OBJECTIVE The aim of the present study was to investigate the anti-tumor effect and mechanism of a novel compound, C3C12PPD, a bioactive unnatural ginsenoside by metabolically engi-neered yeasts based on a new UDP-glycosyl- transferase from Bacillus subtilis. METHODS MTT assay was used to analyze the anti-proliferation activity of C3C12PPD in vitro. The effect of anti-tumor activity was observed by mouse Lewis xenograft model in vivo.The effects of C3C12PPD on suppressing the angio-genesis and invasion of A549 cells were investigated in vitro using Transwell and tube formation assays. RNAseq was used to find tagets of C3C12PPD. Western blotting was performed to investigate the expres-sion level of proteins in tumor tissues treated with C3C12PPD. RESULTS C3C12PPD could inhibit the growth of lung cancer in vitro and in viv o. At the dosage of 10.0 mg·kg-1, C3C12PPD inhibited tumor growth by 40.0% (P<0.05) in tumor weight in mouse Lewis xenograft. The inhibition of tube formation was 77.5%(P<0.01)and 80.3%(P<0.01)following treatment with 1×10-4and 2×10-4mol·L-1C3C12PPD for 5 h, whereas the proliferation of EA.hy926 cells was not influenced under the above concentrations. Under the concentrations of 1×10-4mol·L-1,C3C12PPD inhibited invasive ability of A549 cells(P<0.05).The results of RNAseq susgested that antitumor activity of C3C12PPD were associated with epithelial-mesenchymal transition (EMT) and angiogenesis. Moreover, the proteins related to EMT, Raf/MEK/ERK and AKT/mTOR signal pathways were effected by C3C12PPD analysed by western blotting. CONCLUSION These data suggested that C3C12PPD was able to supress lung cancer through inhibit EMT, invision and angiogenesis.

Objective To investigate the correlation between RDW and disease activity in patients with IBD and evaluate clinical significance of RDW as a potential indicator to monitor IBD activity. Methods 256 patients with IBD were divided into two groups. One was UC group including 136 patients with 80 active period cases and 56 emission period cases. Another was CD group including 120 patients with 75 active period cases and 45 emission period cases. 60 bacillary dysentery diseases and 80 healthy controls were selected as bacillary dysentery group and healthy control group. RDW, Hb, WBC, PLT, CRP, ESR, MCV were tested and monitored with development of disease at different stages. We compared RDW with CRP,ESR, PLT, Hb, MCV parameters. By ROC curve analysis, the sensitivity and specificity of RDW was estimated in identifying the IBD's activity. Results The mean values of RDW in active UC group, remission UC group, bacillary dysentery group and control group were ( 16. 1 ± 2. 7), ( 13.5 ± 2. 1 ), ( 13.0 ± 2. 0)and ( 12. 8 ± 1.8), respectively. There was significant difference among four groups ( F = 51.9, P < 0. 01 ).RDW in active UC group was significant higher than that in remission UC group, bacillary dysentery group and healthy control group ( t = 8. 12, 9. 67, 11.85, P < 0.05) and RDW in remission UC group was significant higher than that in bacillary dysentery group and healthy control group as well ( t = 2. 45, 2. 67,P <0. 05). The mean values of RDW in active CD group, remissive CD group,bacillary dysentery group and control group were ( 16. 9 ± 2. 2 ), ( 13. 8 ± 1.1 ), ( 13.0 ± 2. 0), ( 12. 8 ± 1.8 ). There was significant difference among four groups ( F = 113.9, P < 0. 01 ). RDW in the active CD group was significant higher than that in remission CD group, bacillary dysentery group and healthy control group (t = 11.47,18.63,18. 72, P < 0. 05 ) and RDW in remission CD group was also significant higher than that in bacillary dysentery group and healthy control group ( t = 3.60, 3. 72, P < 0. 05 ). RDW in UC and CD groups demonstrated a positive correlation with CRP and ESR (r=0. 484, 0. 525, 0. 286, 0. 358 and P<0. 01, <0. 01, < 0. 05, < 0. 01, respectively) but an inverse correlation with Hb and MCV (r = -0. 378, -0. 271,- 0. 329, - 0. 298 and P < 0. 01, < 0. 01, < 0. 05, < 0. 01, respectively). In UC groups RDW represented a larger area under ROC curve (0. 8.54) compared with CRP, ESR, PLT, Fib and MCV. When the cut-off value of RDW was 14. 0, the sensitivity and specificity for identifying active UC were 82% (65/80) and 72% (40/56) respectively. In CD groups, the area of RDW under ROC curve was the largest (0. 925 )among all indicators. When the cut-off of RDW was 14.5, the sensitivity and specificity for identifying active CD was 88% (66/75) and 82% (37/45) respectively. Conclusion RDW in patients with IBD is a useful indicator to estimate the IBD activity and predict disease progression.

Objective To evaluate combination multiple interventional therapies for acute lower extremity deep venous thrombosis (DVT).Methods From January 2008 to October 2014,96 patients with acute unilateral proximal or mixed DVT received interventional treatments including 74 DVT cases of the left lower extremity,and 22 patients in the right.Procedures undertaken included catheter-directed thrombolysis (CDT) only (n =7),CDT combined with thrombolysis (n =89),balloon angioplasty (n =32),and stent implantation (n =6).Results The mean circumference difference between the normal and affected thighs dicreased from (6.7 ± 1.8) cm to (0.8 ± 0.3) cm,t =13.48,P ＜ 0.001.That between the normal and affected calves decreased from (5.9 ± 1.6)cm to (0.7 ±0.4)cm,t =12.84,P ＜0.001.After intervention the Porter's score reduced from (9.7 ± 2.4) points to (1.1 ± 0.6) points,t =15.46,P ＜0.001,and the venous patency rate was (90 ± 8)％.Conclusion CDT combined with thrombolysis through dorsal vein,PTA,and stent implantation is a safe and effective therapeutic modality for acute lower extremity DVT.

Background The aspheric intraocular lenses(IOLs)can reduce ocular spherical aberration to some degree.However,the clinical effect depends more on the IOL proper alignment.It becomes more important to study the IOL position in eye,Objective This study was to analyze the position alteration of IOL after phacoemulsification combined with implantation of one-piece soft IOLs.Methods In this prospective control study,80 eyes of 40 patients with age-related cataract were enrolled.The phacoemulsification with IOL implantation was performed in all the eyes.Decentration and tilt of IOL in the nasal superior,superior temporal,inferior temporal and nasal inferior quadrants(the intersection point of the system optical axis and the IOL maximum cross plane were regarded as the ordinate origin)were measured by rotating Scheimpflug camera(Pentacam Oculus)in 3 months postoperatively under the mydriasis condition.Written informed consent was obtained from each subject prior to this trial.Results In the right eye group,the IOL decentered toward temporal in 26 eyes(65％)and infratemporal in 16 eyes(40％).IOLs tilted temporally in the horizontal plane in 37 eyes(92.5％)and tilted inferiorly in the vertical plane in 34 eyes(85.0％).In the left eye group,IOLs decentered temporally 33 eyes(82.5％)and 20 IOLs (50％)infratemporally,IOLs tilted temporally in the horizontal plane in 37 eye(92.5％)and 36 IOLs(90％)tilted inferiorly in the vertical plane.There was no statistical difference for the intercomparsion of horizontal/vertical decentration in various quadrant in the right eye(F =0.221,0.792,P＞0.05).The obvious elevated horizontal decentration was found in the supertemporal and infratemporal quadrants compared with supernasal quadrant in the left eyes but there was no significant difference in the vertical decentration among 3 quadrants(F=0.576,P＞0.05).Decentrations were positively correlated with the tilt in both horizontal and vertical plane(right eye horizontal plane:r=0.374,P=0.002;right eye vertical plane:r=0.402,P=0.001 ;left eye horizontal plane:r=0.377,P=0.002；left eye vertical plane:r=0.347,P=0.002).Conclusions The one-piece soft IOLs(Adapt AO)decenter toward temporal mostly in 3 months after surgery,especially infratemporally in the eye.And the optical axis of the IOL tilt toward infratemperol mostly in both right and left eyes.The decentration and tilt are consisted in the corresponding direction between the right and left eyes.The position of the IOLs showed mirror symmetry between right and left eyes.The IOLs decentration show the positively correlation to tilt whatever in horizontal and vertical plane.

Background Glial cells perform specialized function in many aspects of the development,homeostasis,and function of neurons.Retinal ganglion cells (RGCs)and glia interactions are critically important in glaucomatous neurodegeneration.However,the precise mechanisms of glial activation and ganglion cells damage are still remained unclear. Objective This study was to assess the early responses of glial cells in the retina,optic nerve and optic chiasm in rat models of acute high intraocular pressure (IOP),and to examine the expression of nestin,a neuronal progenitor marker,in the reactive glias. Methods Acute high IOP of 110 mmHg was induced in the right eyes of 6 clean adult female Wistar rats by infusing normal saline solution into the anterior chamber for 60 minutes.Three normal matched Wistar rats were used as controls.The rats were sacrificed by overanaesthesia and sections of retina,optic nerve and optic chiasm were collected on 3 days and 7 days after the injection.Rat retina was examined by Nissl staining to illustrate the gross structure changes.Loss of axons of RGCs in the optic nerve was assessed by immunostaining of β Ⅲ-tubulin.Double labeling of glia] fibrillary acidic protein (GFAP) and nestin was performed in sections of retina,optic nerve and optic chiasm to evaluate the glial responses.The use of the animals complied with Statement of Animal Ethic Committee of Peking University Third Hospital. Results In control rats,GFAP-positive glial cells were observed in the retina,optic nerve and optic chiasm,where only weak positive response for nestin was noticed.Three days after acute IOP elevation,thickness of inner plexus form layer was significantlydecreased in comparison with the control rats.A loss of 46％ RGCs was found in the rats with ocular hypertension.Obvious increase of GFAP expression was displayed in the retina,and processes of GFAP-positive glia cells extended into outer retina accompanied with significant up regulation of nestin.Axons in the optic nerve demonstrated a tendency of degeneration.Nestin expression increased significantly in the GFAP-positive glias in the optic nerve.Cross-sectional area of optic chiasm corresponding to the injured retina decreased relative to its countcrpart.Astrocyte like GFAP and nestin-colabeled glials were observed in this part of optic chiasm.The pathological changes of the retina,optic nerve and optic chiasm in hypertensive eyes aggravated on 7 days. Conclusions Acute ocular hypertension induce early onset of RGCs loss and axon degeneration.Neuronal injury is accompanied with glial reaction.Reactive glial cells express neuronal progenitor markers.The structural changes of the optic nerve and optic chiasm occur simultaneously with the high IOP.

Objective To investigate the technique,efficacy,and safety of percutaneous interventional treatments for biliary complications (BC) after liver transplantation (LT).Methods The clinical and imaging data of 127 patients with BC after LT,who received percutaneous interventional treatments in the Third Affiliated Hospital of Sun Yat-sen University from January 2006 to December 2015,were analyzed retrospectively.On the basis of the cholangiographic appearance,patients were classified into 5 groups:biliary leakage group (n =11),anastomotic biliary strictures group (n=28),hilar biliary strictures group (n =30),multifocal biliary strictures group (n =51),and bilomas group (n =7).The modality of interventional treatments was percutanous transhepatic biliary drainage (PTBD),PTBD combined with balloon dilation,PTBD combined with balloon dilation and stent implantation.The methods of biliary drainage included external drainage and external-internal drainage.All the patients were followed up after treatment.The curative effect and operation-correlated complications were observed.Results The first successful rate of PTBD was 97.6％ (124/ 127).The total curative rate,improvement rate and inefficacy rate of interventional treatments were 37.8％ (48/127),44.9％ (57/127) and 17.3％ (22/127) respectively.In biliary leakage group,all the patients were cured by percutaneous interventional treatments with the curative rate being 100％.In anastomotic biliary strictures group,the cure and improvement rates were 64.3％ (18/28) and 35.7％ (10/28) respectively.The efficacy rate was 100％ (28/28).In hilar biliary strictures group,the cure,improvement and inefficacy rates were 40％ (12/30),53.3％ (16/30) and 6.7％ (2/30) respectively.The efficacy rate was 93.3％ (28/30).In multifocal biliary strictures group,the cure,improvement and inefficacy rates were 13.7％ (7/51),54.9％ (28/51) and 31.4％ (16/51) respectively.The efficacy rate was 68.6％ (35/51).In bilomas group,3 cases (3/7) obtained improvement and treatment of 4 cases was inefficative.The efficacy was the best for the patients with bilary leakage,and it was the worst for the patient with bilomas (P＜0.001).The main operation-correlated complication was bile tract infection during drainage.The rates of bile tract infection were 32.4％ (34/105) and 81.8％ (18/22) in patients with external drainage and external-internal drainage,respectively.There was statistically significant difference between these two items (P＜ 0.001).Conclusion PTBD combined with balloon dilation and biliary stent implantation is a safe and effective therapeutic modality for BC after LT,which can improve patients' clinical symptoms,improve patients' quality of life.The patients with bilomas should be treated by retransplantation as soon as possible.The biliary external drainage can decrease the rate of biliary tract infection significantly.

The specific fragment of Pneumococcal surface protein A(PspA)and Pneumococcal Surface Adhesin A(PsaA)gene was amplified by PCR from Streptococcus pneumonia 5 and Streptococcus pneumonia 19.The amplified fragnent of PspA and PsaA gene was ligated into pET-27b(+)vector and transformed into BL 21 E.coli for expression and obtain the expressive production of PspA and PsaA.Induced by IPTG,the expression level was as high as 75 % of the total disolube protein.The result showed that the recombinant plasmid could express a specific 75 kDa and 37 kDa fusion protein in E.coli BL 21,which showed the good immunogenicity and a broadly cross reactivity with the other serotypes.

Objective To evaluate the efficacy and safety of PES14LF polyethersulfone highflux dialyzer on maintenance hemodialysis(MHD)patients. Methods A total of 72 MHD patients from two hospitals in Shanghai were enrolled in a randomized parallel controlled study.Conventional hemodialysis was performed for 4 h with PES14LF dialyzer in trial group and with German F6 dialyzer in control group.For each patient the study lasted one week.The clearances of urea,creatinine and phosphate were calculated.Adverse event and adverse reaction were recorded.Results There were no significant difierences of urea and creatinine clearance and reduction ratio between trial and control group.The phosphate clearance in trial group was significantly higher than that in control group[(144.57±27.83)ml/min vs(117.15±22.77)ml/min,P＜0.051.There was no significant difference of phosphate reduction ratio between trial and control group.The efficiency of urea clearance and urea reduction ratio achieved clinic effective target in two groups and no significant differences in above indexes between two groups were found. Conclusion PES14LF dialyzer is effective and safe for clinical application.

Objective To study the feasibility and efficacy of percutaneous transhepatic intrahepatic portosystemic shunt (PTIPS) in patients with portal hypertension due to chronic portal vein occlusion after splenectomy.Methods 27 patients who had portal hypertension due to chronic portal vein occlusion after splenectomy underwent PTIPS between December 2010 and March 2015.These patients were enrolled in this retrospective study.The success rates,efficacy,and complications were evaluated.Significance in the differences in the portosystemic pressure gradient (PPG) as measured before and after PTIPS procedure was assessed.Results PTIPS was successfully carried out in 25 patients but failed in 2.No fatal procedural complications were observed.The mean PPG dropped from (22.3 ± 5.7) mmHg to (12.4 ± 3.1) mmHg after successful PTIPS (1 mmHg =0.133 kPa,P ＜0.05).The median follow-up in the 25 patients with successful PTIPS were 22 months and there were 3 (12.0％) deaths from liver failure due to severe cirrhosis,and 1 death (4.0％) from stroke during the follow-up period.Shunt dysfunction happened in 4 (16.0％) patients.The original symptoms reoccurred in 2 patients (8.0％) and the remaining patients were diagnosed by routine CT or US examination.Three patients recovered after shunt revision with stent implantation or balloon angioplasty,while one patient refused any further therapy except oral medication.This patient suffered from the first episode of rebleeding 36 months after PTIPS.Hepatic encephalopathy developed in 2 (8.0％) patients,1 patient recovered after medical treatment,while the other who developed Grade 3 hepatic encephalopathy recovered after implanting a smaller cover stent.The remaining patients were asymptomatic with patent shunts.Conclusion PTIPS was a feasible,safe,and efficacious treatment for portal hypertension due to chronic portal vein occlusion after splenectomy.

Abstract: Objective　To analyze the influencing factors of mother-to-child transmission of hepatitis B virus after combined immunological blockade, and to evaluate the effect of mother-to-child blockade, and to provide a basis for health policies and health interventions for preventing mother-to-child blockade of hepatitis B virus. Methods A total of 11 363 pairs of HBsAg positive pregnant women and their infants aged 7-12 months in Hainan Province from 2015 to 2020 were included in the study. The general situation, the situation of health care and delivery in this pregnancy and perinatal period, the detection of hepatitis B markers, the situation of antiviral therapy, the general situation of mother and infant during delivery and the implementation of blockade measures for mother-to-child transmission of hepatitis B were collected and analyzed. Results Among the 11 363 pairs of HBsAg positive pregnant women and their infants delivered in hospitals in Hainan province from 2015 to 2020, the positive rate of HBsAg in children at 7-12 months after birth was 1.47 %, and the difference in HBsAg positive rate of infants born in different years was not statistically significant (P>0.05). There were no significant differences in the positive rate of HBsAg among children born to pregnant women with different nationalities, educational levels, occupations, delivery modes, delivery places, obstetric operations and perineal laceration, abnormal perinatal period, children with different genders and premature delivery and perinatal (all P<0.05). There was significant difference in HBsAg positive rate among infants born to pregnant women of different ages, the positive rate of HBsAg of infants born to young pregnant women was higher than that of older pregnant women (P<0.05). The rate of antiviral therapy was low in HBeAg positive pregnant women, and the positive rate of HBsAg in their infants was 2.54%, which was higher than 0.83% in HBeAg negative pregnant women (P<0.05). Conclusions Combined immunological blockade with hepatitis B vaccine and hepatitis B immunoglobulin can effectively prevent the mother-to-child transmission of HBV. HBsAg-positive women can give birth at the right age, and HBeAg-positive pregnant women can be treated with antiviral therapy to block mother-to-child transmission, providing the important basis for the formulation of hepatitis B prevention and control strategies and measures.