Coronal Movement during Flexion and Extension of Knee Joints.

Objective: There are variabilities in the distance between the tibial tuberosity and the trochlear groove. The knee angle needs to be considered when talking about patellofemoral instability. Methods: This retrospective study analyses the MRI images of knee angles from 0 and 30 degrees in the patella dislocation group (20 cases) and in the control group (20 cases) from Dec 2017 to Dec 2019. Two experienced orthopedic physicians separately measure the study with a blind experiment method. Results: The TT-TG data of the patella dislocation group and control group are 17.88 ± 3.40 mm and 13.31 ± 3.01 mm when the knee angle is 0, which indicates a difference with statistical significance (P < 0.01). The TT-TG data of the patella dislocation group and control group are 11.51 ± 3.60 mm and 7.40 ± 1.93 mm when the knee angle is at 30 degrees, indicating a statistically significant difference (P < 0.01). Also, the TT-TG data of both the patella dislocation group and control group have statistically significant differences within different knee angles of the same group (P < 0.01). The differences of TT-TG are 6.36 ± 2.43 mm and 5.92 ± 1.65 mm when the knee angle changes from 0 to 30, which shows no statistically significant difference (P > 0.01). Conclusion: This research initially obtained the relevant MRI data of the TT-TG distance from different knee angles between the Chinese patella dislocation patient group and control group. The study received a new criterion to evaluate the TT-TG of patients with patella dislocations when the knee angle is below 30 degrees. The knee flexion angles need to be considered to measure the TT-TG distance when comprehensively evaluating patellofemoral instability. The TT-TG distance gradually increases when the knee changes from flexion to extension. The difference of the TT-TG distances shows no statistically significant difference.

GPCR-mediated EGFR transactivation ameliorates skin toxicities induced by afatinib.

Many G-protein-coupled receptor (GPCR) agonists have been studied for transactivating epidermal growth factor receptor (EGFR) signaling through extracellular or intracellular pathways. Accumulated evidence has confirmed that GPCR transactivation participates in various diseases. However, the clinical application of GPCR transactivation has not been explored, and more translational studies are needed to develop therapies to target GPCR-mediated EGFR transactivation. In cancer patients treated with EGFR inhibitors (EGFRi), especially afatinib, a unique acneiform rash is frequently developed. In this study, we first established the connection between GPCR transactivation and EGFRi-induced skin disease. We examined the ability of three different GPCR agonists to reverse signaling inhibition and ameliorate rash induced by EGFRi. The activation of different agonists follows unique time and kinase patterns. Rats treated with EGFRi show a similar skin phenotype, with rash occurring in the clinic; correspondingly, treatment with GPCR agonists reduced keratinocyte apoptosis, growth retardation and infiltration of inflammatory cytokines by transactivation. This phenomenon demonstrates that EGFR inhibition in keratinocytes regulates key factors associated with rash. Our findings indicate that maintaining EGFR signaling by GPCR agonists might provide a possible therapy for EGFR inhibitor-induced skin toxicities. Our study provides the first example of the translational application of GPCR transactivation in treating diseases.

Polo-like kinase 1 is related with malignant characteristics and inhibits macrophages infiltration in glioma.

Background: Tumor immune microenvironment (TIM) plays a critical role in tumorigenesis and progression. Recently, therapies based on modulating TIM have made great breakthroughs in cancer treatment. Polo-like kinase 1 (PLK1) is a crucial regulatory factor of the cell cycle process and its dysregulations often cause various pathological processes including tumorigenesis. However, the detailed mechanisms surrounding the regulation of PLK1 on glioma immune microenvironment remain undefined. Methods: Public databases and online datasets were used to extract data of PLK1 expression, clinical features, genetic alterations, and biological functions. The EdU, flow cytometry, and macrophage infiltration assays as well as xenograft animal experiments were performed to determine the relationship between PLK1 and glioma immune microenvironment in vivo and in vitro. Results: PLK1 is always highly expressed in multiple cancers especially in glioma. Univariable and Multivariate proportional hazard Cox analysis showed that PLK1 was a prognostic biomarker for glioma. Simultaneously, highly expressed PLK1 is significantly related to prognosis, histological and genetic features in glioma by analyzing public databases. In addition, the enrichment analysis suggested that PLK1 might related to "immune response", "cell cycle", "DNA replication", and "mismatch repair" in glioma. Immune infiltration analysis demonstrated that highly expressed PLK1 inhibited M1 macrophages infiltration to glioblastoma immune microenvironment by Quantiseq and Xcell databases and negatively related to some chemokines and marker genes of M1 macrophages in glioblastoma. Subsequent experiments confirmed that PLK1 knockdown inhibited the proliferation of glioma cells but increased the M1 macrophages infiltration and polarization. Furthermore, in glioma xenograft mouse models, we showed that inhibiting PLK1 blocked tumor proliferation and increased the M1 macrophages infiltration. Finally, PLK1 methylation analysis and lncRNA-miRNA network revealed the potential mechanism of abnormal PLK1 expression in glioma. Conclusions: PLK1 inhibits M1 macrophages infiltration into glioma immune microenvironment and is a potential biomarker for glioma.

Carbon ion ( 12C 6+) inhibits JAK2/STAT3 pathway and promotes CD8 + T cell infiltration in lung cancer / 中华放射肿瘤学杂志

Objective:To explore the alteration of JAK2/STAT3 pathway after carbon ion ( 12C 6+) irradiation and the difference in the infiltration of CD8 + T cells in lung cancer regulated by downstream protein FOXP3. Methods:Significantly altered JAK2/STAT3 pathway and related differentially-expressed genes and proteins such as FOXP3 in lung cancer after carbon ion irradiation were screened based on RNA sequencing analysis in the Lewis tumor model of C57BL/6 mice. The correlation between FOXP3 and major immune cell infiltration in the immune microenvironment of lung cancer was analyzed using the ssGSEA immune infiltration algorithm in the R software "GSVA" and CD8 + T cell infiltration in the immune microenvironment of lung cancer was evaluated based on the carbon ion combined with STAT3 inhibition pathway (niclosamide). Results:The JAK2/STAT3 pathway was inhibited and the expression of related genes and proteins was downregulated in lung cancer after carbon ion irradiation. Immune scoring based on the ssGSEA algorithm showed that FOXP3 expression was significantly negatively correlated with CD8 + T cell infiltration in the immune microenvironment of lung cancer. The role of targeting the JAK2/STAT3 pathway in increasing CD8 + T cell infiltration in lung cancer was further clarified by carbon ion irradiation combined with STAT3 inhibition (niclosamide). Conclusion:Carbon ion irradiation ( 12C 6+) can play a synergistic role with immunotherapy by targeting the JAK2/STAT3 pathway.

Complete Genome Sequence of Bacillus amyloliquefaciens EA19, an Endophytic Bacterium with Biocontrol Potential Isolated from Erigeron annuus.

Bacillus amyloliquefaciens strain EA19 is an endophyte isolated from Erigeron annuus with antifungal activity against Blumeria graminis f. sp. tritici, Magnaporthe oryzae, and Fusarium graminearum. The genome sequence of this strain is 3.96 Mb and contains 3,421 coding sequences, which will facilitate an understanding of the mechanisms of biocontrol.

Consensuses and controversies on pseudomyxoma peritonei: a review of the published consensus statements and guidelines.

BACKGROUND: Pseudomyxoma peritonei (PMP) is a clinical malignant syndrome mainly originating from the appendix, with an incidence of 2-4 per million people. As a rare disease, an early and accurate diagnosis of PMP is difficult. It was not until the 1980s that the systematic study of this disease was started. MAIN BODY: As a result of clinical and basic research progress over the last 4 decades, a comprehensive strategy based on cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) has been established and proved to be an effective treatment for PMP. Currently, CRS + HIPEC was recommended as the standard treatment for PMP worldwide. There are several consensuses on PMP management, playing an important role in the standardization of CRS + HIPEC. However, controversies exist among consensuses published worldwide. A systematic evaluation of PMP consensuses helps not only to standardize PMP treatment but also to identify existing controversies and point to possible solutions in the future. The controversy underlying the consensus and vice versa promotes the continuous refinement and updating of consensuses and continue to improve PMP management through a gradual and continuous process. In this traditional narrative review, we systemically evaluated the consensuses published by major national and international academic organizations, aiming to get a timely update on the treatment strategies of CRS + HIPEC on PMP. CONCLUSION: Currently, consensuses have been reached on the following aspects: pathological classification, terminology, preoperative evaluation, eligibility for surgical treatment, maximal tumor debulking, CRS technical details, and severe adverse event classification system. However, controversies still exist regarding the HIPEC regimen, systemic chemotherapy, and early postoperative intraperitoneal chemotherapy.

Inhibitory Effect of Sangsuyin on Airway Inflammation in Asthmatic Rats by Regulating TLR4 Pathway / 中国实验方剂学杂志

Objective:To investigate the inhibitory effect of Sangsuyin on airway inflammation in asthmatic rats by regulating the Toll-like receptor 4 （TLR4） pathway. Method:Forty-eight SD rats were randomly divided into a normal group （<italic>n</italic>=8） and an experimental group （<italic>n</italic>=40）. Asthma model was induced in the rats of the experimental group which were further divided into the following five groups according to a random number table： a model group， a dexamethasone group （0.005 g·kg^-1），and low- （2.1 g·kg^-1）， medium- （4.2 g·kg^-1）， and high-dose （8.4 g·kg^-1） Sangsuyin groups. The drugs were all dissolved in normal saline at 0.01 L·kg^-1. The rats in the model group and the normal group received normal saline （<italic>ig</italic>） at 0.01 L·kg^-1. The drug treatment was carried out once per day， for a total of 7 days. The grades of allergic reactions were compared among the groups after intervention. The levels of interleukin-1<italic>β</italic> （IL-1<italic>β</italic>），tumor necrosis factor-<italic>α</italic>（TNF-<italic>α</italic>）， and interferon-<italic>γ</italic>（IFN-<italic>γ</italic>） in serum and bronchoalveolar lavage fluid （BALF） were detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of lung tissues，and the inflammatory cell infiltration scores of lung tissues were compared. The mRNA expression of TLR4 and nuclear factor-<italic>κ</italic>B （NF-<italic>κ</italic>B） was detected by quantitative real-time fluorescence-based reverse-transcription polymerase chain reaction （Real-time PCR）. The expression of TLR4，NF-<italic>κ</italic>B， and the level of phosphorylated NF-<italic>κ</italic>B （p-NF-<italic>κ</italic>B） were detected by Western blot. Result:The success rate of modeling was 95.00%. Compared with the normal group， the model group showed a higher grade of allergic reaction and more severe pathological changes of lung tissues，and the groups with drug intervention exhibited relieved conditions. The levels of IL-1<italic>β</italic> and TNF-<italic>α</italic> in the serum and BALF were higher in the model group than in the normal group，and lower in the groups with drug intervention than in the model group （<italic>P</italic><0.01）. The level of IFN-<italic>γ</italic> in the serum and BALF was lower in the model group than in the normal group，and higher in the groups with drug intervention than in the model group （<italic>P</italic><0.05，<italic>P</italic><0.01）. The inflammatory cell infiltration score，mRNA and protein expression of TLR4 and NF-<italic>κ</italic>B，and the mRNA level of p-NF-<italic>κ</italic>B were higher in the model group than in the normal group，and lower in the groups with drug intervention than in the model group （<italic>P</italic><0.01）. Conclusion:Sangsuyin could inhibit allergic reactions，lung tissue lesions， and airway inflammation in asthmatic rats. It is speculated that this effect is achieved by inhibiting the TLR4 pathway，down-regulating the mRNA and protein expression of TLR4 and NF-<italic>κ</italic>B，and reducing the level of p-NF-<italic>κ</italic>B.angsuyin can inhibit allergic reaction，lung tissue lesions and airway inflammation in asthmatic rats. It is speculated that this effect is achieved by inhibiting TLR4 pathway，down regulating the mRNA and protein expression of TLR4，NF-<italic>κ</italic>B，and reducing the levels of p-NF-<italic>κ</italic>B.

Development of fetal growth charts in twins stratified by chorionicity and mode of conception: a retrospective cohort study in China / 中华医学杂志(英文版)

BACKGROUND@#Twin pregnancies continue to increase worldwide; however, the current clinical prenatal evaluation for the intrauterine growth of twins still relies on the growth standards of singletons. We attempted to establish a set of fetal biometric references for Chinese twin pregnancies, stratified by chorionicity and conception mode as spontaneously conceived monochorionic diamniotic (SC-MCDA), spontaneously conceived dichorionic diamniotic (SC-DCDA), and assisted reproductive technology dichorionic diamniotic (ART-DCDA) twins.@*METHODS@#From 2016 to 2019, the ultrasonographic fetal biometric measurements were longitudinally collected in pregnant women, including fetal weight, biparietal diameter, head circumference, abdominal circumference, femur length, and humerus length. The linear mixed models were used to test the difference of growth patterns between groups, and the growth curve of each biometric parameter was modeled by a generalized additive model for location scale and shape.@*RESULTS@#A total of 929 twin pregnant women and 2019 singleton pregnant women, met the inclusion criteria. Among twin pregnancies, 148 were SC-MCDA, 215 were SC-DCDA, and 566 were ART-DCDA twins. Overall, SC-DCDA twins grew faster than SC-MCDA twins, while slower than ART-DCDA twins (all P < 0.05), and all of the three groups showed significant differences comparing with singletons, especially during the third trimester. Hence, the customized fetal growth charts of each fetal biometric parameter were, respectively, constructed for SC-MCDA, SC-DCDA, and ART-DCDA twins.@*CONCLUSIONS@#The fetal biometric trajectories demonstrated characteristic patterns according to chorionicity and conception mode. To fill the gap, we modeled fetal biometric parameters for Chinese SC-MCDA, SC-DCDA, and ART-DCDA twin pregnancies, hoping to provide a reference for the further establishment of fetal growth reference values for Chinese twin fetuses.

Ant Colony Optimization for the Control of Pollutant Spreading on Social Networks.

The rapid development of online social networks not only enables prompt and convenient dissemination of desirable information but also incurs fast and wide propagation of undesirable information. A common way to control the spread of pollutants is to block some nodes, but such a strategy may affect the service quality of a social network and leads to a high control cost if too many nodes are blocked. This paper considers the node selection problem as a biobjective optimization problem to find a subset of nodes to be blocked so that the effect of the control is maximized while the cost of the control is minimized. To solve this problem, we design an ant colony optimization algorithm with an adaptive dimension size selection under the multiobjective evolutionary algorithm framework based on decomposition (MOEA/D-ADACO). The proposed algorithm divides the biobjective problem into a set of single-objective subproblems and each ant takes charge of optimizing one subproblem. Moreover, two types of pheromone and heuristic information are incorporated into MOEA/D-ADACO, that is, pheromone and heuristic information of dimension size selection and that of node selection. While constructing solutions, the ants first determine the dimension size according to the former type of pheromone and heuristic information. Then, the ants select a specific number of nodes to build solutions according to the latter type of pheromone and heuristic information. Experiments conducted on a set of real-world online social networks confirm that the proposed biobjective optimization model and the developed MOEA/D-ADACO are promising for the pollutant spreading control.

CHPF promotes lung adenocarcinoma proliferation and anti-apoptosis via the MAPK pathway.

OBJECTIVE: Recent studies have shown that Chondroitin polymerizing factor (CHPF) is abnormally expressed in malignant tumors, however, the expression of CHPF in lung adenocarcinoma (LUAD) has not been reported. In this study, the relationship of CHPF and LUAD will be explored. METHODS: Differential genes present in LUAD were screened by bioinformatics analysis. The expression status of CHPF in LUAD tissues and cell lines were deteced by Western blotting or Real-time Quantitative Polymerase Chain Reaction Detecting System (qPCR), and the relationship between CHPF and prognosis of LUAD patients was analyzed. CHPF was effectively silenced in LUAD cell lines by lentivirus- mediated methods. The effect of CHPF on proliferation, cell cycle progression and apoptosis of cancer cells was assessed. We further determined the role of CHPF in tumor growth in vivo by using xenograft LUAD tumor models. Western blotting assay was performed to assess the expression changes of MAPK signaling pathway. RESULTS: We found that CHPF is highly expressed in LUAD tissues and cell lines. In vitro experiments, CHPF knockdown in LUAD cells can effectively inhibit proliferation and promote apoptosis of cancer cell. In vivo experiment, tumor growth was markedly inhibited by CHPF knockdown in the xenograft model of LUAD. Notably, CHPF also could promote tumor progression by regulating MAPK pathway. CONCLUSION: CHPF can promote the proliferation and antiapoptosis of LUAD cells, which is promising to become a potential target for LUAD treatment.

Knockdown of TRIM66 inhibits malignant behavior and epithelial-mesenchymal transition in non-small cell lung cancer.

OBJECTIVE: The tripartite motif 66(TRIM66) is an important member of the TRIM protein superfamily, which can participate in the expression of multiple proteins, and is closely associated with the behaviors of non-small cell lung cancer (NSCLC). In this study, we aimed to explore the effect of TRIM66 in this process in vitro using NSCLC cell lines, and the role of TRIM66 in regulating epithelial-mesenchymal transition(EMT) in NSCLC. METHODS: Western blotting was used to detect the TRIM66 protein expression levels in NSCLC cell lines and normal lung epithelial cells BEAS-2B. We silenced its expression in A549 cells by transient siRNA transfection to ascertain the function of TRIM66 in NSCLC cells. Western blotting was used to detect the expression of EMT-related proteins. RESULTS: TRIM66 protein content was highest in NSCLC cell line A549, compared with BEAS-2B, it showed that the TRIM66-siRNA group lung cancer cell proliferation was significantly reduced after knockdown of TRIM66, and knockdown of TRIM66 also suppressed invasion, migration and clonogenic ability of A549 cells. Finally, we found that siRNA-mediated TRIM66 silencing suppressed EMT by downregulating expression of N-cadherin and vimentin and upregulating that of E-cadherin in NSCLC cells, which could effectively reduce the invasive, migratory, and proliferative capacities of lung cancer cells. CONCLUSION: Silence TRIM66 expression suppressed NSCLC cell proliferation, invasion, and migration. The siRNA-mediated TRIM66 silencing could block the occurrence of EMT. TRIM66 could be a promising novel target for future NSCLC treatments.

Association between maternal dietary patterns during pregnancy and risk of ventricular septal defect in offspring / 上海交通大学学报（医学版）

Objective·To examine the association of maternal dietary patterns during pregnancy with the risk of ventricular septal defect (VSD) in offspring.Methods · Seventy-three children with VSD were selected as cases from June 1,2016 to December 1,2016;another 73 children without congenital heart or other defects were selected as controls during the corresponding period.VSD was diagnosed by clinical examination and echocardiography figure.Both cases and controls were recruited from Shanghai Children's Medical Center.All the children's mothers were interviewed using a structured questionnaire,which includes information on demographic characteristics and food frequency during pregnancy.Dietary patterns were defined by the factor analysis module of SPSS 23.0.The association between dietary patterns during pregnancy and VSD risk was analyzed by Logistic regression model.Results · Four dietary patterns were obtained by the factor analysis,i.e.vegetable-fruit-high-quality protein pattern,animal food pattern,high sodium and high fat pattern and aquatic product pattern.After adjusting for possible confounding factors,it was demonstrated that the vegetablefruit-high-quality protein pattern and aquatic product pattern were negatively associated with VSD risk in offspring (P＜0.05).Conclusion · Maternal dietary patterns during pregnancy that are rich in high-quality protein,vegetables,fruit and aquatic products may be helpful for decreasing VSD risk in offspring.

Association between maternal dietary patterns during pregnancy and risk of ventricular septal defect in offspring / 上海交通大学学报（医学版）

Objective: To examine the association of maternal dietary patterns during pregnancy with the risk of ventricular septal defect (VSD) in offspring. Methods: Seventy-three children with VSD were selected as cases from June 1, 2016 to December 1, 2016; another 73 children without congenital heart or other defects were selected as controls during the corresponding period. VSD was diagnosed by clinical examination and echocardiography figure. Both cases and controls were recruited from Shanghai Children's Medical Center. All the children's mothers were interviewed using a structured questionnaire, which includes information on demographic characteristics and food frequency during pregnancy. Dietary patterns were defined by the factor analysis module of SPSS 23.0. The association between dietary patterns during pregnancy and VSD risk was analyzed by Logistic regression model. Results: Four dietary patterns were obtained by the factor analysis, i.e. vegetable-fruit-high-quality protein pattern, animal food pattern, high sodium and high fat pattern and aquatic product pattern. After adjusting for possible confounding factors, it was demonstrated that the vegetablefruit- high-quality protein pattern and aquatic product pattern were negatively associated with VSD risk in offspring (P<0.05). Conclusion: Maternal dietary patterns during pregnancy that are rich in high-quality protein, vegetables, fruit and aquatic products may be helpful for decreasing VSD risk in offspring.

Transcriptome Analyses Shed New Insights into Primary Metabolism and Regulation of Blumeria graminis f. sp. tritici during Conidiation.

Conidia of the obligate biotrophic fungal pathogen Blumeria graminis f. sp. tritici (Bgt) play a vital role in its survival and rapid dispersal. However, little is known about the genetic basis for its asexual reproduction. To uncover the primary metabolic and regulatory events during conidiation, we sequenced the transcriptome of Bgt epiphytic structures at 3 (vegetative hyphae growth), 4 (foot cells initiation), and 5 (conidiophore erection) days post-inoculation (dpi). RNA-seq analyses identified 556 and 404 (combined 685) differentially expressed genes (DEGs) at 4 and 5 dpi compared with their expression levels at 3 dpi, respectively. We found that several genes involved in the conversion from a variety of sugars to glucose, glycolysis, the tricarboxylic acid cycle (TAC), the electron transport chain (ETC), and unsaturated fatty acid oxidation were activated during conidiation, suggesting that more energy supply is required during this process. Moreover, we found that glucose was converted into glycogen, which was accumulated in developing conidiophores, indicating that it could be the primary energy storage molecule in Bgt conidia. Clustering for the expression profiles of 91 regulatory genes showed that calcium (Ca2+), H2O2, and phosphoinositide (PIP) signaling were involved in Bgt conidiation. Furthermore, a strong accumulation of H2O2 in developing conidiophores was detected. Application of EGTA, a Ca2+ chelator, and trifluoperazine dihydrochloride (TFP), a calmodulin (CaM) antagonist, markedly suppressed the generation of H2O2, affected foot cell and conidiophore development and reduced conidia production significantly. These results suggest that Ca2+ and H2O2 signaling play important roles in conidiogenesis and a crosslink between them is present. In addition to some conidiation-related orthologs known in other fungi, such as the velvet complex components, we identified several other novel B. graminis-specific genes that have not been previously found to be implicated in fungal conidiation, reflecting a unique molecular mechanism underlying asexual development of cereal powdery mildews.

Overexpression of Protease Serine 8 Inhibits Glioma Cell Proliferation, Migration, and Invasion via Suppressing the Akt/mTOR Signaling Pathway.

Protease serine 8 (PRSS8), a serine peptidase, has a widespread expression in normal epidermal cells. Recently, many researchers demonstrated downregulation of PRSS8 in cancer tissues as well as its tumor suppressor role in cancer development. However, the biological functions of PRSS8 in glioma remain unclear. In the current study, we demonstrated a decreased expression of PRSS8 in glioma tissues and cell lines. PRSS8 upregulation inhibited glioma cell proliferation, migration, and invasion. In addition, xenograft experiments showed that PRSS8 overexpression suppressed glioma cell growth in vivo. We also found that upregulated PRSS8 reduced the protein expression levels of p-Akt and p-mTOR in glioma cells. Taken together, our study demonstrated that overexpression of PRSS8 inhibited glioma cell proliferation, migration, and invasion via suppressing the Akt/mTOR signaling pathway. Therefore, PRSS8 may act as a novel therapeutic target for glioma.

Clinical comparative analysis of surgical resection of the pregnancy by hysterotomy and hysterectomy for cesarean scar pregnancy / 中华妇产科杂志

Objective To assess the indication and safety of surgical resection of the pregnancy by hysterotomy (SRPH) and hysterectomy for cesarean scar pregnancy (CSP). Methods A retrospective study of women with CSP was conducted at the Women′s Hospital, School of Medicine, Zhejiang University, from Jan. 2003 to Mar. 2016. The women underwent SRPH (SRPH group, n=35) and hysterectomy (Hysterectomy group, n=14) were included. The gestational age (GA), size of gestational mass(GM), level of serum β-hCG, previous treatments and clinical outcomes were analyzed. Results The median GA, the mean size of GM, median serum β-hCG level, median amount of blood loss, rate ot blood transfusion, rate of persistent CSP, and rate of motal status in SRPH group versus Hysterectomy group were 66 versus 84 days, (65 ± 22) versus (92±36) mm, 23755 versus 802 U/L, 400 versus 650 ml, 11%(4/35) versus 13/14, 49%(17/35) versus 12/14, 20% (7/35) versus 14/14, respectively (all P<0.05). In SRPH group, median amount of blood loss was 500 ml in patients with GA≥10 weeks versus 300 ml in patients with GA<10 weeks (P<0.05). Serious complication occurred in 7 patients: severe pelvic inflammation in 1 patient and hematomas in the uterine isthmus in 1 patient in SRPH group; severe pelvic inflammation in 2 patients and hemorrhagic shock and DIC in 3 patients in Hysterectomy group. No blaader damage occurred. Conclusions SRPH is effective and safe for patients with CSP with GA of 9-10 weeks, a diameter of 60-90 mm and stable hemodynamics. Hysterectomy is an alternative to SRPH for patiens in motal status with advanced GA more than 12 weeks.

Clinical analysis on hysteroscopic surgery for the treatment of type Ⅱcesarean scar pregnancy in the first trimester / 中华妇产科杂志

Objective To investigate the safety and efficacy of hysterosopic management of typeⅡcesarean scar pregnancy (CSP) and the value of prophylactic uterine artery embolization (UAE). Methods Totally 104 patients with typeⅡCSP treated with hysteroscopic surgery at the Women′s Hospital,School of Medicine, Zhejiang University, during Jan. 2009 to Jun. 2016 were analyzed retrospectively, 67 patients combined with UAE (UAE group) and 37 patients without combined with UAE (non-UAE group). Laparoscopy or sonography guidance was conducted simultaneously.The following clinical parameters were compared, including: primary cure rate, uterine packing rate, uterine perforation rate, hemoglobin level change,the time for the mass absorption and the return of β-hCG to normal,complications,hospital days and hospital stay cost.Results Median gestational age,size of mass,thickness of the anterior myometrium and β-hCG level in UAE group versus non-UAE group were 47 versus 47 days,30 versus 30 mm,2 versus 2 mm, 36 524 versus 32 226 U/L(all P>0.05).Out of 104,100 patients were managed successfully with hysteroscopic surgery, and 4 patients transformed to laparoscopic or laparotomy surgery. Hysteroscopic surgery was effective in 63 out of 67 patients(94%)in UAE group and 34 out of 37 patients(92%)in non-UAE group(P>0.05). There was no significant differences regarding uterine perforation rate, uterine packing rate, hemoglobin change and recovery time between UAE group and non-UAE group (all P>0.05). The median hospital day was 7 days in UAE group versus 5 days in non-UAE group(P<0.01).The median hospital stay cost was 13 654 yuan in UAE group versus 9 108 yuan in non-UAE group (P<0.01). Serious complication occurred in 4 patients (6%, 4/67) in UAE group and 2 patients (5%, 2/67) in non-UAE group (P=0.906). Conclusions Hysteroscopic surgery is effective and safe for patients with typeⅡCSP in the first trimester with size≤30 mm in diameter and gestation age<7 weeks.The value of prophylactic UAE is uncertain.

Correlation between sentinel polyps and proximal colon carcinoma and analysis of its clinical features / 中国医师杂志

Objective To explore the clinical features of sentinel polyps (rectal polyps with proximal colon carcinoma) and its correlation with proximal colon carcinoma.Methods From January 2011 to June 2015,the clinical features of 331 hospitalized patients with rectal polyps were retrospectively analyzed.According to whether the patient with colon carcinoma,the clinical data of rectal polyps patients were divided into pure polyps group (n =294) and sentinel polyps group (n =37).The characteristics under endoscopy,clinical pathological features,treatment and prognosis of two groups were observed.Results The positive rate of tumor marker of sentinel polyps group was higher (67.6 ％,25/37) than that of pure polyps group (6.8 ％,20/294;x2 =32.174,P ＜ 0.01).When compared to pure polyps group,most polyps of sentinel polyps group were in maximum diameter over 1 cm [62.2％ (23/37) vs 46.9 ％ (138/294)],multi-polyps [n ＞5,43.2％ (16/37)vs11.6％ (34/294)] and adenomatous polyp [83.8 ％ (31/37) vs 35.7 ％ (105/294)] (x2 =10.863,15.686,and 22.653,P ＜0.01).Majority of the proximal colon carcinoma with rectal polyps was papillary adenoearcinoma and tubular adenocarcinoma which was account for 75.7 ％ (28/37);Duke A,29.7％ (11/37),Duke B,29.7％ (11/37),Duke C,24.3％ (9/37) and Duke D,16.2％ (6/37).96.6 ％ (282/294) of patients with pure polyps underwent endoscopic treatment and all of them were cured and discharged.40.5％ (15/37) of patients of sentinel polyps group accepted the radical operation and 24.3％ (9/37) received endoscopic submucosal dissection.Conclusions If multiple,maximum diameter over 1 cm and adenomatous rectal polyps were detected under colon endoscope,the possibility of carcinogenesis of the polyps or the proximal colon should be aware.The patient should be followed up in short-term and complete the whole colon examination.

Randomized controlled study: Sophora flavescens gel in treatment of cervical HPV infection / 中国中药杂志

This study aimed to evaluate the efficacy of Sophora flavescens gel in treatment of cervical HPV infection. 120 patients with cervical HPV infections were selected from department of gynecology, the first affiliated hospital, Heilongjiang university of Chinese medicine. They were randomly divided into three groups: test group(S. flavescens gel, 40 cases), control group(human recombinant interferon α-2b gel, 40 cases) and combined application group(combination of the above two, 40 cases). The treatment course was three months in all three groups. Before and after treatment, the changes of HPV viral load and the changes of viral load for different HPV types were observed.The results could provide guidance for clinical application of S. flavescens gel.

Meta-analysis of the association between GSTT1 and the susceptibility to colorectal cancer among ;Chinese population / 国际肿瘤学杂志

Objective To assess the association between glutathione S-transferase T1 (GSTT1 )gene and the susceptibility of colorectal cancer among Chinese population.Methods Clinical controlled trials of the association between GSTT1 and the susceptibility of colorectal cancer among Chinese population were searched in PubMed,EMBase,Cochrane Library,China Biology Medicine disc,VIP database,China National Knowledge Infrastructure and Wanfang database.According to the inclusion and exclusion criteria,data extraction and quali-ty assessment were done by two researchers independently.Outcomes were pooled with RevMan 5.1 .Results 326 studies were found and 10 clinical controlled trails including 2 983 cases of colorectal cancer and 4 386 cases of healthy objects were included in this analysis.The results of Meta-analysis showed that the lack of GSTT1 gene is associated with colorectal cancer susceptibility (RR =1 .11 ,95%CI:1 .06-1 .17,Z =4.26,P <0.000 1 ). Conclusion The loss of GSTT1 increase the risk of colorectal cancer among Chinese population.