Objective To investigate the cell-type-specific enhancer (CTSE) in HPV16 and its variation in cervical carcinoma. Methods CTSEs were detected by polymerase chain reaction (PCR) in 58 cervical carcinoma from Shaanxi province; in addition variation of CTSEs was analyzed through single-strand conformation polymorphisms (SSCP). Results HPV16 CTSEs were detectable in 34 of 58 (57%) specimens and mutant rate was 41%(14/34) and the main mutations of chosen randomly variant CTSE (CTSEv) happened at YY1 binding sites in addition to glucocoticoid response elements (GRE). Conclusion CTSE in some specimens of Shaanxi province was obviously different from that in HPV16 wild type and variant CTSE might affect the transcriptional regulation of LCR on viral P97, which regulates over-expression of viral oncogenes in cervical carcinoma.

Objective To investigate the indications and results of long channel technique with pedicle inner preputial flap urethroplasty for middle hypospadias repair. Methods During September 2007 to April 2010,28 cases of middle hypospadias were include in this study.The average age was 2.0 years (1.5 -6.0 years).The orifice of urethra was opened in the shaft of penis,and the distance between the urethral meatus and the center of glans was 25 mm ( 16 - 37 mm).A pars-meatus skin incision was made,which was dissected deep to the urethral plate.The urethral plate was transected,and a long channel between the urethral plate and the corpora cavernosa was created.The neourethra was made from the inner prepuce,and transposed to the ventral tunnel through a tunnel between buck's fascia and albuginea of ventrolateral corpora cavernosa.The neourethra was anastomosed with the proximal urethra.The buck's and dartos fascia along the skin incision were brought together and sutured individually,covering the proximal neo-urethra and the anastomosis.Induced penile erection confirmed that 13 cases were with mild penile curvature,and the other 15 case were without penile curvature.The average length of the defected urethra and tunnel was 38 mm (30 -42 mm) and 33 mm (26 -38 mm). ResultsSuccess was achieved in all cases without fistula or urethral stricture formation with the average follow-up of 20 months (6 -31 months),and penile curvature was completely corrected.The urethra was opened in the apex of the glans with normal-looking circumcised penis. ConclusionsLong channel technique with pedicle inner preputial flap urethroplasty can provide another option for repairing middle hypospadias without penile curvature or with mild penile curvature,especially for young children and those with small penis.This technique is simple,and the result is satisfied.

To analyze MR manifestations of postoperative spinal complications and investigate the value of MRI in the diagnosis and differentiated diagnosis, 114 cases of spinal postoperative complications were analyzed retrospectively and compared with the clinical data. The results showed that the main postoperative spinal complications included spinal stenosis (n=33, consisting of 21 cases of epidural fibrosis and 12 cases of epidural hematoma or epidural abscess), lack of spinal stability (n=43), infection (n=23, consisting of 7 cases of para-spinal soft-tissue infection, 5 cases of vertebral discitis, 4 cases of vertebral and appendix infection, 3 cases of epidural abscess, 2 cases of myelitis, 2 cases of spinal arachnoiditis), others (n=28, consisting of 12 cases of inner fixation failure, 9 cases of epidural hematoma, 7 cases of cerebrospinal fluid gusher). It is concluded that MRI can specifically display all kinds of postoperative spinal complications, and is of significant value in the diagnosis and differentiated diagnosis of postoperative spinal complications.

Objective To explore the values of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)measurements in various lesions of multiple sclerosis(MS).Methods Sixty patients with clinically diagnosed remitting-relapsing MS(RRMS)were included to undergo conventional brain MRI and DWI scans.the lesions were included when the diameter was more than 5 mm.mean ADC values were measured for various lesions of MS.The statistical analyses were performed to determine the differences of mean ADC values among various lesions of MS.and to compare the correlation between ADC values of lesions and Expanded Disability Status Scale(EDSS)scores.Results (1)The ADC value of hypointense lesions was significantly higher than that of isointense lesions(F=55.90,P<0.05),the ADC values were(127.5 ±9.3)×10-5mm2/s and(95.7 ±6.3)×10-5mm/s respectively.The nodular enhancing lesions had a significantly lower ADC value than the ring-enhancing lesions(F=64.18,P<0.01).the ADC values were(114.7 ±12.3)×10-5mm2/s and(140.7 ±11.0)×10-5mm2/s respectively.The ADC value of confluent lesions was substantially higher that of discrete lesions(t=9.04,P<0.01).the ADC values were(141.4±6.5)×10-5mm2/s and(105.4±13.9)×10-5mm2/s respectively.(2)No correlation between ADC of lesions and EDSS scores was found(r=0.35,P>0.05).Conclusion DWI and quantitative ADC are useful to explain the pathological changes in different lesions and to monitor the disease duration of MS.

Objective To assess the clinical value of MRI in evaluation of acute spinal cord in-jury. Methods A total of 50 patients with acute spinal cord injury were examined with magnetic reso-nance (MRI), X-ray and CT. Of all, 15 patients for spinal MR imaging were examined with axial and sngittal spin-echo and fast spin-echo imaging and 17 with coronal imaging. All imaging was performed on 1.5T superconducting system (GE/SIEMENS) with spine surface coil. Results Among 50 patients with acute spinal cord injury, spinal cord edema was detected by MRI in 16 patients, by CT in four but none by X-ray. Intraspinal cord hemorrhage was detected by MRI in 21 patients, by CT in 11 but none by X-ray. Compression and dislocation were detected by MRI in 34 patients, by CT in 15 but none by X-ray. Incomplete and complete transection of spinal cord was found by MRI in 10 patients, by CT in three but none by X-ray. Conclusion MRI is superior to CT scanning and X-ray in detection and evaluation of a-cute spinal cord injury and is the optimal method for examination and diagnosis of acute spinal cord injury.

Objective To investigate the expressions of matrix metalloproteinases(MMPs) in Kashin-Beck disease(KBD) cartilage as well as in a KBD rat model of T-2 toxin poisoning under selenium deficient conditions, and to investigate the effect of T-2 toxin on MMP-13 expression in human chondrocytes in vitro in order to determine a possible mechanism underlying KBD. Methods Samples of articular cartilage were divided into 2 groups:controls(samples from 5 normal children, traffic accident or operation), and KBD(samples from 5 children with KBD, auctopsy). Thirty-two Sprague-Dawley rats were divided into two groups by body weight using random number table: normal diet group(n = 16) and selenium-deficient diet group(n=16). The selenium level in normal diet was 101.500μg/kg, and in selenium-deficient diet was 1.118μg/kg. Rats were fed for 4 weeks with selenium-deficient or normal diet, respectively. After successful build up of the low selenium rat model, normal diet group was then subdivided into 2 sub-groups: normal group(n = 8) and normal diet plus low T-2 toxin group(n = 8);and selenium-deficient diet group was also subdivided into 2 sub-groups: selenium-deficient group ( n = 8 ) and selenium-deficient diet plus T-2 toxin group ( n = 8 ) . T-2 toxin of 100 μg·kg-1·d-1 was administered by intragastric administration for 30 days. Then the rats were sacrificed, and their knee joints were processed for histopathological evaluation. MMP-1 and MMP-13 locations in cartilages were performed by inmmunohistochemistry. Human chondrocytes C28/I2 were cultured in vitro. The experiment was divided into 4 groups: empty vector plasmid group, MMP-13 promoter plasmid group, MMP-13 promoter plasmid plus 20 μg/L T-2 toxin group and MMP-13 promoter plasmid plus 40 μg/L T-2 toxin group. MMP-13-luciferase reporter plasmid and vector plasmid were transiently transfected into C28/I2 cells for 24 hours, and then treated with 20 - 40 μg/L T-2 toxin for 24 hours. Transactivation of human MMP-13 promoter was analyzed using luciferase reporter constructs containing sequences spanning-1602 to+20 bp in C28/I2 chondrocytes. Results The percentages of chondrocytes staining for MMP-1 in the superficial and middle zones of KBD samples [(29.73 ± 10.12)%, (28.27 ± 0.91)%] were significantly higher than those of controls[(2.47 ± 0.11)%, (0.00 ± 0.00)%, all P < 0.05]. The percentages of chondrocytes staining for MMP-13 in the superficial and middle zones of KBD samples [(13.21 ± 4.32)%, (41.85 ± 6.32)%] were significantly higher than those of controls[(5.72 ± 0.31)%, (0.00 ± 0.00)%, all P<0.05]. The percentages of chondrocytes staining for MMP-13 in the superficial and middle zones of rats fed with selenium-deficient diet plus T-2 toxin group[(13.21 ± 4.32)%, (61.85 ± 8.68)%] were significantly higher than those of the normal and selenium-deficient groups[(2.43 ± 0.22)%, (5.89 ± 0.69)%, (3.03 ± 0.29)%, (25.99 ± 0.57)%, all P < 0.05]. Moreover, T-2 toxin activated the MMP-13 promoter detected with luciferase reporter assays in C28/I2 cells. The luciferase activities in MMP-13 promoter plasmid plus 20 μg/L T-2 toxin group and MMP-13 promoter plasmid plus 40μg/L T-2 toxin group(0.082 78 ± 0.008 40, 0.103 35 ± 0.013 19) were significantly higher than those in empty vector plasmid group and MMP-13 promoter plasmid group(0.024 19 ± 0.000 96, 0.040 32 ± 0.003 56, all P < 0.05). Conclusions These data suggest that T-2 toxin induces cartilage matrix degradation through up-regulation of MMP-13 promoter expression. Increased MMPs staining intensity in KBD cartilage and the rat KBD model of T-2 toxin poisoning under selenium deficient conditions suggest that matrix degradation appear to be driven by MMPs activity.

Objective To investigate the expressions of interleukin-1β(IL-1β), interleukin-6(IL-6) and tumor necrosis factor alpha(TNF-α) in cartilage of children with Kashin-Beck disease(KBD) in order to provide a possible mechanism of the disease. Methods Articular cartilage tissues of 5 KBD children(KBD group) were selected from KBD children autopsy samples keeping in Institute of Endemic Diseases, Medical School of Xi’an Jiaotong University; articular cartilage tissues of 5 normal children ( control group ) were selected from non-KBD areas of Shaanxi Province, three cases were from accident death children, two cases were the samples of congential malformation of six finger. Expressions of IL-1β, IL-6 and TNF-α in the cartilage were detected using immunohistochemistry; the cells of articular cartilage were divided into three areas (superficial zone, middle zone and deep zone) to analyze the expressions of IL-1β, IL-6 and TNF-α. Results The expressions of IL-1β in superficial zone , middle zone and deep zone of articular cartilage of KBD group (63.50 ± 7.19, 54.75 ± 5.50, 66.20 ± 9.91) were significantly higher than those of control group(5.75 ± 1.26, 0.00 ± 0.00, 0.00 ± 0.00, all P<0.05). The expression of IL-6 in superficial zone of articular cartilage in KBD group(55.25 ± 6.24) was significantly higher than that of control group(0.00 ± 0.00, P<0.05). The expressions of TNF-αin all zone of articular cartilage of KBD group(33.25 ± 6.50, 3.75 ± 0.96, 29.80 ± 1.92) were significantly higher than those of control group (3.74 ± 0.82, 0.00 ± 0.00, 0.00 ± 0.00, all P < 0.05). Conclusion The levels of IL-1β, IL-6 and TNF-α are up-regulated in articular cartilage of KBD children, suggesting that cytokines may play an important role in matrix degradation in KBD children cartilage.

Objective To evaluate the effectiveness and safety of MRI-navigation system EMT-100 in assisting the performance of precise percutaneous puncture biopsy.Methods With the help of MRI-navigation system EMT-100,percutaneous puncture biopsy of thoracic and abdominal lesions was performed in 42 patients.The puncture success rate was used as the main index to evaluate the effectiveness of MRI-navigation system EMT-100.The success rate of puncture biopsy,the total time used for procedure,the average number of puncturing,the average number of scanning,and the incidence of complications were recorded.Results In the 42 patients,the success rates with single and twice puncturing were 86％ (36/42) and 14％ (6/42) respectively.The success rate of puncture biopsy was 100％.The mean time used for locating puncture site was (11.5±5.5) min;the average number of puncturing was (1.4±0.5) times,and the average number of scanningwas(4.2±0.8) times.Among the 32 patients with pulmonary lesions,bloody sputum occurred in 2 patients (6.2％) and small amount pneumothorax in one patient (3.1％),and no serious complications occurred in other patients.Conclusion In performing percutaneous puncture biopsy of thoracic and abdominal lesions,the use of MRI-navigation system is safe.This technique has certain advantages,such as accurate positioning,high puncture success rate,wide range of application,radiationless,etc.It can help precisely obtain the lesion tissue and get pathological diagnosis.Therefore,it is really a valuable guiding technology.(J Intervent Radiol,2017,26:263-265)

OBJECTIVE: Because the double Endobutton plate has more advantages than the clavicle hook plate in the treatment of acromioclavicular joint dislocation, and the trauma is small; it does not need to be removed through secondary surgery. Thus, it has been widely used in clinical practice in recent years. Meta-analysis was used to investigate whether there were differences in the treatment of acromioclavicular dislocation between double Endobutton plate and clavicle hook plate so as to provide effective guidance for clinical treatment. METHODS: The database Cochrane library, PubMed, EBSCO, CNKI, VIP and Wanfang were searched from the database inception to January 2020. All the literatures related to the treatment of acromioclavicular dislocation with double Endobutton plate and clavicle hook plate were collected. The literatures were selected according to the inclusion and exclusion criteria to extract the data and to carry out the relevant analysis. The literatures that meet the requirements were screened out. The quality of the selected relevant literatures was assessed. All outcome indicators were analyzed by RevMan 5.3 software. RESULTS: (1) A total of 38 articles were included, and the total number of cases was 2 199, of which 1 035 cases were in the double Endobutton plate group and 1 164 cases were in the clavicle hook plate group. (2) The results showed that the double Endobutton plate group was superior to the clavicle hook plate group in the excellent and good rate [RR=1.19, 95%CI(1.13, 1.26), P < 0.000 01], operation time [MD=10.54, 95% CI(6.09, 15.00), P < 0.000 01], intraoperative blood loss [MD=-14.83, 95%CI(-20.54,-9.13), P < 0.000 01], hospitalization time [MD=-1.44, 95%CI(-2.65,-0.23), P=0.02], incision length [MD=-2.87, 95%CI (-3.60, -2.14), P < 0.000 01], hospitalization cost [MD=-2 442.10, 95% CI(-4 466.34, -417.86), P=0.02], shoulder pain after operation [RR=0.34, 95%CI(0.22, 0.53), P < 0.000 01], visual analogue scale score [MD=-0.85, 95% CI(-1.28, -0.41), P=0.000 2], final Constant-Murley score at 6 months postoperatively [MD=8.82, 95%CI(1.91, 15.72), P=0.01; MD=6.66, 95%CI(4.46, 8.86), P < 0.000 01]CONCLUSION: The treatment of Rockwood III type and above acromioclavicular joint dislocation with double Endobutton plate is superior to that clavicular hook plate. It has the advantages of short operation time, less intraoperative blood loss, less trauma, short hospitalization time and less cost, and good functional recovery of shoulder joint after operation.

Liquid biopsy is an emerging non-invasive detection technology, which mainly includes detection of circulating tumor cells, circulating tumor DNA and exosomes. It has a wide application prospect in the prevention and treatment of digestive system tumors. This article reviewed the types of liquid biopsy and its value in the diagnosis and treatment of digestive tract tumor, liver tumor, gallbladder tumor and pancreatic tumor.