Objective To investigate the expression and clinical significance of UL16 binding protein 3 (ULBP3) in human esophageal squamous cell carcinoma (ESCC) and its correlation with nature killer (NK) cells.Methods The relative expression of ULBP3 in the ESCC tissues and corresponding carcinoma adjacent tissues of 40 patients was detected by realtime-poly merase chain reaction (PCR),immunohistochemical staining and Western blot methods.The percentage of NK cells in peripheral blood of same patients was examined by flow cytometry.The correlation between ULBP3 and the percentage of NK cells was analyzed with Pearson method.Results The expression of ULBP3 at mRNA level in the tumor tissues ([4.96 ±-6.11]×10-3) was significantly higher than that of corresponding carcinoma adjacent tissues ([1.64 ± 2.96]× 10-3,t =3.656,P＜ 0.01).The immunohistochemical staining results indicated that the positive rate of ULBP3 in the tumor tissues was 60％ (24/40),however that of corresponding carcinoma adjacent tissues was only 32.5％(13/40,t=3.921,P＜0.01).The Western blot results indicated that the expression of ULBP3 at protein level in the tumor tissues was significantly higher than that in the corresponding carcinoma adjacent tissues.The relative expresssion ULBP3 at mRNA level in carcinoma tissues of ESCC patients with lymph node metastasis and at TNM stage Ⅲ was higher than that of ESCC patients without metastasis and at TNM stage Ⅰand Ⅱ (t=4.839,4.192,P＜0.05).There was no significant correlation between the expression and ages,gender,location of tumors and the differentiation degree of tumor (P＞0.05).At early and mid stage of the tumor,the expression of ULBP3 at mRNA level was positively correlated with the percentage of NK cells in peripheral blood (r=0.5233,P＜0.05),however there was no correlation at advanced stage.Conclusion ULBP3 was highly expressed in ESCC and may be involved in the immune regulation of NK cells.

Objective To evaluate the possibility of elevating the age line for pregnant women with advanced age to conducted amniocentesis .Methods A retrospective cohort study was performed .The information of 5 176 advanced age pregnant women in July 2003 to August 2015 from Ningbo Women and Children Hospital were collected and analyzed .Grouped the patients by age , using chi-square analysis , comparing the difference of abnormal rate of target chromosomes (13, 18, 21) and sex chromosomes (X and Y) between the adjacent two age groups .Results Total of 15 408 cases were screened.Among these, 262 cases were diagnosed with abnormal chromosome .The positive rate was 1.70%.Total of 5 176 advanced age pregnant women were included , 82 women were found with abnormal target chromosomes (13, 18, 21) and sex chromosome.The positive rate was 1.58%(82/5 176).For age groups, the positive rates were 0.95%(11/1 156), 0.94%(9/954), 0.87%(10/1 144), 2.16%(14/648), 2.16%(10/464), 2.51%(10/399) and 4.38%(18/411) respectively.Chi-square analysis results showed that the positive rate between group of 37 and 38 was significant difference (chi-square value of 5.181,P value of 0.023).There were no significant differences among all remained groups ( chi-square value: <0.001, 0.028, <0.001, 0.117, 2.129 respectively, P value: 0.985, 0.868, 0.995, 0.733, 0.145 respectively ) .Conclusion It is worthwhile to elevate the age of pregnant women up to 38 years old as the age line for the indications of amniotic fluid chromosome analysis .

Neonatal necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal disease and has most lethal effect. In recent years,with the development of the neonatal intensive care unit,the survival rate of premature infants is increased, but the incidence rate of NEC is also increasing. At the present stage,the etiology of NEC is still not completely clear,which greatly limits the prevention and treatment of NEC. Risk factors including premature birth, infection, bacterial colonization, hypoxia ischemia,inflammatory reaction and enteral nutrition are summarized in this paper to provide basis for clinical diagnosis,treatment and prevention of NEC.

ObjectiveTo evaluate digital chrome endoscopy (I-Scan) and confocal laser endomicroscopy (CLE) for diagnosis of Barrett esophagus (BE).MethodsFrom July 2010 to July 2011,a total of 878 outpatients who had upper gastrointestinal symptoms underwent routine endoscopy and I-Scan examination,screened patients with suspected Barrett's epithelial were further referred to CLE and endoscopy.The detection rate and image features of BE between routine endoscopy and I-Scan,and the diagnosis of BE between pathology and CLE,were compared respectively.ResultsSuspected BE was diagnosed in 46 patients (5.2％) by routine endoscopy,and in52 (5.9％) by I-Scan,and there was no significant difference in detection rate between 2 methods (x2 =0.533,P ＞ 0.05 ).The detection rate of paliform blood vessels between SCJ and GEJ was higher using I-Scan (35/52,67.3％ ) than routine endoscope (21/46,45.7％,P ＜0.05).A total of 19 suspected BE underwent CLE and biopsy,and BE was diagnosed by CLE with a sensitivity of 93％ and a specificity of 100％.ConclusionI-Scan is capable of identifying paliform blood vessels between SCJ and GEJ,and can improve the detection rate of suspected BE.CLE is able to provide in-vivo histological diagnosis of BE with a high sensitivity and specificity.

Objective To evaluate the efficacy of i-scan endoscopy in detecting small colorectal precancerous lesions.Methods A total of 127 patients were randomized into 2 groups to underwent conventional colonoscopy and i-scan endoscopy respectively.The findings were compared with pathologic examinations.Results A total of 84 lesions were detected by conventional endoscopy in 64 patients,while 147 lesions were found in 63 patients with high resolution detection only,which was increased to 259 with i-scan,including 102 flat lesions.With respect to histology,adenomatous lesions could be predicted with a high sensitivity (80％) and a high specificity ( 100％ ) by i-scan endoscopy.Conclusion More small colorectal lesions can be detected by i-scan endoscopy,which can distinguish neoplasm from non-neoplasm colorectal lesions.

Objective:To compare the difference of epileptiform discharges detection in patients with epilepsy between the 25 electrodes electroencephalogram (EEG) system proposed by the International Federation of Clinical Neurophysiology in 2017 and the previous 19 electrodes EEG system.Methods:Patients suspected of epilepsy or with confirmed epilepsy who need a follow-up EEG were collected in Zhongshan Hospital, Fudan University from March 2018 to November 2019, and conventional video-EEG recording was performed on all patients for two hours with the standard 25 electrodes EEG system. Two neurophysiologists reviewed the recordings blindly using the 19 electrodes system and the 25 electrodes system, marking the epileptiform discharges and their amplitudes. Finally, the data were statistically analyzed.Results:A total of 403 patients were included in the study, in which 263 cases were diagnosed as epilepsy, including 129 cases of generalized epilepsy, 115 cases of temporal lobe epilepsy, 13 cases of frontal lobe epilepsy, two cases of parietal lobe epilepsy and four cases of occipital lobe epilepsy. In 115 temporal lobe epilepsy patients, 76 (66.09%) and 100 (86.96%) records were detected epileptiform discharges by the 19 or 25 electrodes EEG system respectively, and the difference was statistically significant (χ2=13.939, P<0.001). While in patients with non-temporal lobe epilepsy, there was not statistically significant difference between the two systems. In 76 patients whose temporal epileptiform discharges were detected by the two systems, the amplitudes of epileptiform discharges in the newly-added inferior temporal electrodes (F9/F10, T9/T10, P9/P10) and the original temporal electrodes (F7/F8, T7/T8, P7/P8) were (61.53±22.64) μV and (48.25±20.90) μV, respectively, with statistically significant difference between the two groups ( t=5.486, P<0.001). In patients with abnormal [79.59% (39/49) vs 61.22% (30/49), χ2=3.967, P=0.046] and normal [95.45% (42/44) vs 70.45% (31/44), χ2=9.724, P=0.003] imaging, the ability of the 25 electrodes EEG system to detect epileptiform discharges was higher than that of the 19 electrodes EEG system. Conclusion:The 25 electrodes EEG system can significantly improve the detection ability of temporal epileptiform discharges in patients with epilepsy, which is recommended for regular use to increase the detection ability of temporal area abnormal wave and assist the diagnosis and treatment of epilepsy.

Objective:To investigate the application value of high-resolution CT in the diagnosis of early lung adenocarcinoma.Methods:The clinical data of 90 patients with early lung adenocarcinoma who received treatment from January to December 2021 in Quzhou People's Hospital were retrospectively analyzed. These patients were divided into a non-invasive group ( n = 27) and an invasive group ( n = 63) according to whether they had invasive lung adenocarcinoma or not. In the non-invasive group, there were 10 patients with atypical adenomatous hyperplasia and 17 patients with in situ adenocarcinoma. In the invasive group, there were 38 patients with minimally invasive adenocarcinoma and 25 patients with invasive adenocarcinoma. A pathological diagnosis was performed in all patients. All patients underwent a high-resolution CT examination. The incidence of lung adenocarcinoma was compared between different loci. CT signs were compared between the non-invasive group and the invasive group. The receiver operating characteristic curve was used to determine the sensitivity and specificity of high-resolution CT in the differential diagnosis of lung adenocarcinoma prior to invasion. Results:There was no significant difference in the incidence of lung adenocarcinoma among the left upper lobe, right upper lobe, left lower lobe, and right lower lobe of the lung in each group (all P > 0.05). The detection rates of pleural indentation sign, spicule sign, and vascular bundle sign in the invasive group were 28.6% (18/63), 31.57% (20/63), and 27.0% (17/63), respectively, which were significantly higher than 7.41% (2/27), 11.11% (3/27), and 7.41% (2/27) in the non-invasive group ( χ2 = 4.90, 4.23, 4.35, all P < 0.05). There were no significant differences in detection rates in the lobar sign and air bronchogram sign between the two groups (both P > 0.05). The receiver operating characteristic curve analysis results showed that the sensitivity and specificity of high-resolution CT in differentiating pre-invasive lesions were 100.0% and 64.7%, respectively. Conclusion:High-resolution CT has a good diagnostic value for early lung adenocarcinoma. It can clearly display various signs of early lung adenocarcinoma, which is worthy of clinical reference.

Objective: To assess the value of non-invasive prenatal testing (NIPT) for the identification of fetal chromosomal aneuploidies. Methods: For 9470 pregnant women with a moderate-to-high risk by conventional serological screening or advanced maternal age, peripheral venous blood samples were collected and, following extraction of free fetal DNA, subjected to large-scale parallel sequencing on a Illumina Hiseq2000 platform. Those with a high risk by NIPT were validated by invasive prenatal diagnosis. Results: Out of the 9470 samples, 194 cases (2.0%) were positive by NIPT testing. These included 50 trisomy 21, 11 trisomy 18, 17 trisomy 13, 44 other autosomal aneuploidies, 55 sex chromosomal aneuploidies, and 17 chromosomal copy number variations. As validated by amniotic fluid or umbilical blood chromosomal karyotyping analysis, NIPT has a false positive rate of 2.0%, 18.2%, 41.2%, 97.7%, 81.8%, 94.1%, respectively. The test has a sensitivity of 100% and a specificity of 98.79%. Conclusion For common chromosomal aneuploidies such as trisomy 21 and trisomy 18, NIPT has a good sensitivity and specificity, therefore has good value for clinical application.

Extracellular vesicles(EVs)are nano-sized bilayer vesicles that are shed or secreted by virtually every cell type.A variety of biomolecules,including proteins,lipids,coding and non-coding RNAs,and mitochondrial DNA,can be selectively encapsulated into EVs and delivered to nearby and distant recipient cells,leading to alterations in the recipient cells,suggesting that EVs play an important role in intercellular communication.EVs play effective roles in physiology and pathology and could be used as diagnostic and therapeutic tools.At present,although the mechanisms of exosome biogenesis and secretion in donor cells are well understood,the molecular mechanism of EV recognition and uptake by recipient cells is still unclear.This review summarizes the current understanding of the molecular mechanisms of EVs'biological journey in recipient cells,from recognition to uptake and cargo release.Furthermore,we highlight how EVs escape endolysosomal degradation after uptake and thus release cargo,which is crucial for studies applying EVs as drug-targeted delivery vehicles.Knowledge of the cellular processes that govern EV uptake is important to shed light on the functions of EVs as well as on related clinical applications.