Objective To evaluate a model for axillary lymph node involvement combining CK19 mRNA with contrast enhanced ultrasound sonography (CEUS) score in operable breast cancer.Methods Operable breast cancer patients planned for sentinel lymph node (SLN) biopsy were enrolled.Preoperative CK19mRNA expressions in peripheral blood and CEUS score of axillary lymph nodes were tested before surgery.In the training set,postoperative sentinel lymph node (SLN) and non-sentinel lymph node (nSLN) pathological results were taken as the gold standard,effective modeling variables were screened,logistic regression was used to establish the prediction model.Parallel control studies were conducted between the validation set and the MSKCC model to evaluate the prediction accuracy and prediction efficiency.Results From Oct 2015 to Nov 2016,359 cases (training set) were enrolled and mathematical formulas for predicting SLN and nSLN were established,respectively.The sensitivity,specificity and AUC of predicting SLN involvement were 91.36％,94.92％ and 0.979 respectively.The sensitivity,specificity and AUC of predicting nSLN metastasis were 91.04％,90.53％ and 0.932 respectively.From Dec 2016 to Jul 2017,219 cases (verification set) were included.The sensitivity of SLN metastasis predicted by the model was 91.84％,the specificity was 96.69％,and the AUC was 0.979,significantly superior to the MSKCC model (0.739).The sensitivity,specificity and AUC of predicting nSLN metastasis were 95.35％,92.73％ and 0.945 respectively,significantly superior to the MSKCC model (0.873).Concolusions Combined with peripheral blood CK19 mRNA and CEUS score,the prediction model for axillary lymph node involvement for operable breast cancer,SLN/nSLN involvement probability can be calculated and qualitative judgment can be made.The overall accuracy and AUC of this model are better than the prediction model of MSKCC.

Objective: To analyze on the identification cases of pneumoconiosis in coal enterprises in Occupational disease identification institution from 2010 to 2017. Discussion on the characteristics of pneumoconiosis identification in Coal enterprises, analyze the existing problems and put forward the countermeasures. Methods: The data of 235 pneumoconiosis cases were analyzed by the descriptive epidemiological method. Results: A total of 235 cases during this period, the mean age of onset was (51.08 ±7.17) years. The mean service length was (20.65±7.96) years. 131 cases were coal miners, accounting for 55.74%, and 132 cases were exposed to coal dust, accounting for 56.17%. The number of Identification cases was the lowest in 2011 (13 cases) , and gradually increased in the following years, with the highest number of Identification cases in 2016 (47 cases) . 96 cases came from western Chongqing, accounting for 41.20%, and 88 cases came from northeastern Chongqing, accounting for 37.77%. Pneumoconiosis stage one have accounted to 58.29%. The results of 74 cases were not consistent with those of diagnosis, and the difference rate was 31.76%. The difference rate of observation object identification results was 60.53%, and the difference rate of nonpneumoconiosisin identification results was 40.00%. Conclusion The main types of work are coal miners, and the dust exposed to them is coal dust. The regional distribution is mainly in the western part of Chongqing and the northeast part of Chongqing. The largest difference rate Pneumoconiosis Identification is observation object and nonpneumoconiosisin.

OBJECTIVE To assess the performance of non-invasive prenatal testing (NIPT) based on massive parallel sequencing. METHODS A total of 10 275 maternal blood samples were collected. Fetal chromosomal aneuploides were subjected to low coverage whole genome sequencing. Patients with high risks received further prenatal diagnosis. The outcome of all patients were followed up. RESULTS High-throughput sequencing detected 72 pregnancies with fetal autosomal chromosomal aneuploidy, including 57 cases of trisomy 21, 14 cases of trisomy 18, and 1 case of trisomy 13. The positive predictive value for trisomies 21 and 18 were 98.25% and 91.67%, respectively. Comparing its performance in intermediate or high risk pregnancies, advanced maternal age pregnancies and volunteering to test pregnancies, the positive predictive value were 100%, 95%, 90% and 50%, respectively. The follow up result was only 1 case of 21 trisomy false negative with high risk. For the 56 cases of trisomy 21, the high risk group accounted for 55%, advanced maternal age accounted for 29%, the intermediate risk referred to 14%, the volunteering to test group accounted for 2%. CONCLUSION The performance of NIPT for trisomies 21, 18 and 13 was satisfactory. The method can be used for women with advanced gestational age. NIPT has offered an ideal secondary screening method for those with an intermediate or high risk, and can reduce the rate of birth defects.

Objective To assess the predictive value for survival of BioCliM index in liver cirrhosis caused esophageal and gastric varices bleeding(EGVB)treated by endoscopic variceal ligation(EVL),endoscopic injection sclerotherapy(EIS)and endoscopic tissue adhesives(ETA).Methods From December 2006 to December 2011, the clinical data of 166 hospitalized patients with first occurrence of EGVB caused by liver cirrhosis and received endoscopic therapies were retrospectively analyzed.The scores of model for end-stage liver disease(MELD),model for end-stage liver disease-Na(MELD-Na),BioCliM index and Child-Turcotte-Pugh(CTP)were calculated. Receiver operating characteristic(ROC)curve and area under the curve(AUC)were applied to assess the accuracy of the four models in one-year and two-year prognosis evaluation,and to obtain the best critical value,and the mortality rates were compared among groups.Chi-square test,t test and rank-sum test were performed for statistical analysis.Results Among 166 patients,the levels of creatinine,bilirubin,albumin,sodium,international normalized ratio and prothrombin time were(0.10 ± 0.06)mmol/L,(0.02 ± 0.01)mmol/L,(30.13 ± 5.06)g/L, (139.13 ± 4.27)mmol/L,1.50 ± 0.32 and(17.83 ± 2.88)s,respectively.During the one-year and two-year follow-up,there were 14 patients and 23 patients dead,respectively.During the one-year and two-year follow-up, the incidences of portal thrombosis of death group were lower than those of survival group(10/14 vs 93.4%,142/152;73.9%,17/23 vs 94.4%,135/143);and the differences were statistically significant(χ2=8.029 and 10.774, both P<0.01).During the one-year and two-year follow-up,BioCliM indexes of death group were 0.12(-0.82, 1.44)and -0.81(-0.87,0.92),respectively,which were both higher than those of survival group(-0.84,-0.94 to -0.73;and -0.84,-0.94 to -0.72),and the differences were statistically significant(Z= -3.074 and -2.260,both P<0.05).During the one-year follow-up,the AUC values of MELD,MELD-Na,BioCliM index and CTP score were 0.698,0.691,0.749 and 0.723,respectively.During the two-year follow-up,the AUC values of MELD,MELD-Na,BioCliM index and CTP score were 0.587,0.582,0.647 and 0.633,respectively. But there was no statistically significant difference in AUC between BioCliM index and MELD,MELD-Na,and CTP score in one-year and two-year follow-up for prognosis evaluation(Z=0.509,0.566,0.271,0.687,0.731 and 0.162,respectively;all P>0.05).The best critical value of BioCliM index was -0.234.Followed up for one year and two years,the mortality rates of patients with BioCliM index over -0.230 were higher than that of patients with BioCliM index less than -0.234(31.0%,9/29 vs 3.6%,5/137;34.5%,10/29 vs 9.5%,13/137);and the differences were statistically significant(χ2=23.242 and 12.526,both P<0.01).Conclusions BioCliM index has a high accuracy in one-year and two-year mortality rate evaluation in liver cirrhosis patients with EGVB and received endoscopical therapies.We should pay attention to the prognosis evaluation before the endoscopical therapy.

Objective:To find out the chemical constituents in Atrichum undulatum var. gacelisetum.Methods:The compounds were isolated by silica gel and TLC, and purified by recrystallization from the ethanol extract. The structures of the compounds were elucidated by spectral analysis and physicochemical properties. Results:Six compounds were obtained and the structures were identified as dotriacontane ( 1 ), montanic acid ( 2 ), β-sitosterol ( 3 ), daucosterol ( 4 ), luteolin 7-O-D-glucoside ( 5 ) and luteolin ( 6 ). Conclusion:Compounds 1-6 are isolated from the species for the first time.

Background To study the pathogenesis and management of diabetic retinopathy (DR) has an important clinical significance.With the development of biomedical photonics in recent years,photobiomodulation therapy has been paid more and more attention.However,the sudy on biological regulation of light to DR is rarely reported.Objective This study was to explore the photobiomodulating effects on the apoptosis of retinal neuronal cells induced by high glucose environment and tried to offer a basis for the management of DR.Methods The retinal neurons were isolated from Wistar rats using immunomagnetic beads and primarily cultured in Neurobasal,and the cells were identified by Nissl staining.The cells were divided into normal control group,high-glucose group and high-glucose+LED group.The glucose at the concentration of 25 mmol/L was added into medium for 48 hours in the high-glucose group,and the cells induced by high-glucose were irradiated in incubator by LED for consecutive 300 seconds per time in a 12-hour interval with the wavelength of 620 nm,maximal power of 1 W,central light radiation exposure of 6.67 mW/cm2 and spot diameter of 2.0 cm.The apoptosis rate of the cells was assayed by flow cytometry;the intracellular Ca2+ content was determined by laser scanning confocal microscope;the relative expression level of phosphorylated serine-threonine kinase (p-AKT) protein in the cells was detected by Western blot.Results The cells grew well 2-3 days after cultured with the polygon and oval shape,and nucleolus were visible.More neuronal processes were obtained in 5-7 days after culture.Nissl staining showed the blue violet color in cytoplasma of neurons.The proportion of neurons and glial cells was 91％.The apoptosis rates of the cells were (7.634±3.176)％,(33.642 ±9.315)％ and (23.914±6.375)％ in the normal control group,high-glucose group and high-glucose+LED group,respectively,and the apoptosis rates of high-glucose group and high-glucose + LED group were significantly higher than that in the normal control group,while the apoptosis rate in the high-glucose+LED group was lower than that in the high-glucose group (all at P＜0.01).The fluorescence of Ca2+ in the cytoplasma was strong in the highglucose group and weak in the normal control group.The fluorescence pixel values in the high-glucose group and highglucose+LED group were significantly higher than that in the normal control group,and that in the high-glucose+LED group was reduced in comparison with high-glucose group (all at P＜0.05).The expressing band of p-AKT protein was strong in the normal control group and weak in the high-glucose group.The relative expressing levels were 10.34± 3.18,2.16±0.46 and 7.15 ±1.72 in the normal control group,high-glucose group and high-glucose+LED group,and relative expression level of high-glucose+LED group was significatly lower than that in the high-glucose group (P＜ 0.05).Conclusions High-glucose environment inhibits PI3K/AKT pathway and calcium homeostasis of retinal neurons,which results in cell apoptosis.Low intensity of LED light irradiation activates the anti-apoptotic PI3K/AKT pathway and therefore reduces apoptosis induced by high glucose.

BACKGROUND: As a combination of reverse transcription (RT) and polymerase chain reaction (PCR), RT-PCR has been used to detect gene expression levels in cells and tissues, RNA virus contents in cells and specific gene cloned cDNA sequences.OBJECTIVE: To detect the inhibitory effcet of Stealth siRNAs on the expression of transforming growth factor β1 (TGF-β1).METHODS: There were blank control, empty vector transfection, stealth-48, stealth-166, and stealth-594 groups. Three stealth siRNAs aimed at different sequences in TGF-β1 mRNA were made, and were then transfected into BALB/c mouse lung fibroblasts in vitro. The expressions of TGF-β1 and connective tissue growth factor were detected by RT-PCR.RESULTS AND CONCLUSION: In different time periods, the TGF-β1 expression was differentially depressed by three stealth siRNAs, especially stealth-166. The inhibitory effects varied with time, which could be detective at 48 hours,reached the peak at 72 hours and then began to attenuate at 96 hours. Our findings show that the inhibitory effect of stealth siRNAs on the TGF-β1 expression in mouse lung fibroblasts can be detected by RT-PCR.

Objective · To explore the relationship of adipose chemerin and its receptor chemerinR gene expression to obesity and type 2 diabetes mellitus. Methods · Twenty-four patients undergoing elective abdominal surgery were enrolled, and were divided into normal glucose regulation-normal weight group (NGR-NW), normal glucose regulation-overweight/obesity group (NGR-OW/OB), and type 2 diabetic overweight/obesity group (T2DMOW/OB) according to the body mass index (BMI). The levels of chemerin and chemerinR mRNA were detected by reverse transcription PCR (RT-PCR).Results · Compare to the NGR-NW group, the chemerin mRNA levels of abdominal subcutaneous and omental fat were significantly increased in the NGR-OW/OB and T2DM-OW/OB group (P<0.05). Correlation analysis showed that the chemerin mRNA levels of abdominal omental fat were positively correlated with BMI, fasting insulin (FINS), triglyceride and serum chemerin (r=0.577, r=0.561, r=0.472, r=0.623, P<0.05 for all). The chemerin mRNA levels of abdominal subcutaneous fat showed significant positive correlation with BMI, FINS and serum chemerin (r=0.692, r=0.513, r=0.497, P<0.05 for all). Conclusion · The chemerin mRNA levels of abdominal subcutaneous and omental fat were positively correlated with BMI, FINS and serum chemerin, suggesting that the chemerin gene may play a crucial role in the pathophysiological mechanism of obesity and type 2 diabetes.

Objective To analyze the clinical characteristics of patients with presbycusis by using disyllabic mandarin speech test materials (MSTMs).Methods A total of 59 subjects (23 men and 36 women) with presbycusis,from 61 to 84 years old with the average as 71.3±6.7.They were divided into three groups:the mild group (10 subjects),the moderate group (35 subjects)and the severe group (14 subjects)according to the pure tone average (PTA) thresholds at 0.5,1,2 and 4 kHz from the better ear.In addition,11 subjects of elderly persons with normal hearing were used as the control group.All the subjects enrolled in this study could speak Mandarin well in their daily lives.Nine lists of disyllabic mandarin speech test materials were utilized to test speech recognition threshold (SRT) and P-I function for these groups respectively.Results The PTA(51.65±11.98)and SRT (50.98±16.05)from presbycusis group were much higher than the control group(PTA 19.55± 4.55,SRT 18.79± 7.45),while the average slope of the P-I function 2.63％/dB from the presbycusis group was lower than the control group 4.65％/dB (P＜0.01).The SRT of male patients (56.54±17.23) was higher than the females(47.99± 15.63) (P＜0.05).The PTA and SRT in these three groups divided by degrees of hearing loss were higher than the control group obviously.The PTA and SRT had significantly increased as the degree of hearing loss increased.The differences among these groups were significant (P＜0.01).The average slope of P-I function of these three groups divided by degrees of hearing loss (mild group:2.47％/dB,moderate group:2.76％/dB,severe group:2.42％/dB) was smaller than the slopes in the control group which was 4.65 ％/dB (P＜0.01).The average slope of P-I function among these groups had no significant difference (P＞0.05).Conclusion The SRT of patients with presbycusis increased and the SRT of male was higher than the females.The average slope of P-I function decreased and the curve moved to right side and became a gradual curve.As hearing loss became more severe,the SRT rose more apparently.