Objective:To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage.Methods:From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared.Results:(1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all P<0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all P<0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all P<0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; P=0.220]. Conclusions:Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.

Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage.Methods:From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared.Results:(1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all P<0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all P<0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all P<0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; P=0.220]. Conclusions:Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.

Objective:To analyze the clinicopathological data of invasive stratified mucinous carcinoma(ISMC)of the cervix,thereby providing comprehensive insights for the diagnosis,treatment,and prognosis of this disease.Methods:A retrospective analysis was conducted on 23 cases of ISMC admitted to the Department of Gynecolo-gy at Wuhan University People's Hospital and the Department of Obstetrics and Gynecology at the Second Affilia-ted Hospital of Fujian Medical University between January 2020 and December 2023.The study examined clinical characteristics,pathological features,immunohistochemical results,and prognostic outcomes.Additionally,we compared the prognostic data of 14 cases of cervical gastric adenocarcinoma and 19 cases of cervical neuroendo-crine carcinoma.Results:A total of 23 patients diagnosed with ISMC ranged in age from 27 to 61 years,with 11(47.83％)being postmenopausal.Only one patient exhibited lesions upon physical examination,while the remai-ning patients presented with varying degrees of vaginal bleeding,sometimes accompanied by abnormal vaginal discharge and other symptoms.Among these patients,three were HPV-negative,while the remainder tested posi-tive for HPV,with types 16 and 18 being the most prevalent.Of the 23 patients,15 had isolated ISMC,five had in-vasive cervical adenocarcinoma with partial ISMC involvement,and three had cervical adenosquamous carcinoma with partial ISMC involvement.ISMC patients tested positive(100.00％)for p16 and CK7,with positivity rates of 26.09％for p16 and 9.52％for CK7.Immunohistochemical analysis of p53 was conducted in 15 ISMC patients,re-vealing that 80.00％(12/15)had wild-type p53,while 20.00％had mutant p53.The proportion of patients with a Ki-67 proliferation index above 60％was 77.27％(17/22).The mean follow-up period for the 15 patients with isola-ted ISMC was 10.0 months(1.0-36.0 months),with a recurrence rate of 20.00％and a mortality rate of 6.67％.For the 14 patients with combined diagnoses,the mean follow-up period was 9.5 months(1.0-35.0 months),with a recurrence rate of 50.00％and a mortality rate of 7.14％.In the case of 19 patients with cervical neuroen-docrine carcinoma,the mean follow-up period was 15.0 months(1.0-33.0 months),with a recurrence rate of 31.58％and a mortality rate of 10.52％.However,no statistically significant differences were observed in the recur-rence or mortality rates between cervical neuroendocrine carcinoma and isolated ISMC(P＞0.05).Conclusions:The primary clinical manifestation of ISMC is characterized by vaginal bleeding or abnormal fluid discharge,which demonstrates a strong association with HPV infection.Notably,ISMC lacks specific tumor markers for diagnosis.However,immunohistochemical analysis reveals distinctive molecular expression patterns that may serve as effec-tive diagnostic indicators.It is important to emphasize that ISMC exhibits comparable recurrence and mortality rates to those observed in cervical gastric adenocarcinoma and cervical neuroendocrine carcinoma,underscoring its aggressive clinical behavior.

Objective:To investigate characteristic CT manifestations of primary pulmonary diffuse large B-cell lymphoma (DLBCL).Methods:CT images of 14 patients [10 males and 4 females, age （54±2） years old, range 32 to 91] with pathologically-proved pulmonary DLBCL lymphoma were retrospectively analyzed．Plain CT and contrast enhanced CT imaging were performed in all 14 patients. Image characteristics including lesion size, locations and distribution, morphology and margin, density and enhancement degrees, bronchia and lesion surroundings, other thoracic extra-pulmonary manifestations, as well as distant metastasis were analyzed and recorded. The maximal diameter of mass and/or nodules, pre and post-contrast CT values were measured. Among all 14 cases, 8 cases were initially diagnosed as lung carcinoma, 5 cases as infection, one case as lymphoma.Results:Among all 14 primary lung DLBCL cases, there were 10 case with multiple lesions and 4 with single lesion. Masses and/or nodules were found in 12 cases, with the maximum diameter of the lesions as 0.8-8.2 cm, the median value as 5.3 (2.9, 7.8) cm. Two cases showed simple consolidation. The margins of the lesions were clear and smooth in 12 cases, and fuzzy in 2 cases. The density of the lesions on pre-contrast CT was relatively uniform, with mean CT value (35.1±1.0) HU. After contrast, 10 cases displayed mild to moderate homogeneous enhancement, 4 cases showed heterogenous enhancement. The mean CT value of post-contrast images was (61.8±1.5) HU. In arterial phase, the mean CT value was (50.9±1.3) HU. Angiographic sign was found in 9 cases in arterial phase. Of the 14 cases, bronchus was clear and smooth in 5 cases. In 4 cases, bronchus was found slight compressed or stenosis; and 5 cases showed intra-lesion bronchi invasion or occlusion. Interstitial tissue around the lesion was found slightly thickened in 8 cases. The pleura showed unevenly thickened and invaded in 8 cases. Mediastinal or hilar lymphadenopathy and fusion were found in 10 cases, with 3 cases involving mediastinal large blood vessels, and 7 cases displaying infiltrative growth pattern. There were 4 cases with pleural effusion. CT follow-up after treatment in 8 cases showed no distant metastasis (7 cases showed good prognosis, with lesions disappearing after radiotherapy, chemotherapy or surgical resection; 1 case showed progressed with lesion increased after chemotherapy). Six patients abandoned the treatment and discharged from the hospital.Conclusions:Primary DLBCL is a high invasive and malignant entity with certain CT characteristics. The confirmed diagnosis of pulmonary DLBCL depends on pathological results.

Objective: To explore CT and PET/CT features of primary mediastinal yolk sac tumor (PMYST). Methods: CT, PET/CT and clinical data of 14 patients with PMYST confirmed by percutaneous biopsy were retrospectively analyzed. All patients underwent plain scan and enhanced chest CT examination, while 7 patients underwent PET/CT examination. Results: CT showed round or lobulated masses in all 14 cases. The maximum diameter of masses was 4.10-13.50 cm, with an average of (10.65±2.27) cm. Lesions with the maximum diameter≥10.00 cm were in 13 cases (13/14, 92.86%).Plain CT showed non-uniform density or heterogeneous density, and the enhanced CT showed multiple strip, thin linear partition enhanced focus and flake non-enhanced area in 14 cases, among which moderate and mild enhancement were observed in 11 cases (11/14, 78.57%) and 3 cases (3/14, 21.43%), respectively. Cardiac envelope involvement was found in 5 cases (5/14, 35.71%), left cephalobrachial vein and/or superior vena cava involvement were detected in 3 cases (3/14, 21.43%), while the right upper and middle lobe involvement was noticed in 1 case (1/14, 7.14%).There were 3 patients (3/14, 21.43%) with right hilar and mediastinal lymph node metastasis, 1 (1/14, 7.14%) with right pleural metastasis and 1 (1/14, 7.14%) with right lower lung metastasis. Pericardial effusion (7/14, 50.00%) and pleural effusion (7/14, 50.00%) were found each in 7 cases, respectively. PET/CT showed markedly increased radioactivity uptake in all 7 cases. During following-up after treatment, stable or recovered well after operation were observed in 9 cases (9/14, 64.29%), whereas progressive or recurred after operation in 5 cases (5/14, 35.71%). Conclusion: The main imaging manifestations of PMYST include large round or lobulated non-uniform mass in the anterior mediastinum, often invading surrounding vessels, tissue and organs, mostly with lymph nodes and distant metastasis. The specific manifestations of PMYST are multiple strip-like, linear septate-like enhancement foci and patchy non-enhancement areas in enhanced CT. 18F-FDG uptake of the lesions are markedly hypermetabolic.

Objective To analyze the effect of miR-497 high expression on the gene expression profile of colon cancer cell line HCT116. Methods MiR-497 high expressing colon cancer cell model HCT116-497 and negative control HCT116-CON were established by lentiviral transduction. The human (V2) gene expression microarray was used to identify genes that were differentially expressed between colon cancer cells overexpressing miR-497 and the controls. The candidates were subjected to the gene ontology (GO) and KEGG pathway enrichment analysis by Molecule Annotation System 3.0 (MAS3.0). The differential expression of representative genes relative to inflammation were confirmed by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). Results Of all the differently expressed genes, 582 genes were down-regulated by at least 3-folds, which were enriched in inflammation-related signaling pathways in colon cancer cells overexpressing miR-497. The decrease in 15 representative genes was validated by qPCR. Compared with those in HCT116-CON cells, expressions of 10 genes in HCT116-497 cells, including CACNB1, FOS, IL-29, RPS6KA2, TNFSF15, IL-11, INHBC, CSF1R, JAK3 and IL-2Rβ, were decreased significantly, and there were statistical differences (all P< 0.05) Conclusion MiR-497 inhibits the mRNA expression of inflammation-related genes in colon cancer cell line HCT116.

Objective To discuss the short-term curative effect and the safety of percutaneous vertebroplasty using high viscosity bone cement for the treatment of severe osteoporotic vertebral body compression fractures. Methods The clinical data of 100 patients with severe osteoporotic vertebral body compression fractures (compression degree>70%), who received percutaneous vertebroplasty by using high viscosity bone cement during the period from December 2010 to May 2013, were retrospectively analyzed. All the patients were followed up for at least one month. Both preoperative and postoperative visual analogue scale (VAS) and quality of life (QOL) scores, as well as the incidence of bone cement leakage, were recorded and the results were used to evaluate the curative effect and the safety of percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Results One week after the treatment, significant pain relief was obtained in 92 patients (92%), VAS scores decreased from preoperative (7.0 ±1.2) to postoperative (2.0±1.5), and QOL scores increased from preoperative (30±5.0) to postoperative (80±18.0);the differences were statistically significant (P<0.01). One month after the treatment, significant pain relief was seen in 91 patients (91%), VAS scores decreased from preoperative (7.0 ±1.2) to postoperative (1.5 ±1.0) and QOL scores increased from preoperative (30±5.0) to postoperative (80±15.0); the differences were statistically significant (P<0.01). No statistically significant differences in VAS scores and QOL scores existed between the data determined at one week after the treatment and the data determined at one month after the treatment (P>0.05). Leakage of bone cement was observed in 40 patients (40%), resulting no severe neurological symptoms; among the 40 patients, intervertebral disc leakage at above and below the vertebral body was detected in 28 patients (70%), vertebral anterior edge leakage was observed in 11 patients (27.5%) and vertebral posterior edge leakage was seen in one patient (2.5%). Conclusion For the treatment of severe osteoporotic vertebral body compression fractures, percutaneous vertebroplasty by using high viscosity bone cement is safe and effective.

Objective To explore the application of serum SELDI proteomic patterns to distinguish breast cancer patients from healthy individuals.Methods All serum samples from 101 breast cancer patients and 45 healthy individuals were analyzed by surface-enhanced laser desorption/ionization time-of-fight mass spectrometry (SELDI-TOF-MS).The spectra were generated on weak cation exchange (WCX2) chips,and protein peaks clustering and classification analysis were made using Biomaker Wizard software and Biomarker Pattern software (BPS).Then the pattern was evaluated by blinded test.Results 49 different proteins were found to have statistically differential expression levels between breast cancer and normal control sera (P ＜ 0.05).A diagnostic model consisting of three protein peaks (M/Z 5627,8124 and 2864) could do the best in the diagnosis between breast cancer and healthy individual.When the diagnostic model was tested with the blinded test set,it yielded a positive value of 95 ％ (139/146),a sensitivity of 97 ％ (98/101) and a specificity of 91％ (41/45).Conclusion These results suggested that serum SELDI protein profiling can distinguish breast cancer patients from normal subjects with relatively high sensitivity and specificity.SELDI-TOF-MS plays a valuable role in the diagnosis of breast cancer and the discovery of new tumor-specific protein biomarkers.

Lizhong decoction was first recorded in the book "Treatise on Febrile Diseases" and was used to treat constant diarrhea of Taiyang disease and cold cholera. Lizhong decoction has the features of composing few medicines, enabling appropriate compatibility, and exerting obvious therapeutic effects. In this article, the compatibility and clinical application of this formula was briefly analyzed.