ObjectiveTo investigate the effect of laminin subunit α3 （LAMA3） on the epithelial-mesenchymal transition （EMT）， invasion， and metastasis abilities of pancreatic cancer （PC）. MethodsA comprehensive analysis was performed for tumor- and EMT-related databases to identify the EMT genes associated with PC， especially LAMA3. The methods of qRT-PCR and Western blot were used to measure the expression level of LAMA3 in PC tissue and cell lines； immunofluorescence assay was used to determine the localization of LAMA3 in PANC-1 cells； Transwell assay was used to investigate the effect of LAMA3 on the invasion and migration abilities of PC cells. The t-test was used for comparison of continuous data between groups. ResultsThe analysis of the TCGA database identified 3 EMT-related oncogenes for PC， i.e.， LAMA3， AREG， and SDC1. The LASSO-Cox regression model showed that LAMA3 had the most significant impact on the prognosis of PC （risk score=0.256 1×LAMA3+0.043 1×SDC1+0.071 4×AREG）. The Cox model and nomogram showed that the high expression of LAMA3 was an independent risk factor for the poor prognosis of PC （hazard ratio=1.32， 95% confidence interval： 1.07‍ ‍—‍ 1.62， P<0.01）. Experimental results showed that there was a significant increase in the expression of LAMA3 in pancreatic cancer tissue compared with the normal pancreatic tissue. Compared with the HPDE cell line， there were varying degrees of increase in the expression of LAMA3 in pancreatic cancer AsPC-1， BxPC-3， PANC-1， MIA PaCa-2， and SW1990 cell lines， with the highest expression level in PANC-1 cells. The enrichment analysis showed that LAMA3 was associated with the biological processes and signaling pathways such as EMT， collagen metabolism， extracellular matrix degradation， the TGF-β pathway， and the PI3K pathway. After the knockdown of LAMA3， there were significant reductions in the expression levels of N-Cadherin， Vimentin， and Snail， while there was a significant increase in the expression level of E-Cadherin. Transwell assay showed that there were significant reductions in the invasion and migration abilities of PANC-1 cells after the knockdown of LAMA3. ConclusionLAMA3 is highly expressed in PC and can promote the EMT， invasion， and migration of PC cells， and therefore， LAMA3 may be used as a novel diagnostic marker and a new therapeutic target for PC.

Objective: To investigate the prevalence of witnessing domestic violence,and to explore the relationship between witness domestic violence in childhood and college students’ injury and violence behaviors. Methods: In October 2018, self-made questionnaire on “Health and Risky Behaviors among University Students in Anhui Province” was conducted among 4 034 college students from 4 universities in Hefei. Multivariate Logistic regression models (control of confounding factors) were used to explore the impact of childhood witnessing domestic violence on college students’ injury and violence. Results: Among 4 034 college students,the prevalence of witnessing domestic emotional violence,mild physical violence and severe physical violence in childhood was 27.6%,22.4%,10.7%,respectively. Univariate analysis showed that students with experiences of witness domestic emotional violence,mild physical violence and severe physical violence had higher rates of self-injury,physical,emotional,and sexual violence compared to those without domestic violence witness(P<0.05). Multivariate Logistic regression analysis showed that witnessing domestic severe physical violence,emotional violence in childhood associated positively with self-harm (OR=1.53,95%CI=1.05-2.23; OR=2.15,95%CI=1.51-3.04) and emotional violence (OR=1.65,95%CI=1.16-2.35; OR=2.57,95%CI=1.87-3.53). Witnessing domestic severe physical violence showed positive association with physical violence (OR=4.99,95%CI=2.58-9.62) and sexual violence (OR=8.68,95%CI=3.30-22.81) among college students (P<0.05). Conclusion The experiences of witness domestic violence can increases the risk of college student’s injury and violence behaviors,especially witness domestic severe physical violence.

Objective: This study was to investigate the necessity of wearing a cervical collar after single-segment anterior cervical discectomy and decompression. Methods: The experimental methods were used to group the two wards in the same department. There were 54 patients in the experimental group and 48 patients in the control group. The patients in the experimental group did not wear the cervical collar during the postoperative outpatient activities and after discharge. The control group patients wore the cervical collar within 3 months after walking and after discharge. The cervical dysfunction index of the two groups before surgery and 3 months after surgery was compared between the two groups; also vertebral fusion at 6 months postoperatively; and SF-36 (Quality of Life Assessment Scale) scores before surgery and 3 months after surgery. Results: The NDI of the experimental group was significantly lower than that of the preoperative NDI (20.62%±1.94% vs 26.06%±2.17%) (t=18.32, P<0.01). The NDI of the control group was 3 months after operation compared with the preoperative NDI (21.30±%1.87% vs26.26%±2.74%) also had a significant decrease (t=16.67, P<0.01). The NDI of the experimental group was significantly lower than that of the preoperative NDI (14.97%±1.85%vs26.06%±2.17%) (t=31.93, P<0.01), the NDI of the control group was significantly lower than that of the preoperative NDI (15.98%±1.49% vs26.26%±2.74%) at 6 months after operation (t=24.45, P<0.01). The difference was statistically significant. The SF-36 score in the last 3 months was higher than that in the control group (53.37±9.23 vs 45.77±8.07), and the difference was statistically significant (t=4.40, P<0.01). Conclusions Compared with the external fixation without neck and neck, the treatment of cervical external fixation does not affect the postoperative treatment effect, and can improve the quality of life of patients.

Objective: To explore molecular characteristics of endometrial endometrioid cancer according to The Cancer Genome Atlas (TCGA) based molecular classification of endometrial carcinomas and to confirm simple and clinically applicable surrogate methodologies in pathological practice. Methods: Two hundred and twenty-eight cases of endometrial endometroid adenocarcinomas (EnACs) collected from August 2001 to August 2017 from Peking University Health Science Center, Peking University Third Hospital were molecularly categorized by using Sanger sequencing for the exonuclease domain mutations (EDM) of POLE, and by immunohistochemistry for p53 and mismatch repair (MMR) proteins. The cohort was classified into polymerase-E exonuclease domain mutation (POLE EDM), mismatch repair deficiency (MMR-D), p53 abnormal (p53-abn) and p53 wild type (p53-wt) groups. The correlation between molecular subgroups and the clinical-pathological features including prognosis were analyzed. Results: The cohort was distributed as follows: 11(4.8%) POLE EDM, 47(20.6%) MMR-D, 9(4.0%) p53-abn and 161(70.6%) p53-wt. p53-wt subgroup patients demonstrated significantly higher lymph node metastasis (P=0.011) and more advanced stage (P=0.036) than those of somatic hypermutation group cases (POLE EDM and MMR-D). In the FIGO grade 2-3 EnACs cohort, TCGA molecular subtyping was significantly correlated with progression-free survival and overall survival (P=0.043). POLE EDM subgroup had the best survival, while p53-abn subgroup had the worst. Conclusions Identification of POLE EDM and MMR-D subgroups provides independent and highly valuable prognostic information beyond established histological classification. Based on immunohistochemistry of MMR, p53 and POLE mutational analysis, this pragmatic molecular classification scheme can be served as a reliable surrogate for TCGA molecular classification, which has potential to be used routinely in Chinese pathological practice.

Objective To explore molecular characteristics of endometrial endometrioid cancer according to The Cancer Genome Atlas (TCGA) based molecular classification of endometrial carcinomas and to confirm simple and clinically applicable surrogate methodologies in pathological practice. Methods Two hundred and twenty?eight cases of endometrial endometroid adenocarcinomas (EnACs) collected from August 2001 to August 2017 from Peking University Health Science Center, Peking University Third Hospital were molecularly categorized by using Sanger sequencing for the exonuclease domain mutations (EDM) of POLE, and by immunohistochemistry for p53 and mismatch repair (MMR) proteins. The cohort was classified into polymerase?E exonuclease domain mutation (POLE EDM), mismatch repair deficiency (MMR?D), p53 abnormal (p53?abn) and p53 wild type (p53?wt) groups. The correlation between molecular subgroups and the clinical?pathological features including prognosis were analyzed. Results The cohort was distributed as follows: 11(4.8%) POLE EDM, 47(20.6%) MMR?D, 9(4.0%) p53?abn and 161(70.6%) p53?wt. p53?wt subgroup patients demonstrated significantly higher lymph node metastasis (P=0.011) and more advanced stage (P=0.036) than those of somatic hypermutation group cases (POLE EDM and MMR?D). In the FIGO grade 2?3 EnACs cohort, TCGA molecular subtyping was significantly correlated with progression?free survival and overall survival (P=0.043). POLE EDM subgroup had the best survival, while p53?abn subgroup had the worst. Conclusions Identification of POLE EDM and MMR?D subgroups provides independent and highly valuable prognostic information beyond established histological classification. Based on immunohistochemistry of MMR, p53 and POLE mutational analysis, this pragmatic molecular classification scheme can be served as a reliable surrogate for TCGA molecular classification, which has potential to be used routinely in Chinese pathological practice.

Objective To investigate the correlation between the expression of four mismatch repair proteins and clinicopathological features of colorectal cancer in elderly patients. Methods The expression of four mismatch repair proteins,MLH1,PMS2,MSH2 and MSH6,in 85 specimens from elderly patients with colorectal cancer,who were treated at the Second Affiliated Hospital of Zhengzhou University from January 2012 to December 2016, was analyzed by immunohistochemistry.The correlation between the expression of these mismatch repair proteins and clinicopathological features of colorectal cancer was also analyzed. Results Of the 85 clinical specimens,76 showed positive expression of the mismatch repair proteins,yielding a positivity rate of 89.4% and a negative rate of 10.6%(9 cases).The negative expression rates of MLHl,PMS2,MSH2 and MSH6 were 7.1%(6 cases),7.1%(6 cases),3.5%(3 cases)and 1.4%(2 cases),respectively.In addition,4 cases(4.7%)had negative expression of MLHl and PMS2,1 case(1.2%)had negative expression of MSH2 and MSH6,and 1 case(1.2%)had negative expression of all four-proteins.Furthermore,univariate and multivariate Logistic regression analyses showed that negative expression rates of the mismatch repair proteins were closely associated with tumor size,tumor differentiation and lymph node metastasis in colorectal cancer(all P < 0.05). Conclusions Concurrent negative expression of MLHl and PMS2 and of MSH2 and MSH6 can be seen in colorectal cancer.Negative expression of mismatch repair proteins is closely related to clinicopathological features of colorectal cancer in elderly patients.

Objective: To investigate the relationship between long non-coding RNA (lncRNA) HIT and cisplatin (DDP) resistance in osteosarcoma cells and the mechanism related to epithelial-mesenchymal transition (EMT). Methods: 42 pairs of osteosarcoma tissues and corresponding para-cancerous tissues (more than 5 cm away from the edge of cancer tissues) were collected at the Department of Orthopedics, Tianjin Hospital during June 2017 to June 2018. Quantitative Real-time PCR (qRT-PCR) was used to detect the mRNAexpression of HIT and EMT related markers (Snail and E-cadherin) in the collected tissues. The DDP-resistant osteosarcoma U2OS cell line was constructed and human adrenal 293T cell line was used as control. Two sets of siRNA vectors targeting HIT loaded on lentivirus were transfected into cells with DDP-resistance as the interference group A and group B. Meanwhile, the U2OS cell line was transfected with HIT full-length vector and blank vector respectively, as over-expression group and blank group. The DDP 50% inhibitory concentration (IC50) was detected by MTT assay. qRT-PCR was used to detect the mRNA expressions of HIT, Snail and E-cadherin. Western blotting was used to detect the protein expressions of Snail and E-cadherin. RNA binding protein immunoprecipitation (RNAIP) assay was used to clarify the combination of HIT and Snail protein in the U2OS and 293T cells. Results: The mRNAexpressions of HIT and Snail in osteosarcoma tissues were significantly higher than those in para-cancerous tissues, while the mRNA expression of Ecadherin was significantly lower than that in the paracancerous tissues. The mRNA expression of HIT and E-cadherin in osteosarcoma tissues was negatively correlated (all P<0.01). The DDP IC50 in the DDP-resistance group was significantly higher than that in the control group, interference group A and B, and the DDP IC50 in over-expression group was significantly higher than that in blank group (all P<0.01). The expression of HIT in resistance group was significantly higher than that in the control group, and the HIT expressions in interference group A and B were significantly lower than that in DDP-resistance and control group; moreover, the expression of HIT in over-expression group was significantly higher than that in blank group (all P<0.05 or P<0.01). The mRNAexpression of Snail in DDPresistance group was significantly higher than that in the control group and interference group A and B, while the mRNA expression of E-cadherin in DDP-resistance group was significantly lower than that in the control group and interference group A and B; and the mRNA expression of E-cadherin in over-expression group was significantly lower than that in blank group. The protein expression of Snail in the DDP-resistance group was significantly higher than that in the control group and interference group A and B,while E-cadherin protein expression was significantly lower; and protein expression of Snail in over-expression group was significantly higher than that in blank group (all P<0.05 or P<0.01). The expression of HIT in the U20S and 293T cells treated by anti-Snail antibody induced by immunomagnetic beads was significantly higher than that in the cells treated by IgG antibody (P<0.01). Conclusion: HIT can promote EMT and cisplatin-resistance in osteosarcoma cells through up-regulation of Snail protein and inhibition of E-cadherin transcription activity.

Objective To understand the characteristics and regularity of child oral mucosal diseases in Chongqing by analyzing its related factors so as to provide a reference for its diagnosis and treatment.Methods A total of 3792 children with oral mucosal diseases in the stomatology department of our hospital from January to December 2015 were taken as the research subjects for analyzing the disease entities,gender,age,onset time.Results Among 3 792 cases,15 kinds of oral mucosal diseases were recorded.The top five places of prevalence rates were herpetic stomatitis (42.67 ％),oral candidiasis(23.36 ％),traumatic ulcer(14.82 ％),recurrent aphthous ulcer (8.81％) and migratory glossitis (8.65％).Conclusion The clinical characteristics of child oral mucosal diseases are complex and various,and the onset age and time have a certain rule,which indicates that early diagnosis and treatment are very important to prognosis.

Objective To analyze the current situation of domestic research on fetal surgery by the method of literature measurement, and analyze the development trend.Methods The key words of ‘fetal surgery’or ‘fetal surgery’were searched respectively as the theme, keyword and Title Retrieval in CHKD Database,Wanfang Data knowledge service platform (Wanfang Data),VIP Chinese Journal database (CQVIP)and Chinese biomedical literature database (CBM).Results The result showed that the literature of fetal surgery increased obvi-ously by NoteExpress,especially after 2013.Some hot words of literature about fetal surgery included prenatal diagnosis,ultrasound,fetal sur-gery,prognosis and complications.The major authors’units located in Guangdong,Liaoning,Shanghai,Zhejiang,Sichuan and other regions. The affiliated Shengjing Hospital of China Medical University,Maternal and Child health Hospital of Foshan City in Guangdong Province,the First Affiliated Hospital of Zhongshan University were as the main research institutions.The literatures were classified by the subject of the ob-stetrics and gynecology,surgery,clinical medicine,pediatrics,oncology,the two accounted for more than 50%.The distribution of journals published this type of literature were more broad,and the content was more dispersed.Conclusion The development of the fetus is still in the early stage of development,which need for more accurate positioning and development of the fund to support its development.

OBJECTIVETo analyze the etiology and clinical characteristics of Marjolin's ulcer, and to explore its prevention and treatment.

METHODSMedical records of 187 patients with Marjolin's ulcers admitted to the Department of Burns and Reconstructive Surgery of Xiangya Hospital of Central South University from January 1998 to May 2015 were retrospectively analyzed, including gender, age of onset of initial injury or primary disease, age of onset of Marjolin's ulcer, initial injury or primary disease, length of latency, lengths of pre- and post-ulceration periods, lesion site, lesion type, lesion area, local scar tension, histopathological type, degree of carcinoma cell differentiation, bone invasion and lymphadenopathy, treatment, and prognosis. The relationships between the age of onset of initial injury or primary disease and the length of latency, and the length of pre-ulceration period and the length of post-ulceration period were assessed by Spearman correlation analysis. The recurrence rates were processed with Fisher's exact test.

RESULTS(1) Among the patients, the ratio of male to female was nearly 1.6:1.0. The age of onset of initial injury or primary disease was 0.17-78.00 (17±18) years, and the age of onset of Marjolin's ulcers was 18-84 (49±14) years. (2) The most common initial injury among the patients was flame burn. The length of latency was 0.25-74.00 (32±16) years, and the lengths of pre- and post-ulceration periods were 0-73.00 (26±19) years and 0.08-59.00 (6±11) years respectively. The common lesion sites were the lower limbs and head and face. The rodent ulcer was the most common lesion type, and the lesion area was 1-625 (69±110) cm(2). There were obviously negative correlations between the age of onset of initial injury or primary disease and the length of latency, as well as the length of pre-ulceration period and the length of post-ulceration period (with r values respectively -0.71 and -0.50, P values below 0.01). The pathological scars of strong tension around lesions were seen in 176 cases. (3) The major histopathological type was squamous cell carcinoma, with high cell differentiation in most cases. (4) Bone invasion of carcinoma cells was observed in 59 cases. Lymph node enlargement was observed in 100 cases, and lymph node metastasis was observed in 18 cases. (5) Twenty patients did not receive any surgery, while 167 patients were treated by surgery with lesion extended resection as the main method. According to the condition of wound after the lesion extended resection, the wounds were mainly repaired by skin grafting and transplantation of local skin flap. The majority of wounds in 139 patients who underwent lesion extended resection were repaired in one surgery. Twenty-eight patients out of 104 followed-up cases had recurrence after surgery, mainly seen on head and face, upper limb, lower limb, and buttock, and there was no significant difference among them (P>0.05). The recurrence time of most patients was longer than 6 months after cure.

CONCLUSIONSPatients with Marjolin's ulcers in younger age of onset of initial injury or primary disease tend to have longer latency, during which the shorter the pre-ulceration period is, the longer the post-ulceration period will be. Marjolin's ulcers are prone to occur in scar sites with large tension. Early treatment of high tension scar and scar ulcer is important in prevention, and surgery is the optimal treatment for Marjolin's ulcers. Regular follow-up should be carried out owning to recurrence rate in certain degree after surgery.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns ; pathology ; Carcinoma, Squamous Cell ; pathology ; surgery ; Child ; Child, Preschool ; Cicatrix ; pathology ; Face ; pathology ; Female ; Humans ; Infant ; Lower Extremity ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Skin Neoplasms ; pathology ; surgery ; Skin Transplantation ; Skin Ulcer ; pathology ; surgery ; Surgical Flaps ; Young Adult