Objective To increase the yield of antitumor substances from marine actinomycete ACMA006 strain.Methods Fermentation conditions were studied,including combination of medium,the age of strain,ventilatory capacity and cultivation time.Results The results showed that the best medium was as following: soya powder 10g,tryptone 5g,yeast extract paste 10g,soluble starch 15g,glycerol 15g,KH2PO4 0.5g,sea water 1000mL,pH7.2.The best culture conditions were temperature 28℃,the age of the strain 6d,the liquid volume of culture medium 50mL in 150mL Triangular flask,and cultivation time 8d.Conclusion At last 78.1g?L-1 biomass was obtained and the inhibition rate on human liver cancer cells HepG2 was 93.7% when the broth was diluted 4000 times.

Objective To explore the value of sonohysterography (SHG) in diagnosis of post-cesarean scar diverticulum.Methods Totally 28 patients with post-cesarean scar diverticulum suspected clinical underwent SHG and conventional transvaginal ultrasound (TVS).The sizes of the diverticulum and the thickness of muscular layer were observed and the diagnostic value of SHG and TVS were compared.All patients underwent hysteroscopy,and the results were considered as diagnostic standard.Results Twenty diverticulums were found by hysteroscopy,20 diverticulums by SHG and 17 diverticulums by TVS.Taking hysteroscopy as diagnostic standard,the accuracy of SHG,TVS in diagnosis of diverticulums were 100％ (20/20) and 89.29％ (17/20) respectively.Superoinferior diameter ([9.17 ± 2.63] mm),left-right diameter ([11.76± 5.67]mm) of diverticulum and thickness of muscular layer ([3.29 ± 1.01]mm) measured by TVS had statistical differences compared with those measured by SHG (superoinferior diameter:[12.01± 4.04]mm,left-right diameter:[12.37±6.14]mm,thickness:[2.85±1.30]mm,all P＜0.05).The altitude of diverticulum measured by TVS and SHG had no statistial difference ([5.62±± 2.13]mm vs [5.50±2.34]mm,P＞0.05).Five patients with intra uterine adhesions,4 with endometrial polyps and 1 with submucosal myoma were detected by SHG.Conclusion SHG has clinical value in di agnosis of post-cesarean scar diverticulum..

Objective To explore the clinical value of serum κ/λ ratio in the differential diagnosis of multiple myeloma (MM) and primary nephritic,and to explore its relationship with MM other laboratory markers.Methods We obtained 88 cases of MM patients with serotyping by immunofixation and 109 cases of primary nephritic patients.In accordance with the composition of protein M in immunofixation electrophoersis (IFE),88 patients were divided into 4 groups:IgGκ,IgGλ,IgAκ and IgAλ.In addition,45 serum samples of health examination were collected as control samples.The levels of serum IgG,IgA,IgM,light chain κ and λ in each group were tested by immune turbidimetry,and κ/λ ratio was calculated.The levels of serum β2-microglobin (β2-MG),albumin (ALB),serum urea (BUN),creatinine (CRE),and M protein percentage were also detected.Results (1) In MM group,there was no significant difference of sex and International Staging System (ISS) stages between each type(P ＞ 0.05),while there was significant difference in age distribution between each type (P ＜ 0.05).(2) Compared to control,the levels of se-rum light chain κ,κ/λ ratio,and matched Ig were significantly higher and the level of light chain λ and other Ig were significantly lower in κ typed MM patients,while the levels of serum light chain λ were significantly higher and the levels of serum light chain κ,and κ/λ ratio were significantly lower in λ typed MM patients(P ＜0.01).The levels of light chain κ,λ,and IgG in primary nephritic patients were significantly lower than control(P ＜0.01),while there was no significant difference in κ/λ ratio between two group (P ＞ 0.05).There were also significant difference of light chain,Ig,BUN and CRE levels between MM patients and primary nephritic patients (P ＜ 0.05).(3) The κ/λ ratio correlated with serum ALB (r =-0.264,P =0.013) and β2-MG (r =0.235,P =0.040) levels in MM.Conclusions Serum levels of light chain κ,λ,and κ/λ ratio have great significance in the differential diagnosis of multiple myeloma and primary nephritic.The κ/λ ratio correlated with several tumor markers in MM progresses,rendering it as a promising method for diagnosis and prognosis monitoring of MM.

Objective This study aimed to assess the risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with multiple myeloma (MM) by systematic analysis.Methods The literature was retrieved in 4 English databases (PubMed,Web of science,OVID,Cochrane Library)and 3 Chinese databases (CNKI,VIP,and Wanfang) as of september 2016.The key word in English/Chinese database retrieval is " MM or multiple myeloma and infection".Newcastle Ottawa Scale (NOS) was used to evaluate the article quality.The overall odds ratio (OR) and 95％ confidence intervals (95％ Cls)were estimated by fixed (heterogeneity test at/2 ＜ 25％) or random (heterogeneity test atI2 ≥25％) effects model.Results A total of 9 studies were included in the Meta analysis.The study found that multiple myeloma patients had an increased risk of HBV and HCV infection,3.17 and 4.16 times higher than the control group.HBV (OR =3.17,95％ CI:1.17-1.96,I2 =27％,P =0.002) and HCV infection (OR =4.16,95％ CI:1.33-2.22,I2 =0％,P ＜0.001) in the multiple myeloma group were significantly different from those of the control group (P ＜ 0.05).Conclusions HBV and HCV infection are risk factors for multiple myeloma and should be highly regarded and controlled before and after treatment.

Objective:To observe pelvic floor muscle′s contraction in women with the second and full term natural parturition by intelligent ultrasonic examination.Methods:Ninety-five postpartum women who underwent natural parturition and post-partum check (6-9 weeks after delivery) in Henan Provincal People′s Hospital were recruited in this study from Jul to Dec 2018. Fifty-four puerpera were first parturition and 41 were second parturition. The morphology of urogenital hiatus was observed during both rest and contract maneuver by real-time 3D ultrasound. Several parameters were measured by intelligent ultrasound, such as hiatal area, anteroposterior diameter, transverse diameter, and the thickness of puborectalis muscles, and the D-values of all parameters were calculated in different maneuver. Meanwhile, the strength of pelvic muscle in two groups were measured and the ultrasonic diameters and muscle strength were compared.Results:The hiatal area, anteroposterior diameter, transverse diameter, and the thickness of bilateral puborectalis muscles between first natural parturition and second natural parturition during rest maneuver were (15.92±2.76)cm 2 vs (16.65±2.63)cm 2, (40.93±5.63)mm vs (40.27±6.21)mm, (55.54±6.05)mm vs (57.92±5.27)mm, (7.03±1.51)mm vs (7.44±1.23)mm, (7.49±1.44)mm vs (7.44±1.44)mm, there was no statistical difference( P>0.05). During contract maneuver, these data were (11.76±2.62)cm 2 vs (12.09±2.78)cm 2, (37.57±5.46)mm vs (37.18±4.71)mm, (42.21±5.69)mm vs (43.03±7.13)mm, (8.92±1.54)mm vs (8.87±1.23)mm, (8.90±1.60)mm vs (9.30±2.71)mm, there was no statistical difference( P>0.05). The D-values of all diameters were (4.16±2.38)cm 2 vs (4.43±2.70)cm 2, 3(1.00, 5.00)mm vs 1(1.00, 5.25)mm, (13.33±6.07)mm vs (14.41±6.54)mm, (1.90±1.78)mm vs (1.68±1.31)mm, 1(0.48, 2.40)mm vs 1.25(0.20, 2.13)mm, there was no statistically significant difference between two groups ( P>0.05). The non-eligibility rate of typeⅠmuscle fiber strength in two groups were 65% vs 68%(35 vs 28) and typeⅡmuscle fiber strength were 74% vs 79%(40 vs 32), there was no statistically difference between two groups ( P>0.05). Conclusions:In comparison to the primary and full term natural parturition women, there is no significant reduction of the pelvic floor muscle′s contraction by intelligent ultrasund in second and full term natural parturition women without abnormal pregancy history and complications. This could provide theoretical basis for the choice of the mode of second parturition and the rahabilitation of postpartum.

Objective:To investigate the clinical characteristics and prognosis of CpG island methylator phenotype (CIMP+ ) colon cancer, and the significance of CIMP status in the diagnosis and prognosis prediction in defective mismatch repair (dMMR) colon cancer.Methods:The keywords "colorectal cancer" "patient" and "CpG Island Methylator Phenotype" were used to search the Gene Expression Omnibus (GEO) database, and the GSE39582 was obtained, which included the clinical data of 585 patients with colorectal cancer and the sequencing data of the whole transcriptome of the tumor tissues. After excluding 72 cases with missing CIMP values, 513 cases were included for further analysis, including 278 males and 235 females, with a mean age of (67±13) years. According to the CIMP status, they were divided into CIMP+ group ( n=93) and CIMP-group ( n=420), then compare the differences in clinical characteristics, the Kaplan-Meier survival curves were plotted to compare the overall survival and disease-free survival; 71 dMMR cases were divided into CIMP+ group ( n=43) and CIMP-group ( n=28), and the K-M curves were plotted to analyze the differences in overall survival (OS) and disease free survival (DFS). Comparisons between groups were performed by t-test, χ2 test or Mann-Whitney U nonparametric test, and the difference in survival curves was tested by Long-rank test. Results:Patients in the CIMP+ group were significantly older than those in the CIMP-group [(70.84±12.60) years vs (66.21±13.08) years, t=3.18, P=0.002]. Right colon tumors originating from the CIMP+ molecular pathway were 9.3 times more likely to be CIMP+ than those of the left colon cancers ( OR=9.3, 95% CI: 5.2-17.9). BRAF mutant colon cancer originating from CIMP+ was 215.2 times more common than BRAF wild-type colon cancer originating with CIMP+ ( OR=215.2, 95% CI: 53.2-1906.7); and patients with dMMR colon cancer originated 12.8 times more common than patients with pMMR ( OR=12.8, 95% CI: 7.0-23.9). The difference between the CIMP+ and CIMP-groups was not statistically significant in terms of overall survival and disease-free survival ( P=0.590, 0.220). In the dMMR colon cancer subgroup, CIMP status did not correlate with patients′ overall survival and disease-free survival ( P>0.05). Conclusions:CIMP+ colon cancer patients were mostly of advanced age, with tumors originating from the right colon, mostly combined with BRAF gene mutations, and manifested as mismatch repair-deficient colon cancers. CIMP status had no correlation with TNM stage and survival of colon cancers patients. There was no significant difference in the survival between dMMR colon cancers caused by CIMP+ and those caused by MMR gene mutations.

Objective:To investigate the normal parameter values of transvaginal E-Cervix cervical elastography of primipara and explore the correlation between E-Cervix parameters and gestational age.Methods:A total of 301 primiparas underwent E-Cervix by transvaginal ultrasound in Henan Provincial People′s Hospital from March 2019 to January 2021, they were divided into 6 groups according to generational weeks: group A (11-13 + 6W), group B (14-17 + 6W), group C (18-21 + 6W), group D (22-25 + 6W), group E (26-29 + 6W), group F (30-33 + 6W). Real-time E-Cervix parameters were obtained, including elasticity contrast index (ECI), hardness ratio (HR), internal ostium (IOS), and external ostium (EOS), strain ratio of the internal and external cervical ostium (IOS/EOS), and the correlations between E-Cervix parameters and the gestational week were analyzed. Results:The normal reference ranges of parameters ECI, IOS, EOS, HR and IOS/EOS were obtained, their 95% reference values in groups A to F were as follows: ECI (1.84-3.38, 2.13-4.50, 2.25-4.12, 2.06-3.96, 2.04-5.15, 2.36-5.53), HR (85.85%-88.72%, 77.31%-80.92%, 74.41%-78.50%, 71.13%-74.35%, 64.49%-68.56%, 63.57%-68.23%), IOS (0.12-0.21, 0.14-0.34, 0.14-0.31, 0.19-0.40, 0.19-0.56, 0.21-0.49), EOS (0.12-0.30, 0.14-0.34, 0.16-0.41, 0.20-0.39, 0.22-0.58, 0.22-0.54), IOS/EOS (0.55-1.12, 0.52-1.45, 0.56-1.26, 0.54-1.38, 0.54-1.52, 0.65-1.46). The differences of ECI, HR, IOS and EOS in different groups were statistically significant (all P<0.05). Spearman correlation analysis results showed that ECI, IOS, and EOS were positively correlated with gestational week( rs=0.524, 0.689, 0.609; all P<0.01). HR was negatively correlated with gestational week ( rs=-0.755, P<0.01). The regression equations of ECI, HR, IOS and EOS were Y=0.06X+ 52.214, Y=99.25-1.07X, Y=8.63E-3X+ 0.05, Y=7.94E-3X+ 0.1, respectively. Conclusions:The normal parameters values of E-TVES are summarized.It provides effective support in data for cervical evaluation in the preterm prediction and success of labor induction.

Objective:To evaluate the development of fetal cerebral sulci and gyrus and the blood perfusion in pregnant women with gestational diabetes mellitus(GDM) by ultrasound.Methods:A total of 1 540 pregnant women with 28-34 weeks of pregnancy who underwent systematic screening in Henan Provincial People′s Hospital from January 2022 to October 2022 were prospectively selected, 100 pregnant women with GDM were selected as the GDM group. According to the effect of blood glucose control, the GDM group was divided into 2 groups: the satisfied control group (GDM group 1), and the dissatisfied control group (GDM group 2), with 50 cases in each group. At the same period, 50 healthy pregnant women at 28-34 weeks of gestation were enrolled as the control group. The differences of the sylvian fissure, parietooccipital sulci, calcarine sulci and cinguli sulci among the 3 groups were statistically analyzed. And the correlations between the deep of the brain cerebral sulci and gyrus and controlled blood glucose levels were evaluated. The umbilical artery pulsation index(UAPI), middle cerebral artery pulsation index(MCAPI) and ductus venosus pulsation index(DVPI) among the 3 groups were compared, and the differences in fetal blood perfusion among the 3 groups were evaluated.Results:There were no significant differences in the depths of the sylvian fissure, parietooccipital sulci, calcarine sulci and cinguli sulci between the control group and the GDM group 1 (all P>0.05), and they were larger than those of the GDM group 2 (all P<0.05). The depths of lateral fissure, parieto-occipital sulcus, cingulate sulcus and calcarine sulcus were negatively correlated with fasting blood glucose, 1 h and 2 h postprandial blood glucose (all P<0.05). There were no significant differences in MCAPI, UAPI and DVPI between the control group and GDM1 group (all P>0.05). The MCAPI in GDM 2 group was lower than that in the control group and GDM 1 group, and the UAPI and DVPI values were higher than those in the control group and GDM1 group(all P<0.05). Conclusions:The maturity of fetal cerebral sulci and gyrus in GDM pregnant women is related to the blood glucose control of pregnant women. The change of blood perfusion caused by persistent hyperglycemia in pregnant women and intrauterine hypoxia may cause the development retardation of cerebral sulci and gyrus.

Objective:To observe the morphological characteristics of urogenital hiatus in patients with gestational diabetes mellitus (GDM) after vaginal delivery.Methods:This study included 192 pregnant patients from Henan Provincial People′s Hospital who met the conditions between Jan.2020 and Aug.2021. All participants were screened for GDM by oral glucose tolerance test (OGTT) or fasting blood glucose at 24-28 weeks of pregnancy, and were divided into GDM group (34 cases) and non-GDM group (158 cases) based on the presence or absence of GDM. All participants underwent pelvic floor ultrasonography at the first trimester (6-8 gestational weeks), 3 days postpartum, 6 weeks postpartum, 6 months postpartum, and 1 year postpartum. Area of urogenital hiatus (AUH), transversal diameter of urogenital hiatus (TDUH) and anteroposterior diameter of urogenital hiatus (APDUH) were measured using Smart Pelvic. The Logistic regression model was used to calculate and match the propensity score between the GDM group and the non-GDM group.Results:In the non-GDM group, TDUH during rest maneuver at 6 weeks postpartum( P=0.319), the indicators during rest and contract maneuver at 6 months postpartum( P=0.586, 0.877, 0.164, 0.226, 0.465, 0.097), and TDUH during tension maneuver at 1 year postpartum( P=0.643) returned to the level of early pregnancy. In the GDM group, the indicators during rest maneuver and TDUH during contract maneuver at 6 months postpartum recovered to the level of early pregnancy ( P=0.647, 0.584, 0.376, 0.440), while APDUH and AUH during contract maneuver ( F=7.784, 9.785; P=0.005, <0.001) and the indicators during tension maneuver at 1 year postpartum( F=15.343, 11.974, 17.981; P<0.001) did not recover to the level of early pregnancy. After propensity score matching, APDUH and AUH during tension maneuver at 1 year postpartum in the GDM group were significantly greater than those in the non-GDM group( t=2.810, 2.926; P=0.006, 0.004). Conclusions:The pelvic floor muscles of GDM patients after vaginal delivery are more severely damaged, and the recovery speed is slower. Pelvic floor muscle exercise during pregnancy and enhanced postpartum follow-up are needed to prevent, diagnose and treat pelvic floor dysfunction early.

Objective: To investigate surface properties of novel flowable composites after polishing and simulated brushing wear, compared to their pasty counterpart. Methods: Composites employed in this study were: three flowable composites (A1: Clearfil Majesty ES Flow; B1: Beautifil Flow Plus F00; C1: Filtek Bulk Fill) and three paste composites (A2: Clearfil Majesty; B2: Beautifil; C2: Filtek Z350. Eleven disk-shaped specimens were made for each material. The specimens were cured, then subjected to sandpaper finishing for 20 s, one-step polishing for 30 s, finally subjected to simulated brushing for 10 000 cycles. Surface roughness and glossiness were measured before finishing, after finishing, after polishing, after 5 000 brushing cycles and after 10 000 brushing cycles, respectively. Data obtained were analyzed using two-way ANOVA method. Scanning electron microscope was employed to examine the microscopic appearance of each material. Results: Surface roughness (0.11~0.22 μm) and glossiness (74.25~86.48 GU) of each material were similar after one-step polishing. After brushing simulation, roughness increased significantly and glossiness decreased significantly for each material (P<0.05). Group A1 presented the best gloss ([50.68±1.58] GU) after final wear (P<0.05). Flowable composites of group A1 and B1 tested in the present setup showed better surface properties compared to their pasty counterpart (group A2 and B2). Conclusions Within the limit of this study, flowable composites tested in the present research can obtain similar surface polish or even better than the paste composite counterpart.