Objective To investigate the expressions of extracellular matrix metalloproteinase inducer molecule CD147 and epidermal growth factor receptor (EGFR) protein in gastric cancer and their relationship with the pathological behavior and prognosis.Methods Immunohistochemical staining was used to detect the expressions of CD147 and EGFR protein in 63 cases of gastric cancer and 40 cases of paracancerous normal tissues.The study was also combined with analysis of the pathological behavior and clinical follow-up survey of gastric cancer.Results The positive expression rates of CD147 and EGFR protein in gastric cancer were 77.8％ (49/63) and 42.9％ (27/63),respectively,which were higher than those in paracancerous normal tissues 25.0％ and 0 (x2 =27.851,P =0.000;x2 =23.233,P =0.000).In gastric cancer,the expressions of CD147 and EGFR were closely related to the depth invasion (x2 =5.992,P =0.014;x2 =13.148,P =0.000),TNM stages (.x2 =8.481,P=0.004;x2=14.589,P=0.000),lymph node metastasis (x2 =5.270,P=0.022;x2=20.261,P =0.000) and prognosis of patients (x2 =5.606,P =0.018;x2 =4.982,P =0.026).The expression of CD147 was also significantly correlated with Ki-67 expression (x2 =10.481,P =0.001).CD147 expression was positively correlated with EGFR expression(r =0.309,P =0.014).Conclusion The expressions of CD147 and EGFR are closely related to carcinogenesis,metastasis and survival time of gastric cancer.Detecting the expressions of CD147 and EGFR may be prognostic indicators of gastric cancer.

BACKGROUND:A large amount of apicocoronal and buccolingual bone resorption occur in alveolar bone after tooth extraction, leading to the distinct shortage of bone mass of alveolar bone in tooth-missing area, which has a certain effect on the stability of early implantation and postoperative aesthetic outcomes and greatly affects the long-term success rate of denture implantation. Therefore, immediate-delayed implantation can shorten the time of repair. OBJECTIVE:To evaluate the effect of implant repair after immediate-delayed implantation and application of guided bone regeneration technique in anterior maxila area. METHODS:Nineteen patients (28 teeth lost) with maxilary anterior tooth loss and labial one-waled bone defects were selected. Twenty-eight OSSTEM implants were implanted at 4 weeks after tooth extraction. Guided bone regeneration technique was applied concurrently in labial bone defect area. The secondary repair was performed after 6 months. RESULTS AND CONCLUSION:The success rate of these 28 implants was 100% at 24 months after denture implantation. The peri-implant bone height loss at 6, 12 and 24 months was 0.1, 0.6 and 0.11 mm, respectively. Red aesthetic scores were satisfactory. Immediate-delayed implantation combined with application of guided bone regeneration technique for treatment of maxilary anterior tooth loss and mild bone defect can restore the height and width of peri-implant bone and acquire stable vertical bone resorption and satisfactory gingival aesthetic outcomes .

In 2010,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Chinese Center for Disease Control and Prevention conducted collaboratively a 2010 China Noncommunicable Disease Surveillance,and reported the results of diabetes prevalence and control in Chinese adults,which was published in the Journal of American Medical Association (JAMA) in 2013.This article is the interpretation of that report by original authors.

Objective To evaluate the feasibility of real-time quantitative PCR (RtPCR) with small volume regarding the stability, efficiency and reliability of amplification, and determine the optimal quantity of cDNA template suitable for small PCR volume. Methods The experiment was carried out in 3 groups with 10, 15 and 20μL reaction volume, respectively. In each group, rat β-actin mRNA was detected by RtPCR with 0.1, 0.2, 0.3 or 0.4μL rat cDNA as template, respectively. The amplification curve and melting curve were used to evaluate the reaction stability. The fitting of a curve of gradient templates against threshold cycle numbers was to show the reaction efficiency and the linear correlativity was to estimate the suitability of the template quantity. In addition, in order to estimate reliability, pristane-induced arthritis (PIA) rat model was established, and spleen TNF-α mRNA expression was detected by RtPCR with the selected reaction volumes. Results The amplification of rat β-actin mRNA was specific and stable in 10μL, 15μL and 20μL PCR volume, and had a high efficiency. Furthermore, the standard curves fitted by 0.1-0.4μL gradient templates showed a significant linear correlation in each volume group. When the 10μL and 20μL PCR volumes, and 0.2μL cDNA templates were chosen, the TNF-α mRNA expression in PIA rat spleen showed significant upregulation in both two volume groups as anticipated. Conclusion The experiment shows that it is feasible in the RtPCR amplification to use the small reaction volume of 10μL and 15μL, which has good stability and reliability. And 0.1-0.4μL templates are all suitable for the reaction system. PCR with small volume can not only save the reagents and template, especially rare clinical specimens, but also is helpful for the realization of high-throughput reaction.

Objective To investigate the relationship between obstructive sleep apneahypopnea syndrome (OSAHS) and carotid stenosis in patients with ischemic cerebrovascular disease (ICVD) and to provide reference for developing the intervention strategy of carotid stenosis. Methods Eighty-seven patients with ICVD were screened from Nanjing Stroke Registry Program. The patients were divided into without (n=21), mild(n=24), moderate (n=27) and severe (n = 11) OSAHS groups according to the apnea-hypopnea index (AHI); in addition, the patients were divided into with (n =34) and without carotid stenosis (n=49) groups according to the results of digital subtraction angiography (DSA). The effects of the risk factors for cerebrovascular diseases and OSAHS on carotid stenosis in patients with ICDV were analyzed.Results There were significant differences in the proportions of alcohol consumption (χ2=8.56, P =0. 036), hypertension (χ2 = 13.20, P =0. 004) and carotid stenosis (χ2 =22.97, P =0. 006) between the no OSAHS and the mild, moderate and severe OSAHS groups. The univariate analysis showed that age (OR = 1. 066, 95% CI 1. 023- 1.112; P = 0. 003),hypertension (OR =3.587, 95% CI 1. 294- 9. 949; P =0. 014), alcohol consumption (OR =5.275,95% CI 1.855-15.001; P= 0.002) and OSAHS (OR= 1.073, 95% CI 1.033-1.115; P = 0. 000) were the risk factors for carotid stenosis. The multivariate logistic regression analysis showed that age (OR = 1. 113, 95% CI 1. 047-1. 182; P =0. 001), OSAHS (OR = 1. 096, 95% CI 1. 034-1. 160; P = 0. 000), and alcohol consumption (OR = 4. 292,95% CI 1. 217-15. 139; P = 0. 024) were the independent risk factors for carotid stenosis.Spearman rank correlation analysis suggested that the AHI levels were positively correlated with the degree of carotid stenosis (r = 0. 435, P = 0. 000). There were significant differences among the without stenosis (n =34), unilateral stenosis (n =22), and bilateral stenosis (n=27)groups (12.97 ± 10.04 vs. 21.40 ± 16.38 vs. 29.33 ± 13.81, F= 11.64, P<0.01).Conclusions OSAHS is an independent risk factor for carotid stenosis and it was positively correlated with the severity of carotid stenosis. AHI may reflect the degree of carotid stenosis and the range of neck vascular involvement to some extent.

Objective To assess the effectiveness of initial Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) as predictors for clinical outcomes in patients with top of the basilar syndrome (TOBS).Methods A total of 64 patients with TOBS were selected from Nanjing Stroke Registration Program (NSRP). Initial GCS and NIHSS were retrospectively evaluated by reviewing patients' records for details of clinical presentation and outcomes at 30 days measured by modified Rankin Scale (mRS) score. Patients were categorized as favorable outcome group (mRS 0-3) and unfavorable outcome group (mRS 4-6).Results The mean GCS was lower in the cases with mRS of 4-6 compared with those with mRS of 0-3 (P<0.01) and the mean NIHSS score was higher in favorable outcome group compared with unfavorable outcome group (P=0.011). In multivariate logistic regression analysis, after adjusting for age, gender and treatment approaches, the GCS OR was 0.301(95% CI 0.167～0.542), NIHSS OR was 1.436(95% CI 1.147～1.796), and both of them turned out to be the independent predictors of outcome at 30 days. ROC curve analysis suggested that GCS score of 10 represented a good cut-off point for predicting the outcome with the prognostic sensitivity of 87.9% and specificity of 83.9%. NIHSS score of 14 could also serve as a good cut-off point with the prognostic sensitivity of 63.6% and specificity of 77.4%.Conclusions Conclusions Both GCS and NIHSS can predict outcomes in patients with acute TOBS with GCS score ≤10 and NIHSS score ≥14 as the cutoff points of poor outcome. GCS cutoff point is more strongly predictive of outcome than that of NIHSS.

Objective To investigate the relationship between obstructive sleep apnea-hypopnea syndrome(OSAHS)and plasma homocysteine(Hcy)levels in patients with ischemie cerebrovascular disease(ICVD).Methods Seventy-six patients with ICVD were monitored with polysomnography(PSG) for 7-8 hours during sleeping.The levels of fibrinogen(FBG),high density lipoprotein cholesterol(HDLC),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG)and plasma Hey were assessed.Results Of the 76 ICVD patients,57 showed apnea symptom during sleeping,of which 53(69.7%)were diagnosed with OSAHS and 4 with central sleep apnea,According to the mean apnea-hypopnea index (AHI),the severity of apnea was classified as no apnea symptom(19 cases with mean AHI of 2.38±0.96 and Hey level of(8.78 ±2.01)μmol/L),mild apnea(21 cages with mean AHI of 14.14 ±4.37 and Hcy level of(12.91 ±3.00)μmol/L),moderate apnea(24 cases with mean AHI of 29.62±5.81 and Hcy level of(14.85 ±4.15)μmol/L)and severe apnea(8 cases with mean AHI of 46.75±2.82 and Hcy level of(19.30±4.82)μmol/L).The level of Hcy was statistical significant among these 4 groups(F=40.32,P<0.01)and correlated with the mean AHI(r=0.598,P<0.01).Conclusion Patients with ICVD have a high morbidity of OSAHS,mainly suffering from mild to moderate apnea;The plasma Hcy level elevates in the ICVD patients with OSAHS and is correlated with the severity of apnea.

In recent years, researches have shown that microglia drive their phenotype polarization through energy and substance metabolism reprogramming, thereby exerting pro-inflammatory or anti-inflammatory effects, which is closely associated with the risk of ischemic stroke. Their specific metabolic pathways involve glucose metabolism, lipid metabolism, and amino acid metabolism. This article reviews regulatory mechanisms of microglia metabolism after ischemic stroke and their role in ischemic stroke.

Objective To investigate whether brachial-ankle pulse wave velocity(baPWV),independently and jointly with the level of body mass index(BMI),affect the risk of incident diabetes with hypertension. Methods The effects of baPWV and BMI level on incident diabetes with hypertension were evaluated using Kaplan-Meier curves (log-rank test) and multi logistical regression models after adjustment for various confounding factors. Results A total of 2 222 participants were recruited in this study. Higher baPWV (Q4) was associated with a greater risk of incident diabetes with hypertension simultaneously compared with baPWV in the lower quartiles(Q1-Q3),with HR 4.16(95% CI 2.14,8.09)in the crude model,2.52(95% CI 1.10,5.78) in modelI,and 2.45(95% CI 1.05, 5.70)in modelⅡ.The highest risk of diabetes with hypertension simultaneously was in the group with high baPWV and BMI≥25 kg/m2,with HR 11.50(95% CI 4.5,29.9)in the crude model,4.20(95% CI 1.4,13.1)in modelI,and 4.30(95% CI 1.4,13.3) in modelⅡ. Conclusions The joint effect of baPWV and BMI level on incident diabetes with hypertension simultaneously is a better predictor than their independent effect. The risk of incident diabetes with hypertension markedly increases in the subjects with BMI≥25 kg/m2and higher baPWV.

Objective:To use three-dimensional (3D) scanning to measure the preoperative and postoperative nasal parameters of the patients received rhinoplasty with ear cartilage and silicone prosthesis, and to evaluate the clinical effect of the surgery.Methods:Sixteen female patients with an average age of 28.3 years, ranged from 21 to 35 years, received rhinoplasty with ear cartilage and silicone prosthesis in Wuhan Tongji Hospital from June 2018 to February 2019. Preoperative and postoperative 3D scanning was performed to measure nasal parameters, including linear length, angle, and proportional index.Results:All patients were satisfied with the postoperative outcomes. The postoperative nasal length, nasal height, and nasal depth increased significantly, and the postoperative nasal width and nasal tip width decreased. The postoperative nasolabial angle and nasofrontal angle were statistically improved, while the preoperative and postoperative data of columellar facial angle, nasal tip angle, and nasal column-lobular angle were not significantly different. The ratios of nasal depth and nasal width, nasal index and nasal tip protrusion were improved after surgery, while the postoperative ratios of nasal columella and nasal lobules length were not statistically improved.Conclusions:The 3D scanning allows for comprehensive and accurate measurement of the nasal parameters. The rhinoplasty with ear cartilage and silicone prosthesis is more effective in improving the overall contour of the nose, but less effective in improving the aesthetics of the nasal tip.