Objective To determine the relative factors of the onset of repeated ectopic pregnancy. Methods The clinical data of the first time ectopic pregnancy of 28 cases with repeated ectopic pregnancy were analysed, and compared with those of 56 cases of non-repeated ectopic pregnancy onsetting at the same period. The factors measured included: age at onset of disease, age at first coitus, gravidity, parity, methods of contraception, duration of amenorrhea,duration of vaginal bleeding, serum ?-human chorionic gonadotropin level, volume of intraperitoneal bleeding, types of ectopic pregnancy, methods of therapy and inflammation evidence of fallopian tube. Logistic regression analysis was performed to determine the relative factors for onset of repeated pregnancy. Results The risk factors and its odds ratio (OR) from the multivariate analysis were as follow: anastomosis of the tube(62.74, P=0.043), positive evidence of inflammation of the tube (54.85, P=0.000), no contraception (11.29, P=0.002), contraception by condom occasionally (4.75, P=0.046); the protective factors and its OR were as follow: therapy being salpingectomy and sterilization of the opposite tube(0.06, P=0.049), oral contraception (0.10, P=0.050) and pharmacotherapy (0.33, P=0.002). Conclusions The risk factors of onset of repeated ectopic pregnancy include: anastomosis of the tube, positive evidence of inflammation of the tube, no contraception and contraception by condom occasionally; the protective factors include: therapy being salpingectomy and sterilization of the opposite tube, oral contraception and pharmacotherapy.

Objective:To evaluate the therapeutic effects of orthodontic therapy with mandibular first molar extraction.Methods:77 cases of malocclusion were divided into 3 groups:Bilateral mandibular first premolar extraction group(A,30 cases),unilateral man-dibular first molar extraction group(B,27cases)and bilateral mandibular first molar extraction group(C,20 cases).The OGS indexes were measured before and after orthodontic treatment and statistically analysed.Results:Remarkable occlusal improvement was seen in all three groups after treatment(P<0.01 ),but the variation of OGS indexes had no significant difference among the 3 groups(P>0.05).OGS indexes among the three groups after treatment were significantly different(P<0.05).The improvement in group A was more significant than that in group C(P<0.01)and the improvement in group C was more significant than that in group B(P<0.01). Conclusion:Orthodontic therapy with bilateral mandibular first molar extraction is effective in orthodontic treatment of malocclusion, but is not as effective as that with bilateral mandibular first premolar extraction.

Objective:To evaluate the influence of minimally invasive corticotomy on the treatment time and molar anchorage of adult orthodontic extraction cases.Methods:60 adult cases of Angle Class Ⅰ crowding malocclusion were devided into 3 groups (n =20) and treated by orthodontic treatment wtih minimally invasive corticotomy(group A),orthodontic treatment with classic modified corticotomy(group B) and routine orthodontic treatment (group C) respectively.Time needed for leveling and alignment,space closure,delicate adjustment,total treatment time and mesial sagittal antedisplacement of first molar anchorage were compared among the 3 groups.Results:Time needed for leveling and alignment of orthodontic treatment of group A,B and C was (5.64 ± 2.57),(4.91 ± 3.31) and (8.87 ± 3.75) months respectively(C vs A or B,P ＜ 0.01).Time needed for space closure of group A,B and C was (6.84 ± 2.69),(6.64 ± 3.87) and (8.63 ± 3.29) months respectively(C vs A or B,P ＜0.01).Time needed for delicate adjustment showed no significant difference among the 3 groups(P ＞ 0.05).Total treatment time of group A,B and C was (16.07 ± 6.21),(15.77 ± 5.11)and (21.94 ± 5.74) months respectively (C vs A or B,P ＜ 0.01).There was on statistical difference of mesial sagittal antedisplacement of first molar anchorage among the 3 groups.Conclusion:Minimally invasive corticotomy can shorten the orthodontic treatment time,but can not decrease the retraction resistance of the anterior teeth.

Objective To investigate the impacts of pyruvate kinase M2 isoform (PKM2) silencing on the radiosensitivity of lung adenocarcinoma cell line (A549 cells) and the radiation synergy of xenografts, and to explore their mechanisms. Methods Plasmid pshRNA?PKM2 for interference with PKM2 expression was transfected into A549 cells, and empty vector?transfected cells and untransfected cells were set as con?trols. The silencing efficiency of pshRNA?PKM2 and the expression level of microtubule?associated protein 1 light chain 3(LC3) were measured by Western blot assay. The radiosensitizing effects in A549 cells and xen?ografts after PKM2 silencing were determined by colony?forming assay and xenografts growth curves. Autoph?agy formation in A549 cells and xenografts was analyzed by transmission electron microscopy, and the ex?pression level of PKM2 in xenografts was measured by immunohistochemistry. Comparison between groups was made by Student′s t?test, and the body weights of nude mice and xenograft volumes were subjected to a?nalysis of variance for continuous variables. Results Stable A549 cell lines transfected with pshRNA?PKM2 were successfully produced. Transfection with pshRNA?PKM2 significantly down?regulated PKM2 expression in A549 cells and xenografts (P= 0?? 001;P= 0?? 000). The sensitizer enhancement ratios for A549 cells and xenografts were 1?? 47 and 2?? 00, respectively. Interference with PKM2 expression enhanced radiation?in duced autophagy formation and significantly increased the ratio of LC 3 ? II / I ( P= 0.000 1 ) . Conclusions Silencing of PKM2 expression may enhance the radiosensitivity of A549 cells and xenografts by regulation of autophagy, which holds promise for becoming an effective radiosensitizing target for non?small cell lung canc?er, but still needs to be confirmed by further studies.

Objective:To establish the cisplatin-resistant human lung adenocarcinoma cell line A549/(DDP) cisplatin and to study the relationship between EHD2 and drug resistance. Methods:DDP-resistant human lung cancer cell line A549/DDP was established by gradual and stepwise dose enhancement. MTT was used to measure drug sensitivity. Western blot and immunofluorescence were used to evaluate expression and subcellular localization of EHD2 and breast cancer resistance protein (BCRP). Results:The DDP-resistant cell line A549/DDP was established, with a resistance index of 7.6. EHD2 and BCRP expressions both increased and were enriched on the cell surface membrane. Conclusion:Both EHD2 and BCRP expressions were enriched on the resistant cell surface membrane, suggesting that EHD2 endocytic protein stabilizes BCRP and is involved in drug resistance.

Objective:This work aims determine the expression of the neurotensin (NTS) gene in hepatocellular carcinoma (HCC) subgrouping using immunohistochemical staining (IHC) as well as to evaluate the correlation between the activation of NTS/IL-8 pathway in HCC and inflammatory response in microenvironment and epithelial mesenchymal transition (EMT) in cancer and in the prognosis of patients. Methods:Tumor tissues and corresponding adjacent normal tissue were collected from 64 cases of HCC patients. The expression levels of NTS protein and multiple inflammation and EMT-related proteins, including IL-8, VEGF, MMP9, CD68, E-Cadherin,β-Catenin, and Vimentin, were examined in 64 cases of paraffin-embedded HCC tissues using the immunohistochemistry (IHC) staining method. The clinical outcome and overall survival (OS) among 64 cases of HCC patients were compared. Results:We found that the frequency of NTS-expressing tissues among all HCC samples was 17.19%(11/64). Significantly increased IL-8 protein was confirmed in 90.91%of NTS+HCC samples and was positively correlated with the levels of NTS protein in cancer tissues (P=0.036), which implied the dysfunctional activation of NTS/IL-8 pathway in HCC. The levels of VEGF and MMP9 were significantly correlated with the co-expression of NTS and IL-8 in HCC. Evident features of EMT, including decreased membrane expression of E-Cadherin and increased accumulation of cytoplasmicβ-Catemin and Vimentin, were found in NTS+IL-8+samples. The co-expression of NTS and IL-8 in cancer was significantly correlated with the clinical outcomes of patients, as the mortality rate of NTS+IL-8+HCC patients is 2.5-fold higher than that of others after surgery (P=0.022).Accordingly, the OS of NTS+IL-8+HCC patients significantly decreased (24.65±4.45 m vs. 75.79±16.32 m, P=0.013), and these patients are at a higher risk of death at an expected hazard ratio (HR) of 3.457. Conclusion:The NTS/IL-8 pathway is dysfunctionally activated in a subgroup of HCC samples. Highly expressed NTS is associated with increased inflammatory response in microenvironment, enhanced EMT in cancer, and worse prognosis in HCC patients.

Objective To investigate the efficacy of dexmedetomidine on sedation in post-cardiac surgery patients with NIV intolerance.The changes of respiratory function and hemodynamics of the patients as well as non-invasive ventilation (NIV) failure rate were also under evaluation.Methods Thirty-five post-cardiac surgery patients with NIV intolerance and hypoxemia were enrolled in this prospective study.All patients were sedated with dexmedetomidine.NIV was standardized according to the uniform protocol.The main outcome was NIV success (avoiding endotracheal intubation) or NIV failure (requiring endotracheal intubation or die).The cardiorespiratory parameters (BP,HtR and RR) and artery blood gas analysis were prospectively recorded before and after sedation.The respiratory function and hemodynamics changes in both groups (NIV success group and NIV failure group) were then evaluated.Factors independently associated with NIV failure were identified using a logistic regression model.Results Twenty out of 35 patients (57.14％) survived while 15 (42.86％) patients failed NIV.After 1 h and 4 h of NIV with dexmedetomidine sedation,respiratory rate in both groups were decreased compared with baseline,especially in NIV success group.The PaO2/FiO2 was also improved after 1h and 4h of NIV treatment compared with baseline.The improvement was more significantly in NIV success group.The heart rate was decreased compared with baseline with no differences between two groups.There were no significant changes on PaCO2 and mean arterial pressure (MAP) during the treatment.The respiratory and hemodynamics variables identified as predictors of NIV failure were included in a multivariate logistic regression.RR ＞ 23 time/min (OR =3.2,95％ CI:2.043 ～ 4.301,P ＜ 0.01) 1 h after NIV,RR ＞ 20 time/min (OR =2.1,95％ CI:1.659～3.231,P=0.025) 4 h after NIV,PaO2/FiO2 ＜178 mmHg (OR=2.4,95％CI:1.892 ～ 3.287,P ＜0.01) 1 h after NIV and PaO2/FiO2 ＜ 185 mmHg (OR =1.7,95％ CI:1.243 ～ 2.365,P =0.041) 4 h after NIV independendy predicted NIV failure.Conclusions Dexmedetomidine might be considered as an effective and safe sedative for post-cardiac surgery patients with NIV intolerance.Early identification of predictors of NIV failure may facilitate early intervention.

Objective:To investigate the role and mechanism of miR-143 in the proliferation and migration of gastric cancer (GC) cells. Methods:Western blot was performed to detect the expression level of avian erythroblastosis oncogene B-3 (ERBB3) in GC tissues, paired non-cancerous tissues, and SGC7901 GC cells. RT-qPCR was conducted to determine the mRNA and miR-143 of ERBB3 quantita-tively. Bioinformatics tools were used to predict the target gene of miR-143. Luciferase reporter assay was carried out to confirm the predicted target gene. Transwell and EdU assays were applied to observe the migration and proliferation of SGC7901 GC cells transfect-ed with miR-143 mimics/inhibitor/NC mimics/inhibitor. Results:Compared with the expression levels of ERBB3 and miR-143 in the paired non-cancerous tissues, the expression level of ERBB3 was upregulated and the expression level of miR-143 was downregulated in GC tissues. In the prediction of the potential target gene, miR-143 could bind to a specific sequence of the 3′-untranslated regions (UTR) of the mRNA of ERBB3. This finding was supported by luciferase reporter assay results. In vitro, ERBB3 protein expression and cell migration and proliferation were suppressed significantly in the SGC7901 cells transfected with miR-143 mimics. By contrast, these processes were remarkably enhanced when the cells were transfected with miR-143 inhibitor. Conclusion:miR-143 can suppress the migration and proliferation of GC cells by downregulating the expression of ERBB3.

Objective To study the incidence,possible risk factors,and influence on patient outcomes of diaphragmatic dysfunction in patients after surgical treatment of type A aortic dissection using ultrasound.Methods Patients who received replacement of hemiarch or total arch with concomitant procedures concerning aortic pathology,and an elephant trunk procedure for the descending aorta were prospectively enrolled in this study from February to May 2017.After surgery,they were transferred to the cardiac surgical intensive care unit.They were divided into two groups based on diaphragmatic excursion:diaphragmatic dysfunction (DD) group and diaphragmatic function normal (DN) grouBilateral diaphragmatic excursions were evaluated using ultrasound during spontaneous breathing trial by T-tube.The differences in demographic characteristics,operation-related variables and outcomes were compared between the two groups.Results A total of 42 patients were enrolled in this study,and 32 of them suffered from diaphragmatic dysfunctions.Compared with DN group,the excursion of the influenced diaphragm in DD group was significantly reduced[(0.450 ± 0.331)cm vs.(1.801 ± 0.616)cm,P＜0.01],while the excursion of the non-influenced diaphragm was not reduced[(2.013±0.655)cm vs.(1.801 ±0.616) cm,P=0.254].Diaphragmatic thickness was comparable [(0.184±0.028)cm vs.(0.189±0.028)cm,P=0.559 ] between the two groups while thickening fraction was significantly reduced in DD group[(4.67％±3.63)％ vs.(23.58％±10.69)％,P＜0.01].Meanwhile,respiratory rate was significantly higher in DD group as compared to DN group [(24.13 ± 4.98)times/min vs.(20.50 ± 3.17)times/min,P=0.037].Patients in DD group showed longer cross-clamp duration[(121.78±27.75)min vs.(93.10±18.84)min,P=0.004] and longer cardiopulmonary bypass duration [(208.09±32.78)min vs.(182.70±24.38)min,P=0.03] than patients in DN grouFurthermore,binary logistic analysis indicated that longer cross-clamp duration was the potential risk factor for diaphragmatic dysfunction after type A aortic dissection surgery.Mechanical ventilation duration was longer in DD group than in DN group (88 h vs.37 h,P=0.194) but without statistical significance.The usage of noninvasive ventilation was significantly increased in DD group as compared to DN group (46.88％ vs.10％,P=0.036).Other outcomes such as post-operative complications,mortality,ICU length of stay were comparable between the two groups.Conclusions Diaphragmatic dysfunction was very common after surgical treatment of type A aortic dissection.Longer duration of cross-clamp was considered as a potential risk factor of diaphragmatic dysfunction.A sequential management of noninvasive ventilation after extubation was feasible for diaphragmatic dysfunction after surgical treatment of type A aortic dissection.

Metabolic reprogramming, such as abnormal utilization of glucose, addiction to glutamine, and increased de-novo lipid synthesis, extensively occurs in proliferating cancer cells, but the underneath rationale has remained to be elucidated. Based on the concept of the degree of reduction of a compound, we have recently proposed a calculation termed as potential of electron transfer (PET), which is used to characterize the degree of electron redistribution coupled with metabolic transformations. When this calculation is combined with the assumed model of electron balance in a cellular context, the enforced selective reprogramming could be predicted by examining the net changes of the PET values associated with the biochemical pathways in anaerobic metabolism. Some interesting properties of PET in cancer cells were also discussed, and the model was extended to uncover the chemical nature underlying aerobic glycolysis that essentially results from energy requirement and electron balance. Enabling electron transfer could drive metabolic reprogramming in cancer metabolism. Therefore, the concept and model established on electron transfer could guide the treatment strategies of tumors and future studies on cellular metabolism.
Electrons ; Energy Metabolism ; Glucose ; Glycolysis ; Humans ; Neoplasms