Objective To investigate the correlation between plasma cathepsin L (CatL) levels and establishment of cerebral collateral circulation in acute ischemic stroke patients with cerebral artery stenosis.Methods The patients with acute ischemic stroke with at least one cerebral large artery (including internal carotid artery,middle cerebral artery,vertebral artery,and basilar artery) stenosis ＞ 70％ diagnosed by whole cerebral angiography were enrolled.ASITN/SIR blood flow classification system was used to systematically evaluate the establishment of cerebral collateral circulation.Grade 0-2 was defined as poor collateral branch and 3-4 was defined as good collateral branch,Enzyme linked immunosorbent assay was used to detect the plasma CatL level.Results A total of 79 acute ischemic stroke patients with cerebral artery stenosis were enrolled,including 63 male and 16 female.Their mean age was 58.76 ± 12.24 years old.There were 51 patients (64.56％) in the poor collateral branch group and 28 (35.44％) in the good collateral branch group.There was no significant difference in plasma CatL levels between the good collateral circulation group and the poor collateral circulation group (7.09± 2.27 mg/L vs.8.79±3.53 mg/L;t =2.751,P =0.069).Multivariable logistic regression analysis showed that only the high National Institutes of Health Stroke Scale score was the independent risk factor for poor collateral circulation (odds ratio 0.935,95％ confidence interval 0.823-0.963;P=0.046),and there was no significant independent correlation between plasma CatL levels and collateral circulation (odds ratio 0.910,95％ confidence interval 0.766-1.081;P =0.285).Conclusion There was no significant correlation between plasma CatL levels and cerebral collateral development in acute ischemic stroke patients with cerebral artery stenosis.

Purpose To explore the difference of expression and prognostic significance of SP1,KLF4 and p21 in low grade ovarian serous carcinoma (LGSC) and high grade ovarian serous carcinoma (HGSC).Methods The expression of SP1,KLF4 and p21 protein was examined with immunohistochemistry EliVision method in cases with LGSC and HGSC.Kaplan-Meier analysis and Cox multivariate survival analysis were used to assess the impact of SP1,KLF4 and p21 expression on prognosis of LGSC and HGSC.Results SP1,KLF4 and p21 expression were detected respectively in 74.5％,17.0％ and 11.7％ HG-SC cases,and in 65.2％,34.8％ and 26.1％ LGSC cases.Compared to control group,the expression level of SP1 was significantly higher (P ＜ 0.05),but the expression level of KLF4 and p21 were significantly lower (P ＜0.05).There was no significant difference of SP1,KLF4 and p21 expression between HGSC and LGSC (P ＞ 0.05).The expression of SP1,KLF4 and p21 were associated with FIGO stage,meanwhile SP1 associated with residual tumor size in HGSC (P ＜ 0.05).There was a significant negative correlation between SP1 and KLF4,p21 proteins in HGSC (P ＜ 0.05).Kaplan-Meier analysis revealed that there were significantly poor overall survival (OS) of 5 years for patients with HGSC displaying high expression of SP1,or low expression of KLF4 and p21 (P ＜0.05),but no significantly improved OS for patients with LGSC (P ＞ 0.05).Cox analysis showed that SP1 overexpression is an independent prognosis factor for HGSC.Conclusion Overexpression of SP1 and low expresion of KLF4 and p21 contribute to carcinogenesis of HGSC and LGSC.They are associated with a poor prognosis of HGSC,but not LGSC,meanwhile SP1 is an independant prognosis factor for HGSC.

Background: Cervical cancer is still present a major public health problem, especially in developing countries. In International Federation of Gynaecology and Obstetrics 2018, allowing assessment of retroperitoneal lymph nodes by imaging and/or pathological findings and, if deemed metastatic, the case is designated as stage IIIC (with r and p notations). Patients with lymph node metastases have lower overall survival (OS), progression free survival (PFS), and survival after recurrence, especially those who have unresectable macroscopical positive lymph nodes. Retrospective analysis suggests that there may be a benefit to debulking macroscopic nodes that would be otherwise difficult to sterilize with standard doses of radiation therapy. However, there are no prospective study reporting that resecting macroscopic nodes before concurrent chemoradiation therapy (CCRT) would improve PFS or OS of cervical cancer and no guidelines for surgical resection of bulky lymph nodes. The CQGOG0103 study is a prospective, multicenter and randomized controlled trial (RCT) evaluating lymph node dissection on stage IIICr of cervical cancer. Methods Eligible patients are histologically confirmed cervical squamous cell carcinoma, adenocarcinoma, adeno-squamous cell carcinoma. Stage IIICr (confirmed by computed tomography [CT]/magnetic resonance imaging/positron emission tomography/CT) and the short diameter of image-positive lymph node ≥15 mm. 452 patients will be equally randomized to receive either CCRT (pelvic external-beam radiotherapy [EBRT]/extended-field EBRT + cisplatin [40 mg/m2] or carboplatin [the area under curve=2] every week for 5 cycles + brachytherapy) or open/minimally invasive pelvic and para-aortic lymph node dissection followed by CCRT. Randomization is stratified by status of para-aortic lymph node. The primary endpoint is PFS. Secondary endpoints are OS and surgical complications. A total of 452 patients will be enrolled from multiple hospitals in China within 4 years and followed up for 5 years.