A nested case-control study on the relationship between red blood cell folate and the prognosis of low-grade cervical intraepithelial neoplasia / 中华预防医学杂志

Objective: To evaluate the relationship between red blood cell folate (RBC folate) and the prognosis of low-grade cervical intraepithelial neoplasia (CIN 1). Methods: In the married women cohort established in 2014, 564 women with CIN 1 diagnosed by pathology were recruited. The demographic characteristics and factors of cervical intraepithelial neoplasia were collected. Meanwhile, the infection status of human papillomavirus (HPV) was detected by molecular diversion hybridization, and the level of RBC folate was measured by chemical photoimmunoassay. After 24 months of follow-up, pathological examination was performed again to observe the prognosis of participants. The women with reversal were taken as the control group,and those with continuous and progressive CIN 1 were taken as the case group respectively. The relationship between RBC folate and CIN 1 outcome was evaluated by logistic regression model. Results: 453 women completed the follow-up, aged (49.72±6.84) years old. CIN 1 was reversed in 342 women, continued in 58 cases and progressed in 53 cases. The RBC folate level M (Q1,Q3) were 399.01 (307.10, 538.97) ng/ml, 316.98 (184.74, 428.49) ng/ml and 247.14 (170.54, 348.97) ng/ml, respectively. With the decrease of RBC folate, the risk of continuous and progressive CIN 1 increased (all P<0.001), while the risk of reversal CIN 1 decreased gradually (P<0.001). Combined with high-risk human papillomavirus (HR-HPV) infection status, low level of RBC folate could increase the risk of CIN 1 progression regardless of HR-HPV infection (HR-HPV infection: OR=21.34, 95%CI: 3.98-114.54; HR-HPV uninfection: OR=11.15, 95%CI: 2.34-53.13). Conclusion: Low level of RBC folate could increase the risk of CIN 1 persistence and progression regardless of HR-HPV infection.

Mechanisms of baicalein inhibiting metastasis of esophageal squamous cell carcinoma through ERK/ELK-1/Snail signaling pathway / 药学学报

This study aims to investigate the effect of baicalein on the metastasis of esophageal squamous cell carcinoma (ESCC) cells, and to elucidate the potential molecular mechanisms. Wound healing and Transwell migration and invasion assays were performed to detect the effect of baicalein on the migration and invasion of EC9706 and KYSE30 cells; the nude mice models of lung metastasis were applied to examine the function of baicalein in metastasis of ESCC by using KYSE30 cells. All animals were received humane care according to the Institutional Animal Care Guidelines approved by the Experimental Animal Ethical Committee of Henan University. Western blot assay was used to detect the protein levels of ERK/ELK-1/Snail signaling pathway. The data showed that baicalein significantly inhibited the migration and invasion of EC9706 and KYSE30 cells; Mechanistically, baicalein treatment led to a dramatically reduced expression of phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2, T202/Y204), p-ETS-domain containing protein-1 (p-ELK-1, S383), Snail, N-cadherin, and Vimentin, and a statistical increase of E-cadherin expression in EC9706 and KYSE30 cells; Furthermore, the inhibition of ERK1/2 by U0126 or siRNA remarkably enhanced the effect of baicalein on the above proteins. In summary, baicalein probably inhibits the migration, invasion, and metastasis of ESCC cells via blocking the ERK/ELK-1/Snail signaling pathway.

Effect of posterior condylar offset on clinical results after posterior-stabilized total knee arthroplasty / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To determine the effect of the posterior condylar offset (PCO) on clinical results after total knee arthroplasty (TKA) using a high-flex posterior-stabilized (PS) fixed-bearing prosthesis.</p><p><b>METHODS</b>We prospectively studied the clinical and radiographic materials of 89 consecutive female patients (89 knees), who had undergone primary TKAs for end-stage osteoarthritis. All operations were performed by a single senior surgeon or under his supervision using the same operative technique. Based on the corrected PCO change, we divided all cases into two groups: group A (corrected PCO change ≥0 mm, 58 knees) and group B (corrected PCO change<0 mm, 31 knees). One-year postoperatively, clinical and radiographic variables from the two groups were compared by independent t-test. The associations between the corrected PCO changes and the improvements of clinical variables in all patients were analyzed by Pearson linear correlation.</p><p><b>RESULTS</b>One-year postoperatively, the Knee Society Scores, the Western Ontario and McMaster Universities Osteoarthritis Index, non-weight-bearing active and passive range of knee flexion, flexion contracture, extensor lag, and their improvements had no statistical differences between the two groups (all p>0.05). The corrected PCO change was not significantly correlated with the improvement of any clinical variable (all p>0.05). Group A demonstrated greater flexion than group B during active weight bearing (p<0.05).</p><p><b>CONCLUSIONS</b>Restoration of PCO plays an important role in the optimization of active knee flexion during weight-bearing conditions after posterior-stabilized TKA, while it has no benefit to non-weight-bearing knee flexion or any other clinical result.</p>

Values of 16-slice CTA and DSA in diagnosis of intracranial aneurysm / 中华神经医学杂志

Objective To assess the values of 16-slice CTA and DSA in the diagnosis of intracranial aneurysms. Methods Eighty-two patients with SAH,suspected having aneurysms and admitted to our hospital from July 2007 to July 2008,received DSA and CTA;the clinical data of these patients were analyzed;CTA images were compared blindly with the DSA findings,including the presence,location,and size of aneurysms.With SPSS 11.5 statistical software,the sensitivity,specificity and accuracy of CTA and DSA were compared. Results Eighty-one aneurysms were detected by DSA and 74 aneurysms by CTA;no significant difirences on the positive detected rate were noted(x2=1.897,P=0.163).The sensitivity of CTA for detection of all aneurysms versus that of DSA was 91.4%,the specificity of CTA 91.7%.and the accuracy of CTA 91.4%.Sixty-five patients underwent surgery (clipping)and 73 aneurysms were confirmed by this surgery;CTA had a sensitivity of 89.0%,specificity of 100%and accuracy of 90.5%:DSA had a sensitivity of 98.6%,specificity of 84.6%and accuracy of 98.8%;significant statistical diference on sensitivity (x2=5.625,P<0.05)and no significant statistical diference on specificity and accuracy (x2=1.846 and 2.450,respetively,P>0.05)were found between them.As compared with the sizes of aneurysms and the diameters of aneurysm necks measured during the operation,these results detected by CTA were significantly larger(P<0.05).CTA had different detection sensitivities to aneurysms at different locations and with different sizes,while DSA had high sensitivity.Conclusion CTA is a noninvasive, quick, sensitive and efficient tool to diagnose inrtacranial aneurysms.It can be specially used to screen aneurysms in SAH patients.In some cases,CTA can guide the surgery.

Application of indocyanine green angiography in surgery for giant intracranial aneurysm / 中华神经医学杂志

Objective To explore the role of intraoperative indocyanine green angiography (ICGA) in the surgery of giant intracranial aneurysm (GIA). Methods Fifty-seven patients, admitted to our hospital from March 2007 to October 2009 and performed GIA clipping and/or resection, were chosen in this study. Intraoperative ICGA was performed using a surgical microscope with integrated ICGA technology before and after GIA clipping. The presence and patency of the parent artery and perforating artery around the aneurysms, and the information of aneurysm were analyzed in the mierosurgical field during surgical dissection and clip application. Assessment of vascular patency and occlusion of aneurysm after clipping was also investigated by DSA or CTA. These findings of ICGA were compared with those of postoperative DSA. Results A total of 128 investigations were performed in these 57 patients, and 61 aneurysms were clipped and removed. ICGA could provide real-time information about the circulation of the operating field and the patency of parent, branching and perforating arteries,and the aneurysm sac. Four out of the 57 patients were noted as having significantly changed information provided by intraoperative ICGA; after adjusting the aneurysm clipping, no such unexpected findings as parent or branching artery occlusion, or aneurysm sac omission were found on postoperative angiograms;the postoperative DSA results were consistent with the intraoperative ICGA findings. Conclusion ICGA is a technique of confirming the relationship between GIA and its surrounding arteries, and monitoring aneurysm residual, parent artery stenosis and vascular anastomotic patency during the surgery.

Dosimetry-guided 131I therapy for differentiated thyroid carcinoma with diffuse pulmonary metastases / 中华核医学杂志

Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.