Objective To explore application value of blood flow ratio indexes in the diagnosis of Hashimoto's thyroiditis(HT) with different thyroid functions.Methods One hundred and four patients who were diagnosed clinically as HT were enrolled in the study.The patients were classified into three groups according to thyroid functions:the hyperthyroidism group,the hypothyroidism group and the euthyroidism group.Thirty-two volunteers with normal thyroid functions were enrolled as control group.All the cases were examined with ultrasound and five blood flow ratio indexes were calculated automatically.Their differences in the four groups were compared.Results ①Among the five blood flow ratio indexes,three indexes(mean ratio,maxratio and minratio) had significant differences between each two groups(P ＜ 0.001),the other two indexes didn't have any differences among the four groups.②Two receiver operating characteristic (ROC) curves on meanratio were drew:a)HT with hyperthyroidism and HT with euthyroidism;b) HT with euthyroidism and HT with hypothyroidism.The cutoff value as a result of the ROC analysis of HT with hyperthyroidism and HT with euthyroidism was 0.235 with the maxim of specificity and sensitivity.The cutoff value of HT with euthyroidism and HT with hypothyroidism was 0.113 with the maxim of specificity and sensitivity.Both Bland-Altamn scatter diagrams and high intraclass correlation coefficient(ICC) showed that blood flow ratio indexes have high repeatability.Conclusions Blood flow ratio indexes are promising quantitative indexes in reflecting the vascularity of thyroid parenchyma,and they are helpful in the differential diagnosis of HT with different thyroid functions.

Objective:To explore the method of the establishment of edentulous mandible All-on-4 implant photoelastic model with various distally tilted implants by computer-aided design(CAD).Methods:The edentulous mandible specimen was scanned by CT. Three-dimensional models of the mandible consisting of implant location were reconstructed and edited with Mimics and Geomagic Stu-dio software.Each of the four models had four implant sockets in the interforaminal area.In the first model,the bilateral distal im-plants were placed vertically.In the other models,the posterior implants were respectively inclined by 1 5°,30°and 45°distally.The four models were manufactured by RP and then the All-on-4 photoelastic models were made by traditional ways.Results:The ob-tained ethoxyline resin models featured bright surface,homogeneous structure,faintly yellowish,high optical sensibility,precision im-plants location and with no natural stress.The model offered a good experimental basis for the stress measurement.Conclusion:The method of fabricating ethoxyline resin models by CAD is reproducible,which simplifies the operating process.

Objective:To analyze the consistency of HER-2 expression among endoscopic biopsy and radical operation specimens of gastric adenocarcinoma and to investigate the clinical application value of HER-2 detection in trastuzumab treated patients. Methods:From March 2013 to February 2014, 167 patients from Shanghai Changhai Hospital were diagnosed with gastric adenocarcinoma using endoscopic biopsy specimens. The corresponding surgical specimens were collected for pathological analysis. The relevant clinical and pathological data were collected. HER-2 protein expression of endoscopic biopsy specimens was detected by immunohistochemistry (IHC). HER-2 protein expression and gene amplification status of the corresponding tumor resection specimens were detected by IHC and fluorescence in situ hybridization (FISH). Results were analyzed for clinicopathological characteristics. Results:Among the 167 cas-es, 18 cases (10.8%) were HER-2 positive, including 10 cases showing IHC3+and 8 cases showing IHC2+with FISH positive. The consis-tency rate result among endoscopic biopsy and surgical operation specimens was 82%. Excluding the cases showing IHC2+, the true positive rate and the true negative rate were 73.3%and 97.0%, respectively. Conclusion:HER-2 detection of endoscopic biopsy speci-men by IHC shows great predictive value. The main reason for the difference of surgery and biopsy specimens is the heterogeneity of tumor expression. Increasing the number of specimens and combined testing with FISH are important methods to reduce misjudge-ment.

Objective To investigate the mechanism that Rubescensine A reduces the podocyte damage induced by high glucose(HG)through the autophagy pathway mediated by AMP activated protein kinase/silent information regulator 1(AMPK/SIRT1)pathway.Methods Human glomerular podocytes were cultured in vitro,and randomly divided into Control group(Con),HG group,hydroxychloroquine(HCQ)group,and Rapamycin(RAP)group.CCK-8 was used to detect cell viability.Western blotting was used to detect cell apoptosis and podocyte injury related protein expression in each group.The podocyte model induced by high glucose(HG)was treated with Rubescensine A(Rub A)at different concentrations and the optimal concentration was selected.Then,human glomerular podocytes were randomly divided into Con group,HG group,Rub A group,Compound C group,and Rub A+Compound C group.The expression of autophagy,AMPK/SIRT1 pathway related proteins were detected in each group.Results Compared with Con group,the podocyte viability and the protein expressions of Synaptopodin and Bcl-2 was significantly reduced(P<0.05),while the protein expressions of Desmin and Bax were significantly increased in HG group(P<0.05).Compared with the HG group,all indicators were relieved in RAP group.However,the levels of all indicators were worsened in HCQ group.Compared with Con group,the expression levels of Desminand Bax proteins in podocytes were significantly increased(P<0.05),and the podocyte viability,number of autophagosomes,the expression levels of Synaptopodin,Bcl-2,microtubule associated protein light chain 3(LC3)II/I,Beclin-1,p-AMPK/AMPK and SIRT1 proteins were significantly reduced in HG group(P<0.05).Compared with HG group and Rub A+Compound C group,the above indicators were improved in Rub A group.Compound C group reversed the protective effect of Rub A.Conclusion Rubescensine A can promote autophagy by activating AMPK/SIRT1 pathway,thereby reduce podocyte damage induced by high glucose.

OBJECTIVE：To establish a method for the content determination of diosgenin in Dioscorea zingiberensis，and to compare the contents of diosgenin in wild D. zingiberensis from different habitats. METHODS：HPLC method was adopted. The determination was performed on Inertsil ODS-3 column with mobile phase consisted of acetonitrile-water （50 ∶ 50，V/V） at the flow rate of 1.0 mL/min. The column temperature was set at 30 ℃. The detection wavelength was set at 203 nm，and sample size was 10 μL. Established method was used to determine the contents of diosgenin in wild D. zingiberensis from different habitats （Shaanxi Shangluo，Shaanxi Ankang，Henan Neixiang，Yunnan Xuanwei，Sichuan Deyang，Hubei Shiyan，Hunan Zhangjiajie，Hunan Changde）. The differences of diosgenin content were compared. RESULTS：The linear range of diosgenin were 4.16-165.6 μg/mL （r＝     0.999 9）. RSDs of precision，reproducible and stability tests were all lower than 2％ （n＝5 or n＝6）. The average recovery of diosgenin was 101.18％ （RSD＝1.27％，n＝6）. The content of diosgenin in wild D. zingiberensis from different habitats were in descending order，i.e. Sichuan Deyang （1 405.36 μg/g）＞Shaanxi Shangluo （1 201.79 μg/g）＞Hunan Zhangjiajie （1 035.18 μg/g）＞Shaanxi Ankang （632.64 μg/g）＞Hunan Changde （598.64 μg/g）＞Yunnan Xuanwei （425.34 μg/g）＞Henan Neixiang （350.13         μg/g）＞Hubei Shiyan （338.39 μg/g）. CONCLUSIONS：Established method is simple，accurate and suitable for the content determination of diosgenin in D. zingiberensis. The contents of diosgenin in wild D. zingiberensis from different habitats are different significantly，and the content of diosgenin in the samples from Sichuan Deyang is the highest.

Objective:To explore the effects of smart stress balls on the compliance of functional exercise and the incidence of complications in patients with midline catheters.Methods:By convenient sampling, totally 59 patients who received midline catheterization in the Department of Gastroenterology at the First Affiliated Hospital of Zhengzhou University from June to August 2019 were selected as the control group, while 58 patients who underwent midline catherization between October and December 2019 were selected as the observation group. Patients in the control group used traditional stress balls in function exercise after catherization, whereas patients in the observation group used smart stress balls in function exercise. The compliance of functional exercise and incidence of catheter-related complications after catherization were compared between the two groups of patients.Results:The functional exercise compliance score in the observation group was (39.66±2.62) , higher than (18.58±6.37) in the control group, and the difference was statistically significant ( t=-50.470, P<0.01) . The total incidence of complications in the observation group was 3.4% (2/58) , lower than 15.3% (9/59) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The use of smart stress balls can improve the functional exercise compliance and reduce the incidence of catheter-related complications after catheterization in patients with midline catheters, which is worth promoting in clinical practice.

Purpose To explore the application and clini-copathological significance of molecular classification in endome-trial cancer(EC)of WHO(2020)tumors of the female repro-ductive system.Methods Sixty-two EC patients were collected and categorized into four subgroups,namely POLE mutation type,mismatch repair deficient(MMRd)type,non-specific molecular spectrum(NMSP)type,and p53 mutation type,based on WHO molecular classification tested by PCR and im-munohistochemistry.The correlation among four molecular sub-groups and their clinicopathological features were analyzed.Re-sults The molecular classification was distributed as follows:3(4.8％)cases were POLE-mutated,15(24.2％)cases MMRd,36(58.1％)cases NSMP and 8(12.9％)cases p53 abnormal expression.There were no significant differences a-mong POLE-mutated and infiltration depth,grade,lymph vascu-lar space invasion and other pathological factors such as lymph node metastasis and FIGO stage(P＞0.05).Among 15 patients with MMRd,the proportion of FIGO stage Ⅱ+Ⅲ significantly increased.One case showed abnormal overexpression of p53 pro-tein,while two cases showed complete loss of expression in MMRd subgroup.36 cases of NSMP were associated with low histopathological grade(Grade Ⅰ+Ⅱ)(P＜0.05),and no significant differences were observed among NSMP and other clinicopathological factors(P＞0.05).The p53 abnormal ex-pression in 8 cases was related to high histopathological grade(Grade Ⅲ)(P＜0.05),and the rate of lymph node metastasis and FIGO stage Ⅱ+Ⅲ significantly increased in patients with p53 abnormal expression,and although the difference was not statistically significant(P＞0.05).Conclusion The molecu-lar subgroups of EC have certain clinical application value,the cases with MMRd and p53 abnormal expression may have poor prognosis than these with POLE-mutated and NSMP.

Objective:To evaluate the efficacy and safety of first-line anti-tuberculosis (TB) drugs combined with linezolid in treatment of children with tuberculous meningitis (TBM).Methods:A retrospective cohort study design was performed . Eight-nine Children diagnosed as TBM during January 1 st 2016 and December 31 st 2023 in Department of Infectious Disease, Children′s Hospital of Chongqing Medical University were enrolled in the study. According to different treatment regimens, children were divided into a group of first-line anti-tuberculous drugs (isoniazid, rifampicin, pyrazinamide, ethambutol (HRZE)) and a group of HRZE and linezolid combination (HRZEL). The efficacy and safety of the 2 regimens were compared and the relationship between linezolid drug concentration and adverse reactions were analyzed. Comparisons between groups were performed using χ2 test and Mann-Whitney U test. Results:The 89 children with TBM included 53 males and 36 females with an onset age of 4.6 (1.4, 9.6) years. There were 27 cases in the HZREL group and 62 cases in the HRZE group. Before treatment, positive rate of interferon-gamma release assays (IGRA) in HRZEL group was lower than that in HRZE group (64% (16/25) vs.92% (55/60), χ2=9.82, P<0.05), but protein level of cerebrospinal fluid (CSF) was higher than that in HRZE group (1.2 (1.0, 2.0) vs.0.8 (0.4,1.4) g/L, Z=0.32, P<0.05). By the end of the intensive phase, there were no significant differences of rates of CSF improvement and etiology negativity between HRZEL group and HRZE group (both P>0.05).The 44 TBM children with high CSF protein (>1 g/L) included 25 males and 19 females with an onset age of 6.7 (3.0, 11.8) years. There were 21 cases in the HZREL group and 23 cases in the HRZE group accordingly. Before treatment, there were no significant differences of positive rate of IGRA test and CSF protein level between the 2 groups (62% (13/21) vs. 87% (20/23), 1.7 (1.1, 2.2) vs. 1.5 (1.2, 1.9) g/L, χ2=3.67, Z=0.23, both P>0.05). There were no significant differences in CSF indicators, etiology negativity or imaging remission between the two groups by the end of intensive phase (all P>0.05). Higher frequencies of granulocytopenia, gastrointestinal symptoms as well as withdrawal or change of drugs were found in HRZEL group when compared to those in HRZE group (44% (12/27) vs. 19% (12/62), 7% (2/27) vs. 0, 33% (9/27) vs. 3% (2/62), χ2=6.01, 4.70, 15.74, all P<0.05). Conclusions:The efficacy of HRZEL regimen is similar to conventional HRZE regimen in children with TBM, but with higher adverse effect. Prudentially evaluating the pros and cons of linezolid in the usage of drug-susceptible TB and carefully monitoring of linezolid associated adverse effects is suggested.

Objective: The aim of this study is to summarize the experience of the orthognathic surgical treatment forsecondary maxillary deformities following the cleft lip and palate repair. Methods: Twenty-two patients with secondary maxillary deformities following the cleft lip and palate repairment(orthognathic approach), were retrospectively analyzed.All the cases were treated in the Hospital of Stomatology, China Medical University from January 2007 to December 2016. There were 9 males and 13 females, ranging from 18 to 24 years in age. Only 3 of those cases were not undergone preoperative and postoperative orthodontic treatments. The anteroposterior maxilla and mandible discrepancy was 6-11 mm preoperatively. The modified surgical procedures are as follows: One-stage alveolar bone graftand maxillary osteotomy were performed for unilateral cleft patients; Internal fixation with micro-plate at the alveolar cleft region was performed to stabilize the maxillary dental arch intraoperatively; Intermolar wire ligation and palatal arch were used to control the width of maxilla intraoperatively and 1 month after operation; 2-3 mm overcorrection for the Le Fort Ⅰ advancement was produced to reduce relapse in sagittal direction. Mandibular set back was performed using bilateral sagittal split osteotomy at the same time. Rigid internal fixation with titanium palates and screws was applied for all the cases. All patients had been followed up for 1 to 2 years postoperatively. Results: Most of the patients had satisfactory facial proportion, and good and stable occlusion relationship, with only one patient developed severely uncontrollable relapse to class Ⅲ malocclusion, and 3 patients experienced relapse resulted in edge to edge incisor relationship. Conclusions Le Fort Ⅰ osteotomy combined with bilateral sagittal split osteotomy was effective to correct the secondary maxillary deformities following the cleft lip and palate repair. The treatment plan should be individualized, depending on the patients′ occlusion relationship, skeletal deformity, and facial appearance as well. It is necessary to modify the surgical techniques of Le Fort Ⅰ osteotomy for the cleft patients.

Gastric cancer is one of the most common malignancies worldwide; however, the molecular mechanism in tumorigenesis still needs exploration. BCL2L11 belongs to the BCL-2 family, and acts as a central regulator of the intrinsic apoptotic cascade and mediates cell apoptosis. Although miRNAs have been reported to be involved in each stage of cancer development, the role of miR-24 in GC has not been reported yet. In the present study, miR-24 was found to be up-regulated while the expression of BCL2L11 was inhibited in tumor tissues of GC. Studies from both in vitro and in vivo shown that miR-24 regulates BCL2L11 expression by directly binding with 3'UTR of mRNA, thus promoting cell growth, migration while inhibiting cell apoptosis. Therefore, miR-24 is a novel onco-miRNA that can be potential drug targets for future clinical use.
Animals ; Apoptosis ; genetics ; Apoptosis Regulatory Proteins ; deficiency ; genetics ; Base Sequence ; Bcl-2-Like Protein 11 ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Down-Regulation ; genetics ; Gene Silencing ; Male ; Membrane Proteins ; deficiency ; genetics ; Mice ; MicroRNAs ; genetics ; Proto-Oncogene Proteins ; deficiency ; genetics ; Rats ; Stomach Neoplasms ; genetics ; pathology