Objective:To investigate the role of dendritic cells (DC) in Chlamydia muridarum ( Cm) respiratory infection and their effect on adaptive immune response. Methods:C57BL/6 mice were exposed to 1×10 3 inclusion-forming units (IFU) of Cm through inhalation to establish the mouse model of Cm respiratory infection. The proportion of CD11c + MHCⅡ + DC and the expression of costimulatory molecules (CD40, CD80 and CD86) in spleen tissues were detected by flow cytometry on 0, 3 and 7 d after infection. The expression of IL-12p40, IL-10 and IL-6 at mRNA level in spleen tissues was detected by qPCR. Mouse splenic DC isolated on 7 d after Cm infection were sorted by magnetic beads and then transferred to recipient mice. Th1 response in the recipient mice was measured using intracellular cytokine staining 14 d after infection. Results:Cm respiratory infection induced massive infiltration of DC and promoted the expression of costimulatory molecules on splenic DC. The expression of IL-12 and IL-10 at mRNA level in splenic DC reached the peak on 3 d after infection. Transferring the splenic DC of Cm-infected mice into the recipient mice could alleviate the disease condition in the recipient mice after Cm infection with reduced Cm inclusion-forming units in lung tissues and significantly increased proportion of Th1 cells in lung and spleen tissues. Conclusions:Cm respiratory infection could induce the maturation and activation of DC, which promoted Th1 immune response. DC played an important role in Cm infection.

Objective:To investigate the effects of Chlamydia muridarum ( Cm) respiratory tract infection on the infiltration and polarization of alveolar macrophages (AMs) and pulmonary interstitial macrophages (IMs). Methods:A C57BL/6 mouse model of Cm respiratory tract infection was established through nasal inhalation. Flow cytometry was used to detect AMs (CD45 + F4/80 + CD11c + ) and IMs (CD45 + F4/80 + CD11c -) in lung tissues at 0, 3, 7 and 14 d after Cm respiratory tract infection. The proportions of M1 (CD80 + , CD86 + , MHCⅡ + , iNOS + ) and M2 (CD206 + , Arg1 + ) macrophages in AMs and IMs were also detected. Results:(1) Cm respiratory tract infection induced the infiltration of AMs and IMs. Compared with the uninfected group (0 d), the proportions and the numbers of AMs and IMs of were significantly increased 3 d after infection ( P<0.05, P<0.01). The numbers of AMs and IMs reached the peak 7 d after infection ( P<0.001). (2) Compared with the uninfected group, the proportions of CD80 + and CD86 + cells in AMs were significantly up-regulated 3 d after infection ( P<0.05, P<0.01); the proportion of MHCⅡ + cells in AMs increased after infection and reached the peak at 14 d ( P<0.05), while the proportion of CD206 + cells decreased after infection ( P<0.05). (3) Compared with the uninfected group, the proportions of CD80 + and CD86 + cells in IMs were increased 3 d after infection ( P<0.05, P<0.001) and the proportion of MHCⅡ + cells was significantly increased 14 d after infection ( P<0.01), while there was no significant change in the proportion of CD206 + cells. (4) In AMs, the proportion of iNOS + cells increased continuously after infection ( P<0.01), while the proportion of Arg1 + cells decreased continuously after infection, especially at 7 d and 14 d ( P<0.05). In IMs, the proportion of iNOS + cells reached the peak at 7 d ( P<0.001), but the proportion of Arg1 + cells showed no significant change after infection. Conclusions:Cm respiratory tract infection induced the infiltration of AMs and IMs, stimulated the polarization of AMs and IMs towards the M1 phenotype and weakened the polarization of AMs to M2 macrophages, but had no significant influence on the polarization of IMs towards the M2 phenotype.

Objective:To explore the effect of family supportive nursing on self-perception and outcome events in elderly patients with chronic diseases.Methods:A simple random sampling method was used to select 115 elderly patients with chronic diseases discharged from Henan Provincial People's Hospital from January 2019 to January 2020. They were divided into the observation group (58 cases) and the control group (57 cases) by random number table method. The control group received routine nursing, while the observation group received family support nursing. The self-perception and family function scores of the two groups were compared before the intervention and after 3 and 6 months of the intervention. The medication compliance and readmission rate were compared between the two groups.Results:After 3 months of intervention, scores of Self-Perceived Burden (SPBS) of the observation group and the control group were respectively (25.73±3.85) and (28.14±3.90) and scores of Family Adaptability Cohesion Environment Scale (FACES) were respectively (105.62±12.41) and (96.35±10.05) . After 6 months of intervention, the SPBS scores of the observation group and the control group were respectively (21.89±4.33) and (25.41±4.20) , and the FACES scores were (122.60±14.70) and (112.35±16.32) respectively. Repeated-measures analysis of variance showed that there were statistically significant differences in interaction effect, time effect and between-group effect in the comparison of SPBS and FACES total scores between the two groups (all P<0.01) . After 6 months of intervention, the rate of good medication compliance in the observation group and the control group was respectively 70.69% (41/58) and 50.88% (29/57) , and that of the observation group was higher than the control group, and the difference was statistically significant (χ 2=4.738, P=0.030) . After one-year follow-up after intervention, the readmission rates of the observation group and the control group were respectively 18.87% (10/53) and 39.22% (20/51) , and the observation group was lower than the control group, and the difference was statistically significant (χ 2=5.243, P=0.022) . Conclusions:Family support nursing can reduce the self-perceived burden of elderly patients with chronic diseases, improve their family function, improve medication compliance and reduce readmission.

Objective To investigate the relationship between various loop electrosurgical excision procedure (LEEP) margin status and residual high grade squamous intraepithelial lesion (HSIL) or worse at hysterectomy following conization. Methods The relevant clinicopathological data were collected in the Obstetrics and Gynecology Hospital, Fudan University from Jan. 2014 to Dec. 2015, including 947 cases who underwent hysterectomy within 6 months of LEEP. The residual HSIL or worse at hysterectomy were analyzed among the groups. (1) Clear margins, involved margins, and without 1 mm negative margins. (2) Only one positive margin, two positive margins and three positive margins. (3) A positive margin of internal ostium of cervix, of external ostium of cervix and of the basement. Results (1) The histological evaluation of the uterine specimens showed residual HSIL or worse in 234 cases (24.7％, 234/947). The proportion of residual lesions was 7.3％ (21/286) in population with clear margins, 33.2％ (211/635) with involved margins, 7.7％ (2/26) without 1 mm negative margins, respectively. The positive margins group had significant difference at the aspect of residual rate in contrast to the negative margins group and the without 1 mm negative margins group (P<0.01). Further studies conclusively showed that the proportion of residual lesions was very similar between the negative margins group and the without 1 mm negative margins group (P>0.05). (2) The involved margins were interpretable in 621 cases. This was detected in 25.3％(111/438) patients with only one positive margin, 47.4％(74/156) with two positive margins and 77.8％(21/27) among three positive margins, respectively (P<0.01). (3) Furthermore, there were 418 cases only one positive margin was definite, and the proportion of residual lesions was 31.0％(62/200) in population with a positive margin of internal ostium of cervix, 18.2％(31/170) of external ostium of cervix and 33.3％(16/48) of the basement. The residual rates were higher in the endocervical and basal margin groups than that in the ectocervical margin group, and the differences were significant (P<0.05). Conclusions The risk of residual HSIL or worse is significantly greater with involved margins at hysterectomy following LEEP. Both the positive endocervical and basal margin are excellent predictors of residual diseases, while the without 1 mm negative margin may be not. Clinicians should avoid treating it as positive margin and prevent overtreatment.

Objective: To investigate the clinical and pathological characteristics and prognosis of ovarian clear cell borderline tumor. Methods: A total of 12 cases of ovarian clear cell borderline tumors recorded were collected from May 2011 to December 2017 at Obstetrics and Gynecology Hospital, Fudan University.Clinical histories were retrieved and pathological slides were reviewed. Results: The age of the patients ranged from 35 to 65 years with a mean age of 52 years. Seven cases were associated with cystic endometriosis of the ovary. All tumors consisted of irregular and crowded glands or cysts embedded in a fibromatous stroma. The cysts and glands were lined by mild to moderate atypical cells.CK7 and HNF-1β were expressed in all cases, and Naspin A was expressed in 11 cases. ARID1A expression was absent in 5 cases and p53 showed wild-type expression. None of the cases developed recurrence during follow-up ranging from 7 to 79 months. Conclusions Ovarian clear cell borderline tumor may be associated with endometriosis and tumor suppressor gene ARIDA. The tumor has a good prognosis without recurrence and progression to carcinoma.

Objective To evaluate the diagnostic value of six-slice coronal reformations in patients with acute midepigastric pain. Methods A total of 974 patients with acute midepigastric pain were included in this study and divided into group A(coronal reformation)and group B(non-coronal reformation).For group A,reconstructed coronal and oblique-coronal images were acquired.A comprehensive diagnosis was made based on coronal reformations and axial planes.Anatomical nomenclature was adopted,including kidney-ureter plane,abdominal aorta plane,superior mesenteric artery plane,ascending colon-appendix plane,stomach-cholecyst plane and colon-small intestine plane.For group B,the diagnosis was made based on axial planes.Finally,a comprehensive analysis was made,missed cases in these two groups were counted and compared,and statistical analysis was performed using the SPSS software(version SPSS V17).Results For group A,the missed diagnosis was made in 12 cases(1.23%)and it was 53 cases(6.58%)for group B.There was a statistically significant difference between two groups(P<0.05).Conclusion Combined with axial planes or oblique coronal reformations,six-sclice coronal reformation can reduce the the rate of missed diagnosis of acute midepigastric pain.

Objective:To investigate the clinical and pathological characteristics of ovarian cellular fibromas.Methods:The sample con-sisted of 24 cases of ovarian cellular fibromas from February 2008 to March 2017 in the Obstetrics and Gynecology Hospital of Fudan University.Clinical histories were retrieved,and pathological slides were reviewed.Results:The age of the patients ranged from 17 to 70 years old,with a mean age of 46.5 years.Clinical symptoms included ovarian masses,abdominal pain,or pleuroperitoneal fluid.Se-rum CA125 notably increased in two patients.Of the 24 cases,13 and 10 occurred in the right and left ovaries,respectively,and one case occurred bilaterally.Tumor cells were densely cellular in all cases and were mitotically active in three cases(5-7/10 high power fields).A minor component of sex cord elements(<10% area of the tumor)was present in three cases,and luteinized cells were ob-served in four cases.None of the cases manifested recurrence during follow-up ranging from 1 month to 109 months.Conclusion:Ovarian cellular fibromas are pure ovarian stromal tumors that may manifest mitotic activity, sex cord elements, and luteinization. Some patients present with pleuroperitoneal fluid and increased CA125.Thus,the pathological features of cellular fibromas must be mastered to avoid misdiagnosis for other benign or malignant tumors and improper treatment.

Objective To clarify the clinicopathological features of ovarian clear cell carcinoma derived from endometriotic cyst (EC-OCCC).Methods Totally 54 cases of EC-OCCC were recruited in the current retrospective study.The relation between ages, clinical symptoms and signs, surgical and pathological stages, serum CA125, findings of ultrasound, treatments and the sites of tumors, macro-and micro-features and expression of immunostainings were analyzed.Results (1) Clinical features: the ages of patients were (50±6) years old (range 31-62 years old).Pelvic mass was the major complaint of 50 patients (93％, 50/54).Forty-five cases belonged to International federation of Gynecology and Obstetrics (FIGO) stage Ⅰ, 4 cases were stage Ⅱ and another 5 cases were stage Ⅲ.Serum CA125 was elevated in 21 cases (54％, 21/39) before therapy.Doppler ultrasound showed 46 cases (85％, 46/54) had solid masses in pelvis.(2) Pathological findings: 52 cases (96％, 52/54) had their tumor unilaterally, and 2 cases (4％, 2/54) occurred bilaterally.The maximal diameters of endometriotic cyst (EC) ranged from 1.5 to 23.0 cm and maximal diameters of ovarian clear cell carcinoma (OCCC) components were from 0.5 to 12.0 cm.Fifty-one cases (94％, 51/54) had their tumor within EC, which showed focally irregular protrudings, grey-white papillae or solid nodules attached to the cyst wall.Three cases (6％, 3/54) appeared as irregular thickened wall of the cysts, ranged from 1.5 to 6.0 cm in the maximal length, with the microscopic features of EC and OCCC and the transitional areas between the 2 morphologies.All cases expressed cytokeratin (CK) 7 and pan-CK AE1/AE3, 17 cases (33％, 17/51) expressed ER and 5 cases (10％, 5/51) expressed PR.TP53 showed mutational phenotype in 19 cases (36％, 19/53).Sixteen cases (30％, 16/54) combined with uterine adenomyosis and 25 cases (46％, 25/54) with endometriosis at other sites.(3) Survival survey: during the period of 39.1 months follow-up, 3 cases relapsed and 2 cases died.(4) There was a significant difference of serum CA125 between patients of early-and advanced-stages (P=0.049).There were no differences identified in ages, diameters of EC and OCCC, the expression level of ER, PR and TP53, the co-existence of adenomyosis and endometrosis, as well as ultrasonic findings (P＞0.05).Conclusion EC-OCCC could be recognized in early stage by symptoms and ultrasound due to accompanied endometriotic cysts, resulting in relatively good prognosis.

OBJECTIVETo study the effect and mechanism of bevacizumab on proliferation and invasion of human lung cancer A549 cells.

METHODSA549 cells were treated with bevacizumab. Proliferation and invasion of the bevacizumab-treated A549 cells were detected using cell counting kit CCK-8 and Transwell assay, respectively. The expression of the mRNA and protein of MMP-2, MMP-9 and c-Met were detected by real-time PCR and Western blotting, respectively.

RESULTSProliferation activity was inhibited at the concentration of 10 µg/ml and promoted at the concentration of 100 µg/ml bevacizumab. Bevacizumab in the concentration of 50 µg/ml had a stronger inhibitory effect on the invasion of A549 cells (16 406.19 ± 5 674.23 penetrated cells) than that of control group (36 108.68 6 263.83, P<0.05). The real-time PCR showed that bevacizumab had a stronger inhibitory effect on the expression of MMP-2 and MMP-9 mRNA at the concentration of 50 µg/ml and on the expression c-Met mRNA at the concentration of 10 µg/ml bevacizumabin the A549 cells. However bevacizumab at the concentration of 100 µg/ml showed a promoting effect on the expression of MMP-2, MMP-9 and c-Met mRNA (1.82 ± 0.31, 1.60 ± 0.25, 2.63 ± 0.48), significantly higher than that of the control group (1.00 ± 0.19, 1.00 ± 0.23, 1.00 ± 0.22, P<0.05). The expression of MMP-2, MMP-9 and c-Met mRNA and protein was inhibited by 10 µg/ml bevacizumab in a time-dependent manner. The Western blot assay showed that bevacizumab had a bi-directional effect on the expression of MMP-2 and c-Met proteins in the A549 cells: a promoting effect at 100 µg/ml and inhibitory effect on the expression of MMP-2 at 50 µg/ml bevacizumab, and inhibitory effect on the expression of c-Met protein at 10 µg/ml bevacizumab.

CONCLUSIONSOur findings indicate that in a certain range of concentrations, bevacizumab has prominent inhibitory effect on the proliferation and invasion of A549 cells. However,over the concentration of 100 µg/ml, bevacizumab shows a weakening anti-invasion effect, even has a promoting effect on cell proliferation. This phenomenon may be related to the inhibiting effect on the expression of MMP-2 and c-Met proteins in a non-concentration-dependent manner by bevacizumab.

Angiogenesis Inhibitors ; pharmacology ; Bevacizumab ; pharmacology ; Blotting, Western ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; drug effects ; Enzyme Inhibitors ; pharmacology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Neoplasm Invasiveness ; Proto-Oncogene Proteins c-met ; metabolism ; RNA, Messenger ; metabolism ; Real-Time Polymerase Chain Reaction

Objective To study the effect and mechanism of bevacizumab on proliferation and invasion of human lung cancer A549 cells. Methods A549 cells were treated with bevacizumab. Proliferation and invasion of the bevacizumab?treated A549 cells were detected using cell counting kit CCK?8 and Transwell assay, respectively. The expression of the mRNA and protein of MMP?2, MMP?9 and c?Met Results Proliferation activity was inhibited at the concentration of 10 μg/ml and promoted at the concentration of 100 μg/ml bevacizumab. Bevacizumab in the concentration of 50 μg/ml had a stronger inhibitory effect on the invasion of A549 cells (16 406.19±5 674.23 penetrated cells ) than that of control group (36 108.68±6 263.83, P<0.05). The real?time PCR showed that bevacizumab had a stronger inhibitory effect on the expression of MMP?2 and MMP?9 mRNA at the concentration of 50 μg/ml and on the expression c?Met mRNA at the concentration of 10 μg/ml bevacizumabin the A549 cells. However bevacizumab at the concentration of 100μg/ml showed a promoting effect on the expression of MMP?2, MMP?9 and c?Met mRNA ( 1. 82 ± 0. 31, 1. 60 ± 0. 25, 2. 63 ± 0.48), significantly higher than that of the control group (1.00±0.19, 1.00±0.23, 1.00±0.22, P<0.05). The expression of MMP?2, MMP?9 and c?Met mRNA and protein was inhibited by 10μg/ml bevacizumab in a time?dependent manner. The Western blot assay showed that bevacizumab had a bi?directional effect on the expression of MMP?2 and c?Met proteins in the A549 cells:a promoting effect at 100 μg/ml and inhibitory effect on the expression of MMP?2 at 50μg/ml bevacizumab, and inhibitory effect on the expression of c?Met protein at 10 μg/ml bevacizumab. Conclusions Our findings indicate that in a certain range of concentrations, bevacizumab has prominent inhibitory effect on the proliferation and invasion of A549 cells. However,over the concentration of 100 μg/ml, bevacizumab shows a weakening anti?invasion effect, even has a promoting effect on cell proliferation. This phenomenon may be related to the inhibiting effect on the expression of MMP?2 and c?Met proteins in a non?concentration?dependent manner by bevacizumab.