Objective:To investigate the expulsion rate of GyneFix postpartum intrauterine device (PPIUD) placed immediately after cesarean section within one year and its influencing factors.Methods:A prospective cohort study was conducted. Women who volunteered to use a GyneFix PPIUD placed immediately after cesarean section (within 10 min after placenta delivery) for postpartum contraception were recruited from September 2017 to November 2020. The relevant information was collected through questionnaires before, during and 24 h after cesarean section. Outpatient follow-up was conducted at 42 d, 3 months, 6 months and 12 months after delivery to obtain information on expulsion of GyneFix PPIUD and unwanted pregnancy. Life table and Cox regression model were used to analyze the cumulative expulsion rate and related influencing factors.Results:A total of 470 subjects were recruited and 461 (98%) subjects were eligible for this study. The cumulative expulsion rate of GyneFix PPIUD within one year after cesarean section was 8.4% (95% CI: 7.0%-9.8%). Multivariate Cox regression analysis showed that women aged >35 years had significantly lower risk of PPIUD expulsion than those aged <25 years ( HR=0.16, 95% CI: 0.04-0.64). The risk of GyneFix PPIUD was not statistically significantly associated with cesarean section history and breastfeeding mode (all P>0.05). Nevertheless, this risk was statistically significant between hospitals. The Pearl index of contraceptive failure of the device was 2.37 (95% CI: 1.09-4.50) per 100 person-years. The rate of contraceptive failure was not associated with maternal age, breastfeeding mode, and history of cesarean delivery (all P>0.05). Conclusion:The one-year cumulative expulsion rate of GyneFix PPIUD placed immediately after cesarean section is 8.4%. Young mothers were at a higher risk of expulsion than their older counterparts. The device users should be counseled regarding the signs of expulsion. In case of expulsion, women should be offered reinsertion or other contraceptive methods. The training of service skills of GyneFix PPIUD should be strengthened in order to mitigate the risk of the device expulsion.

Objective:To investigate the expulsion rate of GyneFix postpartum intrauterine device (PPIUD) placed immediately after cesarean section within one year and its influencing factors.Methods:A prospective cohort study was conducted. Women who volunteered to use a GyneFix PPIUD placed immediately after cesarean section (within 10 min after placenta delivery) for postpartum contraception were recruited from September 2017 to November 2020. The relevant information was collected through questionnaires before, during and 24 h after cesarean section. Outpatient follow-up was conducted at 42 d, 3 months, 6 months and 12 months after delivery to obtain information on expulsion of GyneFix PPIUD and unwanted pregnancy. Life table and Cox regression model were used to analyze the cumulative expulsion rate and related influencing factors.Results:A total of 470 subjects were recruited and 461 (98%) subjects were eligible for this study. The cumulative expulsion rate of GyneFix PPIUD within one year after cesarean section was 8.4% (95% CI: 7.0%-9.8%). Multivariate Cox regression analysis showed that women aged >35 years had significantly lower risk of PPIUD expulsion than those aged <25 years ( HR=0.16, 95% CI: 0.04-0.64). The risk of GyneFix PPIUD was not statistically significantly associated with cesarean section history and breastfeeding mode (all P>0.05). Nevertheless, this risk was statistically significant between hospitals. The Pearl index of contraceptive failure of the device was 2.37 (95% CI: 1.09-4.50) per 100 person-years. The rate of contraceptive failure was not associated with maternal age, breastfeeding mode, and history of cesarean delivery (all P>0.05). Conclusion:The one-year cumulative expulsion rate of GyneFix PPIUD placed immediately after cesarean section is 8.4%. Young mothers were at a higher risk of expulsion than their older counterparts. The device users should be counseled regarding the signs of expulsion. In case of expulsion, women should be offered reinsertion or other contraceptive methods. The training of service skills of GyneFix PPIUD should be strengthened in order to mitigate the risk of the device expulsion.

Objective:To evaluate the value of conventional ultrasound, shear wave elastic parameters and immunohistochemistry in predicting axillary lymph node metastasis of breast cancer.Methods:The ultrasonographic features and pathological results of 172 masses in 152 breast cancer patients who underwent surgery in the First Affiliated Hospital of Shihezi University Medical College from May to October 2020 were analyzed retrospectively. The patients were divided into metastatic group and non-metastatic group according to the status of axillary lymph nodes. The conventional ultrasound characteristics, shear wave velocity (SWV) and immunohistochemical indexes (ER, PR, HER-2, Ki-67) of 2 groups of breast cancer masses were analyzed. Finally, the parameters with statistically significant difference between groups were selected and the Logistic regression model was established.Results:There were significant differences in the aspect ratio, calcification, SWVmean and HER-2 expression between metastatic group and non-metastatic group (all P<0.05). A prediction model was constructed with aspect ratio >1, calcification, high SWVmean and HER-2(+ ). The area under receiver operating characteristic curve (AUC) of the subjects was 0.891, which was larger than the single parameter (all P<0.05), and was in good agreement with pathological results (Kappa=0.731). Conclusions:The joint prediction model can be used to predict the status of lymph nodes, and the axillary lymph node metastasis is more likely to occur in breast cancer with the aspect ratio >1, calcification, high SWVmean and HER-2(+ ).

【Objective】 To investigate the relationship between the expression of PRDX3 （thioredoxin-dependent peroxide reductase）and the occurrence and development of ccRCC （clear cell renal cell carcinoma）. 【Methods】 The expression of PRDX3 was first verified in 16 cases of ccRCC tissues and adjacent normal tissues. In the present study ， according to the PRDX3 over-expression level，we established the stable PRDX3 overexpression cell lines and knockdown cell lines in 786-O cell lines. We detected the growth rate of tumor cells after overexpression and knockdown of PRDX3. Interaction proteins with PRDX3 were searched by anti-flag pull-down test combined with LC- MS/MS technique. The interaction between PRDX3 and PRDX1（peroxiredoxin 1）was preliminarily explored.【Results】The western blot results showed that PRDX3 were down- regulated in 14 out of 16 ccRCC tissue samples about 1.78 times. Stable PRDX3 overexpression and knockdown cell lines and those control group were successfully established［786O- PRDX3（+）and 786O- PRDX3（-），786O- PRDX3 KN and 786O- PRDX3 NCi］. PRDX3 expression in 786O- PRDX3（+）was 2.1 times higher than 786O- PRDX3（-）at mRNA level and 1.8 times at protein level. PRDX3 expression in 786O- PRDX3 KN was 0.48 times lower than 786O-PRDX3 NCi at mRNA level and 0.51 times at protein level. The cell growth rate of 786O-PRDX3 （+）cell lines was significantly lower than that of 786O-PRDX3（-）. Meanwhile ，there was no significant difference in 786O-PRDX3 KN and NCi cell lines. Pull-down results shows that PRDX3 may interact with PRDX1 through disulfide bond and the binding sites of those two proteins were identified respectively.【Conclusion】PRDX3 was down- regulated expression in renal clear cell carcinoma and the interaction with PRDX1 may be involved in the occurrence and development of tumor. Increasing the expression level of PRDX3 can significantly reduce the growth rate of tumor cells. Based on PRDX3 ，it is possible to develop targeted drugs for treating renal clear cell carcinoma.

A 78-year-old male patient received intravenous infusion of levofloxacin 0.5 g once daily due to pneumonia.No other drugs were used during the same period.After medication,the patient's cough and expectoration relieved gradually.However,about 1 week after the medication,skin redness and itching on the face,neck and shoulder,abdominal distension,and muscle pain and weakness appeared and worsened progressively.After 12 days of treatment,levofloxacin was discontinued.The symptoms did not improve 1 week after the drug withdrawal and the patient was hospitalized.On admission,physical examination showed grade 4 and 3 respectively for the upper and lower limbs muscle strength;laboratory tests showed the serum creatine kinase (CK) 9 952 U/L,creatine kinase isozyme (CK-MB) 101 U/L,and myoglobin (Mb) 953 μg/L;muscle biopsy and pathological examination showed partial muscle fiber degeneration,muscle bundle rupture,increased number of myonuclei,slight inflammatory cell infiltration among some muscle bundles,and a little local mucin deposition.Allergic rash and rhabdomyolysis were diagnosed,which was considered to be induced by levofloxacin.Symptomatic supportive treatments such as anti-allergy,alkaline urine,diuresis,and fluid infusion were given.One week later,the rash subsided;3 weeks later,the patient had no muscle pain and his muscle strength of upper and lower limbs returned to grade 5 and 4,with CK 423 U/L,CK-MB 15 U/L,and Mb 128 pg/L.Then the patient was discharged from the hospital and did not take any medicine again.One month later,his muscle strength of limbs recovered and the laboratory tests showed CK 143 U/L,CK-MB 12 U/L,and Mb 62 μg/L.

A 78-year-old male patient received intravenous infusion of levofloxacin 0.5 g once daily due to pneumonia.No other drugs were used during the same period.After medication,the patient's cough and expectoration relieved gradually.However,about 1 week after the medication,skin redness and itching on the face,neck and shoulder,abdominal distension,and muscle pain and weakness appeared and worsened progressively.After 12 days of treatment,levofloxacin was discontinued.The symptoms did not improve 1 week after the drug withdrawal and the patient was hospitalized.On admission,physical examination showed grade 4 and 3 respectively for the upper and lower limbs muscle strength;laboratory tests showed the serum creatine kinase (CK) 9 952 U/L,creatine kinase isozyme (CK-MB) 101 U/L,and myoglobin (Mb) 953 μg/L;muscle biopsy and pathological examination showed partial muscle fiber degeneration,muscle bundle rupture,increased number of myonuclei,slight inflammatory cell infiltration among some muscle bundles,and a little local mucin deposition.Allergic rash and rhabdomyolysis were diagnosed,which was considered to be induced by levofloxacin.Symptomatic supportive treatments such as anti-allergy,alkaline urine,diuresis,and fluid infusion were given.One week later,the rash subsided;3 weeks later,the patient had no muscle pain and his muscle strength of upper and lower limbs returned to grade 5 and 4,with CK 423 U/L,CK-MB 15 U/L,and Mb 128 pg/L.Then the patient was discharged from the hospital and did not take any medicine again.One month later,his muscle strength of limbs recovered and the laboratory tests showed CK 143 U/L,CK-MB 12 U/L,and Mb 62 μg/L.

Objective To observe the inhibitory effect on lymph node metastasis of pancreatic cancer and lymphangiogenesis in mice by injection of KAll gene within xenograft tumor.Methods Pancreatic cancer cell line MiaPaCa-2 wag used to construct the nude mice models bearing tumors,then the mice were divided into normal saline group,Ad group and Ad-KAI1 group.Since the successful model construction,normal saline,Ad,Ad-KAI1 was injected every week for 3 times,respectively in the three groups,then the tumor size was documented.50 d after model construction,the tumor and enlarged lymph nodes were collected and subjected to pathological exam,and the expression of LYVE-1 and the MLVD in xenograft tumor was detected by immunohistochemistry.Results Two weeks after MiaPaCa-2 implantation,the model was 100％ successfully constructed.The growth curve of subcutaneous tumor among 3 groups was not statistically significant (P＞0.05) ; the weights of subcutaneous tumor in the 3 groups were (2514.4 ±351.3),(2466.1 ± 295.5),(2294.4±255.4) mg after 50 d,and the difference among the 3 groups was not statistically significant (P ＞0.05).Enlarged lymph nodes metastasis was observed in 8 mice (80％) in normal saline group,and 20 lymph nodes were collected,with 2.0 lymph nodes per mice; and enlarged lymph nodes metastasis was observed in 7 mice (70％) in Ad group,and 15 lymph nodes were collected,with 1.5 lymph nodes per mice; while enlarged lymph nodes metastasis was observed in 4 mice (40％) in Ad-KAI1 group,and 6 lymph nodes were collected,with 0.6 lymph nodes per mice.All the lymph nodes were confirmed to be metastasis of the primary tumor after pathologic exam.The difference of lymph nodes metastasis,number of lymph nodes metastasis per mice among the 3 groups was statistically significant (F =3.14,3.35,P ＜ 0.05).The MLVD of subcutaneous tumor among the 3 groups was (18.70 ± 5.60),(19.40 ± 4.58),(9.80 ±4.10)/400 times magnification,the MLVD of Ad-KAI1 group was significantly lower than those in normal saline group and Ad group (F10.76,11.36,P ＜ 0.05),but the difference between normal saline group and Ad group was not statistically significant.Conclusions KAI1 can inhibit the lymph node metastasis of pancreatic cancer,and the mechanism may be related with decreased lymphangiogenesis and reduced lymphatic vessel density.

ObjectiveTo investigate the clinical features of patients with painless acute pancreatitis ( AP),and to improve the diagnosis accuracy of painless AP.MethodsThe clinical data of 12 patients with painless AP were retrospectively collected from January 2007 to January 2011.Results The mean age of patients with painless AP was 52 years old.Seven (58.3％) patients complained of abdominal distension and discomfort,4 (33.3％) patients complained of nausea and vomiting,abdominal tenderness occurred in 7(58.3％ ) patients.Serum levels of lipase and amylase was increased in 11 (91.7％) and 8 (66.7％)patients,respectively.The diagnostic accuracy of abdominal ultrasound and CT for AP was 58.3％ and 91.7％,respectively.Five (41.7％) patients were diagnosed to have AP upon admission,and 4 patients were misdiagnosed to have non-digestive diseases.There were 7 severe AP patients among the 12 painless AP patients,and the percentage was significantly higher than that in AP patients with pain (65/327,x2 =7.30,P ＜ 0.05).Painless AP patients needed longer hospital stay when compared with that of AP patients with pain [ ( 20.4 ± 9.1 ) d vs.( 12.9 ± 6.2) d,t =2.296,P ＜ 0.05 ) ].ConclusionsThe misdiagnosis rate of painless AP is high and patients with painless AP are in critical situation,and early measurement of serum levels of lipase and amylase,as well as CT scan is important for correct diagnosis.

Objective To evaluate the endocrine glands derived VEGF (EG-VEGF) influence on growth, migration and apoptosis of pancreatic cancer cells MiaPaCa Ⅱ. Methods MiaPaCa Ⅱ were treated by 100,200 ng/ml EG-VEGF for 24, 48, 72, 96 h, and MTT assay was used to determine the proliferation; and cell scratch experiment was used to investigate the percentage of cell migration distance, flow cytometry was used to measure the apoptosis of the cancer cells. Results After MiaPaCa Ⅱ cells were treated by 0, 100,200 ng/ml EG-VEGF for 72 h, the proliferation of MiaPaCa Ⅱ was 0. 253 ± 0. 012 , 0. 374 ± 0.013,0. 383 ±0.015, respectively EG-VEGF could significantly promote the proliferation of MiaPaCa Ⅱ ( P ＜ 0. 05 ). After MiaPaCa Ⅱ cells were treated by 0, 100 ng/ml EG-VEGF for 24 h, the percentage of cell migration distance was (27.40 ± 3.45 ) % and ( 13.21 ±4.65 ) % ,respectively with statistical difference ( P ＜ 0.05 ), EG-VEGF could significantly promote the migration ability of MiaPaCa Ⅱ cells and inhibite the apoptosis. Conclusions After EG-VEGF treatment, the growth and migration ability of MiaPaCa Ⅱ cells increases, apoptosis decreases.

Objective To investigate the anti-apoptosis effects of EG-VEGF on pancreatic cancer cell MiaPaCa and its molecular mechanism. Methods The cells were treated with 50, 100, 200 ng/ml EG-VEGF. Flow cytometry was used to determine the apoptosis. The expression of p42/44MAPK, STAT3 protein and the phosphorylation, and anti-apoptosis protein Mcl-1 was evaluated by Western blot. Non-specific G protein-coupled receptor antagonist PTX, Rsa/ERK signal transduction blockade PD98059, JAK/STAT3 signal transduction blockade AG490 were used to treat the cells for 1 h, and the change of Mcl-1 protein was observed. Results After treated with 50 ng/ml EG-VEGF, the apoptosis rate of MiaPaCa was decreased from (28.4 ±4.6)% to (13.21 ±4.65)% (P<0.05) ; the phosphorylation of p42/44MAPK increased by 1.735 ± 0.019 folds; the phosphorylation of STAT3 increased by 21.810 ± 0.052 folds; the expression of Mcl-1 protein increased by 3.460 ±0.002 folds when compared with that of control group,and the difference was statistically significant (P < 0.05 ). But the degree of phosphorylation and the expression of Mcl-1 were not further increased with 100, 200 ng/ml EG VEGF treatment. After PTX pre-treatment, the increase of Mcl-1 protein expression was completely inhibited, and after PD98059, AG490 pre-treatment, the increase of Mcl-1 expression was inhibited to 52% and 68%. Conclusions EG-VEGF can inhibit MiaPaCa cell from apoptosis,and the mechanism may be related with activation of Ras MAPK and JAK STAT3 signal transduction pathway and up-regulation of Mcl-1.