Relationship of cervical length, morphology and maternal adverse outcomes in placenta praevia patients on the third trimester of pregnancy / 中国医学影像技术

Objective: To explore the relationship of cervical length (CL), morphology and maternal adverse outcomes in placenta praevia patients on the third trimester of pregnancy. Methods: Ultrasonic and clinical data of 84 singleton pregnancies confirmed as placenta praevia with cesarean section were retrospectively analyzed, including 20 cases with placenta accreta and 27 with massive hemorrhage. Taken 30 mm as the cut-off value of CL, the patients were divided into study group (CL≤30 mm, n=21) and control group (CL>30 mm, n=63).Then the relationship of CL, placenta praevia and massive hemorrhage during cesarean section were investigated. Results: CL was (26.9±2.9)mm in study group, lower than that in control group ([38.5±3.4]mm, P<0.001). The probability of placenta accreta and massive hemorrhage increased in patients with CL≤30 mm, cervical morphological incompleteness and cervical sinus (P<0.1), and CL≤30 mm was a risk factor for placental accreta. Taken CL=35.05 mm as the cut-off value, the best prediction of placental accrete and massive hemorrhage were obtained, with the sensitivity, specificity and AUC of the former was 81.3%, 90.0% and 0.890 (95%CI[0.813,0.967]), of the latter was 82.5%,74.1% and 0.814 (95%CI[0.717,0.912]), respectively. Conclusion: Cervical shortening (CL≤35.05 mm), cervical morphological incompleteness and cervical sinus on the third trimester are related to placenta accreta and massive hemorrhage during cesarean section, which might be used to evaluate placenta praevia and guiding adjustment of treatment plan.

Prospective study of anterior uterocervical angle for prediction of preterm birth in second trimester with transperineal ultrasound / 中华超声影像学杂志

Objective To explore the possibility and value of the anterior uterocervical angle ( ACA) and cervical length for prediction of preterm birth in second trimester with the transperineal ultrasound . Methods This study retrospectively reviewed the relevant medical records of single birth primiparas undergoing prenatal ultrasonographic evaluation in Wuxi People′s Hospital Affiliated to Nanjing Medical University from January 2016 to December 2016 . The pregnant women were divided into preterm group and term group according to the pregnancy outcomes ( with or without preterm birth) . The ACA and cervical length of these pregnancies were measured in the second trimester ( between 22 -24 weeks gestation) with the transperineal ultrasound . Results A total of 1064 pregnant women were enrolled in the study ,with 84 cases in preterm group ( 78 .9％ ,84/1064) and 980 cases in term group ( 92 .11％ ,980/1064) . Age of women in the two groups had no statistics difference( P =0 .86) . The mean ACA and cervical length of preterm group were ( 112 .48 ± 15 .83)° and ( 30 .94 ± 6 .32) mm ,and the mean ACA and cervical length of term group were (103 .52 ± 13 .78)° and (37 .28 ± 6 .74)mm ,there were statistically difference( P <0 .05) . The area under ROC curve of the ACA was 0 .882 ,of the cervical length was 0 .664 ,the corresponding cutoff value were 113°and 27 mm ,respectively . The sensitivity of the ACA and cervical length in predicting preterm birth were 86 .90％ and 71 .43％ ,the specificity were 75 .00％ and 62 .14％ ,the accuracy were 75 .94％ and 62 .66％ ,respectively . Conclusions The ACA is an objective and effective indicator to predict preterm birth in the second trimester with transperineal ultrasound . The diagnostic value of measuring the ACA is better than that of measuring the cervical length in the same period .

Molecular mechanism of MAWBP in the proliferation, invasion and migration of colorectal cancer cells / 实用医学杂志

Objective To study the effects and molecular mechanism of MAWBP in the proliferation, invasion and migration of human colorectal cancer cell lines. Methods Colorectal cancer cell lines, caco-2 and HT-29, were divided into MAWBP over-expressed group and control group. MAWBP was stablely over-expressed in both cell lines by lentivirus, and the positive clones were screened by puromycin. The expression of MAWBP gene at mRNA and protein levels was evaluated by RT-PCR and western blot. Cell proliferation was detected by MTT. Cell migration and invasion were detected by transwell experiment. The EMT related protein levels of Snail, E-cadherin, and MAPK pathway protein of ERK, p38, p-ERK, p-p38 were determined by western blot analysis. Results Compared with the control group, the expression of MAWBP was significantly higher in HT-29-MAWBP and caco2-MAWBP group . The cell proliferation , invasion and migration ability significantly reduced in the HT-29-MAWBP group. The expression of Snail, p-ERK and p-p38 significantly decreased, while the E-cadherin increased in HT-29-MAWBP and caco2-MAWBP group. Conclusions Over- expression of MAWBP exerts an inhibitory effect on the proliferation, invasion and migration of colorectal caner cells via inhibit the MAPK pathway and regulate the EMT process.

Analysis of Correlated Factors Affecting Tumor Volume Doubling Time of Breast Cancer / 实用医学杂志

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P 0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

Analysis of 3D power Doppler ultrasound parameters in the diagnosis and efficacy of BI-RADS Ⅳ breast masses / 中华超声影像学杂志

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS).Methods After adjusting the ultrasonic instrument under property conditions,3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software,the following parameters of breast masses were obtained:total tumor volume,vascularization index (VI),flow index (FI),and vascularization flow index (VFI).According to the pathological results,the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve,and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters.Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P ＜0.001).The area under the ROC curve (AUC) of VI (0.873) ＞VFI (0.866) ＞FI (0.778).AUC of FI was significantly smaller than that of VI (P =0.016) and of VFI (P =0.039),while no statistical difference between that of VI and of VFI (P =0.294).The diagnostic accuracies of VI (cut-point:1.2,sensitivity:84.1％,specificity:83.3 ％,accuracy:83.8 ％) and of VFI (cut-point:0.5,sensitivity:82.5 ％,specificity:85.2％,accuracy:82.9％) were higher than that of FI (cut-point:35.3,sensitivity:74.6％,specificity:70.4 ％,accuracy:72.6 ％).AUC of VI (P =0.001) and of VFI (P =0.033) in small-volume group (＜2cm3) were both larger than those of large-volume group (≥2 cm3),no significant difference in AUC of FI between these two groups (P =0.09).Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses,especially in masses less than 2 cm3 in volume.

Annexin A2 expression in intestinal mucosa of patients with inflammatory bowel disease and its clinical implications / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of annexin A2 (ANXA2) expression in the intestinal mucosa in the pathogenesis of inflammatory bowel disease (IBD).</p><p><b>METHODS</b>Intestinal or colonic mucosal biopsy samples were obtained from 54 patients with ulcerative colitis (UC), 37 with Crohn's disease (CD), and 15 healthy control subjects. Immunohistochemistry was employed to examine the expression of ANXA2 in the intestinal mucosa, and mRNA expression of ANXA2 was detected using real-time PCR.</p><p><b>RESULTS</b>Immunohistochemistry showed a ANXA2 positivity rate of 83.3% (45/54) in patients with UC, 27.0% (10/37) in patients with CD, and 53.3% (8/15) in the control subjects. ANXA2 expression in the intestinal or colonic mucosa was significantly up-regulated in patients with UC compared with the patients with CD and healthy control subjects, but was significantly lower in patients with CD than in the healthy controls (P<0.05). The expression levels of ANXA2 were strongly associated with the severity of clinical manifestations and the histopathological grades of UC (P<0.05). Compared with the healthy controls and patients with CD, patients with UC showed a significantly increased ANXA2 mRNA expression level in the inflamed mucosa of UC (P<0.05).</p><p><b>CONCLUSION</b>ANXA2 can serve as a marker for differential diagnosis of IBD, and its up-regulated expression is closely related to the pathogenesis of UC.</p>

Influence of silencing TMPRSS4 expression on growth and invasion of pancreatic cancer SW1990 cell / 中华胰腺病杂志

Objective To study the influence of the small interfering RNA (siRNA) interference TMPRSS4 expression on human pancreatic cancer SW1990 cell's proliferation and invasion. Methods The four eukaryotic expression vector of TMPRSS4 gene were synthesized in vitro and were transfected transiently into human pancreatic cancer SW1990 cells. TMPRSS4 mRNA expression of transfected cells was detected by real-time RT-PCR. The most efficient eukaryotic expression vector was used to be transfected into SW1990 cells. By using G418, cell strain that can silence TMPRSS4 gene stably was screened. The TMPRSS4 mRNA expression of the stable cell strain was detected by real time PCR TMPRSS4 protein expression was detected by western blot. The proliferation ability of transfected SW1990 cells was detected by CCK-8 method. By Transwell, the invasion change of SW1990 cell was detected. Results A stable cell strain, SW1990/psi TMPRSS4, was successfully constructed, in which the expression level of TMPRSS4 could be reduced stably by RNA interference. Cell transfection efficiency was 82.9%. Compared with the control group, the TMPRSS4 mRNA and protein levels were reduced by 80.1% and 60% ,and number of penetrating cells was 118.6 ±13.4 in SW1990/psi TMPRSS4 group, which was significantly lower than those in the negative control group (157.4 ± 12.9) and control group (157.0±9.5, P <0.01). Cells invasion inhibitory rate was 24.5% in SW1990/psi TMPRSS4 group. The cell proliferation was not significantly different among all the groups. Conclusions A stable cell strain is screened successfully in which the expression level of TMPRSS4 can be reduced stably. The down-regulation of TMPRSS4 gene expression level can inhibit the invasion of SW1990 cells, but has no effect on cell proliferation.

Diagnosis and prognosis of 280 patients with pancreatic carcinoma / 中华胰腺病杂志

Objective To evaluate the factors influencing early diagnosis and prognosis in patients with pancreatic carcinoma.Methods The clinical data of 280 patients who had complete follow-up data with pancreatic carcinoma treated from January 2002 to January 2007 were reviewed retrospectively.The medical history and follow-up data were collected from all patients.Survival rate was calculated by the life table method and the Kaplan-Meier estimation.Log-rank test was used for univariate prognostic analysis and Cox regression was used for multivariate prognostic analysis.Results 91.8%of the patients were more than 40 years old and the peak age was 50～73 years old;the major presentations were abdominal pain and jaundice.Major imaging tests included B-ultrasound and CT,the sensitivity was 70.6%,95.3%,respectively;89.3%of patients had combined B-ultrasound and CT examination.The sensitivity of CA19-9 was 81.1%.The median survival time was(7.0±0.5)months.Overall survival rates at 1～5 year survival rates were 28%,9%,6%,2%,and 1%.Univariate analysis suggested that age＞65 years old,CA19-9＞mean value,TNM Ⅲ or Ⅳ stage,lymph nodes invasion,vascular invasion,and metastasis of two or more organs,non-surgical treatment,KPS score＜60 points,weight loss≥5 kg were poor prognostic factors;Cox multivariate analysis showed that treatment modalities,age,TNM stage,KPS score and ascites were independent risk factors for dismal prognosis.Conclusions The age,ascites,tumor stage and treatment modalities affected the prognosis of patients with pancreatic cancer.Early diagnosis and treatment was important to improve the survival time of patients with pancreatic cancer.