Objective · To investigate the performance of transvaginal ultrasound (TVS) on cesarean scar pregnancy (CSP), and evaluate the value of TVS combined with MRI in the diagnosis and treatment of CSP. Methods · A retrospective analysis was made in 42 patients with CSP in Shanghai General Hospital in recent 3 years. The TVS performance, MRI results, and clinical data of the patients were analyzed. Results · In all 42 cases, 36 were diagnosed as CPS. TVS missed one case, and misdiagnosed 5 cases, which diagnostic accuracy was 85.7%. Thirty-six cases were tested by MRI, therein 32 cases were diagnosed correctly, 3 cases missed, 1 case misdiagnosed, which diagnostic accuracy rate was 88.9%. Among the 36 CSP cases, 30 were simple sac type and 6 were mixedmass type. For the simple sac type, different treatment was chosen according to the muscle thickness of the lower uterine segment incision measured by TVS. When it was more than 3 mm, suction surgery was used. But when it was no more than 3 mm, MRI examination was further used, and the surgical resection or uterine artery embolism+MTX+suction surgery was chosen. Conclusion · Both TVS and MRI have a high diagnostic accuracy for CSP, and TVS combined with MRI can provide important reference for CSP treatment options.

Objective · To evaluate the effect of phacoemulsification combining with intraocular lens (IOL) implantation in cataract patients with Fuchs endothelial corneal dystrophy (FECD) and high myopia. Methods · Five patients (9 eyes) diagnosed with FECD and high myopia were collected retrospectively at Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to February 2016. All the 9 eyes underwent phacoemulsification combining with IOL implantation. Visual acuity, intraocular pressure, corneal endothelial cell density (CD) and central corneal thickness (CCT) were evaluated. Paired t-test was performed to evaluate the differences. Results · 88.89% (8/9) of the vision of the patients was improved, the best corrected visual acuity improved at least 2 lines. The intraocular pressure had no statistically significant difference before and after the operation (t=-1.066, P=0.318). The preoperative and postoperative CDs were (2184.25±196.44) cells/mm2 and (1910.0±83.41) cells/mm2 (t=2.876,P=0.064). The preoperative and postoperative CCTs were (546.83±33.74) μm and (566.67±24.66) μm (t=1.971, P=0.106). The loss rate for endothelial cells was (12.10±7.84)%. Only one patient was observed corneal edema and the CD could not be determined, so he underwent penetrating keratoplasty.Conclusion · Phacoemulsification combining with IOL implantation is safe and effective for patients with FECD and high myopia. Preoperative evaluation of corneal endothelium is necessary. Some measures should be taken into consideration to reduce the loss of endothelial cells during in surgery.

Objective · To explore the correlation between immunofluorescence (IMF) deposition and corticosteroid effect in childhood focal segmental glomerulosclerosis (FSGS) manifesting with nephrotic syndrome (NS). Methods · Renal IMF deposition and clinical data of the children clinically diagnosed with NS and pathologically diagnosed with FSGS in the Department of Pediatric Nephrology in Xinhua Hospital, Shanghai Jiao Tong University from January 1990 to December 2015 were reviewed and analyzed retrospectively. Results · The renal pathological types classified by IMF of 47 patients diagnosed with FSGS manifesting with NS showed that 2 cases (4.26%) were IgA type, 12 cases (14.89%) were IgM type, 4 cases (8.51%) were complement (C) type, 1 case (2.13%) was IgG+A+M type, 5 cases (10.64%) were IgG+A+M+C type, 1 case (2.13%) was IgA+C type, 12 cases (25.53%) were IgM+C type, and there was no immune complexes present in 15 cases (31.91%). The IMF deposition showed 9 cases with IgA+, 25 cases with IgM+, 8 cases with IgG+, 23 cases with C3+, 3 cases with C4+, 6 cases with C1q+, 5 cases with FN+, 12 cases with all negative. After 4 weeks of treatment with oral prednisone at full dose, complete remission was presented in 34 cases (72.34%), partial remission was presented in 7 cases (14.89%), and no remission was presented in 6 cases (12.77%). There was no statistically difference in the corticosteroid effect among the different types of IMF (H=1.792, P=0.408). The corticosteroid effect had statistical differences between C1q+ and C1q- patients (χ2=7.22, P=0.027), while it had no significant differences in other conditions. Conclusion · In childhood FSGS manifesting with NS, C1q+ patients have relatively poor reaction to the corticosteroid therapy compared to C1q- ones.

Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.

Objective · To investigate the expression levels of estrogen receptor GPR30, elastin, collagen Ⅰ (Col Ⅰ ), and Col Ⅲ in the uterus round ligament and the cardial ligament in patients with pelvic organ prolapse (POP) and main components in extracellular matrix (ECM). Methods · 22 patients with POP (the POP group) and 10 patients with cervical intraepithelial neoplasia (CIN) Ⅲ (the control group) were enrolled. Hysterectomy specimens were collected and expressions of GPR30, elastin, Col Ⅰ and Col Ⅲ in the uterine round ligament and the cardial ligament tissues were detected with Western blotting and immunohistochemistry. Results · Western blotting and immunohistochemistry results showed that the expressions of GPR30, elastin, Col Ⅰ and Col Ⅲ in the uterine round ligament and the cardial ligament tissues were significantly lower in the POP group than in the control group. The differences were statistically significant (P<0.05). Conclusion · The occurrence of POP may be associated with estrogen receptor deficiency and decreased contents of collagen and elastin in relevant tissues. Whether GPR30 is involved in the synthesis, secretion and degradation of ECM major components in pelvic support tissues needs further investigation.

Objective · To explore the association between cerebrospinal fluid (CSF) protein level and peripheral nerve demyelination in patients with Guillain-Barré syndrome (GBS). Methods · Clinical and biochemical data of 86 patients with GBS were retrospectively analyzed. According to electromyograms examination of peripheral nerve, GBS patients were divided into group with demyelination and group with axonal degeneration, and their clinical and biochemical characteristics were compared between the two groups. The correlation between CSF protein level and peripheral nerve demyelination was assessed by Spearman's correlation analysis. Results · Between the group with demyelination and group with axonal degeneration,there was no significant difference in gender, age, Hughes score, respiratory infection, gastrointestinal infection, erythra, ganglioside sodium injection and immunoglobulin G (IgG) index (P>0.05). Significant higher level of CSF protein, CSF albumin/serum albumin, IgG, and 24 h IgG intrathecal synthesis rate were detected in group with demyelination than that of in group with axonal degeneration (P<0.01). CSF protein level was positively correlated with peripheral nerve demyelination (r=0.345, P=0.001). Conclusion · The incidence of peripheral nerve demyelination increased accompanied with CSF protein level, and analysis of CSF protein level may be helpful in investigating the immunologic mechanism of peripheral nerve demyelination in GBS patients.

Objective · To study the effect of miR-137 overexpressed trophoblast cells on the biological functions of vascular endothelial cells.Methods · Lentivirus vectors Up-LV-miR-137 and LV-miR-NC were constructed and transfected into the trophoblast cells HTR-8/SVneo, respectively.And transfection efficiency was verified by PCR. Vascular endothelial cells were cultured with transfected trophoblast cells or their culture medium supernatant. Proliferation, migration activity and ability to recruit monocytes U937 of endothelial cells were detected by CCK8 method, scratch test and Transwell migration test, respectively. Results · miR-137 overexpressed trophoblast cells were obtained. The results of CCK8 test showed that proliferation of vascular endothelial cells cultured with miR-137 overexpressed trophoblast cells or their culture medium supernatant was inhibited, especially in high glucose condition. The repair of endothelial cells in the transfected cells culture medium slowed down in the scratch test. Transwell migration test results showed that after the endothelial cells were cultured with miR-137 overexpressed trophoblast cells, more monocytes passed through the chambers with higher chemotactic index. Conclusion · miR-137 overexpressed trophoblast cells can regulate the biological functions of vascular endothelial cells, i.e. reduce proliferation and migration activity and enhance ability to recruit monocytes.

Objective · To investigate the effect of a new type of allene compound, 1-phenylpropadienyl phosphine oxide (PHPO), on proliferation and apoptosis of lung cancer cell line A549. Methods · A549 cells were treated with different concentrations of PHPO. The effects of PHPO on cell proliferation, apoptosis and cell cycle were detected by CCK-8 and flow cytometry assay. Wound healing test was used to measure the migration ability of A549 cells. Real-time PCR was used to detect the expression of apoptosis and cell cycle related gene. The expression of proteins in MAPK pathway was assayed by the Western blotting. The nude mice xenograft model of human lung cancer A549 cells was established. After tumor formation, PHPO was injected daily for treatment, and the tumor size was observed. Results · Compared to the control group, PHPO significantly inhibited the cell viability of A549 cells and induced apoptosis of them, and the IC50 value of 24 h is 44.23 μmol/L. PHPO blocked the cell cycle in the G1 phase significantly. The migration capacity of PHPO-treated cells was decreased. The mRNA levels of Bax and P21 were up-regulated in PHPO-treated group, and the mRNA lever of Bcl-2 was down-regulated (P<0.05). PHPO increased the phosphorylation levels of p38, ERK and JNK. Injection of PHPO could significantly inhibit the growth of tumor in the xenograft model compared to the control group (P<0.05). Conclusion · PHPO can induce the apoptosis and inhibit the proliferation of A549 cells, block the cell cycle in the G1 phase and decrease the migration ability of A549 cells significantly. The mechanism may be related to the activation of MAPK signaling pathway by PHPO and the increase of phosphorylation of p38, ERK and JNK.

The abnormal changes in the apoptosis activities are relevant to a number of diseases including the tumor genesis and development. Since the gene structure of NF-κB being cloned three decades ago, the investigation of the transcriptional factor has been improved over time. A series of target genes are revealed to be modulated, which participate in physiological and pathological activities, including inflammation, proliferation, differentiation,senescence, and apoptosis. This review is focused on the signaling network of cell apoptosis regulated by NF-κB, the molecular involved, as well as the environmental variants associated. Furthermore, as NF-κB is unusually up-regulated in diseases such as cancer, searching for its specific antagonists may prevent the occurrence of those diseases.

Diabetic peripheral neuropathy is one of the most common complication of diabetes, which causes pain and inconvenience to the patients and reduces the quality of life. The pathogenesis of DPN is not yet clear, which is the result of multi-factor interaction. Hyperglycemia is clearly an important factor for its pathogenesis and development. Several metabolic pathways have been identified that may relate to the cellular metabolic including glucose flux through the polyol pathway, the hexosamine pathway, production of the protein kinase C isoforms and accumulation of advanced glycation end products. The additive imbalance of these pathways alters the mito-chondrial redox state of the cell and results in oxidative stress. It also causes inflammation. Additionally, growth factors, insulin resistance and lipid abnormality may participate in the metabolic pathway. This review is aimed to elaborate the pathogenesis and complement the known mechanism.