OBJECTIVE Cervical cancer is the third most malignant tumor in the world. Farnesoid X receptor (FXR) is a member of nuclear receptor superfamily. It is highly expressed in liver, kidney and small intestine, while it showed low expression level in other tissues. It not only plays an important role in the metabolism of bile acids and sugars, but also in the production of chronic inflammation in the early stage of cancer, the proliferation and migration of tumor. Compared with the normal tissue, the expression of FXR in most tumor tissues decreased. But there is no correlation between cervical cancer and FXR. So we aimed to find out the relationship between FXR and cervical cancer. METHODS A clinical study using qPCR, western blot and immunohistochemistry detected the expression of FXR in tumor tissues and normal tissues of clinical patients. FXR was activated by agonists or over-expressed by lentivirus. MTT, clone formation and flow cytometry were used to detect the relationship between FXR and proliferation of cervical cell lines. Tumor growth ability of FXR was detected by nude mice tumorigenicity. The interaction between FXR and CDKN2A-p14ARF-MDM2-p53 pathway was detected by qPCR, Western blot and immunohistochemistry. RESULTS FXR was decreased in cancer tissues compared to normal control. Activation of FXR by agonist or constitutively- over- expression of FXR inhibited cervical cell proliferation. Over- expressed FXR attenuated Caski, Hela and Siha xenograft tumor growth in nude mice compared with control. Over-expression of FXR caused G1 cell-cycle arresting and up-regulated CDKN2A-p14ARF-MDM2-p53 pathway. CONCLUSION FXR inhibits cervical cancer cell proliferation and cervical tumorigenicity which is related to CDKN2A-p14ARF-MDM2-p53 pathway. Activation or overexpression of FXR may be a potential target for the treatment of cervical cancer.

Objective To compare the values of a screening methods by OC-Hemodia and chemical fecal occult blood test (COB) for colorectal cancer in elderly people. Methods The screening programme targeted colorectal cancer in old people was conducted on 1 100 participants aged 60-92 years (mean was 81.3 years). All subjects received OC-Hemodia and COB examinations. Positive subjects were examined by colonoscopy and/or barium enema. Out of 1 100 subjects 1 046 were followed up in the next five years. Results Among 1 100 subjects, 231 subjects (21.0%) were positive by OC-Hemodia test and 159 subjects (14.5%) were positive by COB. There was a significant difference in positive rate between OC-Hemodia test and COB (P

Objective To investigate the efficacy of sodium hyaluronate on reducing adhesions in patients undergoing peritoneal cavity surgery. Methods Peritoneum and the surface of the related organs was coated with 3～15 ml sodium hyaluronate gel before closing the peritoneal cavity. Findings on 23 reoperations out of 1 360 sessions of primary abdominal surgery with sodium hyaluronate were compared with that of 26 reoperations without the use of sodium hyaluronate in their first episode of laparotomy during the same period. Results The severity of adhesion was graded as 4 degrees. In treatment group, adhesion Ⅰ?,Ⅱ?,Ⅲ?,Ⅳ? were in 11,9,3 and 0 cases, respectively. Compared with adhesion Ⅰ?,Ⅱ?,Ⅲ?,Ⅳ? in 1,5,17 and 3 cases in control group,respectively( P

Adult ; Bronchoalveolar Lavage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Alveolar Proteinosis ; therapy ; Treatment Outcome

Objective To discuss some problems about current learning objectives for the speciality of clinical medicine in China,including the concepts,the decision-making systems and value-orientation,and to provide the reference for stipulating the learning objectives in future. Methods The objectives of some Chinese medical universities were collected from their websites.Some medical educators were consulted about their feelings about these learning objectives,and also were asked to identify their own objectives. Results Medical educators failed to distinguish their own objectives,and there were four main problems in current learning objectives: generalization,similarity and lack of individuality,difficulty in guide the curricula and teaching,and setting up too high object. Conclusion The learning objectives in clinical medicine should reflect both specialty characteristic and university individuality,so they should be drawn up by teachers,students and educatirnal administrators,moreover their value orientation should be eligible standard,not excellence.

Objective To investigate the comparison of clinical effects between two models of alimentary reconstruction after total gastrectomy in the elderly patients with gastric cancer.Methods 70 patients receiving alimentary tract reconstructions of Orr-type Roux-en-Y reconstruction (Orrtype,40 cases) and modified Brawn Ⅰ (30 cases) from January 2007 to December 2012 were retrospectively analyzed.The operative time,amount of bleeding,early postoperative complications and mortality,food intake,nutritional status and alimentary tract function were compared at 6 months after surgery.Results There were no significant differences between the two methods in the operative time [(198.8±14.0)min vs 233.5±30.7)min,t=-l.697,P＞0.05)],amount of bleeding [(420 ± 43) ml vs (340 ± 25) ml t =-1.956,P ＞ 0.05],and early postoperative complications [(17.5％ vs 16.7％),x2 =0.008,P＞0.05].However,times of liquid diet intake and semi liquid diet intake of the Orr-type reconstruction method was comparatively shorter than that of the modified Brawn Ⅰ [(4.8±2.1) d vs (7.6±2.4) d,and (9.5±3.6) d vs (11.5±3.7) d,t=-5.192,P＜0.05)].Nutritional status (weight,hemoglobin,total serum proteins and serum albumin) at 6 months after operation showed no significant differences between the two methods.But constituent ratio of Visick scores Ⅰ-Ⅱ of Orr-type was bigger than that of modified Brawn Ⅰ (86.7％ vs 62.5％,x2 =5.063,P＞0.05).Conclusions Orr-type Roux-en-Y reconstruction method can avoid reflux esophagitis,and the procedure is more simple than the modified Brawn Ⅰ method.Therefore,Orr-type Roux-en-Y reconstruction should be recommended as an adoptable method of digestive reconstruction after total gastrectomy for gastric cancer in the elderly patients.

AIM:To determine the effect of rhBMP2 on the migration of human breast cancer cells MCF-7. METHODS:MCF-7 was induced by rhBMP2 (30 ?g/L) for 24 h. Atomic force microscopy (AFM) was used to observe the changes in cell morphology. Cell migration and invasion abilities were assayed by scratch healing and transwell experiments. RESULTS:The formation of lamellipodia and cell polarity together with increased cell length were observed in the cells treated with rhBMP2,whereas lamellipodia of cells in control group were not obvious and the majority of cells tended to be rounder with shorter cell diameter. Compared to control group,scratch healing and transwell experiments showed that the migration and invasion capacity of rhBMP2-induced MCF-7 cells was markedly enhanced. CONCLUSION:rhBMP2 induces human breast cancer cell MCF-7 to present the phenotype of migration and enhances the invasion capacity.

Objective:To investigate the expression levels of matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells (sTREM-1) and soluble cell differentiation 14 (sCD14) in pregnant women with premature rupture of membranes (PROM) and their predictive value for chorioamnionitis.Methods:A total of 132 pregnant women with PROM who received treatment in Tengzhou Central People's Hospital from January 2016 to June 2017 were included in the study group. These women were assigned to pre-term PROM group (gestational age < 37 weeks, n = 58) and full-term PROM group (gestational age > 37 weeks, n = 74). A total of 106 concurrent full-term healthy pregnant women were included in the control group. Pregnant women in the PROM group were also assigned into an infection group ( n = 51) and a non-infection group ( n = 81). Serum levels of MMP-9, PCT, sTREM-1 and sCD14 were compared between study and control groups, and their value in the diagnosis of PROM complicated with chorioamnionitis was analyzed. Results:The expression levels of MMP-9 [(271.42 ± 34.16) ng/L], PCT [(54.57 ± 8.16) pg/mL], sTREM-1 [(0.51 ± 0.11) ng/mL] and sCD14 [(60.23 ± 9.49) ng/mL] in the study group were significantly higher than those in the control group [(54.97 ± 10.08) ng/L, (26.04 ± 1.98) pg/mL, (0.19 ± 0.04) ng/mL, (42.04 ± 10.33) ng/mL, t = 27.064, 13.767, 14.831, -13.342, all P < 0.01). The expression levels of MMP-9 [(314.05 ± 45.37) ng/L], PCT [(0.61 ± 0.18) ng/mL], sTREM-1 [(63.12 ± 10.12) pg/mL] and sCD14 [(68.07 ± 11.05) ng/mL] in the pre-term PROM group were significantly higher than those in the full-term PROM group [(238.01 ± 40.45) ng/L, (47.87 ± 8.90) pg/mL, (0.43 ± 0.14) ng/mL, (54.09 ± 10.33) ng/mL, t = 9.103, 8.862, -10.538, 6.494, all P < 0.05). The expression levels of MMP-9 [(343.74 ± 43.74) ng/L], PCT [(69.88 ± 8.83) pg/mL], sTREM-1 [(0.67 ± 0.16) ng/mL], sCD14 [(70.41 ± 8.89) ng/mL] in the infection group were significantly higher than those in the non-infection group [(230.09 ± 49.82) ng/L, (45.82 ± 11.04) pg/mL, (0.42 ± 0.19) ng/mL and (54.41 ± 12.42) ng/mL, t = 23.655, 12.014, 9.382, 11.306, all P < 0.01]. The sensitivity (94.23%), specificity (93.75%), positive predictive value (92.45%) and negative predictive value (96.20%) of combined detection of these indexes in the diagnosis of PROM complicated by chorioamnionitis were significantly higher than those of other indexes detected alone (all P < 0.05). Conclusion:Combined detection of serum levels of MMP-9, PCT, sTREM-1 and sCD14 can be used as an effective auxiliary index for the diagnosis of early premature rupture of membranes complicated with chorioamnionitis.

OBJECTIVETo compare the effect of laparoscopic radical operation and open operation on systemic immunity in patients with colorectal cancer.

METHODSSixty patients with colorectal cancer were randomly divided into laparoscopic and open operation groups from March 2004 to December 2004, each group had 30 cases. CRP, IgA, IgM, IgG, CD3 (+) cells, CD4 (+) cells, CD8 (+) cells, NK cells, CD4 (+) CD5RA (+) cells, CD4 (+) CD45RO (+) cells and lymphocytes in peripheral blood were counted and compared on the 1st day before operation, 3rd and 7th day after operation.

RESULTSThe two groups were comparable as for age, tumor location and stages. In open operation group, lymphocyte counts were (1.09+/- 0.29) x 10(9)/L, CD4 (+) cell (0.54 +/- 0.14) x 10(9)/L, CD8 (+) cell (0.31 +/- 0.08) x 10(9)/L, CD4 (+) CD45RO (+) (61.1+/- 8.9)%, and IgM level (136.9+/- 52.8) IU/ml, IgG (115.2 +/- 45.7) IU/ml on the 3rd day after operation, CD8 (+) cell counts were (0.32 +/- 0.09) x 10 (9)/L, CD4 (+) CD45RO (+) cell (63.2 +/- 9.1)% on the 7th day after operation, were all significantly lower than those on the 1st day before operation respectively(P< 0.05, P< 0.01). In laparoscopic operation group, the decreases of such parameters except CD4 (+) CD45RO (+) cell (62.7 +/- 12.5)% were not obvious on the 3rd day after operation. There were significant difference in lymphocyte counts (1.29 +/- 0.37) x 10( 9 )/L, IgM (164.5 +/- 48.2) IU/ml and CD8 (+) cell counts (0.38 +/- 0.09) x 10 (9) /L on the 3rd day after operation between two groups (P< 0.05).

CONCLUSIONCompared with open radical operation, laparoscopic radical operation has predominance in protecting systemic immunity to treat colorectal carcinoma.

Aged ; CD4-CD8 Ratio ; CD4-Positive T-Lymphocytes ; immunology ; Colorectal Neoplasms ; immunology ; surgery ; Female ; Humans ; Killer Cells, Natural ; immunology ; Laparoscopy ; Lymphocyte Count ; Male ; Middle Aged

Objective To compare the different effects of 1% diatrizoate meglumine,2.5% mannitol and water as oral contrasts in PET/CT scan in gastrointestinal tract delineation and 18F-fluorodeoxyglucose (FDG) uptake. Methods Sixty-one patients referred for PET/CT scan without gastrointestinal diseases were divided into three groups randomly ( random number method). One liter of 1% diatrizoate meglumine,2.5% mannitol,or water was orally taken by groups 1 (25 cases),2 (20 cases) and 3 ( 16 cases),respectively before scan. The scan was performed with GE Discovery LS PET/CT scanner in two-dimensional (2D) mode 50 min after 18F-FDG (5.55 MBq/kg) injection. Patients with abdominal lesions were excluded from this study. The degree of gastrointestinal filling and 18F-FDG uptake was evaluated by 3 nuclear medicine physicians using visual analysis according to a 4-grade classification method:none,mild,moderate,and high. Statistically analysis was performed by Kruskal-Wallis,Mann-Whitney and paired t tests.Results Both the differences of serum glucose and insulin levels were not significant before and after contrast taken in group 2. Group 2 had better gastrointestinal filling than that of group 1 and also better than group 3 except in rectum. The stomach,jejunum,ascending,and transverse colon were better filled in group 1 than in group 3. The degree of 18F-FDG uptake of group 3 was significantly higher than that of group 2 in stomach,jejunum and ileum (z= -3. 192,-3.290,-3.290,all P＜0.05),and was also significantly higher than that of group 1 (z = - 3. 603,P ＜ 0.05) in jejunum. The degree of 18 F-FDG uptake of group 3 was significantly lower than that of group 1 in ascending colon (z = - 2. 706,P ＜ 0. 05 ) and was significantly lower than that of group 1 and 2 in transverse and descending colon (z= - 3. 503,- 2.403,- 4.225,-4. 027,all P ＜0.05),and was also significantly lower than that of group 2 in rectum (z = -4. 128,P ＜0. 01 ). The maximum CT values in stomach,jejunum,ileum and ascending colon in group 1 were ( 132 ±23),(191 ±31),(313 ±47) and (374±53) HU,respectively,whose difference was significant (t = -7.088--1.781,all P ＜0. 01 ). Conclusion Oral iso-osmotic mannitol intake has better gastrointestinal filling and less physiological 18F-FDG uptake compared to diatrizoate meglumine and water.