An effective, reliable and practical staging is of great help to the diagnosis and treatment of malignant tumors. Cervical cancer is a malignant tumor using clinical stage in gynecological tumors, but staging lacks objectivity in judging the tumor size, para-uterine invasion, vaginal margin, vascular invasion and so on. By October 2018, the International Federation of Obstetrics and Gynecology (FIGO) had revised the 2009 FIGO cervical cancer staging that had been used before.However, the changed points of the 2018 FIGO cervical cancer staging are controversial.

Objective: To systematically evaluate the effectiveness of epidermal growth factor (EGF) in treating patients with inhalation injury by meta analysis. Methods: Databases including PubMed, Cochrance Library, and Embase were searched using key words " inhalation injury, smoke inhalation injury, epidermal growth factor, and EGF" , and Chinese Journals Full-text Database, China Biology Medicine disc, VIP Database, and Wanfang Database were searched using key words in Chinese version "吸入性损伤,表皮生长因子" to obtain the randomized controlled trails about EGF published publicly in the treatment of patients with inhalation injury from the establishment of each database to December 2017. The measurement indexes included content of total protein and albumin, colloid osmotic pressure (COP), the number of total cells, percentages of neutrophils, lymphocytes, and fibroblasts in bronchoalveolar lavage fluid (BALF), the time of disappearance of pulmonary symptoms, the time of exfoliation of necrotic mucous membrane, the time of removal of tracheal tube, the amount of respiratory secretions, and the incidence of lung infection. Meta-analysis was conducted by RevMan 5.3 statistical software. Results: A total of 6 trials involving 375 patients were included, with 182 patients in group EGF who received EGF treatment and 173 patients in conventional treatment group who received conventional treatment. All of the 6 trails had unclear risk of bias. The content of total protein and albumin and COP in BALF of patients in group EGF were lower than those in conventional treatment group, with standardized mean differences (SMDs) respectively -9.37, -26.77 , and -8.13 [with 95% confidence intervals (CIs) respectively -14.11--4.63, -41.85--11.69, -9.54--6.73, P<0.001]. The number of total cells and percentages of neutrophils and lymphocytes in BALF of patients in group EGF were lower than those in conventional treatment group, while the percentage of fibroblasts in BALF of patients in group EGF was higher than that in conventional treatment group, with SMDs respectively -20.22, -13.08, -12.28, 2.99 (with 95% CIs respectively -22.27--17.66 , -14.76--11.40, -13.86--10.70, 2.48-3.50, P<0.001). The time of disappearance of pulmonary symptoms, the time of exfoliation of necrotic mucous membrane, and the time of removal of tracheal tube of patients in group EGF were shorter than those in conventional treatment group, with SMDs respectively -1.05, -1.22 , -1.11 (with 95% CIs respectively -1.36--0.74, -1.54--0.91, -1.39--0.82, P<0.001). The amount of respiratory secretions of patients in group EGF was lower than that in conventional treatment group, with SMD -1.44 (with 95% CI -1.90--0.98, P<0.001). The incidence rate of pulmonary infection of patients in group EGF was lower than that in conventional treatment group, with relative risk 0.46 (with 95% CI 0.24-0.89, P<0.05). There may be publication bias in the content of total protein, albumin, and COP in BALF (P<0.05), while the time of disappearance of pulmonary symptoms, the time of exfoliation of necrotic mucous membrane, and the time of removal of tracheal tube showed no significant publication bias (P>0.05). Conclusions Conventional treatment combined with EGF therapy can reduce respiratory inflammation of inhalation injury, promote restoration of respiratory epithelium, shorten the time of removal of tracheal tube, reduce the incidence of pulmonary infection of patients, and therefore has good effect on inhalation injury.

Objective: To evaluate the effectiveness of surgery combined with multiple interventions in treating patients with ear keloid by network meta-analysis. Methods: Databases including " PubMed" , " Cochrane Library" were searched using key words " (((((((((((Ear, External[MeSH Terms]]] OR (Ears, Exernal]] OR (Outer Ear]] OR (Ear, Outer]] OR (Ears, Outer]] OR (External Ear]]] AND (((keloid[Mesh Terms]]] OR (keloids]]] AND ((((((surgery[MeSH Terms]]] OR (operative therapy]] OR (operative procedures]] OR (invasive procedures]] OR (operations]]]] AND (randomized controlled trial[pt]]" , database " Embase" was searched using key words ((′external ear′/exp] OR(′auricle′/exp] OR (′ear lobe′/exp]] AND ((′surgery′/exp] OR (′ear surgery′/exp]] AND (′keloid′/exp] AND (′randomized controlled trial′/exp] and Chineses journals full-text database, China biology medicine disc, VIP database, and Wanfang database were searched using key words in chinese version "耳瘢痕疙瘩,手术" to obtain the randomized controlled trails about surgery combined with multiple interventions in the treatment of ear keloid from the establishment of each database to June 2018. EndNote X7, Revman 5.3, STATA 14.0, GeMTC 14.3 statistical software were used to extract data from studies, study quality assessment, drawing network figure, publication bias analysis, traditional meta-analysis, heterogeneity test, consistency test, similarity test, network meta-analysis. Results: A total of 18 trails involving 8 therapeutic measures were included, and 1 425 patients with ear keloid were included. All of the 18 trails had high risk of bias. The network figure shows that there are 28 different pairwise comparisons among the eight treatments. Of the 18 studies included, 10 were directly compared, and the remaining 18 were not directly evidenced, those comparisons will be made indirectly by the network meta-analysis. The basic symmetry of each point in the funnel plot and the P values of Beggs test and Eggers test were all greater than 0.05, shows that the existence of publication bias is less likely. Traditional meta-analysis showed that the efficiency of surgery + hormone, surgery + pressure, surgery + radiotherapy and surgery + hormone + radiotherapy were better than that of simple surgery, and the difference was statistically significant(P<0.05); the efficiency of surgery + hormone + radiotherapy was better than that of surgery + hormone, the difference was statistically significant(P=0.001); surgery + hormone + fluorouracil and surgery + hormone + radiotherapy had statistical significance(P<0.05). Efficiency is higher than surgery + radiotherapy, the difference is statistically significant. The rest of the direct comparisons are not statistically significant. All P values in the heterogeneity test were greater than 0.1 and I² was less than 50%, so there was no significant heterogeneity in the study. 8 treatments formed 4 closed loops, the inconsistency factor IF ranged from 0.06 to 0.23, and the lower limit of 95% CI was 0, it means than the consistency of those loops were good. The similarity test of the 18 studies was good. Based on Bayesian theory, the random effect model of MCMC method was analyzed by network meta analysis. The results of 7 combined therapies were statistically significant compared with those of simple operation, and were superior to those of simple operation. The results of the seven combined therapies were statistically significant as follows: surgery + hormone + fluorouracil VS surgery + radiotherapy (OR = 0.28, 95% CI 0.08-0.93], surgery + hormone + fluorouracil was better than surgery + hormone; surgery + hormone + radiotherapy + VS surgery + hormone (OR = 0.06, 95% CI 0.01-0.23], surgery + hormone + radiotherapy Surgery + hormone + radiotherapy VS surgery + pressure (OR = 0.07, 95% CI 0.01-0.37], surgery + hormone + radiotherapy is better than surgery + pressure; surgery + hormone + radiotherapy VS surgery + radiotherapy (OR = 0.06, 95% CI 0.01-0.30], surgery + hormone + radiotherapy is better than surgery + radiotherapy. There was no significant difference in the curative effect between the other combined treatments. The SUCRA curves were drawn according to the randomized effect model of MCMC. The SUCRA values of each treatment measure were as follows: surgery, 0.4%; surgery + hormone, 33.0%; surgery + pressure, 52.2%; surgery + radiotherapy, 34.6%; surgery + imiquimod 53.3%; surgery + fluorouracil 51.6%; surgery + hormone + fluorouracil, 76.4%; surgery + hormone + radiotherapy, 34.6%; surgery + hormone + fluorouracil, 53.3%; surgery + hormone Radiotherapy, 98.4%. According to the results of SUCRA chart, the effectiveness of each treatment measure was sorted as follows: operation + hormone + radiotherapy > operation + hormone + fluorouracil > operation + imiquimod > operation + pressure > operation + fluorouracil > operation + radiotherapy > operation + hormone > operation. Conclusions Surgery combined with a variety of treatments for ear keloid were superior to simple surgical treatment, of which surgery + hormone + radiotherapy is the best.

Objective An optimal radiation dose was made research on tumor cells to develop effective tumor fusion vaccines. Methods We used the RS 2000 biological X-ray radiation instrument to produce different dose of X-rays.Mouse liver cancer cells line,BNL 1ME a.7R.1(MEAR),was used for experiment.The RS 2000 biological X-ray radiation was applied to create different tumor cell clones,which could help us to study the rela-tionship between irradiation dose and tumor cells′proliferation activity.Furthermore,the fusion cells′anti-tumor ef-fect was examined by flow cytometry. Results High-dose radiation would induce the lower proliferation of cancer cells than low-dose irradiation do.Conclusions During the preparation of fusion vaccines,irradiation dose should be considered as a factor that would influence the tumor cells′ proliferation activity. When the dose of irradiation was appropriate,we could make safe and efficient integration cell vaccines.

Chronic obstructive pulmonary disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. In addition to smoking COPD caused by cigarette smoke, the phenotype of non-smoking COPD accounts for at least 1/4. Non-smoking COPD accounts for a large proportion, especially in developing countries. Non-smoking COPD and smoking COPD should be paid equal attention. More in-depth study on the prognosis of non-smoking COPD is needed.

[Abstract] Objective: To explore the regulatory effect of lncRNA maternal imprinting gene 3 (MEG3) on proliferation, migration, invasion and epithelial-mesenchymal transition (EMT) of cervical cancer cells via miR-9-5p/SOCS5 axis. Methods: A total of 20 pairs of cancer and para-cancerous tissue specimens resected from cervical cancer patients in Chongqing Hospital of Traditional Chinese Medicine from January 2017 to June 2019 were collected for this study. Using liposome transfection technology, pcDNA3.1-MEG3,si-MEG3, miR-9-5p mimics, miR-9-5p inhibitor and their control plasmids were transfected into cervical cancer HeLa and SiHa cells respectively to construct overexpression and silence cell model. qPCR was used to detect the expression levels of MEG3, miR-9-5p and SOCS5 in cervical cancer tissues and cell lines. CCK-8 method and Transwell chamber method were used to detect cell proliferation, migration and invasion ability. The expression levels of E-cadherin and vimentin in cells were detected by cellular immunofluorescence experiments. Target genes were predicted through the Online Bioinformatics TargetScan database. Dual luciferase reporter gene assay was used to verify the targeting relationship between miR-9-5p and MEG3, SOCS5, respectively. Results: Compared with para-cancerous tissues and cervical epithelial HcerEpic cells, the expressions of MEG3 and SOCS5 were significantly down-regulated and the expression of miR-9-5p was significantly up-regulated in cervical cancer tissues and cell lines (all P<0.01). TargetScan database analysis and Dual luciferase reporter gene assay confirmed the targeting relationship between miR-9-5p and MEG3 or SOCS5. MEG3 and SOCS5 significantly inhibited while miR-9-5p significantly promoted cell proliferation, migration and invasion ability (all P<0.01). MEG3 and SOCS5 promoted E-cadherin expression and inhibited vimentin expression, while miR-9-5p inhibited E-cadherin expression and promoted vimentin expression (P<0.05 or P<0.01). Conclusion: lncRNA MEG3 regulates proliferation, migration, invasion and EMT of cervical cancer cells via miR-9-5p/SOCS5 axis.

Objective: To investigate the role of exosome (EXO) transporting Let-7a to regulate MYC gene in the malignant biological behaviors of triple negative breast cancer (TNBC) cell, and to explore the underlying mechanism. Methods: After the completion of cell culture, the gene and protein expressions of MYC and Let-7a in TNBC MDA-MB-231cells were detected by qPCR and WB, respectively. Recombinant lenti-virus vector carrying Let-7a and Crisper/Cas-9 system with MYC knockdown were transfected into MDA-MB-231 cells; MTT assay, Transwell assay and Scratch healing assay were performed to examine the proliferation, invasion and migration of MDA-MB-231 cells. Luciferase activity assay was performed to validate the binding between MYC and Let-7a. EXO was isolated and identified by transmission electron microscopy and WB assay in wild-type and Let-7a over-expressed MDA-MB-231 cells, respectively. After co-incubation of two types of EXO and MDA-MB-231 cells, the effects of Let-7a on biological behaviors of MDAMB-231 cells via EXO were detected by qPCR, WB, MTT and Transwell etc. Results: Let-7a was negatively correlated with MYC in breast cancer tissues and cell lines (all P<0.05); MYC promoted while Let-7a inhibited the proliferation, migration and invasion of breast cancer cells (all P<0.01); Let-7a silenced MYC by acting on 3'UTR of MYC gene, thereby reducing the expression of MYC protein (P<0.05); Let-7a was enveloped by EXO and transported to cancer cells, there by inhibiting the proliferation, migration and invasion of MDA-MB-231 cells. Conclusion: EXO some mediated Let-7a silences MYC gene by acting on its 3'UTR region, thus inhibiting the proliferation, migration and invasion of MDA-MB-231 cells.

OBJECTIVE To prepare Xiongzhi shigao decoction soluble microneedles， characterize it and investigate its transdermal properties in vitro. METHODS Two-step centrifugal method was used to prepare Xiongzhi shigao decoction soluble microneedles. The formability and mechanical property of the microneedles were evaluated from aspects of stroma fluidity， microneedle formability， needle hardness， etc. The appearance， mechanical strength， dissolution performance， skin barrier recovery performance and drug loading of the prepared microneedles were characterized by using active components of the soluble microneedle （chlorogenic acid， ferulic acid， notopterol， imperatorin， ligustilide， isoimperatorin） as indicators. The in vitro transdermal performance was investigated by Franz diffusion cell. RESULTS The soluble microneedle tips of Xiongzhi shigao decoction prepared in this study were conical， evenly distributed and of the same thickness， with good mechanical properties； the tip of the needle could be almost completely dissolved after being penetrated into the skin of rats for 2 hours， and the skin barrier recovery performance was good； the drug loading of chlorogenic acid， ferulic acid， notopterol， imperatorin， ligustilide and isoimperatorin were （87.04±1.12）， （67.69±1.23）， （20.65±0.17）， （35.00±0.11）， （153.83±0.21） and （23.52±0.50） μg per patch respectively. The results of in vitro transdermal study showed that cumulative release rates of 6 active components in this microneedle after 72 hours were 36.94%， 56.72%， 19.36%， 57.98%， 11.06% and 35.19%， respectively. CONCLUSIONS Xiongzhi shigao decoction soluble microneedles are prepared successfully in this study and have good formability， mechanical properties and pliable backing， which can significantly promote the transdermal drug delivery.