Objective:To identify the risk factors that predict pathological upstaging of low-grade intraepithelial neoplasia (LGIN) or low-grade dysplasia (LGD) in forceps biopsy after endoscopic resection.Methods:A systematic search of Web of Science, Embase, PubMed and Cochrane Library was conducted using the terms "Risk Factor" "Low-Grade Dysplasia or Low-Grade Intraepithelial Neoplasia" "gastric or stomach" with a deadline of October 2022. Observational studies related to risk factors for biopsy pathology diagnosis of gastric LGIN or LGD lesions with pathology escalation after endoscopic resection were included. Meta-analysis was performed using random-effects models to calculate pooled odds ratio ( OR). Results:Fifteen studies were identified on pathologic upstaging associated with 5 different risk factors: erythema, lesion diameter, depressed lesions, nodularity, and lesion location. Factors that significantly increase the risk of upgrading the pathological diagnosis after endoscopic resection included erythema ( P<0.01, OR=2.87, 95% CI: 1.94-4.25), lesion diameter ( P<0.01, OR=2.50, 95% CI: 1.85-3.37), depressed morphology ( P=0.02, OR=1.70, 95% CI: 1.09-2.64), and nodularity ( P<0.01, OR=2.95, 95% CI: 1.81-4.81). The risk of pathologic diagnostic escalation after endoscopic resection was similar for lesions in the upper 1/3 of the stomach compared to lesions in the lower 1/3 of the stomach ( P=0.86, OR=1.03, 95% CI: 0.72-1.47), whereas the risk of pathologic diagnostic escalation for lesions in the middle 1/3 of the stomach was even lower ( P<0.01, OR=0.75, 95% CI: 0.60-0.93). Conclusion:Several endoscopic factors, including lesion diameter, location and surface morphology, are associated with the pathologic upstaging of LGIN/LGD on pre-treatment forceps biopsy. Clinical attention should be paid to the risk of pathological diagnosis upgrading after endoscopic resection of large lesions, including redness, depression, and nodular surface lesions in the lower 1/3 of the stomach.

Objective:To identify the risk factors that predict pathological upstaging of low-grade intraepithelial neoplasia (LGIN) or low-grade dysplasia (LGD) in forceps biopsy after endoscopic resection.Methods:A systematic search of Web of Science, Embase, PubMed and Cochrane Library was conducted using the terms "Risk Factor" "Low-Grade Dysplasia or Low-Grade Intraepithelial Neoplasia" "gastric or stomach" with a deadline of October 2022. Observational studies related to risk factors for biopsy pathology diagnosis of gastric LGIN or LGD lesions with pathology escalation after endoscopic resection were included. Meta-analysis was performed using random-effects models to calculate pooled odds ratio ( OR). Results:Fifteen studies were identified on pathologic upstaging associated with 5 different risk factors: erythema, lesion diameter, depressed lesions, nodularity, and lesion location. Factors that significantly increase the risk of upgrading the pathological diagnosis after endoscopic resection included erythema ( P<0.01, OR=2.87, 95% CI: 1.94-4.25), lesion diameter ( P<0.01, OR=2.50, 95% CI: 1.85-3.37), depressed morphology ( P=0.02, OR=1.70, 95% CI: 1.09-2.64), and nodularity ( P<0.01, OR=2.95, 95% CI: 1.81-4.81). The risk of pathologic diagnostic escalation after endoscopic resection was similar for lesions in the upper 1/3 of the stomach compared to lesions in the lower 1/3 of the stomach ( P=0.86, OR=1.03, 95% CI: 0.72-1.47), whereas the risk of pathologic diagnostic escalation for lesions in the middle 1/3 of the stomach was even lower ( P<0.01, OR=0.75, 95% CI: 0.60-0.93). Conclusion:Several endoscopic factors, including lesion diameter, location and surface morphology, are associated with the pathologic upstaging of LGIN/LGD on pre-treatment forceps biopsy. Clinical attention should be paid to the risk of pathological diagnosis upgrading after endoscopic resection of large lesions, including redness, depression, and nodular surface lesions in the lower 1/3 of the stomach.

Objective:To assess the diagnostic performance of 68Ga-PSMA PET/CT and mpMRI in initial staging of prostate cancer. Methods:A retrospective analysis was conducted on patients with initial diagnosis of prostate cancer who underwent prostatectomy at Fudan University Shanghai Cancer Center from December 2021 to June 2023. All had biopsy-confirmed prostate cancer preoperatively and had not undergone any anti-tumor treatment. Prior to surgery, all patients underwent 68Ga-PSMA PET/CT and mpMRI scans. The surgical samples were processed by whole-mount slides pathology. Thirty patients were included, with a median age of 68 years (range 67-76 years). The preoperative median PSA level was 17.91 ng/ml (range 9.41-39.53 ng/ml). The median interval between the two examinations was 21.00 days (range 2.75-35.50 days). Based on the postoperative whole-mount slides pathology which was the gold standard, we compared the sensitivity and specificity of 68Ga-PSMA PET/CT and mpMRI in diagnosing extraprostatic extension, seminal vesicle invasion, and intraprostatic tumor lesion. Results:According to the postoperative pathology, among the 30 patients, 12 had extraprostatic extension (EPE), 8 had seminal vesicle invasion (SVI). Among the 50 lesions found before surgery, postoperative pathology showed that 38 of them were clinically significant prostate cancer lesions (76.0%, 38/50). Using whole-mount pathology, preoperative mpMRI, and 68Ga-PSMA PET/CT imaging for triple fusion comparison, the sensitivity and specificity of 68Ga-PSMA PET/CT in diagnosing EPE were 66.7% (8/12) and 88.9% (16/18), respectively. The sensitivity and specificity of mpMRI in diagnosing EPE were 50.0% (6/12) and 83.3% (15/18), respectively. In diagnosing SVI, the sensitivity and specificity of 68Ga-PSMA PET/CT were 50.0% (4/8) and 86.3% (19/22), respectively. The sensitivity and specificity of mpMRI were 75.0% (6/8) and 90.9% (20/22), respectively. When diagnosing clinically significant tumor lesions within the prostate, the sensitivity of 68Ga-PSMA PET/CT was 89.5% (34/38), which was significantly better than the mpMRI of 63.2% (24/38), with no significant difference in specificity. Conclusions:The sensitivity of 68Ga-PSMA PET/CT in diagnosing intraprostatic lesions was significantly higher than that of mpMRI, with no significant difference in specificity.

Objective:To investigate the method of determining oral implantation sites based on an anatomical model of mandibular premolar area of a Beagle dog.Methods:This study was performed in the Second Affiliated Hospital of Zhejiang Chinese Medical University between January 2019 and October 2020. Mandibular anatomical structure and measurement data were compared between before and after removal of premolar teeth to determine safe implantation areas and oral implantation sites.Results:Among all mandibular premolars, the roots of the 1 st to 4 th premolars (P1-P4) gradually increased. The diameter of the mesial roots of the double root teeth P2, P3, and P4 was (2.72 ± 0.45) mm, (3.22 ± 0.32) mm, (4.16 ± 0.34) mm, respectively, which was significantly shorter than those in the distal roots [P2: (2.98 ± 0.29) mm, P3: (3.48 ± 0.27) mm, P4: (4.58 ± 0.22) mm]. The length of distal roots P2, P3 and P4 was (8.79 ± 0.41) mm, (9.21 ± 0.31) mm, (10.12 ± 0.36) mm), respectively, which was significantly shorter than that of mesial root [P2: (8.91 ± 0.69) mm, P3: (9.48 ± 0.27) mm, P4: (11.58 ± 0.24) mm]. Among all mandibles, the distance (H) from the mental foramen to the first molar and the width (W) of the alveolar crest increased successively [H1: (7.24 ± 0.49) mm, H2: (8.28 ± 0.71) mm, H3: (9.52 ± 0.37) mm, W1: (5.71 ± 0.81) mm, W2: (5.82 ± 0.28) mm, W3: (6.72 ± 0.54) mm]. Conclusion:The mental foramen and the distal part outside the canine apical area are safe implantation areas. In the safe implantation area, the length and diameter of the implant prosthesis do not exceed the root length in the implantation area and the maximum diameter in the buccal lingual direction.

OBJECTIVE:To provide reference indexs for the quality evaluation of Glycyrrhetinic acid lipo-emul. METHODS:Croy-TEM was used to detect the morphology of Glycyrrhetinic acid lipo-emul,laser nano-particle size analyzer was used to deter-mine the particle size,polydispersity index(PDI)and the zeta potential;UPLC was used to determine the drug loading of its ac-tive ingredient glycyrrhetinic acid;placing 10 d in 30 ℃,then stability was detected. RESULTS:Prepared Glycyrrhetinic acid li-po-emul was clear outline,structural integrity,roundlike and arranged closely;the mean particle size was(245.2±4.29)nm,PDI was (0.054 ± 0.01) and the mean zeta potential was (-6.25 ± 0.54) mV;the average drug loading of glycyrrhetinic acid was (1.25±0.09)mg/mL;the sample with mass concentration of 0.82 mg/mL showed good stability in within 10 d. CONCLUSIONS:Particle size,zeta potential,drug loading and stability can be used as the evaluation index of Glycyrrhetinic acid lipo-emul.

OBJECTIVE:To study the effect of hydrophilic/hydrophobic nano-silica with different adding amount on the stabili-ty of lipo-emulsion. METHODS:Glycyrrhetinic acid lipo-emulsion 4 mL was taken,respectively adding into 0.5%,1.0%,1.5%(m/m,the same below) hydrophilic nSiO2,and 0.4%,0.75,1.0% hydrophobic nSiO2,incubating 2 h in 30 ℃ water;the same batch of Glycyrrhetinic acid lipo-emulsion was treated as blank control. The forms were observed under electron microscopy after treatment,absorbance value was determined,the stability parameter (KE) was calculated according to the absorbance value,then the adding amount of nSiO2 was optimized,3 batches of preparations was prepared,and the verification test was conducted. RE-SULTS:The spherical structure was Glycyrrhetinic acid lipo-emulsion in the electron microscopy,the substance wrapping its sur-face white ring (fully wrapped) or semi-circular structure (not fully wrapped) was nSiO2. KE of hydrophilic nSiO2 were 4.66%, 5.01% and -2.08%,and KE of hydrophobic nSiO2 were 3.02%,4.51% and 7.24%. The optimized adding amount of hydrophilic nSiO2 was 0.2%,0.3% and 0.4%,hydrophobic nSiO2 was 0.1%,0.2% and 0.3%;KE were 6.19%,3.05%,7.84%,8.42%, 2.41%,2.93%,respectively. The optimal adding amount was 0.3% hydrophilic nSiO2 and 0.2% hydrophobic nSiO2;the 3 batches of preparation showed the optimum stability in its own adding amount. CONCLUSIONS:Both hydrophilic and hydrophobic nSiO2 can improve the stability of Glycyrrhetinic acid lipo-emulsion,and preferably 0.3%,0.2%.

OBJECTIVETo investigate the distribution and proportion of subtypes of pol gene in HIV-1 epidemic strains in Guangxi Autonomous Region.

METHODS152 HIV-1 patients were enrolled from 11 cities in Guangxi Autonomous Region from 2010 to 2012 by convenient sampling. Inclusion criterias were listed as the fdlowing: HIV-1 infection was confirmed by Western blot, HIV-1 viral load >1 000 copies/ml, > 18 year-old, and without any serious illnesses. 5 ml of peripheral blood samples were obtained from each patient. The viral RNA was isolated from plasma and used for amplification of full-length pol gene by nested RT-PCR. The amplified products were sequenced. After editing and modification, all sequences were characterized for preliminary subtyping by genotyping and confirmed with phylogenetic tree constructed by MEGA 5.03 software. The recombinant identification of 2 unknown recombinant strains was determined by RIP and jpHMM at GOBICS.

RESULTSAmong 152 patients, 137 full-length pol genes were successfully amplified and 127 HIV-1 subtypes were identified. The distribution and proportion of subtypes was summarized as the following 71 cases of CRF01_AE, accounting for 55.9% (71/127), 38 CRF08_BC, 29.9% (38/127), 13 CRF07_BC, 10.2% (13/127), and 3 B (B'), 2.4% (3/127), 2 unknown recombinant strains, 1.6% (2/127). In 11 cites of Guangxi Autonomous Region, subtype CRF01_AE was the dominant strain. Among heterosexual transmitted patients and drug abusers, the proportions of subtype CRF01_AE were 67.4% (58/86) and 34.1% (14/41), respectively. There was a significance different in the distribution of CRF01_AE in different routes of transmission (χ(2)=15.07, P<0.001). In age 21- 35, age 36- 60 and age>60 groups, the proportions of CRF01_AE was 43.6% (17/39), 57.6% (38/66), 77.3% (17/22), and CRF08_BC was 43.6% (17/39), 28.8% (19/66), 9.1% (2/22), respectively, the difference in proportions was significant(χ(2)=8.48, P= 0.014). The patterns of two unknown recombinant strains were found to be CRF01_AE/B (B') and CRF01_AE/C/B(B'), respectively.

CONCLUSIONCRF01_AE was the dominant HIV-1 subtype in Guangxi Autonomous Region from 2010 to 2012, with heterosexual transmission as its main spreading route. The two unknown recombinant strains in Guangxi Autonomous Region were reconstructed by subtype CRF01_AE and CRF_BC.

Blotting, Western ; China ; epidemiology ; Cities ; Drug Users ; Genes, pol ; Genotype ; HIV Infections ; epidemiology ; transmission ; virology ; HIV-1 ; genetics ; Humans ; Phylogeny ; Polymerase Chain Reaction ; RNA, Viral ; blood ; pol Gene Products, Human Immunodeficiency Virus ; genetics

Objective To study the phylogenetic evolution and genetic variations of gag gene among the prevalent human immunodeficiency virus (HIV )‐1 strains in Guangxi Zhuang Autonomous Region . Methods Plasma samples of 158 HIV‐1 infected patients in Guangxi area were collected during October 2011 to March 2012 .The gag gene fragments of HIV‐1 were amplified by reverse transcription/nested‐polymerase chain reaction and then sequenced .MEGA 5 .03 was utilized to construct phylogenetic tree and to calculate the genetic distances and selection pressures (globle ω) of gag gene and its coding regions . The comparisons between two groups were tested by Student′s t test ,and the comparisons of multiple groups were tested by one‐way ANOVA .Results A total of 140 amplification products of gag gene were obtained from 158 samples .Four subtypes of HIV‐1 were found ,including CRF01_AE (80 ,57 .1% ) , CRF08_BC (46 ,32 .9% ) ,CRF07_BC (10 ,7 .1% ) ,and subtype B (B′) (4 ,2 .9% ) .The genetic distances of gag gene of the above subtypes were 0 .036 ± 0 .001 ,0 .031 ± 0 .002 ,0 .043 ± 0 .003 and 0 .102 ± 0 .006 ,respectively ,with statistical significance (F=220 .62 ,P<0 .01) .The p17 and p24 coding regions suffered negative selection pressure (globleω<1) .Neither the globle ω in p17 region nor that in p24 region had significant differences among different subtypes (F=0 .761 ,P=0 .469 and F=0 .037 ,P=0 .964 , respectively ) . Conclusion CRF01_AE is the major subtypes of HIV‐1 in Guangxi Zhuang Autonomous Region .The coding regions of gag gene are relatively conserved during evolution .Changes of HIV‐1 prevalence ,however ,may affect the genetic variation of gag gene ,which should be continuously monitored .

Objective To investigate the HIV-1 drug resistance in Guangxi during 2009 to 2012 and to analyze the correlations between drug resistance and HIV-1 subtypes.Methods Patients with human immunodeficiency virus infection or acquired immune deficiency syndrome ( HIV/AIDS) were randomly re-cruited from different areas in Guangxi.HIV-1 RNA was extracted from blood samples of the subjects and converted into complementary DNA ( cDNA) by using reverse transcription.The pol gene was amplified and sequenced.Subtyping analysis was performed by using the online analysis tool of Genotyping in combination with the MEGA 5.03 software.The HIV resistance mutations were determined and scored with the use of Stanford HIV Drug Resistance Database.Results A total of 196 pol gene sequences were obtained from 103 antiretroviral therapy (ART)-treated subjects (52.55%) and 93 ART-na?ve subjects (47.45%).The 196 pol gene sequences were classified into four subtypes including CRF01_AE, CRF08_BC, CRF07_BC and B, accounting for 48.47%, 44.90%, 6.12%and 0.51%, respectively.The HIV drug resistance rates in sub-jects with and without ART were 10.68% and 7.53%, respectively.Among the 196 subjects, 14 cases showed low level of drug resistance, 3 cases showed moderate level of drug resistance and 4 cases showed high level of resistance.Only one case was resistant to both nucleoside reverse transcriptase inhibitors ( NR-TIs) and non-nucleoside reverse transcriptase inhibitors ( NNRTIs) .The resistance rates of the 196 cases to protease inhibitor (PIs), NRTIs, NNRTIs, and integrase inhibitors (INs) were 6.63%, 3.06%, 11.22%and 8.67%, respectively.The frequencies of PIs-related mutations in subtypes CRF01_AE, CRF07_BC and CRF08_BC were 6.32%, 41.67% and 2.27%, respectively.Most of the PI-related A71V/T mutations were identified in strains belonging to subtype CRF07_BC, accounting for 75% of all A71V/T mutations found in the 196 strains.The NNRTI-related E138A mutations only appeared in strains belonging to subtype CRF08_BC.Conclusion The drug resistance rate among patients with HIV-1/AIDS in Guangxi was higher than the average level in China.The drug resistance rates varied with the subtypes of HIV-1 strains.

Objective To investigate the effects of alcohol on hepatitis C virus( HCV) replication and type I interferon signaling pathway in human hepatocytes .Methods Primary hepatocytes were treated with different concentrations of alcohol , and then infected with HCV .The infected cells were collected to measure the level of HCV RNA .The alcohol-treated hepatocytes were also collected to detect the expression of HCV Core, IFN-α, IFN-β, IRF-7, suppressor of cytokine signaling SOCS-2 and SOCS-3 at mRNA and protein levels by real-time quantitative PCR and ELISA or Western blot , respectively .Results Alcohol treatment enhanced HCV infection and replication in primary hepatocytes at concentrations higher than 10 mmol/L in a dose-dependent manner (P<0.05).Treatment with 40 mmol/L of alcohol significantly reduced the expression of IFN-α, IFN-βand IRF-7 at mRNA and protein levels , and increased the expression of SOCS-2 and SOCS-3 at mRNA and protein levels .Conclusion Alcohol treatment could damage the host in-nate immunity in human hepatocytes and promote HCV replication by reducing the expression of type Ⅰinter-feron ( IFN-αand IFN-β) and IRF-7 and increasing the expression of negative regulators including SOCS-2 and SOCS-3.These results demonstrated that the impairment of innate immunity in liver of alcohol abusers might contribute to the enhancement of HCV infection and result in poor therapeutic effect of IFN -α.