We reported two cases of pelvic retroperitoneal schwannomawe occurred in the young unmarried female successfully resected by laparoscopic surgery.One was a 16-year-old girl presented with secondary amenorrhea.Ultrasound and MRI found the existence of an ovarian cystic and solid mass,5.3 cm × 4.5 cm in size.Laparoscopic exploration found pelvic mass completely located in the left retroperitoneal obturator fossa and complicated with rudimentary horn of the uterus.The other was a 25-year-old female and asymptomatic.Ultrasound showed a mass in the right ovary.During operation a pelvic mass was discovered in the anterior of right sacral retroperitoneum,8 cm× 6 cm in size.Two cases of retroperitoneal lesions were preoperatively misdiagnosed as ovarian mass and had densely adhered to the surrounding tissues.Histopathologic examinations confirmed to be benign schwannoma and resected radically by laparoscopy without any complications.The operation time was 120 min and 166 min,respectively.The intraoperative bleeding was 150 ml and 600 ml,respectively.The S-100 protein on pathological immunohistochemistry showed strong positivity.We deem that laparoscopic resection is necessary for diagnosis and treatment of pelvic retroperitoneal schwannomawe,being safe and effective.Complete excision is benefical to prevent recurrence.

Objective To assess the clinical value of color doppler sonography in the evaluation of effects of uterine artery embolization(UAE) for the treatment of uterine fibroid.Methods Twentythree patients with symptomatic uterine fibroid were given transvaginal color Doppler sonography before and 1~7 days,1~3 months and 6~12 months after the UAE.Measurements of the uterus,myomas,and resistance index(RI) of the uterine artery were obtained. Results Out of 21 patients examined at 1~7 days after UAE,the uterus volume increased by a mean of 10% in 7 patients(4%~63%) and decreased by a mean of 21% in 14 patients(1%~67%) with the dominant myoma decreased by 24% in size(1%~56%).In 21 patients examined at 1~3 months after embolization,the uterus and dominant myoma decreased in size by 53%(24%~82%) and 47%(6%~88%),respectively.In 19 patients examined at 6~12 months,the uterus and myoma decreased in size by 66%(5%~91%) and 71%(32%~99%),respectively.Vessels inside and surrounding the myoma remarkably diminished or completely disappeared after embolization.No statistically significant changes in uterine artery RI were noted before and after UAE(F=0.47,P=0.70).Symptomatic improvements were achieved in 87% of patients(20/23) at 1 year after UAE. Conclusions UAE for the treatment of symptomatic uterine fibroid is safe and effective.Color Doppler sonography can evaluate the effect of UAE by means of measuring the volume of the uterus and myoma and the hemodynamic changes of the uterine artery before and after embolization.

Objective To analyze the regulation of estrogen receptor α (ERα) on truncated neurokinin-1 receptor (NK1R-Tr), and the influence of this regulation on cell proliferation in estrogen receptor-positive breast cancer cell lines. Methods The chromatin immune coprecipitation (CHIP) was used to observe the transcriptional regulation function of ERαon NK1R-Tr in breast cancer cells. Luciferase reporter gene assay was used to verify whether ERα played a positive regulatory role in the expression of NK1R-Tr. Western blot assay and real-time-PCR were used to detect the expression of ERα and NK1R-Tr in breast cancer cells, MCF-7 and T47D, as well as the expression of NK1R-Tr protein and mRNA level. NK1R-Tr levels were also detected after using estradiol (E2, ERα agonist) and small interfering RNA (knock out ERα). CCK-8 and clone formation experimen were used to detect the proliferation ability of breast cancer cells after knocking out NK1R-Tr with small interfering RNAs. Results CHIP test and Luciferase reporter gene assay proved that ERα can positively regulate the expression of NK1R-Tr via the ERα sequences in the upstream of the NK1R-Tr gene promoter. The expression of NK1R-Tr at both protein level and mRNA level dropped in the estrogen receptor-positive breast cancer cell line MCF-7 upon knocking out ERα. After knocking out NK1R-Tr, the proliferation ability of estrogen receptor-positive breast cancer cells was lower than that of the control group. Conclusion The ERα positively regulates the expression of NK1R-Tr, resulting in the increased cell proliferation in estrogen positive breast cancer cells.

Background and purpose: Systemic reports about the prognosis of patients with renal cell carcinoma (RCC) of stage T_(1-3a)N_0M_0 combined with inflammatory enlargement of hilar lymph nodes have not been observed in the literature. This study was to investigate the prognostic role of inflammatory enlargement of hilar lymph nodes in the patients with RCC of stage T_(1-3a)N_0M_0 and its association with clinical features. Methods; Forty-nine patients with RCC of stage T_(1-3a)N_0M_0 combined with inflammatory enlargement of hilar lymph nodes were reviewed and all these patients underwent radical nephrectomy from January 1995 to January 2000. Results: The duration of follow-up was 8-14 years with the average of 7.5 years. Seven patients were lost to follow-up. Seventeen patients without RCC and four with RCC metastases are alive at present. Eighteen patients died of RCC relatad complications and three died of cerebro-cardiovascular disease. Metastases occurred in twenty-two patients one year after surgery. The 5- and 10- year survival rates were 53.1% and 42.9%, respectively. Conclusion: Most of the enlarged hilar lymph nodes in RCC were diagnosed as lymphadenitis. The rate of inflammatory enlargement of hilar lymph nodes in the long-term survival patients with RCC of stage T_(1-3a)N_0M_0 were comparatively low. Regional lymphadenectomy or resection of enlarged inflammatory lymph nodes could not protect the patients from metastasis completely. It is advised that limited lymphadenectomy with resection of enlarged inflammatory lymph nodes should be performed for the patients in RCC combined only with inflammatory enlargement of hilar lymph nodes.

Objective To evaluate the effect of haploidentical lymphocyte infusion on refractory and relapse acute leukemia. Methods The haploidentical donor lymphocyte infusion was used to treat for relapse acute myeloid leukemia 3 patients (M2 2 eases, M4 lcase), one relapse acute lymphocyte leukemia from April 2006 to October 2007. Four cases who had accepted secondly regimens were ineffective,after relapse. Collecting donor lymphocytes, parents children as donor supply in 3 cases, mother as donor supply one case. Before donor lymphocyte infusion patients received chemotherapy of different regimens. Donor haploidentical iymphocytes irradiated by 6-8 Gy radial were infused when patients white cell count was at the lowest after the chemotherapy. The average of infusion cells was 2.3 (1.4-3.1)×108/kg. Results One patient acquired complete remission and two patients were effective in three relapse acute myeloid leukemia. It was ineffective in relapse acute lymphocyte leukemia. No transfusion related graft versus host disease was observed. One patient has had herpes zoster virus infection. Conclusion Haploidentical donor lymphocyte infusion with chemotherapy are effective for refractory and relapse in acute myeloid leukemia, but the infused cell quantity and irradiated dosage must be further discussed.

Objective: To investigate the influence of different variable combinations of the carrying system on gait and muscle fatigue during weight-bearing walking on both shoulders and back, and to optimize daily carrying experience. Methods: From September to December, 2018, 6 male college students were selected as subjects; the electromyographic signal of the anterior tibial muscle and plantar pressure were measured during weight-bearing walking under six different variable combinations of the carrying system (with the three variables of gravity center, single or double shoulders, and waist cushion), and a subjective evaluation test was performed for the degree of fatigue. The electromyographic data and plantar pressure data were processed and compared to evaluate behavior and fatigue. Results: Different variable combinations of the carrying system had significant influence on the degree of fatigue and gait (P<0.05). Both subjective and objective analyses found that the carrying system with different heights of gravity center and single-or double-shoulder carrying mode had great influence on human fatigue and walking gait, while the hardness of waist cushion had little influence. Compared with the other groups, the group with a high gravity center, a double-shoulder carrying mode, and a soft waist cushion had a significantly smaller slope of average electromyographic amplitude, a significantly larger slope of median frequency, and a significantly lower degree of plantar pressure curve disorder. Conclusion The carrying system with a relatively high gravity center, a double-shoulder carrying mode, and a soft waist cushion can significantly relieve fatigue, with low influence on walking gait.

Objective: To investigate surface electromyography signal (sEMG) of the major back muscle group and subjective fatigue assessment under different experimental combinations during walk with weight on both shoulders, as well as the functional status and fatigue property of human muscles. Methods: From October to December, 2017, 10 college students were recruited to participate in shoulder weight-bearing work and walk under the combinations of different shoulder strap widths, weights, and hardness of waist cushion. The subjects were required to complete 12 sets of experiments, with each set lasting for 15 minutes, and the rest time between work was 30 minutes. The sEMG signals of the upper trapezius and the erector spinae were measured during the experiment, and subjective fatigue assessment was performed during rest. The time domain evaluation index (average amplitude, aEMG) , the frequency domain evaluation index (median frequency, MF) , and the data of subjective assessment were processed and analyzed. Results: Weight and shoulder strap width had a significantly effect on fatigue (P<0.01) , and the change in the hardness of waist cushion had no significant effect on fatigue (P>0.05) . There was an interaction effect between weight and shoulder strap width (P<0.01) , and there was no interaction effect between weight, shoulder strap width, and hardness of waist cushion (P>0.05) . For the backpack carrying system, the combination of 10% weight and 50 mm shoulder strap width was the best one for relieving fatigue. The subjective test also showed that subjective feelings of muscle fatigue were associated with the weight and width, which was consistent with sEMG results. Conclusion The results of this experiment show that the combination of 10% weight and 50 mm shoulder strap width can help to relieve muscle fatigue during walk with weight on both shoulders, and weight-bearing walking is more likely to cause the fatigue of the erector spinae.

Objective To measure the titers of varicella live attenuated vaccines ( VarV) during the process of transportation and storage in different seasons and communities of Minhang Distract, Shang-hai, to evaluate the operation of cold chain system and the thermal stability of vaccines and to provide refer-ences for the management, introduction, research and development of vaccine in future.Methods Four communities with high outbreak rates of varicella during 2012 to 2013 and four communities with low out-break rates were randomly selected from 13 communities in Minhang District, Shanghai.The titers of VarVs were detected by using the quantitative plaque assay before and after 30 days of storage in November 2013 and February, May, August 2014.Results The overall rate of qualified VarVs was 90.63% with a geo-metric mean titer (GMT) of 3.67 (LgPFU/0.5 ml).96.88%of the VarVs produced by company C met the quality standard with a GMT of 3.89 ( LgPFU/0.5 ml) followed by those produced by company B with a rate of 91.67%and a GMT of 3.75 ( LgPFU/0.5 ml) .The rate of qualified VarVs produced by company A was the lowest, which was 80.00%, with GMT of 3.29 (LgPFU/0.5 ml).There were significant differences in the rates of qualified VarV among the three companies (χ2=8.288, P=0.016).The rate of qualified vac-cines in communities close to the Shanghai Minhang Center for Disease Control and Prevention ( Minhang CDC) was 91.67%, while 100%of the vaccine samples collected form the communities at a middling dis-tance from or far from the Minhang CDC met the quality standard.No significant difference in the rate of qualified vaccine was found among the three types of communities (χ2=3.441, P=0.179).The quarterly rates of qualified vaccines produced by B and C companies were 100%except for the third quarter.The rates of qualified vaccines produced by A, B and C companies in the third quarter were respectively 70.00%, 66.67%and 87.50%.No statistical differences in the quarterly rates of qualified vaccines were found among the three companies (χ2=1.25, P=0.7412;χ2=6.545, P=0.088; χ2=6.194, P=0.103).No statistical differences in the rates of qualified vaccines before and after 30 days of storage were found among the three companies (χ2=0.625, P=0.347;χ2=0.000, P=1.000;χ2=2.065, P=0.492).Conclusion A well-managed and-operated cold chain system was implemented in Minhang District in the storage and transport of vaccines as well as other related links.The thermal stability of vaccines produced by company C was better than those of the other two companies.A surveillance for the titers of vaccines produced by com-pany A should be strengthened.

OBJECTIVETo analyze clinical features and mutations of EFEMP1 gene in a Chinese pedigree with familial dominant drusen.

METHODSClinical features of the pedigree were studied with fundus photography, fundus fluorescein angiography and optical coherence tomography. Molecular genetic analysis was performed on the patients and unaffected individuals from the family. All coding exons of the EFEMP1 gene were amplified by polymerase chain reaction (PCR) and sequenced. The results were compared with wild-type sequences from NCBI. The proband who had suffered from choroidal neovascularization and preretinal hemorrhage received an intravitreal injection of an anti-vascular endothelial growth factor (VEGF) preparation.

RESULTSA heterozygous mutation C>T (R345W) was identified in exon 10 of the EFEMP1 gene in two affected individuals from the family. The same mutation was not detected in unaffected family members and 100 healthy individuals. Postoperative follow-up of the patient receiving intravitreal injection of anti-VEGF drug showed that visual acuity was improved and fundus appeared to be stable.

CONCLUSIONThe R345W mutation in EFEMP1 is responsible for the dominant drusen in this family. Intravitreal injection of anti-VEGF drug is a promising treatment for the improvement in vision.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Exons ; Extracellular Matrix Proteins ; genetics ; Female ; Genes, Dominant ; Humans ; Male ; Molecular Sequence Data ; Mutation, Missense ; Pedigree ; Retinal Drusen ; genetics ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Young Adult

Objective:To investigate the effect of miRNA-34b/c-5p on the expression of neurokinin 1 receptor-truncated(NK1R-Tr)in breast cancer and the effect of miRNA-34b/c-5p and NK1R-Tr on the migration and invasion abilities of breast cancer cells.Methods:Real-time fluorescence quantitative PCR(RT-PCR)was used to detect the expression of miRNA-34b/c-5p and NK1R-Tr in 50 breast can-cer specimens that were collected at Tianjin Medical University Cancer Institute&Hospital from February to May 2013.Western blot analysis was performed to detect the expression of miRNA-34b/c-5p and NK1R-Tr in breast cancer cell lines MDA-MB-231 and MCF-7. Scratch and Transwell assays were carried out to explore the effects of miRNA-34b/c-5p and NK1R-Tr on the migration and invasion abilities of MDA-MB-231 cells.Results:The expression of miRNA-34b/c-5p and NK1R-Tr in breast cancer tissues and cells were signifi-cantly negatively correlated.The relative expression of NK1R-Tr in breast cancer patients with lymph node metastasis was 5.75,and the relative expression of NK1R-Tr in patients with non-lymph node metastasis was 4.29.The relative expression was significantly dif-ferent between the two groups(P=0.026).Overexpression of miRNA-34b/c-5p and knockdown of NK1R-Tr could significantly inhibit the migration and invasion abilities of MDA-MB-231 cells(all P<0.001).Conclusions:The expression of miRNA-34b/c-5p and NK1R-Tr was significantly negatively correlated.MiRNA-34b/c-5p and NK1R-Tr might be potential therapeutic targets for inhibiting the invasion of breast cancer cells.