Clinical Outcomes and Prognostic Factors in Stage III C Cervical Cancer Patients Treated with Radical Radiotherapy or Radiochemotherapy.

Objective: Since the update of the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria, there have been few reports on the prognosis of stage III C cervical cancer. Moreover, some studies have drawn controversial conclusions, necessitating further verification. This study aims to evaluate the clinical outcomes and determine the prognostic factors for stage III C cervical cancer patients treated with radical radiotherapy or radiochemotherapy. Methods: The data of 117 stage III C cervical cancer patients (98 III C1 and 19 III C2) who underwent radical radiotherapy or radiochemotherapy were retrospectively analyzed. We evaluated 3-year overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. Prognostic factors were analyzed using the Log-rank test and Cox proportional hazard regression model. The risk of para-aortic lymph node metastasis (LNM) in all patients was assessed through Chi-squared test and logistic regression analysis. Results: For stage III C1 and III C2 patients, the 3-year OS rates were 77.6% and 63.2% (P = .042), and the 3-year DFS rates were 70.4% and 47.4% (P = .003), respectively. The pretreatment location of pelvic LNM, histological type, and FIGO stage was associated with OS (P = .033, .003, .042, respectively); the number of pelvic LNM and FIGO stage were associated with DFS (P = .015, .003, respectively). The histological type was an independent prognostic indicator for OS, and the numbers of pelvic LNM and FIGO stage were independent prognostic indicators for DFS. Furthermore, a pelvic LNM largest short-axis diameter ≥ 1.5 cm and the presence of common iliac LNM were identified as high-risk factors influencing para-aortic LNM in stage III C patients (P = .046, .006, respectively). Conclusions: The results of this study validated the 2018 FIGO staging criteria for stage III C cervical cancer patients undergoing concurrent chemoradiotherapy. These findings may enhance our understanding of the updated staging criteria and contribute to better management of patients in stage III C.

Modified gradual ulnar lengthening for treatment of Masada type IIb forearm deformity in children with hereditary multiple osteochondromas.

Objective: To investigate the effect of modified gradual ulnar lengthening in the treatment of Masada type IIb forearm deformity in children with hereditary multiple osteochondromas (HMO). Patients and methods: From May 2015 to October 2020, 12 children with Masada type IIb forearm deformity caused by HMO underwent modified gradual ulnar lengthening in our hospital. Clinical and imaging data were retrospectively analyzed. Clinical evaluation included wrist flexion and extension, wrist ulnar and radial deviation, forearm pronation and supination, and elbow range of motion. The radiographic parameters measured included the radial articular angle, carpal slip, and relative ulnar shortening. Results: The mean operative age of the 12 patients (9 male, 3 female) was 8.5 ± 2.7 years, the mean follow-up was 31.5 ± 5.7 months, and the mean ulnar lengthening was 43.3 ± 9.9 mm. There was no significant difference in the radial articular angle between the preoperative period and the last follow-up (from 36.5° ± 9.2° to 33.8° ± 5.1°, p > 0.05). However, significant changes were found in carpal slip (from 61.3% ± 18.8% to 33.8% ± 20.8%) and relative ulnar shortening (from 5.8 ± 3.5 mm to -0.9 ± 4.85 mm) (p < 0.05). The range of motion significantly improved after modified gradual ulnar lengthening, including wrist flexion (from 38.3° ± 6.2° to 55.8° ± 9.0°), wrist extension (from 45.0° ± 9.8° to 61.7° ± 8.1°), wrist ulnar deviation (from 41.3° ± 8.6° to 29.6° ± 7.8°), wrist radial deviation (from 18.3° ± 6.2° to 30.0° ± 5.6°), forearm pronation (from 44.6° ± 7.2° to 62.1° ± 8.6°), forearm supination (from 50.0° ± 7.1° to 52.9° ± 6.6°), and elbow range of motion (from 117.1° ± 10.1° to 127.9° ± 5.4°) (all p < 0.05). During follow-up, there was one case of needle tract infection and one case of bone nonunion. Conclusion: Modified gradual ulnar lengthening can effectively treat Masada type IIb forearm deformity caused by HMO and improve forearm function.

Medium-term and Long-term Follow-up Surgical Outcomes of the 1-stage Posterior-only Lumbosacral Hemivertebra Resection With Short-segment Fusion in Children.

BACKGROUND: The objective of this study was to evaluate the medium-term and long-term surgical outcomes of the 1-stage posterior-only lumbosacral hemivertebra resection with short-segment fusion in children. METHODS: This retrospective chart review included 21 children with congenital scoliosis due to lumbosacral hemivertebra who received 1-stage posterior-only hemivertebra resection with short-segment fusion from 2012 to 2016 with at least 5 years of follow-up. Standing anteroposterior and lateral radiographs of the spine were compared preoperatively, postoperatively, and at last follow-up. Radiographic evaluation included measured changes in segmental scoliosis and lordosis, compensatory scoliosis, thoracic kyphosis, lumbar lordosis, trunk shift, and sagittal spinopelvic alignment. RESULTS: There were 12 boys and 9 girls with a mean age of 6.5±3.2 years. The mean follow-up period was 6.7±1.3 years. The mean fusion level was 2.7±0.9 segments. The mean segmental scoliosis was 29±6 degrees preoperatively, 9±3 degrees (correction rate of 71%) postoperatively ( P <0.05), and 7±3 degrees (correction rate of 76%) at the latest follow-up. The compensatory curve of 26±12 degrees was spontaneously corrected to 14±8 degrees (correction rate of 47%) at last follow-up ( P <0.05). Trunk shift was significantly improved on both coronal (53%) and sagittal (56%) planes after surgery ( P 0.05) and stable at follow-up. The sagittal spinopelvic alignment was balanced in all cases. There were no neurological or infectious complications. CONCLUSIONS: It is safe and effective to perform 1-stage posterior-only lumbosacral hemivertebra resection with short-segment fusion, which can significantly correct the segmental scoliosis, prevent the compensatory curve progress and improve the trunk shift. This strategy also can save motion segments and avoid long lumbar fusion. Medium-term and long-term follow-up outcomes are satisfactory. LEVEL OF EVIDENCE: Level III.

Prognostic factors for IB2-IIIB cervical cancer patients treated by radiation therapy with high-dose-rate brachytherapy in a single-institution study.

Purpose: To evaluate the efficacy of radiotherapy in locally advanced cervical cancer, and to determine the factors affecting prognosis. Material and methods: Clinical data of 211 patients with cervical cancer, treated at our institution between June 2014 and February 2017 were reviewed retrospectively. All patients were treated with definitive radiotherapy and received external irradiation of 45-50.4 Gy. High-dose-rate brachytherapy (HDR-BT) of 24-36 Gy was prescribed to a high-risk clinical target volume (HR-CTV) as a local boost. All statistical analyses were performed with SPSS version 19.0 using Kaplan-Meier survival test and Cox regression analysis. Additionally, dose parameters of patients with IIIB stage treated with combined intracavitary/interstitial (IC/IS) implants were compared with IC only. Results: With a median follow-up time of 69 months, local control (LC), overall survival (OS), disease-free survival (DFS), and nodal control (NC) at 5 years were 89%, 78%, 67%, and 88%, respectively. In multivariate analysis, the major determinant of LC was the level of pre-treatment squamous cell carcinoma antigen (SCC-Ag). The predictors of shorter OS were adenocarcinoma, pre-treatment SCC-Ag, and FIGO stage. Worse DFS was associated with adenocarcinoma, pre-treatment SCC-Ag, and involved lymph nodes. The predictors for nodal failure were positive pelvic lymph nodes. Patients with IIIB treated with IC/IS brachytherapy tended to improve DFS compared with IC alone, and obtained similar HR-CTV D90 EQD2 (n = 10) and biological effective dose (BED), 91 ±6 Gy vs. 89 ±3 Gy, and 107 ±4.5 Gy vs. 107 ±5.6 Gy, whereas decreased organs at risk (OARs) doses, including rectum and bladder D2cm3 were 7.5 Gy and 7.2 Gy lower, respectively. Late grade 3-4 bladder and bowel toxicities were observed in 1.9% of patients. Conclusions: Radiation therapy carried out in our institution results in good survival, with acceptable toxicity in locally advanced cervical cancer. Different individualized therapeutic strategies should be considered for patients with high-risk factors.

Effects of adding eubiotic lignocellulose on the performance, the gut microbiota, and short-chain fatty acids of layer chickens.

The eubiotic lignocellulose has to be proven a useful source of dietary fiber. Dietary fiber is broken down into monosaccharides and then is fermented into short-chain fatty acids (SCFAs) by gut microorganisms of chickens. However, research on impacts of it on the gut microbiota of chickens was limited. Given this, three different levels (0%, 1%, and 2%) of eubiotic lignocellulose were added to the feed of ISA brown hens for 0-8 weeks, with the aim of observing the impacts of it on the performance, gut microbiota, and SCFAs. The results showed that there were no significant effects on the performance and the development of the cecum (P > 0.05); however, added eubiotic lignocellulose increased the relative abundance of the most excellent fiber-degradation species Bacteroides thetaiotaomicron and fiber digestibility (P < 0.05). The addition of 1% significantly increased Lactobacillus panis and Oscillospira (P < 0.05), resulting in increasing of the production of SCFAs. Adding 1% eubiotic lignocellulose is appropriate in this experiment, but one or more group less than 1% (e.g., 0.75%, 0.5%, or 0.25%) should be set to verify the impact and determine a more appropriate amount of it added in the feed of chickens between 0 and 8 weeks in the future.

FOXA1 Leads to Aberrant Expression of SIX4 Affecting Cervical Cancer Cell Growth and Chemoresistance.

Cervical cancer (CC) is among the most prevalent cancers among female populations with high recurrence rates all over the world. Cisplatin (DDP) is the first-line treatment for multiple cancers, including CC. The main problem associated with its clinical application is drug resistance. This study is aimed at investigating the function and downstream regulation mechanism of forkhead-box A1 (FOXA1) in CC, which was verified as an oncogene in several cancers. Using GEO database and bioinformatics analysis, we identified FOXA1 as a possible oncogene in CC. Silencing of FOXA1 inhibited CC cell growth, invasion, and chemoresistance. Afterwards, the downstream gene of FOXA1 was predicted using a bioinformatics website and validated using ChIP and dual-luciferase assays. SIX4, a possible target of FOXA1, promoted CC cell malignant aggressiveness and chemoresistance. In addition, overexpression of SIX4 promoted phosphorylation of PI3K and AKT proteins and activated the PI3K/AKT signaling pathway. Further overexpression of SIX4 reversed the repressive effects of FOXA1 knockdown on CC cell growth, invasion, and chemoresistance in DDP-resistant cells. FOXA1-induced SIX4 facilitates CC progression and chemoresistance, highlighting a strong potential for FOXA1 to serve as a promising therapeutic target in CC.

Utilization of intraoperative neuromonitoring during the Woodward procedure for treatment of Sprengel deformity.

BACKGROUND: Brachial plexus injury (BPI) leading to palsy of the upper extremities is the most serious complication of the Woodward procedure for treatment of Sprengel deformity. Intraoperative neuromonitoring (IONM) is widely used for detecting emerging spinal cord or peripheral nerve injury during spinal and shoulder surgery. However, to date, its utilization in pediatric patients with Sprengel deformity is limited. Furthermore, it remains unclear whether IONM can help prevent BPI during surgery. The purpose of the current study was to assess the feasibility and effectiveness of IONM for early identification and prevention of nerve injury during the Woodward procedure. METHODS: We retrospectively reviewed the records of patients who underwent the Woodward procedure for Sprengel deformity at our institution between January 2017 and January 2020. IONM, including somatosensory evoked potentials (SEP) and motor evoked potentials (MEPs), was performed in all patients. Detailed IONM data were collected and analyzed. Preoperative and postoperative cosmetic appearance (according to the Cavendish classification), shoulder joint abduction function, and radiologic evaluation of the scapula were reviewed. Surgical complications were recorded. RESULTS: Forty-six patients (19 girls, 27 boys) were included (mean age, 5.1 ± 2.1 years). Both SEP and MEP (amplitude of the abductor pollicis) were successfully performed (100%). MEP alerts occurred in 3 patients (6.5%). After scapula position adjustment, signals recovered in 2 patients and remained unchanged in 1 patient-this patient exhibited postoperative motor deficits that resolved completely by 4 months recovery. The SEP amplitudes decreased in all 3 patients but did not reach the warning criteria. Forty patients were classified as grade III and 6 as grade IV in the Cavendish classification, whereas 35 patients were classified as grade II and 11 as grade III in the Rigault scale. The preoperative Cavendish grade was III (III, IV) and the postoperative Cavendish grade was I (I, II) (χ2 = 88.098, P < .001). The preoperative Rigault grade was II (II, III) and the postoperative Rigault grade was I (I, II) (χ2 = 62.133, P < .001). The mean arc of shoulder joint abduction improved from 99° ± 8° to 167° ± 7° (t = -45.871, P < .001) after surgery. Except for temporary motor deficits detected in 1 patient, no other postoperative complications were observed through the time of final follow-up. CONCLUSION: IONM during the Woodward procedure for Sprengel deformity is feasible and effective in detecting intraoperative neurologic changes and may be effective in preventing BPI associated with surgery.

Surgical Treatment of the Intraspinal Rib Head Dislocation in Children With Dystrophic Scoliosis Secondary to Type 1 Neurofibromatosis.

BACKGROUND: The purpose of this study was to explore the surgical treatment of intraspinal rib head dislocation (IRH) in children with dystrophic scoliosis secondary to type 1 neurofibromatosis (NF1-DS). METHODS: From 2006 to 2019, 32 of 128 patients with NF1-DS were found to have IRH and enrolled in this study. There were 19 boys and 13 girls with an average age of 8.8±2.6 years. Patients were divided into 2 groups: group A (n=25) without IRH resection and group B (n=7) with IRH resection. The intraspinal rib proportion (IRP), apical vertebra rotation, apical vertebral translation, main thoracic curve Cobb angle, trunk shift and thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were measured before and after the operation. Spinal injury was graded based on the American Spinal Injury Association (ASIA) Impairment Scale. RESULTS: The study group had a total of 42 IRH. The mean follow-up duration was 46.1±28.7 months. The preoperative IRP in both groups was similar (35.5±14.3% vs. 31.2±15.3%, P=0.522). The postoperative IRP was lower in group B (18.5±11.2% vs. 0%, P=0.002). The IRP in group A decreased from preoperative (31.2±15.3%) to postoperative (18.5±11.2%) (P<0.05). There was no significant difference in the apical vertebra rotation, apical vertebral translation, main thoracic curve Cobb angle, trunk shift, thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis between the 2 groups before surgery and after surgery. Four patients with nerve injury caused by the IRH had full neurological recovery postoperatively. All patients were ASIA grade E at the last follow-up. CONCLUSIONS: The surgical treatment of IRH in children with NF1-DS should be determined on the basis of the presence of preoperative neurological symptoms. This study supports the practice of correcting spinal deformities only in patients with mild or no spinal cord injury. If there are obvious neurological symptoms, IRH resection is necessary to relieve spinal cord compression to recover nerve function. LEVEL OF EVIDENCE: Level III.

Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring.

Flash glucose monitoring (FGM) was introduced in China in 2016, and it might improve HbA1c measurements and reduce glycaemic variability during T1DM therapy. A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. The patients were randomly divided into the FGM group or self-monitoring blood glucose (SMBG) group. Both groups wore the FGM device for multiple 2-week periods, beginning with the 1st, 24th, and 48th weeks for gathering data, while blood samples were also collected for HbA1c measurement. Dietary guidance and insulin dose adjustments were provided to the FGM group patients according to their Ambulatory Glucose Profile (AGP) and to the SMBG group patients according to their SMBG measurements taken 3-4 times daily. All of the participants underwent SMBG measurements on the days when not wearing the FGM device. At the final visit, HbA1c, time in range (TIR), duration of hypoglycaemia and the number of diabetic ketoacidosis (DKA) events were taken as the main endpoints. There were no significant difference in the baseline characteristics of the two groups. At 24 weeks, the HbA1c level of the FGM group was 8.16 ± 1.03%, which was much lower than that of the SMBG group (8.68 ± 1.01%) (p = 0.003). The interquartile range (IQR), mean blood glucose (MBG), and the duration of hypoglycaemia in the FGM group also showed significant declines, compared with the SMBG group (p < 0.05), while the TIR increased in the FGM group [(49.39 ± 17.54)% vs (42.44 ± 15.49)%] (p = 0.012). At 48 weeks, the differences were more pronounced (p < 0.01). There were no observed changes in the number of episodes of DKA by the end of the study [(0.25 ± 0.50) vs (0.28 ± 0.51), p = 0.75]. Intermittent use of FGM by T1DM patients can improve their HbA1c and glycaemic control without increasing the hypoglycaemic exposure in insulin-treated individuals with type 1 diabetes in an developing country.

Chinese Expert Consensus on Iodine125 Seed Implantation for Recurrent Cervical Cancer in 2021.

The treatment modality for recurrent cervical cancer (rCC) is limited, and the prognosis of these patients is poor. Seed implantation could be an important component of rCC management in the context of dose boost or salvage therapy after surgery or radiotherapy, which is characterized by a minimally invasive, high local dose, and rapidly does fall, sparing normal tissue. For patients with good performance status and lateral pelvic wall recurrence with an available puncture path, seed implantation was recommended, as well as for selected central pelvic recurrence and extra-pelvic recurrence. The combination of brachytherapy treatment planning system and CT guidance was needed, and three-dimensional printing templates could greatly improve the accuracy, efficiency, and quality of seed implantation to achieve a potential ablative effect and provide an efficient treatment for rCC. However, the recommendations of seed implantation were mainly based on retrospective articles and lack high-quality evidence, and multicenter prospective randomized studies are needed. In this consensus on iodine125 seed implantation for rCC, indication selection, technical process and requirements, dosimetry criteria, radiation protection, combined systemic therapy, and outcomes of seed implantation for rCC are discussed.

Effects of Adding Eubiotic Lignocellulose on the Growth Performance, Laying Performance, Gut Microbiota, and Short-Chain Fatty Acids of Two Breeds of Hens.

Eubiotic lignocellulose is a new and useful dietary fiber source for chickens. However, few studies have been undertaken on the impacts of its use as a supplement in different chicken breeds. In this experiment, 108 Chinese native breed Bian hens (BH) and 108 commercial breed ISA Brown hens (IBH) were chosen. They were randomly divided into three groups, and 0, 2, or 4% eubiotic lignocellulose was added to their feed during the growing periods (9-20 weeks), respectively. We aimed to observe the impacts of adding eubiotic lignocellulose on the growth and laying performance, gut microbiota, and short-chain fatty acid (SCFA) of two breeds of hens. In this study, the addition of eubiotic lignocellulose had no significant effect on the growth performance and gut microbial diversity in the two breeds of chickens (P > 0.05). Compared with the control group, adding 4% eubiotic lignocellulose significantly increased the cecum weight, laying performance (P < 0.05), but had no significant effect on the SCFA of BH (P > 0.05); however, adding 4% significantly inhibited the intestinal development, laying performance, butyrate concentration, and SCFA content of IBH (P < 0.05). Moreover, the relative abundances of the fiber-degrading bacteria Alloprevotella and butyrate-producing bacteria Fusobacterium in the 4% group of BH were significantly higher than those in the 4% group of IBH (P < 0.05), resulting in the concentration of butyrate was significantly higher than those in it (P < 0.05). Combining these results suggests that the tolerance of BH to a high level of eubiotic lignocellulose is greater than that of IBH and adding 2-4% eubiotic lignocellulose is appropriate for BH, while 0-2% eubiotic lignocellulose is appropriate for IBH.

The Development of the Gut Microbiota and Short-Chain Fatty Acids of Layer Chickens in Different Growth Periods.

A long-term observation of changes of the gut microbiota and its metabolites would be beneficial to improving the production performance of chickens. Given this, 1-day-old chickens were chosen in this study, with the aim of observing the development of the gut microbiota and gut microbial function using 16S rRNA gene sequencing and metabolites short-chain fatty acids (SCFAs) from 8 to 50 weeks. The results showed that the relative abundances of Firmicutes and genus Alistipes were higher and fiber-degradation bacteria were less at 8 weeks compared with 20 and 50 weeks (P < 0.05). Consistently, gut microbial function was enriched in ATP-binding cassette transporters, the energy metabolism pathway, and amino acid metabolism pathway at 8 weeks. In contrast, the abundance of Bacteroidetes and some SCFA-producing bacteria and fiber-degradation bacteria significantly increased at 20 and 50 weeks compared with 8 weeks (P < 0.05), and the two-component system, glycoside hydrolase and carbohydrate metabolism pathway, was significantly increased with age. The concentration of SCFAs in the cecum at 20 weeks was higher than at 8 weeks (P < 0.01), because the level of fiber and the number of dominant fiber-degradation bacteria and SCFA-producing bacteria were more those at 20 weeks. Notably, although operational taxonomic units (OTUs) and the gut microbial α-diversity including Chao1 and abundance-based coverage estimator (ACE) were higher at 50 than 20 weeks (P < 0.01), the concentration of SCFAs at 50 weeks was lower than at 20 weeks (P < 0.01), suggesting that an overly high level of microbial diversity may not be beneficial to the production of SCFAs.

Reliability and Validity of the Simplified Chinese Early-onset Scoliosis Quality of Life 24-item Questionnaire.

STUDY DESIGN: Questionnaire translation and validation. OBJECTIVE: The aim of this study was to translate the Early-Onset Scoliosis 24-Item Questionnaire (EOSQ-24) into simplified Chinese and to evaluate the reliability and validity of this questionnaire in children with early-onset scoliosis (EOS) in mainland China. SUMMARY OF BACKGROUND DATA: The EOSQ-24 is a validated quality of life questionnaire in children with EOS and has been translated into multiple languages and used worldwide. However, there is currently no simplified Chinese version available for use in mainland China. METHODS: The English version of the EOSQ-24 questionnaire was translated into simplified Chinese based on the recommendations of the International Quality of Life Assessment (IQoLA) group. The reliability of the scale was evaluated using test-retest reliability and internal consistency, and construct validity was examined through factor analysis. Hundred childrenwith EOS were enrolled in the study. To assess the test-retest reliability of the scale, the parents or caregivers of 38 of participants repeated the questionnaire after 2 weeks. RESULTS: Test-retest reliability was excellent overall (intraclass correlation coefficient [ICC] = 0.935) and ranged from moderate to excellent for each domain (ICC = 0.681-0.945). The overall internal consistency was excellent (Cronbach α = 0.893) and had a variable range for each domain (Cronbach α = 0.560-0.889). Factor analysis was performed, and seven principal components were extracted that accounted for 70.1% of the variance. CONCLUSION: The simplified Chinese version of the EOSQ-24 scale has acceptable reliability and construct validity, and it can be used for the assessment of health-related quality of life (HRQL), caretaker burden, and satisfaction for children with EOS in mainland China.Level of Evidence: 3.

Ovatodiolide exerts anticancer effects on human cervical cancer cells via mitotic catastrophe, apoptosis and inhibition of NF-kB pathway.

PURPOSE: Being the second most prevalent cancer in females, cervical cancer causes significant mortality across the globe. Owing to the adverse effects and inefficiency of the currently used anticancer drugs, there are increasing efforts for the identification of safer and effective anticancer agents from plants. This study was undertaken to investigate the anticancer effects of Ovatodiolide, a plant-derived macrocyclic diterpenoid, against the human cervical cancer. METHODS: The anticancer effects were examined by WST-1 proliferation assay. DAPI and annexin V/propidium iodide (PI) staining were used for apoptosis detection. Flow cytometry was used for cell cycle analysis. Protein expression was used for cell cycle analysis. RESULTS: The results revealed that Ovatodiolide caused inhibition of the viability of all the cervical cancer cells with IC50 ranging from to 14 to 56 µM. Ovatodiolide exerted more profound antiproliferative effects on the DoTc2 cells with and IC50 of 14 µM. However, minimal cytotoxicity was observed for the normal cervical cells as evidenced from the IC50 of 100 µM. Ovatodiolide triggered apoptotic cell death of the DoTc2 cells. The induction of apoptosis was accompanied with increase in Bax and decrease in Bcl-2 expression. Ovatodiolide also caused arrest of the DoTc2 cells at the G2/M phase of the cell cycle, which was also accompanied with suppression of cyclin B1 expression. Investigation of the effects of Ovatodiolide on NF-kB expression revealed that the molecule caused significant decrease in the expression of the NF-kB expression. CONCLUSION: Taken together, Ovatodiolide may prove a lead molecule for the development of systemic therapy for cervical cancer.

Effects of Added Dietary Fiber and Rearing System on the Gut Microbial Diversity and Gut Health of Chickens.

It is of merit to study the appropriate amount of dietary fiber to add to free-range chickens' feed to improve their microbial diversity and gut health in times of plant fiber deprivation. Lignocellulose is a useful source of dietary fiber, and its positive effects on the growth performance and laying performance of chickens has already been proven. However, few researchers have researched the effects of adding it on the gut microbiota of chickens. In this research, we added three different levels of eubiotic lignocellulose (0%, 2%, and 4%) to the feed of caged and free-range Bian chickens from September to November, aiming to observe the effects of added dietary fiber and different rearing systems on the gut microbial diversity and gut health of chickens, as well as to determine an appropriate amount of lignocellulose. The results showed that adding dietary fiber increased the thickness of the cecum mucus layer and the abundance of Faecalibacterium and Faecalibacterium in caged chickens, and 4% lignocellulose was appropriate. In addition, adding lignocellulose increased the microbial diversity and the abundance of the butyrate-producing bacteria Faecalibacterium and Roseburia in fee-range chickens. The α-diversity and the length of the small intestine with 2% lignocellulose in free-range chickens were better than with 2% lignocellulose in caged chickens. Maybe it is necessary to add dietary fiber to the feed of free-range chickens when plant fibers are lacking, and 2% lignocellulose was found to be appropriate in this experiment. In addition, compared with caged chickens, the free-range chickens had a longer small intestine and a lower glucagon like peptide-1 (GLP-1) level. The significant difference of GLP-1 levels was mainly driven by energy rather than short chain fatty acids (SCFAs). There was no interaction between added dietary fiber and the rearing system on SCFAs, cecum inner mucus layer, and GLP-1.

MicroRNA-877 is downregulated in cervical cancer and directly targets MACC1 to inhibit cell proliferation and invasion.

Previously, a number of microRNAs (miRNAs) have been reported to be dysregulated in cervical cancer, and dysregulated miRNAs may play crucial roles in the development and progression of cervical cancer. Hence, investigating the detailed roles of miRNAs that are aberrantly expressed in cervical cancer and the underlying molecular mechanisms is essential for early diagnosis and effective therapeutic approaches. miRNA-877 (miR-877) was found to be downregulated in hepatocellular carcinoma and renal cell carcinoma, and function as a tumor-suppressive miRNA. However, how miR-877 exerts an effect in cervical cancer progression and its underlying molecular mechanisms remains to be elucidated. In the current study, reverse transcription-quantitative PCR was performed to determine miR-877 expression in cervical cancer tissues and cell lines. The effects of miR-877 overexpression on cervical cancer cell proliferation and invasion were evaluated using MTT and Transwell cell invasion assays. In the present study, miR-877 was significantly downregulated in cervical cancer tissues and cell lines, and the decreased expression levels of miR-877 were significantly associated with increased International Federation of Gynecology and Obstetric stage as well as increased lymph node metastasis in patients with cervical cancer. Upregulation of miR-877 using miR-877 mimics resulted in the decreased proliferation and invasion of cervical cancer cells. Metastasis-associated in colon cancer-1 (MACC1) was assessed using bioinformatics analyses to determine whether it could be a potential target gene of miR-877, and the results were confirmed using a luciferase reporter assay. Furthermore, MACC1 was markedly upregulated in cervical cancer tissues, and its level was negatively correlated with the miR-877 level. Overexpression of miR-877 resulted in decreased expression levels of MACC1 in cervical cancer cells at both the mRNA and protein levels. In addition, the functional effects of MACC1 knockdown were similar to those induced by upregulated miR-877 in cervical cancer cells. MACC1 restored miR-877 overexpression-mediated suppression of cervical cancer cell proliferation and invasion. In conclusion, miR-877 may play an antitumor role in cervical cancer by directly targeting MACC1, which suggests that this miRNA may be a promising therapeutic target for the treatment of patients with such an aggressive gynecological cancer.

Surgical Treatment of Dystrophic Scoliosis in Neurofibromatosis Type 1: Outcomes and Complications.

STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To investigate surgical outcomes and instrumentation-related complications (IRCs) of dystrophic scoliosis associated with neurofibromatosis type 1 (NF-1). SUMMARY OF BACKGROUND DATA: Surgical management, including the growing rod technique and early definitive fusion, has been recommended to avoid progression of NF-1 scoliosis. However, no study has investigated the outcomes and complications of different surgical interventions. MATERIALS AND METHODS: We performed a retrospective review of a cohort of 59 patients diagnosed with NF-1 dystrophic scoliosis and treated surgically. All clinical and radiographic data within a 3-year follow-up period were collected. The patients were divided into 2 groups according to the surgical procedure used: those who underwent initial fusion surgery were assigned to group A (n=32) and those who underwent growing rod surgery to group B (n=27). RESULTS: Patients in group A were older than those in group B at the initial surgery (10.4 vs. 5.8 y; P<0.001). There was no difference in the sex ratio, preoperative Cobb angle, or preoperative kyphosis angle between the 2 groups (P>0.05). The correction rate of the main curve Cobb angle was higher in group A than B (55.1% vs. 42.4%; P<0.05). The incidence of IRC was higher in group B than A (48.1% vs. 12.5%; P<0.05). Complications in group A comprised 1 case of screw pullout, 1 case of rod breakage, 1 case of adding-on phenomenon, and 1 case of proximal junctional kyphosis. Complications in group B comprised 5 cases of adding-on phenomenon, 4 cases of trunk shift, 3 cases of curve progression, 1 case of rod breakage, and 1 case of cap loosening. CONCLUSIONS: The use of growing rod effectively controls the spinal deformity and facilitates growth of the spine. Compared with fusion surgery, however, growing rod surgery yields a higher incidence of IRCs and lower corrective rate for scoliosis associated with NF-1.

Diagnostic Value of the Survivin Autoantibody in Four Types of Malignancies.

BACKGROUND: Tumor-associated antigen overexpression, which has been reported in many types of cancers, may trigger autoantibody secretion. The present study was designed to test whether levels of circulating autoantibodies to survivin protein-derived antigens is altered in liver, esophageal, breast, and lung cancers. METHODS: Patients with liver (144), esophageal (159), breast (124), and lung cancers (267), and healthy volunteers (362) were recruited for the study, and serum samples were collected for ELISA autoantibody analysis. RESULTS: Compared with the control group, survivin autoantibody levels were significantly higher in serum from patients with breast cancer and lung cancer, but were significantly lower in serum from patients with liver cancer (p < 0.05). In stage I and II lung cancer, the best-fit areas under the receiver operating characteristic curve was 0.731 (standard error [SE] = 0.023; 95% confidence interval [CI] 0.687-0.776) and the sensitivity, with 90% specificity, was 23.7%. CONCLUSION: Analysis across four types of malignancies revealed that the survivin autoantibody had good specificity and sensitivity in lung cancer. Circulating autoantibodies to survivin could be a potential biomarker for the early lung cancer diagnosis.

The therapeutic characteristics of serial casting on congenital scoliosis: a comparison with non-congenital cases from a single-center experience.

BACKGROUND: The therapeutic efficacy of serial casting on idiopathic scoliosis has been gradually documented. However, literatures on serial casting for congenital scoliosis (CS) remain extremely rare. This paper aimed to compare the treatment outcomes of serial casting between CS and non-CS patients to comprehensively evaluate the therapeutic characteristics of serial casting on CS patients. METHODS: A total of 23 early-onset scoliosis cases were included and divided into congenital scoliosis (CS, n = 8) and non-congenital group (non-CS, n = 15). Therapeutic outcomes including the major curve Cobb angle, thoracic kyphosis angle, lumbar lodosis angle, and thoracic spine growing rate were compared between groups at precast, after the first cast, and at the latest follow-up, respectively. RESULTS: All patients received the first cast at the age of 3.25 ± 1.20 years and 5.70 ± 1.18 times of cast corrections. The average casting time was 17.17 ± 3.38 months, and the mean follow-up time was 23.91 ± 12.28 months. Both CS and non-CS groups had significant decrease in Cobb angle after the first cast and at the latest follow-up (all P < 0.05). Cobb angle was significantly lower in non-CS group than in CS group at both time points (all P < 0.01). The correction rate of Cobb angle was significantly higher in non-CS group than in CS group (around 50 vs. 20%, both P < 0.01). The mean thoracic growth rate was significantly lower in CS group than in non-CS group (0.72 ± 0.20 vs. 1.42 ± 0.22 cm/year, P < 0.001). At the latest follow-up, there are 2 cases receiving growing rod surgery, 8 cases wearing a brace, and 13 cases continuing serial casting. CONCLUSIONS: Although the therapeutic efficacy of casting on CS patients is not as good as that on non-CS patients, casting is still an efficient treatment option for CS patients to delay the need for initial surgery.

Detecting of p16 Autoantibody as a Potential Early Diagnostic Serum Biomarker in Patients with Cervical Cancer.

BACKGROUND: Over-expression of tumor-associated antigens (TAAs) may trigger secretion of their auto-antibodies. The present work was designed to test whether circulating antibody to P16 protein-derived antigens was altered in cervical cancer. METHODS: 141 cases of cervical cancer patients, 133 cases of cervical benign tumor patients, and 153 healthy volunteers matched in age were recruited. The level of circulating P16 auto-antibody was tested using an ELISA developed in-house with linear peptide antigens derived from the P16 protein. RESULTS: The P16 auto-antibody in the malignant tumor group had a significantly higher level than the healthy control group and the benign tumor group (t = 4.016, p < 0.001; t = 3.879, p < 0.001). Patients with stage I cervical cancer have the highest level of P16 autoantibody and the sensitivity against > 90% specificity was 20.3%. CONCLUSIONS: The circulating auto-antibody to P16 may be one of a series of potential biomarkers with early prognostic values for cervical cancer.