Objective To analyze the morphological alterations of corpus callosum in children with spastic cerebral palsy(SCP)using three-dimensional magnetization prepared rapid acquisition gradient echo(3D-MPRAGE)technology and to investigate the correlation between morphological indexes and gross motor function.Methods Sagittal T1WI 3D-MPRAGE data was collected from 136 children with SCP(SCP group)and 132 age-and gender-matched healthy controls(HC)(HC group),and the gross motor function measure-88(GMFM-88)was applied to assess the gross motor function.Independent sample t-test was used to compare the corpus callosum surface area,volume,maximum anterior-posterior diameter,median sagittal area(total area and area of Ⅰ-Ⅴ zone)between the two groups.Partial correlation analysis was performed to calculate the correlation between morphological indexes of the corpus callosum and GMFM-88 with age as a covariate.Results Children under 3 years old,the corpus callosum surface area of the SCP group(3 914.51 mm2±1 207.97 mm2)was lower than that of the HC group(5 725.51 mm2±1 412.66 mm2).The volume of the corpus callosum(6 108.46 mm3±2 803.97 mm3)in the SCP group was lower than that of the HC group(11 297.96 mm3±4 109.02 mm3).Also,the maximum anterior-posterior diameter of the corpus callosum in the SCP group(53.40 mm±6.31 mm)was lower than that of the HC group(57.74 mm±6.04 mm)(all P<0.05).Children over 3 years old,the corpus callosum surface area of the SCP group(4 970.06 mm2±1 191.31 mm2)was lower than that of the HC group(6 372.55 mm2±1 445.59 mm2).The volume of the corpus callosum(8 330.20 mm3±2 888.20 mm3)in the SCP group was lower than that of the HC group(13 599.82 mm3±3 429.81 mm3)(all P<0.05).Partial correlation analysis showed significant correlation between corpus callosum volume,median sagittal area and gross motor score(P<0.01)with age as a covari-ate.Conclusion The 3D-MPRAGE technology can be useful for the comprehensive assessment of morphological alterations of the corpus callosum in SCP.The corpus callosum volume,and median sagittal area may become neuroimaging references for the assess-ment of motor development in cerebral palsy(CP).

Objective:To analyze the brain functional fluctuation of benign epilepsy in children with central-temporal spikes(BECTS) by using ReHo algorithm based on the resting-state brain functional imaging, and to explore the connection of the brain function and changes of the connection pattern, so as to find the damage of the cognitive function of BECTS children in the early stage.Method:s Perspectiveness and simple random selection of 20 BECTS children and 20 healthy control children admitted to Shenzhen Children′s Hospital from January 2015 to December 2017 were conducted for basic information collection and functional magnetic resonance imaging (fMRI) testing in a resting-state.Result:s Significantly lower ReHo value appeared in the default mode network (DMN) area, and the precuneus (voxel=422, t=-5.085 6), cuneus (voxel=85, t=-4.240 3), angular gyrus (voxel=191, t=-4.681 2), cingulate cortex (voxel=313, t=-5.238 2), anterior central gyrus (voxel=12, t=-3.482 7), and supplementary motor area (voxel=1 356, t-6.596 2). The significantly increased ReHo was found in the bilateral cerebellum (voxel=71, t=5.658 2), right superior temporal gyrus (voxel=24, t= 5.184 0), operculum insulae (voxel=337, t=6.814 9), left parietal lobe (voxel=12, t=4.378 7), and inferior parietal lobule (voxel=11, t=3.433 7). Conclusions:Significant impairment of DMN, Wernicke and angular gyrus functions in BECTS children may be one of the mechanisms of cognitive dysfunction.Enhanced sensorimotor area and cortical brain functions near the operculum insulae and central sulcus lead to seizures with typical clinical symptoms.fMRI has a high specificity and sensitivity for evaluating the brain function of children with BECTS, and it can detect the impairment of cognitive function in children with this type of epilepsy at an early stage.

Objective To explore the effect of cytoglobin (CYGB) low expression on the proliferation of glioma cells and its mechanism.Methods Glioma samples were chosen from patients accepted glioma resection in our hospital from June 2012 to December 2015;primary glioma cells extracted from these samples were cultured and performed purity identification.The nominated cells were divided into transfection of 24 h group,transfection of 48 h group,transfection of 72 h group,and negative control group;cells,excepted from negative control group,were transfected by CYGB shRNA for 24,48 and 72 h,respectively,to inhibit the CYGB expression.CCK-8 assay was used to observe the proliferation of glioma cells after different transfection times (0,1,2,3,4 and 5 d after cell culture).The expressions of CYGB,phosphatidylinositol 3 kinase (PI3K),total alanine aminotransferase (Akt) and phosphorylated (p)-Akt were detected by Western blotting,and the levels of interleukin (IL)-6,IL-10,tumor necrosis factor (TNF)-α,transforming growth factor (TGF)-β and vascular endothelial growth factor (VEGF) were examined by ELISA.Results (1) The proliferation of glioma cells was enhanced at different times after CYGB shRNA transfection,and the optical density showed significant differences at different times after CYGB shRNA transfection (P＜0.05);as compared with those in the negative control group,the cell proliferative capacity and optical density in the transfection of 24 h group,transfection of 48 h group and transfection of 72 h group were significantly increased (P＜0.05).As compared with those in the negative control group,the CYGB protein expression was significantly d ecreased and PI3K and p-Akt protein expressions were significantly increased in the transfection of 24 h group,transfection of 48 h group and transfection of 72 h group,accordingly (P＜0.05),while no significant difference was noted in the total Akt protein expression (P＞0.05).The levels of IL6,IL10,TNF-α,TGF-β,and VEGF were successively increased in the transfection of 24 h group,transfection of 48 h group and transfection of 72 h group as compared with those in the negative control group (P＜0.05).Spearman correlation analysis showed that the expression of CYGB in the glioma was negatively correlated with PI3K and p-Akt expressions,and IL-6,IL-10,TNF-α,TGF-β,and VEGF levels (P＜0.05).Conclusion The effect of cytoglobin on proliferation of glioma cells may be related to the signal pathway of PI3K-Akt.

Objective To determine the optimal procedure for preparation of the SPIO nanoparticles modified by dextran polylysine,and to evaluate the quality of this product.Methods The optimal preparation procedure of four factors (solution pH value,dextran concentration,reaction temperature and stirring rate) affecting SPIO hydrodynamic size were obtained through orthogonal experiments (3 levels).SPIO nanoparticles were synthesized under an optimum procedure.The shape and hydrodynamic size were detected by transmission electron microscope (TEM) and Malvern Zetasizer respectively.The content of Fe was detected by atomic absorption spectrophotometer,while chemical structures of SPIO nanoparticles were characterized and analyzed by infrared spectroscopy (IR) method.X-ray powder diffraction method was used to identify the ingredients,and the magnetic parameters were measured by vibrating sample magnetometer.Furthermore,experiments with ovarian cancer cells were performed to primarily validate the magnetic property of SPIO nanoparticles.Results The results of the orthogonal experiments showed that the optimum preparation procedure was as follows:dextran concentration of 10 mg/ml,pH 10,reaction temperature of 80 ℃ and stirring rate of 600 r/min.The TEM results showed the SPIO nanoparticles were in spherical shape,homogeneously distributed and uniform in size,and the mean diameter was 7.0 nm.The content of Fe was (12.36±0.08) g/L.The IR results clearly showed that the Fe3O4 was coated by dextran successfully.The Xray powder diffraction method showed that the sample contained Fe3O4 and the magnetism parameters indicated that the sample had superparamagnetism.The experiments with ovarian cancer cells demonstrated that SPIO nanoparticles could enter into the cells and then the cells had certain magnetic properties.Conclusions The SPIO nanoparticles synthesized under the optimal procedure are stable,small in size,with good dispersion and are feasible to enter into cells for rendering certain magnetic properties.This study has provided a good foundation and potential for further research.

Objective To study the expression of Notch 1,Jagged1 and Notch intracellular domain (NICD) in epithelial ovarian carcinoma tissues and analyze the clinical significance.To explore the activity of γ-secretase in epithelial ovarian carcinoma cell line SKOV3 and the effect of N-[N-(3,5-dil uorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester (DAPT),a γ-secretase inhibitor on the activity of γ-secretase in SKOV3.Methods Immunohistochemistry staining method was performed in 43 patients with epithelial ovarian carcinoma and 11 patients with benign epithelial ovarian tumor to detect the expression of Notch1,Jagged1 and NICD.The differences of expressionof Notch1,Jagged1 and NICD between malignant and benign ovarian tumors was compared and alsoanalyzed the correlation with clinicopathological parameters of ovarian carcinoma.Human serous ovarian cancer cell line SKOV3 and immortalized nontumorigenic ovarian epithelial cell line T29 were incubated in vitro.The activities of γ-secretase in SKOV3 and T29 with dimethyl sulfoxide (DMSO) and DAPT were detected respectively by Gal4VP16/UAS and dual luciferase reporter assay system.Results (1) The immunohistochemical composite scores (ICS) of Notch1 in epithelial ovarian carcinoma (6.7±2.2) were not significantly different with those in benign epithelial ovarian tumor (5.4± 2.7,P=0.153),while the ICS of Jagged 1 and NICD in epithelial ovarian carcinoma (5.3± 2.4,5.3± 2.3) were higher than those in benign epithelial ovarian tumor (1.6± 1.4,3.1± 1.7; all P＜0.01).The expression of Notch 1,Jagged 1 and N ICD had no correlation with patients' aged,history of carcinoma,ascites,the level of serum CA125,maximum length of ovarian tumor,Federation International of Gynecology and Obstetrics (FIGO) stage,grade and pathology subtypes (all P＞0.05).The hazard ratio between the high expression of Notch1,Jagged1,or NICD and the moderate to low expression of Notch1,Jagged1,or NICD,and Jagged1 were 0.771,1.648 and 1.316,respectively (all P＞0.05).The 5-year survival rate and median survival time between the high expression of Notch,Jagged 1 or NICD in subgroup and moderate to low expression in subgroup were of no difference (all P＞0.05).The activity of γ-secretase in SKOV3 was significantly higher than that in T29 [(12.2± 1.4)％,P=0.019].(2)After DAPT treated,the relative activity of γ-secretase in SKOV3 (50 μmol/L) was declined from (100.0±5.3)％ to (6.6±0.8)％ (P=0.001).Conclusions Jagged1 and NICD in Notch1 pathway may play a key role in the occurrence of ovarian carcinoma.The activity of γ-secretase in epithelial ovarian carcinoma was higher than that in ovarian epithelial cell which suggest that DAPT,γ-secretase inhibitor,may become the target of ovarian carcinoma treatment.

Objective To evaluate the clinical application of perforator flap in extended radical vulvectomy of vulvar carcinoma.Methods Retrospectively,twelve cases of vulva carcinoma were treated by radical extensive excision,and the defects were repaired with perforator flap.Results All the flaps were survived and healed with first intention except one infection.The wound infection patient was treated with change of the dressing and antibiotics.The reconstructed vulvae were plump and elastic.It appeared like the normal vulvae and there was no contraction of the vagina.Conclusions Vulvar reconstruction with the perforator flap after the radical vulvectomy could make the patients recover easily,which produces almost normal appearance and function of the vulvae,reduces the time of wound healing,the patient could get the next therapy more quickly and the quality of life improving.It has wide clinical application value.

Adult ; Endometrial Neoplasms ; surgery ; Female ; Fertility ; physiology ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy Outcome ; Sarcoma, Endometrial Stromal ; surgery

Objective To evaluate the clinical value of HPV genotyping in diagnosis of cervical lesions.Methods Totally 1715 patients seen in Department of Obstetrics and Gynecology,Peking University First Hospital from January 2010 to December 2012 were chosen to be evaluated.All the patients experienced cervical Liquid-based cytology test,HPV genotyping and multiple punch biopsy during colposcopy and they were confirmed of cervical intraepithelial neoplasia (CIN) through histopathological examination.The clinical efficacy of HPV genotyping was evaluated.Results HPV 16,58,52,33 and 31 were the first five types detected in all of the 1715 patients.The first five types detected in the patients with CIN2 + (including CIN2/CIN3/adenocarcinoma in situ/cervical cancer) were HPV 16,58,33,52 and 31.Logistic regression analysis showed that in the CIN2 + patients who were negative for intraepithelial lesion or malignancy (NILM),those with positive HPV 16,33 and 18 had higher risk of CIN2 +,with the regression coefficient OR 5.031 (P =0.000),2.375 (P =0.000) and 1.598 (P =0.027).The cervical liquid-based cytology showed that there was a higher risk of CIN2 + for atypical squamous cells of undetermined significance (ASCUS) with positive HPV 16 and 18,and the regression coefficients OR were 5.139 (P =0.000) and 2.096 (P =0.025),respectively ; and the low-grade squamous intraepithelial lesion (LSIL) with positive HPV 16,33 and 52 had higher risk of CIN2 +,the regression coefficients OR were 5.774(P =0.000),3.368(P =0.000) and 1.747(P =0.034).Conclusion HPV genotyping is significantly useful for cervical screening.It is an important parameter for directing the clinical treatment in ASCUS and LSIL patients with negative cytology results,especially HPV 16 positive patients need to be further evaluated.

Objective To investigate the effects of postoperative adjuvant chemotherapy (CT) and chemoradiotherapy (CRT) or radiotherapy(RT) for Ⅰ b-Ⅱ a cervical cancer with risk factors.Methods From March 1995 to June 2010,there were 137 patients underwent radical hysterectomy and systematic pelvic lymphadenectomy for stage Ⅰ b-Ⅱ a cervical cancer admitted at Peking University First Hospital.These patients had risk factors,intermediate risk factors including bulky tumor (＞4 cm),lymph vascular space invasion,deep stromal invasion; high risk factors including positive surgical margin,parametrial invasion,lymph node involvement.Of the all patients,79 cases of them were treated with CT,58 of them were treated with RT or CRT.The 5-year survival and prognosis factors were analyzed retrospectively,the prognosis was compared between two adjuvant therapy groups.Results The univariate analysis shown that types of pathology,different grade of risk factors,stroma invasion and lymph node involvement were prognostic factors of 5-year overall survival Patients with squamous cell carcinoma,intermediate risk factors,no parametrial invasion,and no lymph node involvement had better prognosis (P ＜ 0.05).Whether patients with high-risk factors or intermediate-risk factors,the 5-year overall survival and 3-year disease-free survival had no difference between CT and RCT or RT groups respectively.Cox regression multivariate analysis of survival indicated that clinical stages,types of histology,different grade of risk factors were independent prognostic indicator.Patients with early stage,squamous cell carcinoma,intermediate risk factors had better prognosis.Univariate and multivariate analysis indicated that different postoperative adjuvant therapies had no effects on the prognosis.The 5-year overall survival was 88.6％ in patients treated with CT,and 89.7％ in patients treated with RT or CRT (P =0.455).Conclusion There are equivalent therapeutic results between CT and RT or CRT for patients with risk factors after radical surgery,CT may be as one choice of postoperative adjuvant therapy for stage Ⅰ b-Ⅱ a cervical carcinoma with risk factors.

Objective To study the expression and clinical significance of Notch3 and Notch intracellular domain (NICD) in ovarian carcinoma and the effects of N-[N-(3 ,5-difluorophenyl) acetyl-L-alanyl]-S-phenyl glycine t-butyl ester (DAPT), a γ-secretase inhibitor on the proliferation and apoptosis in OVCAR3, A2780 ovarian carcinoma cell lines. Methods Western blot was used to detect the expression of NICD in the tissues from 58 ovarian carcinomas patients and 21 normal ovarie, who were admitted in Peking University First Hospital from July 2006 to June 2009. Immunohistochemistry was also used to detect the expression of Notch3 in these tissues. The relationship with clinical features of ovarian carcinoma was also analyzed. Proliferation of OVCAR3 and A2780 ovarian cancer cells was determined by methyl thiazolyl tetrazolium (MTT) assay, cell cycles and apoptosis and index of proliferation were detected by flow cytometry method. The expression of NICD in OVCAR3 and A2780 cells incubated with DAPT was detected by western blot. Results (1)The expression level of NICD in ovarian carcinomas was significantly higher than that in normal ovarian tissues (1.64 ±0. 19 vs. 0.98 ±0.20;P <0.05). The NICD expression was higher in ovarian cancers with low grade or advanced stage than those in high-middle grade or early stage,respectively (1.90 ± 0. 22 vs. 1.25 ± 0. 21,1.80 ± 0. 21 vs. 1.21 ± 0. 15; all P < 0. 05). The Notch3 protein was stained positively in cytoplasm, nuclear and cell membrane. The expression of Notch3 was higher in ovarian carcinomas than that in normal ovaries [78% (45/58) vs. 24% (5/21); P < 0. 01]. While,there were no stasistical difference in different pathological types, stages, differentiation of ovarian carcinoma. There was no difference between the patients with adjuvant chemotherapy or not. (2)After OVCAR3 and A2780 cells incubated with DAPT 24, 48, 72 hours, NICD expression was significantly lower than that in control group (P < 0. 05). The effects of DAPT inhibited the proliferation and prompted the apoptosis of OVCAR3 and A2780 cells were depended on the concentrations and times. Conclusions Notch3 and NICD may play a key role in the occurrence and progress of ovarian carcinoma. The mechanism of DAPT inhibited the proliferation and prompted the apoptosis of OVCAR3 and A2780 cells may be due to decreased the formation of NICD.