Objective To study the effect of 17α-hydroxyprogesterone caproate (17P) and medroxyprogesterone acetate (MPA) on expression of tumor necrosis factor-α (TNF-α)and cyclooxygenase-2 (COX-2) in placenta and uterine myometrium of inflammation-induced preterm birth mouse model to investigate the mechanism of preventing inflammation-induced preterm birth by progestogen.Methods Thirty clean CD-1 mice were divided into 6 groups (5 mice in each group) at 15th day of gestation:control group,lipopolysaccharides (LPS) group,17P 1 mg+LPS group,17P 2 mg+ LPS group,MPA 1 mg+LPS group and dimethyl sulfoxide (DMSO) + LPS group.Progestogens at different dosage were administered 1 h before LPS and 6 h after LPS administration.After these mice were sacrificed,TNF-α and COX-2 levels in the myometrium and placenta were detected by real-time PCR and immunohistochemistry.Data were analyzed by ANOVA,and comparisons between groups were adopted LSD method.Results 1.The comparison of relative expression of COX-2 mRNA and TNF-α mRNA in myometrium and placenta among groups:(1) Expressions of COX-2 mRNA and TNF-α mRNA in myometrium and placenta in the study groups were obviously higher than those of control group (P＜0.05).(2) COX-2 mRNA expression in myometrium of 17P 1 mg+LPS group (11.410±3.931),17P 2 mg+LPS group (8.352±3.209) and MPA 1 mg+LPS group (11.920± 2.905) were obviously lower than that of LPS group (20.540± 4.147) and DMSO+ LPS group (18.620 ± 4.156) (P＜0.05,respectively) ; although TNF-α mRNAexpression had similar trends among these groups,there were no statistical significance (P＞0.05,respectively).(3) COX-2 mRNA expression in placenta of 17P 1 mg+LPS group (10.864±3.777),17P 2 mg+LPS group (7.084±1.667) and MPA 1 mg+LPS group (11.830±3.652) were obviously lower than that of LPS group (18.920±4.106) and DMSO+LPS group (23.820±7.554)(P＜0.05,respectively).(4) TNF-α mRNA expression in placenta in 17P 1 mg+LPS group (14.340±1.618),17P 2 mg+ LPS group (11.488 ± 2.910) and MPA 1 mg+ LPS group (13.040 ± 2.982) were obviously lower than that of LPS group (24.240±7.059) and DMSO+LPS group (23.040±5.896) (P＜0.05,respectively).2.The comparison of protein expression of COX-2 and TNF-α in placenta among groups:(1) The expression of COX-2 protein in placenta of the study groups was significantly higher than that of control group (P＜0.05).(2) There were no differences among the COX-2 protein expression of 17P 1 mg+ LPS group (14 360.92± 1766.01),17P 2 mg+ LPS group (13 340.18±965.35) and MPA 1 mg+LPS group (12 870.81±1521.97)(P＞0.05),while the COX-2 protein expressions of them were significantly lower than that of LPS group (16 426.64 ± 1823.87) and DMSO+LPS group (16 761.23±2388.17)(P＜0.05,respectively).(3) There were no differences among the TNF-α protein expression of 17P 1 mg+LPS group (22 750.96±4656.68),17P 2 mg+LPS group (22766.24± 3500.34) and MPA 1 mg+LPS group (20770.01±3318.48)(P＞0.05),while the TNF-α protein expressions of them were significantly lower than that of LPS group (26204.49±5090.34) and DMSO+LPS group (27346.18±3269.30)(P＜0.05,respectively).Conclusions 17P and MPA might prevent the preterm parturition of inflammation-induced mouse model by inhibiting inflammation cytokines and prostaglandins.

Objective To estimate the concentrations of trace element contents in plasma and serum of cases with major depression.Methods The search for all the related literatures in CBMDisc,CNKI,VIP,ScienceDirect,Medline and so on has been made.Selection criteria:examination of plasma and serum trace elements in patients with major depression and control group.Data collection and analysis:a quantitative meta-analysis was carried out by two reviewers using information based on inclusion and exclusion criteria from all papers available.Results 24 studies met inclusion criteria,all with scores of 4 or more.Zn concentration in plasma and serum of patients with major depression significantly decreased compared with that in healthy people by 2.35 mol/L,95％ CI (-2.94,-1.75) (P＜0.01).The concentration of Cu and Fe had no significant difference between the two groups (P＞ 0.05).Conclusion There were abnormal trace elements in the patients with major depression,Zn decreased,Cu and Fe mainly appeared as an unbalanced state.It is necessary to carry out more extensive research and in-depth exploration.

Objective To analyze the pathological voice ,normal voice range chart crowd voice characteristics through tests and analyze the differences between the two groups of test‐related parameters chart range between indicators ,so as to explore the value of the test range map in the polyp of vocal cord .Methods One hundred and twenty patients with vocal polyps according to in‐clusion and exclusion criteria were selected .Sixty cases of normal voice were randomly selected .Germany XION DIVAS system dia‐gram test mode range were recorded for both groups ,with the strongest voice of the bass were measured at different frequencies , first obtain low VRP intensity curve ,then get high‐intensity curve VRP .The maximum frequency of the vocal cord polyp group and normal control group ,the minimum frequency ,maximum intensity ,most quietly strong ,maximum phonation time ,fundamental fre‐quency perturbation and dysphonia index of the data were compared statistically .Results Compared with the control one ,the mean maximum frequency of vocal cord polyp group were lower (P= 0 .029 6) ,the average minimum frequency were significantly higher ( P= 0 .000 3) ,frequency range reduced(P= 0 .022 9) ;vocal cord polyp average loudest group was stronger(P= 0 .003 9) ,the whis‐pered strength values were significantly higher (P = 0 .000 0) ,significantly limited the average sound intensity range than normal voice group group (P= 0 .006 9) .Classification index based on objective voice disorders ,in terms of frequency ,mild voice disorders at the maximum frequency .There was no significant difference in the minimum frequency ,frequency range with a normal voice group ;and in severe voice disorders average maximum frequency lower than the normal voice group ,the smallest than normal voice frequency was significantly higher frequency range than the normal group was significantly limited .In terms of strength ,mild im‐pairment in the loudest voice is strong ,most quietly strong .There was no significant difference with the normal voice group intensi‐ty range ;and in severe voice disorders average maximum sound intensity ,most quietly strong values were higher than normal voice group .However ,the average sound intensity narrow range than normal voice group .Conclusion The range map test can be quanti‐fied assessment of voice ,and can distinguish normal voice ,clinical pathological voice and the severity of damage ,which is an impor‐tant means of voice feature detection to provide an objective basis .

OBJECTIVE: To analyze the clinical features & variation features of cervical tuberculous lymphadenitis and to discuss its effective surgical treatment. METHOD: Retrospective analysis of 27 cases of cervical tuberculous lymphadenitis patients admitted to the hospital from January 2008 to December 2013. The cervical tuberculous lymphadenitis is classified based on the enhanced CT scanning conducted before operation and the preoperative evaluation of clinical characters of patients. The lymphaden ncisional biopsy was conducted on the type I patients with cervical tuberculous lymphadenitis. The lesion resection was performed on the type II and mixed type I + II patients. The regional cervical lymph node dissection was carried on the type III, the type IV and other mixed type patients. The negative pressure drainage ball was placed after operation, and the cavity was flushed with 5% povidone iodine solution. The antituberculosis therapy was performed after wound healing. RESULT: The analysis of the clinical features for 27 patients: the incidence rate on the left side, right side, both sides and middle-line is 63.0%, 25.9%, 7.4% and 3.7% respectively. The majority of patients whose lesion involving more than one region account for 62.1%; the patients whose lesion involving one region account for 37.9%. The most common is level V involved lesion (69.0%), then level IV (62.1%), level III (51.7%), level II (34.5%), level I (10.3%) and level VI (3.4%) in order. The analysis of the CT imageology features for 27 patients: the simple type is the majority (65.5%), and the most common is type III (24.1%), then the type I (17.2%), type II (13.8%) and type IV (10.3%) in order. The mixed type is minority (34.5%), but the two mixed is often (31.0%). The three mixed is only located on one side (3.4%). The recurrence never happened on the patients with resection and standard antituberculosis therapy. CONCLUSION For the cervical tuberculous lymphadenitis, the suitable surgical treatments shall be selected according to the lesion characteristics & location and CT imaging manifestations presurgical evaluation. The effective way to treat cervical tuberculous lymphadenitis is to conduct negative pressure drainage after operation, to flush the cavity with 5% povidone iodine solution and to perform antituberculosis therapy.
Antitubercular Agents ; therapeutic use ; Drainage ; Humans ; Neck ; Neck Dissection ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node ; classification ; drug therapy ; surgery

Objective To discuss the differences of clinical features and characteristics and features of polysomnography be‐tween elderly patients and middle‐aged patients with obstructive sleep apnea hypopnea syndrome (OSAHS) ,so as to provide refer‐ence for the diagnosis and individualized intervention of elderly OSAHS .Methods Totally 81 aged OSAHS cases and 123 youth OSAHS cases were analyzed in terms of general condition ,clinical manifestations and polysomnographic characteristics ,and the clin‐ical manifestations and polysomnographic difference indicators of the two groups were matched according to body mass index (BMI) .Results Most OSAHS patients were males in both groups ,with BMI and neck waist circumference in the aged group less than those in the middle‐aged group ,and the difference was statistically significant (P<0 .05) ,while the bust was larger than that in the middle‐aged group ,but the difference was not statistically significant (P>0 .05);clinical symptoms of senile groups such as drowsiness ,snoring ,morning headaches ,dry mouth and nighttime awakenings were lower than the middle‐aged group ,the difference was statistically significant (P<0 .05) ,and complications such as hypertension ,diabetes and other risk disease were significantly higher than those in the middle‐aged group ,and the difference was statistically significant (P<0 .05);in the aged group ,the degree of OSAHS was dominated by mild to moderate ,while the middle‐aged group ,was dominated by moderate to severe ,but the differ‐ence was not statistically significant (P>0 .05);REM AHI was more than the middle‐aged group ,the difference was statistically significant (P< 0 .05) ,AHI was less in old age group than in the middle‐aged group ,the difference was statistically significant (P<0 .05);NREMⅠ + Ⅱ stage in the aged group was more than that in the middle‐aged group(P<0 .05) ,and NREM Ⅲ + Ⅳstage ,REM period ,the average SaO2 (% ) ,MAI clear were less than those in the young group;LSAT (% ) was greater than that in the middle‐aged group ,but the difference was not statistically significant (P>0 .05) .Conclusion The incidence of typical clinical manifestations of aged OSAHS patients was lower than that in the middle‐aged group ,but high blood pressure ,diabetes and other complications prevalence were significantly higher than those in the middle‐aged group ,with similar severity of OSAHS in both groups ,there were differences PSG monitoring results with the middle‐aged group ,and the difference of REM AHI was significant .

Purpose To study the clinicopathological characteristics in 22 cases of ovarian mature teratoma with malignant transforma-tion. Methods Clinical and pathologic features were collected and analyzed in 22 out of 1 826 cases of ovarian mature teratoma by retrospective studies, together with immunohistochemical staining. Results In our study, 22 cases (1. 2%) of ovarian mature terato-ma with malignant transformation were identified. The median age was 56. 5 (range, 31~79) years. The main clinical manifestations were pelvic masses, including 13 cases in the left ovary, 8 cases in the right, 1 case was bilateral. Gross cystic teratoma were saw in 19 cases, 3 cases of cystic and solid, the bilateral one was solid in the left which the right was cystic. The teratomas size were 5. 0~30 cm with average 12. 4 cm in diameter. The malignant components’ maximum diameter was about 1. 0~10. 0 cm with average 3. 7 cm. Microscopicically, there were poorly differentiated squamous cell carcinoma in 14 cases, carcinoid carcinoma in 4 cases, adeno-carcinoma in 2 cases, papillary thyroid carcinoma in 2 cases, and the last one was sarcomatoid carcinoma. The FIGO stage distribution was as follows:16 were stage IA, 1 was stage IB, 1 was stage IIA, 4 were stage IIB. Follow up showed 6 cases recurrened, 2 patients died, the rest are survival. Conclusions A low incidence of ovarian mature teratoma in somatic cells with malignant transformation, which are common in postmenopausal women and present with pelvic mass. The main malignant components is squamous cell carcino-ma, patients of stage I have better prognosis. Both clinic and pathology should take more attention to the comprehensive examination and diagnosis of teratoma for prevent misdiagnosis.

Objective To evaluate the clinical efficacy and safety of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of Kummell'disease.Methods Databases of Cochrane Library,PubMed,Medline,Embase,Web of Science,CNKI,VIP,Wanfang Data and CBM were used to search clinical studies on percutaneous kyphoplasty virus percutaneous vertebroplasty in the treatment of Kummell's disease from database inception until June 1st,2022.Literature screening was performed according to the speci-fied inclusion and exclusion criteria.In strict compliance with Cochrane's systematic evaluation principle,authors reasonably screened,e-valuated and analyzed the quality of the retrieved papers and then the evaluating indicator of postoperative ODI,JOA,VAS,operation time and intraoperative complications in each included study was evaluated in Review Manager 5.4software.Results Nine papers were included,involving 243 patients in the percutaneous vertebroplasty group and 222 patients in the percutaneous kyphoplasty group.Percu-taneous kyphoplasty had advantages in postoperative ODI score,cement leakage,and postoperative Cobb's angle,which was statistically significant(P＜0.05),but the operation time was longer and the postoperative VAS score improved poorly.There was no significant difference in intraoperative bleeding and height of the postoperative vertebral margin(P＞0.05).Conclusion In the surgical treatment of Kummell's disease,percutaneous vertebral kyphoplasty can more effectively improve the postoperative ODI score,and reduce the post-operative Cobb's angle and the risk of cement leakage compared to the traditional percutaneous vertebroplasty.It has more advantages in improving the clinical efficacy and reducing the postoperative risk.However,the conclusions of this study require more high-quality,multi-angle and large-sample studies in the future.

OBJECTIVE To investigate the effect of mono-2-ethylhexyl phthalate(MEHP) on proliferation of primary neural stem cells(NSCs)of rats and NE-4C cells of mice and on the migration of NE-4C cells and the mechanism. METHODS NE-4C or NSCs were treated with MEHP 1,10,100 and 1000 μmol · L-1 for 72 h,respectively. The cytotoxicity was estimated with the cell counting kit-8 (CCK-8). Cell proliferation was analyzed by EdU assay. The mRNA expression levels of the glucocorticoid receptor(GR),signal transducer and activator of transcription 3(Stat3)and sex determining region Y (SRY)-box 2(Sox2) were detected by qRT-PCR. The protein expression levels of total GR,GRβ, Sox2,Stat3 and p-Stat3 were measured by Western blotting. RESULTS Cell viability of NE-4C cells and NSCs at MEHP 1000μmol·L-1 was significantly decreased,which was 70.3%and 40.0%of the control group, respectively. EdU assay showed that MEHP 100 μmol · L-1 decreased NE-4C cells and NSCs by 74.8%and 12.0%(P<0.05)compared with control. The effect of MEHP on the cell migration of NE-4C was evidenced by the fact that the migration was obviously reduced to (63.4±2.0)%(P<0.05)after treatment with MEHP 100μmol · L-1 for 72 h. The mRNA expression levels associated with proliferation and migration in NE-4C of GR,Stat3 and Sox2 in MEHP 100 μmol · L-1 group were down-regulated to 49.8%,26.0% and 14.0%of control(P<0.05). At MEHP 100μmol · L-1,mRNA of GR, Stat3 and Sox2 in NSCs declined to 10.0%,14.0% and 15.3% of normal control. Western blotting results revealed that protein expressions of GR,GRβ,Sox2 and p-Stat3 were remarkably inhibited by MEHP 100 μmol · L-1 in that the relative expression of NE-4C was 0.92 ± 0.17,0.87 ± 0.35,0.81 ± 0.22 and 0.62 ± 0.24(P<0.05). The corresponding protein expression in NSCs was 0.82 ± 0.20,0.56 ± 0.12,0.84 ± 0.36 and 0.53 ± 0.20(P<0.05)when the cells were treated with MEHP 100μmol · L-1 for 72 h. CONCLUSION MEHP can inhibit the proliferation and migration of NE-4C cells and NSCs possibly by decreasing Stat3 and Sox2 that are mediated by GRβ.

OBJECTIVETo evaluate the immunophenotype conversion of fibroblasts and its clinical significance in the process of breast tumor stromal remodeling.

METHODSCD34, FAP-α, p63 and a-SMA were detected by immunohistochemistry in 273 breast biopsies, including 60 normal breast tissues, 46 atypical ductal hyperplasia (ADH), 60 ductal carcinoma in situ (DCIS), 47 DCIS microinvasive carcinoma (DCIS-MI) and 60 invasive ductal carcinoma (IDC).

RESULTSThe positive expression rates of CD34, FAP-α and α-SMA in the stromal fibroblasts of normal breast tissues were 93.3%, 6.7% and 18.3%, respectively. Those in the stromal fibroblasts of ADH tissues were 95.7%, 4.3% and 10.9%, respectively. Those in the stromal fibroblasts of DCIS tissues were 95.0%, 8.3% and 15.0%, respectively. Those in the IDC tissues were 35.0%, 85.0% and 93.3%, respectively. The expressions of CD34, α-SMA and FAP-α in the stromal fibroblasts of normal, ASH and DCIS breast tissues did not show significant differences (χ(2) = 1.142, P = 0.896). The main immunophenotype of stromal fibroblasts in the tumor-host interface at the invasive front of ADH and DCIS lesions was CD34(+)α-SMA(+)FAP-α(+). There were statistically significant differences in the expression of CD34, α-SMA and FAP-α between IDC and ADH, DCIS and normal breast tissues (χ(2) = 8.351, P < 0.001). The immunophenotype of stromal fibroblasts in the IDC and DCIS-MI breast tissues was CD34(-) α-SMA(+) FAP-α(+).

CONCLUSIONSImmunophenotype conversion from CD34(+) α-SMA(-) FAP-α(-) to CD34(-) α-SMA(+)FAP-α(+) may be a sensitive indicator to judge whether DCIS has microinvasion. Detection of the immunophenotype conversion of stromal fibroblasts may be helpful to determine the presence of microinvasion, and to improve the diagnostic accuracy rate of DCIS.

Breast ; Breast Neoplasms ; immunology ; pathology ; Carcinoma in Situ ; Carcinoma, Ductal, Breast ; Carcinoma, Intraductal, Noninfiltrating ; Fibroblasts ; immunology ; Gelatinases ; metabolism ; Humans ; Hyperplasia ; Immunohistochemistry ; Immunophenotyping ; Membrane Proteins ; metabolism ; Serine Endopeptidases ; metabolism

Objective:To evaluate the operating performance, effectiveness and safety of a new portable endoscopic system for upper gastrointestinal endoscopy in an animal model.Methods:A parallel control, non-inferiority study was designed. Ten healthy Bana pigs were selected as the study subjects, and underwent upper gastrointestinal endoscopy using portable endoscope followed by Olympus GIF-Q260 endoscope. The instrument quality, image quality and safety of the new system were evaluated by means of quantitative scores.Results:The time for deployment and installing of the new portable endoscopic system during single operation was 110.24±8.93 s and 91.33±11.59 s, respectively, and the time for the endoscope with disposable protective cover was 233.48±17.06 s. The time of attracting 400 mL normal saline of the portable endoscope and Olympus endoscope was 56.44±5.18 s and 33.71±3.56 s, respectively. The water vapor attraction performance of the portable endoscope was not as good as the Olympus endoscope, but still met the technical requirements of medical devices (attraction capacity >400 mL/min). While in terms of the seal property, biopsy channel, softness and curvature of gastroscopy body, knob operation, and field of view, the two endoscopic systems were equivalent. In terms of image quality evaluation, including clarity, distortion, color resolution, illumination and quality comprehensive evaluation, the performance of the new portable endoscopic system was similar to that of the Olympus endoscopic system. One pig developed nausea during operation with the Olympus endoscope. No adverse events occurred during operation with the new portable endoscope.Conclusion:The new portable endoscopic system is easy to assemble. In terms of device quality, image quality and safety, the new portable endoscopic system is similar to the clinically used Olympus endoscopic system. Therefore, the new portable endoscope system is safe and effective for upper gastrointestinal endoscopy.