Adjuvant chemotherapy versus adjuvant concurrent chemoradiotherapy after radical surgery for early-stage cervical cancer: a randomized, non-inferiority, multicenter trial / 医学前沿

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.

Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-course methotrexate for low-risk gestational trophoblastic neoplasia: a multi-centric randomized clinical trial / 医学前沿

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

Morphological analysis of proximal tibial epiphyseal fusion site in normal adults / 中华骨科杂志

Objective:To study the morphologic features of the fusion site of proximal tibial epiphysis in normal adults and analyze its potential clinical value based on Mimics three-dimensional (3D) reconstruction.Methods:CT images of knee joint of 68 patients without obvious abnormalities of lower limbs were retrospectively analyzed in electronic database of our hospital from June 2020 to June 2021, including 41 males and 27 females. The mean age of the patients was 38.7±8.4 years (range, 25-55 years), and the mean body mass index (BMI) was 25.3±4.0 kg/m 2 (range, 18.75-41.8 kg/m 2). Mimics 3D reconstruction technique was used to reconstruct the 3D model of the proximal tibia and epiphyseal fusion site. The relationship between the surface area of epiphyseal fusion site and age and BMI was studied, and the changes of cortical thickness and density at epiphyseal fusion site were also explored. Results:The fusion site of adult epiphyseal reconstructed by Mimics 3D reconstruction is a complex wavy surface structure in 3D space. The surface area of the epiphyseal fusion site was 2,994.7±645.3 mm 2 (range, 1,704.0-4,650.0 mm 2) obtained by 3-Matic Research 12.0. The fusing area of male epiphysis was 3 269.3±533.9 mm 2 than that of female 2,577.6±578.7 mm 2, the difference was statistically significant ( t=5.06, P<0.001). However, there was no significant correlation between the epiphyseal fusion site surface area and age ( R2=0.02, P=0.268) and BMI ( R2=0.04, P=0.125). Mimics software was used to obtain the CT values of bone cortex at the epiphysis line and the distal end of the epiphysis line at 10 mm and 20 mm levels as 451.059±74.953 Hu, 1,018.412±125.732 Hu and 1,414.162±107.848 Hu, respectively. The thickness of bone cortex was 1.814±0.090 mm, 2.511±0.089 mm and 3.189±0.185 mm at 10 mm and 20 mm layers of epiphysis line and distal epiphysis line, respectively. Conclusion:In this study, Mimics 3D reconstruction technique was used to visualize the fusion site of the proximal tibial epiphysis in normal adults. The epiphyseal fusion site of adult is a undulating plate-like structure, and the cortical bone density of epiphyseal fusion site is low and thin, theoretically, it is easy to fracture under indirect violence.

EMA/CO regimen for chemotherapy 24 patients with ultra high-risk gestational trophoblastic neoplasia / 中华妇产科杂志

Objective To evaluate etoposide,methotrexate and dactinomycin (EMA)/ cyclophosphamide and vincristine (CO) regimen for treatment of ultra high-risk gestational trophoblastic neoplasia (GTN).Methods A total of twenty-four ultra high-risk patients who had International Federation of Gynecology and Obstetrics (FIGO) prognostic scores greater or equal to 12 with liver,brain,or extensive metastases did poorly when treated with primary chemotherapy admitted in Women's Hospital,School of Medicine,Zhejiang University from January 2001 to December 2015.All of the patients were treated by EMA/CO regimen and followed up to death or December 2017.The clinical data of patients were analyzed retrospectively and the efficacy and toxicity of EMA/CO were evaluated.Results All of the cases with ultra high-risk GTN had FIGO prognostic scores ≥12 (ranged 12-18,median 13.0).Twenty patients (83％,20/24) received EMA/CO regimen as primary treatment and 4 patients (17％,4/24) had a history of failed chemotherapy.Seven patients (29％,7/24) had metastasis of liver or brain and 17 patients (71％,20/24)had no metastasis of liver and brain.Twenty-four patients received totally 167 courses of EMA/CO regimen (average 7.0 courses).Sixteen patients achieved complete remission and 8 patients showed drug-resistant.The complete remission rate was 67％ (16/24) and the resistance rate was 33％ (8/24).Of the 16 patients who got complete remission,6 cases were treated with EMA/CO regimen alone,and 10 cases were treated by chemotherapy combined with surgery.For the 8 patients who showed drug-resistant to EMA/CO,5 cases of them received EMA/etoposide and cisplatin (EP) regimen and 3 cases got remission,1 case received methotrexate,dactinomycin and cyclophosphamide (MAC) regimen and got remission,2 cases gave up treatment because of economic factors.The side effects of EMA/CO mainly included Ⅲ-Ⅳ degree neutropenia,anemia and alopecia.The incidence of Ⅲ-Ⅳ degree neutropenia during the treatment of EMA/CO was 21.6％ (36/167),the incidence of anemia was 96.4％ (161/167),and the incidence of alopecia was 60.5％ (101/167).In these 24 ultra high-risk GTN patients,4 patients died during follow-up.In the 20 patients who got complete remission,no recurrence or secondary tumor by chemotherapy were occurred.Conclusion EMA/CO is an effective regimen with manageable toxicity for patients with ultra high-risk GTN.

Epidemiological survey of glenoid fractures between the east and west areas in China from 2010 through 2011 / 中华创伤骨科杂志

Objective To compare the epidemiological characteristics of glenoid fractures between the east and west areas in China from 2010 through 2011.Methods The data of glenoid fractures treated between January 2010 and December 2011 at 35 east hospitals and 28 west ones in China were analyzed retrospectively.The patients' gender,age and type of Ideberg classification were documented.The data from the 35 east hospitals were classified as group A while those from the 28 west ones as group B.Comparisons were made to find out the general epidemiological characteristics.Results A total of 347 glenoid fractures were collected.The total male/female ratio was 2.69∶ 1.The glenoid fractures predominated in 2 age ranges from 41 to 50 years and from 51 to 60 years (19.60％).According to the Ideberg classification,there were 75 cases (21.61％) of type Ⅰ,152 ones (43.80％) of type Ⅱ,27 ones (7.78％) of type Ⅲ,20 ones (5.76％) of type Ⅳ,46 ones (13.26％) of type Ⅴ and 27 ones (7.78％) of type Ⅵ.The male/female ratio was 2.80∶1 in group A of 228 patients and 2.50∶1 in group B of 119 patients.The median age of group A was 47 years old and that of group B 44 years old.The differences were not statistically significant in male/female ratio,median age or distribution of age between the 2 groups (P ＞ 0.05).The fractures predominated in the age range from 51 to 60 years old (23.68％) in group A and in the age range from 31 to 40 years old (21.85％) in group B.The most frequent fracture type was type Ⅱin both groups,accounting for 41.23％ and 48.74％ respectively.There was a significant difference between the 2 groups in distribution of Ideberg classification (P ＜ 0.05).Conclusions The peak age of glenoid fractures was from 41 to 60 years,the high-risk type was Ideberg type Ⅱ and there were more male patients than female ones.The proportion of Ideberg type Ⅴ in the east area was higher than that in the west area.

Epidemiological survey of scapular neck fractures between the east and west areas in China from 2010 through 2011 / 中华创伤骨科杂志

Objective To compare the epidemiological characteristics of scapular neck fracture between the east and west areas in China from 2010 through 2011.Methods Tbe data of scapular neck fractures treated between January 2010 and December 2011 at 35 east hospitals and 28 west ones were analyzed retrospectively.The patients' gender,age and Miller classification were documented.The data from the 35 east hospitals were classified as group A while the data from the 28 west ones as group B.Comparisons were made to find out the general epidemiological characteristics.Results A total of 584 scapular neck fractures were collected.The total male/female ratio was 3.46∶ 1.The scapular neck fractures predominated in an age range from 41 to 50 years (25.17％).According to the Miller classification,there were 150 cases (25.68％) of type Ⅰ,306 ones (52.40％) of type Ⅱ and 128 ones (21.92％) of type Ⅲ.426 cases (72.95％) were stable fractures and 158 ones (27.05％) unstable fractures.The male/female ratio was 3.64∶1 in group A of 427 patients and 3.03∶1 in group B of 157 patients.There were no significant differences between the 2 groups in male/female ratio (P ＞ 0.05).The median age of group A (44 years) was significantly older than that of group B (39 years).The fractures predominated in an age range from 41 to 50 years (24.36％) in group A and in the age range from 31 to 40 years (36.31％) in group B.The most frequent fracture type was type Ⅱ in both groups,accounting for 51.52％ and 54.78％ respectively.There were no significant differences between the 2 groups in distribution of Miller classification (P ＞ 0.05).Conclusions The peak age of scapular neck fractures was from 41 to 50 years,the high-risk type was Miller type Ⅱ and stable fractures were more common.There were more male patients than female ones.The median age in the east area was older than that in the west area.

Comparison of medial and lateral locking plates for Schatzker type Ⅵ fractures of tibial plateau: a finite element analysis / 中华创伤骨科杂志

Objective To compare the biomechanical characteristics of medial and lateral locking plates for Schatzker typeⅥfractures of tibial plateau by finite element analysis. Methods A 38 year-old male volunteer was enrolled for CT scan of his lower limbs. His CT images of the left tibial plateau were used for 3D reconstruction of a model of Schatzker type Ⅵ fracture by NX 9.0 software. After the boundary con-ditions were set, a 500 N load was applied to the tibial plateau to simulate the stress on a single leg when an adult weighing 60 kg walked. The displacement and stress on plate and screws were analyzed by Abaqus software. Results The ultimate stress on the model fixated with a medial locking plate was 81.7 MPa, located at the proximal tibiofibular joint surface. The ultimate stress on the model fixated with a lateral locking plate was 487.4 MPa, located at the junction of plate and screws. The ultimate stress on the fibula was much larger in the model fixated with a medial locking plate than in the model fixated with a lateral locking plate. The ultimate displacement was smaller and more homogeneous in the model fixated with a medial locking plate (1.15 mm) than in the model fixated with a lateral locking plate (3.44 mm).Conclusion The Schatzker type Ⅵ fractures of tibial plateau should be fixated with a medial locking plate because it has more biomechanical advantages than a lateral locking plate.

Epidemiological investigation and analysis of upper cervical spine injury in The Third Affiliated Hospital to Hebei Medical University from 2003 to 2012 / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of upper cervical spine injury in The Third Affiliated Hospital to Hebei Medical University from 2003 to 2012.Methods The clinical data of upper cervical spine fractures treated between January 2003 and December 2012 at our hospital were collected through the PACS system and case reports checking system.The fractures treated from January 2003 through December 2007 were assigned into group A while those from January 2008 through December 2012 into group B.Analytic items included gender,age and fracture type.Results A total of 201 upper cervical spine fractures were treated during the 10 years,accounting for 1.6％ (201/12,427) of the spinal fractures and 0.2％ (201 / 107,648) of all human fractures.They were 125 males and 76 female,with a male to female ratio of 1.64∶ 1.Their ages ranged from 16 to 97 years,with a mean age of 42 years.The age distribution showed that the peak age was from 21 to 50 years (65.2％,131/201).Sixty cases were atlas fractures and 141 axis fractures,most of which were both males.Sixteen upper cervical spine fractures were complicated with lower cervical spine injury,accounting for 8.0％ of all the upper cervical spine fractures (16/201).In group A,the upper cervical spine injury accounted for 2.3％ (106/4,676) of the contemporary spinal injury and 0.2％ (106/55,423) of the contemporary human fractures;in group B,the upper cervical spine injury accounted for 1.2％ (95/7,751) of the contemporary spinal injury and 0.2％ (95/52,225) of the contemporary human fractures.Compared with group A,the proportion of type C atlas injury in group B increased by 39.6％.Conclusions The upper cervical spine fractures during the 10 years accounted for 1.6％ of the spinal fractures and 0.2％ of all human fractures.Most of the patients were young male adults.The axis fractures accounted for 70.1％ of the upper cervical spine injury,most of which (62.4％) were dens fractures.8.0％ of the patients were complicated with lower cervical spine injury.Comparisons between the former and latter 5 years showed no significant difference in gender constituent ratio,a significant difference in age constituent ratio and an increasing trend in type C atlas injury.

Epidemiological investigation and analysis of upper cervical spine injury in The Third Affiliated Hospital to Hebei Medical University from 2003 to 2012 / 中华创伤骨科杂志

Objective To investigate the epidemiological features and trends of upper cervical spine injury in The Third Affiliated Hospital to Hebei Medical University from 2003 to 2012.Methods The clinical data of upper cervical spine fractures treated between January 2003 and December 2012 at our hospital were collected through the PACS system and case reports checking system.The fractures treated from January 2003 through December 2007 were assigned into group A while those from January 2008 through December 2012 into group B.Analytic items included gender,age and fracture type.Results A total of 201 upper cervical spine fractures were treated during the 10 years,accounting for 1.6％ (201/12,427) of the spinal fractures and 0.2％ (201 / 107,648) of all human fractures.They were 125 males and 76 female,with a male to female ratio of 1.64∶ 1.Their ages ranged from 16 to 97 years,with a mean age of 42 years.The age distribution showed that the peak age was from 21 to 50 years (65.2％,131/201).Sixty cases were atlas fractures and 141 axis fractures,most of which were both males.Sixteen upper cervical spine fractures were complicated with lower cervical spine injury,accounting for 8.0％ of all the upper cervical spine fractures (16/201).In group A,the upper cervical spine injury accounted for 2.3％ (106/4,676) of the contemporary spinal injury and 0.2％ (106/55,423) of the contemporary human fractures;in group B,the upper cervical spine injury accounted for 1.2％ (95/7,751) of the contemporary spinal injury and 0.2％ (95/52,225) of the contemporary human fractures.Compared with group A,the proportion of type C atlas injury in group B increased by 39.6％.Conclusions The upper cervical spine fractures during the 10 years accounted for 1.6％ of the spinal fractures and 0.2％ of all human fractures.Most of the patients were young male adults.The axis fractures accounted for 70.1％ of the upper cervical spine injury,most of which (62.4％) were dens fractures.8.0％ of the patients were complicated with lower cervical spine injury.Comparisons between the former and latter 5 years showed no significant difference in gender constituent ratio,a significant difference in age constituent ratio and an increasing trend in type C atlas injury.

Epidemiological survey of glenoid fractures in the Third Affiliated Hospital to Hebei Medical University from 2003 through 2012 / 中华创伤骨科杂志

Objective To analyze the epidemiological features and trends of glenoid fractures from 2003 through 2012 in the Third Affiliated Hospital to Hebei Medical University.Methods The clinical data were collected of the patients with glenoid fracture who had been treated between January 2003 and December 2012 in our hospital.The patients' gender,age and fracture type of Ideberg classification were documented.The data from January 2003 to December 2007 were assigned into group A and those from January 2008 to December 2012 into group B.The 2 groups were compared to find out the general epidemiological characteristics and trends in the recent 10 years.Results A total of 225 patients with glenoid fracture were collected,including 176 males and 49 females.The total male/female ratio was 3.59∶ 1.The glenoid fractures predominated in an age range of 31 to 40 years (23.56％).According to Ideberg classification,there were 35 cases (15.56％) of type Ⅰ,58 ones (25.78％) of type Ⅱ,64 ones (28.44％) of type Ⅲ,21 ones (9.33％) of type Ⅳ,30 ones(13.33％) of type Ⅴ and 17 ones(7.56％) of type Ⅵ.The male/female ratio was 5.29∶1 in group A of 107 patients and 2.69∶1 in group B of 118 patients.The mean age of group A was 40.2 ± 16.0 years and that of group B 47.5 ± 14.8 years.The differences in male/female ratio,mean age and distribution of age were statistically significant between the 2 groups (P ＜ O.05).The fractures predominated in an age range of 31 to 40 years (28.97％) in group A and in the age group of 51 to 60 years (27.12％) in group B.The most frequent fracture type was type Ⅲ in both groups,accounting for 29.91％ and 27.12％ respectively.There was no significant difference between the 2 groups in distribution of Ideberg classification (P ＞ 0.05).Conclusions The peak age of glenoid fractures was from 31 to 40 years.There was an increasing trend in the mean age.There were more male patients than female ones.The high-frequency type was Ideberg type Ⅲ.

Application value of combined detection of serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in diagnosis of cerebral infarction / 国际检验医学杂志

Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.

Epidemiological analysis of Galeazzi fractures from 2003 through 2012 in The Third Affiliated Hospital to Hebei Medical University / 中华创伤骨科杂志

Objective To analyze the epidemiological features of Galeazzi fractures from 2003 through 2012 in The Third Affiliated Hospital to Hebei Medical University. Methods We retrospectively analyzed the data of Galeazzi fractures between January 2003 and December 2012 in the Third Affiliated Hospital to Hebei Medical University. The data from 2003 through 2008 were defined as group A and those from 2008 through 2012 as group B. The general information was compared between the 2 groups. The epi-demiological characteristics and trends during the 10 years were analyzed concerning gender, age and fracture type of the patients. Results A total of 153 Galeazzi fractures were recorded, accounting for 0. 81％ of ulnoradial fractures and 0. 12％ of all fractures. There were 109 males and 44 females, with a male/female ratio of 2. 48:1. The age range from 11 to 20 years had the highest constituent ratio ( 22. 22％) and type Ⅱthe highest proportion ( 76. 47％) . There were 74 cases in group A, with a male/female ratio of 2. 22:1. There were 79 cases in group B, with a male/female ratio of 2. 76:1. There was no significant difference between the 2 groups concerning the male/female ratio ( P > 0. 05 ) . The median age for group A was 29 years, significantly younger than that for group B ( 34 years ) ( P 0. 05 ) . Conclusions Galeazzi fractures accounted for 0. 81％ of ulnoradial fractures and 0. 12％ of all fractures. There were more male patients than female ones. The age range from 11 to 20 years and typeⅡhad the highest constituent ratios. Compared with the first 5 years, the latter 5 years witnessed increased mean age.

Expression of miR-let-7e-3p in cervical intraepithelial neoplasm and cervix carcinoma and its clinical significance / 浙江大学学报·医学版

To investigate the expression of microRNA (miRNA, miR) let-7e-3p in different cervical lesions and its clinical significance.The expression of miR-let-7e-3p in the tissues of normal cervix (=26), high-grade squamous intraepithelial lesion (HSIL) (=37), and cervix carcinoma (=101) were detected by reverse transcription and quantitative polymerase chain reaction (RT-qPCR). The correlation of miR-let-7e-3p expression with the clinicopathological parameters of patients with cervical cancer was analyzed. miR-let-7e-3p mimic was transfected into cervical carcinoma Siha cells. The cell cycle and apoptosis were determined by flow cytometry; cell proliferation was determined by CCK-8 kit; and the migration and invasion of cells were determined by Transwell assay.The relative expression levels of miR-let-7e-3p in normal cervix, HSIL, and cervical carcinoma were 1.45±0.24, 0.79±0.05 and 0.46±0.04, respectively (all<0.05). After transfection with miR-let-7e-3p mimic, the S-phase fraction and apoptosis rate of Siha cells were increased significantly compared with control group[(29.76±6.6)% vs (13.38±1.3)%,<0.05; (5.98±1.38)% vs (3.53±0.79)%,<0.05, respectively]. OD of transfected Siha cells at 48, 72 and 96 h were 0.57±0.11,0.65±0.04 and 0.84±0.14, which were significantly lower than those of untransfected Siha cells (0.74±0.05, 0.93±0.10 and 1.47±0.14, all<0.05). The migration and invasion abilities of transfected Siha cells were not significantly changed (all>0.05).The expression of miR-let-7e-3p is down-regulated in cervical neoplasms, which is associated with cell cycle arrest and proliferation inhibition of cervical cancer cells.

The evaluation of Xpert MTB/RIF for the diagnosis of tuberculous meningitis / 中华检验医学杂志

Objective To evaluate the diagnostic performance of Xpert MTB/RIF for the diagnosis of tuberculous meningitis (TBM).Methods This was a prospective, single center clinical trial.A total of 116 consecutive patients with suspected meningitis who were admitted to Xijing Hospital from October 2013 to June 2015 were recruited.Mycobacterium tuberculosis ( MTB) and rifampicin ( RIF) resistance mutations in 1 ml cerebrospinal fluid ( CSF) were detected with Xpert MTB/RIF and the remaining sample was tested by Ziehl-Neelsen staining , MGIT960 liquid culture and other laboratory tests .And the enrolled patients were grouped according to the 2010 South African expert consensus .The diagnostic performance of Xpert MTB/RIF was evaluated by comparing against clinical score >5 points and MGIT960 liquid culture as reference standards respectively .The comparison was performed using a χ2 test or Fisher′s exact test for categorical variables and a nonparametric rank sum test for continuous variables .Results Among the enrolled 116 subjects, 23 subjects were diagnosed as definite-TBM by MGIT960 liquid culture, 16 subjects were classified as probable TBM , 27 subjects were classified as possible TBM , and 50 subjects were classified as non-TBM.When clinical score >5 points was used as a reference standard , the sensitivity of Xpert MTB/RIF (39.4%) was comparable with that of MGIT960 liquid culture (34.8%) (χ2 =0.292, P=0.589), and significantly better than that of Ziehl-Neelsen staining (9.9%) (χ2 =16.500, 12.771, P<0.001). No significant differences were found among the specificities of Xpert MTB /RIF, MGIT960 liquid culture and Ziehl-Neelsen staining ( 98.0%, 100.0% vs 98.0%, χ2 =1.014, P=0.602 ) .When tested against MGIT960 liquid culture as a reference standard , the sensitivity of Xpert MTB/RIF was 91.3%. Conclusions Xpert MTB/RIF is a rapid and specific method to detect MTB and RIF resistance in CSF .It exhibits a good rule in value for the diagnosis of TBM and a comparable sensitivity with MGIT 960 liquid culture, thus it can be used as the initial method for the diagnosis of tuberculous meningitis .

The diagnostic value of combined detection of four indexes in early diagnosis of nephropathy / 国际检验医学杂志

Objective To explore the value of joint detection of serum cystatin C (Cys C) ,retinol‐binding protein(RBP) ,urea ni‐trogen(BUN) and creatinine(Cr) in early diagnosis of nephropathy .Methods A total of 230 cases of inpatients with nephropathy form April 2013 to June 2014 were collected and divided into diabetic nephropathy group (130 cases)and hypertensive nephropathy group(100 cases) .Other 200 healthy individuals were collected as healthy control group .The serum levels of Cys C ,RBP ,BUN and Cr were detected by using the Hitachi 7180 automatic biochemistry analyzer .Results Compared with the healthy control group ,the sertum levels of Cys C ,RBP ,BUN and Cr were significantly increased in the diabetic nephropathy group ,and the serum levels of Cys C and RBP were significantly increased in hypertensive nephropathy group ,there were statistically significant differences (P0 .05) .Positive rates(81 .9% ) of the four indicators in the two nephropathy groups were high‐er than those in the healthy control group ,and the positive rate of joint detection of the four indicators was higher than single detec‐tion in patients with nephropathy .Conclusion Serum RBP and Cys C are sensitive indicators for early renal damage ,and combined with BUN and Cr could increase sensitivity of early diagnosis of nephropathy ,which has significant clinical value .

Expression and diagnostic value of HBHA truncated protein / 国际检验医学杂志

Objective To express recombinant HBHAΔC and HBHAΔN protein,and compare the HBHA series protein activity with each other.It will be provide a experimental basis for the research on clinical diagnostic of HBHA.Methods The HBHAΔC and HBHAΔN gene fragments were cloned and expressed by transforming E.coli BL-21.Test the protein heparin binding ability by CL-6B column.And then added protein to the BCG 7H9 culture medium,to observe the induced BCG aggregation.Results nHB-HA,rHBHA and HBHAΔN protein have heparin binding ability.Meanwhile nHBHA,rHBHA and HBHA Δ C protein have in-duced BCG aggregation effect.Conclusion The HBHAΔC and HBHAΔN protein were successfully obtained.It was proved that the HBHA C-terminal could be combined with heparin and the N-terminal involved could induce the aggregation of BCG.This results provide a basis for further study on molecular mechanism of TB infection and clinical application.

Expression and significance of SIRT1 and p53 in endometrial carcinoma with diabetes mellitus / 国际肿瘤学杂志

Objective To investigate the expressions and significances of SIRT1 and p53 in endometrial carcinoma with diabetes mellitus.Methods Immunohistochemistry was carried out to examine the expressions of SIRT1 and p53 in 39 cases of endometrial carcinoma with diabetes mellitus and 40 cases of endometrial carcinoma without diabetes mellitus and 25 cases of normal endometrium,and the correlations between these indexs were analysed.Results The positive rate of SIRT1 and p53 in experimental group was 64.1％,59.0％ respectively,and 85.0％,52.5％ in control group.The positive rate of SIRT1 in experimental group was lower than that of control group (x2 =4.561,P =0.033).The positive rates of SIRT1 and p53 in control group were higher than that of normal endometrium (x2 =21.462,P＜ 0.001; x2 =6.771,P =0.009).Expression of SIRT1 was positively correlated with p53 (r =0.360,P =0.024).Conclusions Hyperglycemia deregulates SIRT1 in endometrial carcinoma.SIRT1 may promote tumorigenesis by silence of p53.

Research progress of thioredoxin-related protein 14 / 国际肿瘤学杂志

Thioredoxin-related protein 14 (TRP14),a new member of Trx family,is a novel disulfide reductase with conservative CPDC motif.Its structure and function are comparable to Trx,which is the representative member of Trx family.However,there are many differences.When tumor necrosis factor-α (TNF-α) induced cells to produce the active oxygen,TRP14 can change oxidatin state of dynein light chain(its substrate),act as a sensor of the intracellular redox state to regulate NF-κB signaling pathways induced by TNF-α,MAPK and apoptosis signaling pathways.

Expression and clinical significance of GRIM-19 in epithelial ovarian carcinoma / 中华妇产科杂志

Objective To investigate the expression and clinicopathological features of gene associated with retinoid-interferon mortality-19 (GRIM-19) in epithelial ovarian carcinoma.Methods The expression of GRIM-19 gene in tissues from 138 cases of epithelial ovarian carcinoma,102 cases of benign ovarian epithelial tumor and 46 cases of normal ovarian tissues were detected by Immunohistochemistry and Western blot methods.Assembled clinical survival data were analyzed with Kaplan-Meier and Cox regression models.Results The expression level of GRIM-19 in epithelial ovarian carcinoma (3.4 ± 2.0) was lower than that in benign ovarian tumor tissues (4.7 ± 2.9) and that in normal ovarian tissues (7.5 ± 2.2 ; P ＜0.01).The level of GRIM-19 expression was related to the survival time of epithelial ovarian carcinoma patients by Kaplan-Meier analysis (P =0.002).The shorter survival time of epithelial ovarian carcinoma patients was significantly associated with the level of GRIM-19 expression (P =0.001),clinical stage (P =0.001),volume of ascites (P =0.023) and the largest diameter of the primary tumor lesion (P =0.044) by Cox regression models.Conclusions The low expression of GRIM-19 in the epithelial ovarian carcinoma suggests that GRIM-19 may be a key gene involved in its carcinogenesis.The expression level of GRIM-19 may be also an independent prognostic factor for epithelial ovarian carcinoma patients.

Mitochondrial protein NDUFS3 and tumor / 国际肿瘤学杂志

NDUFS3 is an essential subunit of mitochondrial NADH:ubiquinone oxidoreductase (complex Ⅰ ) and plays a critical role in the mitochondrial typeⅠ respiration chain.Mutations in this gene are shown to cause neurodegenerative disease such as Leigh syndrome (subacute necrotizing encephalopathy).In recent years,many evidences show that the expression of NDUFS3 proteins are lower in many cancerous cells compared to the corresponding normal cells.It comes to the conclusion that NDUFS3 may play a role in the tumorigenesis.