The expression of transcription factor forkhead box protein 3 (Foxp3) is predominantly restricted to the CD25+CD4+population in both the thymus and periphery. Limited evidence indicated that Foxp3 is also expressed, albeit to a lesser extent, in the tis-sues outside of the thymus and spleen. However, recent studies showed that Foxp3 is expressed in many tumor cells, and has a definite relation with the occurrence, progress, and prognosis of malignant tumors. Foxp3 has become a popular topic in research on malignant tumor treatment, thereby bringing a new turning point for malignant tumor therapy.

Objective To investigate the causes and prevention of hemorrhage and recurrent laryngeal nerve injury during the endoscopic thyroidectomy via the breast areola approach.Methods Totally 36 patients underwent endoscopic thyroidectomy via the breast areola approach from January 2006 to January 2008.Results All the procedures were completed under an endoscope with a mean operation time of 105 min(50 to 180 min),and mean blood loss of 30 ml(20 to 150 ml).None of the patients were converted to an open surgery.One patient developed fat liquefaction,and one showed subcutaneous emphysema,no patient had injuries to any of the nerves or the parathyroid glands.The drainage tube was removed in 24 to 72 months after the surgery.The patients were discharged from the hospital 3 to 7 days postoperation.Postoperative pathological examination showed thyroid adenoma in 7 cases and thyroid nodular goiter in 29.The 36 patients were followed up for 3 to 24 months with a mean of 12 months.During the period,3 patients complained of chest symptoms and were cured spontaneously in 3 to 7 months.All the patients were satisfied with the aesthetic outcomes,none of them had local recurrence of the tumor.Conclusions Endoscopic thyroidectomy via the breasts areola approach is feasible and effective with good short-term and aesthetic outcomes.

Objective:To investigate the expression of miR-92a in colorectal cancer (CRC) and its effect on the regulation mechanisms of tumor angiogenesis. Methods:The miRNA-92a expression in 25 CRC tissues and HT29, SW620, SW480, and HCT116 CRC cells was detected using quantitative real-time polymerase chain reaction. The CD31 positive expression of blood microvessels in CRC tissues was measured by immunohistochemistry. Pearson correlation analysis was used to analyze the relationship between miR-92a and tu-mor angiogenesis. The miR-92a mimic or inhibitor was transfected into HCT116 and SW620 cells in vitro to upregulate or downregu-late the miR-92a expression. The effect of miR-92a overexpression or suppression on the formation of human umbilical vein endotheli-al cell (HUVEC) tubules was detected by tube formation assay. Changes in phosphatase and tensin homolog (PTEN) protein expression were measured by Western blot. Results:The expression level of miR-92a in CRC tissues was significantly higher than that in matched adjacent tissues (P<0.01). The expression levels of miR-92a in HT29, SW480, SW620, and HCT116 colon cancer cell lines were signifi-cantly higher than that of the normal colorectal epithelium control (P<0.05). The number of CD31 positive expression of microvessel density (MVD) in CRC tissues was significantly higher than that in adjacent tissues (P<0.01), and the miR-92a expression level was posi-tively correlated with the MVD in CRC tissues (r=0.580, P=0.01). The cell culture supernatant of HCT116 with miR-92a overexpression could significantly promote the formation of HUVEC tubules (P<0.05). The upregulation of miR-92a expression could significantly inhib-it the expression of PTEN protein in CRC cells (P<0.01). Conclusion:The miR-92a was highly expressed in CRC cells and tissues, which was closely related to the formation of tumor angiogenesis in CRC. The miR-92a could promote tumor angiogenesis in CRC by inhibit-ing PTEN expression.

Objective To explore the expression characteristic of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 in colorectal cancer , evaluate the clinical significance of candidate miRNAs in CRC diagnosis.Methods Case-control study was used.The expression levels of serum mir-16,mir-21,mir-29a, mir-92a and mir-143 from 50 CRC patients and 27 normal controls were detected by real-time PCR, the levels of miRNAs expression in serum of 8 CRC patients 1 day before and 7 days after radical surgery were analyzed.The sensitivity and specificity of serum miRNAs expression for the diagnosis of colorectal cancer were evaluated using the receiver operating characteristic ( ROC) curve.Results The expression level of mir-16, miR-21, mir-92a in serum of patients with CRC were (75.55 ±37.73), (35.96 ±23.81), (24.79 ±8.97) fmol/ml, significantly higher than that of the healthy control group (32.73 ±18.94), (24.36 ±13.27), (16.36 ±5.58) fmol/ml (tmir-16 =2.77, tmir-21 =2.34, tmir-92a =3.85,P <0.05).However, the expression levels of mir-29a and mir-143 showed no significant difference between two groups (tmir-29a=-0.17, tmir-143 =1.59,P>0.05).In addition, serum miR-16 and miR-92a levels of CRC patients 7 days after tumor resection were (36.02 ±19.95), (14.82 ±7.78) fmol/ml, significantly lower than that before operation (62.18 ±34.17), (24.06 ±12.99) fmol/ml (tmir-16 =3.59, tmir-92a =2.60,P<0.05).Area under the ROC curve ( AUC) of combined detection of mir-16, miR-21and mir-92a was 0.877, the sensitivity and specificity were 88% and 85%, respectively, which was higher than any of 3 miRNAs alone and the conventional tumor marker CEA.Conclusion Combination of mir-16, mir-21 and mir-92a in the diagnosis of CRC shows a better sensitivity and specificity , which would be expected as new tumor biomarkers for noninvasive diagnosis and monitoring progression of colorectal cancer.

This paper aims to discuss the use and management of operation instrument in treatment of the wounded on the sea by using the new type of field operation instrument set so as to improve the rescue ability on the sea. The operation set has a new structure and is designed reasonably. It is easy to be washed and disinfected. It can be packed sterilizedly for a long time and deployed rapidly. All of the operation instrument is fixed in the box to prevent it from falling when it is used on the sea and it is convenient to count and arrange. The new type of field operation instrument set is fit for rescuing the wounded on the sea. It is convenient to be used, sterilized, stored and carried.

With the further research on the pathogenic factors of ankylosing spondylitis (AS), though the mechanism of its pathogenesis is not fully understood, many treatment methods of traditional Chinese medicine (TCM) have achieved good results in the treatment.Therefore, TCM has certain advantages in the treatment of AS, and shows a good application prospect.Retrieval CNKI, Wanfang database and VIP Chinese database, retrieval of domestic clinical research literature on AS in recent years, with the latest advances in the understanding of TCM in the treatment of AS.

Objective To evaluate the effect of microRNA-92a (miR-92a) on regulating cell proliferation by targeting Krüppel-like factor 4 (KLF4) in colon cancer.Methods The miR-92a expressions in 21 colon cancer tissues and matched normal tumor-adjacent tissues and 4 colon cancer cells (HT29,SW480,SW620,HCT116) were detected using quantitative real-time polymerase chain reaction (qRT-PCR).Models of over-expression and suppression of miR-92a were established by transient transfection of miR-92a-3p mimic to HCT116 and transient transfection of miR-92a-3p inhibitor to SW620,respectively.Cell proliferation activity was detected by the CCK-8 colorimetry method,cell cycles were detected by flow cytometry,KLF4 protein expression was detected by Western blotting,and cell luciferase activity was detected by the dual luciferase reporter gene experiment.Results The expression level of miR-92a in colon cancer tissues was (0.648 ± 0.489) fmol/μg total RNA,significantly higher than that in matched normal tumor-adjacent tissues [(0.064 ± 0.062) fmol/μg total RNA],with statistically significant difference (t =-5.420,P ＜ 0.001).In 4 colon cancer cell lines,the miR-92a expression level in HCT116 cells was the lowest,and highest in SW620 cell.When the expression of miR-92a was up-regulated,the cell proliferation activity of 72 h in HCT116 cells was higher than that in the negative control group (0.919 ±0.014 vs.0.765 ± 0.025),with statistically significant difference (t =-9.309,P =0.001),the proportion of S phase cells was also significantly increased [(41.670 ±0.461)％ vs.(38.703 ±0.554)％,t =-7.127,P =0.002),and KLF4 protein expression was decreased (0.460 ± 0.048 vs.0.758 ± 0.109,t =22.865,P =0.028).When the expression of miR-92a was down-regulated,the cell proliferation activity of 72 h in SW620 cells was lower than that in the negative control group (0.608 ± 0.011 vs.0.713 ± 0.005),with statistically significant difference (t =15.920,P ＜ 0.001),while the proportion of S phase cells was decreased [(31.935 ± 0.365) ％ vs.(34.955 ± 0.465) ％,t =8.849,P =0.001],and KLF4 protein expression was increased (0.694 ± 0.121 vs.0.479 ± 0.044,t =-5.246,P =0.034).KLF4 3'UTR wild-type dual luciferase report plasmids were co-transfected with miR-92a-3p mimic to HCT116 cell,and dual luciferase assay showed that miR-92a slightly repressed firefly luciferase actively,but the difference was not statistically significant (t =0.878,P =0.429).There was a negative correlation between the expression of miR-92a and the expression of KLF4 protein in colon cancer tissues,but with no statistical significance (r =-0.163,P =0.699).Conclusion miR-92a is highly expressed in colon cancer tissues.It can promote colon cancer cells proliferation via enhancement of the cell cycle transition of G0-G1 phase to S phase.Up-expression of miR-92a may play a role in down-regulating the expression of KLF4 protein in colon cancer cells.However,KLF4 is not a direct target gene of miR-92a.

Objective To analyze the infection characteristics and epidemic trend of 9 respiratory pathogens in Shenzhen popula-tion .Methods The 5918 patients with acute respiratory tract infection were collected ,indirect immunofluorescence was used to de-tect the IgM antibody of 9 respiratory pathogens ,including legionella pneumophila type 1 (LP1) ,mycoplasma pneumoniae (MP) , rickettsia Q (COX) ,rickettsia and chlamydia pneumoniae (CPn) ,adenovirus (ADV) ,respiratory syncytial virus (RSV) ,influenza A virus (INFA) ,influenza B virus (INFB) ,parainfluenza virus (PIVs) ,the results were analyzed statistically .Results A total of 1376 samples were detected at least one pathogen in 5918 serum samples ,the total positive rate was 23 .25% .The positive rate of MP was the highest (15 .19% ) ,followed by the INFB (8 .11% ) .The positive rates of other pathogens were relatively low .The mixed infection positive rate was 4 .29% .The positive rates of MP ,INFB and PIVs in women were significantly higher than those in men(P<0 .001) .The positive rates of MP ,INFB and PIVs were different in different seasons ,the differences were statistically sig-nificant(P<0 .001) .The positive rates of MP ,ADV and INFB in 0 to 14 years old group were significantly higher than those in >14 to 60 years old group and >60 years old group(P<0 .05) .The positive rates of MP ,CPn ,ADV ,RSV ,INFB and PIVs were closely related with age in infant and children (0 to 14 years old)(P<0 .05) .Conclusion The main respiratory pathogens of SARS in Shenzhen city were MP and INFB ,the 9 pathogens had their own infection characteristics and epidemic trend .

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.