Objective To explore the changes of placental growth factor (PLGF) in patients with acute coronary syndrome (ACS).Methods One hundred and twelve patients were divided into four groups according to clinical data and coronary angiography:non-coronary artery disease (non-CAD) group (27 cases),stable angina (SA) group (28 cases ),unstable angina (UA) group (29 cases) and acute myocardial infarction (AMI) group (28 cases).Fifty-seven patients with ACS were divided into single lesion group (19 cases),twice lesion group ( 16 cases) and triple lesion group (22 cases) by coronary angiography,and 0-7 scores group (23 cases),8-15 scores group (27 cases) and 16-32 scores group (7 cases) by Jenkins scores.The serum PLGF levels of all the cases were determined on admission.The serum PLGF levels of 40 cases receiving percutaneous coronary intervention (PCI) were determined at 30 min before operation,the first and second day after operation.Results The serum PLGF levels of AMI group and UA group were (38.33 ±10.14) ng/L and (37.44 ± 13.32) ng/L respectively,which were significant higher than that of SA group [(20.90 ± 3.88) ng/L] and non-CAD group [(20.34 ±4.53) ng/L](P＜ 0.01),and there was no significant difference between AMI group and UA group,SA group and non-CAD group (P ＞0.05).There was no significant difference in the serum PLGF level among triple lesion group,twice lesion group and single lesion group (P ＞ 0.05 ).There was no significant difference in the serum PLGF level among 0-7 scores group,8-15scores group and 16-32 scores group (P ＞ 0.05).The serum PLGF level of patients receiving PCI on the first day after operation [ (32.03 ± 7.41 ) ng/L] was significantly higher than that before operation [ (23.86 ± 6.91 ) ng/L](P＜ 0.05 ),and on the second day after operation the serum PLGF level [ (29.37 ± 6.99) ng/L] was less than that on the first day after operation,showing a fall tendency(P＞ 0.05).Pearson correlation analysis showed that the serum PLGF levels in patients with ACS were not related with cardiac troponin T and creatine kinase isozyme-MB (r =-0.158,P=0.421;r =0.302,P=0.118).Conclusion The serum PLGF level of ACS patients is an inflammatory marker reflecting coronary atherosclerotic plaque destabilizing or plaque ruptured,and may also play an important role in early diagnosis of the borderline case of ACS.

Objective To compare the effects of different methods of anesthesia on immune function during renal transplantation. Methods Thirty-nine uremic patients of both sexes (20 male, 19 female) aged 19-65 yr, undergoing renal transplantation were studied. Patients who had infection, fever, immune system disease or had received immunoregulatory drugs were excluded. The patients were randomly divided into 3 equal groups: Ⅰ continuous epidural anesthesia group (CEA , n = 13); Ⅱ combined spinal-epidural anesthesia group (CSEA, n = 13) and Ⅲ general anesthesia group (GA , n = 13). In group I an epidural catheter was inserted at T12-L1 or L1-2 into epidural space and advanced in cephalad direction and a mixture of 2% lidocaine and 0.7% dicaine (1: 1) 11-12 ml was given. The height of block was T8 In group II CSEA was performed at L2-3 and a mixture of 1% dicaine, 10% glucose and 3% ephedrine (1 : 1 : 1) 3 ml was injected intrathecally. An epidural catheter was threaded in a cephalad direction. The block height was T8. 2 % lidocaine was given epidurally when the operation lasted more than 2 hours. In both group I and II pathidine 50 mg and droperidol 5 mg were given iv. In group III anesthesia was induced with fentanyl 5 ?g kg-1 , etomidate 0.3 mg ? kg-1 and vecuronium 0.08 mg ? kg-1 and maintained with isoflurane supplemented with intermittent iv boluses of vecuronium. Blood samples were obtained from peripheral vein for determination of CD+3 , CD+4 , CD+8 , CD+4 /CD+8 ratio and IgG, IgA, IgM, C3 , C4 before anesthesia (T0 ) , after anesthesia (T1), before blood transfusion (T2), 30 min and 1 h after blood transfusion (T3,4) ,when renal circulation was restored (T5), at the end of operation (T6 ) and 1 and 3 days after operation (T7.8) .Results There were no significant changes in T lymphocyte subgroups, immunoglobulins and complements measured after anesthesia (T1 ) as compared with the baseline values(T0) in the 3 groups. In group Ⅰ and Ⅱ CD+3 , CD+4 , IgG, IgA, IgM, C3 , C4 and CD+8 unchanged significantly as compared with the baseline values (T0 ) ; CD+4 /CD+8 ratio decreased after anesthesia ( P

Objective To investigate the association between distribution of protein gene product (PGP) 9.5-immunoactive nerve fibers in peritoneal endometriotic lesions and disease-associated pain symptoms.Methods Thirty two peritoneal endometriotic lesions from patients with endometriosis (16 cases with pain and 16 cases without pain) and matched with 20 peritoneal tissues from patients with uterine leiomyoma without endometriosis were stained immunohistochemically for PGPg.5-immunoactive nerve fibers.Results The positive rate and density of PGP9.5-immunoreactive nerve fibers in peritoneal endometriotic leision were 62% (10/16) and (3.8 ± 1.7)/mm~2 in endometriosis patients with pain, which were significantly higher than 19% (3/16) and (1.7 ± 0.5)/mm~2 in endometriosis patients without pain (P <0.05) and 25% (5/20) and (1.3±0.6) /mm~2 in peritoneal tissues in women without endometriosis (P <0.05).However, no differences were found between endometriosis patients without pain and women without endometriosis (P > 0.05) .Moreover, the density of PGP9.5-immunoreactive nerve fibers in peritoneal lesions in endometriosis patients with pain was positively correlated with the severity of pain (r = 0.855, P < 0.05).In addition, the density of PGP9.5-immunoreactive nerve fibers in peritoneal lesions was statistically higher in endometriosis patients with chronic pelvic pain and(or) dysmenorrhea than those in endometriosis patients with other type of pain(P < 0.05), which was not associated with active lesion, site and staging (P > 0.05).Conclusion It suggested that PGP9.5-immunoreactive nerve fibers might confer the mechanism of pelvic pain with endometriosis.

Objective:To further understand the current status of diagnosis and treatment of endometriosis in China, the implementation of guideline in different levels of hospitals, and the need for continuing education in endometriosis among primary doctors.Methods:The survey was conducted in the form of convenience sampling questionnaire among the Wechat public platform. The doctors were free to participate in the investigation without any reward. All questions answered were assessed as valid questionnaire. The datas were collected on the questionnaire network platform and analyzed by SPSS 19.0.Results:Totally 1 494 valid questionnaires were collected in this survey. 60.17% (899/1 494) of them were from tertiary hospital, and 32.60% (487/1 494) were from grade two hospital. Only the hospitals where 9.97% (149/1 494) participants based opened the specialist clinic for endometriosis. 70.35% (1 051/1 494) of participants said they had read the second edition of guideline for the diagnosis and treatment of endometriosis which published in 2015. The American Society for Reproductive Medicine (ASRM) staging system was adopted in the clinical practices of only 25.03% (374/1 494) participants. And 18.74% (280/1 494) participants used the endometriosis fertility index (EFI) scoring during the laparoscopic surgery for endometriosis with infertility. 45.18% (675/1 494) of participants said they had not attended any academic conference on endometriosis in the past six months. 64.46% (963/1 494) of the participants believed their diagnosis and treatment in practice should be improved and standardized. 87.15% (1 302/1 494) of the participants expressed the hope that more conferences or workshops on endometriosis would be held.Conclusions:At presents, the diagnosis and treatment of endometriosis in China has been greatly improved, but the implementation of guidelines and the new concept is still a long-term job. The specialist clinic are held only in a few hospitals. It’s the expectation and voice of primary doctors to the association to organize the more academic congresses on endometriosis.

Objective:To study the expression of methyltransferase-like protein 14 (METTL14) in epithelial ovarian cancer and its clinical significance, and to explore the effect of METTL14 expression on the proliferation, invasion and migration of ovarian cancer cells.Methods:Immunohistochemistry (IHC) was used to detect METTL14 expression in tumor tissue samples, and analyze the relationships among METTL14 expression, clinicopathological factors, and prognosis in ovarian cancer. Lentiviral vectors and small interfering RNA (siRNA) were used to up-regulate and down-regulate the METTL14 expression in ovarian cancer cell lines A2780 and SKOV3, respectively. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect the N6-methyladenosine (m6A) content in ovarian cancer cells. Cell counting kit-8 (CCK-8), wound healing assay, and transwell assay were used to examine the function of METTL14 expression in the cells.Results:(1) The IHC score of METTL14 protein was 6.2±3.7 in 20 samples of ovarian cancer tissues and 3.3±2.5 in 15 samples of normal ovarian tissues, and the difference was statistically significant ( t=-2.64, P=0.012). Among the patients who suffered from ovarian cancer, there were 69 cases with high expression of METTL14 protein (IHC score≥6), accounting for 57.0% (69/121), and the cases with low expression of METTL14 protein (IHC score<6) accounting for 43.0% (52/121). Compared with the patients with low expression of METTL14, the patients with high expression of METTL14 had later stages, higher rates of lymph node metastasis, abdominal metastasis, and more ascite amount. The differences were statistically significant (all P<0.05). The overall survival rate was significantly lower in patients with high METTL14 expression than the low expression ( P=0.009). (2) LC-MS/MS data showed that the relative expression of m6A in A2780 and SKOV3 cells in the lentivirus (LV)-METTL14 group were 0.213±0.024 and 0.181±0.018, which were significantly higher than those in the LV-normal control (NC) group (0.109±0.022 and 0.128±0.020; all P<0.05). While the relative expression of m6A in A2780 and SKOV3 cells in the si-METTL14 group were 0.063±0.012 and 0.069±0.015, which were significantly lower than the expression in si-NC group of 0.108±0.014 and 0.121±0.014 (all P<0.05). CCK-8 assay showed that the absorbance values were significantly lower in the si-METTL14 group compared with the si-NC group at 36, 48, 60 hours (all P<0.05); while were significantly increased in the LV-METTL14 group compared with the LV-NC group at 48, 60 hours (all P<0.01). Scratch wound assays showed that the migration rate of the si-METTL14 group was lower than those of the si-NC group, while the LV-METTL14 group were higher than the LV-NC group by 24 hours, the differences were statistically significant (all P<0.01). Cell migration and invasion were detected by transwell migration and invasion assays. After cultivated for 24 hours, the invasion cell number and the migration cell number in the si-METTL14 group were less than those in the si-NC group. While the invasion cell number and the migration cell number in the LV-METTL14 group were more than those in the LV-NC group, respectively. The differences were statistically significant (all P<0.01). Conclusion:Patients with high METTL14 expression have a worse prognosis in ovarian cancer, which may increase the m6A modification of ovarian cancer cells and promote cells proliferation, invasion and migration.

Objective:To investigate the effect of somatostatin receptor ligands (SRLs) on bone metabolism in patients with acromegaly.Methods:Retrospective analysis of clinical data of acromegaly patients( n=100) received surgery or SRLs alone for 3 months. The changes of growth hormone (GH), insulin-like growth factor-1 (IGF-1), osteocalcin (OC), N-mid fragment of osteocalcin (N-MID), amino-terminal peptide of type I procollagen (P1NP) and C-terminal peptide degradation product of type I collagen(CTX) were compared before and after treatment. Patients were divided into drug treatment group and surgical group according to treatment methods. According to the decline of GH after medication, patients in the drug treatment group were further divided into drug sensitive group and drug insensitive group. Results:The average dynamic GH and IGF-1 indexes in the drug treatment group were significantly decreased after treatment compared with before treatment (both P<0.05), and CTX was also significantly decreased after treatment [1.25 (0.67, 1.40) ng/mL vs 1.34 (0.57, 1.68) ng/mL, P<0.05]. The mean dynamic GH, IGF-1 index, OC, N-MID, P1NP, and CTX in surgical group were significantly decreased after treatment compared with before treatment (all P<0.01). In the surgical group, there was a positive correlation between GH difference (ΔGH) and N-mid difference (ΔN-MID; r=0.454, P=0.026), and there was a positive correlation between IGF-1 index difference (ΔIGF-1 index) and CTX difference (ΔCTX; r=0.339, P=0.036). After treatment, the mean dynamic GH, IGF-1 index, CTX, P1NP, and N-MID in drug treatment group were significantly higher than those in surgical group (all P<0.001). CTX and N-MID decreased significantly after treatment in drug sensitive group compared with drug insensitive group (35.3% vs 7.2%, P<0.001; 24.1% vs 11.8%, P<0.05), and ΔGH was positively correlated with ΔCTX ( r=0.328, P=0.004). Conclusion:SRLs treatment can reduce bone formation marker N-MID and bone resorption marker CTX, improving the high turnover state of bone metabolism in patients with acromegaly, which may attribute to the reduction of GH and IGF-1 levels.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.