Objective:To investigate the methods and skills required for the safe and swift removal of primary or secondary sacral tumors located between the second (inclusive) and fourth sacral vertebrae.Methods:The clinical images, pathology reports, surgical procedures, operation durations, intraoperative bleeding volumes, and postoperative functional follow-up data of 26 patients undergoing sacral tumor resection at the First Affiliated Hospital of Zhengzhou University and Xinjiang Production and Construction Corps Hospital between May 2020 and February 2025 were retrospectively examined. Additionally, the safety measures for sacral tumor resection and techniques for expedited specimen removal were evaluated.Results:According to magnetic resonance imaging (MRI) findings, all 26 patients presented with sacral tumors located between the second (inclusive) and fourth sacral vertebrae. Specifically, 9 patients were diagnosed with primary sacral tumors, pathologically confirmed as chordomas, while 17 patients had secondary sacral tumors. Among the secondary tumor cases, 12 were attributed to recurrent rectal cancer invading the sacrum, and 5 were due to malignant teratomas invading the sacrum. The 26 patients underwent a treatment strategy that began with managing the relationship between the internal iliac artery, vein branches, and the tumor, followed by the resection of the sacrum. During surgery, the bilateral sciatic foramina were accurately positioned, and the presacral fascia was dissected subsequent to the fracture of the sacrum. Among the 26 patients, 9 underwent sacral tumor resection directly through the posterior sacral approach. The average operation time for these patients was (71.1±4.9) minutes, with average blood loss of (186.7±72.8) milliliters. On the other hand, 17 patients underwent sacral tumor resection by transitioning from the supine position to the prone knife position through a combined abdominal and sacral approach. The average operation time for this group was (213.5±19.3) minutes, with average blood loss of (480.0±93.0) milliliters, significantly longer than that of the posterior sacral approach. The follow-up period ranged from 1 to 48 months, with a median of 20 months, ending on March 31, 2025. During this time, 26 patients achieved autonomous defecation with the aid of medication. None of the patients reported any functional movement disorders or pain in their lower limbs. It was observed that two out of the 26 patients developed distant metastasis, while the remaining 24 patients survived without any tumors.Conclusion:By pretreated the relationship between the internal iliac vessels and sacral tumors prior to resecting sacral tumors, utilizing the approach of initially fracturing the sacrum followed by rupturing the presacral fascia, the tumor can be entirely eliminated, resulting in a brief surgical procedure, reduced intraoperative bleeding, and minimal postoperative complications.

Objective:To investigate the methods and skills required for the safe and swift removal of primary or secondary sacral tumors located between the second (inclusive) and fourth sacral vertebrae.Methods:The clinical images, pathology reports, surgical procedures, operation durations, intraoperative bleeding volumes, and postoperative functional follow-up data of 26 patients undergoing sacral tumor resection at the First Affiliated Hospital of Zhengzhou University and Xinjiang Production and Construction Corps Hospital between May 2020 and February 2025 were retrospectively examined. Additionally, the safety measures for sacral tumor resection and techniques for expedited specimen removal were evaluated.Results:According to magnetic resonance imaging (MRI) findings, all 26 patients presented with sacral tumors located between the second (inclusive) and fourth sacral vertebrae. Specifically, 9 patients were diagnosed with primary sacral tumors, pathologically confirmed as chordomas, while 17 patients had secondary sacral tumors. Among the secondary tumor cases, 12 were attributed to recurrent rectal cancer invading the sacrum, and 5 were due to malignant teratomas invading the sacrum. The 26 patients underwent a treatment strategy that began with managing the relationship between the internal iliac artery, vein branches, and the tumor, followed by the resection of the sacrum. During surgery, the bilateral sciatic foramina were accurately positioned, and the presacral fascia was dissected subsequent to the fracture of the sacrum. Among the 26 patients, 9 underwent sacral tumor resection directly through the posterior sacral approach. The average operation time for these patients was (71.1±4.9) minutes, with average blood loss of (186.7±72.8) milliliters. On the other hand, 17 patients underwent sacral tumor resection by transitioning from the supine position to the prone knife position through a combined abdominal and sacral approach. The average operation time for this group was (213.5±19.3) minutes, with average blood loss of (480.0±93.0) milliliters, significantly longer than that of the posterior sacral approach. The follow-up period ranged from 1 to 48 months, with a median of 20 months, ending on March 31, 2025. During this time, 26 patients achieved autonomous defecation with the aid of medication. None of the patients reported any functional movement disorders or pain in their lower limbs. It was observed that two out of the 26 patients developed distant metastasis, while the remaining 24 patients survived without any tumors.Conclusion:By pretreated the relationship between the internal iliac vessels and sacral tumors prior to resecting sacral tumors, utilizing the approach of initially fracturing the sacrum followed by rupturing the presacral fascia, the tumor can be entirely eliminated, resulting in a brief surgical procedure, reduced intraoperative bleeding, and minimal postoperative complications.

Objective:To explore the expression of long non-coding RNA (lncRNA) CDK5RAP3 in gastric cancer tissue and its regulatory effect on gastric cancer cell proliferation and invasion.Methods:The expression differences of CDK5RAP3 in gastric cancer tissues and adjacent tissues were analyzed by TCGA database. By transfecting the pcDNA3.1-CDK5RAP3 plasmid into Hs-746T cells, a gastric cancer cell line overexpressing CDK5RAP3 (CDK5RAP3 group) was constructed, and the pcDNA3.1 plasmid was transfected into Hs-746T cells as a control group. The changes of CDK5RAP3 expression in the two groups of cells were detected by real-time quantitative PCR (qRT-PCR). The effects of overexpression of CDK5RAP3 on the proliferation and invasion of Hs-746T cells were detected by CCK-8 assay and Transwell assay, respectively. The binding sites of CDK5RAP3 and miR-223-3p were predicted by the starBase v2.0 database. The direct binding of CDK5RAP3 and miR-223-3p was verified by dual-luciferase reporter gene experiment. The expression levels of miR-223-3p in Hs-746T cells in each group were detected by qRT-PCR. Western blot was used to detect the expression levels of proliferation proteins and invasion proteins in Hs-746T cells in each group. The experimental data were analyzed by SPSS 17.0 software, and the measurement data conforming to the normal distribution were expressed as Mean±SD. The t-test was used to compare between two groups, and the one-way analysis of variance was used to compare the means of multiple groups. Results:Compared with adjacent tissues, the expression level of CDK5RAP3 in gastric cancer tissues was significantly lower ( P<0.01). The expressions of CDK5RAP3 in Hs-746T cells in the control group and CDK5RAP3 group were (1.08±0.77) and (10.63±2.14), respectively, and the difference was statistically significant ( P<0.01). Up-regulation of CDK5RAP3 significantly decreased the proliferation activity of Hs-746T cells ( P<0.05). The number of invasive cells in the control group and CDK5RAP3 group were (137.80±28.72) and (57.76±24.95), respectively, and the difference was statistically significant ( P<0.01). CDK5RAP3 could directly bind miR-223-3p ( P<0.01). The expression of miR-223-3p in Hs-746T cells in control group and CDK5RAP3 group were (6.22±1.20) and (1.01±0.98), respectively, and the difference was statistically significant ( P<0.01). Compared with the control group, up-regulation of CDK5RAP3 significantly reduced the expression levels of proliferation and invasive proteins. Conclusion:The expression of CDK5RAP3 is low in gastric cancer tissue, and CDK5RAP3 inhibits the proliferation and invasion of gastric cancer Hs-746T cells by targeting miR-223-3p.

Objective:To explore the influencing factors of the secondary sex ratio (SSR) of singleton babies born following assisted reproductive technology.Methods:A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2000 to December 2018 were collected in a retrospective cohort study. The effect of influencing factors, such as maternal age, fertilization method, embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results:Among 7020 babies, 3730 were boys and 3290 were girls. The total SSR was 113∶100. The SSR of in vitro fertilization (IVF) was significantly higher than that of intracytoplasmic sperm injection (ICSI) fertilization (121∶100 vs. 95∶100, P<0.001), while other factors had no significant effect on the SSR of infants born. In the stratified analysis, there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older ( P<0.05), while the SSR of IVF in the other groups was higher than that of ICSI (<35 years old group: P<0.001; fresh embryo group: P=0.001; frozen-thawed embryo group: P=0.003; cleavage embryo transfer group: P<0.001). Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR ( OR=0.792, 95% CI=0.712-0.881, P<0.001). After removing confounding factors, logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR (a OR=0.793, 95% CI=0.713-0.883, P<0.001). Conclusion:The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns. The SSR of IVF is significantly higher than that of ICSI and the difference was significant.

Objective:To explore the influencing factors of the secondary sex ratio (SSR) of singleton babies born following assisted reproductive technology.Methods:A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2000 to December 2018 were collected in a retrospective cohort study. The effect of influencing factors, such as maternal age, fertilization method, embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results:Among 7020 babies, 3730 were boys and 3290 were girls. The total SSR was 113∶100. The SSR of in vitro fertilization (IVF) was significantly higher than that of intracytoplasmic sperm injection (ICSI) fertilization (121∶100 vs. 95∶100, P<0.001), while other factors had no significant effect on the SSR of infants born. In the stratified analysis, there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older ( P<0.05), while the SSR of IVF in the other groups was higher than that of ICSI (<35 years old group: P<0.001; fresh embryo group: P=0.001; frozen-thawed embryo group: P=0.003; cleavage embryo transfer group: P<0.001). Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR ( OR=0.792, 95% CI=0.712-0.881, P<0.001). After removing confounding factors, logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR (a OR=0.793, 95% CI=0.713-0.883, P<0.001). Conclusion:The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns. The SSR of IVF is significantly higher than that of ICSI and the difference was significant.

Objective To explore the role of the visceral afferent nerve hyperesthesia and acid-sensing ion channel 1 (ASIC1) in rats with reflux esophagitis (RE).Methods Sixty male Sprague-Dawley rats were selected and animal model was established.Rats were divided into control group (n=20) and RE group (n=40).The esophageal mocosa biopsy were routinely performed in two groups.The esophageal specific DRG neurons were identified by 1,1'dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate tracing method and the whole-cell patch clamp assay was performed.The expression of ASIC1 in esophageal mucosa and thoracic spine cord three to five segments at protein level and mRNA level were detected by Western blotting and quantitative real time-polymerase chain reaction (qPCR).Two independent samples t test was performed for statistical analysis.Results The body weight of RE group was significantly lower than that of control group ((179.41±-16.38) g vs (290.75 ±-22.20) g),and the difference was statistically significant (t=17.090,P＜ 0.01).Esophageal basal cell hyperplasia,papillary elongation,vascular dialation and congestion,inflammatory cells infiltration were found in RE group rats.The results of whole-cell patchclamp showed depolarization of the resting potential of esophageal-specific DRG neurons of RE group was more significant than that of control group (-(46.20 ± 1.92) mV vs-(51.60 ± 1.52) mV),and the difference was statistically significant (t=4.930,P＜0.01).The threshold current of RE group was much lower than that of control group ((18.00±13.04) pAvs (80.00±12.25) pA),and the difference was statistically significant (t=7.750,P＜0.01).When stimulated with two to three times the threshold current,the frequency of action potential of RE group significantly increased (5.80 ±1.48 vs 3.00 ±1.58,10.60±2.30 vs 5.20±1.92),and the differences were statistically significant (t=2.890 and 4.030,both P＜0.01).The results of Western blotting indicated that the expression of ASIC1 in esophageal mucosa of RE group was significatly lower than that of control group (0.614±0.120 vs 0.976±0.283),and the difference was statistically significant (t =2.885,P＜ 0.05),while there was no statistically significant difference in the expression of ASIC1 in DRG between RE group and control group (0.804 ± 0.182 vs 1.032±0.316;t=1.528,P＞0.05).The results of qPCR showed that the expression of ASIC1 mRNA in esophageal mucosa of RE group was lower than that of control group (0.694 ± 0.118 vs 1.036 ±0.137),and the difference was statistically significant (t=4.642,P＜0.01).However there was no statistically significant difference in ASIC1 at mRNA level between RE group and control group (1.002± 0.074 vs 0.985±0.120;t=0.294,P＞0.05).Conclusion The sensitivity of esophageal visceral afferent nerve of rats in RE group increases and ASIC1 may negatively regulate the formation of esophageal visceral hypersensitivity.

Objective To observe the changes of expression levels of NMDA receptor NR2A and NR2B in anterior cingulate cortex (ACC) of chronic pancreatitis (CP) rats and explore its roles in the pathogenesis of pain in CP.Methods Male adult SD rats were randomly divided into CP group,control group and normal group using random number method.CP rat model was established by injecting 8mg/kg dibutyltin dichloride (DBTC) through tail vein.Control group was injected with a equal volume mixture of ethanol and glycerol via tail vein.After 4 weeks,yon Frey hair of different sizes (3.85,5.50,7.05,10.4,17.8 g) were used to stimulate the abdomen of the rats and the percentage of the positive pain response was recorded.Then the rats were sacrificed.The pancreas was collected for pathological examination.NR2A and NR2B subunit mRNA and protein expression in ACC was detected by realtime-PCR and Western Blotting,respectively.Results The success rate of CP model establishment was 60％.As Van Frey hair used to stimulate the rat abdomen increased from 3.85 g to 17.8 g,the percentage of positive pain response increased from (38.33 ±7.53)％ to(73.33±8.17)％ in CP group,from (7.80±6.70)％ to (34.44±5.27)％ in control group,from(6.57±5.48) ％ to(33.33 ± 5.00) ％ in normal group,which was increased with the increase of the stimulation intensity.For each stimulation intensity,the percentage of positive pain response in CP group was all obviously higher than those in control and normal group,and the differences were all statistically significant (all P ＜ 0.01),but there was no statistical difference between control group and normal group.The protein expression of NR2A of ACC in CP group,control group and normal group was 1.25 ± 0.78,0.95 ± 0.14 and 0.91 ± 0.09,respectively.The protein of NR2B in three groups were 1.44 ± 0.12,0.93 ± 0.08 and 0.94 ±0.04,respectively.NR2A and NR2B protein expressions in the CP group were both significantly higher than those in control group and normal group,and the difference was statistically significant (P＜0.01).The mRNA expression of NR2A in three groups were 1.43 ± 0.20,0.80 ± 0.10 and 1.01 ± 0.13,respectively.The mRNA expression of NR2B in three groups were 1.40 ± 0.09,0.98 ± 0.14 and 0.94 ± 0.05,respectively.The mRNA expressions of NR2A and NR2B in CP group were significantly higher than those in normal and control group,and the difference was statistically significant (P ＜0.01).Conclusions The expression of glutamate receptor NR2A and NR2B in ACC were upregulated in CP rats and may be involved in the development of the pain.

OBJECTIVE: To investigate the clinical efficacy of oral medicine and sodium hyaluronate in prevention of intrauterine adhesions after artificial abortion.
 METHODS: A total of 572 patients with early pregnancy termination through artificial abortion, who experienced two or more times of abortion, were retrospectively analyzed. Patients were randomly and voluntarily divided into 4 groups: an artificial cycle group, a drospirenone and ethinylestradiol tablets group, a sodium hyaluronate group, and a control group. The thickness of the endometrium, return time of menses, and the status of intrauterine adhesions were observed.
 RESULTS: The thickness of the endometrium in the artificial period group was greater than that in the control group (P<0.001). It was less in the drospirenone and ethinylestradiol tablets group comparing with that in the control group (P<0.001). There was no significant difference in the thickness of the endometrium between the sodium hyaluronate group and the control group (P=0.717). Return time of menses in the artificial menstrual cycle group and the drospirenone and ethinylestradiol tablets group was shorter than that in the control group (P<0.001). There was no significant difference in return time of menses between the sodium hyaluronate group and the control group (P=0.813). The incidence of intrauterine adhesions could be reduced by the 3 preventive measures (All P<0.01).
 CONCLUSION Drugs for artificial cycle and drospirenone and ethinylestradiol tablets medication immediately after artificial abortion can effectively promote endometrial repair and reduce the incidence of intrauterine adhesions. However, for the patients with poor compliance, drospirenoneand ethinylestradiol tablets are the first choice for prevention of intrauterine adhesion.
Abortion, Induced ; adverse effects ; Androstenes ; pharmacology ; therapeutic use ; Endometrium ; anatomy & histology ; drug effects ; Ethinyl Estradiol ; pharmacology ; therapeutic use ; Female ; Humans ; Hyaluronic Acid ; pharmacology ; therapeutic use ; Menstrual Cycle ; drug effects ; Menstruation ; drug effects ; Pregnancy ; Tissue Adhesions ; etiology ; prevention & control

OBJECTIVE: To investigate the risky factors for pelvic floor functional disorder.
 METHODS: A total of 346 patients, who undergone surgery for pelvic floor reconstruction from January 2007 to December 2013 in the Third Affiliated Hospital of Zhengzhou University, were enrolled for this study and served as an experimental group. Meanwhile, 349 female healthy subjects were selected as a control group. The data including the times of gestation and parity, history of menopause, hysterectomy surgery, uterine fibroid and leucorrhea were recorded.
 RESULTS: Compared with the controls, the numbers of people with hysterectomy, menopause and clean vagina≥III degree, lack of lactobacillus as well as the times of gestation and parity in the experimental group were significantly increased (P<0.05). The history of hysterectomy, the times of gestation and parity and lack of lactobacillus in vagina were the independent risk factors of pelvic floor dysfunction.
 CONCLUSION The history of hysterectomy, the times of gestation and parity, and clean vagina may involve in the occurrence and development of pelvic floor functional disorder, and the existence of lactobacillus in the vagina might be a protective factor.
Case-Control Studies ; Female ; Humans ; Hysterectomy ; Lactobacillus ; isolation & purification ; Menopause ; Multivariate Analysis ; Parity ; Pelvic Floor ; physiopathology ; Pelvic Floor Disorders ; physiopathology ; Pregnancy ; Risk Factors ; Vagina ; microbiology

Objective To investigate the effect of leg cycle ergometer on walking ability of stroke patients with hemiplegia at convalescent period.Methods Seventy patients with hemiplegia after stroke for 3 to 6 months with a certain walking capability were randomly divided into the treatment group and control group with 35 cases in each group.The control group was treated with routine rehabilitation training;the treatment group was added with leg cycle ergometer training.All patients in the two groups were assessed with simplified Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS),ambulation capacity(walking time in 10 meters and walking distance in 6 minutes and Holden's functional ambulance classification),changes of spasticity,and the ability of daily living(ADL)at the time of begin and 6 weeks later.Results The motor function of lower extremity,balance performance,walking capability and ADL of the patients in two groups improved(P<0.05)after 6 weeks' treatment,but the therapeutic effect of the treatment group was better than the control group(P<0.05).Conclusion The application of leg cycle ergometer combined with routine rehabilitation training can distinctly improve the motor function of lower extremity,balance performance,walking ability and ADL for patients after stroke.