Objective To study the relationship between micro-vessel density(MVD), proliferating cell nuclear antigen(PCNA) expression and clinicopathological characteristics in cervix squamous cell carcinoma. Methods PCNA and CD 34 expression in 32 cervix squamous cell carcinomas were examined by SP immunohistochemical staining. MVD and proliferation index (PI) were calculated. Results PI and MVD were significantly correlated with the differentiatial degree and FIGO stage of cervix squamous cell carcinomas, and in the low differential cancers with high FIGO stage were obviously higher than those in the high differential cancers with low FIGO stage. In addition, PI and MVD in the cancers with lymph node metastasis were significantly higher than those in the cancers without one (P

Objective To evaluate the effect of esophagogastric intramural implantation anastomosis after esophagectomy. Methods One thousand and two hundred thirty-six patients with esophageal and cardial cancers were treated by esophagogastric intramural implantation anastomosis after esophagectomy. The mucosal layer, the esophageal and gastric muscular layers were on three different levels after the anastomosis. Results Among 1236 patients, 842 cases were esophageal cancer,and 394 cases were cardial cancer.The anastomoses were performed in different levels including 15 cases below the pharynx, 193 cases on neck,634 case above the aortic arch and 394 cases below the aortic arch. One of the patients died 24 hours after the operation due to myocardial ischemia, and two of them died of respiratory failure. Anastomotic leakage, stenosis and refluxing esophagitis did not appear in this series. Conclusions Esophagogastric intramural implantation anastomosis can decrease the incidence of anastomotic leakage, stenosis and refluxing esophagitis after esophagectomy.

Objective To analyze 4 child patients with 3-methylcrotonyl-coenzyme A carboxylase deficiency (MCCD) identified by neonatal screening and confirmed by urine gas chromatography-mass spectrometry (GC/MS) and genetic analysis.Methods Newborns whose C4DC + CSOH concentration was above 0.6 μmol/L in newborn screening were recalled for rescreening,and the CADC + C5OH concentrations in their mothers were detected.The child patients suspected with MCCD were further confirmed by urine GC/MS and genetic analysis.Results Three child patients were definitely diagnosed as MCCD by genetic analysis,including 1 MCCD,1 maternal MCCD and 1 paternal MCCD.The other 1 child patient suspected with MCCD had only one allele in MCCC1.Conclusion The mother and father of newborns with elevated C4DC + C5OH identified in neonatal screening should routinely perform MS / MS testing.When only one pathogenic locus is found in the suspected MCCD child patients by genetic analysis,they should be followed up regularly.

Objective To investigate the clinical outcomes of using modified antegrade digital artery island flap for the treatment of the severely flexion contracture of the burned finger.Methods Between August,2013 to August,2015,21 patients (21 fingers) with severely flexion contracture of the burned finger were hospitalized for treatment.According to the Stren classification standard for the interphalangeal joint flexion contracture,all the patients were rated as type Ⅲ.The volar soft-tissue defect with exposed tendons,nerves,vessels or bone ranged from 1.0 cm × 2.0 cm to 2.5 cm × 4.0 cm after scar relaxation.The artery and the nerve defect were 1.5 to 4.5 cm and 2.0 to 4.2 cm,respectively.The wound were reconstructed with the modified antegrade digital artery island flap.The dorsal branches of the proper digital nerve of the flap were anastomosised with the proper digital nerve of the wound.The flap donor site was resurfaced with full-thickness skin grafting from inner aspect of the forearm.All the cases were called back for postoperative follow-up.Results All the reconstructed fingers and flaps survived completely without vascular problems.The donor skin graft survived and wound healed by first intention.All the patients were followed up with 11.5 months (range,6-22 months).The finger appearance was satisfactory.The texture and color of flaps in all cases were good.There was no pigmentation and contraction relapse.The contracted fingers received no cold intolerance.At the final examination,the average values of static 2-point discrimination were 5.2 mm (range,4.3-6.5 mm) of the flap.In the series,based on the Michigan Hand Outcome Questionnaire,18 patients were strongly satisfied with the injured finger appearance and 3 patients satisfied with the appearance.Conclusion The modified antegrade digital artery island flap,which is easy to raise with large flap size and can result with the good finger appearance and function,is an ideal technique for reconstruction of the severe flexion contracture of the burned finger.

Objective To explore the clinical feature and gene types in patients with primary carnitine deficiency. MethodsClinical data of 6 patients with primary carnitine deficiency and 2 patients with maternal carnitine deficiency found in the screening by tandem mass spectrometry technology during December 2013 to December 2016 were retrospectively analyzed. Results The free carnitine levels of 8 patients in initial and recall screening were 5.85±1.65 μmol/L and 5.22±1.02 μmol/L. Two pathogenic alleles were detected in each patient with primary carnitine deficiency by genetic and metabolic disease panel based on Ion Torrent semiconductor sequencing. After treatment with oral L-carnitine, the free carnitine levels of 6 patients with primary carnitine deficiency were 20.24±3.88 μmol/L. The carnitine levels returned to normal after mixed feeding for one week in 2 patients with maternal carnitine deficiency, and no genetic diagnosis was carried out. Conclusion Primary carnitine deficiency can be effectively detected using tandem mass spectrometry technology and next generation sequencing panel and the prognosis is good with early standard treatment.

Objective To explore the anti- inflammatory of pricking blood therapy in acute gouty arthritis rats. Methods 60 Sprague-Dawley rats were equally divided into normal group, bloodletting normal group, sham group, arthritis group, bloodletting group and ibuprofen group. The acute gouty arthritis model was established with injecting uric acid sodium salt into the right ankle joint cavity. The ibuprofen group was administrated with ibuprofen intragastrically, the bloodletting normal group and bloodletting group were pricked the right Kunlun (BL60) acupoint. The cross section diameter of the right ankle joint were measured before and after treatment. Levels of mRNA and protein of interleukin (IL)-10 and IL-4 expressed in ankle were determined with RT-PCR and Western blotting Results The cross section diameter increased in the bloodletting group compared with the normal group after treatment (P<0.05), and decreased (P<0.05) compared with the arthritis group and the ibuprofen group, while the expression of IL-10 mRNA increased (P<0.05) compared with the normal group, the arthritis group and the ibuprofen group, as well as the IL-10 protein compared with the normal group and the arthritis group (P< 0.05). The expression of IL-4 mRNA and protein increased without significance (P>0.05) in the bloodletting group compared with the normal group. Conclusion IL-10 may play a role of anti-inflammatory in pricking bloodletting therapy for acute gouty arthritis.

Objective:To investigate the clinical characteristics and pathogenic mutations of propionic acidemia.Methods:Clinical data of two patients with propionic acidemia admitted to the Obstetrics and Gynecology Hospital of Nanjing Medical University from May 2017 to June 2018 were collected. Genomic DNA was extracted from the peripheral blood of the patients and their parents. Inherited disease panel based on Ion Torrent semiconductor sequencing technology was performed to detect gene mutations, and those with suspected pathogenic mutations were verified by Sanger sequencing. Descriptive statistical analysis was used for data analysis.Results:Case 1 was suspected of sepsis and admitted to the Obstetrics and Gynecology Hospital of Nanjing Medical University due to "drowsiness and milk rejection" on the second day after birth. Tandem mass spectrometry suggested the level of propionyl carnitine and its ratios to acetylcarnitine and free carnitine were increased. Urine gas chromatography-mass spectrometry showed elevated 3-hydroxypropionic acid and methylcitric acid. Genetic analysis revealed that the infant carried c.331C>T (p.R111X)/c.1228C>T (p.R410W) compound heterozygous mutations in the PCCB gene. The infant was diagnosed with propionic acidemia and treated with a special diet with an L-Carnitine supplement but died of sudden coma and vomiting without precipitating factors at three months of age. Case 2 presented with sudden vomiting, drowsiness, and anergia on the admission at five-months old. Tandem mass spectrometry showed increased propionyl carnitine level and its ratios. Compound heterozygous mutations of c.146delG (p.G49EfsX16)/c.1253C>T (p.A418V) in the PCCB gene were identified in the patient, of which c.146delG (p.G49EfsX16) was a de novo mutation and was evaluated as a pathogenic mutation. The patient was on a special diet with an L-Carnitine supplement, but with disobedience. Followed up to the age of three years and eight months, the child was severely underdeveloped. Conclusions:Neonates with clinically suspected sepsis may have propionic acidemia, and tandem mass spectrometry and genetic testing should be performed as soon as possible to confirm or rule out the diagnosis. Further investigations on the pathogenesis and function of the new mutation are still needed.

Objective: To observe the effect of electroacupuncture (EA) on serum interleukin (IL)-6, IL-8 and IL-10 in rat models of cerebral ischemia-reperfusion, and to discover the mechanism of EA in preventing and treating cerebral ischemia.
Methods:Male Sprague Dawley (SD) rats were randomized into a sham-operation (SO) group, a model control (MC) group, and an EA group, which were sub-grouped into a 6-hour group and a 24-hour group. In the SO group, rats only received vessel separation with filament placed inside without any treatment. In the MC and EA groups, the focal cerebral ischemia-reperfusion model was induced by using modified Longa method with intraluminal filament. The MC group didn’t receive any treatment;the EA group received EA at Baihui (GV 20) and Dazhui (GV 14) with sparse-dense wave for 30 min. The levels of serum IL-6, IL-8 and IL-10 were detected by using Elisa test.
Results: Six hours after ischemia-reperfusion injury, the levels of serum IL-6, IL-8 and IL-10 in the MC group were significantly higher than those in the SO group (P<0.01, P<0.05, P<0.05);the level of serum IL-8 in the EA group was significantly lower than that in the MC group (P<0.05), while there were no significant differences in comparing IL-6 and IL-10 between the EA group and the MC group. Twenty-four hours after ischemia-reperfusion injury, the levels of serum IL-6 and IL-8 in the EA group were significantly lower than those in the MC group (both P<0.05), while there were no significant differences in comparing the level of IL-10 among the three groups.
Conclusion:Early intervention by EA can regulate the levels of serum IL-6 and IL-8 in cerebral ischemic injury.

The impact of acupuncture for the pregnancy of in vitro fertilization-embryo transfer (IVF-ET) is discussed in the paper. Nowadays there are various conclusions about the impact of acupuncture for IVF-ET, and it may result from the differences in research designs. The effect is closely related to the demographic and clinical characteristics of subjects, such as age, the diagnosis of barrenness, blood flow index of uterine spiral arteries, the cycle of IVF, etc. Besides, the efficacy is influenced by treatment based on syndrome differentiation or not, the frequency and course of acupuncture in both the treating group and the control group, etc. If more reasonable design is achieved in the further study based on them, more reliable evidence will be provided for the effect and mechanism of the pregnancy of IVF-EF by acupuncture.
Acupuncture Therapy ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Male ; Pregnancy ; Pregnancy Rate ; Randomized Controlled Trials as Topic ; Treatment Outcome

Objective To investigate the chemical constituents of the marine sponge Theonella swinhoei collected from the Xisha Islands in the South China Sea .Methods The petroleum ether and dichloromethane extract of the marine sponge T . swinhoei were purified by solvent extraction and chromatographic methods including vacuum liquid chromatography (VLC) , medium pressureliquidchromatography(MPLC),thinlayerchromatography(TLC)onsilicagel,highperformanceliquidchro-matography(HPLC) ,and Sephadex LH-20 .The chemical structures were determined by spectroscopic analysis and comparison with the reported data .Results Eight compounds were isolated and their structures were determined as cholest-7-ene-3β,5α, 6β-triol (1) ,ergosta-7 ,22-diene-3β,5α,6β-triol (2) ,25-norcycloartane-3β,6α,16β,24-tetraol (3) ,sinuflexibilin D (4) ,14-de-oxycrassin (5) ,N-(2-phenylethyl)-(9Z)-tetradecanamide(6) ,N-(2-phenylethyl)-tetradecanamide (7) ,7 ,8-dimethyl-isoallox-azine (8) .Conclusion Compounds 1～ 7 were isolated from the sponge of genus Theonella for the first time .