Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889-0.948), 0.923 (0.855-0.990), 0.918 (0.872-0.963), and 0.887 (0.813-0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889-0.955) in the combined validation cohort; 0.955 (0.912-0.997) in VC1; 0.939 (0.901-0.977) in VC2; 0.917 (0.824-1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.
Humans ; Female ; Blood Platelets/pathology* ; Biomarkers, Tumor/genetics* ; Ovarian Neoplasms/pathology* ; China

Humans ; Lipoma/pathology* ; Immunohistochemistry

As total mesorectal excision (TME) for rectal cancer is widely carried out in China, lateral ligament of rectum, as an important anatomical structure of the lateral rectum with certain anatomical value and clinical significance, has been the focus of attention. In this paper, by comparing and analyzing the characteristics about ligaments of the abdomen and pelvis, reviewing the membrane anatomy and the theory of primitive gut rotation, and combining clinical observations and histological studies, the author came to a conclusion that lateral ligament of rectum does not exist, but is only a relatively dense space on the rectal side accompanied by numerous tiny nerve plexuses and small blood vessels penetrating through it.
Humans ; Rectum/anatomy & histology* ; Pelvis/anatomy & histology* ; Rectal Neoplasms/surgery* ; Peritoneum ; Collateral Ligaments ; Cognition

Objective: To evaluate the effects of polycyclic aromatic hydrocarbons (PAHs) and high risk human papillomavirus (HR-HPV) infection and their interaction on the progression of cervical intraepithelial neoplasia. Methods: A total of 486 patients, including 208 women with normal cervix (NC), 154 patients with low-grade cervical intraepithelial neoplasm (CINⅠ), 124 patients with high-grade cervical intraepithelial neoplasm (CINⅡ/Ⅲ), were selected from the cervical lesions cohort from June to December, 2014. HR-HPV was detected by using flow-through hybridization technology and the urine concentration of 1-hydroxypyrene (1-OHP) was detected with high performance liquid chromatography. By using software SPSS 22.0, the χ(2) test, trend χ(2) test, Kruskal-Wallis H test, Nemenyi rank test and Spearman rank correlation analysis were performed. And the interaction effects were evaluated by additive model. Results: The HR-HPV infection rates in NC, CINⅠ and CINⅡ/Ⅲ groups were 27.9%, 37.0% and 58.9%, respectively. The urine concentrations of 1-OHP (μmol/molCr) were 0.07±0.09, 0.11±0.10 and 0.17±0.15, respectively. With increasing severity of the cervical lesions, the HR-HPV infection rate gradually increased (trend χ(2)=29.89, P<0.001) and the high exposure rate of PAHs gradually increased (trend χ(2)=27.94, P<0.001). HR-HPV infection was positively correlated with 1-OHP exposure (r=0.680, P<0.001). There was a positive additive interaction between HPV infection and PAHs exposure in CIN Ⅱ/Ⅲ group, but it was not found in CIN Ⅰ group. Conclusion: Both HR-HPV infection and high exposure of PAHs might increase the risk of cervical intraepithelial neoplasm, and might have a synergistic effect on the progression of high-grade cervical intraepithelial neoplasia.
Case-Control Studies ; Cohort Studies ; Disease Progression ; Female ; Humans ; Papillomaviridae/isolation & purification* ; Papillomavirus Infections/virology* ; Polycyclic Aromatic Hydrocarbons/pharmacology* ; Pyrenes/urine* ; Severity of Illness Index ; Uterine Cervical Dysplasia/virology* ; Uterine Cervical Neoplasms/virology*

Objective: To explore the relationship between abnormal expression of fragile histidine triad (FHIT) gene and methyl-CpG-binding protein 2 (MeCP2) as well as their interaction on cervical cancerization. Methods: A total of 73 patients with cervical squamous cell carcinoma (SCC), 113 patients with cervical intraepithelial neoplasia (CIN Ⅰ, n=45; CINⅡ/Ⅲ, n=68) and 60 women with normal cervix (NC) were included in the study. Real time PCR and Western blot were performed to detect the expression levels of mRNA and protein about FHIT and MeCP2, respectively. The methylation status of FHIT gene CpG island was tested by methylation-specifc PCR (MSP). Kruskal-Wallis H test, χ(2) test, trend χ(2) test and Spearman correlation analysis were conducted with software SPSS 20.0. The interaction was evaluated by generalized multifactor dimensionality reduction (GMDR) model. Results: With the deterioration of cervical lesion, the methylation rates of FHIT gene CpG island (χ(2)=18.64, P<0.001; trend χ(2)=18.08, P<0.001) increased gradually, while the expression levels of FHIT mRNA (H=27.32, P<0.001; trend χ(2)=12.65, P<0.001) and protein (H=47.10, P<0.001; trend χ(2)=29.79, P<0.001) decreased gradually. There was a negative correlation between the methylation rates of FHIT gene CpG island and the expression level of FHIT protein (r=-0.226, P<0.001). The levels of MeCP2 mRNA (H=26.19, P<0.001; trend χ(2)=11.81, P=0.001) and protein (H=69.02, P<0.001; trend χ(2)=47.44, P<0.001) increased gradually with the aggravation of cervical lesions. There was a positive correlation between the expression level of MeCP2 protein and the FHIT mRNA Ct ratio (r=0.254, P<0.001). Expression of proteins were negatively correlated between MeCP2 and FHIT (r=-0.213, P=0.001). The results analyzed by GMDR model showed that there were interactions among high MeCP2 protein expression, the CpG island methylation of FHIT and mRNA and protein expression in CINⅡ/Ⅲ group, and among high MeCP2 mRNA and protein expression, the CpG island methylation of FHIT and low mRNA and protein expression in SCC group. Conclusion: High expression of MeCP2 mRNA and protein, the CpG island methylation and low mRNA and protein expression of FHIT could increase the risk of cervical carcinogenesis, and there might be a synergistic effect on cervical carcinogenesis.
Acid Anhydride Hydrolases/metabolism* ; Carcinoma, Squamous Cell/pathology* ; DNA Methylation ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Methyl-CpG-Binding Protein 2/metabolism* ; Neoplasm Proteins/metabolism* ; Polymerase Chain Reaction/methods* ; RNA, Messenger ; Uterine Cervical Neoplasms/pathology* ; Uterine Cervical Dysplasia/pathology*

Objective: To explore the relationship between male sexual function and daily exposure to bisphenol A (BPA) at a reproductive center in Taiyuan. Methods: Male patients who were seeking treatment of infertility due to problems caused by either of the spouse were selected from the Shanxi reproductive center between September 2014 and April 2015. Information on general characteristics, sexual function and fasting venous blood samples were collected. Total scores of sexual function were evaluated by Delphi expert scoring method. Levels of serum BPA were measured by high-performance liquid chromatography. Data was analyzed by Spearman rank correlation, rank sum test, multivariate logistic regression analysis and χ(2) trend test. Relationship between BPA and sexual function was presented as OR and corresponding 95%CI. Results: Among the 353 participants, 45.0% was defined as sexual dysfunction with low sexual desire (47.3%) as the major reason. BPA was detected in all the 353 patients, with a range of concentration as 0.38-21.93 ng/ml and an average as 5.79 ng/ml. Results from the Spearman rank correlation analysis revealed significant negative correlations between serum BPA and sexual function, sexual desire, erectile ability and ejaculation intensity, while serum BPA was positively correlated with premature ejaculation. According to the four percentile of BPA concentration (ng/ml), the subjects were divided into four groups. Compared with the low concentration group (0.38-3.79 ng/ml), the risk of sexual dysfunction significantly increased in the groups with higher BPA levels. Particularly, in the highest BPA group (8.68-21.93 ng/ml), more obvious effects were seen on sexual dysfunction (OR=1.55, 95%CI:1.00-3.23), reduced sexual desire (OR=4.75, 95%CI: 2.44-9.22), reduced erection ability (OR=2.40, 95%CI: 1.18-4.88), reduced ejaculation intensity (OR=2.53, 95%CI: 1.25-5.16) and premature ejaculation (OR=1.95, 95%CI: 1.02-3.72). Conclusion: Low sexual desire appeared as the main type of male sexual dysfunction, the exposure to higher levels of BPA in daily life might lead to male sexual dysfunction.
Benzhydryl Compounds/toxicity* ; Ejaculation/drug effects* ; Environmental Exposure/adverse effects* ; Erectile Dysfunction/chemically induced* ; Humans ; Male ; Occupational Exposure/adverse effects* ; Phenols/toxicity*

Objective: To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017. Methods: From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI. Results: We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415(52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ(2)=9.227, P=0.010), wheezing (χ(2)=7.273, P=0.026) and vomiting (χ(2)=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95%CI: 630.1-746.7) for influenza-negative children; 768.0 Yuan (95%CI: 686.8-849.3) for influenza-positive children and 738.3 Yuan (95%CI: 655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ(2)=7.237, P=0.028). Conclusion: Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.
Ambulatory Care/statistics & numerical data* ; Child ; Child, Preschool ; China/epidemiology* ; Cost of Illness ; Cough/virology* ; Female ; Fever/virology* ; Humans ; Infant ; Infant, Newborn ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Influenza, Human/epidemiology* ; Outpatient Clinics, Hospital/statistics & numerical data* ; Outpatients/statistics & numerical data* ; Prospective Studies ; Socioeconomic Factors ; Surveys and Questionnaires ; Virus Diseases

Objective: To investigate the drinking status and associated factors in adults in China. Methods: Based on the 2010-2012 China National Nutrition and Health Survey (CNNHS), a total of 135 824 participants aged ≥18 were included in this cross-sectional analysis. Multivariable logistic regression model was used to investigate the associated factors for drinking status. Results: The overall drinking rate was 30.5% in Chinese adults, 53.8% in men, and 12.2% in women. The excessive drinking rate was 14.0% in men and 1.1% in women. The daily drinking rate was 25.7% in men and 10.9% in women. Men mainly consumed multi-type wines, but women preferred beer. The overall harmful drinking rate was 7.1%. The excessive drinking rate, daily drinking rate, and harmful drinking rate increased first but then declined with age. All the four rates were positively related with physical activity. Conclusions: The drinking rate, excessive drinking rate, daily drinking rate and harmful drinking rate were high in adults in China. Drinking status was associated with age, sex, marital status, education level, smoking status and physical activity.
Adult ; Alcohol Drinking/epidemiology* ; Alcoholism/epidemiology* ; Asian People/statistics & numerical data* ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Male ; Smoking/epidemiology*

Objective: To explore the effect of vaginal micro-environment alterations and HPV16 infection and their interaction in the progression of cervical intraepithelial neoplasia. Methods: The participants of this study came from the cervical lesions study cohort in Shanxi province, including 623 women with normal cervical (NC), 303 patients with pathogenically diagnosed low-grade cervical intraepithelial neoplasia (CINⅠ) and 93 patients with pathogenically diagnosed high-grade cervical intraepithelial neoplasia (CINⅡ/Ⅲ). The data of the demographic characteristics of the study subjects and factors related to cervical intraepithelial neoplasia were collected, and HPV16 infection were detected by using flow-through hybridization technology and H(2)O(2), β-glucuronidase, clotting enzyme, neuraminidase and leucocyte esterase in vaginal secretions were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis. pH value and vaginal cleanliness were also detected at the same time. The database was established and analyzed by SPSS statistical software (version 22.0). Results: The HPV16 infection rate (trend χ(2)=55.45, P<0.001) and the abnormal rates of H(2)O(2) (trend χ(2)=26.19, P<0.001), pH (trend χ(2)=5.06, P=0.024), vaginal cleanliness (trend χ(2)=19.55, P<0.001), β-glucuronidase (trend χ(2)=17.52, P<0.001) and neuraminidase (trend χ(2)=14.90, P<0.001) increased gradually along with the severity of cervical intraepithelial neoplasia, but the abnormal rates of clotting enzyme and leucocyte esterase showed no same trend. The results of GMDR model analysis showed that there was interaction between HPV16 infection and abnormalities of H(2)O(2), β-glucuronidase, clotting enzyme and neuraminidase in CINⅠ group, and the interaction between HPV16 infection and the abnormalities of vaginal cleanliness, H(2)O(2), β-glucuronidase and neuraminidase in CIN Ⅱ/Ⅲ group. Conclusion: Our findings indicated that the vaginal micro-environment alterations and HPV16 infection could increase the risk of cervical intraepithelial neoplasia, and they might have an important synergistic effect in the progression of cervical intraepithelial neoplasia.
Female ; Human papillomavirus 16/isolation & purification* ; Humans ; Hydrogen Peroxide ; Papillomavirus Infections/virology* ; Uterine Cervical Neoplasms/virology* ; Uterine Cervical Dysplasia/virology*

Objective: To describe the characteristics of newly reported HIV/AIDS cases via non-marital or non-commercial heterosexual transmission and to find out the relative factors in Hangzhou, from 2015 to 2017. Methods: Data were collected through the national HIV/AIDS comprehensive control and prevention data system. Study subjects would include those reported HIV/AIDS cases who were residents of Hangzhou and were infected via non-marital heterosexual transmission, between January 1, 2015 and December 31, 2017. Demographic characteristics and behavioral information were collected. χ(2) test was used to compare different characteristics of the non-married heterosexual transmission subjects. Logistic regression was used to assess factors that associated with non-marital but non-commercial HIV heterosexual transmission with SPSS. 20 software used to analyze statistically. Results: Non-marital HIV heterosexual transmission accounted for 38.03% (1 393/3 663) of the total new reported HIV/AIDS cases in 2015-2017. Out of the 1 393 HIV/AIDS cases, those infected through non-marital but non-commercial heterosexual transmission accounted for 50.83% (708/1 393), and those through non-martial commercial transmission was accounted for 49.17% (685/1 393). Male to female ratio was 3.51 ∶ 1 (1 084/309). Male HIV cases reported that their major way of infection was via non-marital commercial transmission (670/1 084, 61.81%), while female patients reported the way was via non-marital non-commercial (294/309, 95.1%). Results from multivariate logistic analysis showed that the related risk factors and ORs for non-marital but non-commercial transmission appeared as: female (aOR=48.25, 95%CI: 26.94- 88.44),<30 year olds (aOR=2.43, 95%CI: 1.31-4.51), 30-39 year olds (aOR=1.92, 95%CI: 1.11- 3.33), 40-49 year olds (aOR=1.80, 95%CI: 1.08-3.00), married or unmarried (vs. divorced or widowed, aOR=1.57, 95%CI: 1.10-2.24; aOR=1.78, 95%CI: 1.15-2.78), high school and above of education level (vs. primary school and under of education level, aOR=1.82, 95%CI: 1.18-2.80), administrative officers or employee (vs. farmers, aOR=2.03, 95%CI: 1.04-1.91). Number of non- marital partners less than 5 (vs. number of non-marital partners more than 5, aOR=10.65, 95%CI: 6.41-17.42). Conclusions: HIV/AIDS cases with non-marital heterosexual transmission accounted for considerable proportion regarding the HIV transmission in Hangzhou from 2015 to 2017. Differences were found in the following factors as non-marital and non-commercial heterosexual transmission with diverse gender, age, marital status, educational level and occupation among of the HIV/AIDS patients.
Female ; HIV ; HIV Infections/transmission* ; Heterosexuality ; Humans ; Male ; Risk Factors ; Sexual Behavior/psychology* ; Sexual Partners ; Single Person