentrations of 1,25-(OH)2D3. Intraportal islet transplantation (IPIT) was performed with islets harvested from the Sprague-Dawley rats and transplanted to the diabetic rats. The transplanted rats were assigned to receive 1,25-(OH)2D3 or propylene glycol (control). Islet graft survival; inflammatory cytokine (TNF-α and interleukin [IL]-1); numbers and percentages of macrophages, CD4(+), and CD8(+) T cells in bloods; and expression of nuclear factor (NF)-κB and TNF-α were analyzed. Hematoxylin and eosin staining was performed. RESULTS: We found 100 mg/mL 1,25-(OH)2D3 per day to have the strongest inhibitory effect on macrophages. Survival time of islet grafts significantly increased in the rats receiving 1,25-(OH)2D3. There were fewer infiltrated inflammatory cells in both islet graft and adjacent tissue in the drug-treated rats with lower serum IL-1 and TNF-α. Furthermore, percentage of macrophages and expression of p-NF-κB p65 and TNF-α in graft sites were significantly lower in the treated rats. CONCLUSION: Our results demonstrated that 1,25(OH)2D3 prolongs islet graft survival by decreasing nonspecific inflammation in syngeneic IPIT through inhibiting TNF-α/NF-κB pathway and macrophage infiltration.

Resolvin D1 improves survival in experimental sepsis through reducing bacterial load and preventing excessive activation of inflammatory response.

Sepsis is characterized as an uncontrolled inflammatory response. Spite et al. (Nature 461(7268):1287-1291, 2009) had demonstrated that resolvin D2, which is derived from docosahexaenoic acid (DHA), improves survival in cecal ligation and puncture (CLP)-initiated sepsis and enhances bacterial clearance without immune suppression. Resolvin D1, which is also derived from DHA and homologous with resolvin D2, is an endogenous anti-inflammatory and proresolving lipid molecule. We sought to investigate the effects of resolvin D1 on sepsis and to explore the mechanism of action. Six-to-eight-week-old male C57BL/6 mice were randomly divided into three groups: the sham group underwent the sham operation followed by tail vein injection of vehicle (0.1 % ethanol); the CLP group received vehicle (0.1 % ethanol) after CLP; the resolvin D1 group received resolvin D1 (100 ng) after CLP. Blood, peritoneal lavage fluid, and organs of mice were harvested 24 h after treatment for cytokine analysis, cell counts, bacterial cultures, histopathological studies, and apoptosis quantification. Compared with the vehicle control group, the survival rate and bacterial clearance of mice with sepsis induced by CLP were improved after resolvin D1 treatment, but the numbers of neutrophils in peritoneal lavage fluid, the inflammatory cytokines, the phosphorylation of the nuclear factor-κB (NF-κB) (P65) pathway, and the apoptosis rate of CD3(+) T lymphocytes of the thymus were suppressed. Resolvin D1 treatment improved survival in mice with sepsis induced by CLP, enhanced organism bacterial clearance, suppressed the increase of the numbers of neutrophils in peritoneal lavage fluid, reduced the release of inflammatory cytokines, and decreased the apoptosis rate of CD3(+) T lymphocytes of the thymus. These results suggest that resolvin D1 may attenuate the degree of inflammatory reaction in sepsis caused by CLP, without harming the host defense response.

Association of suppressor of cytokine signalling 3 polymorphisms with insulin resistance in patients with chronic hepatitis C.

Suppressor of cytokine signalling 3 is thought to be associated with insulin resistance in patients with chronic hepatitis C. We evaluated the role of suppressor of cytokine signalling 3 polymorphisms in determining insulin resistance in patients with chronic hepatitis C. Two hundred and ninety untreated hepatitis C virus-infected patients without diabetes and cirrhosis were genotyped for the SNPs rs4969168, rs4969170 and rs12952093 of suppressor of cytokine signalling 3 using the TaqMan Genotyping Assay. We found that the rs4969170 AA genotype and rs4969170 A allele frequency were significantly more common in the insulin-resistant group than the non-insulin-resistant group (89.5% vs 76.1%, OR = 2.693, 95% CI: 1.221-5.939, P = 0.012 and 94.8% vs 88.0%, OR = 2.463, 95% CI: 1.151-5.271, P = 0.017, respectively). Haplotype G-C was likely associated with non-insulin resistance (adjusted P = 0.011). Multiple logistic regression analysis indicates that the independent risk factors for insulin resistance are the SNP rs4969170 AA genotype (OR = 3.005, 95% CI: 1.194-7.560, P = 0.019), HCV genotype 1 (OR = 2.524, 95% CI: 1.099-5.794, P = 0.029) and BMI (OR = 0.514, 95% CI: 0.265-0.999, P = 0.05).