Objective To investigate the influence of menstrucal cycle and anatomic site on the fractional anisotropy (FA) values of diffusion tensor imaging (DTI) in normal breast. Methods Prospectively enrolled 96 volunteers, who have identified with normal menstrucal phase and without breast diseases were found via the breast examination, ultrasound and MRI scan. The cases were divided into three groups according to menstrucal phase: menstrual period group(menstrual cramps 1 to 6 d), proliferative phase group(menstrual cramps 7 to 14 d) and secretory phase group(menstrual cramps 15 d to the next), and each group consisted of 32 subjects. All subjects were performed bilateral breast cross-sectional T1WI, T2WI, DWI and DTI scaning. On the nipple level figture, the mammary gland was divided into three regions including the anterior, central and posterior parts, and the FA values of the different phases and regions were measured. The Kruskal-Wallis H test was applied to analyse the difference of FA values in different menstrual phase and anatomic site. Results The FA values of the anterior region in menstrual phase, proliferative phase and secretary phase were 0.21 ± 0.07, 0.24 ± 0.09 and 0.17 ± 0.07, and the difference had significant difference(P=0.014).The FA values of the central region were respectively 0.15±0.08, 0.18±0.09 and 0.15±0.07, and without the statistically significant difference(P=0.090). The FA values of the posterior region were 0.21 ± 0.11, 0.24 ± 0.13 and 0.16 ± 0.11, and also showed significant difference(P=0.002). In different regions, the difference of FA values between menstrual phases and proliferative phases were also had statistically significant(P=0.018, 0.045, respectively). In the same region, the FA value was lowest in the secretary phase, and the proliferative phase was slightly higher than menstrual phase. Conclusion The FA values are affected by menstrual cycle and anatomic site.

Objective To investigate the clinicopathological features and prognosis in patients with thymoma and patients with thymoma and myasthenia gravis ( MG) . Methods A retrospective analysis was performed on the clinicopathological data of 161 patients pathologically diagnosed with thymoma alone or thymoma and MG from 2008 to 2014. In those patients, 128 had thymoma with MG and 33 had thymoma alone. The survival rates were calculated using the Kaplan?Meier method and analyzed using χ2 test or Fisher′s exact probability test. Results The mean age of onset was 45. 2 years for patients with thymoma and MG and 48. 5 years for patients with thymoma alone. In patients with thymoma and MG, 74. 2% had a tumor diameter of ≤5 cm, while 75. 8% of patients with thymoma alone had a tumor diameter of ≥5 cm. According to the Masaoka staging system, 78. 1% of patients with thymoma and MG had stage Ⅰ+Ⅱdisease, while 51. 1% of patients with thymoma alone had stage Ⅲ+Ⅳ disease. There was no significant difference in the 3?year overall survival ( OS) rate between the two groups ( 98. 1% vs. 81. 8%, P=1. 000) . The 5?year OS rate was significantly higher in patients with thymoma and MG than in patients with thymoma alone ( 91. 1% vs. 42. 9%, P= 0. 000 ) . In all patients, 140 patients with complete resection had significantly higher 3?and 5?year OS rates than 21 patients with incomplete resection ( 97. 2% vs. 58. 8%, P=0. 000;92. 7% vs. 25. 0%, P=0. 000). In patients with stage Ⅱ disease, there were no significant differences in the 3?or 5?year OS rates between patients with complete resection alone ( n=25) and patients with complete resection and postoperative radiotherapy ( n=25) ( 95% vs. 100%, P=1. 000;86% vs. 100%, P=0. 467). Conclusions Compared with patients with thymoma alone, patients with thymoma and MG have an earlier age of onset, substantially smaller tumor diameters, and earlier Masaoka stages. MG and complete resection are positive prognostic factors for patients with thymoma. Radiotherapy after complete resection can reduce the recurrence rate in patients with stage Ⅱ disease.

The treatment of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) is prone to more time-consuming, complex, toxic and ineffective. MDR-TB has low treatment success rate (52%) and high fatality rate (17%), as well as high rate of lost visits(15%), while the treatment success rate of XDR-TB is only 26%. It’s urgent to develop new drugs and chemotherapy regimens to improve the efficacy for MDR/XDR-TB. Delamanid (Dlm) has a strong killing effect on Mycobacterium tuberculosis (MTB) in vitro and in vivo. When MDR-TB patients are treated with optimized background regimen containing Dlm, the two-month sputum negative conversion rate is increased, case fatality is decreased and the prognosis is improved. This article reviews the progress on characteristics, in vitro activity, animal tests, clinical efficacy and safety of Dlm.

OBJECTIVETo investigate the effect of low-molecular-weight heparin (LMWH) combined with paclitaxel (PTX) on the invasiveness and migration of nasopharyngeal carcinoma cells and explore the molecular mechanisms.

METHODSMTT assay was used to detect the growth inhibition induced by LMWH and PTX in CNE1 and CNE2 cells. Wound healing assay and Transwell migration assay were employed to assess the effects of the drugs on the cell migration, and Transwell invasion assay was used to evaluate the cell invasiveness. The cellular expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) were analyzed by Western blotting. ELISA was used to determine the expression of heparanase (HPA) in the culture medium of the cells.

RESULTSMTT assay showed an obvious suppression of CNE1 and CNE2 cell proliferation in response to LMWH and PTX treatments. Treatment with 200 U·ml LMWH combined with 0.1 µmol·L PTX for 24 h resulted in the inhibition rates of migration of 66.70% and 70.53% in CNE1 and CNE2 cells, respectively significantly higher than the rates in cells with PTX treatment alone. The combined treatment with LMWH and PTX for 24 h also caused a significantly higher inhibition rate of cell invasion than LMWH and PTX alone. LMWH enhanced the down-regulation of MMP-9 and HPA induced by PTX.

CONCLUSIONLMWH can enhance the inhibitory effect of PTX on the migration and invasion of nasopharyngeal carcinoma cells, the mechanism of which may involve the down-regulation of MMP-9 and HPA expressions.

Carcinoma ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Glucuronidase ; metabolism ; Heparin Lyase ; metabolism ; Heparin, Low-Molecular-Weight ; administration & dosage ; pharmacology ; Humans ; Matrix Metalloproteinase 9 ; metabolism ; Nasopharyngeal Neoplasms ; pathology ; Paclitaxel ; administration & dosage ; pharmacology ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism

OBJECTIVETo study the effects of tunicamycin (a glycosylation inhibitor) combined with cisplatin on the proliferation and apoptosis of human nasopharyngeal carcinoma cells and explore the molecular mechanism.

METHODSNasopharyngeal carcinoma CNE-1 and CNE-2 cells cultured in vitro were treated with different concentrations of tunicamycin with or without cisplatin. The inhibition of cell proliferation was examined using MTT assay and colony formation assay, and the cell apoptosis was analyzed using flow cytometry with propidium iodide staining. The expressions of Bax, Bcl-2, and GRP78 in cells treated with 3 µmol/L tunicamycin with or without 6.00 µmol/L cisplatin were measured with Western blotting.

RESULTSTreatment with tunicamycin or cisplatin obviously inhibited the proliferation of CNE-1 and CNE-2 cells. Treatment with 3 µmol/L tunicamycin for 24, 36 and 48 h resulted in a viability of 72.13%, 51.97%, and 37.56% in CNE-1 cells and 85.61%, 56.95%, and 43.66% in CNE-2 cells, respectively, and the combined treatment with 6 µmol/L cisplatin lowered the cell viability to 67.97%, 47.76%, and 34.68% in CNE-1 cells and 56.89%, 37.05%, and 29.30% in CNE-2 cells, respectively. Tunicamycin at 0.3 µmol/L combined with 0.6 µmol/L cisplatin showed an obviously enhanced inhibitory effect on colony formation of CNE-1 and CNE-2 cells. Tunicamycin treatment (3 µmol/L) of CNE-1 and CNE-2 cells for 48 h induced an apoptosis rate of only 8.89% and 8.67%, but when combined with 6 µmol/L cisplatin, the cell apoptosis rate increased to 37.02% and 32.25%, significantly higher than that in cells with cisplatin treatment alone (7.25% and 6.36%, respectively). Compared with tunicamycin and cisplatin alone, the combined treatment significantly increased Bax expression and decreased Bcl-2 expression in the cells; tunicamycin up-regulated the expression of GRP-78 and enhanced the activity of caspase-3.

CONCLUSIONTunicamycin can inhibit the proliferation of CNE-1 and CNE-2 cells and enhance cisplatin-induced cell death, the mechanism of which may involve excessive endoplasmic reticulum stress response and increased activity of caspase-3.

Apoptosis ; drug effects ; Carcinoma ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Endoplasmic Reticulum Stress ; drug effects ; Heat-Shock Proteins ; metabolism ; Humans ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tunicamycin ; pharmacology ; bcl-2-Associated X Protein ; metabolism

Objective: To define radiographic features that response to serial casting and bracing for progressive early-onset scoliosis (EOS). Methods: A retrospective study of a total of 20 patients (10 females and 10 males) with complete radiographic data diagnosed as progressive early onset scoliosis treated with serial cast or brace for at least 12 months in the 306th Hospital of PLA from June 2011 to April 2018. Ages at initial diagnosis were all less than 5 years old. They were divided into two groups according to the main curve degree, those with cobbs angles more than 50 degree treated with serial cast, or else with brace. All the cases have radiographs of pretreatment, posttreatment, and last follow-up, and anteroposterior (lateral) film of the full length spine in standing position were taken to evaluate magnitudes and balance of coronal and sagittal malformations. We compared the general data of the two groups by independent sample t test and that of pretreatment, posttreatment and the last follow-up by paired-sample t test. Results: According to the effective standard of not less than 10 degrees improvement, 9 of them were effective, 4 cast and 5 brace, the effective rates were 44.44% and 45.45%, 3 cases from brace group progressed. The magnitudes of the main curve improved significantly after the first treatment of cast and brace (55.4±24.36 vs 42.35±23.62) degree (t=5.850, P=0.000), and at the last follow up, the curve decreased slightly compared of that before interventions (55.4±24.36 vs 51.8±26.33). The compensatory curves, segmental kyphosis, thoracic kyphosis, lumbar lordosis, balance of both coronal and sagittal also had no significant differences between the primal and the latest follow up. The widths 159.63±19.27 mm, 160.81±14.54 mm, 176.08±28.10 mm (t=3.942, P=0.001; t=-3.096, P=0.006) and heights 153.78±29.24 mm, 161.14±29.53 mm, 175.01±36.91 mm of the thoracic were significantly different between pre-posttreatment and the last follow up (t=-5.950, P=0.000; t=-3.997, P=0.001). Serial cast and brace application can preserve the growth of the thorax. Conclusion Serial cast and brace are viable growth friendly methods to deal with progressed EOS, Although a cure improvement cannot be always expected, they can stabilize relatively large curves in young children and may help delay eventual surgical intervention.

Objective To assess the influences of early implementation of patient-controlled epidural analgesia (PCEA) in labor on uterine myoelectrical activity and delivery outcomes. Methods A prospective study was conducted on 240 singleton cephalic primiparae with spontaneous labor at Guangzhou Women and Children's Medical Center from January 2015 to October 2018. Those women, who were ready to accept PCEA, were randomly assigned to early- or late-PCEA group based on cervical dilation of 0-3 cm or 3-6 cm at the time of commencing PCEA, while those who refused PCEA in labor were classified as non-PCEA group. Uterine electromyographic activity and visual analogue score (VAS)were recorded before and 1 h and 2 h after PCEA. Patient satisfaction with labor, duration of the first stage of labor, volume of postpartum bleeding within 2 h after delivery and neonatal Apgar score were compared between different groups using multivariate analysis of variance, repeated measures analysis of variance, LSD-t test or Chi-square test. Results The VAS values 1 h after PCEA in the early- and late-PCEA group were both lower than that in the non-PCEA group (2.08±1.34 and 2.00±1.28 vs 7.65±1.04, LSD-t were － 27.713 and － 27.663, P<0.001) and those before PCEA (7.65±0.91 and 7.62±0.86, LSD-t were －32.879 and －33.349, P<0.001). The VAS values 2 h after PCEA in the early- and late-PCEA group were both lower than that in the non-PCEA group (1.63±1.53 and 1.41±1.56 vs 7.66±0.87, LSD-t were －27.018 and －27.823, P<0.001) and those before PCEA (LSD-t were －31.379 and －32.718, P<0.001).The patient satisfaction rate with labor was higher in the early-PCEA group comparing to the late-PCEA group [80.0% (72/90) vs 61.1% (55/90), P<0.001], and the two figures above were both higher than that of the non-PCEA group [20.0% (12/60), both P<0.001]. There was no significant difference in the duration of the first stage of labor, the volume of postpartum blood loss 2 h after delivery, oxytocin usage rate, the rate of convertion to cesarean section, neonatal birth weight or Apgar score at 1 or 5 min among the three groups (all P>0.05). There was also no significant difference in uterine electromyographic parameters among the three groups before or 2 h after PCEA (all P>0.05). The number and duration of burst, power density spectrum peak frequency, root mean square and total power 1 h after PCEA in the early- and later-PCEA group were all lower than those in the non-PCEA group [4.80±2.49 and 5.54±3.04 vs 9.67±2.44; (34.41±1.21) and (36.94±1.18) vs (41.68±1.53) s; (0.36±0.08) and (0.36±0.07) vs (0.48±0.05) Hz ; (0.05±0.04) and (0.05±0.05) vs (0.07±0.05) mV; (4.33±0.51) and (5.36 ±0.59) vs (9.90±1.43) pV2; all P<0.05]. Conclusions The effect of PCEA on uterine myoelectrical activity has no association with the commencing time. While early PCEA could alleviate the labor pain as soon as possible, which enable us to improve the efficacy of labor analgesia, patient satisfaction and maternal and neonatal safety without increasing cesarean section rate.

Follicular lymphoma (FL) is the most common inert B-cell lymphoproliferative disease characterized by extensive lymph node involvement, splenomegaly, and bone marrow infiltration. In recent years, with the development of molecular imaging technology and precision medicine, the imaging research of FL has been moving towards a more refined direction. 18F-FDG PET/CT plays an increasingly important role in the diagnosis, staging, efficacy evaluation, and prognosis judgment of FL patients, promoting more precise personalized treatment and improving the efficacy and survival of FL patients. This article reviews the research progress of 18F-FDG PET/CT in the diagnosis and prognosis of FL based on domestic and foreign research progress, summarizing existing literature, in order to provide reference for personalized diagnosis and treatment of FL.

Objective:To compare and analyze the effects of total laparoscopic wedge resection and lobectomy in the treatment of stage ⅠA non-small cell lung cancer(NSCLC).Methods:A retrospective cohort study was used to collect 113 cases of stage IA NSCLC treated with total endoscopic surgery in Yantai Affiliated Hospital of Binzhou Medical University from January 2018 to January 2020. The clinical data of patients with NSCLC, including 69 males and 44 females. The age was (65.65±5.19) years old. According to the different surgical methods, they were divided into two groups: wedge resection group ( n=57) and lobectomy group ( n=56). The wedge resection group underwent total laparoscopic and the lobectomy group underwent total laparoscopic lobectomy. The operation related indexes(operation time, intraoperative blood loss, postoperative drainage time, postoperative drainage volume, number of lymph node dissection, first time to get out of bed after operation, first time to exhaust after operation, first time to defecation after operation and hospitalization time), lung function before and after operation [forced expiratory volume in the first second(FEV1), forced vital capacity(FVC), maximum expiratory flow(PEF), maximum ventilation volume (MVV)], complications and prognosis were collected between the two groups. The measurement data of normal distribution were expressed as mean ± standard deviation ( ± s). Independent t-test was used for comparison between groups, and paired sample t-test was used for comparison within groups. The chi-square test was used for comparison of enumeration data between groups. If there were two expected counts < 5, the continuous correction chi-square test was used. Multiple time points were compared using repeated measures one-way analysis of variance. Kaplan-Meier survival curve was used to analyze the survival of the two groups of patients, and Log-Rank test was used to test the survival difference. Results:The postoperative drainage time, postoperative drainage volume, the first time to get out of bed, the first exhaust time and hospitalization time in the pulmonary wedge resection group were(3.25±0.76) d, (218.77±15.93) mL, (18.86±3.51) h, (19.25±2.35) h, (9.23±1.65) d, and those in the lobectomy group were (5.09±1.21) d, (359.74±19.55) mL, (21.55±4.27) h, (22.02±2.85) h, (13.96±3.21) d. The difference between the two groups was statistically significant ( P<0.05). Both groups showed a decrease in FEV1, FVC, PEF and MVV volume at 3 months and 1 year after surgery, but the above indicators increased at 1 year after surgery compared to 3 months after surgery in the lobectomy group ( P<0.05). There was no statistical significant difference in FEV1, FVC, PEF and MVV between the two groups before and 1 year after surgery ( P>0.05). However, FEV1, FVC, PEF and MVV in the wedge resection group were higher than those in the lobectomy group at 3 months after operation ( P<0.05). After 3 years of follow-up, the recurrence-free survival rate and overall survival rate of the wedge resection group were 84.2%, 86.0%, and those of the lobectomy group were 98.2%, 98.2%. The difference between the two groups was statistically significant ( P<0.05). Conclusions:The safety of the two surgical methods for treating stage ⅠA NSCLC is comparable. Compared to patients undergoing lobectomy, lung wedge resection has a better short-term prognosis, reduces postoperative drainage, promotes postoperative recovery, and has a relatively small impact on short-term lung function. However, in terms of long-term prognosis, total laparoscopic lobectomy can achieve a relatively ideal survival prognosis.