Objective To explore the relationship between periodontal disease and preeclampsia and the effects of periodontal treatment on preeclampsia.Methods China National Knowledge Infrastructure,Chinese Biomedical Literature Database,WANGFANG DATA,China Dissertation Full-Text Database,China Proceedings of Conference Full-Text Database,Cochrane Library,PubMed,EMbase,Elsevier,Springer,and Science Direct OnSite were extracted from inception till September 30,2014.The case-control,cohort and randomized controlled trials about the association of matemal periodontal disease and preeclampsia were searched according to the inclusion and exclusion criteria.RevMan5.1 and Stata12.0 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models.Results Twenty studies (15 case-control and 5 cohort) involving 8 775 women assessed the association between periodontal disease and preeclampsia.A positive association was found (OR=2.48,95％CI:1.76-3.48,P ＜ 0.01).Meta-analysis of the case-control studies showed more than twice in the odds of preeclampsia with the presence of periodontal disease (OR=2.75,95％CI:1.93-3.92,P ＜ 0.01).Meta-analysis of cohort studies did not reveal any significant differences (OR=1.84,95％CI:0.91-3.74,P ＞ 0.05).Four randomized controlled trials with 3 712 women evaluated the effect of periodontal treatment on preeclampsia,and meta-analysis showed no relative risk reduction in preeclampsia with periodontal treatment (RR=1.04,95％CI:0.84-1.30,P ＞ 0.05).Conclusions Periodontal disease appears to be a possible risk factor for preeclampsia,but treatment during pregnancy does not prevent preeclampsia.High-quality prospective studies are needed to confirm the relationship between periodontal disease and preeclampsia.

Objective To investigate the epidemiological characteristics,clinical features,diagnosis,treatment and prognosis of benign tumor of the bile ducts.Methods The retrospective cross-sectional multicenter study was conducted.The clinical data of 136 patients with benign tumor of the bile ducts who were admitted to the eight hospitals between January 2007 and December 2016 were collected,including 70 in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University,19 in the First Affiliated Hospital of Zhengzhou University,15 in the First Affiliated Hospital of Xi'an Jiaotong University,11 in the First Affiliated Hospital of Dalian Medical University,7 in the Affiliated Hospital of North Sichuan Medical College,6 in the Southwest Hospital of the Third Military Medical University,4 in the Cancer Center of Sun Yat-Sen University and 4 in the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.All the patients received laboratory and imaging examinations,and then underwent corresponding surgery when treatment planning was respectively determined by comprehensive hospitals according to clinical features and results of examinations.Surgical procedures were performed based on the results of intraoperative frozen section in rapid pathological diagnosis.Observation indicators:(1) epidemiological characteristics;(2) clinical features;(3) results of laboratory and imaging examinations;(4) treatment situations;(5) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the survival of patients up to March 2017.Measurement data with normal distribution were represented as-x±s.Results (1) Epidemiological characteristics:Of 136 patients,the male to female ratio was 1.78 ∶ 1.The incidence of whole bile duct tumors was from high to low,including 52 patients with duodenal papilla adenoma,32 with extrahepatic bile duct adenoma,24 with intrahepatic biliary cystadenoma,11 with intrahepatic papillary adenoma,9 with intrahepatic bile duct epithelial tumor,7 with epithelial tumor of duodenal papilla and 1 with neuroendocrine tumor of duodenal papilla.Among 136 patients,adenomas (including cystadenoma) was detected in 108 patients,papillomas in 11 patients,intraepithelial neoplasias in 16 patients,neuroendocrine tumor in 1 patient;intrahepatic bile duct benign tumors in 44 patients and extrahepatic bile duct (including duodenal papilla) benign tumors in 92 patients.(2) Clinical features:of 44 patients with intrahepatic bile duct benign tumors,29 had abdominal pain,fever and abdominal masses,4 had jaundice,11 had no obvious clinical symptoms and were diagnosed by physical examination.Among 92 patients with extrahepatic bile duct benign tumors,76 developed obstructive jaundice,68 were accompanied by abdominal pain or colicky pain,8 were combined with pancreatitis and 2 deveIoped hemobilia,some patients were combined with multiple clinical symptoms.(3) Results of laboratory and imaging examinations:82 patients received CA19-9 test,results of 22 patients were abnormal,with a level of (148-± 126)U/mL.Ninety-seven patients received carcinoembryonic antigen (CEA) test,with a level of test of (2.7±2.0) μg/L,and a level of CEA in 1 patient was slight abnormal,with a level of 11.2 pμg/L.One hundred and thirty-six patients underwent preoperative ultrasound examinations,showing unqualified hepatic and bile duct space occupying lesions and bile duct dilatation.Ninetyfive patients underwent preoperative computed tomography (CT),80 underwent preoperative magnetic resonance imaging (MRI) or magnetic resonanced cholangio-pancreatography (MRCP),and 13 underwent preoperative endoscopic ultrasonography (EUS).Twenty-nine patients were considered for intrahepatic bile duct benign tumors;76 were diagnosed with obstructive jaundice,with uncertain benign or malignant tumors;other patients had bile duct space occupying,considering bile duct tumor (including cancer).Twelve patients with bile duct obstruction underwent ERCP,showing obstruction site and morphology.(4) Treatment situations:among 136 patients,65 underwent pancreaticoduodenectomy,17 underwent right hemihepatectomy + cholecystectomy,16 underwent cholecystectomy + hepatic left lateral lobectomy,11 underwent left hemihepatectomy + cholecystectomy,11 underwent duodenal papillary local excision+papilla reconstruction,11 underwent Roux-en-Y choledochojejunostomy anastomosis,4 underwent cholecystectomy + extrahepatic bile duct local excision + end-to-end bile duct anastomosis and 1 underwent endoscopic mucosal resection of duodenal papillary adenomna.Of 136 patients with postoperative complications,25 were complicated with pancreatic leakage,11 with bile leakage,2 with postoperative hemorrhage and 1 with hepatic failure.Two patients with pancreatic leakage died of massive hemorrhage caused by abdominal infection,1 died of hepatic failure and other patients were discharged from hospital after symptomatic treatment.(5) Follow-up situations:47 of 136 patients were followed up for 3-123 months,with a follow-up rate of 34.6％.During follow-up,2 patients undergoing duodenal papillary local excision + papilla reconstruction had canceration,and other patients had good survival.Conclusions There is a low clinical incidence of benign tumor of the bile ducts,which is more common in male than in female,and in adenomas (including cystadenoma) and papillomas.The preoperative imaging examinations or ERCP biopsy pathological examination can increase an accuracy of preoperative diagnosis.Benign tumors with high canceration rates need positive surgical treatment.

Na +-K +-2Cl-cotransporter 1 (NKCC1) is highly expressed in malignant gliomas,which is closely related to the degree of malignancy.NKCC1 protein has a vital function in the volume regulation of glioma cells.NKCC1 allows glioma cells to transform its volume freely,migrating through the narrow extracellular space to achieve distant metastases.There is also close relationship between NKCC1 and tumor cytoskeleton regulation.In addition,NKCC1 is closely associated with cell cycle,nerve activity and other biological functions.In conclusion,NKCC1 plays an important role in gliomas.

Objective To investigate the effects of siRNA-mediated knockdown of S100A4 expression on the inva?sion and migration of SNB19 glioma cells. Methods The S100A4 expression was knockdowned using S100A4 siRNA in SNB19 glioma cells. Glioma cells were assigned into control group,siRNA-negative control treated group (siRNA-NC) and siRNA-S100A4 group. RT-PCR and western blot were used to detect the mRNA and protein expression of S100A4, respectively. The wound-healing assay and transwell invasion assay were used to determine the ability of migration and invasion of SNB19 glioma cells, respectively. The expression of matrix metalloproteinase 9 (MMP-9), matrix metallopro?teinase 2 (MMP-2) and E-cadherin proteins were evaluated by using western blot. Moreover, the morphology of lamellipo?dia of glioma cells were examined by using inverted phase-contrast microscopy. Results The mRNA and protein expres?sion levels of S100A4 was obviously down-regulated after transfection of S100A4 siRNA. Compared with control group, the mRNA expression levels of S100A4 in siRNA-NC group and siRNA-S100A4 group were 0.97±0.07 and 0.21±0.04,respectively(P<0.01). The protein expression levels of S100A4 in control, siRNA-NC and siRNA-S100A4 groups were 78.12%±2.63%, 77.16%±3.00%and 37.95%±2.71%, respectively(P<0.01). The migration and invasiveness capability were decreased up to 46% and 55% in the siRNA-S100A4 group compared with the control group(P<0.01). The pro?tein expression levels of MMP-9 and MMP-2 were inhibited up to 62% and 68%(P<0.01)whereas the expression of E-cadherin was increased up to 154%(P<0.01)in the siRNA-S100A4 group. The lamellipodia became smaller or unex?tended in siRNA-S100A4-treated SNB19 glioma cells. Conclusion S100A4 plays an important role in the invasion and migration of glioma cells, suggesting that S100A4 might be a potential candidate for anti-glioma strategy to prevent the invasion and migration of glioma cells.

Objective To investigate the inhibitory effect of a disintegrin and metalloprotease 12 silenced by shR?NA on self-renewal capacity of CD133 positive giloma cells. Methods The shRNA recombinant lentivirus aimed at si?lencing ADAM12 was prepared. Human glioma cells U87 were employed in this study and assigned into three groups:shRNA-ADAM12, shRNA-NCandshRNA-C. ADAM12 expression was detected at mRNA and protein level using Re?al-time quantitative-PCR and western bloting, respectively. U87 cells were cultured with stem cell culture medium, to obtain cell sphere formation in which CD133 positive glioma cells were enriched. Immunofluorescence was employed to detect the expression of ADAM12 and CD133 in cell spheres and U87 cells; Self-renewal was tested by using tumor sphere formation assay. Molecular markers for differentiated or undifferentiated cells (CD133,GFAP and Tuj1) were de?tected at protein using western blotting. Western blotting was employed to test protein expression of HES1. Results AD?AM12 shRNA significantly down-regulated the mRNA and protein expression levels of ADAM12. Compared with shRNA–C group, the relative expression levels of mRNA in shRNA-ADAM12 group and shRNA-NC group were 0.22 ± 0.03 and 0.98 ± 0.06 (F=425.37,P<0.01). The relative expression levels of protein in shRNA-ADAM12 group, shRNA-NC group and shRNA-C group were 28.72%±2.36%, 69.21%±3.92%and 69.04%±3.57%, respectively (F=145.42,P<0.01). Immunofluorescence staining showed that expression levels of ADAM12 and CD133 in cell spheres were significantly higher than those in normal cells. The number of spheres in three groups were 45.5±2.3、104.2±5.8 and 109.6±6.2, tumor sphere formation ability of shRNA-ADAM12 group was lower than that of shRNA-NC group and shRNA-C group (F=147.03,P<0.01). Compared with the shRNA-NC group and shRNA-C group, the protain expression of GFAP and Tuj1 were increased up to 166% and 146% (P<0.01) whereas the protein expression levels of CD133 and HES1 were down-regulated by 54% and 50% (P<0.01). Conclusion Knockdown of ADAM12 may suppress self-renewal ability of CD133 positive glioma cells by inhibiting the Notch pathway activity.

The 53rd annual meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago,United States between June 2 and 6,2017.The latest advances in biliary tract cancer research from this meeting were summarized and analyzed in this paper.The adjuvant therapy in biliary tract cancer made a breakthrough in this meeting,the findings could provide the basis for a new standard of changing the current management model in the disease.The precision medicine and targeted therapy will be the development direction in the future.Doctors should attach great importance to the adjuvant and comprehensive therapy in biliary tract cancer and initiate high level multi-center clinical trials to improve the overall the diagnostic and treatment levels of biliary tract cancer.

Objective To investigate the role of cortactin in migration and invasion of U251 glioma cells and role of Rac1 activation in this process.Methods Human glioma U251 cells were cultured in vitro.The expressions and distributions of Rac1 and cortactin in U251 glioma cells were detected by immunofluorescence.U251 glioma cells assigned into 4 treatment groups:siRNA-cortactin group (transfected by siRNA specific cortactin),siRNA-NC group (transfected by negative control RNA sequence),siRNA-N group (transfected by empty vector) and siRNA-cortactin+Rac1 group (transfected by siRNA specific cortactin and Rac1 inhibitor).Forty-eighty h after grouping and each treatment,the protein expressions of cortactin and Rac1 in the 4 groups were detected by Western blotting;the migration and invasion of glioma cells were evaluated by wound-healing and Transwell-chamber invasion assays;the lamellipodia of glioma cells was observed by immunofluorescence.Results Cortactin and Rac1 were co-localized in the front ofglioma cells,where actin was polymerized and lamellipodia was formed.As compared with siRNA-NC group and siRNA-N group,siRNA-cortactin group and siRNA-cortactin+Rac1 group had significantly lower cortactin and Rac1 expressions (P＜0.05);siRNA-cortactin+Rac1 group had significantly lower cortactin and Rac1 expressions as compared with siRNA-cortactin group (P＜0.05).As compared with siRNA-NC group and siRNA-N group,siRNA-cortactin group and siRNA-cortactin+Rac1 group had significantly smaller healing areas and number of perforator cells (P＜0.05);siRNA-cortactin+Rac1 group had significantly smaller healing areas and number of perforator cells as compared with siRNA-cortactin group (P＜0.05).As compared with siRNA-NC group and siRNA-N group,siRNA-cortactin group and siRNA-cortactin+Rac1 group had decreased lamellipodia of glioma cells;siRNA-cortactin+Rac1 group had decreased lamellipodia of glioma cells as compared with siRNA-cortactin group.Conclusion Cortactin can promote the migration and invasion of glioma cells by regulating lamellipodia formation;combined inhibition of Rac 1 and cortactin may be an effective mean for treatment ofglioma.

Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare and enhanced CT or MRI can be used for its diagnosis. Surgical procedure is the main treatment for HCC with BDTT. The authors introduce the experiences of recurrent patient with HCC and BDTT who was treated with targeted therapy plus immunotherapy, in order to provide reference for its clinical diagnosis and treatment.

Objective: To explore the prognosis of patients with T1b stage gallbladder carcinoma underwent different surgical procedure. Methods: The clinicopathological data of 97 patients with T1b stage gallbladder carcinoma came from 8 clinical centers from January 2010 to December 2016 and 794 patients who were admitted to the SEER database of USA from January 1973 to December 2014 were analyzed.There were 891 patients including 254 males and 637 females (1.0∶2.5) with age of (69.5±12.0)years. There were 380 patients who were less than 70 years old, 511 patients who were more than 70 years old. And there were 213 patients with the diameter of tumor less than 20 mm, 270 patients with the diameter of tumor more than 20 mm, 408 patients were unclear. There were 196 patients with well differentiation, 407 patients with moderately differentiation, 173 patients with poorly differentiation, 8 patients with undifferentiated, 107 patients were unclear. In the 891 patients with T1b stage gallbladder carcinoma, there were 562 cases accepted the simple cholecystectomy, 231 cases with simple cholecystectomy plus lymphadenectomy, and 98 cases with radical cholecystectomy. The time of follow-up were until June 2017. χ² test was used to analyze the enumeration data, rank-sum test was used to analyze the measurement data, the analyses of prognostic factors were used Cox proportional hazards model, the survival analysis was performed using Kaplan-Meier method. Results: The results of Cox proportional hazards model indicated, age, differentiation, surgical procedure were the risk factors of prognostic(1.929(1.594-2.336), P<0.01; 1.842(1.404-2.416), P<0.01; 1.216(0.962-1.538), P<0.01). The results of Kaplan Meier test indicated, the overall survival of T1b stage gallbladder carcinoma were (85.5±3.8)months, the overall survival of patients with simple cholecystectomy were (71.3±4.4)months, the overall survival of patients with cholecystectomy plus lymphadenectomy were(87.6±5.8)months, and the overall survival of patients with radical cholecystectomy were(101.7±9.3)months. The overall survival of patients with cholecystectomy plus lymphadenectomy and radical cholecystectomy were more than simple cholecystectomy(P<0.05). There were 329 patients with Lymph nodes examined in and after operations(231 patients with cholecystectomy plus lymphadenectomy, 98 patients with radical cholecystectomy). There were 265 patients with negative lymph node metastasis, the overall survival were(98.3±4.2)months. There were 64 patients with positive lymph node metastasis, the overall survival were(75.5±3.1)months. The overall survival of 38 patients with cholecystectomy plus lymphadenectomy were(62.7±2.6) months, and 26 patients with radical cholecystectomy were (82.2±3.7)months. The overall survival of patients with radical cholecystectomy were more than cholecystectomy plus lymphadenectomy(P<0.05). Conclusions The T1b stage gallbladder carcinoma patients with cholecystectomy plus lymphadenectomy or radical cholecystectomy has improved the prognosis comparing with simple cholecystectomy, significantly. When lymph node metastasis occurs, radical cholecystectomy has improved the prognosis comparing with cholecystectomy plus lymphadenectomy.

Objective To analyze the pathological results and current treatment situation of patients with unexpected gallbladder carcinoma from multi-centers in China,and explore the diagnosis and treatment of unexpected gallbladder carcinoma.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 223 patients with unexpected gallbladder carcinoma who were admitted to the 8 clinical centers from January 2010 to December 2016 were collected,including 86 in the First Affiliated Hospital of Xi'an Jiaotong University,41 in the First Affiliated Hospital of Zhengzhou University,30 in the Eastern Hepatobiliary Surgery Hospital of the Second Military Medical University,27 in the Xinhua Hospital of Shanghai Jiaotong University,13 in the First Affiliated Hospital of Dalian Medical University,11 in the Tianjin Medical University Cancer Institute & Hospital,9 in the First Affiliated Hospital of Army Medical University (Third Military Medical University) and 6 in the Affiliated Hospital of North Sichuan Medical College.Treatment of patients with unexpected gallbladder carcinoma who were diagnosed by intraoperative frozen section biopsy and postoperative pathological examination followed guideline for the diagnosis and treatment of gallbladder carcinoma (2015 edition).According to tumor staging and patients' decision,postoperative adjuvant treatment was selectively performed.Observation indicators:(1) diagnosis and treatment of unexpected gallbladder carcinoma;(2) followup and survival.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to June 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).The survival time was calculated using the Kaplan-Meier method.Results (1) Diagnosis and treatment of unexpected gallbladder carcinoma:of 223 patients with unexpected gallbladder carcinoma,80 were initially diagnosed using intraoperative frozen section biopsy [20 received T stage results (intraoperative T stage of 14 patients had not matched postoperative results),and 60 didn't receive T stage results],and 143 were initially diagnosed using postoperative pathological examination (13 were initially diagnosed with gallbladder benign disease by intraoperative frozen section biopsy and 130 didn't intraoperatively receive frozen section biopsy).Of 223 patients,209,10,3 and 1 were respectively confirmed as adenocarcinoma,adenoma canceration,neuroendocrine tumor and squamous cell carcinoma;6,16,32,73,75,12 and 9 were respectively detected in Tis,T1a,T1b,T2,T3 and T4 stages and undefined stage;140 underwent reoperations,including 106 with radical resection of gallbladder carcinoma and 34 with extended radical resection of gallbladder carcinoma;operation of 126 patients reached the standard and operation of 97 patients didn't reach the standard.Of 27 patients with postoperative complications,12 with postoperative hemorrhage received successful hemostasis by reoperations (7 with cystic artery hemorrhage and 5 with blood oozing from gallbladder bed);8 with suppurative cholangitis received endoscopic retrograde cholangiopancreatography and choledochotomy with drainage,including 2 deaths and 6 with improvement;2 with common bile duct injury were improved by reoperation of choledochojejunostomy + T tube drainage;2 were complicated with bile leakage induced to peritonitis and underwent bile duct repair with drainage,including 1 death and 1 with improvement;2 with hepatic failure died of treatment failure;1 with colonic injury was improved by reoperation of anastomosis.Of 223 patients,207 didn't receive postoperative adjuvant treatment and 16 received postoperative adjuvant treatment,including 8 with chemotherapy,4 with radiotherapy,2 with immunologic therapy and 2 with Chinese medicine treatment.(2) Follow-up and survival:of 223 patients,193 were followed up for 6-90 months,with a median time of 33 months.Of 193 patients with follow-up:① The operation of 2 patients in stage Tis reached the standard,including 1 with cholecystectomy and 1 with radical resection of gallbladder carcinoma,and the postoperative survival time of them were respectively 28 months and 52 months.② The operation of 14 patients in stage T1a reached the standard,including 8 with cholecystectomy and 6 with radical resection of gallbladder carcinoma,and the postoperative survival time of them were respectively (74±5)months and (79±6)months.③ Of 26 patients in stage T1b,13 and 13 received respectively cholecystectomy and radical resection of gallbladder carcinoma (reaching the standard),and postoperative survival time of them were respectively (66±4)months and (76±8)months.④ Of 68 patients in stage T2,25,37,4 and 2 patients received respectively cholecystectomy,radical resection of gallbladder carcinoma (reaching the standard),extended radical resection of gallbladder carcinoma (reaching the standard) and palliative resection,and postoperative survival time of them were respectively (42±7) months,(66±6) months,(42±3) months and (26±3) months.⑤ Of 71 patients in stage T3,20,48 and 3 patients received respectively cholecystectomy,radical resection of gallbladder carcinoma (reaching the standard) and extended radical resection of gallbladder carcinoma (reaching the standard),and postoperative survival time of them were respectively (39±8) months,(48± 11) months and (10±6) months.⑥ Of 12 patients in stage T4,3,1,5 and 3 patients received respectively cholecystectomy,radical resection of gallbladder carcinoma (reaching the standard),extended radical resection of gallbladder carcinoma (reaching the standard) and palliative resection,and postoperative survival time of them were respectively (10±4) months,12 months,(9± 5) months and (11±3) months.Conclusions The intraoperative frozen section biopsy and pathological results are the key points for diagnosis and treatment of unexpected gallbladder carcinoma.Patients in stage Tis and T1a should undergo cholecystectomy,while patients in stage T1b and above should undergo radical resection of gallbladder carcinoma or extended radical resection of gallbladder carcinoma.