Objective To explore the clinical diagnostic value of quantitative detection of the slit homologue 2 (SLIT2) methylation for cervical high grade precancerous lesions. Methods According to histopathologic diagnostic results, 178 patients infected with high-risk HPV were divided into normal cervix group (n=45), low-grade lesion group (n=50) and high-grade lesion group (n=83). The cervical exfoliated cells were collected in three groups. The methylation levels of SLIT2 were measured by pyrosequencing in three groups. The diagnostic threshold of SLIT2 in high grade precancerous lesions was estimated by receiver operating characteristic (ROC) curve. Results The percentages of SLIT2 methylation were (4.53 ± 1.37)%, (5.81 ± 2.26)% and (11.80 ± 8.47)% in normal cervix group, low-grade lesion group and high-grade lesion group, respectively. And the differences between three groups were statistically significant (F=27.61, P<0.001). The percentage of SLIT2 methylation was significantly higher in high-grade lesion group than that of normal cervix group and low-grade lesion group (P<0.001). There was no significant difference in the percentage of SLIT2 methylation between normal cervix group and low-grade lesion group (P=0.297). The area under the ROC curve was 0.895 and optimal cut-off value was 6.41%. The sensitivity and specificity were 80.7% and 83.2%, respectively for the detection by SLIT2 methylation. Conclusion The quantitative detection of SLIT2 gene methylation level in cervical exfoliated cells by pyrosequencing can effectively diagnose cervical high grade precancerous lesions.

Objective Quantifiably and located measure the methylation rate of 21 cytosinephosphate-guanosine (CpG) sites in the 3' region of L1 gene and long control region (LCR) gene of HPV16 DNA in asymptomatic patients,cervical intraepithelial neoplasia (CIN) patients,and cervical cancer patients.To analysis the relationship between HPV16 methylation and it's pathogenicity.Methods Chosen 30 cases with HPV16 positive in each group.Firstly,extract DNA from the remaining cells of liquid-based cytology specimen and bisulfite treatment DNA,then amplify the 3' region of L1 gene and LCR gene,test the methylation rate of 21 CpG sites of HPV16 DNA in three groups.Results All of the 5 CpG sites in E6/E7 promoter (31,37,43,52,58) were hypomethylation in cervical cancer group (21.86％,28.15％,21.37％,26.15％,15.48％,respectively),hypermethylation in asymptomatic group,and middle-methylation in CIN group,in which there were significant difference among three groups (all P ＜0.01).The CpG site in 7032,7091,7136 of the 3' region of L1 gene was also different methylated among three groups (all P＜0.01).Hypermethylation was found in cancer group (18.89％,27.72％),hypomethylation was found in asymptomatic group (2.71％,6.95％) in 7032 and 7091.In 7136,the highest methylation was detected in CIN (66.45％),the lowest in asymptomatic (34.85％),middle in cancer group (46.43％).Conclusion The methylation status of CpG sites in the 3' region of L1 gene and E6/E7 promoter of HPV16 is significant different among three groups,which is likely to anticipate the pathogenesis of CIN and cervical cancer.

Objective To explore the value of MRI combined with tumor markers in the differential diagnosis of borderline ovarian tumor(BOT)and stage I epithelial ovarian carcinoma(EOC),increase the rate of preoperative diagnosis.Methods Fifty -six patients with BOT(BOT group)and forty -seven patients with stage I EOC(EOC group)confirmed pathologically underwent tumor markers and MRI examination were selected.The MRI imaging features and tumor markers level were compared between the two groups.Results BOTand EOC group onset age were (39.45 ±11.83),(44.38 ±12.44)years old respectively,two groups had statistically significant difference(t =2.05,P <0.05).The location of tumor,size,number of septation had no differences between the two groups(all P >0.05).However,the solid components were larger (76.0 ±54.9)mm and the septations were thicker (6.2 ± 3.5)mm in EOC group than in BOT group (49.0 ±47.2)mm,(3.6 ±3.5)mm(t =-2.642,-3.784,all P <0.05),and solid components and thick septations were more frequently seen in EOC group(59.6%)than 37.5% in BOT group(χ2 =4.992,P <0.05).The serum CA125 and CA199 levels between the two groups had no statistically significant differences(all P >0.05).The serum HE4 levels between BOT group[(86.9 ±82.2)pmol/L]and EOC group[(166.3 ±87.1)pmol/L]had statistically significant difference (t =-4.723,P <0.05).MRI prompt tumors maximum diameter and thickness of the separated solid ingredients combined serum HE4 levels to identify two groups of AUC of the tumor and its sensitivity,specificity were 0.820,72.3%,80.4%,respectively.Conclusion The fea-tures like younger,increased solid components,thickened septum and higher serum HE4 level may be helpful in the differential diagnosis of BOT and stage I EOC.

Intrauterine adhesion (IUA) can occur after trauma to the basal layer of the endometrium, contributing to severe complications in females, such as infertility and amenorrhea. To date, the proposed therapeutic strategies are targeted to relieve IUA, such as hysteroscopic adhesiolysis, Foley catheter balloon, and hyaluronic acid injection have been applied in the clinic. However, these approaches showed limited effects in alleviating endometrial fibrosis and thin endometrium. Mesenchymal stem cells (MSCs) can offer the potential for endometrium regeneration owing to reduce inflammation and release growth factors. On this basis, MSCs have been proposed as promising methods to treat intrauterine adhesion. However, due to the drawbacks of cell therapy, the possible therapeutic use of extracellular vesicles released by stem cells is raising increasing interest. The paracrine effect, mediated by MSCs derived extracellular vehicles (MSC-EVs), has recently been suggested as a mechanism for their therapeutic properties. Here, we summarizes the main pathological mechanisms involved in intrauterine adhesion, the biogenesis and characteristics of extracellular vesicles, explaining how these vesicles could provide new opportunities for MSCs.

Objective: To study the current development of thoracic surgery in China. Methods: Chinese Society for Thoracic and Cardiovascular Surgery and Chinese Association for Thoracic Surgeons jointly conducted a network survey to directors of thoracic surgery departments in the tertiary hospitals in China from November to December 2018. The contents of the survey included the basic information of the hospital and the status of thoracic surgery department in the hospital. Rank sum test was used to compare the data between different regional hospitals Results: A total of 636 tertiary hospitals participated in the survey. The total number of beds for thoracic surgery departments was 30 646, with M(Q_R) of 40(20) (range: 3 to 393) for each hospital. The total number of thoracic surgeons was 6 747, with M(Q_R) of 9(6) (range: 1 to 75) in each hospital. In 2015, a total of 312 425 operations were performed in the 636 hospitals, with M(Q_R) of 268(484.5) (range: 4 to 8 320) for each hospital. The total number of lung cancer surgeries was 146 601 in 2015, with M(Q_R) of 100(216) (range: 0 to 6 911) operations in each hospital. The total number of esophageal cancer operations was 67 076, with M(Q_R) of 40(95) (range: 0 to 1 550) in each hospital. Minimal invasive thoracic surgery was performed in 94.3% (601/636) of the hospitals, with 86.6% (551/636) of hospitals carried out video-assisted thoracoscopic (VATS) lobectomy. Among the hospitals performing VATS lobectomy, 89.3% (492/551) of them started to perform the technique after 2006, and 93.1% (513/551) of them do single-direction thoracoscopic lobectomy. A total of 403 640 VATS lobectomies had been performed until 2015, including 163 682 cases of single-direction thoracoscopic lobectomy. In 2015, 73.74% (108 116/146 601) lung cancer operations and 37.44% (25 110/67 076) of esophageal cancer resections were performed by minimally invasive technique. The development level of hospitals among eastern, middle and Western China was different significantly on number of doctors, number of total operations, number of lung cancer surgeries, proportion of minimally invasive lung cancer surgery, number of esophageal cancer surgeries, and proportion of minimally invasive esophageal cancer surgery (χ²∶7.65 to 60.8, all P<0.05). Conclusions The discipline of thoracic surgery, especially the minimally invasive thoracic surgery in China is now experiencing a rapid development. The proportion of minimally invasive lung cancer surgery is higher than that of in the developed countries. However, unbalanced development among different regions is still a great challenge in China.

Objective:To investigate the clinical and pathological characteristics of acquired immunodeficiency syndrome (AIDS) patients with intestinal Talaromycosis marneffei (TM) infection. Methods:A total of 64 AIDS patients who underwent colonoscopy in Guangzhou Eighth People′s Hospital from January, 2010 to December, 2018 were retrospectively collected. Among them, 32 patients were co-infected with TM (AIDS with intestinal TM infection group) and 32 patients were not (AIDS without intestinal TM infection group) according to the colonic mucosa pathology. The clinical manifestations and pathological differences were compared between the two groups. Nonparametric rank sum test and Fisher exact probability method were used for statistical analysis.Results:The proportions of patients presented with fever, cough, retroperitoneal lymph nodes tume faction, nausea and vomiting, abdominal muscle tension, abdominal tenderness and rebound pain in AIDS with intestinal TM infection group were 28 (87.5%), 16 (50.0%), 13 (40.6%), 9 (28.1%), 8 (25.0%), 20 (62.5%) and 12 (37.5%), respectively, which were all significantly higher than those in AIDS without intestinal TM infection group 11 (34.4%), 6 (18.8%), 3 (9.4%), 2 (6.2%), 1 (3.1%), 8 (25.0%) and 1 (3.1%), respectively, the differences were statistically significant (Fisher exact test, all P<0.05). The median counts of peripheral blood CD4 + T lymphocyte, lymphocytes, monocytes, hemoglobin, platelet and albumin in AIDS with intestinal TM infection group were 13.5/μL, 0.30×10 9/L, 0.16×10 9/L, 88 g/L, 122×10 9/L and 23.5 g/L, respectively, which were all significantly lower than those in AIDS without intestinal TM infection group 207.0/ μL, 1.35×10 9/L, 0.35×10 9/L, 128 g/L, 201×10 9/L and 37.5 g/L, respectively, the differences were all statistically significant ( Z=-6.111, -6.191, -4.273, -5.353, -2.974 and-6.666, respectively, all P<0.05). Multivariate logistic regression analysis showed that CD4 + T lymphocytes <50/μL, hemoglobin <90 g/L and fecal occult blood positive were independent risk factors for AIDS with intestinal TM infection. The main manifestations of colonoscopy in AIDS with intestinal TM infection group were discontinuous ulcers (31.2%(10/32)), erosion (31.2%(10/32)) or co-exitance of ulcer and erosion (21.9%(7/32)), while suspected tumor-like eminence lesions were less common (15.6%(5/32)). The pathological features of colon mucosa were ulcer and/or erosion (53.1%(17/32)), chronic inflammation (46.9%(15/32)) and inflammatory granuloma (43.8%(14/32)). Oval or round spore with apparent septum could be seen by special staining. In AIDS with intestinal TM infection group, 27 patients were cured or improved, five patients died or deteriorated, while all patients in the AIDS without intestinal TM infection group improved after treatment without death. Conclusions:There are no specific gastrointestinal symptoms in AIDS patients with intestinal TM infection, while the patients present with decreased immunological cells and multiple colony pathological features. Specific fungal spores can be seen.

The Hedgehog (Hh) signalling pathway is essential for cellular proliferation and differentiation during embryonic development. Gain and loss of function of Hh signalling are known to result in an array of craniofacial malformations. To determine the critical period for Hh pathway antagonist-induced frontal bone hypoplasia, we examined patterns of dysmorphology caused by Hh signalling inhibition. Pregnant mice received a single oral administration of Hh signalling inhibitor GDC-0449 at 100 mg•kg or 150 mg•kg body weight at preselected time points between embryonic days (E)8.5 and 12.5. The optimal teratogenic concentration of GDC-0449 was determined to be 150 mg•kg. Exposure between E9.5 and E10.5 induced frontal bone dysplasia, micrognathia and limb defects, with administration at E10.5 producing the most pronounced effects. This model showed decreased ossification of the frontal bone with downregulation of Hh signalling. The osteoid thickness of the frontal bone was significantly reduced. The amount of neural crest-derived frontal bone primordium was reduced after GDC-0449 exposure owing to a decreased rate of cell proliferation and increased cell death.
Administration, Oral ; Anilides ; pharmacology ; Animals ; Bone Diseases, Developmental ; chemically induced ; Cell Proliferation ; drug effects ; physiology ; Female ; Frontal Bone ; abnormalities ; Hedgehog Proteins ; antagonists & inhibitors ; Limb Deformities, Congenital ; chemically induced ; Mice ; Micrognathism ; chemically induced ; Osteogenesis ; drug effects ; Pregnancy ; Pyridines ; pharmacology ; Signal Transduction ; drug effects