Spontaneous abortion is one of the most common complications of pregnancy， and two or more spontaneous abortions in a row are defined as recurrent spontaneous abortion （RSA）， of which about half of patients have unknown etiology. However， the pathogenesis of unexplained RSA （URSA） has not been elucidated， and the lack of effective treatment has made it one of the key and difficult points in the field of obstetrics and gynecology. This article conducts a literature review of recent research on URSA and finds that the pathogenesis of URSA is related to the imbalance of immune tolerance at the maternal-fetal interface， apoptosis of trophoblast cells， inhibition of angiogenesis， and activation of immune responses. Immunotherapy （including cell therapy， cytokine therapy， and immunosuppressive intervention）， hormone drugs， anticoagulant regimens， and traditional Chinese medicine therapies are commonly used in clinical practice to intervene in URSA， but the safety and effectiveness of some therapies are still controversial.

Objective:To investigate the effects of low-dose radiation(LDR)combined with human telomerase reverse transcriptase C-terminal polypeptide 27(hTERTC27)overexpression on the proliferation and apoptosis of lung cancer A549 cells,and to observe the in vivo antitumor effects of LDR combined with C27.Methods:The pEgr-hTERTC27 plasmid was transfected into human non-small cell lung cancer(NSCLC)A549 cells and mouse Lewis lung carcinoma(LLC)cells.Cells stably expressing C27(A549-C27 and LLC-C27)were screened by G418 selection.The cells were divided into six groups:conventional radiation(CONV-RT)group(A549-Con),LDR group(A549-Low),C27 group(A549-C27),CONV-RT combined with C27 group(A549-C27-Con),LDR combined with C27 group(A549-C27-Low),and control group(A549-Mock).The irradiation dose in LDR group was only 36%of CONV-RT group.MTT assay was used to detect cell proliferation,and flow cytometry was used to measure cell apoptosis.LLC cell-transplanted tumor model in mice was established through subcutaneous implantation,and the animal experiment groups were similar with cell experiments.Tumor growth,volume,and mass were recorded in each group.Muscle infiltration near the transplanted tumors was observed using H-E staining.Results:Compared with A549-Mock group,the proliferative activity of A549-Con and A549-Low group was significantly decreased(all P<0.01).Furthermore,the proliferation activity of A549-C27-Con and A549-C27-Low cells was significantly lower than that of A549-C27 cells(all P<0.01).Compared with A549-Mock,the apoptosis rates were significantly higher in A549-Con and A549-Low groups(P<0.01);however,no significant difference in apoptosis rates were observed among A549-C27,A549-C27-Con and A549-C27-Low groups(all P>0.05).In tumor-bearing mice,both CONV-RT and LDR significantly reduced tumor mass compared with unirradiated mice(all P<0.01).In addition,the tumor mass and local infiltration were significantly reduced in both LLC-C27-Low and LLC-C27-Con groups.Conclusion:LDR combined with C27 achieves similar antitumor effects to CONV-RT alone while reducing the total radiation dose in NSCLC.Moreover,LDR and C27 peptide synergize in their anti-tumor effects,with their combination reducing local tumor infiltration in transplanted tumor models.

Objective: To explore how to select osteotomy line and its significance in mandibular distraction osteogenesis in infants and young children. Methods: From May 2013 to July 2018, 208 infants and young children with mandibular deformity were admitted to the Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children Medical Center, including 131 males and 77 females, with the age range of 8 days to 4 years, mean age of 6 months. Their clinical records were retrospectively analyzed. There were 162 cases of Robin sequence, 37 cases of the first and branchial arch anomalies, 2 cases of Treacher-Collins syndrome, and 7 cases of other congenital malformations. During the distraction osteogenesis, different osteotomy lines were selected according to the characteristics of the mandibular deformity: (1) For short mandibular body, the straight osteotomy line was used to extend the mandibular body. (2) For short mandibular ramus, a polygonal osteotomy line was used to extend the ramus. (3) For the increased mandibular angle, a curved osteotomy line was used to change the angulation. Results: Linear osteotomy was used in 38 patients, polygonal line osteotomy were used in 129 patients, and curved osteotomy was performed in 41 patients. Among them, 4 patients with linear osteotomy had deciduous embryo injury, 6 patients with linear osteotomy and 2 patients with polygonal osteotomy had open occlusion, and patients with curved osteotomy did not have tooth and mandible damage, or malocclusion. All patients were followed up for 3 months to 5 years. The average follow-up time was 6.2 months. All osteotomy healed well, without osteonecrosis or nonunion. Conclusions For the mandibular distraction osteogenesis, osteotomy line could be individualized, according to the characteristics of mandibular deformity of infants and young children, which can reduce complications such as dental damage and open occlusion.

Objective To detect the changes in vertebral marrow fat fraction (MFF) using T2 *-corrected water-fat MRI and to analyze the relationships between MFF with bone biomarkers of non-dialysis chronic kidney disease (CKD).Methods 78 CKD patients were divided into five groups according to the eGFR and underwent water/fat MRI to obtain MFF.The reliability of MFF measurements by two radiologists was assessed with intra-class correlation coefficient (ICC).Serum calcium,phosphorus,alkaline phosphatase,osteocalcin,intact parathyroid hormone and 25(OH)D3 were determined.Results Mean CV for MFF measurements reproducibility was 2.37％.The inter-observer agreement for MFF was excellent (ICC=0.901).The ICC for each intra-observer agreement was excellent (ICC=0.959 and 0.948,respectively).There were statistical differences in MFF among five groups of CKD.Changes of MFF were earlier than those of serum calcium,phosphorus,parathyroid hormone,alkaline phosphatase and osteocalcin.MFF was positively correlated with serum phosphorus (r =3.011,P =0.003),parathyroid hormone (r=3.852,P＜0.001),and negatively associated with calcium (r=-2.767,P=0.017),25(OH)D3 (r=6.032,P＜0.001),eGFR (r=-5.104,P＜0.001),respectively.Multivariable regression analysis showed MFF was negatively correlated with 25(OH)D3(Sβ=-0.343)and eGFR(S(S=-0.284,P＜0.001).Conclusion CKD patients had higher marrow fat.T2 *-corrected water fat MRI could serve as a useful tool to quantify marrow fat content for CKD patients.

OBJECTIVES: To explore the genetic variation sites of caveolin （CAV） and their correlation with sudden unexplained death （SUD）. METHODS: The blood samples were collected from SUD group （71 cases）, coronary artery disease （CAD） group （62 cases） and control group （60 cases）, respectively. The genome DNA were extracted and sequencing was performed directly by amplifying gene coding region and exon-intron splicing region of CAV1 and CAV3 using PCR. The type of heritable variation of CVA was confirmed and statistical analysis was performed. RESULTS: A total of 4 variation sites that maybe significative were identified in SUD group, and two were newfound which were CAV1： c.45C>T （T15T） and CAV1：c.512G>A （R171H）, and two were SNP loci which were CAV1：c.246C>T （rs35242077） and CAV3：c.99C>T （rs1008642） and had significant difference （P<0.05） in allele and genotype frequencies between SUD and control groups. Forementioned variation sites were not found in CAD group. CONCLUSIONS The variants of CAV1 and CAV3 may be correlated with a part of SUD group.
Caveolins/genetics* ; Coronary Artery Disease ; Death, Sudden/etiology* ; Exons ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide